bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sepsis biomarkers in neutropaenic systemic inflammatory response syndrome patients on standard care wards
Authors: Ratzinger Franz , Haslacher Helmuth , Perkmann Thomas , Schmetterer Klaus G. , Poeppl Wolfgang , Mitteregger Dieter , Dorffner Georg , Burgmann Heinz 
Published: June 2015

AbstractBackgroundNeutropaenic patients are at a high risk of contracting severe infections. In particular, in these patients, parameters with a high negative predictive value are desirable for excluding infection or bacteraemia. This study evaluated sepsis biomarkers in neutropaenic patients suffering from systemic inflammatory response syndrome (SIRS). Further, the predictive capacities of evaluated biomarkers in neutropaenic SIRS patients were compared to non‐neutropaenic SIRS patients.Material and methodsIn this prospective observational cohort study, patients with clinically suspected sepsis were screened. The predictive capacities of procalcitonin (PCT), C‐reactive protein and lipopolysaccharide‐binding protein (LBP) in neutropaenic SIRS patients were evaluated in terms of their potential to identify infection or bacteraemia and were compared to results for non‐neutropaenic SIRS patients. To select an appropriate control cohort, propensity score matching was applied, balancing confounding factors between neutropaenic and non‐neutropaenic SIRS patients.ResultsOf 3370 prospectively screened patients with suspected infection, 51 patients suffered from neutropaenic SIRS. For the identification of infection, none of the assessed biomarkers presented a clinically relevant discriminatory potency. Lipopolysaccharide‐binding protein and PCT demonstrated discriminatory capacity to discriminate between nonbacteraemic and bacteraemic SIRS in patients with neutropaenia [receiver‐operating characteristics‐area under the curves (ROC‐AUCs): 0·860, 0·818]. In neutropaenic SIRS patients, LBP had a significantly better ROC‐AUC than in a comparable non‐neutropaenic patient cohort for identifying bacteraemia (P = 0·01).ConclusionIn neutropaenic SIRS patients, none of the evaluated biomarkers was able to adequately identify infection. LBP and PCT presented a good performance in identifying bacteraemia. Therefore, these markers could be used for screening purposes to increase the pretest probability of blood culture analysis.
Delirium among elderly patients admitted to a post‐acute care facility and 3‐months outcome
Authors: Miu Doris Ka Ying , Chan Ching Wai , Kok Ching 
Published: June 2015

AimTo investigate the prevalence and risk factors of delirium in an extended care unit, the persistence of delirium and 3‐month outcome.MethodPatients aged >65 years were recruited. Basic demographic data, medical comorbidity using the Charlson Comorbidity Index, pre‐existing cognitive impairment using the informant questionnaire on cognitive decline in the elderly, place of residence and physical function as measured by the modified Barthel Index were recorded. Delirium was assessed by the Confusion Assessment Method and Direct Observation Scale. Delirium status, physical function and placement were reassessed on discharge, and at 1 month and 3 months after discharge.ResultsA total of 261 patients were recruited with a mean age of 81.9 years. Delirium was present in 89 participants (34.1%). Of these, 70 patients continued to be delirious on discharge. A total of 76 patients had persistent delirium at 1 month, and 49 remained to be delirious at 3 months. Pre‐existing cognitive impairment (OR 9.12), use of psychoactive drugs (OR 3.61), presence of metabolic disturbances (OR 3.53), acute infection (OR 3.49) and old age home residents (OR 3.04) were associated with delirium on admission. A smaller number of delirium patients can return home on discharge, and they have poorer functional status on admission, at discharge, and at 1 month and 3 months after discharge. Unplanned hospital admission was significantly higher among the delirium group (42.9% vs 24.1%, P < 0.001).ConclusionDelirium in post‐acute convalescence units is highly prevalent and persistent. It is associated with poor functional recovery, higher nursing home placement and unplanned hospital admission. These findings reinforce the necessity to implement a program to prevent, early detect and treat delirium in elderly patients admitted to post‐acute care units. Geriatr Gerontol Int 2016; 16: 586–592.
Evaluation of an educational activity in the oral health of students
Authors: Barros VJ de A , Costa S M , Zanin L , Flório FM 
Published: June 2015

AbstractObjectiveTo investigate the influence of educational activity in the school environment based on prescriptive and subjective oral health indicators.MethodsCross‐sectional, comparative study involving students between 9 and 12 years of age, from schools that have educational activities and those that do not, designated schools A and B. The oral health indicators used were the Simplified Oral Hygiene Index (OHI‐S) and the Community Periodontal Index (CPITN). Knowledge and attitudes with regard to oral health were evaluated using a structured questionnaire.ResultsA total of 289 schoolchildren took part, 50.5% from school A and 49.5% from school B, in the town of Montes Claros, in the Brazilian state of Minas Gerais. In school A, the schoolchildren's OHI‐S was satisfactory for 9.6%, normal for 78.8% and deficient for 11.6%, while in school B, the respective percentages were 3.5%, 17.5% and 79% (chi‐squared, P < 0.001). The students in school A showed better CPITN results, namely lack of bleeding for 61.6%, the presence of bleeding for 29.5% and presence of tartar for 8.9%, while in school B, the respective results were 25.2%, 45.5% and 29.4% (chi‐squared, P < 0.001). Students in school A achieved more correct answers in questions that evaluated knowledge of oral health. The account of daily use of dental floss in school A was 21.7% and in B, 3.6% (chi‐squared, P < 0.001).ConclusionIt is believed that educational activity in the school environment had a positive effect on oral health conditions, the consolidation of knowledge and incorporation of oral hygiene habits.
Rationale and Design of the Prevention of Cardiovascular Events in Ischemic Stroke Patients with High Risk of Cerebral Hemorrhage (Picasso) Study: A Randomized Controlled Trial
Authors: Hong Keun-Sik , Kim Bum Joon , Lee Jun-Young , Kwon Sun U. 
Published: June 2015

Rationale Prior intracerebral haemorrhage and cerebral microbleeds may increase the risk of haemorrhagic stroke. However, the optimal long-term antiplatelet therapy and lipid management in these patients remain unclear. Aim PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage was designed to compare cilostazol and aspirin and to assess the effect of adding probucol, a lipid-lowering and anti-oxidative agent, in patients at high risk of haemorrhagic stroke. Sample size estimate The projected sample size is 1600 patients with at least 12 months of follow-up. Methods and design PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage is a randomized trial involving 67 institutes from 3 countries. Patients with non-cardioembolic ischemic stroke or transient ischemic attack within 180 days and with prior intracerebral haemorrhage or multiple cerebral microbleeds on gradient echo imaging are eligible. Enrolled patients are simultaneously randomized in a 2 × 2 factorial design: double-blind for cilostazol 200 mg/day vs. aspirin 100 mg/day, and an open-label, blind end-point evaluation for probucol 500 mg/day vs. non-probucol. Study outcomes The co-primary end-points are the safety end-point of haemorrhagic stroke and the efficacy end-point of a composite of stroke, myocardial infarction, or vascular death. Time-to-event will be analyzed separately for each intervention: superiority testing for the safety of cilostazol over aspirin as well as the efficacy of probucol over non-probucol, and non-inferiority testing for the efficacy of cilostazol to aspirin. Discussion PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage is the largest secondary stroke prevention trial for informing antiplatelet therapy and lipid management in patients at high risk of haemorrhagic stroke.
Improved Ischemic Stroke Outcome Prediction Using Model Estimation of Outcome Probability: The THRIVE-c Calculation
Authors: Flint Alexander C. , Rao Vivek A. , Chan Sheila L. , Cullen Sean P. , Faigeles Bonnie S. , Smith Wade S. , Bath Philip M. , Wahlgren Nils , Ahmed Niaz , Donnan Geoff A. , Johnston S. Claiborne 
Published: June 2015

Background and purpose The Totaled Health Risks in Vascular Events (THRIVE) score is a previously validated ischemic stroke outcome prediction tool. Although simplified scoring systems like the THRIVE score facilitate ease-of-use, when computers or devices are available at the point of care, a more accurate and patient-specific estimation of outcome probability should be possible by computing the logistic equation with patient-specific continuous variables. Methods We used data from 12 207 subjects from the Virtual International Stroke Trials Archive and the Safe Implementation of Thrombolysis in Stroke – Monitoring Study to develop and validate the performance of a model-derived estimation of outcome probability, the THRIVE-c calculation. Models were built with logistic regression using the underlying predictors from the THRIVE score: age, National Institutes of Health Stroke Scale score, and the Chronic Disease Scale (presence of hypertension, diabetes mellitus, or atrial fibrillation). Receiver operator characteristics analysis was used to assess model performance and compare the THRIVE-c model to the traditional THRIVE score, using a two-tailed Chi-squared test. Results The THRIVE-c model performed similarly in the randomly chosen development cohort ( n = 6194, area under the curve = 0·786, 95% confidence interval 0·774–0·798) and validation cohort ( n = 6013, area under the curve = 0·784, 95% confidence interval 0·772–0·796) ( P = 0·79). Similar performance was also seen in two separate external validation cohorts. The THRIVE-c model (area under the curve = 0·785, 95% confidence interval 0·777–0·793) had superior performance when compared with the traditional THRIVE score (area under the curve = 0·746, 95% confidence interval 0·737–0·755) ( P < 0·001). Conclusion By computing the logistic equation with patientspecific continuous variables in the THRIVE-c calculation, outcomes at the individual patient level are more accurately estimated. Given the widespread availability of computers and devices at the point of care, such calculations can be easily performed with a simple user interface.
Prevalence and Cognitive Impact of Medial Temporal Atrophy in a Hospital Stroke Service: Retrospective Cohort Study
Authors: Kebets Valeria , Gregoire Simone M. , Charidimou Andreas , Barnes Josephine , Rantell Khadija , Brown Martin M. , Jäger Hans R. , Cipolotti Lisa , Werring David J. 
Published: June 2015

Background Cerebrovascular disease and neurodegeneration cause cognitive impairment and frequently coexist. Aims Our objectives were to investigate the prevalence and cognitive impact of medial temporal lobe atrophy – a radiological marker often associated with Alzheimer's disease – in a hospital stroke service. Methods Retrospective cohort study of patients from a hospital stroke service. Patients assessed for suspected ischemic stroke or transient ischemic attack, irrespective of final diagnosis, underwent neuropsychological testing and magnetic resonance imaging. medial temporal lobe atrophy, white matter hyperintensities, lacunes, and cerebral microbleeds were rated using established criteria and validated scales. The associations between medial temporal lobe atrophy and cognition were tested using multivariable logistic regression analyses, adjusted for age and imaging markers of cerebrovascular disease. Results Three hundred and ninety-three patients were included, of whom 169 (43%; 95% confidence interval: 38·1–48·1%) had medial temporal lobe atrophy; in 38 patients (9·7%), medial temporal lobe atrophy was severe (mean score ≥2). In unadjusted logistic regression analyses in the whole cohort, mean medial temporal lobe atrophy score was associated with verbal memory, nominal and perceptual skills, executive function, and speed and attention. After adjustment for age, white matter hyperintensities, number of lacunes, presence of cerebral microbleeds, previous ischemic stroke or transient ischemic attack, and premorbid intelligence quotient, mean medial temporal lobe atrophy score remained associated with impairment in verbal memory (odds ratio: 1·64; 95% confidence interval 1·04–2·58) and nominal skills (odds ratio: 1·61; 95% confidence interval 1·04–2·48). Conclusions Medial temporal lobe atrophy is common and has an independent impact on cognitive function in a stroke service population, independent of confounding factors including age and magnetic resonance imaging markers of cerebrovascular disease. Medial temporal lobe atrophy is independently related to verbal memory and nominal skills, while small vessel pathology also contributes to speed and attention, and executive and perceptual functions.
Workforce planning and financing on a production/capital discrete‐time model
Authors: Martins Pedro , Quelhas Ana Paula 
Published: June 2015

AbstractTraditionally, companies have considered production planning and financial commitments separately. Production planning involves planning when to produce how much of a product, while the financial commitment considers which loans to take and how to repay them. In the current difficult financial environment with new challenges and with different opportunities, such as short‐term flexible loans for paying salaries, these related problems must be considered together. In this paper, we model the two processes (production and cash flows) in a single framework, using a mixed‐integer programming discrete‐time formulation. When taken individually, each of the problems has been thoroughly discussed in the literature, while the combined version that also incorporates labor financial costs and workforce sizing is more scarce. The main contribution of the paper involves new strategies for financing labor costs in strong agreement with the company's production plan and financial commitments. The new strategy relates credit ceiling with employment funding, using a sequence of flexible short‐term loans. We consider applications and propose mathematical programming based tools that can be used by companies’ managers for conducting their own solutions analysis, following their own findings and discussion of alternative scenarios.
Work‐to‐family conflict as a mediator of the relationship between job satisfaction and turnover intention
Authors: Chen I‐Hui , Brown Roger , Bowers Barbara J. , Chang Wen‐Yin 
Published: June 2015

AbstractAimsTo investigate the mediating effect of work‐to‐family conflict on the relationship between job satisfaction and turnover intention among licensed nurses in long‐term care settings.BackgroundThe considerable research on turnover in long‐term care has primarily focused on the impact of job satisfaction on turnover intention. Given the well‐documented high turnover rate in nursing home staffing, dissatisfaction is expected to continue. Alternatives (e.g. reduction in work‐to‐family conflict) for reducing turnover under the circumstance of job dissatisfaction have not been investigated extensively.DesignA cross‐sectional mailed survey.MethodsA convenience sample comprising 200 nurses from 25 private nursing homes in Central Taiwan was created. Data were collected from nurses about their level of turnover intention, job satisfaction and work‐to‐family conflict in 2012. A composite indicator structural equation model was used to examine the mediation model of this study.ResultsOverall, 186 nurses (93%) returned the completed questionnaires. Consistent with published research from other countries, turnover intention in our study was significantly and negatively associated with job satisfaction and significantly and positively associated with work‐to‐family conflict. In addition, job dissatisfaction indirectly influenced turnover intention through high work‐to‐family conflict.ConclusionFindings from this study indicate the importance of work‐to‐family conflict to nurse turnover. While work setting has a strong, well‐documented influence on job satisfaction, limiting job satisfaction efforts to work setting improvements may not yield the hoped‐for results unless work‐to‐family conflict is also considered and addressed.
Effect of serum 25‐hydroxyvitamin D3 on insulin resistance and β‐cell function in newly diagnosed type 2 diabetes patients
Authors: Yang Yan , Zhang Xuejun , Bao Mingjing , Liu Limei , Xian Yang , Wu Jichuan , Li Pengqiu 
Published: June 2015

AbstractAims/IntroductionTo evaluate serum 25‐hydroxyvitamin D3 (25(OH)D3) in newly diagnosed type 2 diabetes patients and to explore the associations of 25(OH)D3 with insulin resistance and β‐cell function.Materials and MethodsA total of 97 newly diagnosed type 2 diabetes patients and 69 healthy controls were recruited. Serum 25(OH)D3 was determined using high‐pressure liquid chromatography. Insulin resistance was measured using a homeostasis model assessment of insulin resistance (HOMA‐IR). β‐Cell function was determined using the HOMA β‐cell function index (HOMA‐β), early‐phase insulin secretion index (ΔI30/ΔG30) and area under the insulin curve (AUCins). Correlation analysis was carried out using Pearson's correlation and multiple stepwise regression analysis.ResultsSerum 25(OH)D3 was much lower in patients with newly diagnosed type 2 diabetes (t = −13.00, P < 0.01), and the prevalence of hypovitaminosis 25(OH)D3 was 62.9% (61/97) in diabetic patients. Among the diabetic patients, patients with hypovitaminosis 25(OH)D3 showed higher glycosylated hemoglobin and AUCglu (P < 0.01) as well as lower HOMA‐β, ΔI30/ΔG30 and AUCins. Serum 25(OH)D3 was independently positively correlated with ΔI30/ΔG30 and AUCins (P < 0.05), but was not significantly correlated with either HOMA‐IR or HOMA‐β. Only triglycerides, glycosylated hemoglobin and ΔI30/ΔG30 emerged as independent factors associated with serum 25(OH)D3 in both diabetes patients and the health control group.ConclusionsThe present results further showed a low serum 25(OH)D3 concentration in patients with newly diagnosed type 2 diabetes. 25(OH)D3 deficiency is associated with disturbances in glucose metabolism and lipid metabolism. Serum 25(OH)D3 is not correlated with basal insulin resistance or β‐cell function, but is significantly positively correlated with glucose‐stimulated insulin secretion and β‐cell function.
Relationship of menstrual cycle and vaginal infection in female rhesus macaques challenged with repeated, low doses of SIVmac251
Authors: Morris Monica R. , Byrareddy Siddappa N. , Villinger Francois , Henning Tara C. , Butler Katherine , Ansari Aftab A. , McNicholl Janet M. , Kersh Ellen N. 
Published: June 2015

AbstractVarying susceptibility during menstrual cycling could be a factor for S(H)IV infection risk in female rhesus macaques. We retrospectively determined vaginal SIV infection time points relative to the menstrual cycle in a group of rhesus macaques (n=11) enrolled in an HIV transmission trial. Eight of nine rhesus macaques became infected around menstruation time.
A new role for α‐ketoglutarate dehydrogenase complex: regulating metabolism through post‐translational modification of other enzymes
Authors: McKenna Mary C. , Rae Caroline D. 
Published: June 2015

Abstract
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This Editorial highlights a study by Gibson et al. published in this issue of JNeurochem, in which the authors reveal a novel role for the α‐ketoglutarate dehydrogenase complex (KGDHC) in post‐translational modification of proteins. KGDHC may catalyze post‐translational modification of itself as well as several other proteins by succinylation of lysine residues. The authors' report of an enzyme responsible for succinylation of key mitochondrial enzymes represents a major step toward our understanding of the complex functional metabolome. TCA, tricarboxylic acid; KG, α‐ketoglutarate; KGDHC, α‐ketoglutarate dehydrogenase complex; FUM, fumarase; MDH, malate dehydrogenase; ME, malic enzyme; GDH, glutamate dehydrogenase; AAT, aspartate aminotransferase; GS, glutamine synthetase; PAG, phosphate‐activated glutaminase; SIRT3, silent information regulator 3; SIRT5, silent information regulator 5.
Muscle spindle and fusimotor activity in locomotion
Authors: Ellaway Peter H. , Taylor Anthony , Durbaba Rade 
Published: June 2015

AbstractMammals may exhibit different forms of locomotion even within a species. A particular form of locomotion (e.g. walk, run, bound) appears to be selected by supraspinal commands, but the precise pattern, i.e. phasing of limbs and muscles, is generated within the spinal cord by so‐called central pattern generators. Peripheral sense organs, particularly the muscle spindle, play a crucial role in modulating the central pattern generator output. In turn, the feedback from muscle spindles is itself modulated by static and dynamic fusimotor (gamma) neurons. The activity of muscle spindle afferents and fusimotor neurons during locomotion in the cat is reviewed here. There is evidence for some alpha–gamma co‐activation during locomotion involving static gamma motoneurons. However, both static and dynamic gamma motoneurons show patterns of modulation that are distinct from alpha motoneuron activity. It has been proposed that static gamma activity may drive muscle spindle secondary endings to signal the intended movement to the central nervous system. Dynamic gamma motoneuron drive appears to prime muscle spindle primary endings to signal transitions in phase of the locomotor cycle. These findings come largely from reduced animal preparations (decerebrate) and require confirmation in freely moving intact animals.