bluuebunny/crossref_metadata_2025_split huggingface dataset:
Involvement of the Subplate Zone in Preterm Infants with Periventricular White Matter Injury
Authors: Pogledic Ivana , Kostovic Ivica , Fallet‐Bianco Catherine , Adle‐Biassette Homa , Gressens Pierre , Verney Catherine 
Published: October 2013

AbstractStudies of periventricular white matter injury (PWMI) in preterm infants suggest the involvement of the transient cortical subplate zone. We studied the cortical wall of non‐cystic and cystic PWMI cases and controls. Non‐cystic PWMI corresponded to diffuse white matter lesions, the predominant injury currently detected by imaging. Glial cell populations were analyzed in post‐mortem human frontal lobes from very preterm [24–29 postconceptional weeks (pcw)] and preterm infants (30–34 pcw) using immunohistochemistry for glial fibrillary acidic protein (GFAP), monocarboxylate transporter 1 (MCT1), ionized calcium‐binding adapter molecule 1 (Iba1), CD68 and oligodendrocyte lineage (Olig2). Glial activation extended into the subplate in non‐cystic PWMI but was restricted to the white matter in cystic PWMI. Two major age‐related and laminar differences were observed in non‐cystic PWMI: in very preterm cases, activated microglial cells were increased and extended into the subplate adjacent to the lesion, whereas in preterm cases, an astroglial reaction was seen not only in the subplate but throughout the cortical plate. There were no differences in Olig2‐positive pre‐oligodendrocytes in the subplate in PWMI cases compared with controls. The involvement of gliosis in the deep subplate supports the concept of the complex cellular vulnerability of the subplate zone during the preterm period and may explain widespread changes in magnetic resonance signal intensity in early PWMI.
Phyletic groups on networks
Authors: Wheeler Ward C. 
Published: October 2013

AbstractThree additional phyletic group types, “periphyletic,” “epiphyletic”, and “anaphyletic” (in addition to Hennigian mono‐, para‐, and polyphyletic) are defined in terms of trees and phylogenetic networks (trees with directed reticulate edges) via a generalization of the algorithmic definitions of Farris. These designations concern groups defined as monophyletic on trees, but with additional gains or losses of members from network edges. These distinctions should be useful in discussion of systems with non‐vertical inheritance such as recombination between viruses, horizontal exchange between bacteria, hybridization in plants and animals, as well as human linguistic evolution. Examples are illustrated with Indo‐European language groups.
Immediate function on the day of surgery compared with a delayed implant loading process in the mandible: a randomized clinical trial over 5 years
Authors: Jokstad Asbjorn , Alkumru Hassan 
Published: October 2013

AbstractObjectivesTo appraise the feasibility of loading four implants with a pre‐existing denture converted to a fixed dental prosthesis (FDP) on the day of implant surgery compared with waiting for 3‐ to 4‐month healing.MethodsPatients with an edentulous, fully healed mandible were recruited in a faculty clinic to partake in a blinded two‐arm parallel randomized controlled trial (RCT). The participants received four parallel intraforamina mandibular implants with a moderately rough titanium surface (Brånemark System Mk III or Mk IV TiUnite; Nobel Biocare AB, Göteborg, Sweden). The implants were loaded on the same day by converting the participants' pre‐existing denture in the experimental group. The implants were placed using a one‐stage surgery procedure, and the participants' pre‐existing denture were soft‐relined in the control group. For both groups, the permanent 10‐ to 12‐unit FDP consisting of a type‐3 cast precious alloy veneered with acrylic and artificial teeth was placed 3–4 months after implant surgery. All participants have been recalled annually for 5 years for appraisal of bone loss and registration of adverse events.ResultsThirty‐five of the original 42 participants (83%) returned for clinical and radiological examinations at the 5‐year follow‐up recall. No selective dropout or specific reasons for dropout was identified in the two study arms; leaving n = 17 (Intention‐to‐treat group, ITT) in the experimental group, alternatively n = 13 as per protocol group (PP), and n = 18 participants in the control group (ITT = PP). At study commencement, five of the participants assigned to the experimental group did not receive their planned intervention. In the control group, one implant failed to osseointegrate and another failed due to bone loss after 5 years. The crestal bone level changes over 5 years were identical in the experimental and control groups, that is, 1.2 mm (SD = 0.7). There were no differences between the two study arms with regard to incidence of biological and technical adverse events.ConclusionsImplants in the anterior mandible loaded immediately with a converted pre‐existing denture appear to yield analogous clinical outcomes compared with waiting for 3–4 months over the first 5 years following implant surgery.
Readability of websites containing information on dental implants
Authors: Jayaratne Yasas S. N. , Anderson Nina K. , Zwahlen Roger A. 
Published: October 2013

AbstractIt is recommended that health‐related materials for patients be written at sixth grade level or below. Many websites oriented toward patient education about dental implants are available, but the readability of these sites has not been evaluated.ObjectiveTo assess readability of patient‐oriented online information on dental implants.Materials and methodsWebsites containing patient‐oriented information on dental implants were retrieved using the Google search engine. Individual and mean readability/grade levels were calculated using standardized formulas. Readability of each website was classified as easy (≤6th‐grade level) or difficult (≥10th grade level).ResultsThirty nine websites with patient‐oriented information on dental implant were found. The average readability grade level of these websites was 11.65 ± 1.36. No website scored at/below the recommended 6th grade level. Thirty four of 39 websites (87.18%) were difficult to read. The number of characters, words, and sentences on these sites varied widely.ConclusionAll patient‐oriented websites on dental implants scored above the recommended grade level, and majority of these sites were “difficult” in their readability. There is a dire need to create patient information websites on implants, which the majority can read.
Diagnostic concordance rates in the subtyping of basal cell carcinoma by different dermatopathologists
Authors: Nedved Drew , Tonkovic‐Capin Viseslav , Hunt Edgar , Zaidi Nasir , Kucenic Michael J. , Graves Jeffery J. , Fraga Garth R. 
Published: October 2013

BackgroundThere are numerous subtypes of basal cell carcinoma (BCC). Defining the histopathologic subtype is an essential element in patient management, but there is little known data regarding interobserver precision in subtyping BCC.MethodsWe studied interobserver variance between six board‐certified dermatopathologists who subtyped 100 BCCs in a blinded fashion. We used kappa statistic to calculate the concordance in suggested subtype by different dermatopathologists. Provided diagnoses were then re‐categorized into low‐risk and high‐risk phenotypes, and kappa statistic for concordance on high‐risk BCC was determined.ResultsThe overall κ statistic was 0.301, indicating fair agreement among the six observers. Superficial and fibroepithelial BCC had the highest individual kappa statistics. When subtypes were re‐classified into a two‐tier system of high‐risk and low‐risk phenotypes, there was substantial interobserver agreement on high‐risk BCC with a κ statistic of 0.699.ConclusionThese results suggest only fair agreement among dermatopathologists on specific BCC subtypes, but substantial agreement on superficial, fibroepithelial and high‐risk BCC growth patterns. A simplified classification system comprised of superficial, fibroepithelial, nodular and infiltrative subtypes would increase interobserver precision and facilitate clinical decision‐making.
Evidence for continuous glucose monitoring: sufficient for reimbursement?
Authors: Heinemann L. , DeVries J. H. 
Published: October 2013

AbstractEvidence for continuous glucose monitoring is mounting. Meta‐analyses consistently show lowering of HbA1c, and the first trial reporting a reduction in severe hypoglycaemic events in patients with hypoglycaemia unawareness has recently been presented. The more recent trials studied larger numbers of patients and may have shown better results because of improved technology. The various combinations of pump and sensor, with automated bolus calculators and low glucose suspend features, make evaluation more challenging from a reimbursement point of view, but evidence seems convincing enough to justify reimbursement for selected patient groups, including those who have shown a substantial improvement in HbA1c during a trial period, and those with hypoglycaemia unawareness who encountered severe hypoglycaemia in the recent past. More data on cost–efficacy are needed.
A multi‐country comparison of reasons for dental non‐attendance
Authors: Listl Stefan , Moeller John , Manski Richard 
Published: October 2013

The purpose of this study was to describe differences across countries with respect to the reasons for dental non‐attendance by Europeans currently 50 yr of age and older. The analyses were based on retrospective life‐history data from the Survey of Health, Ageing, and Retirement in Europe and included information on various reasons why respondents from 13 European countries had never had regular dental visits in their lifetime. A series of logistic regression models was estimated to identify reasons for dental non‐attendance across different welfare‐state regimes. The highest proportion of respondents without any regular dental attendance throughout their lifetime was found for the Southern welfare‐state regime, followed by the Eastern, the Bismarckian, and the Scandinavian welfare‐state regimes. Factors such as patients’ perception that regular dental treatment is ‘not necessary’ or ‘not usual’ appear to be the predominant reason for non‐attendance in all welfare‐state regimes. The health system‐level factor ‘no place to receive this type of care close to home’ and the perception of regular dental treatment as ‘not necessary’ were more often referred to within the Southern, Eastern, and Bismarckian welfare‐state regimes than in Scandinavia. This could be relevant information for health‐care decision makers in order to prioritize interventions towards increasing rates of regular dental attendance.
Impact of Benzodiazepines on Functional Outcome and Occurrence of Pneumonia in Stroke: Evidence from VISTA
Authors: Frank Benedikt , Fulton Rachael L. , Lees Kennedy R. , Sanders Robert D. ,   for the VISTA Collaborators
Published: October 2013

Background Benzodiazepines have been proposed both as a neuroprotectant and risk factor for pneumonia in acute stroke. Aims We assessed the impact of benzodiazepine exposure on the modified Rankin scale score distribution at 90 days as well as pneumonia rates among patients registered in a trials archive. Method We used an age, baseline National Institutes of Health Stroke Score, and thrombolysis-rate adjusted Cochran–Mantel–Haenszel test to test significance ( P) followed by proportional odds logistic regression analysis to estimate the odds ratios for improved modified Rankin scale score, and binary logistic regression to estimate the odds ratio for developing pneumonia. Results Data were available for 5938 patients, of whom 1800 received benzodiazepines. No association of benzodiazepine use and overall stroke outcome could be found (odds ratio 0·90, 95% confidence interval 0·82–1·00, P = 0·121). Pneumonia occurred in 12·8% of patients treated with benzodiazepines and in 13·6% of the controls (odds ratio 0·99, 95% confidence interval 0·83–1·18, P = 0·904). Conclusion In this nonrandomized comparison, treatment with benzodiazepines as a concomitant medication had no independent impact on stroke outcome.
Exercise-Induced Changes in Cardiovascular Function after Stroke: A Randomized Controlled Trial
Authors: Tang Ada , Eng Janice J. , Krassioukov Andrei V. , Madden Kenneth M. , Mohammadi Azam , Tsang Michael Y. C. , Tsang Teresa S. M. 
Published: October 2013

Background and aims Cardiovascular co-morbidities are prevalent after stroke, with heart disease, hypertension and impaired glucose tolerance present in the majority of cases. Exercise has the potential to mediate cardiovascular risk factors commonly present in people with stroke. This single-blinded randomized controlled trial compared the effects of high versus low intensity exercise on fitness, cardiovascular risk factors, and cardiac function after stroke. Methods Fifty participants (age 50–80 y, >1 y post-stroke) were randomized to a high-intensity Aerobic Exercise (AE) or low-intensity non-aerobic Balance/Flexibility (BF) program (6 months, 3 60-min sessions/week). Outcomes assessed by VO2peak (primary outcome), arterial stiffness, ambulatory capacity, hemodynamics and cardiac function using echocardiography, and lipid, glucose and homocysteine levels. Assessors were blinded to group allocation. Results Twenty-three (92%) of 25 AE group participants (withdrawals unrelated to the intervention) and all BF group participants completed the program. One BF group participant experienced 2 non-injurious falls during class. No other adverse events occurred. There were no changes in VO2peak in either group (AE 16·9 ±7 to 17·4 ± 7 ml•kg−1•min−1 vs. BF 16·9 ±6 to 16·6 ± 5 ml•kg−1•min−1, P = 0·45), but AE group demonstrated greater improvement in right atrial emptying fraction (AE 30 ± 22 to 37 ± 22% vs. BF 35 ± 20 to 31 ± 20%, P = 0·04). Both groups demonstrated improvements in lipid profiles, glucose and homocysteine levels, and ambulatory capacity ( P < 0·04). Conclusions This was the first study to examine the effects of aerobic exercise after stroke on cardiovascular hemodynamics. High-intensity exercise improved right-sided function and early myocardial relaxation. Low-intensity exercise may also benefit plasma lipid, glucose and inflammatory markers, and ambulatory capacity. This study is an important step towards understanding mechanisms by which exercise may reduce cardiovascular risk and function.
Prognostic Value of Plasma Chitotriosidase Activity in Acute Stroke Patients
Authors: Bustamante Alejandro , Dominguez Carmen , Rodriguez-Sureda Víctor , Vilches Angel , Penalba Ana , Giralt Dolors , García-Berrocoso Teresa , Llombart Victor , Flores Alan , Rubiera Marta , Molina Carlos , Alvarez-Sabín José , Montaner Joan 
Published: October 2013

Background and aims Chitotriosidase, a component of innate immunity, constitutes a sensitive parameter of macrophage activation and its elevated plasma activity reflects an inflammatory response. Given the deleterious effects of inflammation in brain ischemia, we aimed to assess the prognostic value of chitotriosidase activity in acute stroke patients. Methods The study comprised 159 acute stroke patients and 51 age-matched controls. Plasma chitotriosidase activity was serially determined by fluorometric assay. Short-term neurological outcome was determined at 48 h and functional outcome at three-months. Predictors of neurological and functional outcome were determined via multivariate analysis, and the additional predictive value of chitotriosidase was tested with the Integrated Discrimination Index and the Net Reclassification Improvement. Results Stroke patients showed increased levels of baseline chitotriosidase activity compared to controls [114·2 (74·65–182·95) nmol/ml/h vs. 54·4 (32·7–76·4); P < 0·0001]. Chitotriosidase activity (<118·75) was found to be an independent predictor of neurological improvement at 48 h (odds ratio: 3·25; 95% confidence interval: 1·54–6·85; P = 0·002), and the addition of plasma chitotriosidase activity showed a better prediction of improvement at 48 h (Integrated Discrimination Index = 5·7%, Net Reclassification Improvement = 11·6%, P < 0·05) over the predictive model constituted only with clinical information. Although patients disabled at three-months showed higher baseline chitotriosidase levels, it was not an independent predictor of long-term disability. Conclusions Baseline chitotriosidase activity in acute stroke patients treated with tissue plasminogen activator (tPA) may constitute a prognostic predictor of short-term outcome, adding a moderate additional predictive value. Our results underline the deleterious role of inflammation in acute stroke patients.
Do-Not-Resuscitate (DNR) Orders in Patients with Intracerebral Hemorrhage
Authors: Silvennoinen Katri , Meretoja Atte , Strbian Daniel , Putaala Jukka , Kaste Markku , Tatlisumak Turgut 
Published: October 2013

Background and purpose Do-not-resuscitate orders may be associated with poor outcome in patients with intracerebral hemorrhage because of less active management. Aims We sought to characterize the practice of issuing do-not-resuscitate orders in intracerebral hemorrhage. We also aimed to identify possible differences in care according to do-not-resuscitate status. Methods We conducted a retrospective study of all consecutive intracerebral hemorrhage patients admitted to the Meilahti Hospital of the Helsinki University Central Hospital between January 2005 and March 2010. Data obtained from medical records allowed comparison of characteristics of patients and care of do-not-resuscitate and non-do-not-resuscitate patients as well as patients with early (within 24 h) and late (>24 h) do-not-resuscitate decisions. Logistic regression was used to identify factors independently associated with do-not-resuscitate decisions. Results Of our 1013 patients, a do-not-resuscitate order was issued in 368 (35%), of which 262 (73%) occurred within 24 h from admission. Advanced age (odds ratio 1.06 per year; 95% confidence interval 1.04–1.08), more severe stroke (1.09 per National Institutes of Health Stroke Scale point; 1.06–1.13), and deterioration soon after admission (5.12, 3.33–7.87) had the strongest associations with do-not-resuscitate decisions. Patients with do-not-resuscitate orders received recommended care including stroke unit care (43% vs. 64%; P < 0.001) and prophylaxis for deep venous thrombosis (45% vs. 54%; P = 0.027) less often than non-do-not-resuscitate patients. This was especially the case when the do-not-resuscitate order was issued early. Conclusions In addition to confirming the role of known intracerebral hemorrhage prognostic factors in do-not-resuscitate decision-making, our results demonstrate that do-not-resuscitate orders led to less active care of intracerebral hemorrhage patients.
Differential Clinical Characteristics and Prognosis of Patients with Longstanding Persistent Atrial Fibrillation Presenting with Recurrent Atrial Tachycardia versus Recurrent Atrial Fibrillation After First Ablation
Authors: ZHAO LIANG , WU SHAOHUI , JIANG WEIFENG , ZHOU LI , GU JUN , WANG YUANLONG , LIU YUGANG , ZHANG XIAODONG , LIU XU 
Published: October 2013

Baseline Characteristics and Prognosis of LS‐AF PatientsBackgroundIt is unknown if baseline characteristics and prognosis of patients with longstanding persistent (defined as history greater than 1 year) atrial fibrillation (LS‐AF) differ among those with either recurrent atrial tachycardia (R‐AT) or recurrent AF (R‐AF) after first ablation.MethodsIn 222 consecutive LS‐AF patients treated for R‐AT or R‐AF after first ablation, activation and entrainment mapping was used to identify R‐AT mechanism and to guide the following ablation, and the ablation endpoints for all patients included complete pulmonary vein isolation, bidirectional block of lines, and disappearance of complex fractionated atrial electrograms.ResultsThere were 102 patients in the R‐AF group. LS‐AF patients with R‐AT as compared to R‐AF had shorter AF duration and recurrence interval, smaller left atrium size and left ventricular end‐diastolic diameter, and less mitral and aortic regurgitation before first ablation. During follow‐up (17.7 ± 4.0 months) after R‐AT/R‐AF ablation, 78 LS‐AF patients developed recurrent atrial tachyarrhythmia, with lower overall and recurrence as AF in R‐AT versus R‐AF groups.ConclusionsLS‐AF patients who develop R‐AT versus R‐AF after first ablation have more favorable baseline characteristics and prognosis.
Non‐invasive in vivo dermatopathology: identification of reflectance confocal microscopic correlates to specific histological features seen in melanocytic neoplasms
Authors: Gill M. , Longo C. , Farnetani F. , Cesinaro A.M. , González S. , Pellacani G. 
Published: October 2013

AbstractBackgroundReflectance confocal microscopy (RCM) allows for non‐invasive, in vivo evaluation of skin lesions and it has been extensively applied in skin oncology although systematic studies on nevi characterization are still lacking.ObjectiveThe aim of this study was to determine whether reliable RCM correlates to histological features used to diagnose melanocytic neoplasms exist.MethodsWe blindly evaluated the RCM and histological features of 64 melanocytic neoplasms (19 non‐dysplastic nevi, 27 dysplastic nevi, 14 melanomas) and analysed the data using Spearman's rho calculation.ResultsMany histological features can be identified using RCM. Elongated rete ridges corresponded on RCM to edge papillae, whereas flattened rete ridges to several features which involve dermal–epidermal junction disruption. Bridging of junctional nesting (JN) corresponded on RCM to both JN with irregular size/shape and JN with short interconnections. While we could reliably identify dermal melanocytes, the RCM features did not reliably distinguish between benign and concerning dermal melanocytic arrangements, suggesting further refinement of dermal melanocytic RCM features is needed.ConclusionReliable correlates for epidermal and junctional histological features used to diagnose melanocytic neoplasms are identifiable on RCM, suggesting harnessing histological criteria may be a reasonable method to move beyond the algorithmic approach.
Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel
Authors: Keller H. H. , Vesnaver E. , Davidson B. , Allard J. , Laporte M. , Bernier P. , Payette H. , Jeejeebhoy K. , Duerksen D. , Gramlich L. 
Published: October 2013

AbstractBackgroundMalnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care.MethodsEight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically.ResultsFive themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence‐based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care.ConclusionsThe findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed.