bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal head–symphysis distance and mode of delivery in the second stage of labor
Authors: Youssef Aly , Maroni Elisa , Cariello Luisa , Bellussi Federica , Montaguti Elisa , Salsi Ginevra , Morselli‐Labate Antonio Maria , Paccapelo Alexandro , Rizzo Nicola , Pilu Gianluigi , Ghi Tullio 
Published: July 2014

AbstractObjectiveTo evaluate whether the fetal head–symphysis distance measured by three‐dimensional transperineal ultrasound during the active second stage predicts operative delivery.DesignProspective observational study.SettingUniversity hospital, Bologna, Italy.PopulationSeventy‐one nulliparous women at term in active second stage of labor.MethodsWe acquired a series of sonographic volumes at the beginning of the active second stage (T1) and every 20 min thereafter (T2, T3, T4, T5, T6) until delivery. All volumes were retrospectively analyzed and head–symphysis distance was measured for each acquisition. We compared head–symphysis distance between women with spontaneous vaginal delivery and those with operative delivery. Receiver operator characteristic curves were constructed to estimate the accuracy of head–symphysis distance in the prediction of operative delivery. Logistic regression was used to identify independent variables associated with operative delivery.Main outcome measuresOperative delivery (vacuum or cesarean).ResultsOf the women included, 81.7% had a spontaneous vaginal delivery and 18.3% underwent operative delivery. Women with spontaneous vaginal delivery had shorter head–symphysis distance than women in the operative delivery group at T1 (p < 0.001), T2 (p < 0.001) and T3 (p = 0.025), whereas no significant differences were recorded thereafter. Receiver operator characteristic curves revealed accuracy values of 81.0%, 87.9% and 77.6% in the prediction of operative delivery at T1, T2 and T3, respectively. At multivariate logistic regression head–symphysis distance and epidural analgesia were the only independent predictors of operative delivery among ultrasonographic, maternal and intrapartum variables.ConclusionsUltrasonographic measurement of head–symphysis distance in the second stage of labor can be used to predict operative delivery.
Recurrent miscarriage is a useful and valid clinical concept
Authors: Christiansen Ole B. 
Published: July 2014

AbstractAlthough epidemiological, clinical and biochemical risk factors are known for recurrent miscarriage (RM), the etiology is mainly unknown. Two main hypotheses dominate: that RM is mainly caused by aneuploid conceptions and other conception errors and that the recurrence rate is explained by the combination of chance and increased risk, or that maternal endocrinological, thrombophilic or immunological abnormalities play a main role in causing loss of euploid conceptions. Believers of the former hypothesis advocate that management of RM should be conservative and that the spontaneous prognosis is very favorable. Believers of the latter hypothesis think that treatments aimed at the woman may improve pregnancy outcome, but that testing of such treatments in randomized controlled trials is needed. In this article in favor of RM being a specific and useful clinical concept, arguments are advanced that a significant subset of RM patients exhibit a poor spontaneous prognosis and should be offered relevant investigations, close surveillance during pregnancy, and treatment, preferably as part of randomized controlled trials.
The implications of a connectivist learning blog model and the changing role of teaching and learning
Authors: Garcia Elaine , Elbeltagi Ibrahim , Brown Mel , Dungay Kerry 
Published: July 2014

AbstractWhile the use of Web 2.0 tools and specifically blogs is becoming increasingly popular within higher education (HE) and has been shown to promote learning, relatively little is known about the manner in which such tools may affect how teaching and learning may change as a result of the use of such tools. It is within this context that a connectivist learning model was created and has been further developed within this paper in order to consider the implications of how the use of blogs may change the manner in which teaching and learning occurs. Within this research, a case study of the use of collective student blogs utilized as part of a formally assessed module, undertaken within an HE institution, is utilized to explore the manner in which teaching and learning can be seen to change through a connectivist learning model of blog usage. From this case study, it appears that connectivism does provide a theoretical model for the way in which teaching and learning may change as a result of the use of blogs by learners. However, the experience of staff and students who undertook the project suggests that while a number of elements of the connectivist model can be identified, these are not seen universally among all students.
Designing computer‐supported collaborative learning at work for ruralITworkers: Learning ensembles and geographic isolation
Authors: Goggins Sean P. 
Published: July 2014

AbstractThis paper presents the results of a 9‐month ethnographic and action research study of rural technology workers where computer support for collaborative learning through workplace technologies was introduced to aUS‐based technology firm. Throughout the implementation of this support and participation, issues related to geographic isolation are contrasted with the information and learning needs of 89 employees. The development of information seeking, cataloguing and coordination practices through technology is described. Resulting insights have led to the identification oflearning ensemblesas an informal, socio‐technical unit of organization within geographically isolated firms. Learning ensembles are hypothesized as a bridge between the mid‐level, limited knowledge required in order to perform particular duties at the firm, and the greater potential of individual team members that is enabled by participation in the firm's technologically mediated, geographically dispersed customer teams. The discussion calls for future research on learning ensembles to further inform technologically mediated workplace learning.
Red blood cells of sickle cell disease patients exhibit abnormally high abundance of N‐methyl D‐aspartate receptors mediating excessive calcium uptake
Authors: Hänggi Pascal , Makhro Asya , Gassmann Max , Schmugge Markus , Goede Jeroen S. , Speer Oliver , Bogdanova Anna 
Published: July 2014

SummaryRecently we showed that N‐methyl D‐aspartate receptors (NMDARs) are expressed in erythroid precursors (EPCs) and present in the circulating red blood cells (RBCs) of healthy humans, regulating intracellular Ca2+ in these cells. This study focuses on investigating the possible role of NMDARs in abnormally high Ca2+ permeability in the RBCs of patients with sickle cell disease (SCD). Protein levels of the NMDAR subunits in the EPCs of SCD patients did not differ from those in EPCs of healthy humans. However, the number and activity of the NMDARs in circulating SCD‐RBCs was substantially up‐regulated, being particularly high during haemolytic crises. The number of active NMDARs correlated negatively with haematocrit and haemoglobin levels in the blood of SCD patients. Calcium uptake via these non‐selective cation channels was induced by RBC treatment with glycine, glutamate and homocysteine and was facilitated by de‐oxygenation of SCD‐RBCs. Oxidative stress and RBC dehydration followed receptor stimulation and Ca2+ uptake. Inhibition of the NMDARs with an antagonist memantine caused re‐hydration and largely prevented hypoxia‐induced sickling. The EPCs of SCD patients showed higher tolerance to memantine than those of healthy subjects. Consequently, NMDARs in the RBCs of SCD patients appear to be an attractive target for pharmacological intervention.
Mitotic Index is an Independent Predictor of Recurrence‐Free Survival in Meningioma
Authors: Olar Adriana , Wani Khalida M. , Sulman Erik P. , Mansouri Alireza , Zadeh Gelareh , Wilson Charmaine D. , DeMonte Franco , Fuller Gregory N. , Aldape Kenneth D. 
Published: July 2014

AbstractWhile World Health Organization (WHO) grading of meningioma stratifies patients according to recurrence risk overall, there is substantial within‐grade heterogeneity with respect to recurrence‐free survival (RFS). Most meningiomas are graded according to mitotic counts per unit area on hematoxylin and eosin sections, a method potentially confounded by tumor cellularity, as well as potential limitations of accurate mitotic figure detection on routine histology. To refine mitotic figure assessment, we evaluated 363 meningiomas with phospho‐histone H3 (Ser10) and determined the mitotic index (number of mitoses per 1000 tumor cells). The median mitotic indices among WHO grade I (n = 268), grade II (n = 84) and grade III (n = 11) tumors were 1, 4 and 12. Classification and regression tree analysis to categorize cut‐offs identified three subgroups defined by mitotic indices of 0–2, 3–4 and ≥5, which on univariate analysis were associated with RFS (P < 0.01). In multivariate analysis, mitotic index subgrouped in this manner was significantly associated with RFS (P < 0.01) after adjustment for Simpson grade, WHO grade and MIB‐1 index. Mitotic index was then examined within individual WHO grade, showing that for grade I and grade II meningiomas, mitotic index can add additional information to RFS risk. The results suggest that the use of a robust mitotic marker in meningioma could refine risk stratification.
Association of cognitive impairment with magnetic resonance imaging findings and social activities in patients with multiple sclerosis
Authors: Niino Masaaki , Mifune Nobuhiro , Kohriyama Tatsuo , Mori Masahiro , Ohashi Takashi , Kawachi Izumi , Shimizu Yuko , Fukaura Hikoaki , Nakashima Ichiro , Kusunoki Susumu , Miyamoto Katsuichi , Yoshida Kazuto , Kanda Takashi , Nomura Kyoichi , Yamamura Takashi , Yoshii Fumihito , Kira Jun‐ichi , Nakane Shunya , Yokoyama Kazumasa , Matsui Makoto , Miyazaki Yusei , Kikuchi Seiji 
Published: July 2014

AbstractObjectiveThe aim of the present study was to investigate the association of magnetic resonance imaging (MRI) findings and social activity with cognitive function in Japanese patients with multiple sclerosis (MS).MethodsThe Brief Repeatable Battery of Neuropsychological tests (BRB‐N) was carried out in 184 Japanese patients with MS, and 163 controls matched for age, sex and education. MRI findings of cerebral, brainstem, and cerebellar lesions and social activities of MS patients were further examined.ResultsMS patients with higher numbers of cerebral lesions on MRI had lower scores in most BRB‐N tests. BRB‐N scores in the majority of tests were significantly lower in patients with brainstem and cerebellar lesions. Data from an analysis of variance model in which only the main effects of cerebral, brainstem and cerebellar lesions were hypothesized showed an association of cerebral lesions with decreased scores in all BRB‐N tests, except symbol digit modalities test (SDMT) and paced auditory serial addition test (PASAT). In contrast, cerebellar lesions were associated with decreased SDMT and PASAT scores. Patients categorized as “unemployed because of MS” had lower BRB‐N scores than other social activity groups. Lower SDMT scores had an effect on the “unemployed because of MS” group, whereas the Expanded Disability Status Scale had a significantly greater negative impact on patients in this social category.ConclusionsHigher numbers of brain lesions on MRI could have an impact on cognitive function in patients with MS, and impairment of information processing appears significantly associated with cerebellar lesions. Cognitive impairment affects the employment status of patients with MS.
Readability of product ingredient labels can be improved by simple means: an experimental study
Authors: Yazar Kerem , Seimyr Gustaf Ö. , Novak Jiri A. , White Ian R. , Lidén Carola 
Published: July 2014

SummaryBackgroundIngredient labels on products used by consumers and workers every day, such as food, cosmetics, and detergents, can be difficult to read and understand.ObjectiveTo assess whether typographical design and ordering of ingredients can improve the readability of product ingredient labels.MethodsThe study subjects (n = 16) had to search for two target ingredients in 30 cosmetic product labels and three alternative formats of each. Outcome measures were completion time (reading speed), recognition rate, eye movements, task load and subjective rating when the reading of ingredient labels was assessed by video recording, an eye tracking device, and questionnaires.ResultsThe completion time was significantly lower (p < 0.001) when subjects were reading all alternative formats than when they were reading the original. The recognition rate was generally high, and improved slightly with the alternative formats. The eye movement measures confirmed that the alternative formats were easier to read than the original product labels. Mental and physical demand and effort were significantly lower (p < 0.036) and experience rating was higher (p < 0.042) for the alternative formats. There were also differences between the alternative formats.ConclusionsSimple adjustments in the design of product ingredient labels would significantly improve their readability, benefiting the many allergic individuals and others in their daily struggle to avoid harmful or unwanted exposure.
All in the blink of an eye: new insight into cerebellar and brainstem function in DYT1 and DYT6 dystonia
Authors: Sadnicka A. , Teo J. T. , Kojovic M. , Pareés I. , Saifee T. A. , Kassavetis P. , Schwingenschuh P. , Katschnig‐Winter P. , Stamelou M. , Mencacci N. E. , Rothwell J. C. , Edwards M. J. , Bhatia K. P. 
Published: July 2014

Background and purposeTraditionally dystonia has been considered a disorder of basal ganglia dysfunction. However, recent research has advocated a more complex neuroanatomical network. In particular, there is increasing interest in the pathophysiological role of the cerebellum. Patients with cervical and focal hand dystonia have impaired cerebellar associative learning using the paradigm eyeblink conditioning. This is perhaps the most direct evidence to date that the cerebellum is implicated in patients.MethodsEleven patients with DYT1 dystonia and five patients with DYT6 dystonia were examined and rates of eyeblink conditioning were compared with age‐matched controls. A marker of brainstem excitability, the blink reflex recovery, was also studied in the same groups.ResultsPatients with DYT1 and DYT6 dystonia have a normal ability to acquire conditioned responses. Blink reflex recovery was enhanced in DYT1 but this effect was not seen in DYT6.ConclusionsIf the cerebellum is an important driver in DYT1 and DYT6 dystonia our data suggest that there is specific cerebellar dysfunction such that the circuits essential for conditioning function normally. Our data are contrary to observations in focal dystonia and suggest that the cerebellum may have a distinct role in different subsets of dystonia. Evidence of enhanced blink reflex recovery in all patients with dystonia was not found and recent studies calling for the blink recovery reflex to be used as a diagnostic test for dystonic tremor may require further corroboration.
‘MaxClover’ grazing experiment: I. Annual yields, botanical composition and growth rates of six dryland pastures over nine years
Authors: Mills A. , Lucas R. J. , Moot D. J. 
Published: July 2014

AbstractSix dryland pastures were established at Lincoln University, Canterbury, New Zealand, in February 2002. Production and persistence of cocksfoot pastures established with subterranean, balansa, white or Caucasian clovers, and a perennial ryegrass‐white clover control and a lucerne monoculture were monitored for nine years. Total annual dry‐matter (10.0–18·5 t DM ha−1) and sown legume yields from the lucerne monoculture exceeded those from the grass‐based pastures in all but one year. The lowest lucerne yield (10 t ha−1 yr−1) occurred in Year 4, when spring snow caused ungrazed lucerne to lodge and senesce. Cocksfoot with subterranean clover was the most productive grass‐based pasture. Yields were 8·7–13·0 t DM ha−1 annually. Subterranean clover yields were 2·4–3·7 t ha−1 in six of the nine years which represented 26–32% of total annual production. In all cocksfoot‐based pastures, the contribution of sown pasture components decreased at a rate equivalent to 3·3 ± 0·05% per year (R2 = 0·83) and sown components accounted for 65% of total yield in Year 9. In contrast, sown components represented only 13% of total yield in the ryegrass‐white clover pastures in Year 9, and their contribution declined at 10·1 ± 0·9% per year (R2 = 0·94). By Year 9, 79% of the 6.6 t ha−1 produced from the ryegrass‐white clover pasture was from unsown species and 7% was dead material. For maximum production and persistence, dryland farmers on 450–780 mm yr−1 rainfall should grow lucerne or cocksfoot‐subterranean clover pastures in preference to ryegrass and white clover. Inclusion of white clover as a secondary legume component to sub clover would offer opportunities to respond to unpredictable summer rainfall after sub clover has set seed.
Numerical Analysis of Thermal Remediation in 3D Field‐Scale Fractured Geologic Media
Authors: Chen Fei , Falta Ronald W. , Murdoch Lawrence C. 
Published: July 2014

AbstractThermal methods are promising for remediating fractured geologic media contaminated with volatile organic compounds, and the success of this process depends on the coupled heat transfer, multiphase flow, and thermodynamics. This study analyzed field‐scale removal of trichloroethylene (TCE) and heat transfer behavior in boiling fractured geologic media using the multiple interacting continua method. This method can resolve local gradients in the matrix and is less computationally demanding than alternative methods like discrete fracture‐matrix models. A 2D axisymmetric model was used to simulate a single element of symmetry in a repeated pattern of extraction wells inside a large heated zone and evaluate effects of parameter sensitivity on contaminant recovery. The results showed that the removal of TCE increased with matrix permeability, and the removal rate was more sensitive to matrix permeability than any other parameter. Increasing fracture density promoted TCE removal, especially when the matrix permeability was low (e.g., <10−17 m2). A 3D model was used to simulate an entire treatment zone and the surrounding groundwater in fractured material, with the interaction between them being considered. Boiling was initiated in the center of the upper part of the heated region and expanded toward the boundaries. This boiling process resulted in a large increase in the TCE removal rate and spread of TCE to the vadose zone and the peripheries of the heated zone. The incorporation of extraction wells helped control the contaminant from migrating to far regions. After 22 d, more than 99.3% of TCE mass was recovered in the simulation.
Relationship between Hospital Volume and Early Outcomes in Acute Ischemic Stroke Patients Treated with Recombinant Tissue Plasminogen Activator
Authors: Wada Tomoki , Yasunaga Hideo , Inokuchi Ryota , Horiguchi Hiromasa , Fushimi Kiyohide , Matsubara Takehiro , Nakajima Susumu , Yahagi Naoki 
Published: July 2014

Background There is controversy whether the annual number of acute ischemic stroke patients receiving stroke thrombolysis per hospital (hospital volume) is associated with outcomes in these patients. Aims The study aims to assess the relationship between hospital volume and early outcomes in acute ischemic stroke patients treated with recombinant tissue plasminogen activator. Methods Patients with acute ischemic stroke treated with recombinant tissue plasminogen activator from July 1, 2010 to March 31, 2012 were identified in the Japanese Diagnosis Procedure Combination database. Hospital volume was categorized into three levels (low, medium, and high volume) to obtain approximately equal numbers of patients in each group. Primary outcomes were seven-day mortality and functional independence (modified Rankin Scale score of 0 to 2) at discharge. Univariate analyses and multivariate logistic regression analyses fitted with generalized estimating equations were performed. Results We identified 7476 eligible patients, including 2339 (31·3%) treated in low-volume hospitals (1–7 patients annually), 2670 (35·7%) in medium-volume hospitals (8–16 patients annually), and 2467 (33·0%) in high-volume hospitals (17–48 patients annually). Seven-day mortality and functional independence at discharge were comparable among the three hospital volume groups ( P = 0·17 for seven-day mortality; P = 0·22 for functional independence at discharge). The comparability between groups persisted after multivariate adjustment. Conclusion Hospital volume was not significantly associated with seven-day mortality or functional independence at discharge in acute ischemic stroke patients treated with recombinant tissue plasminogen activator in Japan.
Prevalence of Vertebral Artery Origin Stenosis in a Multirace-Ethnic Posterior Circulation Stroke Cohort: Miami Stroke Registry (MIAMISR)
Authors: Perue Gillian L. Gordon , Narayan Ram , Zangiabadi Amir H. , Romano Jose G. , Rundek Tatjana , Sacco Ralph L. , Koch Sebastian 
Published: July 2014

Background Vertebral artery origin stenosis is an important etiology for stroke in the posterior circulation. Data from the Oxford Vascular Study and New England Registry show a prevalence of vertebral artery origin disease of 26–32%. These populations are largely comprised of Caucasians. The prevalence of vertebral artery origin disease in multirace-ethnic stroke population is unknown. Aim The study aims to assess the prevalence of vertebral artery origin stenosis in a multirace population with posterior circulation stroke. Design/Methods The Miami Stroke Registry is a prospective registry which offers enrollment to consecutive patients admitted with a diagnosis of stroke/transient ischemic attack. Baseline demographics, vascular risk factors, and stroke topography in the posterior circulation were analyzed. All vascular imaging studies were reviewed for the presence of vertebral artery origin stenosis, and stroke etiology was adjudicated by TOAST classification. Results Mean age of the population was 63 ± 13 years; 149 (70%) were men. Among cases, 123 were Hispanic (58%), almost one third 70 (32%) were of African descent, and 15 (7%) were white. The most common stroke etiology was small vessel occlusion (27%), followed by large artery intracranial disease 25% (posterior cerebral arteries, basilar and vertebral arteries), cardioembolic 19%, and cryptogenic 16%. Vertebral artery origin stenosis/occlusion was present in 28 (13·1%) patients, of whom only 2 (0·9%) were bilateral; it was attributed as the direct cause of stroke in 11 (5·2%) patients. Conclusions We found a lower prevalence of vertebral artery origin stenosis in a predominately non-white population with posterior circulation stroke than previously reported. Vertebral artery origin stenosis was a direct cause of posterior circulation stroke in only 5·2% of patients.