bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a Set of Indicators to Evaluate Injury Control Research Centers
Authors: Runyan Carol , Garrettson Mariana , Yee Sue Lin 
Published: April 2014

Background: Few methods have been defined for evaluating the individual and collective impacts of academic research centers. In this project, with input from injury center directors, we systematically defined indicators to assess the progress and contributions of individual Injury Control Research Centers (ICRCs) and, ultimately, to monitor progress of the overall injury center program. Method: We used several methods of deriving a list of recommended priority and supplemental indicators. This included published literature review, telephone interviews with selected federal agency staff, an e-mail survey of injury center directors, an e-mail survey of staff at the Centers for Disease Control and Prevention, a two-stage Delphi process (e-mailed), and an in-person focus group with injury center directors. We derived the final indicators from an analysis of ratings of potential indicators by center directors and CDC staff. We also examined qualitative responses to open-ended items that address conceptual and implementation issues. Results: All currently funded ICRCs participated in at least one part of the process, resulting in a list of 27 primary indicators (some with subcomponents), 31 supplemental indicators, and multiple suggestions for using the indicators. Conclusion: Our results support an approach that combines standardized definitions and quantifiable indicators with qualitative reporting, which allows consideration of center distinctions and priorities. The center directors urged caution in using the indicators, given funding constraints and recognition of unique institutional environments. While focused on injury research centers, we suggest these indicators also may be useful to academic research centers of other types.
Grief, Anger, and Relationality
Authors: Kontos Pia , Miller Karen-Lee , Colantonio Angela , Cott Cheryl 
Published: April 2014

Background: Therapeutic emotion work is performed by health care providers as they manage their own feelings as well as those of colleagues and patients as part of efforts to improve the physical and psychosocial health outcomes of patients. It has yet to be examined within the context of traumatic brain injury rehabilitation. Objective: To evaluate the impact of a research-based theater intervention on emotion work practices of neurorehabilitation staff. Research Design: Data were collected at baseline and at 3 and 12 months postintervention in the inpatient neurorehabilitation units of two rehabilitation hospitals in central urban Canada. Subjects: Participants ( N = 33) were recruited from nursing, psychology, allied health, recreational therapy, and chaplaincy. Measures: Naturalistic observations ( N = 204.5 hr) of a range of structured and unstructured activities in public and private areas, and semistructured interviews ( N = 87) were conducted. Results: Preintervention analysis indicated emotion work practices were characterized by stringent self-management of empathy, suppression of client grief, adeptness with client anger, and discomfort with reactions of family and spouses. Postintervention analysis indicated significant staff changes in a relationality orientation, specifically improvements in outreach to homosexual and heterosexual family care partners, and support for sexual orientation and intimacy expression. No improvements were demonstrated in grief support. Conclusion: Emotion work has yet to be the focus of initiatives to improve neurorehabilitative care. Our findings suggest the dramatic arts are well positioned to improve therapeutic emotion work and effect cultures of best practice. Recommendations are made for interprofessional educational initiatives to improve responses to client grief and potential intimate partner violence.
Low expression of insulin-like growth factor binding protein 7 associated with poor prognosis in human glioma
Authors: Tian Xiangyang , Zhang Ling , Sun Laiguang , Xue Yihong , Xie Shuang 
Published: April 2014

Objectives To investigate insulin-like growth factor binding protein 7 (IGFBP7) mRNA levels in human glioma and normal brain tissue, and to determine their clinical significance. Methods In this retrospective study, IGFBP7 mRNA was quantified by real-time reverse transcription–polymerase chain reaction in brain tissue samples from patients with glioma and normal control subjects. Kaplan–Meier and Cox proportional hazards analyses were performed to determine any clinical and prognostic associations. Results IGFBP7 mRNA levels were significantly lower in glioma tissue ( n = 120) than in normal brain tissue ( n = 20). Low (i.e. below the median, 5.9) IGFBP7 mRNA levels were significantly associated with larger tumour size (≥5 cm, compared with <5 cm, diameter). Patients with high (above median) IGFBP7 had longer overall survival than those with low IGFBP7. Tumour grade and IGFBP7 mRNA level were independent predictors of overall survival. Conclusions IGFBP7 downregulation is associated with poor prognosis in glioma, and this molecule may represent both a prognostic marker and a potential therapeutic target.
A Novel Amiodarone-Eluting Biological Glue for Reducing Postoperative Atrial Fibrillation
Authors: Beckerman Ziv , Azran Adi , Cohen Oved , Nir Rony-Reuven , Maessen Jos G. , Bianco-Peled Havazelet , Bolotin Gil 
Published: April 2014

Objective: Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, leading to increased morbidity and mortality. The aim of this preliminary study was to evaluate a novel drug delivery system for local release of amiodarone. Methods: In the current prospective study, 9 goats underwent attachment of right atrial (RA) epicardial electrodes. Alginate-based glue with amiodarone was applied to the RA of the treatment groups. Rapid atrial response (RAR) to burst pacing was assessed before application and in the third postoperative day (POD3). Average RAR frequency was defined as the average percentage of inductions resulting in RAR per animal. Myocardial and extracardiac tissue amiodarone concentrations were analyzed. Results: Differences in RAR proportions between baseline and POD3 were greater in the treatment group versus the control group ( P = .034). Average RAR frequency was reduced by 34% in the treatment group (baseline: 65%; POD3: 31%), while it was increased by 11.3% in the control (baseline:43.8%; POD3: 55%). The treatment group demonstrated a greater proportion of animals meeting the success criterion of net percentage reduction in RAR frequency greater than 25% ( P = .047). The average amount of total amiodarone detected in the RA was 104.4 ± 28.9 µg; the transmural concentration was linearly distributed ( P < .0001). Extracardiac tissue concentrations were below the detection level. Conclusions: Local alginate-based amiodarone delivery demonstrated an RAR frequency reduction of clinical importance in response to burst pacing. The electrophysiological response was achieved while maintaining below-detection systemic drug levels. Current findings may point to the system’s future applicability in reducing POAF risk in humans.
Childhood Diabetes in the Nordic Countries
Authors: Hanberger Lena , Birkebaek Niels , Bjarnason Ragnar , Drivvoll Ann Kristin , Johansen Anders , Skrivarhaug Torild , Thorsson Arni V. , Samuelsson Ulf 
Published: April 2014

Background: In 2008 a Nordic collaboration was established between the quality registries in Denmark, Iceland, Norway, and Sweden to improve quality of care for children with diabetes. This study aimed to describe those registries and confirm that the registry variables are comparable. Selected variables were used to demonstrate outcome measurements. Methods: The organization of the registries and methodology are described. Cross-sectional data for patients between birth and 14.9 years with type 1 diabetes mellitus in 2009 (n = 6523) from 89 centers were analyzed. Variables were age, gender, and diabetic ketoacidosis at onset, together with age, gender, HbA1c, insulin regimen, and severe hypoglycemia at follow-up in 2009. Results: All 4 registries use a standardized registration at the onset of diabetes and at follow-up, conducted at the local pediatric diabetes centers. Methods for measuring HbA1c varied as did methods of registration for factors such as hypoglycemia. No differences were found between the outcomes of the clinical variables at onset. Significant variations were found at follow-up for mean HbA1c, the proportion of children with HbA1c < 57 mmol/mol (NGSP/DCCT 7.4%), (range 15-31%), the proportion with insulin pumps (range 34-55%), and the numbers with severe hypoglycemia (range 5.6-8.3/100 patient years). Conclusions: In this large unselected population from 4 Nordic countries, a high proportion did not reach their treatment target, indicating a need to improve the quality of pediatric diabetes care. International collaboration is needed to develop and harmonize quality indicators and offers possibilities to study large geographic populations, identify problems, and share knowledge.
Evaluation of Intravascular Microdialysis for Continuous Blood Glucose Monitoring in Hypoglycemia
Authors: Schierenbeck Fanny , Wallin Mats , Franco-Cereceda Anders , Liska Jan 
Published: April 2014

Background: We have previously shown that intravascular microdialysis in a central vein is an accurate method for continuous glucose monitoring in patients undergoing cardiac surgery. However, no hypoglycemia occurred in our earlier studies, prompting further evaluation of the accuracy of intravascular microdialysis in the hypoglycemic range. Thus, this animal study was performed. Method: A porcine model was developed; hypoglycemia was induced using insulin injections. The pigs were monitored with intravascular microdialysis integrated in a triple-lumen central venous catheter. As reference, venous blood gas samples were taken every 5 minutes and analyzed in a blood gas analyzer. Ethical permission for the animal experiments was obtained from the Stockholm Regional Ethical Committee, reference no N397/09. Results: A total of 213 paired samples were obtained for analysis, and 126 (59.2%) of these were in the hypoglycemic range (<74 mg/dl). Using Clarke error grid analysis, 100% of the paired samples were in region AB and 99% in region A. The ISO standard (ISO15197) was met. Bland–Altman analysis showed bias (mean difference) ± limits of agreement was −0.18 ± 16.2 mg/dl. No influence from glucose infusions was seen. The microdialysis monitoring system was found to be very responsive in rapid changes in blood glucose concentration. Conclusions: This study shows that intravascular microdialysis in a central vein is an accurate method for continuous glucose monitoring in hypoglycemia in a porcine experimental model. Furthermore, the system was not influenced by glucose administration and was found to be responsive in rapid blood glucose fluctuations.
Counseling Athletes on the Risk of Chronic Traumatic Encephalopathy
Authors: Concannon Leah G. , Kaufman Marla S. , Herring Stanley A. 
Published: April 2014

Context: Chronic traumatic encephalopathy (CTE) is a rare progressive neurologic disorder that can manifest as a combination of cognitive, mood and behavioral, and neurologic symptoms. Despite clinically apparent symptoms, there is no imaging or other diagnostic test that can confirm diagnosis in living subjects. Diagnosis can only be confirmed postmortem by specific histopathologic features within the brain tissue identified on autopsy. CTE represents a unique tauopathy that is distinct from other neurodegenerative diseases. Evidence Acquisition: PubMed was searched from 1990 to 2013 for sport concussion and chronic traumatic encephalopathy. Articles were also identified from bibliographies of recent reviews and consensus statements. Study Design: Clinical review. Level of Evidence: Level 5. Results: Although CTE is postulated to occur as a result of repetitive mild traumatic brain injury, the specific etiology and risk factors have not yet been elucidated, and postmortem diagnosis makes causality difficult to determine. Conclusion: When counseling athletes and families about the potential association of recurrent concussions and the development of CTE, discussion of proper management of concussion is cornerstone. Unfortunately, to date, there is no equipment that can prevent concussions; however, rule changes and legislation may decrease the risk. It is imperative that return to play is medically supervised by a provider trained in the management of concussion and begins only once symptoms have resolved. In addition, athletes with permanent symptoms should be retired from contact sport.
Fatal case of cephalexin-induced toxic epidermal necrolysis
Authors: Hafermann Matthew J , Barber Gerard R , Dreskin Stephen C , Lindberg Gordon K 
Published: April 2014

Purpose: To describe a case of toxic epidermal necrolysis likely caused by cephalexin with a review of the literature. Case: An 80-year-old male with a known allergy to cephalosporins, residing at a long-term acute care hospital, received cephalexin for a urinary tract infection. And 1 day after starting therapy, the patient developed an extensive erythematous rash accompanied by skin sloughing; 4 days after receiving cephalexin, the patient was directly admitted to the burn intensive care unit and was diagnosed with toxic epidermal necrolysis involving 56% of the total body surface area. Progressive deterioration to multisystem organ failure ensued, and the patient died 5 days following his admission to the burn intensive care unit. At the time of death, ulcerations were noted over approximately 80% of his body. Summary: The temporal association of the patient’s ingestion of cephalexin for a urinary tract infection to his onset of toxic epidermal necrolysis suggests that this 80-year-old man developed toxic epidermal necrolysis following the administration of cephalexin for a urinary tract infection.
Lower Back Symptoms in Adolescent Soccer Players
Authors: Shah Talib , Cloke David J. , Rushton Steven , Shirley Mark D.F. , Deehan David J. 
Published: April 2014

Background: There are little published data on factors relating to low back pain in the younger athletic population. Hypothesis: Independent predictors of recovery and return to participation in sports could be determined by event analysis, which investigates the impacts of covariates, including age, position, and injury type, on the risk of delayed recovery after injury. Study Design: Descriptive epidemiology study. Methods: This study examined 41 English Premiership soccer academy squads consisting of 12,306 player seasons for the incidence of lower back injury, injury severity, and investigated time to recovery in relation to potential risk factors. Injury risk was assessed for different times in a match and season, mechanism of injury, player position, player age, and competitive compared with noncompetitive play. Results: A total of 310 (3.0% of all injuries sustained in the population) lumbar spine injuries were recorded. Overall, 10,265 training days (median, 14 days; interquartile range, 8-30 days) were lost. The risk of injury increased as the first half progressed and was maintained throughout the second half with a contact mechanism and with increasing age. Neither competitive play compared with noncompetitive play nor player position had an effect on injury incidence. Prognostic factors for poor recovery were bony injuries and increasing age. Conclusion: These findings indicate that prolonged absence from training after a back injury is seen, especially in bony injuries and in older adolescents. It is suggested that there should be a low threshold for investigation of adolescent patients with back pain in the hope of early appropriate management of more severe diagnoses.
Evaluation of the Association between Compensated Hepatitis C Infectivity and Endothelial Dysfunction, Using Flow-Mediated Vasodilatation of the Brachial Artery
Authors: Mathur Jagrati , Guthrie Joy D. , Javed Usman , Sheikh Muhammad Y. 
Published: April 2014

Background and Aim: We prospectively investigated, using sonographic methods, whether hepatitis C infection in compensated patients is related to endothelial dysfunction of the brachial artery, a potential indicator of subclinical atherosclerosis. Methods: Brachial artery flow-mediated dilatation (FMD) was used as a noninvasive test to measure the endothelial function of the brachial artery among the cases and the controls. The peak systolic velocity (PSV) and the resistive index (RI) were also measured. Multivariate statistics were used to compare the FMD, PSV, and RI in 28 cases (diagnosed with hepatitis C) and 14 healthy controls, all of whom were without cardiovascular risk factors or a history of cardiovascular disease. Results: Flow-mediated dilatation (baseline to 1 minute post-cuff inflation) was positively correlated with the patient’s body mass index (BMI) (Pearson’s r = .309, P = .025). When the BMI was accounted for using analysis of covariance (ANCOVA), there was no evidence for a significant difference between the mean FMD of the cases versus the controls ( F = 0.11, P = .598). The mean FMD was 6.6% (95% confidence interval [CI], 3.1%-10.2%) among the cases and 7.3% (95% CI, 1.1%-13.6%) among the controls. Peak systolic velocity and RI (baseline to 3 minutes post-cuff inflation) were not positively correlated with BMI. The mean PSV was 0.57 m/s (95% CI, 0.51-0.66) for the cases and 0.64 m/s (95% CI, 0.56-0.72) for the controls; repeated measures analysis of variance (ANOVA) indicated no significant difference ( F = 1.65, P = .208). Similarly, the mean RI was 0.87 (95% CI, 0.85-0.89) among the cases and 0.64 (95% CI, 0.82-0.88) among the controls, with no significant difference ( P = .772). Conclusion: Our results show that hepatitis C positivity in compensated patients, in the absence of cardiovascular risk factors, does not appear to be independently associated with endothelial dysfunction when objectively analyzed by brachial artery flow-mediated vasodilatation.
Exhaled breath metabolomics as a noninvasive diagnostic tool for acute respiratory distress syndrome
Authors: Bos Lieuwe D.J. , Weda Hans , Wang Yuanyue , Knobel Hugo H. , Nijsen Tamara M.E. , Vink Teunis J. , Zwinderman Aeilko H. , Sterk Peter J. , Schultz Marcus J. 
Published: April 2014

There is a need for biological markers of the acute respiratory distress syndrome (ARDS). Exhaled breath contains hundreds of metabolites in the gas phase, some of which reflect (patho)physiological processes. We aimed to determine the diagnostic accuracy of metabolites in exhaled breath as biomarkers of ARDS.Breath from ventilated intensive care unit patients (n=101) was analysed using gas chromatography and mass spectrometry during the first day of admission. ARDS was defined by the Berlin definition. Training and temporal validation cohorts were used.23 patients in the training cohort (n=53) had ARDS. Three breath metabolites, octane, acetaldehyde and 3-methylheptane, could discriminate between ARDS and controls with an area under the receiver operating characteristic curve (AUC) of 0.80. Temporal external validation (19 ARDS cases in a cohort of 48) resulted in an AUC of 0.78. Discrimination was insensitive to adjustment for severity of disease, a direct or indirect cause of ARDS, comorbidities, or ventilator settings. Combination with the lung injury prediction score increased the AUC to 0.91 and improved net reclassification by 1.17.Exhaled breath analysis showed good diagnostic accuracy for ARDS, which was externally validated. These data suggest that exhaled breath analysis could be used for the diagnostic assessment of ARDS.
Benzodiazepine drug use and adverse respiratory outcomes among older adults with COPD
Authors: Vozoris Nicholas T. , Fischer Hadas D. , Wang Xuesong , Stephenson Anne L. , Gershon Andrea S. , Gruneir Andrea , Austin Peter C. , Anderson Geoffrey M. , Bell Chaim M. , Gill Sudeep S. , Rochon Paula A. 
Published: April 2014

Our purpose was to evaluate the association of new benzodiazepine use relative to non-use with adverse clinical respiratory outcomes among older adults with chronic obstructive pulmonary disease (COPD).This was a retrospective population-based cohort study of Ontario, Canada, residents between 2003 and 2010. A validated algorithm was applied to health administrative data to identify adults aged 66 years and older with COPD. Relative risks (RRs) of several clinically important respiratory outcomes were examined within 30 days of incident benzodiazepine use compared with non-use, applying propensity score matching.New benzodiazepine users were at significantly higher risk for outpatient respiratory exacerbations (RR 1.45, 95% CI 1.36–1.54) and emergency room visits for COPD or pneumonia (RR 1.92, 95% CI 1.69–2.18) compared to non-users. Risk of hospitalisation for COPD or pneumonia was also increased in benzodiazepine users, but was nonsignificant (RR 1.09, 95% CI 1.00–1.20). There were no significant differences in intensive care unit admissions between the two groups and all-cause mortality was slightly lower among newversusnon-users.Benzodiazepines were associated with increased risk for several serious adverse respiratory outcomes among older adults with COPD. The findings suggest that decisions to use benzodiazepines in older patients with COPD need to consider potential adverse respiratory outcomes.
MicroRNA clusters: dysregulation in lung adenocarcinoma and COPD
Authors: Molina-Pinelo Sonia , Pastor M. Dolores , Suarez Rocío , Romero-Romero Beatriz , González De la Peña Miriam , Salinas Ana , García-Carbonero Rocío , De Miguel María José , Rodríguez-Panadero Francisco , Carnero Amancio , Paz-Ares Luis 
Published: April 2014

Lung adenocarcinoma and chronic obstructive pulmonary disease (COPD) are pulmonary diseases that share common aetiological factors (tobacco smoking) and probable dysregulated pathways. MicroRNAs (miRNAs) play an essential role in regulating numerous physiological and pathological processes. The purpose of this study was to assess global miRNA expression patterns in patients with COPD and/or adenocarcinoma to elucidate distinct regulatory networks involved in the pathogenesis of these two smoking-related diseases.Expression of 381 miRNAs was quantified by TaqMan Human MicroRNA A Array v2.0 in bronchoalveolar lavage fluid samples from 87 patients classified into four groups: COPD, adenocarcinoma, adenocarcinoma with COPD, and control (neither COPD nor adenocarcinoma). 11 differentially expressed miRNAs were randomly selected for validation in an independent cohort of 40 patients.Distinct miRNA expression profiles were identified and validated for each pathological group, involving 66 differentially expressed miRNAs. Four miRNA clusters (the mir-17-92 cluster and its paralogues, mir-106a-363 and mir-106b-25; and the miR-192-194 cluster) were upregulated in patients with adenocarcinoma and one miRNA cluster (miR-132-212) was upregulated in patients with COPD.These results contribute to unravelling miRNA-controlled networks involved in the pathogenesis of adenocarcinoma and COPD, and provide new tools of potential use as biomarkers for diagnosis and/or therapeutic purposes.