bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early ambulance initiation versus in-hospital initiation of high dose clopidogrel in ST-segment elevation myocardial infarction
Authors: Postma Sonja , Dambrink Jan-Henk , Ottervanger Jan Paul , Gosselink Marcel , Koopmans Petra , ten Berg Jurrien , Suryapranata Harry , van ’t Hof Arnoud 
Published: June 2014

SummaryPre-hospital infarct diagnosis gives the opportunity to start anti-platelet and anti-thrombotic agents before arrival at the PCI centre. However, more evidence is necessary to demonstrate whether high dose (HD) clopidogrel (600 mg) administered in the ambulance is associated with improved initial patency of the infarct related vessel (IRV) and/or clinical outcome compared to in-hospital initiation of HD clopidogrel. From 2001 until 2009 all consecutive ST-Segment Elevation Myocardial Infarction (STEMI) patients who underwent pre-hospital diagnosis and therapy in the ambulance were prospectively included in our single-centre cohort study. We compared initial patency of the IRV and clinical outcome in patients treated from 2001 until June 2006 (in-hospital HD clopidogrel) with patients treated from July 2006 until 2009 (ambulance HD clopidogrel). A total of 2,475 patients with STEMI were registered; of these 1,110 (44.8%) received in-hospital HD clopidogrel and 1,365 (55.2%) received ambulance HD clopidogrel. Ambulance HD clopidogrel was not independently associated with initial patency (TIMI-2/3-flow pre-PCI (odds ratio: 1.18, 95% confidence interval [CI] 0.96–1.44); however, it was associated with fewer recurrent myocardial infarctions at 30 days (hazard ratio [HR]: 0.45, 95% CI 0.22–0.93) and at one year (HR: 0.45, 95% CI 0.25–0.80). No difference in TIMI 2/3 flow post-PCI, major bleeding, mortality, MACE – and the combination of mortality and recurrent myocardial infarction at 30-days and at one year was present between the two groups. In conclusion, early in-ambulance as compared to in-hospital initiation of HD clopidogrel in STEMI patients did not improve initial patency of the IRV or clinical outcome, except for a reduction of recurrent myocardial infarction. Therefore, early administration of HD clopidogrel seems to have net clinical benefit for these patients .
Indirect comparison meta-analysis of two enoxaparin regimens in patients undergoing major orthopaedic surgery
Authors: Chapelle Céline , Bertoletti Laurent , Lega Jean-Christophe , Cucherat Michel , Zufferey Paul , Darmon Jean-Yves , Mismetti Patrick , Laporte Silvy ,   the META-EMBOL Group
Published: June 2014

SummaryTwo enoxaparin dosage regimens are used as comparators to evaluate new anticoagulants for thromboprophylaxis in patients undergoing major orthopaedic surgery, but so far no satisfactory direct comparison between them has been published. Our objective was to compare the efficacy and safety of enoxaparin 3,000 anti-Xa IU twice daily and enoxaparin 4,000 anti-Xa IU once daily in this clinical setting by indirect comparison meta-analysis, using Bucher’s method. We selected randomised controlled trials comparing another anticoagulant, placebo (or no treatment) with either enoxaparin regimen for venous thromboembolism prophylaxis after hip or knee replacement or hip fracture surgery, provided that the second regimen was assessed elsewhere versus the same comparator. Two authors independently evaluated study eligibility, extracted the data, and assessed the risk of bias. The primary efficacy outcome was the incidence of venous thomboembolism. The main safety outcome was the incidence of major bleeding. Overall, 44 randomised comparisons in 56,423 patients were selected, 35 being double-blind (54,117 patients). Compared with enoxaparin 4,000 anti-Xa IU once daily, enoxaparin 3,000 anti-Xa IU twice daily was associated with a reduced risk of venous thromboembolism (relative risk [RR]: 0.53, 95% confidence interval [CI]: 0.40 to 0.69), but an increased risk of major bleeding (RR: 2.01, 95% CI: 1.23 to 3.29). In conclusion, when interpreting the benefit-risk ratio of new anticoagulant drugs versus enoxaparin for thromboprophylaxis after major orthopaedic surgery, the apparently greater efficacy but higher bleeding risk of the twice-daily 3,000 anti-Xa IU enoxaparin regimen compared to the once-daily 4,000 anti-Xa IU regimen should be taken into account.
Clinical and laboratory characteristics of paediatric and adolescent index cases with venous thromboembolism and antithrombin deficiency
Authors: Limperger Verena , Franke Andre , Kenet Gili , Holzhauer Susanne , Junker Ralf , Heller Christine , Gille Christian , Manner Daniela , Kurnik Karin , Knoefler Ralf , Mesters Rolf , Halimeh Susan , Picard Veronique , Nowak-Göttl Ulrike 
Published: June 2014

SummaryVenous thromboembolism [TE] is a multifactorial disease and antithrombin deficiency [ATD] constitutes a major risk factor. In the present study the prevalence of ATD and the clinical presentation at TE onset in a cohort of paediatric index cases are reported. In 319 un - selected paediatric patients (0.1–18 years) from 313 families, recruited between July 1996 and December 2013, a comprehensive thrombophilia screening was performed along with recording of anamnestic data. 21 of 319 paediatric patients (6.6%), corresponding to 16 of 313 families (5.1%), were AT-deficient with confirmed underlying AT gene mutations. Mean age at first TE onset was 14 years (range 0.1 to 17). Thrombotic locations were renal veins (n=2), cerebral veins (n=5), deep veins (DVT) of the leg (n=9), DVT & pulmonary embolism (n=4) and pelvic veins (n=1). ATD co-occurred with the factor- V-Leiden mutation in one and the prothrombin G20210A mutation in two children. In 57.2% of patients a concomitant risk factor for TE was identified, whereas 42.8% of patients developed TE spontaneously. A second TE event within primarily healthy siblings occurred in three of 313 families and a third event among siblings was observed in one family. In an unselected cohort of paediatric patients with symptomatic TE, the prevalence of ATD adjusted for family status was 5.1%. Given its clinical implication for patients and family members, thrombophilia testing should be performed and the benefit of medical or educational interventions should be evaluated in this high risk population.
Television Viewing, Computer Use, Time Driving and All‐Cause Mortality: The SUN Cohort
Authors: Basterra‐Gortari Francisco Javier , Bes‐Rastrollo Maira , Gea Alfredo , Núñez‐Córdoba Jorge María , Toledo Estefanía , Martínez‐González Miguel Ángel 
Published: June 2014

Background
Sedentary behaviors have been directly associated with all‐cause mortality. However, little is known about different types of sedentary behaviors in relation to overall mortality. Our objective was to assess the association between different sedentary behaviors and all‐cause mortality.

Methods and Results

In this prospective, dynamic cohort study (the
SUN
Project) 13 284 Spanish university graduates with a mean age of 37 years were followed‐up for a median of 8.2 years. Television, computer, and driving time were assessed at baseline. Poisson regression models were fitted to examine the association between each sedentary behavior and total mortality. All‐cause mortality incidence rate ratios (
IRR
s) per 2 hours per day were 1.40 (95% confidence interval (
CI
): 1.06 to 1.84) for television viewing, 0.96 (95%
CI
: 0.79 to 1.18) for computer use, and 1.14 (95%
CI
: 0.90 to 1.44) for driving, after adjustment for age, sex, smoking status, total energy intake, Mediterranean diet adherence, body mass index, and physical activity. The risk of mortality was twofold higher for participants reporting ≥3 h/day of television viewing than for those reporting <1 h/d (
IRR
: 2.04 [95%
CI
1.16 to 3.57]).

Conclusions
Television viewing was directly associated with all‐cause mortality. However, computer use and time spent driving were not significantly associated with higher mortality. Further cohort studies and trials designed to assess whether reductions in television viewing are able to reduce mortality are warranted. The lack of association between computer use or time spent driving and mortality needs further confirmation.
Brachial-Ankle Pulse Wave Velocity for Predicting Functional Outcome in Acute Stroke
Authors: Kim Jinkwon , Song Tae-Jin , Kim Eun Hye , Lee Ki Jeong , Lee Hye Sun , Nam Chung Mo , Song Dongbeom , Nam Hyo Suk , Kim Young Dae , Heo Ji Hoe 
Published: June 2014

Background and Purpose—
We investigated whether the brachial-ankle pulse wave velocity (baPWV) has prognostic value for predicting functional outcome after acute cerebral infarction and whether the prognostic value differs between stroke subtypes.

Methods—
We included 1091 consecutive patients with first-ever acute cerebral infarction who underwent baPWV measurements. Stroke subtypes were classified using the Trial of Org 10172 in Acute Stroke Treatment classification. Poor functional outcomes were defined as modified Rankin Scale score >2 at 3 months after stroke onset.

Results—
We noted that 181 (16.59%) patients had a poor functional outcome. In multivariate logistic regression, patients in the highest tertile of baPWV (>22.25 m/s) were found to be at increased risk for poor functional outcome (adjusted odds ratio, 1.88; 95% confidence interval, 1.06–3.40) compared with those in the lowest tertile (<17.55 m/s). No significant interaction between baPWV and stroke subtype was noted. Receiver operating characteristic curve analysis indicated that the addition of baPWV to the prediction model significantly improved the discrimination ability for poor functional outcome.

Conclusions—
baPWV has an independent prognostic value for predicting functional outcome after acute cerebral infarction. The prognostic value did not differ according to the stroke subtype.
Evaluation of Cloud Fraction Simulated by Seven SCMs against the ARM Observations at the SGP Site*
Authors: Song Hua , Lin Wuyin , Lin Yanluan , Wolf Audrey B. , Donner Leo J. , Del Genio Anthony D. , Neggers Roel , Endo Satoshi , Liu Yangang 
Published: June 2014

Abstract
This study evaluates the performances of seven single-column models (SCMs) by comparing simulated cloud fraction with observations at the Atmospheric Radiation Measurement Program (ARM) Southern Great Plains (SGP) site from January 1999 to December 2001. Compared with the 3-yr mean observational cloud fraction, the ECMWF SCM underestimates cloud fraction at all levels and the GISS SCM underestimates cloud fraction at levels below 200 hPa. The two GFDL SCMs underestimate lower-to-middle level cloud fraction but overestimate upper-level cloud fraction. The three Community Atmosphere Model (CAM) SCMs overestimate upper-level cloud fraction and produce lower-level cloud fraction similar to the observations but as a result of compensating overproduction of convective cloud fraction and underproduction of stratiform cloud fraction. Besides, the CAM3 and CAM5 SCMs both overestimate midlevel cloud fraction, whereas the CAM4 SCM underestimates. The frequency and partitioning analyses show a large discrepancy among the seven SCMs: Contributions of nonstratiform processes to cloud fraction production are mainly in upper-level cloudy events over the cloud cover range 10%–80% in SCMs with prognostic cloud fraction schemes and in lower-level cloudy events over the cloud cover range 15%–50% in SCMs with diagnostic cloud fraction schemes. Further analysis reveals different relationships between cloud fraction and relative humidity (RH) in the models and observations. The underestimation of lower-level cloud fraction in most SCMs is mainly due to the larger threshold RH used in models. The overestimation of upper-level cloud fraction in the three CAM SCMs and two GFDL SCMs is primarily due to the overestimation of RH and larger mean cloud fraction of cloudy events plus more occurrences of RH around 40%–80%, respectively.
Near-Inertial Internal Waves and Sea Ice in the Beaufort Sea*
Authors: Martini Kim I. , Simmons Harper L. , Stoudt Chase A. , Hutchings Jennifer K. 
Published: June 2014

Abstract
The evolution of the near-inertial internal wavefield from ice-free summertime conditions to ice-covered wintertime conditions is examined using data from a yearlong deployment of six moorings on the Beaufort continental slope from August 2008 to August 2009. When ice is absent, from July to October, energy is efficiently transferred from the atmosphere to the ocean, generating near-inertial internal waves. When ice is present, from November to June, storms also cause near-inertial oscillations in the ice and mixed layer, but kinetic energy is weaker and oscillations are quickly damped. Damping is dependent on ice pack strength and morphology. Decay scales are longer in early winter (November–January) when the new ice pack is weaker and more mobile, decreasing in late winter (February–June) when the ice pack is stronger and more rigid. Efficiency is also reduced, as comparisons of atmospheric energy available for internal wave generation to mixed layer kinetic energies indicate that a smaller percentage of atmospheric energy is transferred to near-inertial motions when ice concentrations are &gt;90%. However, large kinetic energies and shears are observed during an event on 16 December and spectral energy is elevated above Garrett–Munk levels, coinciding with the largest energy flux predicted during the deployment. A significant amount of near-inertial energy is episodically transferred to the internal wave band from the atmosphere even when the ocean is ice covered; however, damping by ice and less efficient energy transfer still leads to low Arctic internal wave energy in the near-inertial band. Increased kinetic energy below 300 m when ice is forming suggests some events may generate internal waves that radiate into the Arctic Ocean interior.
Median Filter Effects on Radar Wind Profiler Spectral Noise Statistics
Authors: Wilfong Timothy L. , Lau Elias M. , Weber Bob L. , Merritt David A. , McLaughlin Scott A. 
Published: June 2014

Abstract
Radar wind profiler (RWP) systems observe radar returns from refractive index fluctuations due to clear-air turbulence. The Doppler spectra used to compute the moments of the returned signal always include noise from various sources and may contain multiple signals. A critical first step in detecting signals is the objective determination of the noise level in each spectrum. Several spectra may be averaged to improve signal detection. In addition to or instead of a mean, a median may be applied to successive spectra in order to reject transient interference. Monte Carlo simulations were used to examine the effects of the median versus the mean on the objective noise determination. When a median is used, it was found the noise statistics calculations must be slightly modified.
Physician–patient end-of-life care discussions: Correlates and associations with end-of-life care preferences of cancer patients—a cross-sectional survey study
Authors: Tang Siew Tzuh , Liu Tsang-Wu , Liu Li Ni , Chiu Chang-Fang , Hsieh Ruey-Kuen , Tsai Chun-Ming 
Published: June 2014

Background: Honoring patients’ treatment preferences is a key component of high-quality end-of-life care. Connecting clinical practices to patients’ preferences requires effective communication. However, few cancer patients reported discussing end-of-life-care preferences with their physicians. Aim: To identify correlates of physician–patient end-of-life-care discussions and to investigate associations of physician–patient end-of-life-care discussions with patient end-of-life-care preferences. Design: A cross-sectional survey from April 2011 through November 2012. Setting/participants: A convenience sample of 2467 cancer patients (89.3% participation rate) whose disease was diagnosed as terminal and unresponsive to current curative cancer treatment was recruited from 23 teaching hospitals throughout Taiwan. Results: Only 7.8% of respondents reported discussing end-of-life-care preferences with their physicians. Physicians were more likely to discuss end-of-life-care preferences with cancer patients who accurately understood their prognosis but less likely to do so if patients were married or received care in a hospital with an inpatient hospice unit. Furthermore, physician–patient end-of-life-care discussions were significantly, positively associated with the likelihood of preferring comfort-oriented care and hospice care, but negatively associated with preferences for receiving cardiopulmonary resuscitation when life is in danger and aggressive life-sustaining treatments at end of life, including intensive care unit admission, cardiac massage, intubation, and mechanical ventilation support. Conclusion: Physician–patient end-of-life-care discussions are correlated with accurate prognostic awareness, marital status, and institutional characteristics and negatively associated with terminally ill cancer patients’ preferences for aggressive end-of-life care. Interventions should be developed to facilitate timely end-of-life-care discussions between at-risk patients and their physicians, thus honoring patients’ end-of-life-care preferences and possibly avoiding futile life-sustaining treatments.
Comparison of continuous subcutaneous insulin infusion and multiple daily insulin injections in Chinese patients with type 2 diabetes mellitus
Authors: Yang Honghong , Heng Xueyuan , Liang Cuige , Liu Xiaomeng , Du Wenhua , Li Shoujie , Wang Yueli , Dong Qingyu , Li Wenxia , Pan Zhenyu , Gong Qian , Gao Guanqi 
Published: June 2014

Objective To investigate prospectively the insulin dose requirements of Chinese patients with type 2 diabetes mellitus treated with either multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII) therapy during a 2-week therapeutic intervention. Methods Patients with type 2 diabetes mellitus were randomly assigned to MDI or CSII therapy. The effects of the two treatment methods were determined based on blood glucose parameters, total daily insulin dose and rates of hypoglycaemia. Results A total of 609 patients were enrolled in the study. Glycaemic goals were achieved after a mean ± SD of 6.90 ± 2.10 and 5.44 ± 2.22 days’ treatment in the MDI and CSII groups, respectively. Once stabilized, the mean ± SD total daily insulin doses were 37.12 ± 10.19 IU and 32.58 ± 8.78 IU for the MDI and CSII groups, respectively. Once stabilized, the mean ± SD total basal and bolus doses were 19.46 ± 7.95 IU/day and 17.66 ± 3.53 IU/day for the MDI group, and 22.79 ± 7.55 IU/day and 9.81 ± 2.64 IU/day for the CSII group, respectively. There were significant differences in the total, basal and bolus insulin doses between the two groups. Conclusion CSII therapy may be considered as an effective method to achieve good glycaemic control in Chinese patients with type 2 diabetes mellitus.
A Response to Jane Sahi’s ‘Dialogue as Education
Authors: Baniwal Vikas 
Published: June 2014

This article is inspired by Jane Sahi’s commentary, ‘Dialogue as Education: Martin Buber’, published under the feature ‘Classics with Commentary’ in the Monsoon 2005 issue of Contemporary Education Dialogue. I seek to further the discussion of the contributions of Martin Buber to the discourse of education through an elaboration and clarification of the ideas, concerns and critiques exposited by Jane Sahi. These concerns can perhaps be understood under the following themes: (i) reflections on educational practice in the light of Buber’s ideas; (ii) the role of language in dialogue; (iii) the idea of learning; (iv) attitudes towards the ‘other’; (v) the teacher–pupil relationship and (vi) the role of the teacher. Although ideas on these themes in the writings on Martin Buber’s have helped me in articulating this response, Jane Sahi’s commentary forms the basis of my reflections.
Analysis of Differentially Expressed Genes Associated With Alzheimer’s Disease Based on Bioinformatics Methods
Authors: Feng Bo , Hu Peng , Chen Jinbo , Liu Qingxin , Li Xizhi , Du Yifeng 
Published: June 2014

Objective: To screen differentially expressed genes (DEGs) of Alzheimer’s disease (AD). Methods: The gene expression profile (GSE26972) of AD was downloaded from Gene Expression Omnibus database. The DEGs were mapped to protein–protein interaction (PPI) data for acquiring the potential PPI relationship. The coexpressed significance of a gene pair in AD was determined. Then significantly enriched Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of DEGs were analyzed based on database for annotation visualization and integrated discovery tool. Results: The PPI network showed 7 upregulated genes and 4 downregulated genes that might play meaningful functional roles in AD. Meanwhile, 3 significantly enriched KEGG pathways as well as several significant GO terms (included α-actinin binding, interleukin 33 receptor activity, and telethonin binding) were identified. Conclusions: The screened DEGs have the potential to become candidate target molecules to monitor, diagnose, and treat AD.
Patient radiation exposure during carotid artery stenting
Authors: Stanišić Michał-Goran , Majewska Natalia , Makałowski Marcin , Juszkat Robert , Błaszak Magdalena , Majewski Wacław 
Published: June 2014

Objectives The main purpose of this study was to document the radiation doses to patients during carotid stenting. Material and method Fluoroscopy and exposure time, air kerma and dose-area product during carotid artery stenting in 160 patients were retrospectively reviewed with regard to body mass index, degree of stenosis and use of cerebral protection devices. Results Total air kerma was lower than 0.5 Gy in 80%, 0.5–1 Gy in 17% and higher than 1 Gy (maximum 1.2) in 3% of patients. Mean total dose-area product value for carotid stenting was 54 Gy cm2. The mean air kerma (fluoroscopy), air kerma (exposure), total air kerma and dose-area product (fluoroscopy), dose-area product (exposure), total dose-area product of patients with body mass index within the range 25–29.9 and with body mass index >30 were significantly increased compared to that of patients with body mass index 18–24.9 (H = 40.2, df = 2; p = 0.0000001 and p = 0.000003, respectively). Conclusion Carotid artery stenting is a relatively safe radiological procedure in terms of the radiation dose acquired by the patient. The main factors contributing to possible radiation overdosing are body mass index value and complexity of the carotid lesion. Proper preoperative planning in obese and complicated patients may reduce the fluoroscopy time and contribute to reduced dose acquisition.