bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy outcome for fetuses with increased nuchal translucency but normal karyotype
Authors: Lithner Christina Unger , Kublickas Marius , Ek Sverker 
Published: July 2015

Objective To investigate pregnancy outcome for fetuses with nuchal translucency (NT) ≥3.5 mm but normal karyotype in the Stockholm (Sweden) area. Methods A retrospective population-based cohort study. From 2006 to 2012, fetal NT was measured in 55123 singleton pregnancies. There were 341 pregnancies with NT thickness ≥3.5 mm; 139 had a normal karyotype, 164 had an abnormal karyotype and 38 were removed from the study. Pregnancy outcome was defined as adverse (termination of pregnancy [TOP], miscarriage [MC], intrauterine fetal death [IUFD], or delivery of a child with structural defects or genetic disorders), or favourable (delivery of a child without any structural defects or genetic disorders diagnosed before discharge). Results Of the 139 high NT pregnancies with normal karyotype, 110 (79.2%) resulted in live births, one (0.7%) IUFD, 23 (16.5%) TOP and five (3.6%) MC. The risk of an adverse pregnancy outcome increased with increasing NT. Structural fetal defects were found in 28 (19.5%) of pregnancies undergoing second trimester ultrasound screening, of which seven resulted in live births and 21 were terminated. The most common structural defect was cardiac defects. Conclusions Adverse pregnancy outcome increased with increasing NT, even with normal karyotype, however, the prognosis is good if the second trimester ultrasound screening is normal.
Reliability of the Colorado Family Support Assessment
Authors: Richmond Melissa K. , Pampel Fred C. , Zarcula Flavia , Howey Virginia , McChesney Brenda 
Published: July 2015

Purpose: Family support programs commonly use self-sufficiency matrices (SSMs) to measure family outcomes, however, validation research on SSMs is sparse. This study examined the reliability of the Colorado Family Support Assessment 2.0 (CFSA 2.0) to measure family self-reliance across 14 domains (e.g., employment). Methods: Ten written case studies were developed. Family advocates ( n = 24) independently coded each case study on each domain of the CFSA 2.0. Intraclass correlation (ICC) coefficients were calculated to determine the level of agreement between participants. Rating accuracy was calculated by subtracting the correct score for each domain and case study from the score given by the raters. Results: ICCs ranged from .79 to .96. Across all domains and case studies, family advocates were 84.4% accurate. Allowing for minor deviations (off by 1 on the 5-point scale) shows 96% accuracy. Discussion: A well-constructed SSM can be used to collect reliable and objective data on family self-sufficiency.
Dipeptidyl peptidase-4 inhibitor sitagliptin improves pancreatic β-cell function in hypertensive diabetic patients treated with angiotensin receptor blockers
Authors: Fukui Kensuke , Kawahito Hiroyuki , Wakana Noriyuki , Kikai Masakazu , Terada Kensuke , Yamamoto Keita , Irie Daisuke , Kato Taku , Miyagawa Sonoko , Yamada Hiroyuki 
Published: July 2015

Introduction: Dipeptidyl peptidase (DPP)-4 inhibitors, a novel oral anti-diabetic agents, exert a protective effect on pancreatic β-cell function in patients with type 2 diabetic mellitus (T2DM). However, their beneficial effect in hypertensive T2DM patients treated with angiotensin receptor blockers (ARBs) has not been investigated. Methods: In this open-label multicenter randomized study, a total of 55 hypertensive T2DM patients treated with ARBs were randomly assigned to receive the DPP-4 inhibitor sitagliptin or sulfonylurea (SU). Results: After 24 weeks of treatment, a significant reduction in fasting blood glucose was only observed in the sitagliptin group, while HbA1c was significantly reduced in both groups. Homeostasis model assessment of insulin resistance was not significantly improved in either group. Indicators of pancreatic β-cell function, including proinsulin to insulin ratio and homeostasis model assessment of β-cell function, were significantly improved in the sitagliptin group, but not in the SU group. The beneficial effects of sitagliptin were observed in hypoglycemic drug naïve patients, but not in patients who had received SU monotherapy prior to the study. Conclusion: Treatment with the DPP-4 inhibitor sitagliptin might exert beneficial effects on pancreatic β-cell function in ARB-treated T2DM patients and its efficacy might be more pronounced in hypoglycemic drug naïve patients.
Association of ACE insertion or deletion polymorphisms with the risk of coronary restenosis after percutaneous coronary intervention: A meta-analysis
Authors: Miao Hai-Wei , Gong Hui 
Published: July 2015

Objective: Previous case-control studies on the relationship between the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and coronary restenosis did not reach the same conclusion. In the present study, we aimed to further evaluate the relationship between the ACE gene I/D polymorphisms and coronary restenosis, after percutaneous coronary intervention (PCI). Methods: By searching PubMed, EMBase, the Chinese Biomedical Literature Database and Wanfang database, we selected 16 case-control studies related to ACE gene I/D polymorphism and coronary restenosis after PCI. To test for heterogeneity in each study, we utilized the Q-test and I2 test. To merge the odds ratio (OR) and 95% CI, we utilized the random effects model during the analyses. Results: The present study included 4693 subjects: 1241 patients with coronary restenosis and 3452 without coronary restenosis. By meta-analysis, we found there was significant association of ACE gene I/D polymorphism with coronary restenosis (D allele versus I allele: OR = 1.92; 95% CI (1.40–2.43); p < 0.001). A subgroup analysis, by stratification according to ethnicity, also showed that this association was found not only in the Caucasian population ((D allele versus I allele: OR = 1.94; 95% CI (1.38–2.80); p < 0.001)), but also in the Asian population ((D allele versus I allele: OR = 1.83; 95% CI (1.05–3.20); p = 0.03)). After stratification according to age, we found that the D allele carriers have a higher risk for development of coronary restenosis in subjects < 60 years old (OR = 2.13; 95% CI: 1.40–3.24; p = 0.0004); while in the subjects ⩾ 60 years old, the association was present with bordering significance (OR = 1.48; 95%CI: 0.98–2.25; p = 0.06). Conclusions: The present study suggested that the ACE gene I/D polymorphism was associated with coronary restenosis, regardless of age and ethnicity.
Sample size adjustment based on promising interim results and its application in confirmatory clinical trials
Authors: Chen YH Joshua , Li Caiyan , Lan KK Gordon 
Published: July 2015

Background: For a carefully planned and well-designed Phase 3 confirmatory trial, there is still a potential risk of failing to meet the study objective due to possible differences between Phase 2 and Phase 3 studies. As illustrated by the ENGAGE trial, potential sample size increase at an interim analysis can mitigate the risk for an otherwise underpowered study. Many approaches for sample size adjustment (SSA) require certain modifications to the conventional statistical method, such as changing critical values or using a weighted Z-statistic for final hypothesis testing. Without modification, the type I error rate can be inflated, primarily caused by sample size increase for nonpromising interim observation that is close to null or no treatment effect. As illustrated by the TOPICAL trial, increasing sample size for nonpromising interim result could waste limited resource on ineffective treatment. The modifications in these approaches are therefore unnecessary costs of flexibility/interpretability for unnecessary scenarios of sample size increase. Purpose: To discuss and illustrate the appropriateness of SSA based on promising interim results, that is, conditional power being greater than 50% (or CDL approach), in a carefully planned and well-designed Phase 3 confirmatory trial. Methods: Two clinical trials are used to illustrate the clinical setting for the CDL approach and appropriateness of its application. Operating characteristics are assessed and compared to other methods using numeric computation. Hypothetical trials based on real clinical data are used to illustrate the approach. Results: The CDL approach for SSA leads to a small increase in expected sample size resulting in a small power gain versus the fixed design. This indicates that adding SSA will not on average substantially affect the budget at the portfolio level. However, when the interim result is promising, the CDL approach can dramatically increase the conditional power therefore mitigating the risk of an otherwise underpowered study. Limitations: Implementation challenges of the SSA methods are not in the scope of this paper. SSA is not intended to replace careful design of a confirmatory trial; instead, it can mitigate the risk for a well-designed trial. Conclusions: The CDL approach for SSA based on promising interim results, that is, conditional power being greater than 50%, is particularly useful in mitigating the risk for a carefully planned and well-designed Phase 3 confirmatory trial. No modification to the conventional statistical procedure is necessary while the type I error rate is controlled. Such a feature of ''no interference,'' or no change to the conventional statistical procedure with or without sample size adjustment, is important for the interpretation of a confirmatory trial. Similar to the fixed design, carefully planned and well-designed group sequential studies can also benefit from SSA to mitigate the risk of failing to meet the study objective.
Association between caffeine consumption and nonalcoholic fatty liver disease: a systemic review and meta-analysis
Authors: Shen Huafeng , Rodriguez Andrea C. , Shiani Ashok , Lipka Seth , Shahzad Ghulamullah , Kumar Ambuj , Mustacchia Paul 
Published: July 2015

Objectives: Caffeine consumption is reported to be associated with reduced hepatic fibrosis in patients with chronic liver diseases. We performed a systematic review and meta-analysis to assess the association between caffeine consumption and prevalence or hepatic fibrosis of nonalcoholic fatty liver disease (NAFLD) in observational studies. Methods: We searched the literature of all languages from PubMed, EMBASE, and the Cochrane library from 1 January 1980 through 10 January 2015. Total caffeine consumption was defined as the daily intake of caffeine (mg/day) from all caffeine-containing products. Combined and subgroup analyses stratified by study designs, study locations, and type of caffeine intake were performed. Results: Four cross-sectional and two case control studies with a total of 20,064 subjects were included in the meta-analysis. Among these, three studies with 18,990 subjects were included in the analysis for prevalence of NAFLD while the other three studies with 1074 subjects were for hepatic fibrosis. Total caffeine consumption (mg/day) was not significantly associated with either the prevalence [pooled mean difference (MD) 2.36; 95% confidence interval (CI) −35.92 to 40.64] or hepatic fibrosis (higher versus lower stages; pooled MD −39.95; 95% CI −132.72 to 52.82) of NAFLD. Subgroup analyses stratified by study designs and locations were also not significant. However, after stratifying by type of caffeine intake, regular coffee caffeine intake (mg/day) was significantly associated with reduced hepatic fibrosis of NAFLD (pooled MD −91.35; 95% CI −139.42 to −43.27; n = 2 studies). Conclusion: Although total caffeine intake is not associated with the prevalence or hepatic fibrosis of NAFLD, regular coffee caffeine consumption may significantly reduce hepatic fibrosis in patients with NAFLD.
An exploration of physical activity and wellbeing in university employees
Authors: Cooper Kay , Barton Gillian C 
Published: July 2015

Aims: The aim was to explore levels of physical activity (PA) and mental wellbeing in university employees, as well as barriers to and incentives for workplace PA. Methods: An electronic survey was distributed to all staff at one UK university. The survey consisted of a PA stages of change questionnaire, an international PA questionnaire (short-form), the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), questions on perceived barriers to and incentives for workplace PA, questions on methods of enhancing employee wellbeing and demographics. A self-selected sample participated in two focus groups to explore key themes arising from the survey. Descriptive statistics were reported for survey data; associations between PA and wellbeing were tested for using Kruskal–Wallis with post hoc Mann–Whitney. Descriptive, thematic analysis was performed on focus group transcripts. Results: A total of 502 surveys were completed (34% response rate); 13 staff participated in focus groups. In all, 42% of the sample reported PA below the recommended guideline amount. Females were less active than males ( p < 0.005). The mean WEMWBS was 49.2 (95% confidence interval (CI): 48.3–49.9). Low PA levels were related to lower WEMWBS scores, with statistically significant differences in WEMWBS demonstrated between low and moderate PA ( p = 0.05) and low and high PA ( p = 0.001). Lack of time and perceived expense of facilities were common barriers to workplace PA. The main focus group finding was the impact of university culture on workplace PA and wellbeing. Conclusion: University staff demonstrate PA levels and a relationship between PA and wellbeing similar to the general population. Carefully designed strategies aimed at enhancing PA and wellbeing in university staff are required. The specific cultural and other barriers to workplace PA that exist in this setting should be considered. These results are being used to inform PA and wellbeing interventions whose effectiveness will be evaluated in future research.
Racial Disparity in Juvenile Diversion
Authors: Ericson Rebecca D. , Eckberg Deborah A. 
Published: July 2015

Purpose: Interpretations of focal concerns and “loose coupling” are used to explain juvenile diversion decisions by police and prosecutors from a large metropolitan county in the Midwest. Methods: Juveniles eligible for police diversion are compared to those actually diverted using a population of juveniles arrested in eight police urban and suburban agencies. Multinomial logistic regression is used to analyze data on juveniles referred for charging in the same county. Results: Non-White juveniles were significantly less likely to be diverted by police, formally entering them into the juvenile justice system earlier than their White counterparts. Prosecutors charged, rather than diverted, non-White juveniles significantly more frequently than White juveniles, particularly for theft cases. Conclusion: The racial disparity observed may result from differing focal concerns and loose coupling in the first stages of the justice system.
Trends in mortality associated with opening of a full-capacity public emergency department at the main tertiary-level hospital in Tanzania
Authors: Sawe Hendry R. , Mfinanga Juma A. , Mwafongo Victor , Reynolds Teri A. , Runyon Michael S. 
Published: July 2015

Abstract

Background
Emergency medicine is an emerging specialty in Sub-Saharan Africa, and most hospitals do not have a fully functional emergency department (ED). We describe the mortality rates of the Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania before and after the opening of a full-capacity ED.

Methods
This retrospective study investigated ED and hospital mortality rates for patients admitted to MNH from January 2008 to January 2012. This period represents 2 years before and 2 years after the opening of the full-capacity ED in January 2010. Trained abstractors analyzed patient care logbooks, attendance registers, nurse report books, and death certificates. The January 2008 to December 2009 data are from the limited-capacity casualty room (precursor of the ED), and for February 2010 to January 2012, they are from the new ED. Data are presented as proportions or differences with 95 % confidence intervals (CIs).

Results
During the 4-year study period, the number of visits increased from 53,660 (January 2008 to December 2009) in the casualty room to 77,164 (February 2010 to January 2012) in the new ED. During this time, the overall hospital mortality rate decreased from 13.6 % (95 % CI 13.3–13.9 %) in the January 2008 to December 2009 period to 8.2 % (95 % CI 8.0–8.3 %) in the February 2010 to January 2012 period. The corresponding casualty room and ED mortality rates were 0.34 % (95 % CI 0.25–0.35 %) and 0.74 % (95 % CI 0.68–0.80 %), respectively. In the casualty room, the most commonly reported cause of death was lower respiratory tract infection and least common was poisoning. In the new ED, the most commonly reported cause of death was congestive cardiac failure and the least common was cancer.

Conclusions
The opening of a full-capacity ED in a tertiary-level hospital in sub-Saharan Africa was associated with a significant decrease in hospital mortality. This is despite a small, but significant, increase in the mortality rate in the ED as compared to that in the casualty room that it replaced.
The role of interleukin-1 beta in the pathophysiology of Schnitzler’s syndrome
Authors: de Koning Heleen D. , Schalkwijk Joost , Stoffels Monique , Jongekrijg Johanna , Jacobs Joannes F. M. , Verwiel Eugène , Koenen Hans J. P. M. , Preijers Frank , Holzinger Dirk , Joosten Irma , van der Meer Jos W. M. , Simon Anna 
Published: July 2015

Abstract
Introduction
Schnitzler’s syndrome (SchS) is a disabling autoinflammatory disorder, characterized by a chronic urticarial rash, an M-protein, arthralgia, and other signs of systemic inflammation. Anti-interleukin-1 (IL-1) beta antibodies are highly effective, but the pathophysiology is still largely unknown. Here we studied the effect of in-vivo IL-1 inhibition on serum markers of inflammation and cellular immune responses.

Methods
Eight patients with SchS received monthly subcutaneous (s.c.) injections with 150 mg canakinumab for six months. Blood was drawn for measurement of serum markers of inflammation (12 times per patient) and for functional and phenotypic analysis of both freshly isolated and toll-like receptor (TLR)-ligand-stimulated peripheral blood mononuclear cells (PBMCs) (five times per patient). All data were compared to results of healthy controls.

Results
IL-6 levels in serum and in lysates of freshly isolated PBMCs and serum myeloid-related protein (MRP8)/14 and S100A12 levels correlated with disease activity. In vitro, LPS stimulation resulted in higher IL-6 and IL-1 beta production in PBMCs from symptomatic SchS patients compared to healthy controls, whereas patient cells were relatively hyporesponsive to poly:IC and Pam3Cys. The mRNA microarray of PBMCs showed distinct transcriptomes for controls, symptomatic patients and anti-IL-1-treated patients. Numbers of T- and B-cell subsets as well as M-protein concentrations were not affected by IL-1 inhibition. Free light chain levels were elevated in 4 out of 8 patients.

Conclusions
In conclusion, patient PBMCs are hyperresponsive to LPS, and clinical efficacy of IL-1 beta inhibition in patients with SchS is associated with in-vivo and ex-vivo suppression of inflammation. Interestingly, patient PBMCs showed divergent responses to TLR2/6, TLR3 and TLR4 ligands. Our data underscore that IL-1 beta plays a pivotal role in SchS.
A prospective evaluation of ultrasound as a diagnostic tool in acute microcrystalline arthritis
Authors: Zufferey Pascal , Valcov Roxana , Fabreguet Isabelle , Dumusc Alexandre , Omoumi Patrick , So Alexander 
Published: July 2015

Abstract
Introduction
The performance of ultrasound (US) in the diagnosis of acute gouty (MSU) arthritis and calcium pyrophosphate (CPP) arthritis is not yet well defined. Most studies evaluated US as the basis for diagnosing crystal arthritis in already diagnosed cases of gout and few prospective studies have been performed.

Methods
One hundred nine consecutive patients who presented an acute arthritis of suspected microcrystalline arthritis were prospectively included. All underwent an US of the symptomatic joints(s) and of knees, ankles and 1st metatarsopalangeal (MTP) joints by a rheumatologist “blinded” to the clinical history. 92 also had standard X-rays. Crystal identification was the gold standard.

Results
Fifty-one patients had MSU, 28 CPP and 9 had both crystals by microscopic analysis. No crystals were detected in 21. One had septic arthritis. Based on US signs in the symptomatic joint, the sensitivity of US for both gout and CPP was low (60 % for both). In gout, the presence of US signs in the symptomatic joint was highly predictive of the diagnosis (PPV = 92 %). When US diagnosis was based on an examination of multiple joints, the sensitivity for both gout and CPP rose significantly but the specificity and the PPV decreased. In the absence of US signs in all the joints studied, CPP arthritis was unlikely (NPV = 87 %) particularly in patients with no previous crisis (NPV = 94 %). X-ray of the symptomatic joints was confirmed to be not useful in diagnosing gout and was equally sensitive or specific as US in CPP arthritis.

Conclusions
Arthrocenthesis remains the key investigation for the diagnosis of microcrystalline acute arthritis. Although US can help in the diagnostic process, its diagnostic performance is only moderate. US should not be limited to the symptomatic joint. Examination of multiple joints gives a better diagnostic sensitivity but lower specificity.
Cabinet Tree: an orthogonal enclosure approach to visualizing and exploring big data
Authors: Yang Yalong , Zhang Kang , Wang Jianrong , Nguyen Quang Vinh 
Published: July 2015

Abstract
Treemaps are well-known for visualizing hierarchical data. Most related approaches have been focused on layout algorithms and paid little attention to other display properties and interactions. Furthermore, the structural information in conventional Treemaps is too implicit for viewers to perceive. This paper presents Cabinet Tree, an approach that: i) draws branches explicitly to show relational structures, ii) adapts a space-optimized layout for leaves and maximizes the space utilization, iii) uses coloring and labeling strategies to clearly reveal patterns and contrast different attributes intuitively. We also apply the continuous node selection and detail window techniques to support user interaction with different levels of the hierarchies. Our quantitative evaluations demonstrate that Cabinet Tree achieves good scalability for increased resolutions and big datasets.
Propolis: a new frontier for wound healing?
Authors: Martinotti Simona , Ranzato Elia 
Published: July 2015

AbstractPropolis is a resin produced by honeybees by mixing wax, pollen, salivary secretions, and collected natural resins.The precise composition of propolis varies with the source, and over 300 chemical components belonging to the flavonoids, terpenes, and phenolic acids have been identified in propolis. Moreover, its chemical composition is subjected to the geographical location, botanical origin, and bee species.Propolis and its compounds have been the focus of many works due to their antimicrobial and anti-inflammatory activity; however, it is now recognized that propolis also possesses regenerative properties.There is an increasing interest in the healing potential of natural products, considering the availability and low cost of these products. Propolis contains a huge number of compounds that explicate some biological effects that speeds up the healing process and is widely used in folk remedies.This review aims to condense the results on the mechanism of activity of propolis and its compounds.