bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploration and confirmation of factors associated with uncomplicated pregnancy in nulliparous women: prospective cohort study
Authors: Chappell Lucy C , Seed Paul T , Myers Jenny , Taylor Rennae S , Kenny Louise C , Dekker Gustaaf A , Walker James J , McCowan Lesley M E , North Robyn A , Poston Lucilla 
Published: December 2014

STUDY QUESTIONWhich variables at 15 and 20 weeks' gestation, particularly those amenable to modification before pregnancy, are associated with a subsequent uncomplicated pregnancy?SUMMARY ANSWERNormalising body mass index, increasing fruit intake before pregnancy, reducing blood pressure, stopping misuse of drugs, and being in paid employment are all associated with subsequent uncomplicated pregnancy outcomes.
Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal
Authors: Neuman Melissa , Alcock Glyn , Azad Kishwar , Kuddus Abdul , Osrin David , More Neena Shah , Nair Nirmala , Tripathy Prasanta , Sikorski Catherine , Saville Naomi , Sen Aman , Colbourn Tim , Houweling Tanja A J , Seward Nadine , Manandhar Dharma S , Shrestha Bhim P , Costello Anthony , Prost Audrey 
Published: December 2014

ObjectivesTo describe the prevalence and determinants of births by caesarean section in private and public health facilities in underserved communities in South Asia.DesignCross-sectional study.Setting81 community-based geographical clusters in four locations in Bangladesh, India and Nepal (three rural, one urban).Participants45 327 births occurring in the study areas between 2005 and 2012.Outcome measuresProportion of caesarean section deliveries by location and type of facility; determinants of caesarean section delivery by location.ResultsInstitutional delivery rates varied widely between settings, from 21% in rural India to 90% in urban India. The proportion of private and charitable facility births delivered by caesarean section was 73% in Bangladesh, 30% in rural Nepal, 18% in urban India and 5% in rural India. The odds of caesarean section were greater in private and charitable health facilities than in public facilities in three of four study locations, even when adjusted for pregnancy and delivery characteristics, maternal characteristics and year of delivery (Bangladesh: adjusted OR (AOR) 5.91, 95% CI 5.15 to 6.78; Nepal: AOR 2.37, 95% CI 1.62 to 3.44; urban India: AOR 1.22, 95% CI 1.09 to 1.38). We found that highly educated women were particularly likely to deliver by caesarean in private facilities in urban India (AOR 2.10; 95% CI 1.61 to 2.75) and also in rural Bangladesh (AOR 11.09, 95% CI 6.28 to 19.57).ConclusionsOur results lend support to the hypothesis that increased caesarean section rates in these South Asian countries may be driven in part by the private sector. They also suggest that preferences for caesarean delivery may be higher among highly educated women, and that individual-level and provider-level factors interact in driving caesarean rates higher. Rates of caesarean section in the private sector, and their maternal and neonatal health outcomes, require close monitoring.
Moxibustion for the treatment of pressure ulcers: study protocol for a pilot, multicentre, randomised controlled trial
Authors: Zhang Qin-hong , Yue Jin-huan , Li Chao-ran , Sun Zhong-ren 
Published: December 2014

IntroductionPressure ulcers are common in the elderly and immobile. Currently, there are few proven effective treatments for pressure ulcers. This trial aims to evaluate the feasibility, efficacy and safety of moxibustion for pressure ulcers.Methods/analysisThis is a multicentre, two-armed, parallel-design randomised controlled trial (RCT). 30 eligible patients with pressure ulcers will be randomised in a ratio of 1:1 to the treatment group and control group. The participants in the treatment group will undergo indirect moxibustion for 30 min before application of a dressing, one session daily, five sessions weekly for 4 weeks. The patients in the control group will only receive a dressing, applied in the same way as in the treatment group. Both groups will be followed up for 3 months. The primary outcome measures will be wound surface area (WSA) and proportion of ulcers healed within trial period (PUHTP). The secondary outcomes will be the Pressure Ulcer Scale for Healing (PUSH Tool), visual analogue scale (VAS) and adverse events. All outcomes will be evaluated at the beginning of the study, at the end of the second week, at 4 weeks after randomisation and at 1 and 3 months after treatment cessation.Ethics/disseminationThis trial has undergone ethical scrutiny and been approved by the ethics review boards of First Affiliated Hospital of Heilongjiang University of Chinese Medicine and Second Affiliated Hospital of Heilongjiang University of Chinese Medicine (Permission number: HZYEYLP2014). The results of this study will provide clinical evidence for the feasibility, efficacy and safety of moxibustion for pressure ulcers.Trial registration numberChiCTR-TRC-13003959.
Necessity of amoxicillin clavulanic acid in addition to prednisolone in mild-to-moderate COPD exacerbations
Authors: Brusse-Keizer Marjolein , VanderValk Paul , Hendrix Ron , Kerstjens Huib , van der Palen Job 
Published: December 2014

BackgroundThe effectiveness of antibiotics in chronic obstructive pulmonary disease (COPD) exacerbations is still a matter of debate, especially in outpatients with an intermediate probability of bacterial infection.MethodsIn this study, 35 COPD outpatients diagnosed by their chest physician with moderately severe COPD exacerbation, but without pneumonia, were randomised in a double blind, placebo-controlled study. Patients had one or two of the following characteristics: a positive Gram's stain of the sputum, 2 or more exacerbations in the previous year, a decrease in lung function of>200 mL and>12%. Patients received amoxicillin clavulanic acid (500/125 mg three times daily) or placebo for 7 days, always combined with a course of prednisolone (30 mg/day) for 7 days. Primary outcome was duration of the exacerbation. Additionally, we measured severity of the exacerbation, health-related quality of life, sputum parameters, number of relapses within 28 days and the number of re-exacerbations within 4 months after the study.ResultsThere was no difference observed in time to resolution of the exacerbation between the two groups (HR=1.12; (95% CI 0.5 to 2.3; p=0.77)), nor in any other treatment parameter.ConclusionsWe detected no evidence for the effectiveness of addition of antibiotics to prednisolone for COPD exacerbations of moderate severity and with intermediate probability of bacterial infection in this underpowered study. More placebo-controlled studies are needed to properly define subgroups of COPD outpatients in which antibiotics are of additional value.Trials registration numberclinical trial registered withhttp://www.trialregister.nl/(NTR351).
Publication rate of abstracts presented at the emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012
Authors: Kalkan Asim , Kose Ozkan , Bilir Ozlem , Ersunan Gokhan , Ozel Deniz , Guler Ferhat 
Published: December 2014

PurposeThe purpose of this study was to assess the publication rate of the abstracts presented at the 6th Mediterranean Emergency Medicine Congress, 2011 and the 7th European Congress on Emergency Medicine, 2012.Materials and methodsAll abstracts, both posters and oral presentations, from the international emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012 were identified. To establish whether these abstracts were subsequently published in peer-reviewed medical journals, the names of all the authors and the title of the abstracts were searched for in the databases of Clinical Key/Elsevier, EBSCO Discovery Service, MD Consult, Science Direct, Scopus, EMBASE, Medscape, Google Scholar and local ULAKBIM. The year of publication, consistency of author names and titles, the type of study, the journals in which papers were published and countries from which reports were submitted were all recorded.ResultsA total of 1721 abstracts were examined; 626 from 2011 (307 oral presentations and 319 posters) and 1095 from 2012 (154 oral presentations and 941 posters). Of all abstracts in 2011, 172 (27.5%) and of all abstracts in 2012, 265 (24.2%) were subsequently published as full-text reports in peer-reviewed journals. Of the 172 papers published in 2011, 152 (88.4%) were accepted by Science Citation Index (SCI) and/or SCI Expanded (SCI-E) journals and 155 (58.5%) of 265 papers were accepted by SCI and/or SCI-E journals in 2012 (p=0.0001).ConclusionsThe publication rate of abstracts submitted to international emergency medicine congresses held by EUSEM over those 2 years was low compared with that of abstracts presented in other emergency medicine congresses. Presenters should be encouraged to send their studies to peer-reviewed journals. During the selection process by the scientific panel, constructive critics should be notified to the presenters instead of simply accepting or rejecting the studies that submitted to the congress, which may increase the subsequent publication rate.
Are estimates of socioeconomic inequalities in chronic disease artefactually narrowed by self-reported measures of prevalence in low-income and middle-income countries? Findings from the WHO-SAGE survey
Authors: Vellakkal Sukumar , Millett Christopher , Basu Sanjay , Khan Zaky , Aitsi-Selmi Amina , Stuckler David , Ebrahim Shah 
Published: December 2014

BackgroundThe use of self-reported measures of chronic disease may substantially underestimate prevalence in low-income and middle-income country settings, especially in groups with lower socioeconomic status (SES). We sought to determine whether socioeconomic inequalities in the prevalence of non-communicable chronic diseases (NCDs) differ if estimated by using symptom-based or criterion-based measures compared with self-reported physician diagnoses.MethodsUsing population-representative data sets of the WHO Study of Global Ageing and Adult Health (SAGE), 2007–2010 (n=42 464), we calculated wealth-related and education-related concentration indices of self-reported diagnoses and symptom-based measures of angina, hypertension, asthma/chronic lung disease, visual impairment and depression in three ‘low-income and lower middle-income countries’—China, Ghana and India—and three ‘upper-middle-income countries’—Mexico, Russia and South Africa.ResultsSES gradients in NCD prevalence tended to be positive for self-reported diagnoses compared with symptom-based/criterion-based measures. In China, Ghana and India, SES gradients were positive for hypertension, angina, visual impairment and depression when using self-reported diagnoses, but were attenuated or became negative when using symptom-based/criterion-based measures. In Mexico, Russia and South Africa, this distinction was not observed consistently. For example, concentration index of self-reported versus symptom-based angina were: in China: 0.07 vs −0.11, Ghana: 0.04 vs −0.21, India: 0.02 vs −0.16, Mexico: 0.19 vs −0.22, Russia: −0.01 vs −0.02 and South Africa: 0.37 vs 0.02.ConclusionsSocioeconomic inequalities in NCD prevalence tend to be artefactually positive when using self-report compared with symptom-based or criterion-based diagnostic criteria, with greater bias occurring in low-income countries. Using standardised, symptom-based measures would provide more valid estimates of NCD inequalities.
Hip fractures sustained in hospital: comorbidities and outcome
Authors: Shabani Farzad , Farrier Adam J , Smith Robert , Venkatesan Murali , Thomas Christopher , Uzoigwe Chika Edward , Isaac Sheriff , Chami George 
Published: December 2014

ABSTRACT

Background
Guidelines on the management of hip fracture in the elderly focus on fractures suffered in the community. Between 4% and 7% of hip fractures occur in hospital. Mortality is higher in those who sustain hip fracture in hospital than those who sustain a fracture in the community. However, it is not known if sustaining a nosocomial fracture is an independent risk factor for a poor outcome.

Objective
To compare outcomes of hip fracture sustained in the community and sustained while in hospital for another reason. After adjusting for confounders, we sought to determine if sustaining a fracture in hospital was an independent risk factor for a poor outcome.

Methods
Using the National Hip Fracture Database, we identified all patients admitted to Leicester Royal Infirmary with hip fracture between July 2009 and February 2013. We extracted demographic data, details of comorbidity, and 30-day and long-term mortality. Age, gender, American Society of Anaesthesiologists (ASA) grade, time to surgery, and survival were compared between patients with hospital-acquired and those with community-acquired hip fracture.

Results
During the study period, 2987 patients were treated for hip fracture; 2984 were included in the study. Of these, 261 (8.7%) sustained the fracture while in hospital. Those who sustained the fracture in hospital were more commonly men (106/261 (41%)) than those with a community-acquired fracture (738/2723 (27%)) and had a worse ASA grade (III or IV, 215/230 (93%) vs 1647/2573 (64%)). Thirty-day mortality was higher in those with a hospital-acquired fracture (48/261 (18%)) than in those with a community-acquired fracture (212/2723 (7.8%)) (p&lt;0.001). However, after adjustment for confounding variables, the association between hip fracture, in-hospital and 30-day mortality was not significant: OR 1.2 (95% CI 0.8 to 2.0), p=0.40. Longer-term mortality was associated with hip fracture in hospital after adjustment for confounding variables in multivariate proportional hazards regression: HR 1.5 (95% CI 1.2 to 1.8), p&lt;0.001.

Conclusions
Patients who sustain hip fractures in hospital are unsurprisingly sicker than those who sustain hip fractures in the community. Although being in hospital is not an independent risk factor, this easily identifiable group of patients are at particular risk of a poor outcome. We suggest that it might be appropriate to consider modifying the guidelines for treatment of hip fracture for this group in an attempt to improve outcome.
Online Monitoring Systems for Performance Fault Detection
Authors: Gioiosa Roberto , Kestor Gokcen , Kerbyson Darren J. 
Published: December 2014

To achieve the exaFLOPS performance within a contained power budget, next generation supercomputers will feature hundreds of millions of components operating at low- and near-threshold voltage. As the probability that at least one of these components fails during the execution of an application approaches certainty, it seems unrealistic to expect that any run of a scientific application will not experience some performance faults. We believe that there is need of a new generation of light-weight performance and debugging tools that can be used online even during production runs of parallel applications and that can identify performance anomalies during the application execution. In this work we propose the design and implementation of a monitoring system that continuously inspects the evolution of running applications and the health of the system. To achieve minimum runtime overhead while maintaining the desired level of flexibility, we propose a decoupled approach in which accurate monitoring is performed at kernel-level while performance anomaly disambiguation and corrective actions are performed at user-level.We evaluate our monitoring system on a 128-core AMD Interlagos system: First, we show that the runtime overhead of the monitoring system is negligible (0-2%). Then we show how our system can be used to precisely identify performance faults in three different scenarios: OS noise, application co-scheduling and dynamic power capping.
Re-Evaluation of the Anticoagulant Properties of High-Density Lipoprotein—Brief Report
Authors: Fernandez Jose A. , Deguchi Hiroshi , Banka Carole L. , Witztum Joseph L. , Griffin John H. 
Published: December 2014

Objective—
This study was conducted to resolve the striking controversy between our previous report that high-density lipoprotein (HDL) enhances activated protein C (APC)/protein S anticoagulant actions and a subsequent, contradicting report that HDL lacks this activity.

Approach and Results—
When fresh HDL preparations from 2 laboratories were subjected to Superose 6 column chromatography, fractions containing HDL-enhanced APC:protein S anticoagulant actions in clotting assays, thereby validating our previous report. Moreover, the ability of HDL to enhance the anticoagulant actions of APC:protein S was neutralized by anti-apoAI antibodies, further indicating that the activity is because of HDL particles and not because of contaminating phospholipid vesicles. Density gradient subfractionation studies of HDL showed that large HDL subfractions (densities between 1.063 and 1.125 g/mL) contained the APC:protein S–enhancing activity. Fresh HDL stored at 4°C gradually lost its anticoagulant enhancing activity for 14 days, indicating moderate instability in this activity of purified HDL.

Conclusions—
These studies conclusively demonstrate that freshly prepared HDL fractions possess anticoagulant activity. Fractions from Superose 6 columns that contain HDL reproducibly enhance APC:protein S anticoagulant activity, consistent with the hypothesis that HDL has antithrombotic activity and with the observation that low HDL levels are found in male venous thrombosis patients. Understanding the basis for this activity could lead to novel therapeutic approaches to regulate venous thrombosis.
Extracellular Cyclophilin A Activates Platelets Via EMMPRIN (CD147) and PI3K/Akt Signaling, Which Promotes Platelet Adhesion and Thrombus Formation In Vitro and In Vivo
Authors: Seizer Peter , Ungern-Sternberg Saskia N.I.v. , Schönberger Tanja , Borst Oliver , Münzer Patrick , Schmidt Eva-Maria , Mack Andreas F. , Heinzmann David , Chatterjee Madhumita , Langer Harald , Malešević Miroslav , Lang Florian , Gawaz Meinrad , Fischer Gunter , May Andreas E. 
Published: December 2014

Objective—
Cyclophilin A (CyPA) is secreted under inflammatory conditions by various cell types. Whereas the important role of intracellular CyPA for platelet function has been reported, the effect of extracellular CyPA on platelet function has not been investigated yet.

Approach and Results—

Inhibition of extracellular CyPA through a novel specific inhibitor MM284 reduced thrombus after ferric chloride–induced injury in vivo. In vitro extracellular CyPA enhanced thrombus formation even in CyPA
−/−
platelets. Treatment of isolated platelets with recombinant CyPA resulted in platelet degranulation in a time- and dose-dependent manner. Inhibition of the platelet surface receptor extracellular matrix metalloproteinase inducer (cluster of differentiation 147) by an anticluster of differentiation 147 monoclonal antibody significantly reduced CyPA-dependent platelet degranulation. Pretreatment of platelets with CyPA enhanced their recruitment to mouse carotid arteries after arterial injury, which could be inhibited by an anticluster of differentiation 147 monoclonal antibody (intravital microscopy). The role of extracellular CyPA in adhesion could be confirmed by infusing CyPA
−/−
platelets in CyPA
+/+
mice and by infusing CyPA
+/+
platelets in CyPA
−/−
mice. Stimulation of platelets with CyPA induced phosphorylation of Akt, which could in turn be inhibited in the presence of phosphoinositid-3-kinase inhibitors. Akt-1
−/−
platelets revealed a markedly decreased degranulation on CyPA stimulation. Finally, ADP-induced platelet aggregation was attenuated by MM284, as well as by inhibiting paracrine-secreted CyPA without directly affecting Ca
2+
-signaling.

Conclusions—
Extracellular CyPA activates platelets via cluster of differentiation 147–mediated phosphoinositid-3-kinase/Akt-signaling, leading to enhanced adhesion and thrombus formation independently of intracellular CyPA. Targeting extracellular CyPA via a specific inhibitor may be a promising strategy for platelet inhibition without affecting critical functions of intracellular CyPA.
Central Cardiac Limit to Aerobic Capacity in Patients With Exertional Pulmonary Venous Hypertension
Authors: Santos Mário , Opotowsky Alexander R. , Shah Amil M. , Tracy Julie , Waxman Aaron B. , Systrom David M. 
Published: December 2014

Background—
The mechanism of functional limitation in heart failure with preserved ejection fraction remains controversial. We examined the contributions of central cardiac and peripheral mechanisms and hypothesized that the pulmonary vascular response to exercise is an important determinant of aerobic capacity among patients with exertional pulmonary venous hypertension (ePVH).

Methods and Results—

We compared 31 ePVH patients (peak V
O
2
<80% of predicted and peak pulmonary arterial wedge pressure≥20 mm Hg) with 31 age- and sex-matched controls (peak V
O
2
>80% predicted) who underwent invasive cardiopulmonary exercise testing for unexplained exertional intolerance. ePVH patients had lower peak cardiac output (73±14% versus 103±18% predicted;
P
<0.001) compared with controls, related both to impaired chronotropic response (peak heart rate 111±25 beats per minute versus 136±24 beats per minute;
P
<0.001) and to reduced peak stroke volume index (47±10 mL/min per m
2
versus 54±15 mL/min per m
2
;
P
=0.03). Peak systemic O
2
extraction was not different between groups (arterial-mixed venous oxygen content difference: 13.0±2.1 mL/dL versus 13.4±2.4 mL/dL;
P
=0.46). ePVH patients had higher resting (150±74 versus 106±50 dyne/s per cm
−5
;
P
=0.009), peak (124±74 dyne/s per cm
−5
versus 70±41 dyne/s per cm
−5
;
P
<0.001), and isoflow pulmonary vascular resistance (124±74 dyne/s per cm
−5
versus 91±33 dyne/s per cm
−5
at cardiac output≈10.6 L/min;
P
=0.04). Pulmonary vascular resistance decreased with exercise in all control subjects but increased in 36% (n=11) of ePVH patients. Abnormal pulmonary vascular response was not associated with peak V
O
2
.

Conclusions—

Reduced cardiac output response, rather than impaired peripheral O
2
extraction, constrains oxygen delivery and aerobic capacity in ePVH. Pulmonary vascular dysfunction is common in patients with ePVH at rest and during exercise.