bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tissue‐factor‐bearing microparticles (MPs‐TF) in patients with acute ischaemic stroke: the influence of stroke treatment on MPs‐TF generation
Authors: Świtońska M. , Słomka A. , Sinkiewicz W. , Żekanowska E. 
Published: November 2014

Background and purposeStroke is an important cause of death and disability throughout the world. Microparticles play a cardinal role in vascular hemostasis. The primary aim of this study was to evaluate the procoagulant activity of microparticles and levels of tissue‐factor‐bearing microparticles (MPs‐TF), tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with acute ischaemic stroke.MethodsSeventy‐three patients with a diagnosis of acute ischaemic stroke were included. Venous blood samples were drawn on the first day and the seventh day after stroke onset. Plasma microparticles, MPs‐TF, TF and TFPI were determined by enzyme‐linked immunosorbent assay. Assessment variables were timing of blood collection, type of stroke treatment, presence or absence of diabetes mellitus and hypertension, and scores on the National Institutes of Health Stroke Scale together with scores on the modified Rankin Scale.ResultsWhilst MPs‐TF and TFPI levels of stroke subjects were significantly higher (median, 1.63 vs. 0.73 pg/ml; median, 114.26 vs. 78.60 ng/ml, respectively), TF levels in the plasma of stroke patients were significantly lower (median, 82.27 vs. 97.80 pg/ml) than those of healthy individuals. Lower levels of TF were detected in patients with severe stroke in comparison with patients with mild stroke. Moreover, the data also showed that in stroke patients not treated with alteplase the activity of microparticles was significantly higher 1 week after diagnosis in comparison with the activity at the time of diagnosis.ConclusionOur findings suggest that patients with acute ischaemic stroke have increased generation of MPs‐TF. Nevertheless, further studies are needed in order to confirm such inference.
Dyskerin expression in human fetal, adult and neoplastic intrahepatic bile ducts: correlations with cholangiocarcinoma aggressiveness
Authors: Vasuri Francesco , Rocchi Laura , Degiovanni Alessio , Giunchi Francesca , Brandi Giovanni , Treré Davide , Montanaro Lorenzo , D'Errico‐Grigioni Antonia 
Published: November 2014

AimsTo investigate the immunohistochemical expression of dyskerin, a biomarker involved in ribosome production and telomere maintenance, in human fetal, adult and neoplastic bile ducts, and possible correlations with cholangiocarcinoma aggressiveness.Methods and resultsSixty consecutive intrahepatic cholangiocarcinomas were collected and used for tissue microarray construction (total: 176 cores); clinical data and follow‐up were also collected. Five fetal and 10 normal adult livers were included as controls. Automated immunohistochemistry for dyskerin, p53, and Ki67, and nucleolar silver staining, were performed. In normal livers, dyskerin expression was negative in smaller bile ducts (mean 44.8 μm) and positive in bile ducts of larger diameter (mean 116.1 μm; P < 0.001). Expression was positive in 56.7% of cholangiocarcinomas, and correlated with p53 mutation (P = 0.008) and a higher proliferative (Ki67) index (P = 0.003), which were included as markers of tumour aggressiveness. Finally, dyskerin‐positive cholangiocarcinomas showed a negative trend in disease‐free survival (P = 0.078) on univariate analysis.ConclusionsThe non‐neoplastic biliary tree seems to progressively lose dyskerin expression from the major branches to the peripheral portal bile ducts. Similarly, intrahepatic cholangiocarcinomas showed two patterns of dyskerin expression, and the dyskerin‐positive phenotype seemed to characterize more aggressive cholangiocarcinomas.
Composite metamorphic history recorded in garnet porphyroblasts of Sambagawa metasediments in the Besshi region, central Shikoku, Southwest Japan
Authors: Kouketsu Yui , Enami Masaki , Mouri Takashi , Okamura Mitsuya , Sakurai Tsuyoshi 
Published: November 2014

AbstractThis report describes an investigation of the composite metamorphic history recorded in garnet porphyroblasts of Sambagawa metasediments, and presents discussions of the possible distribution of eclogite facies lithologies in the Besshi region, central Shikoku, southwest Japan. Garnet grains usually show chemically composite zoning with resolved inner and overgrown outer segments, respectively. The inner segment usually contains paragonite as a sodic phase inclusion and rarely contains omphacite or glaucophane, whereas the outer segment rarely includes albite but no paragonite. The inner segment often includes quartz grains that preserve high residual pressures corresponding to the eclogite facies conditions, whereas the outer segment includes quartz grains that preserve lower residual pressures corresponding to the epidote–amphibolite facies conditions. For this composite‐zoned garnet, the assemblage of sodic phase inclusions and the values of the residual pressure of quartz inclusions imply the following successive metamorphic path: prograde eclogite facies stage → decompression and hydration reaction stage → prograde epidote–amphibolite facies stage. Metasediments containing this composite‐zoned garnet with such evidence for eclogite facies conditions are more widely distributed than the eclogitic lithologies that contain the assemblage of omphacite + garnet. These results imply that the combination of (i) the chemical composite zoning of garnet, (ii) the nature of sodic phase inclusions, and (iii) the residual pressure of quartz inclusions is useful as criteria to ascertain the true distribution of the lithologies that have experienced eclogite facies metamorphism for the Sambagawa metasediments, which was difficult to recognize in earlier studies.
Sudanese community pharmacy practice and its readiness for change to patient care
Authors: Mohamed Sumia S E , Mahmoud Adil A , Ali Abdulazim A 
Published: November 2014

AbstractObjectivesThis study aims to describe the current state of Sudanese community pharmacy practice and explore the capacity of existing community pharmacies to foster the change to pharmaceutical care (PC) and to assess attitude and knowledge of community pharmacists regarding PC and identify barriers.MethodsA structured, self-administered, piloted questionnaire was distributed to the pharmacists in charge of 274, randomly selected, community pharmacies in Khartoum state. The questionnaire included six domains: demographic characteristics, organizational structure of community pharmacies, current activities of community pharmacists, their attitudes and knowledge regarding PC, and potential barriers. Attitude responses were measured by a 5-point Likert scale.Key findingsResponse rate was 67%. Community pharmacies are short on some tools that are deemed necessary for PC implementation, e.g. consultation areas. Community pharmacists provide mainly product-focused services with no or little PC activities. However, there is a highly positive attitude among the majority of respondents towards practice change to include PC (mean positive score ± standard deviation = 4.39 ± 0.73, frequency (%) = 89%). Many barriers to implementation of PC were identified, e.g. pharmacists' clinical knowledge and lack of understanding of pharmacist’s new role.ConclusionSudanese community pharmacists favour practice change to include PC. Successful implementation of PC requires substantial organizational and structural changes in community pharmacies, including provision of clinical knowledge, strengthening of clinical training and new practice standards. This change in practice could benefit from involvement of academia, governmental bodies and professional organizations working together for the pharmacy profession.
Healthcare professional requirements for the care of adult diabetes patients managed with insulin pumps in Australia
Authors: Xu S. , Alexander K. , Bryant W. , Cohen N. , Craig M. E. , Forbes M. , Fulcher G. , Greenaway T. , Harrison N. , Holmes‐Walker D. J. , Howard G. , Jackson J. , Jenkins A. , Kamp M. , Kaye J. , Sinha A. , Stranks S. , O'Neal D. , Colman P. ,   Australian National Adult Insulin Pump Therapy Working Group
Published: November 2014

AbstractBackgroundHealthcare professional (HCP) time supporting insulin pump therapy (IPT) has not been documented, yet it is important in planning and allocating resources for effective care.AimThis study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery.MethodsTwenty‐four Australian adult IPT‐experienced institutions (14 government funded, seven private, three both) collected data between April 2012 and January 2013 prospectively, including: patient demographics, HCP classification, purpose of HCP–patient interaction, interaction mode and HCP time with the patient. A subset of patients was tracked from pre‐pump education until stable on IPT.ResultsData on 2577 HCP‐adult patient interactions (62% face‐to‐face, 29% remote, 9% administrative) were collected over 12.2 ± 6.4 weeks for 895 patients; age 35.4 ± 14.2 years; 67% female; 99% type 1 diabetes, representing 25% of all IPT patients of the institutions. Time (hours) spent on IPT interactions per centre per week were: nurses 5.4 ± 2.8, dietitians 0.4 ± 0.2 and doctors 1.0 ± 0.5. IPT starts accounted for 48% of IPT interaction time. The percentage of available diabetes clinic time spent on outpatient IPT interactions was 20.4%, 4.6% and 2.7% for nurses, dietitians and doctors respectively. Fifteen patients tracked from pre‐pump to stabilisation over 11.8 ± 4.5 weeks, required a median (range) of 9.2 (3.0–20.9), 2.4 (0.5–6.0) and 1.8 (0.5–5.4) hours per patient from nurses, dietitians and doctors respectively.ConclusionsIPT patient care represents a substantial investment in HCP time, particularly for nurses. Funding models for IPT care need urgent review to ensure this now mainstream therapy integrates well into healthcare resources.
Dose tailoring of anti‐tumour necrosis factor‐alpha therapy delivers useful clinical efficacy in Crohn disease patients experiencing loss of response
Authors: Ghaly S. , Costello S. , Beswick L. , Pudipeddi A. , Agarwal A. , Sechi A. , Antoniades S. , Headon B. , Connor S. , Lawrance I. C. , Sparrow M. , Walsh A. J. , Andrews J. M. ,   AIBDA
Published: November 2014

AbstractBackground‘Dose tailoring’ of anti‐tumour necrosis factor alpha (TNF‐α) therapy in Crohn disease (CD), by dose escalation, or shortening of dosing intervals, has been suggested to regain clinical response following a flare in a proportion of patients. However, reported outcome data are sparse and none exists from Australia.MethodIn an observational multicentre, retrospective study, the impact of anti‐TNF‐α dose tailoring on corticosteroid use, the need for surgery and physician perception of clinical efficacy was examined in a real‐world setting at six Australian adult teaching hospitals. Demographics, disease characteristics, medications, indication for and duration of dose tailoring were documented.ResultsFifty‐five CD patients were identified as requiring dose tailoring and secondary loss of response was the indication in 96%. Either adalimumab (64%) or infliximab (36%) was dose escalated for a median of 5 months (range 1–47), with a median of 20 months follow up (range 3–65). At 3 months, dose tailoring reduced the mean number of days on high‐dose corticosteroids (45 vs 23, P = 0.01). Most (78%) patients remained resection free, and 73% of physicians reported good clinical efficacy of dose tailoring. Of those who de‐escalated therapy due to induction of remission, long‐term (>12 months) follow up and complete data on steroid use were available in 15/28, with 12/15 (80%) remaining steroid free at 1 year.ConclusionShort‐term dose tailoring regains disease response in the majority of patients with CD. Of these, most will remain free of corticosteroids at 1 year after de‐escalating therapy.
Clinical outcome of drug‐eluting versus bare‐metal stents in patients with calcified coronary lesions: a meta‐analysis
Authors: Zhang B.‐C. , Wang C. , Li W.‐H. , Li D.‐Y. 
Published: November 2014

AbstractBackgroundThe relative safety and efficacy of drug‐eluting stents (DES) versus bare‐metal stents (BMS) in patients with calcified coronary lesions is still debated.AimsTo evaluate clinical outcome of DES versus BMS in patients with calcified coronary lesions using a meta‐analysis of the current literature.MethodsWe performed a systematic literature search using Medline, Embase, Cochrane and several other databases. Randomised controlled trials, prospective and retrospective cohort studies with a mean follow‐up period >6 months were included. Primary efficacy was target lesions revascularisation (TLR) and primary end‐point for safety was stent thrombosis. Secondary end‐points were cardiac death and recurrent myocardial infarction (MI).ResultsFive trials were included in the meta‐analysis, including 2440 patients (1230 in the DES group, 1210 in the BMS group). TLR was significantly lower in patients treated with DES as compared with patients treated with BMS (8.5% vs 16.0%; odds ratio (OR) = 0.50; 95% confidence interval (CI) 0.38–0.65; P < 0.00001). There were no significant differences in the incidence of stent thrombosis (0.9% vs 0.3%; OR = 2.01; 95% CI 0.34–11.88; P = 0.44), cardiac death (3.3% vs 4.2%; OR = 0.81; 95% CI 0.50–1.30; P = 0.38) and recurrent MI (5.0% vs 5.2%; OR = 0.99; 95% CI, 0.66–1.49; P = 0.97) between the two groups. Subgroup analysis by the sample size and follow‐up duration showed that the associations were similar between DES versus BMS.ConclusionsDES significantly reduces TLR rates as compared with BMS in patients with calcified coronary lesions, with non‐significant differences in terms of stent thrombosis, cardiac death and MI.
Clinical outcomes of chronic hepatitis C patients related to baseline liver fibrosis stage: a hospital‐based linkage study
Authors: Huang Y. , de Boer W. B. , Adams L. A. , MacQuillan G. , Bulsara M. K. , Jeffrey G. P. 
Published: November 2014

AbstractBackground and AimsRates of long‐term clinical outcomes of chronic hepatitis C in patients with none, mild or severe liver fibrosis are required to determine benefits of anti‐viral therapies. This study evaluated long‐term outcomes for chronic hepatitis C stratified by all Metavir fibrosis stages.MethodsClinical outcomes were determined using population‐based data linkage methodology for 880 hepatitis C patients who had a liver biopsy performed from 1992 to 2012.ResultsDuring 9386 person‐years of follow up, 28 patients developed hepatocellular carcinoma, 58 developed liver decompensation and 122 died or underwent liver transplantation. There was no significant difference in liver‐related death for those with F0–F2 with an 18‐year survival probability >94%. Hazard ratio of liver‐related death for F3 compared with F0–F2 was 4.24 (P = 0.003), with no significant difference in the first 13‐year follow up. The 15‐year decompensation‐free survival for F0, F1 and F2 was 100%, 96% and 94% respectively and for hepatocellular carcinoma‐free survival was 100%, 99% and 98%. Hazard ratio of liver complication (hepatocellular carcinoma or decompensation)‐free survival for F3 compared with F0–F2 was 3.22 (P = 0.001), with no significant difference during the first 7‐year follow up. F4 had significantly higher risk of liver‐related death, decompensation and hepatocellular carcinoma than F3 (P < 0.001).ConclusionsChronic hepatitis C patients with F2 or less had few liver complications after 15 years. For F3 patients, the significant increase in liver‐related death occurred after 13 years and for liver complications after 7 years.
Different genetic impact in the development of renal length and width: a twin study
Authors: Tarnoki D. L. , Tarnoki A. D. , Bata P. , Littvay L. , Garami Z. , Berczi V. , Karlinger K. 
Published: November 2014

AbstractBackgroundUltrasound measurements of renal dimensions are conventionally limited to renal length, shape and cortical thickness. These are regarded as adequate for normal therapeutic decision‐making and volume measurements are reserved for a few clinical trials. However, there is no evidence concerning the degree to which renal length or volume is independently susceptible to heritable and environmental influences.AimWe aimed to determine whether renal length or width (as a surrogate of volume) was more influenced by heritability.MethodsA single operator measured renal length and width in 114 adult monozygotic and same‐sex dizygotic Hungarian twin pairs (mean age 43.6 ± 16.3 years), using an Esaote MyLab 70X ultrasound machine with curved array transducer (1–8 MHz, CA431).ResultsAnalysis of within‐pair co‐twin correlations adjusted for age and gender showed that the age‐ and sex‐adjusted heritability of average renal length was 51% (95% confidence interval, 29–72%). Renal width showed negligible genetic influence. Common environmental effects had no influence, and unshared environments were responsible for 49–80% of the variance, mainly renal width.ConclusionsThis study is the first to demonstrate the moderate heritability and limited environmental influence on renal length, and the contrasting lack of heritability of renal width, which is mainly influenced by unshared environmental components, that is lifestyle habits. Renal width therefore better represents the influence of modifiable environmental factors than renal length. The results suggest that renal width not length should be reported to facilitate early detection and monitoring of renal disease.
Rules of Procedure as a Cause of Legislative Paralysis: The Case of Costa Rica, 2002–2012
Authors: Borges Fabián A. 
Published: November 2014

AbstractResearch on executive-legislative relations in Latin America has focused on the impact of minority presidents and multiparty legislatures on legislative productivity. But an additional deadlock scenario, the blocking of a majority president by a minority through filibustering, has been understudied. This article analyzes filibustering in Costa Rica and explains the legislative paralysis in the wake of the nation's transition to a multiparty system in 2002. Legislative paralysis is seen as a product of the interaction between increased legislative fragmentation and polarization and the legislature's preexisting rules of procedure, which enable legislators easily to block bills they oppose, even when those bills are supported by supermajorities. This argument is tested through a comparison of major economic reforms in the 2000s to the reforms tackled in the 1990s. The role of filibustering, well acknowledged in U.S. politics, should also be studied in comparative politics.
Pre‐clinical evaluation of the osteogenic potential of bone morphogenetic protein‐2 loaded onto a particulate porcine bone biomaterial
Authors: Yon Jeyoung , Lee Jung‐Seok , Lim Hyun‐Chang , Kim Min‐Soo , Hong Ji‐Youn , Choi Seong‐Ho , Jung Ui‐Won 
Published: November 2014

AbstractAimThe objective of study was to determine the osteogenic potential of bone morphogenetic protein‐2 (BMP‐2) loaded onto a particulate porcine bone mineral (PBM) biomaterial using a sinus augmentation model.MethodsRelease kinetics of BMP‐2/PBM was determined in vitro. Eight rabbits received BMP‐2/PBM or PBM alone into contra‐lateral sinus sites. The animals were killed following a 2‐week healing interval for micro‐CT and histometrical analysis.ResultsApproximately 40% of the BMP‐2 was released from PBM over the first 3 days in vitro; release maintained at a reduced level through day 21. In vivo, total augmented implant volume did not differ significantly between treatments. However, local bone formation was enhanced in the BMP‐2/PBM group compared with PBM control (10.5% versus 6.6%; p = 0.03), specifically in the central aspect of the PBM implant (14.2% versus 5.5%; p < 0.01) and adjoining the Schneiderian membrane (11.9% versus 5.0%; p < 0.05). There were no significant overall differences in residual biomaterial and fibrovascular tissue.ConclusionBone morphogenetic protein‐2 enhanced local bone formation in the rabbit maxillary sinus model following implantation using a PBM carrier.
Teaching dermatoscopy of pigmented skin tumours to novices: comparison of analytic vs. heuristic approach
Authors: Tschandl P. , Kittler H. , Schmid K. , Zalaudek I. , Argenziano G. 
Published: November 2014

AbstractBackgroundThere are two strategies to approach the dermatoscopic diagnosis of pigmented skin tumours, namely the verbal‐based analytic and the more visual‐global heuristic method. It is not known if one or the other is more efficient in teaching dermatoscopy.ObjectiveTo compare two teaching methods in short‐term training of dermatoscopy to medical students.MethodsFifty‐seven medical students in the last year of the curriculum were given a 1‐h lecture of either the heuristic‐ or the analytic‐based teaching of dermatoscopy. Before and after this session, they were shown the same 50 lesions and asked to diagnose them and rate for chance of malignancy. Test lesions consisted of melanomas, basal cell carcinomas, nevi, seborrhoeic keratoses, benign vascular tumours and dermatofibromas. Performance measures were diagnostic accuracy regarding malignancy as measured by the area under the curves of receiver operating curves (range: 0–1), as well as per cent correct diagnoses (range: 0–100%).ResultsDiagnostic accuracy as well as per cent correct diagnoses increased by +0.21 and +32.9% (heuristic teaching) and +0.19 and +35.7% (analytic teaching) respectively (P for all <0.001). Neither for diagnostic accuracy (P = 0.585), nor for per cent correct diagnoses (P = 0.298) was a difference between the two groups.ConclusionsShort‐term training of dermatoscopy to medical students allows significant improvement in diagnostic abilities. Choosing a heuristic or analytic method does not have an influence on this effect in short training using common pigmented skin lesions.
PASI90 response: the new standard in therapeutic efficacy for psoriasis
Authors: Puig L. 
Published: November 2014

AbstractIn a non‐life‐threatening disease such as psoriasis, treatment goals should be referred to the improvement in severity and extent of the disease and their impact on patients’ perceived health‐related quality of life (HRQoL), usually measured by the Dermatology Life Quality Index (DLQI). The ultimate goal of therapy is blanching, and an improvement of 90% or better (PASI90 response) with respect to baseline Psoriasis Area and Severity Index (PASI) is considered as treatment success by the European Medicines Agency. PASI75 response has become accepted as a less stringent reasonable therapeutic goal, but absolute PASI values might provide a better benchmark, irrespective of baseline PASI. Anyway, objective measures of psoriasis involvement are clinically meaningful only if they correlate with significant improvements in DLQI, and especially with the achievement of a DLQI = 0–1 status, corresponding to lack of effect of the disease on patient's HRQoL. Even though PASI75 response meets therapeutic expectations in most patients, PASI90 response or better has a significantly higher impact on DLQI improvement and is associated with significantly higher DLQI = 0–1 response rates. The introduction of anti‐IL17 drugs in clinical practice bears the promise of achieving PASI90 response or better in the majority of patients, and initial data suggest that the PASI90 benchmark provides better discriminatory value as regards achievement of DLQI = 0–1 response. Further research is required to confirm the value of absolute PASI cut‐offs as a measure of therapeutic success independent of baseline and duration of treatment, and to develop newer, more practical and more accurate measures of psoriasis severity.