bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective cohort study: 10-year trend of disease-modifying antirheumatic drugs and biological agents use in patients with rheumatoid arthritis at Veteran Affairs Medical Centers
Authors: Ng Bernard , Chu Adeline , Khan Myrna M 
Published: April 2013

ObjectivesTo evaluate the trends in patterns of disease-modifying antirheumatic drugs (DMARDs) and biological agents use from 1999 to 2009 and to identify patient characteristics associated with different patterns of their use in a national sample of Veterans with rheumatoid arthritis (RA).DesignA retrospective cohort study.SettingsAdministrative databases of the USA Department of Veterans Affairs.ParticipantsAn incident cohort of 13 254 patients with newly diagnosed RA was identified.Primary outcome measuresTrends and choice of DMARDs and biological agents’ usage, and time intervals between RA diagnosis and treatmentResultsMethotrexate use as first-line agent increased from 39.9% to 57.2% over the study period (p<0.001). Although biological dispensations increased over other DMARDs and biological agents, from 3.4% to 25% from 1999 to 2009, the percentage of RA patients diagnosed between 1999 and 2007 who had biologics dispensations remained steady at 23.3–26.7%. Compared with Caucasian, African Americans were less likely to receive biologics (HR 0.71, 95% CI 0.63 to 0.81). Patients aged 75 and older were less likely to receive biologics than those younger than 45 (HR 0.29, 95% CI 0.23 to 0.36). The time interval between RA diagnosis and treatment with DMARDs and biological agents decreased significantly over time (median: 51 days in 1999–2001 to 28 days in 2006–2007).ConclusionsMethotrexate use increased as it became the preferred first-line agent, while other traditional agents declined. Dispensation of biologics increased significantly, but the proportion of RA patients eventually given biologics stabilised below 30%. A significant shorter time between RA diagnosis and DMARD or biological agent initiation in recent years suggests improvements in quality of care. There were disproportionately lower use of biologics in certain age and ethnic groups, and further studies will be needed to elucidate these observations.
Acute electrocardiographic changes during smoking: an observational study
Authors: Ramakrishnan Sivasubramanian , Bhatt Kinjal , Dubey Akhilesh K , Roy Ambuj , Singh Sandeep , Naik Nitish , Seth Sandeep , Bhargava Balram 
Published: April 2013

ObjectiveTo study the temporal relationship of smoking with electrophysiological changes.DesignProspective observational study.SettingTertiary cardiac center.ParticipantsMale smokers with atypical chest pain were screened with a treadmill exercise test (TMT). A total of 31 such patients aged 49.8±10.5 years, in whom TMT was either negative or mildly positive were included. Heart rate variability (HRV) parameters of smokers were compared to those of 15 healthy non-smoking participants.InterventionsAll patients underwent a 24 h Holter monitoring to assess ECG changes during smoking periods.ResultsHeart rate increased acutely during smoking. Mean heart rate increased from 83.8±13.7 bpm 10 min before smoking, to 90.5±16.4 bpm during smoking, (p<0.0001) and returned to baseline after 30 min. Smoking was also associated with increased ectopic beats (mean of 5.3/h prior to smoking to 9.8/h during smoking to 11.3/h during the hour after smoking; p<0.001). Three patients (9.7%) had significant ST–T changes after smoking. HRV index significantly decreased in smokers (15.2±5.3) as compared to non-smoking controls participants (19.4±3.6; p=0.02), but the other spectral HRV parameters were comparable.ConclusionsHeart rate and ectopic beats increase acutely following smoking. Ischaemic ST–T changes were also detected during smoking. Spectral parameters of HRV analysis of smokers remained in normal limits, but more importantly geometrical parameter—HRV index—showed significant abnormality.
Identifying intensive care unit discharge planning tools: protocol for a scoping review
Authors: Stelfox Henry T , Perrier Laure , Straus Sharon E , Ghali William A , Zygun David , Boiteau Paul , Zuege Danny J 
Published: April 2013

BackgroundTransitions of care between providers are vulnerable periods in healthcare delivery that expose patients to preventable errors and adverse events. Patient discharge from the intensive care unit (ICU) to a medical or surgical hospital ward is one of the most challenging and high risk transitions of care. Approximately 1 in 12 patients discharged will be readmitted to ICU or die before leaving the hospital. Many more patients are exposed to unnecessary healthcare, adverse events and/or are disappointed with the quality of their care. Our objective is to conduct a scoping review by systematically searching the literature to identify ICU discharge planning tools and their supporting evidence-base including barriers and facilitators to their use.Methods and analysisSystematic searching of the published health literature will be conducted to identify the existing ICU discharge planning tools and supporting evidence. Literature (research and non-research) reporting on the tools used to facilitate decision making and/or communication at ICU discharge with patients of any age will be included. Outcomes will include adverse events and provider and patient/family-reported outcomes. Two investigators will independently review the abstracts (screen 1) to identify those meeting the inclusion criteria and then independently assess the full text articles (screen 2) to determine if they meet the inclusion criteria. Data collection will include information on citations and identified tools. A quality assessment will be performed on original research studies. A descriptive summary will be developed for each tool.Ethics and disseminationOur scoping review will synthesise the literature for ICU discharge planning tools and identify the opportunities for knowledge to action and gaps in evidence where primary evidence is necessary. This will serve as the foundational element in a multistep research programme to standardise and improve the quality of care provided to patients during ICU discharge. Ethics approval is not required for this study.
The comparison of modified early warning score with rapid emergency medicine score: a prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department
Authors: Bulut Mehtap , Cebicci Huseyin , Sigirli Deniz , Sak Ahmet , Durmus Oya , Top Ahmet Ali , Kaya Sinan , Uz Kamil 
Published: April 2013

ObjectiveThere are a few scoring systems in emergency departments (ED) to establish critically ill patients quickly and properly and to predict hospitalisation. We aim to compare the efficacy of Modified Early Warning Score (MEWS) and Rapid Emergency Medicine Score (REMS) on in-hospital mortality, and as predictor of hospitalisation in general medical and surgical patients admitted to ED.MethodsThis is a prospective, multicentre and observational cohort study. The study included general medical and surgical patients admitted to the EDs of three education and research hospitals during a period of 6 months. The primary outcome of the study is the admission of the patient to a ward/an intensive care unit (ICU)/high dependency unit (HDU) and in-hospital mortality. Receiver operating characteristics (ROC) curve analysis was performed to evaluate and compare the performances of two scores.ResultsTotal patients were 2000 (51.95% male, 48.05% female). The mean age was 61.41±18.92. Median MEWS and REMS values of the patients admitted to the ICU/HDU from ED were 1 and 6, respectively; and there was a significant difference in terms of REMS values, compared with patients discharged from ED. REMS (area under the curve (AUC): 0.642) was found to have a better predictive strength than MEWS (AUC: 0.568) in discriminating in-patients and discharged patients. Additionally, REMS (0.707) was superior to MEWS (AUC 0.630) in terms of predicting in-hospital mortality of patients presenting to ED.ConclusionsThe efficiency of REMS was found to be superior to MEWS as a predictor of in-hospital mortality and hospitalisation in medical and surgical patients admitted to ED.
Clinical relevance of the new IASLC/ERS/ATS adenocarcinoma classification
Authors: Kerr Keith M 
Published: April 2013

In 2011, recommendations for a multidisciplinary classification of lung adenocarcinoma were published under the auspices of the International Association for the Study of Lung Cancer, the American Thoracic Society and the European Respiratory Society. The review was considered necessary due to emerging data on the radiological features, genetics and therapeutic approaches to lung adenocarcinoma, all underpinned by expanding the knowledge of the pathology of this common tumour. The existing WHO classification of 2004 was not really fit for this multidisciplinary focus on the disease.This review describes the recommendations made on the reporting of surgically resected lung cancers according to their predominant pattern, and argues the case for replacing the term bronchioloalveolar carcinoma (WHO 1999 and 2004 definition) with adenocarcinoma in situ and for the introduction of minimally invasive adenocarcinoma. There is also a discussion of diagnosis of non-small-cell lung carcinomas in the small biopsy or cytology setting, a practice that was inadequately addressed in WHO 2004, yet this is much more relevant to most pathologists’ daily practice because 85% or so of adenocarcinomas are never resected. Predictive immunohistochemistry, used correctly, can reduce non-specific diagnosis to less than 10% of the cases. Finally, there is an overview of the emerging data on therapeutically relevant lung adenocarcinoma genetics, considering targetable mutations that are now the focus of much activity. The clinical relevance of these changes is discussed.
Impact of SAMMPRIS on the future of intracranial atherosclerotic disease management: polling results from the ICAD symposium at the International Stroke Conference
Authors: Zaidat Osama O , Castonguay Alicia C , Nguyen Thanh N , Becker Kyra J , Derdeyn Colin P , Nelson Peter K , Amarenco Pierre , Brott Thomas G 
Published: April 2013

ObjectiveThere are few data regarding the effect of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial results on the management of intracranial atherosclerotic disease (ICAD). We sought to understand the impact of the SAMMPRIS trial on current ICAD clinical practices and future trial design.MethodsDuring the ICAD symposium at the 2012 International Stroke Conference, electronic data were collected regarding attendees’ clinical management of ICAD and opinions on the feasibility of future trials post-SAMMPRIS.Results217 attendees from different specialties, including neurologists (57%), neurointerventionalists (9%) and neurosurgeons (5%), participated in the session. The majority of respondents (77%) indicated that the results of SAMMPRIS have impacted their consideration for intracranial stenting. Post-SAMMPRIS, 84% selected ‘SAMMPRIS-style’ medical management for the treatment of ICAD. For patients with ICAD who failed aggressive medical therapy, 82% would consider an alternative approach to continuing medical therapy (30% considered clinical trial enrollment, 28% suggested angioplasty and stenting and 24% angioplasty). The majority of participants (85%) were willing to randomize patients with symptomatic ICAD in future trials. For the next ICAD trial, 29% indicated that angioplasty alone should be compared with aggressive medical therapy.ConclusionsOur polling results suggest that the SAMMPRIS trial has had an impact on the current treatment of ICAD. Treatment of patients who failed medical therapy varied widely from aggressive medical therapy to balloon angioplasty, stenting or enrollment in future clinical trials. The willingness to continue clinical trials and randomize patients supports the need for future ICAD studies.
On an Extension of Kummer's Second Theorem
Authors: Rakha Medhat A. , Awad Mohamed M. , Rathie Arjun K. 
Published: April 2013

The aim of this paper is to establish an extension of Kummer's second theorem in the form  e-x/2F22[a,2+d;x2a+2,d;]=F10[-;x2/16a+3/2;]+((a/d-1/2)/(a+1))x F10[-;x2/16a+3/2;]+(cx2/2(2a+3))F10[-;x2/16a+5/2;], where c=1/a+11/2-a/d+a/d(d+1),  d≠0,-1,-2,…. Ford=2a, we recover Kummer's second theorem. The result is derived with the help of Kummer's second theorem and its contiguous results available in the literature. As an application, we obtain two general results for the terminatingF23(2)series. The results derived in this paper are simple, interesting, and easily established and may be useful in physics, engineering, and applied mathematics.
Diagnosing Contact Processes from their Outcomes: The Importance of Life Stages
Authors: Ross Malcolm 
Published: April 2013

This paper addresses the questions, Do bilingually induced and shift-induced change have different outcomes? If they do, can these differences assist us in reconstructing the prehistoric past, specifically the linguistic prehistory of the (smallscale neolithic) societies of Melanesia.
A key to better interpreting differences in the outputs of contact-induced change is to understand how such change in smallscale societies actually occurs. I argue that it is important to know the life-stage loci of change. I suggest that language shift has two life-stage loci, one in early childhood, where evidence of shift, if any, is restricted to specialist lexicon, and one in adulthood. Adult language shift appears to have been rare in Melanesia. I also suggest that bilingually induced change, which entails the syntactic restructuring of one’s heritage language on the model of a second language, takes place among preadolescent children–a claim which is supported by various kinds of evidence.
This understanding helps us in turn to interpret the outcomes of contact-induced change and to infer prehistoric events, since adult second-language learning typically leads to simplification, whilst childhood language learning may lead to an increase in complexity.
Ukrainian in the Language Map of Central Europe: Questions of Areal-Typological Profiling
Authors: Danylenko Andrii 
Published: April 2013

The paper deals with the areal-typological profiling of Ukrainian among languages of Europe, constituting Standard Average European (SAE) and especially Central European (CE). Placed recently in the context of the ‘areal typology’ and the ‘dynamic taxonomy’, Ukrainian together with Russian and Belarusian appear to be mere replica languages. Such languages are capable of only borrowing surface structures migrating all over the Europe unie or imitating deep structures on the model of SAE or CE.
In order to elaborate on an alternative profiling of Ukrainian among languages of (Central) Europe, the author concentrates on both phonological and morphosyntactic features treated commonly as CE Sprachbund-forming (the spirantization of *g, the dispalatalization of the palatalized consonants, the existence of medial l, the umlauting, the three-tense system, including a simple preterit from the perfect, and the periphrastic ‘ingressive’ future). As a result, the author advances another vector of areal classification, thus positioning Russian in the core of ‘Standard Average Indo-European’ and (Southwest) Ukrainian as an intermediate language between Russian and the rest of (Central) European languages.
Preaspiration in Shetland Norn
Authors: Knooihuizen Remco 
Published: April 2013

The Shetland dialect of Scots does not contain preaspiration, a phonetic areal feature that is otherwise prevalent in languages around the North Atlantic Ocean. While it is understood that Shetland’s pre-language shift Scandinavian variety, Norn, did contain preaspiration, an analysis of phonetic transcriptions from Jakob Jakobsen’s An Etymological Dictionary of the Norn Language in Shetland, collected in the 1890s, shows a more complicated picture: preaspiration occurs in only 11% of relevant vowel-stop sequences, but in 92% of relevant sonorant-stop and sonorant-fricative sequences.
This article provides a contact-based explanation of the gradual disappearance of preaspiration from Shetland. The proposed trajectory of change is made up of a series of language and dialect contact-induced sub-changes and reflects the influence of Norn as well as of successive waves of immigration from the Scottish mainland. In the first stage, during language shift, preaspiration in vowel-stop sequences disappeared as it (co-)signaled a phonemic contrast in Norn not necessary for Scots, but (non-phonemic) preaspiration in sonorant-stop/fricative sequences was retained. In a later stage, dialect contact after renewed immigration from the Scottish mainland caused voiceless stops to be unaspirated, removing the phonetic basis for preaspiration also in the remaining contexts.
The study highlights the different susceptibility of phonetic and phonemic features in contact-induced change and calls for further integration of second-language acquisition study and variationist sociolinguistics into historical linguistics.
Externally Forced and Internally Generated Decadal Climate Variability Associated with the Interdecadal Pacific Oscillation
Authors: Meehl Gerald A. , Hu Aixue , Arblaster Julie M. , Fasullo John , Trenberth Kevin E. 
Published: April 2013

AbstractGlobally averaged surface air temperatures in some decades show rapid increases (accelerated warming decades), and in other decades there is no warming trend (hiatus decades). A previous study showed that the net energy imbalance at the top of the atmosphere of about 1 W m−2 is associated with greater increases of deep ocean heat content below 750 m during the hiatus decades, while there is little globally averaged surface temperature increase or warming in the upper ocean layers. Here the authors examine processes involved with accelerated warming decades and address the relative roles of external forcing from increasing greenhouse gases and internally generated decadal climate variability associated with interdecadal Pacific oscillation (IPO). Model results from the Community Climate System Model, version 4 (CCSM4), show that accelerated warming decades are characterized by rapid warming of globally averaged surface air temperature, greater increases of heat content in the upper ocean layers, and less heat content increase in the deep ocean, opposite to the hiatus decades. In addition to contributions from processes potentially linked to Antarctic Bottom Water (AABW) formation and the Atlantic meridional overturning circulation (AMOC), the positive phase of the IPO, adding to the response to external forcing, is usually associated with accelerated warming decades. Conversely, hiatus decades typically occur with the negative phase of the IPO, when warming from the external forcing is overwhelmed by internally generated cooling in the tropical Pacific. Internally generated hiatus periods of up to 15 years with zero global warming trend are present in the future climate simulations. This suggests that there is a chance that the current observed hiatus could extend for several more years.
SUNA and red ear syndrome: a new association and pathophysiological considerations
Authors: Lambru Giorgio , Bakar Norazah Abu , Matharu Manjit 
Published: April 2013

Abstract
Red ear syndrome (RES) is characterised by attacks of unilateral or bilateral burning ear pain associated with erythema. Primary and secondary forms have been described. Primary RES appears to have a frequent association with primary headaches especially migraine. Here, we describe the case of a woman with short-lasting unilateral neuralgiform attacks with cranial autonomic symptoms (SUNA) and recurrent episodes of ipsilateral red ear triggerable by cutaneous stimulation. Lamotrigine was beneficial for her SUNA but not for the RES. Both these disorders are extremely rare therefore their coexistence in the same individual may suggest similar pathophysiological mechanisms rather than a chance association.
Identification of genes related to agarwood formation: transcriptome analysis of healthy and wounded tissues of Aquilaria sinensis
Authors: Xu Yanhong , Zhang Zheng , Wang Mengxi , Wei Jianhe , Chen Hongjiang , Gao Zhihui , Sui Chun , Luo Hongmei , Zhang Xingli , Yang Yun , Meng Hui , Li Wenlan 
Published: April 2013

AbstractBackgroundAgarwood is an expensive resinous heartwood derived fromAquilariaplants that is widely used in traditional medicines, incense and perfume. Only wounded trees can produce agarwood, and the huge demand for the agarwood products has led allAquilariaspp. being endangered and listed in the Appendix II of the CITES (http://www.cites.org). The major components of agarwood are sesquiterpenes and phenylethyl chromones. Owing to a lack of genomic information, the molecular basis of wound-induced sesquiterpenes biosynthesis and agarwood formation remains unknown.ResultsTo identify the primary genes that maybe related to agarwood formation, we sequenced 2 cDNA libraries generated from healthy and woundedA. sinensis(Lour.) Gilg. A total of 89,137 unigenes with an average length of 678.65 bp were obtained, and they were annotated in detail at bioinformatics levels. Of those associated with agarwood formation, 30 putatively encoded enzymes in the sesquiterpene biosynthesis pathway, and a handful of transcription factors and protein kinases were related to wound signal transduction. Three full-length cDNAs of sesquiterpene synthases (ASS1-3) were cloned and expressed inEscherichia coli, and enzyme assays revealed that they are active enzymes, with the major products being δ-guaiene. A methyl jasmonate (MJ) induction experiment revealed that the expression ofASSwas significantly induced by MJ, and the production of sesquiterpenes was elevated accordingly. The expression of some transcription factors and protein kinases, especiallyMYB4,WRKY4,MPKK2andMAPK2, was also induced by MJ and coordinated withASSexpression, suggesting they maybe positive regulators ofASS.ConclusionsThis study provides extensive transcriptome information forAquilariaspp.and valuable clues for elucidating the mechanism of wound-induced agarwood sesquiterpenes biosynthesis and their regulation.