bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of acenocoumarol on the antiplatelet effect of clopidogrel
Authors: Bergmeijer Thomas , Kelder Johannes , Hackeng Christian , ten Berg Jurriën , Dewilde Willem , Janssen Paul 
Published: July 2015

SummaryPatients exhibiting high on-clopidogrel platelet reactivity (HPR) are at an increased risk of atherothrombotic events following percutaneous coronary interventions (PCI). The use of concomitant medication which is metabolised by the hepatic cytochrome P450 system, such as phenprocoumon, is associated with HPR. We assessed the level of platelet reactivity on clopidogrel in patients who received concomitant treatment with acenocoumarol (another coumarin derivative). Patients scheduled for PCI were included in a prospective, single centre, observational registry. Patients who were adequately pre-treated with clopidogrel were eligible for this analysis, which included 1,582 patients, of whom 104 patients (6.6 %) received concomitant acenocoumarol treatment. Platelet reactivity, as measured with the VerifyNow P2Y12 assay and expressed in P2Y12 Reaction Units (PRU), was significantly higher in patients on concomitant acenocoumarol treatment (mean PRU 229 ± 88 vs 187 ± 95; p< 0.001). In patients with concomitant acenocoumarol use, the proportion of patients with HPR was higher, defined as PRU > 208 (57.7 % vs 41.1 %; p=0.001) and PRU236 (49.0 % vs 31.4 %; p< 0.001). In multivariable analysis, concomitant acenocoumarol use was independently associated with a higher PRU and the occurrence of HPR defined as PRU236 (OR 2.00, [1.07–3.79]), but not with HPR defined as PRU > 208 (OR 1.37, [0.74–2.54]). PRU also was significantly increased after 1:1 propensity matching (+28.2; p< 0.001). As this was an observational study, confounding by indication cannot be excluded, although multivariable analyses and propensity matching were performed. The impact of the findings from this hypothesis-generating study on clinical outcome requires further investigation.
Trends and Natural Variability of Spring Onset in the Coterminous United States as Evaluated by a New Gridded Dataset of Spring Indices
Authors: Ault Toby R. , Schwartz Mark D. , Zurita-Milla Raul , Weltzin Jake F. , Betancourt Julio L. 
Published: July 2015

Abstract
Climate change is expected to modify the timing of seasonal transitions this century, impacting wildlife migrations, ecosystem function, and agricultural activity. Tracking seasonal transitions in a consistent manner across space and through time requires indices that can be used for monitoring and managing biophysical and ecological systems during the coming decades. Here a new gridded dataset of spring indices is described and used to understand interannual, decadal, and secular trends across the coterminous United States. This dataset is derived from daily interpolated meteorological data, and the results are compared with historical station data to ensure the trends and variations are robust. Regional trends in the first leaf index range from −0.8 to −1.6 days decade−1, while first bloom index trends are between −0.4 and −1.2 for most regions. However, these trends are modulated by interannual to multidecadal variations, which are substantial throughout the regions considered here. These findings emphasize the important role large-scale climate modes of variability play in modulating spring onset on interannual to multidecadal time scales. Finally, there is some potential for successful subseasonal forecasts of spring onset, as indices from most regions are significantly correlated with antecedent large-scale modes of variability.
Canalplasty for Exostoses With Maximal Skin Preservation With Temporoparietal Fascia Grafting and Use of Bone Wax for Skin Flap Protection
Authors: Moss William J. , Lin Harrison W. , Cueva Roberto A. 
Published: July 2015

Background: External auditory canal exostoses are benign, bony overgrowths that arise in patients who experience chronic cold water exposure. While considerable advancement has been made in canalplasty techniques in recent decades, many patients continue to experience prolonged healing periods and recurrent stenosis following surgery. Objective: To perform a retrospective outcomes analysis of our experience with a skin-preserving canalplasty technique with temporoparietal fascia grafting and use of bone wax for skin flap protection. Study Design: Retrospective review. Subjects and Methods: Thirty-four patients (41 ears) underwent canalplasty from 2008 to 2014 at a tertiary referral center. Primary outcome measures included rates of prolonged healing and restenosis, need for revision surgery, and audiometric results. Rates of intraoperative and postoperative complications were also tabulated. Results: No patient experienced recurrent stenosis or required a revision surgery within the follow-up period. All but one patient (97%) achieved complete healing within 8 weeks. Minimal intraoperative complications were found. Statistically significant improvements in air pure tone averages and air-bone gaps were achieved. Conclusion: The proposed technique is a safe and effective method of canalplasty for exostoses that imparts accelerated wound healing and minimizes the rate of recurrent stenosis.
Effects of Balloon Dilation for Idiopathic Laryngotracheal Stenosis on Voice Production
Authors: Hoffman Matthew R. , Brand William T. , Dailey Seth H. 
Published: July 2015

Objective: To evaluate the effects of balloon dilation for idiopathic laryngotracheal stenosis on voice production. Methods: Retrospective review of 10 female patients with idiopathic laryngotracheal stenosis undergoing balloon dilation. Voice outcomes were evaluated by comparing pre- and posttreatment patient-reported, perceptual, aerodynamic, and acoustic parameters. Complete data sets were not available for all subjects; sample size for each parameter is reported with the corresponding result. Results: Total Voice Handicap Index (VHI) decreased significantly (22.9 ± 13.5 to 6.8 ± 6.5; n = 8; p = .015), as did glottal function index (7.2 ± 4.9 to 1.5 ± 2.0; n = 6; p = .022). No changes were observed in the GRBAS (grade, roughness, breathiness, asthenia, strain) scale. Changes in aerodynamic parameters were not statistically significant. Percent jitter decreased (1.32 ± 1.37 to 0.60 ± 0.29; n = 7; P = .078), and fundamental frequency range was preserved (507 ± 325 to 612 ± 281; n = 7; P = .309). Conclusions: Our sample of patients with idiopathic laryngotracheal stenosis had a mild-moderate dysphonia that improved with balloon dilation. Importantly, adverse effects on voice that can occur with open procedures were not observed. Patient perception of dysphonia improved while fundamental frequency range was maintained and aerodynamic parameters remained within or moved toward the normal range. Larger prospective studies are warranted to further evaluate changes in voice production associated with balloon dilation.
Damage Control and the Open Abdomen
Authors: Griggs Cornelia , Butler Kathryn 
Published: July 2015

Background: As strategies in acute care surgery focus on damage control to restore physiology, intensivists spanning all disciplines care for an increasing number of patients requiring massive transfusion, temporary abdominal closures, and their sequelae. Objective: To equip the nonsurgical intensivist with evidence-based management principles for patients with an open abdomen after damage control surgery. Data Source: Search of PubMed database and manual review of bibliographies from selected articles. Data Synthesis and Conclusions: Temporary abdominal closure improves outcomes in patients with abdominal compartment syndrome, hemorrhagic shock, and intra-abdominal sepsis but creates new challenges with electrolyte derangement, hypovolemia, malnutrition, enteric fistulas, and loss of abdominal wall domain. Intensive care of such patients mandates attention to resuscitation, sepsis control, and expedient abdominal closure.
Effect of pretreatment with hydromorphone or buprenorphine on thermal antinociception induced by fentanyl in awake cats
Authors: Ambros Barbara 
Published: July 2015

Objectives The aim of this study was to determine the effect of pretreatment with hydromorphone or buprenorphine on thermal antinociception induced by fentanyl in cats. Methods Seven healthy cats received five different treatments consisting of two drugs. Drug 1 was administered intravenously 1 h before drug 2. Drug 2 was given as an intravenous loading dose followed by an infusion for 4 h. The drug combinations used were: buprenorphine 20 µg/kg followed by fentanyl (BF; 7 μg/kg, 7 μg/kg/h), buprenorphine 20 µg/kg followed by 0.9% saline solution (B), hydromorphone 0.07 mg/kg followed by 0.9% saline solution (H), hydromorphone 0.07 mg/kg followed by fentanyl (HF; 7 μg/kg, 7 μg/kg/h) and 0.9% saline solution followed by fentanyl (F; 7 μg/kg, 7 μg/kg/h). Thermal thresholds were obtained prior to treatment and at predetermined times up to 7 h after drug 1. Results Thermal thresholds were significantly higher than baseline in all treatment groups as follows: H from 0.25 to 2.50 h; B from 0.25 to 2.50 h; F from 1.25 to 5.50 h; HF from 0.25 to 5.50 h and BF from 0.25 to 5.25 h. Thermal thresholds were significantly higher in HF and BF than in F treatment before the fentanyl infusion was commenced (from 0.25 to 1.00 h). During the fentanyl infusion thermal thresholds in BF compared with F were lower at 1.75 h and from 2.50 to 3.50 h. After the constant rate infusion of fentanyl was started, thermal thresholds were significantly lower in HF compared with F at one time point (3 h). Conclusions and relevance Pretreatment with buprenorphine did partially inhibit the antinociceptive action of fentanyl. Hydromorphone did inhibit the antinociceptive action of fentanyl at one single time point in cats.
Laser Therapy for an Acquired Glomuvenous Malformation (Glomus Tumour)
Authors: Rivers Jason K. , Rivers Catherine A. , Li Monica K. , Martinka Magdalena 
Published: July 2015

Background: Glomuvenous malformations (GVMs) (previously known as glomus tumours) are uncommon, benign, vascular neoplasms. Current treatments include surgical excision and sclerotherapy, often with high recurrence rates and poor cosmetic results. Objective: We sought to use a nonsurgical approach for treatment of a GVM. Methods: We present a patient with an acquired, biopsy-proven GVM of the heel unamenable to surgical excision, treated with a long pulsed 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. Results: Excellent cosmesis and long-term remission were achieved after several treatment sessions. Conclusion: Our experience provides further evidence to support the safety and effectiveness of the 1064-nm Nd:YAG laser in the management of large and surgically challenging GVMs.
Intra-aneurysmal microcatheter looping technique for stent-assisted embolization of complex intracranial aneurysms
Authors: Wang C-C , Lv N , Feng Z-Z , Li Z-F , Zhao R , Li Q , Liu J-M , Huang Q-H 
Published: July 2015

The endovascular treatment of wide-necked, large and giant aneurysms remains challenging. This retrospective study investigated the feasibility and safety of an intra-aneurysmal microcatheter looping technique for stent-assisted embolization of complicated intracranial aneurysms. This technique was used for 31 patients with complicated cerebral aneurysms from January 2007 to November 2013. The clinical and angiographic results were retrospectively evaluated. The target aneurysms were successfully treated in all cases (100%). A flow diverter was used in seven procedures. There were no aneurysmal perforations or ischemic complications, except for a microguidewire perforation of the distal vessel in one case. Among the 24 cases with conventional stent-assisted embolization, complete embolization or neck residual was obtained in 21 cases. Partial occlusion occurred in three cases. In conclusion, the intra-aneurysmal microcatheter looping technique is a safe and feasible alternative treatment of complicated intracranial aneurysms. This approach is a reasonable choice for patients and leads to successful outcomes.
Informed consent in clinical research: Consensus recommendations for reform identified by an expert interview panel
Authors: Lorell Beverly H , Mikita J Stephen , Anderson Annick , Hallinan Zachary P , Forrest Annemarie 
Published: July 2015

Background Informed consent is the cornerstone for protection of human subjects in clinical trials. However, a growing body of evidence suggests that reform of the informed consent process in the United States is needed. Methods The Clinical Trials Transformation Initiative conducted interviews with 25 experienced observers of the informed consent process to identify limitations and actionable recommendations for change. Results There was broad consensus that current practices often fail to meet the ethical obligation to inform potential research participants during the informed consent process. The most frequent single recommendation, which would affect all participants in federally regulated clinical research, was reform of the informed consent document. The interviews also identified the need for reform of clinical research review by institutional review boards, including transitioning to a single institutional review board for multi-site trials. Conclusion The consensus recommendations from the interviewees provide a framework for meaningful change in the informed consent process. Although some proposed changes are feasible for rapid implementation, others such as substantive reform of the informed consent document may require change in federal regulations.
Paediatric toe-to-hand transfer: an assessment of outcomes from a single unit
Authors: Nikkhah D. , Martin N. , Pickford M. 
Published: July 2015

Toe-to-hand transfer is an acceptable treatment option for children born with absent digits. Toe transfer can provide functionally useful digits and may enhance patient wellbeing. A total of 19 children had 31 free second-toe-to-hand microsurgical transfers between 1998 and 2012. The mean age of these children at the time of the first operation was 45 months. All transferred toes survived. The donor site was satisfactory in all 19 patients. Twelve children (19 toes) attended a special review clinic; all children could grasp large objects (Duplo bricks) after toe transfer. The total passive range of motion was greater than total active range of motion by an average of 54 degrees. Static 2-point discrimination was generally excellent (mean = 5 mm). Eleven out of 12 children strongly agreed that their toe transfer had improved hand function. Microsurgical toe-to-hand transfer is a safe and reliable technique that can provide useful function for children with congenital differences. Our series compares favourably with the published literature. Level of evidence: IV
Comprehensive Coach Education and Practice Contact Restriction Guidelines Result in Lower Injury Rates in Youth American Football
Authors: Kerr Zachary Y. , Yeargin Susan , Valovich McLeod Tamara C. , Nittoli Vincent C. , Mensch James , Dodge Thomas , Hayden Ross , Dompier Thomas P. 
Published: July 2015

Background: Research evaluating the effect of comprehensive coach education and practice contact restriction in youth football injury rates is sparse. In 2012, USA Football released their Heads Up Football coaching education program (HUF), and Pop Warner Football (PW) instituted guidelines to restrict contact during practice. Purpose: To compare injury rates among youth football players aged 5 to 15 years by whether their leagues implemented HUF and/or were PW-affiliated. Study Design: Cohort study; Level of evidence, 2. Methods: Athletic trainers (ATs) evaluated and tracked injuries at each practice and game during the 2014 youth football season. Players were drawn from 10 leagues across 4 states. The non–Heads Up Football (NHUF) group consisted of 704 players (none of whom were PW-affiliated) from 29 teams within 4 leagues. The HUF+PW group consisted of 741 players from 27 teams within 2 leagues. The HUF-only group consisted of 663 players from 44 teams within 4 leagues. Injury rates and injury rate ratios (IRRs) were reported with 95% CIs. Results: A total of 370 injuries were reported during 71,262 athlete-exposures (AEs) (rate, 5.19/1000 AEs). Compared with the NHUF group (7.32/1000 AEs), the practice injury rates were lower for the HUF+PW group (0.97/1000 AEs; IRR, 0.13; 95% CI, 0.08-0.21) and the HUF-only group (2.73/1000 AEs; IRR, 0.37; 95% CI, 0.26-0.53). Compared with the NHUF group (13.42/1000 AEs), the game injury rate was lower for the HUF+PW group (3.42/1000 AEs; IRR, 0.25; 95% CI, 0.15-0.44) but not for the HUF-only group (13.76/1000 AEs; IRR, 1.02; 95% CI, 0.73-1.43). Also, the HUF+PW game injury rate was lower than that of HUF-only (IRR, 0.20; 95% CI, 0.12-0.36). Higher injury rates were typically found in those aged 11 to 15 years compared with those aged 5 to 10 years. However, stronger effects related to HUF implementation and PW affiliation were seen among 11- to 15-year-olds. When restricted to concussions only, the sole difference was found between the practice concussion rates among 11- to 15-year-olds in the HUF+PW (0.14/1000 AEs) and NHUF groups (0.79/1000 AEs) (IRR, 0.18; 95% CI, 0.04-0.85). Conclusion: These findings support comprehensive coach education and practice contact restrictions as effective methods of injury mitigation. Future research should continue evaluating similar programming within other levels of competition and sports.
Dignity Reevaluated: A Theological Examination of Human Dignity and the Role of the Church in Bioethics and End-of-Life Care
Authors: Genuis Quentin I. T. 
Published: July 2015

Predominant among the terminological ambiguities that plague contemporary bioethics is confusion attending the meaning of the term “human dignity,” particularly as it applies to so-called end-of-life discussions. This study surveys current trends in treatment of the concept of dignity, examining relevant thinkers who see dignity as redundant or as capability-dependent. These inadequate views are contrasted with an attitude, based theologically in Mark 5, that understands human dignity to represent an absolute characteristic that is donated graciously to all bearers of imago Dei. Human dignity must thus be affirmed as inviolable and independent of autonomy, rationality, or capability. A specific task of the Christian Church is to faithfully recognize and proclaim this dignity. This investigation is particularly relevant in the face of contemporary discussions regarding euthanasia and physician-assisted death. Lay Summary: Much of the polarization within the contemporary bioethical discussion proceeds out of confusion regarding how we ought to define the terms of the debate. If we may take the existing debates regarding euthanasia and physician-assisted death as an example, we may understand the vital need for a sensible definition of the term that stands at the heart of the arguments of both sides of the debate: “human dignity.” As such, this study seeks to define dignity in a logical, theological, deeply personal, and highly practical fashion, and to outline the critical role of the Church within such an understanding. Sometimes, when I walk into the room, he ignores me. Sometimes he thinks I am someone else. Most often he is asleep, subjugated by drugs designed to prevent agitation, although “agitation” is the sterilized hospital word for what I would call unbridled panic, total disorientation. The night he had the stroke, they had to tie him to the bed just to keep him in the hospital. And they wouldn't let me see him because he had been calling my name. Very dramatic, but most of his suffering, and our grief, is not dramatic. It is just the mundane process of one man slowly fading, becoming, every day, more of a stranger to himself and to those he loves.
Further generalized contraction mapping principle and best proximity theorem in metric spaces
Authors: Su Yongfu , Yao Jen-Chih 
Published: July 2015

AbstractThe aim of this paper is to prove a more generalized contraction mapping principle. By using this more generalized contraction mapping principle, a further generalized best proximity theorem was established. Some concrete results have been derived by using the above two theorems. The results of this paper improve many important results published recently in the literature.
Implementation of searchable symmetric encryption for privacy-preserving keyword search on cloud storage
Authors: Salam Md Iftekhar , Yau Wei-Chuen , Chin Ji-Jian , Heng Swee-Huay , Ling Huo-Chong , Phan Raphael C-W , Poh Geong Sen , Tan Syh-Yuan , Yap Wun-She 
Published: July 2015

AbstractEnsuring the cloud data security is a major concern for corporate cloud subscribers and in some cases for the private cloud users. Confidentiality of the stored data can be managed by encrypting the data at the client side before outsourcing it to the remote cloud storage server. However, once the data is encrypted, it will limit server’s capability for keyword search since the data is encrypted and server simply cannot make a plaintext keyword search on encrypted data. But again we need the keyword search functionality for efficient retrieval of data. To maintain user’s data confidentiality, the keyword search functionality should be able to perform over encrypted cloud data and additionally it should not leak any information about the searched keyword or the retrieved document. This is known as privacy preserving keyword search. This paper aims to study privacy preserving keyword search over encrypted cloud data. Also, we present our implementation of a privacy preserving data storage and retrieval system in cloud computing. For our implementation, we have chosen one of the symmetric key primitives due to its efficiency in mobile environments. The implemented scheme enables a user to store data securely in the cloud by encrypting it before outsourcing and also provides user capability to search over the encrypted data without revealing any information about the data or the query.
Perceptions and experiences of HIV and acceptability of vaginal microbicides in Zambia
Authors: Maimbolwa Margaret , Rice Valerie Montgomery , Nkandu Esther Munalula , Hildreth James EK 
Published: July 2015

Background/Aims: The development of vaginal microbicides for sexually transmitted infections (STIs) is a welcome clinical and research intervention for countries heavily burdened with HIV and AIDS. These microbicides are formulated as gels, creams, films and suppositories, and work by either providing a physical barrier that keeps HIV and other pathogens from reaching the target cells or by enhancing the natural vaginal defence mechanisms. This study examines women's and men's perceptions on STIs and acceptability of vaginal microbicides. Methods: An exploratory qualitative research study using five focus group discussions was conducted in the Kafue and Mumbwa districts in Zambia between 2009 and 2010. Five themes were identified: i) knowledge about HIV/AIDS; ii) condom use; iii) women's options and the challenges of using existing interventions; iv) use and acceptability of a placebo microbicide gel; v) partner involvement. Results: In general, participants were knowledgeable about the modes of HIV transmission and prevention. The majority of participants believed that condom use was the man's decision and current available HIV prevention techniques are often not controlled by women. Although the availability and use of microbicides would greatly empower women to protect themselves and their partner, many women have little control over their choice of contraception. Conclusions: Most social science research to date has confirmed the urgent need women feel for an HIV prevention method that they can control, particularly in countries with a severe generalised HIV epidemic. In this study, women and men expressed positive attitudes toward the use of microbicides.