bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a full-body digital X-ray imaging system in acute medical emergencies: a systematic review
Authors: Yang Lei , Ye Li-gang , Ding Jian-bo , Zheng Zhong-jun , Zhang Mao 
Published: December 2014

BackgroundTo evaluate the available evidence for the clinical effectiveness and biohazard safety of a full-body digital X-ray imaging system (Lodox) in acute medical emergencies.MethodsElectronic databases (including PubMed, Embase and the Cochrane Library; up to January 2014) and reference lists of articles were searched. The quality of the included studies was determined, and a narrative assessment was undertaken.ResultsA total of 256 articles were reviewed. Fifteen clinical studies and eight case series met the eligibility criteria. All 23 studies reporting use of a full-body X-ray imaging system in acute medical emergencies on Lodox. Based on figures in six studies comprising various evaluation methods, image quality of Lodox was mostly comparable to that of conventional X-rays and the radiation dose was considerably lower. Lodox demonstrated a sensitivity ranging from 62% to 73%, and a specificity ranging from 99% to 100% compared with CT for the evaluation of emergency patients with polytrauma, which is similar to that of conventional X-rays. Examination time using Lodox ranged from 3.5  to 13.9 min compared with 8 to 25.7 min using conventional X-rays. However, there was no evidence it significantly shortened resuscitation time or emergency department length of stay. Publication bias might have occurred; some published studies might have been influenced by conflicts of interest.ConclusionsThe Lodox machine is capable of rapidly scanning the entire body and offers an equivalent diagnostic assessment tool compared with conventional X-rays. It seems to have the potential to reduce cumulative radiation dosage for emergency patients compared with conventional X-rays. Application of Lodox might be helpful to reduce resource use and simplify care in lower-resourced areas.
Growth patterns of white British and Pakistani children in the Born in Bradford cohort: a latent growth modelling approach
Authors: Mebrahtu Teumzghi F , Feltbower Richard G , Petherick Emily S , Parslow Roger C 
Published: December 2014

BackgroundChildhood growth patterns have been proposed as a key predictor of health during childhood and adult life. In earlier studies, however, the statistical methodologies employed failed to uncover the more subtle patterns in growth trajectories.MethodsStudy participants were 1364 singleton term children (602 white British and 762 Pakistani origin) drawn from the Born in Bradford (BiB) prospective cohort. Weights were measured at 0, 1, 3, 6, 12, 18, 24 and 36 months. Age-specific and sex-specific standardised weight scores were derived based on the World Health Organisation growth standards. Missing growth data were estimated using Full Information Maximum Likelihood (FIML) method. Growth Mixture Model was used to analyse growth patterns of children from birth until 36 months.ResultsOn average, Pakistani children were 190 g lighter than white British children at birth. Based on our Growth Mixture Model results, the study children had three distinct growth patterns: ‘normal growers’ (95.9%), ‘fast growers’ (2.5%) and ‘slow growers’ (1.6%). The Pakistani children were more likely to be in either the ‘fast’ (OR=2.90; 95% CI 0.91 to 9.25) or ‘slow’ (OR=15.63; 95% CI 1.06 to 230) grower class than the white British. Pakistani children showed faster growth than the white British between 3 and 36 months of age.ConclusionsIn this growth study we have identified that the study children have three distinct growth patterns. These growth patterns may provide greater insight in predicting the risk of childhood or early adulthood diseases in life-course studies.
THE EFFECT OF SHIFT WORK ON CORTISOL PRODUCTION IN FEMALE HOSPITAL EMPLOYEES: STUDY IN PROGRESS
Authors: Hung E , Aronson KJ , Corbin R , Tranmer J 
Published: December 2014

IntroductionCardiovascular disease (CVD) is currently the leading cause of death worldwide, contributing to 30% of all deaths. CVD etiology is complex, with many modifiable and non-modifiable risk factors. Epidemiological evidence generally supports an association between shiftwork and an increased risk for CVD. However, the underlying physiological mechanisms remain poorly understood. Limited research suggests that the production of cortisol may differ between shift workers and non-shift workers, resulting in physiological changes that potentially increase the risk of CVD among shift workers. This study will focus on females who comprise the largest proportion of workers in healthcare settings.Objectives 1) To describe and compare total cortisol levels and its diurnal pattern in relation to current shiftwork status, and cumulative duration of exposure to shiftwork. 2) To determine if current shiftwork status and/or cumulative duration are associated with total cortisol levels, and diurnal pattern.Study design and methodsFemale participants were recruited from a tertiary acute care teaching hospital in southeastern Ontario, Canada between September 2011 and February 2014 (n=330). An interview and a questionnaire were used to ascertain shiftwork exposure, and covariate information. Urine samples were provided at every void over a 48-hour period to approximate free cortisol levels. A multivariate regression model will be used to describe, and determine the significance of the effect of shiftwork on total cortisol and its diurnal pattern.HypothesesWe anticipate that the overall production of cortisol will be higher in current shift workers than non-shift workers. Cumulative duration of shiftwork exposure will be associated with higher total cortisol levels and with cortisol patterns in a dose-dependent manner.RelevanceShift work is a highly prevalent work pattern: approximately 30% of Canadians are employed in shift work positions. Determining the mechanisms through which shiftwork may influence CVD has the potential to inform interventions.
MAPPING DAIRY COW HEAT STRESS IN SOUTHERN ONTARIO—A COMMON GEOGRAPHIC PATTERN FROM 2010–2012
Authors: Bishop-Williams KE , Berke O , Pearl DL , Kelton DF 
Published: December 2014

In Southern Ontario, climate change has resulted in an increased occurrence of heat waves, causing heat stress among humans and livestock, with potentially fatal consequences. Heat waves are defined as three consecutive days of temperatures greater than or equal to 32°C. Maps visualizing the distribution of heat stress can provide information about related health risks and insight for control strategies.Weather data were collected from weather stations throughout Southern Ontario for dry bulb temperature and dew point temperature. The Dairy Cow Heat Stress Index (HSI) was estimated by averaging the first three days for three heat waves, during 2010, 2011 and 2012. Geostatistical kriging was used to map three-day averages of maximum heat stress over periods involving a heat wave and control periods three weeks prior to and following heat waves.Average HSI for each period across Southern Ontario ranged from 55 to 78 during control periods, and from 65 to 84 during heat waves, surpassing levels where mortality is known to increase substantially. Heat stress followed a consistent geographic pattern with the most affected areas in the southern region of the study area, surrounding major metropolitan areas.These HSI maps indicate areas which are less optimal for dairy farming within the study boundary. Thus, some areas currently used for dairy farming and at high-risk for heat stress mortality may require heat abatement strategies to sustain dairy cow production as heat waves become more frequent and intense due to climate change.
COST UTILITY ANALYSIS OF BOTOX VS. ANTICHOLINERGIC MEDICATION FOR URINARY INCONTINENCE, DUE TO NEUROGENIC DETRUSOR OVERACTIVITY ASSOCIATED WITH SPINAL CORD INJURY OR MULTIPLE SCLEROSIS
Authors: Tang A , Goeree R , Blackhouse G , Tsoi B 
Published: December 2014

IntroductionUrinary incontinence (UI) negatively impacts quality of life, potentially contributing to depression, urinary tract infection, and renal impairment. Early treatment includes behavioural modification and anticholinergics. Among the general population, ∼40% of patients with overactive bladder do not improve with such treatment. Diapers, pads, and intermittent catheterization may also be used. When earlier options fail, surgery is considered. Botox was approved by Health Canada for UI due to neurogenic detrusor overactivity (NDO), resulting from neurogenic bladder associated with multiple sclerosis or subcervical spinal cord injury in adults who had an inadequate response to or are intolerant of anticholinergic medications.Botox is a sterile form of botulinum neurotoxin type A, derived from the anaerobic bacterium Clostridium botulinum. It is believed to prevent muscle contractions by temporarily blocking nerve impulses to the bladder muscle.ObjectiveTo evaluate whether the benefit in urinary incontinence patients with neurogenic detrusor overactivity treated with Botox provides good value for Ontario public funding.MethodsA Markov model was used to estimate population outcomes and costs for NDO patients, receiving either Botox or best supportive care (oxybutynin). A Cost Utility Analysis was conducted, using 3 month cycles with a 2 year time horizon (discounted at 5%), plus one-way and probabilistic sensitivity analyses.ResultsFrom the incremental cost-effectiveness ratio (ICER) of $9,710/QALY, Botox is more cost-effective compared to oxybutynin. From the cost-effectiveness acceptability curve (CEAC), at a maximum acceptable ceiling ratio of $50,000/QALY, the probability that Botox is cost-effective compared to oxybutynin is 0.987.ConclusionBased on ICER and CEAC, Botox appears to be a cost-effective intervention for urinary incontinence due to neurogenic detrusor overactivity compared with anticholinergic.
DEPRESSIVE SYMPTOMS, C-REACTIVE PROTEIN, AND INCIDENCE OF DIABETES
Authors: Au B , Smith KJ , Schmitz N 
Published: December 2014

IntroductionDepressive symptoms are associated with increased risk of incident diabetes. Inflammatory mechanisms have been suggested to be involved in depression and diabetes. Specifically, increased levels of C-reactive protein (CRP), a biomarker for inflammation, is associated with depression and have also been linked to risk of developing diabetes.ObjectiveTo assess the association of both CRP and depressive symptomatology with diabetes incidence in a representative sample of English people ≥50 years old.MethodsParticipants were 5475 community-dwelling men and women without diabetes at baseline from the English Longitudinal Study of Ageing (ELSA). Wave 2 of ELSA was used as baseline (first assessment of CRP), with assessment of diabetes incidence at waves 3, 4, and 5. Elevated depressive symptoms were based on a score ≥4 using the 8-item Center for Epidemiologic Studies Depression (CES-D) scale, and high CRP level was defined as >3 mg/L. Diabetes incidence was indicated by self-reported doctor diagnosis. Association of diabetes incidence with baseline CRP and depressive symptomatology groups was examined using multivariate logistic regression adjusted for socio-demographic, lifestyle, metabolic, and health variables.ResultsIn comparison to participants with normal CRP levels and low depressive symptoms, those with both high CRP and elevated depressive symptoms were more likely to develop diabetes over 6 years of follow-up (adjusted OR: 1.90, 95% CI: 1.10–3.30). Individuals with high CRP and low depressive symptoms (adjusted OR: 1.26, 95% CI: 0.89–1.78) and those with normal CRP and elevated depressive symptoms (adjusted OR: 1.55, 95% CI: 0.88–2.73) were not associated with diabetes incidence.ConclusionPeople with high CRP and elevated depressive symptoms are more likely to develop diabetes. Further analyses will examine the possible interactions between CRP and depression with diabetes incidence.
INTERRELATIONSHIPS AMONG SEDENTARY BEHAVIOUR, SHORT SLEEP, AND THE MEBAOLIC SYNDROME IN ADULTS
Authors: Saleh D , Janssen I 
Published: December 2014

IntroductionSedentary behaviour is gaining attention as an important cardiometabolic risk factor. Studies of sedentary behavior and cardiometabolic risk have not considered sleep duration, although there is evidence that sleep duration may be related to both sedentary behaviour and cardiometabolic risk.ObjectiveThe purpose of this study is to determine if sedentary behaviour is related to the metabolic syndrome (MetS) while controlling for sleep duration.MethodsThis cross-sectional study is based on the 2003–2006 National Health and Nutrition Examination Survey. A sample of 1371 adults over the age of 20 were studied. Average daily sedentary time and sleep duration were determined via 7-day accelerometry. Screen time was determined via questionnaire. The MetS was determined using standard criteria. Analysis of variance was used to examine relationships among sedentary time and screen time with sleep duration. Multiple logistic regression was used to examine associations between total sedentary time, screen time, and sleep duration with the MetS after controlling for several covariates.ResultsSedentary time and screen time did not vary across the sleep quartiles (p=0.08 and p=0.87, respectively). Participants in the highest quartile of sedentary time were significantly more likely to have the MetS than participants in the lowest quartile (odds ratio=1.60, 95% CI:1.05–2.45). The odds of the MetS was higher in participants in the highest screen time tertile as compared to the lowest tertile (odds ratio=1.67, 95% CI:1.13–2.48). Sleep duration was not independently related to the MetS.ConclusionHighly sedentary individuals and individuals with a high screen time are more likely to have the MetS.
Clinical significance of the circle of Willis in intracranial atherosclerotic stenosis
Authors: Kim Kang Min , Kang Hyun-Seung , Lee Woong Jae , Cho Young Dae , Kim Jeong Eun , Han Moon Hee 
Published: December 2014

IntroductionThe effectiveness of a scoring system based on the circle of Willis for evaluations of collateral circulation was studied in patients with intracranial atherosclerotic stenosis.MethodsEighty-three patients who underwent medical or endovascular treatment for symptomatic and severe intracranial atherosclerotic stenosis were enrolled in the study. Clinical profiles, status of the circle of Willis (poor and good integrity group), and clinical outcomes were analyzed. Primary endpoints were: (1) symptomatic ischemic or hemorrhagic stroke within 30 days; and (2) recurrent transient ischemic attack or ischemic stroke beyond 30 days.ResultsThe estimated rates of the primary endpoint at 1 and 2 years after treatment were 8.5% and 11.4% in the medical group and 7.0% and 9.7% in the endovascular group, respectively. A primary endpoint event after medical treatment was only identified in patients with poor integrity of the circle of Willis (p=0.059). In patients with poor integrity of the circle of Willis, previous antiplatelet medication before initial presentation (p=0.026) and hypertension (p=0.006) were more prevalent. During the follow-up period, complete arterial occlusion was identified in 9 patients. The circle of Willis score of the patients with complete arterial occlusion was 1.33±1.52 in the fatal stroke group (n=3) and 3.20±1.64 in the asymptomatic group (n=6, p=0.099).ConclusionsIf patients have poor integrity of the circle of Willis, the risk of recurrent stroke may be increased. Such patients appear to be good candidates for endovascular treatment.
Midkine Lacking Its Last 40 Amino Acids Acts on Endothelial and Neuroblastoma Tumor Cells and Inhibits Tumor Development
Authors: Dianat Noushin , Le Viet Barbara , Gobbo Emilie , Auger Nathalie , Bièche Ivan , Bennaceur-Griscelli Annelise , Griscelli Frank 
Published: December 2014

AbstractMidkine (MDK) is a member of a new family of neurotrophic factors considered as rate-limiting growth and angiogenic factors implicated in the onset, invasion, and metastatic process of neuronal tumors, including neuroblastoma. We showed that all neuroblastoma cell lines highly expressed MDK, indicating that it is a critical player in tumor development, which may henceforth represent an attractive therapeutic target. We showed that the knockdown of MDK expression by siRNA led to a marked and significant decrease in neuroblastoma (IGR-N91 and SH-SY5Y) cell proliferation in vitro. Using a new strategy, we then evaluated the antitumor effect of a truncated MDK protein, lacking the C-terminal 81–121 portion of the molecule (MDKΔ81-121), which may act as a dominant-negative effector for its mitogenic, angiogenic, and tumorigenic activities by heterodimerizing with the wild-type protein. In vitro studies showed that MDKΔ81-121 selectively inhibited MDK-dependent tumor cells and was able to strongly reduce endothelial cell proliferation and migration and to induce ER stress–mediated apoptosis. We then investigated the effects of MDKΔ81-121 in vivo using electrotransfer of a plasmid encoding a secretable form of MDKΔ81-121 into tibialis cranialis muscles of nude mice. We showed that MDKΔ81-121 dramatically inhibited (up to 91%) tumor development and growth. This inhibition was correlated with the detection of the MDKΔ81-121 molecule in plasma and the suppression of intratumor neovascularization. Our findings demonstrate that MDK inhibition is a tractable therapeutic target for this lethal pediatric malignancy. Mol Cancer Ther; 14(1); 213–24. ©2014 AACR.
Left-Sided Strokes Are More Often Recognized Than Right-Sided Strokes
Authors: Portegies Marileen L.P. , Selwaness Mariana , Hofman Albert , Koudstaal Peter J. , Vernooij Meike W. , Ikram M. Arfan 
Published: December 2014

Background and Purpose—
Left-sided strokes are reported to be more common than right-sided strokes, but it is unknown whether they occur more often or are simply recognized more easily by clinicians. In a large unselected community-dwelling population, we examined the frequency of clinical left- and right-sided strokes and transient ischemic attacks (TIAs) and compared it with the frequency of left- and right-sided infarcts on MRI.

Methods—
This study was conducted within the population-based Rotterdam Study. Between 1990 and 2012, 13 894 participants were followed up for first-ever stroke and TIA. MRI scans were performed within a random subgroup of 5081 persons and were rated for the presence of supratentorial cortical and lacunar infarcts. We compared frequencies of left- and right-sided strokes, TIAs, or MRI infarcts using binomial and Fisher exact tests.

Results—
After a mean follow-up of 9.6 (±6.0) years, 1252 patients had a stroke, of which 704 were ischemic, and 799 participants had a TIA. Within the subgroup with MRI, we identified 673 infarcts. Ischemic strokes were more frequently left-sided (57.7%; 95% confidence interval, 53.7–61.6) than right-sided, similar to TIAs (57.8% left-sided; 53.4–62.3). In contrast, we found no left-right difference in distribution of infarcts on MRI (51.9% left-sided; 48.1–55.6).

Conclusions—
Clinical ischemic strokes and TIAs are more frequently left-sided than right-sided, whereas this difference is not present for infarcts on MRI. This suggests that left-sided strokes and TIAs are more easily recognized. Consequently, there should be more attention for symptoms of right-sided strokes and TIAs.
Isolation and Characterization of Human Mesenchymal Stem Cells Derived From Synovial Fluid in Patients With Osteochondral Lesion of the Talus
Authors: Kim Yong Sang , Lee Ho Jin , Yeo Jee Eun , Kim Yong Il , Choi Yun Jin , Koh Yong Gon 
Published: December 2014

Background: Recently, mesenchymal stem cells (MSCs) have been suggested as a source for cell-based treatment of cartilage lesions based on the ability of these cells to differentiate into chondrocytes. Purpose: To characterize MSCs derived from the synovial fluid in ankle joints with osteochondral lesion of the talus (OLT). Study Design: Controlled laboratory study. Methods: Synovial fluid was collected from the ankle joints of 28 patients with OLT who underwent arthroscopic marrow stimulation between September 2011 and April 2012. Epitope profiles and multilineage differentiation were assessed to characterize the synovial fluid MSCs. To clarify the origin of synovial fluid MSCs, we assessed gene profiles of MSCs derived from various mesenchymal tissues by reverse transcription–polymerase chain reaction (RT-PCR) analysis. Results: Synovial fluid MSCs expressed CD90 and CD105, showed low expression of CD14 and CD34, and underwent multilineage differentiation in vitro. The RT-PCR revealed strong expression of CD90, CD44, and CD73, whereas CD45 and CD133 were not detected. The colony number of synovial fluid MSCs from OLT significantly increased in stages C and D, as defined by arthroscopic classification. Gene expression profiles indicated that synovial fluid MSCs derived from the patients with OLT were more similar to MSCs from synovium than to MSCs from bone marrow and adipose tissue. Conclusion: This study confirmed that human synovial fluid is a good source of MSCs, with the capacity to differentiate toward several cell lineages. Further study with matched controls of synovial fluid MSCs derived from ankle joints without OLT is required for a more accurate evaluation of synovial fluid MSCs. Clinical Relevance: The findings of this study provide a platform for exploring the potential role of synovial fluid MSCs in OLT and their therapeutic potential in novel joint regeneration strategies.
Return to Sports After Plate Fixation of Displaced Midshaft Clavicular Fractures in Athletes
Authors: Ranalletta Maximiliano , Rossi Luciano A. , Piuzzi Nicolás S. , Bertona Agustin , Bongiovanni Santiago L. , Maignon Gaston 
Published: December 2014

Background: Recent prospective randomized trials support primary plate fixation of displaced midshaft clavicle fractures. However, the safety and efficacy of this practice have not been well documented in athletes, nor has the time to return-to-sport. Purpose: To analyze the time to return-to-sport, functional outcomes, and complications in a group of athletes with displaced midshaft clavicle fractures treated using precontoured locking plates. Study Design: Case series; Level of evidence, 4. Methods: A total of 54 athletes with displaced midshaft clavicle fractures were treated with plate fixation between November 1, 2008, and December 31, 2012. The mean follow-up time was 22.4 months. Patients completed a questionnaire focused on the time to return-to-sport and treatment course. Functional outcomes were assessed with the Constant score and short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Pain was evaluated with the visual analog scale (VAS). Radiographs were reviewed to identify radiographic union time, malunion, and nonunion. Results: Of the 54 patients, 53 returned to sports after open reduction and internal fixation of their fracture; 94% returned to the same level. The mean time to return-to-sport was 68 days (range, 5-180 days). Nine (16.6%) of the cases returned to sports before 6 weeks after surgery, 40 (74%) returned between 6 and 12 weeks, and 5 patients (9.2%) returned 12 weeks after surgery. The mean Constant score was 94.1 ± 5.2 (range, 78-100), and the mean QuickDASH score was 0.4 ± 4.7 (range, 0-7.1). The mean VAS pain score during follow-up was 0.29 ± 1.0 (range, 0-5). Three major complications occurred: 1 extrinsic compression of the subclavian vein, 1 nonunion, and 1 hardware loosening. Hardware removal was necessary in 5 patients (9.3%). Conclusion: Plate fixation of displaced clavicle fractures in athletes is a safe procedure resulting in excellent functional outcomes, with an early return to the same level of sports in the majority of patients.