bluuebunny/crossref_metadata_2025_split huggingface dataset:
Site-Specific Relationship Between Intracranial Aneurysm and Aortic Aneurysm
Authors: Shin Yong-Won , Jung Keun-Hwa , Moon Jangsup , Lee Soon-Tae , Lee Sang Kun , Chu Kon , Roh Jae-Kyu 
Published: May 2015

Background and Purpose—
The high prevalence of intracranial aneurysms (IAs) in patients with a bicuspid aortic valve or coarctation of the aorta suggests a link between IA and aortic pathology. However, studies reporting this link do not sufficiently address the heterogeneity of IAs arising from different anatomic locations. This study aimed to explore whether a location-specific relationship exists between the 2 kinds of aneurysms.

Methods—
Retrospective institutional analysis of patients aged ≥18 years with both IA and an aortic aneurysm (AA) was performed from 2005 to 2014. IAs were categorized based on their locations: internal carotid artery, other anterior circulation, and posterior arteries. AAs were classified as ascending, descending, infrarenal, or multiple. We analyzed the clinical characteristics and the distribution of IA in each AA group.

Results—

Of 2375 patients, 660 with available intracranial angiography were screened for IA. We identified 71 patients with 97 IAs. The frequency of both anterior circulation-IAs and internal carotid artery-IAs differed significantly among the AA groups (
P
=0.001 and
P
=0.01, respectively). Anterior circulation-IAs were most frequently observed in ascending AA group and least frequently in infrarenal AA group. In contrast, internal carotid artery-IAs were found mostly in infrarenal AA group, least in ascending AA group. Proportions of patients having anterior circulation-IA and internal carotid artery-IA were also highest in ascending AA group and infrarenal AA group, respectively. The number of posterior arteries-IAs was too small to characterize.

Conclusions—
The differing distribution patterns of IA among AA groups suggest a site-specific sharing of pathomechanism between the 2 types of aneurysms.
Two new species of Eugenia (Myrtaceae) from the Cabo Frio Center of Plant Diversity, Rio de Janeiro, Brazil
Authors: DE FARIA JAIR EUSTÁQUIO QUINTINO , MAZINE FIORELLA FERNANDA , PROENÇA CAROLYN ELINORE BARNES 
Published: May 2015

Two apparently narrow-endemic species of Eugenia are described from the Cabo Frio Center of Plant Diversity in the state of Rio de Janeiro, Brazil. Both present a limited distribution restricted to coastal areas north of Rio de Janeiro. The new species are described and compared with closely related species. Illustrations, distribution maps and conservation status assessments are also provided. Eugenia gastropogena and Eugenia farneyi are presumably closely related to Eugenia pyriformis and Eugenia malacantha. Eugenia gastropogena can be recognized by its leaves with arched secondary veins not forming a clear marginal vein, subcordate to obtuse leaf bases, petioles 2.1–4.8 mm long, buds 3.5–4 mm long and 2 ovules per locule. E. farneyi can be recognized by having leaves with straight secondary veins that form a single marginal vein running 0.7–1.5 mm from the margin, cuneate leaf bases, petioles 4–6.4 mm long, buds 6.2–8.4 mm long, and 10–12 ovules per locule.
Observing and Forecasting Vog Dispersion from Kīlauea Volcano, Hawaii
Authors: Businger Steven , Huff Roy , Pattantyus Andre , Horton Keith , Sutton A. Jeff , Elias Tamar , Cherubini Tiziana 
Published: May 2015

Abstract
Emissions from Kīlauea volcano, known locally as “vog” for volcanic smog, pose significant environmental and health risks to the Hawaiian community. The Vog Measurement and Prediction (VMAP) project was conceived to help mitigate the negative impacts of Kīlauea’s emissions. To date, the VMAP project has achieved the following milestones: i) created a custom application of the Hybrid Single-Particle Lagrangian Integrated Trajectory model (HYSPLIT, hereafter Vog model) to produce statewide forecasts of the concentration and dispersion of sulfur dioxide (SO2) and sulfate aerosol from Kīlauea volcano; ii) developed an ultraviolet (UV) spectrometer array to provide near-real-time volcanic gas emission rate measurements for use as input into the Vog model; iii) developed and deployed a stationary array of ambient SO2 and meteorological sensors to record the spatial characteristics of Kīlauea’s gas plume in high temporal and spatial resolution for model verification; and iv) developed web-based tools to facilitate the dissemination of observations and model forecasts to provide guidance for safety officials and the public, and to raise awareness of the potential hazards of volcanic emissions to respiratory health, agriculture, and general aviation.
Wind fields and thermodynamic data from the Weather Research and Forecasting (WRF) Model provide input to the Vog model, with a statewide grid spacing of 3 km and a 1-km grid covering the island of Hawaii. Validation of the Vog model forecasts is accomplished with reference to data from Hawaii State Department of Health ground-based air quality monitors. VMAP results show that this approach can provide useful guidance for the people of Hawaii.
The changing demographics of inpatient hospice death: Population-based cross-sectional study in England, 1993–2012
Authors: Sleeman Katherine E , Davies Joanna M , Verne Julia , Gao Wei , Higginson Irene J 
Published: May 2015

Background: Studies in the United Kingdom and elsewhere have suggested inequality of hospice provision with respect to factors such as age, diagnosis and socio-economic position. How this has changed over time is unknown. Aim: To describe the factors associated with inpatient hospice death in England and examine how these have changed over time. Design: Population-based study. Multivariable Poisson regression compared 1998–2002, 2003–2007 and 2008–2012, with 1993–1997. Explanatory variables included individual factors (age, gender, marital status, underlying cause of death) and area-based measures of deprivation. Setting: Adults aged 25 years and over who died in inpatient hospice units in England between 1993 and 2002 ( n = 446,615). Results: The annual number of hospice deaths increased from 17,440 in 1993 to 26,032 in 2012, accounting for 3.4% of all deaths in 1993 and 6.0% in 2012. A total of 50.6% of hospice decedents were men; the mean age was 69.9 (standard deviation: 12.4) years. The likelihood of hospice decedents being in the oldest age group (>85 years) increased over time (proportion ratio: 1.43, 95% confidence interval: 1.39 to 1.48 for 2008–2012 compared to 1993–1997). Just 5.2% of all hospice decedents had non-cancer diagnoses, though the likelihood of non-cancer conditions increased over time (proportion ratio: 1.41, 95% confidence interval: 1.37 to 1.46 for 2008–2012 compared to 1993–1997). The likelihood of hospice decedents being resident in the least deprived quintile increased over time (proportion ratio: 1.25, 95% confidence interval: 1.22 to 1.29 for 2008–2012 compared to 1993–1997). Conclusion: The increase in non-cancer conditions among hospice decedents is encouraging although absolute numbers remain very small. Deprivation trends are concerning and require further exploration.
Enhancing students’ moral competence in practice
Authors: Solum Eva Merethe , Maluwa Veronica Mary , Tveit Bodil , Severinsson Elisabeth 
Published: May 2015

Background: Nurses and student nurses in Malawi often encounter challenges in taking a moral course of action. Several studies have demonstrated a need for increased awareness of ethical issues in the nursing education. Objective: To explore the challenges experienced by nurse teachers in Malawi in their efforts to enhance students’ moral competence in clinical practice. Research design: A qualitative hermeneutic approach was employed to interpret the teachers’ experiences. Participants and research context: Individual interviews (N = 8) and a focus group interview with teachers (N = 9) from different nursing colleges were conducted. Ethical considerations: Ethical approval was granted and all participants signed their informed consent. Findings: Two overall themes emerged: (1) authoritarian learning climate, with three subthemes: (a) fear of making critical comments about clinical practice, (b) fear of disclosing mistakes and lack of knowledge and (c) lack of a culture of critical discussion and reflection that promotes moral competence; and (2) discrepancy between expectations on learning outcome from nursing college and the learning opportunities in practice comprising three subthemes: (a) gap between the theory taught in class and learning opportunities in clinical practice, (b) lack of good role models and (c) lack of resources. Discussion: Our findings indicated that showing respect was a central objective when the students were assessed in practice. A number of previous studies have enlightened the need for critical reflection in nursing education. Few studies have linked this to challenges experienced by teachers for development of moral competence in practice. This is one of the first such studies done in an African setting. Conclusion: There is a clear relationship between the two themes. A less authoritarian learning climate may enhance critical reflection and discussion between students, teachers and nurses. This can narrow the gap between the theory taught in college and what is demonstrated in clinical practice. Moral competence must be enhanced in order to ensure patients’ rights and safety.
What healthcare teams find ethically difficult
Authors: Rasoal Dara , Kihlgren Annica , James Inger , Svantesson Mia 
Published: May 2015

Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss. Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation. Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was applied, using thematic content analysis. Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation. Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient’s/next-of-kin’s emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient’s autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have. Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders. Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective.
The Effect of Evolving Fluid Resuscitation on the Outcome of Severely Injured Patients: An 8-year Experience at a Tertiary Trauma Center
Authors: Brinck T. , Handolin L. , Lefering R. 
Published: May 2015

Background and Aims: Fluid resuscitation of severely injured patients has shifted over the last decade toward less crystalloids and more blood products. Helsinki University trauma center implemented the massive transfusion protocol in the end of 2009. The aim of the study was to review the changes in fluid resuscitation and its influence on outcome of severely injured patients with hemodynamic compromise treated at the single tertiary trauma center. Material and Methods: Data on severely injured patients (New Injury Severity Score > 15) from Helsinki University Hospital trauma center’s trauma registry was reviewed over 2006–2013. The isolated head-injury patients, patients without hemodynamic compromise on admission (systolic blood pressure > 90 or base excess > –5.0), and those transferred in from another hospital were excluded. The primary outcome measure was 30-day in-hospital mortality. The study period was divided into three phases: 2006–2008 (pre-protocol, 146 patients), 2009–2010 (the implementation of massive transfusion protocol, 85 patients), and 2011–2013 (post massive transfusion protocol, 121 patients). Expected mortality was calculated using the Revised Injury Severity Classification score II. The Standardized Mortality Ratio, as well as the amounts of crystalloids, colloids, and blood products (red blood cells, fresh frozen plasma, platelets) administered prehospital and in the emergency room were compared. Results: Of the 354 patients that were included, Standardized Mortality Ratio values decreased (indicating better survival) during the study period from 0.97 (pre-protocol), 0.87 (the implementation of massive transfusion protocol), to 0.79 (post massive transfusion protocol). The amount of crystalloids used in the emergency room decreased from 3870 mL (pre-protocol), 2390 mL (the implementation of massive transfusion protocol), to 2340 mL (post massive transfusion protocol). In these patients, the blood products’ (red blood cells, fresh frozen plasma, and platelets together) relation to crystalloids increased from 0.36, 0.70, to 0.74, respectively, in three phases. Conclusion: During the study period, no other major changes in the protocols on treatment of severely injured patients were implemented. The overall awareness of damage control fluid resuscitation and introduction of massive transfusion protocol in a trauma center has a significant positive effect on the outcome of severely injured patients.
Association of AT1R polymorphism with hypertension risk: An update meta-analysis based on 28,952 subjects
Authors: Liu Dong-Xing , Zhang Yu-Qing , Hu Bo , Zhang Jianfeng , Zhao Qiang 
Published: May 2015

Background: Previous studies have shown that angiotensin II AT1 receptor gene ( AT1R) polymorphisms are associated with the risk for hypertension. However, the results remain controversial. In the present study, we performed a meta-analysis to systematically summarize the association between AT1R genetic polymorphisms and the risk for hypertension. Methods: We searched the literature in PubMed, EMBASE, ISI Web of Science, Wanfang, and Chinese National Knowledge Infrastructure databases (CNKI) to find case-control studies on the associations of AT1R genetic polymorphisms with the risk for hypertension. The meta-analysis was performed by using RevMan 5.0 software. The association of hypertension risk with AT1R genetic polymorphism was estimated by pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: Fifty-six studies involving 28,952 subjects were included in the present meta-analysis. Our results suggest that the polymorphism (A1166C) of AT1R gene is associated with a statistically increased hypertension risk, not only in Asian populations but also in Caucasian populations. We did not find any association in African populations. Conclusions: This meta-analysis suggests that A1166C polymorphism in the AT1R gene is associated with the risk of hypertension in Asian and Caucasian populations.
The relationship between angiotensin-converting enzyme gene insertion/deletion polymorphism and digestive cancer risk: Insights from a meta-analysis
Authors: Yang Hualing , Cai Chengfu , Ye Linyang , Rao Yiqing , Wang Qingxiang , Hu Dan , Huang Xi 
Published: May 2015

Background and objective: The gene encoding angiotensin-converting enzyme (ACE) has been implicated in the development of several malignancies. We aimed to meta-analyze the association of ACE gene insertion/deletion (I/D) polymorphism with digestive cancer risk and seek possible sources of between-study heterogeneity. Methods: Two authors independently assessed eligibility of each retrieved publication and gathered relevant data. Risk estimates were expressed as odds ratio (OR) and 95% confidence interval (CI). Results: Sixteen publications were qualified for analysis, involving 2903 digestive cancer cases and 10,833 controls. Overall analyses failed to show any significance for digestive cancer risk. There was moderate heterogeneity and lower publication bias for overall comparisons. In subgroup analyses, ACE gene II genotype was associated with a 15% reduced risk (OR=0.85, 95% CI: 0.57–1.27, p=0.434) for gastric cancer, but a 16% increased risk (OR=1.16, 95% CI: 0.89–1.52, p=0.273) for colorectal cancer. By source of controls, the I allele appeared to be a protective factor against digestive cancer in population-based studies (OR=0.87, 95% CI: 0.75–1.00, p=0.055) but a risk-conferring factor in hospital-based studies (OR=1.17, 95% CI: 1.01–1.35, p=0.033). Conclusion: Our findings suggested that ACE gene I allele might be a protective factor against gastric cancer, necessitating further confirmation in large, population-based studies.
Fluorescent protein biosensors applied to microphysiological systems
Authors: Senutovitch Nina , Vernetti Lawrence , Boltz Robert , DeBiasio Richard , Gough Albert , Taylor D Lansing 
Published: May 2015

This mini-review discusses the evolution of fluorescence as a tool to study living cells and tissues in vitro and the present role of fluorescent protein biosensors (FPBs) in microphysiological systems (MPSs). FPBs allow the measurement of temporal and spatial dynamics of targeted cellular events involved in normal and perturbed cellular assay systems and MPSs in real time. FPBs evolved from fluorescent analog cytochemistry (FAC) that permitted the measurement of the dynamics of purified proteins covalently labeled with environmentally insensitive fluorescent dyes and then incorporated into living cells, as well as a large list of diffusible fluorescent probes engineered to measure environmental changes in living cells. In parallel, a wide range of fluorescence microscopy methods were developed to measure the chemical and molecular activities of the labeled cells, including ratio imaging, fluorescence lifetime, total internal reflection, 3D imaging, including super-resolution, as well as high-content screening. FPBs evolved from FAC by combining environmentally sensitive fluorescent dyes with proteins in order to monitor specific physiological events such as post-translational modifications, production of metabolites, changes in various ion concentrations, and the dynamic interaction of proteins with defined macromolecules in time and space within cells. Original FPBs involved the engineering of fluorescent dyes to sense specific activities when covalently attached to particular domains of the targeted protein. The subsequent development of fluorescent proteins (FPs), such as the green fluorescent protein, dramatically accelerated the adoption of studying living cells, since the genetic “labeling” of proteins became a relatively simple method that permitted the analysis of temporal–spatial dynamics of a wide range of proteins. Investigators subsequently engineered the fluorescence properties of the FPs for environmental sensitivity that, when combined with targeted proteins/peptides, created a new generation of FPBs. Examples of FPBs that are useful in MPS are presented, including the design, testing, and application in a liver MPS.
Treatment response, safety, and tolerability of paliperidone extended release treatment in patients recently diagnosed with schizophrenia
Authors: Helldin Lars , Peuskens Joseph , Vauth Roland , Sacchetti Emilio , bij de Weg Haye , Herken Hasan , Lahaye Marjolein , Schreiner Andreas 
Published: May 2015

Objective: This study was designed to explore the efficacy and tolerability of oral paliperidone extended release (ER) in a sample of patients who were switched to flexible doses within the crucial first 5 years after receiving a diagnosis of schizophrenia. Methods: Patients were recruited from 23 countries. Adults with nonacute but symptomatic schizophrenia, previously unsuccessfully treated with other oral antipsychotics, were transitioned to paliperidone ER (3–12 mg/day) and prospectively treated for up to 6 months. The primary efficacy outcome for patients switching for the main reason of lack of efficacy with their previous antipsychotic was at least 20% improvement in Positive and Negative Syndrome Scale (PANSS) total scores. For patients switching for other main reasons, such as lack of tolerability, compliance or ‘other’, the primary outcome was non-inferiority in efficacy compared with the previous oral antipsychotic. Results: For patients switching for the main reason of lack of efficacy, 63.1% achieved an improvement of at least 20% in PANSS total scores from baseline to endpoint. For each reason for switching other than lack of efficacy, efficacy maintenance after switching to paliperidone ER was confirmed. Statistically significant improvement in patient functioning from baseline to endpoint, as assessed by the Personal and Social Performance scale, was observed ( p < 0.0001). Treatment satisfaction with prior antipsychotic treatment at baseline was rated ‘good’ to ‘very good’ by 16.8% of patients, and at endpoint by 66.0% of patients treated with paliperidone ER. Paliperidone ER was generally well tolerated, with frequently reported treatment-emergent adverse events being insomnia, anxiety and somnolence. Conclusions: Flexibly dosed paliperidone ER was associated with clinically relevant symptomatic and functional improvement in recently diagnosed patients with non-acute schizophrenia previously unsuccessfully treated with other oral antipsychotics.
Perceptions of Primary Care Among Breast Cancer Survivors
Authors: Christian Allison , Hudson Shawna V. , Miller Suzanne M. , Bator Alicja , Ohman-Strickland Pamela A. , Somer Robert A. , Ferrante Jeanne 
Published: May 2015

Background: Obese breast cancer survivors (BCSs) are impacted by diminished quality of life (QOL), multiple comorbid conditions, and poor disease outcomes. Despite national guidelines recommending a healthy weight to improve QOL and outcomes posttreatment, support and education are not routinely provided to BCSs in primary care. To fill this gap, we assessed perceptions of primary care received among BCSs by weight status. Methods: Cross-sectional surveys were administered to early-stage BCSs (N = 188) from 2 New Jersey cancer centers between May 2012 and July 2013. Sociodemographics, medical history, functional health status, perceived satisfaction with one’s primary care provider (PCP), and PCP involvement in follow-up care were assessed. Results: In total, 82% of overweight BCSs and 30% of obese BCSs reported not being told by their doctor that they were overweight or obese, despite these conditions being highly prevalent (35% and 35%, respectively). Obese BCSs were more likely than healthy weight BCSs to be African American, have a higher comorbidity score, poorer functional health, and greater satisfaction with their PCPs. Conclusion: The PCP–patient encounter may represent an opportunity for PCPs to correct misperceptions and promote weight reduction efforts among BCSs, thus improving QOL and disease outcomes.