bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community care for the Elderly: Needs and Service Use Study (CENSUS): Who receives home care packages and what are the outcomes?
Authors: Low Lee‐Fay , Fletcher Jennifer , Gresham Meredith , Brodaty Henry 
Published: April 2014

AimInvestigate factors associated with waiting times for home care packages and outcomes for care recipients and carers.MethodAnalyses of data collected every four months for 12 months from 55 community‐dwelling older adults eligible for government‐subsidised packaged care and their carers.ResultsThirty of fifty‐five participants were offered a package; they waited from one to 237 days. Baseline quality of life was higher for those offered a package than those not. Baseline care needs and unmet needs, neuropsychiatric symptoms, and cognitive decline did not predict offers. Package receipt compared to non‐package receipt was associated with decreased carer burden over time but did not affect levels of unmet care needs, care needs or quality of life.ConclusionsBeing offered a home care package was not based on waiting time or unmet care needs. Reforms should include a transparent system of wait listing and prioritisation.
QT Dispersion in HIV‐Infected Patients Receiving Combined Antiretroviral Therapy
Authors: Wongcharoen Wanwarang , Suaklin Somkhuan , Tantisirivit Nualnit , Phrommintikul Arintaya , Chattipakorn Nipon 
Published: April 2014

BackgroundA higher prevalence of QT prolongation has been reported among human immunodeficiency virus (HIV)‐infected patients. Previous studies have demonstrated that QT dispersion is a better predictor of serious ventricular tachyarrhythmia and cardiac mortality than corrected QT (QTc) interval. However, data of QT dispersion in HIV‐infected patients receiving a combined antiretroviral therapy (cART) is limited. We sought to assess QTc interval and QT dispersion in HIV‐infected patients receiving cART. The association between QT parameters and heart rate variability (HRV) was also examined.MethodsNinety‐one HIV‐infected patients receiving cART (male = 33, mean age = 44 ± 10 years) and 70 HIV‐seronegative subjects (male = 25, mean age = 44 ± 8 years) were enrolled in the study. In a resting 12‐lead electrocardiogram, QT interval was measured by the tangent method in all leads with well‐defined T waves. The QT dispersion was defined as the difference between maximum and minimum QTc intervals in any of 12 leads.ResultsThe baseline characteristics were not different between the two groups. We demonstrated the significantly longer mean QTc interval (420 ± 21 vs. 409 ± 21 ms, P < 0.001), and greater QT dispersion in HIV‐infected group compared to the control group (85 ± 29 vs. 55 ± 23 ms, P < 0.001). Among the HIV‐infected patients, those who had lower CD4 lymphocyte count (<350 cells/mm3) tended to have greater QT dispersion (92 ± 28 vs. 81 ± 29 ms, P = 0.098). There were no associations between QT parameters and either HRV or cART regimens.ConclusionsHIV‐infected patients receiving cART were associated with prolonged QTc interval and increased QT dispersion, independent of autonomic dysfunction and antiretroviral drugs, which may have led to the potentially higher risk of ventricular arrhythmia and cardiac mortality.
Detection of Premature Ventricular Contractions on a Ventricular Electrocardiogram for Patients With Left Ventricular Assist Devices
Authors: Park Sung Min , Lee Jin Hong , Choi Seong Wook 
Published: April 2014

AbstractThe ventricular electrocardiogram (v‐ECG) was developed for long‐term monitoring of heartbeats in patients with a left ventricular assist device (LVAD) and does not normally have the functionality necessary to detect additional heart irregularities that can progress to critical arrhythmias. Although the v‐ECG has the benefits of physiological optimization and counterpulsation control, when abnormal heartbeats occur, the v‐ECG does not show the distinct abnormal waveform that enables easy detection of an abnormal heartbeat among normal heartbeats on the conventional ECG. In this study, the v‐ECGs of normal and abnormal heartbeats are compared with each other with respect to peak‐to‐peak voltage, area, and maximal slopes, and a new method to detect abnormal heartbeats is suggested. In a series of animal experiments with three porcine models (Yorkshire pigs weighing 30–40 kg), a v‐ECG and conventional ECG were taken simultaneously during LVAD perfusion. Clinical experts found 104 abnormal heartbeats from the saved conventional ECG data and confirmed that the other 3159 heartbeats were normal. Almost all of the abnormal heartbeats were premature ventricular contractions (PVCs), and there was short‐term tachycardia for 3 s. A personal computer was used to automatically detect abnormal heartbeats with the v‐ECG according to the new method, and its results were compared with the clinicians' results. The new method found abnormal heartbeats with 90% accuracy, and less than 15% of the total PVCs were missed.
A pseudo‐penalized quasi‐likelihood approach to the spatial misalignment problem with non‐normal data
Authors: Lopiano Kenneth K. , Young Linda J. , Gotway Carol A. 
Published: April 2014

SummarySpatially referenced datasets arising from multiple sources are routinely combined to assess relationships among various outcomes and covariates. The geographical units associated with the data, such as the geographical coordinates or areal‐level administrative units, are often spatially misaligned, that is, observed at different locations or aggregated over different geographical units. As a result, the covariate is often predicted at the locations where the response is observed. The method used to align disparate datasets must be accounted for when subsequently modeling the aligned data. Here we consider the case where kriging is used to align datasets in point‐to‐point and point‐to‐areal misalignment problems when the response variable is non‐normally distributed. If the relationship is modeled using generalized linear models, the additional uncertainty induced from using the kriging mean as a covariate introduces a Berkson error structure. In this article, we develop a pseudo‐penalized quasi‐likelihood algorithm to account for the additional uncertainty when estimating regression parameters and associated measures of uncertainty. The method is applied to a point‐to‐point example assessing the relationship between low‐birth weights and PM2.5 levels after the onset of the largest wildfire in Florida history, the Bugaboo scrub fire. A point‐to‐areal misalignment problem is presented where the relationship between asthma events in Florida's counties and PM2.5 levels after the onset of the fire is assessed. Finally, the method is evaluated using a simulation study. Our results indicate the method performs well in terms of coverage for 95% confidence intervals and naive methods that ignore the additional uncertainty tend to underestimate the variability associated with parameter estimates. The underestimation is most profound in Poisson regression models.
Semiparametric transformation models for semicompeting survival data
Authors: Lin Huazhen , Zhou Ling , Li Chunhong , Li Yi 
Published: April 2014

SummarySemicompeting risk outcome data (e.g., time to disease progression and time to death) are commonly collected in clinical trials. However, analysis of these data is often hampered by a scarcity of available statistical tools. As such, we propose a novel semiparametric transformation model that improves the existing models in the following two ways. First, it estimates regression coefficients and association parameters simultaneously. Second, the measure of surrogacy, for example, the proportion of the treatment effect that is mediated by the surrogate and the ratio of the overall treatment effect on the true endpoint over that on the surrogate endpoint, can be directly obtained. We propose an estimation procedure for inference and show that the proposed estimator is consistent and asymptotically normal. Extensive simulations demonstrate the valid usage of our method. We apply the method to a multiple myeloma trial to study the impact of several biomarkers on patients' semicompeting outcomes—namely, time to progression and time to death.
Robotic management of genitourinary injuries from obstetric and gynaecological operations: a multi‐institutional report of outcomes
Authors: Gellhaus Paul T. , Bhandari Akshay , Monn M. Francesca , Gardner Thomas A. , Kanagarajah Prashanth , Reilly Christopher E. , Llukani Elton , Lee Ziho , Eun Daniel D. , Rashid Hani , Joseph Jean V. , Ghazi Ahmed E. , Wu Guan , Boris Ronald S. 
Published: April 2014

ObjectiveTo evaluate the utility of robotic repair of injuries to the ureter or bladder from obstetrical and gynaecological (OBGYN) surgeryPatients and MethodsA retrospective review of all patients from four different high‐volume institutions between 2002 and 2013 that had a robot‐assisted (RA) repair by a urologist after an OBGYN genitourinary injury.ResultsOf the 43 OBGYN operations, 34 were hysterectomies: 10 open, 10 RA, nine vaginally, and five pure laparoscopic. Nine patients had alternative OBGYN operations: three caesarean sections, three oophorectomies (one open, two laparoscopic), one RA colpopexy, one open pelvic cervical cerclage with mesh and one RA removal of an invasive endometrioma. In all, 49 genitourinary (GU) injuries were sustained: ureteric ligation (26), ureterovaginal fistula (10), ureterocutaneous fistula (one), vesicovaginal fistula (VVF; 10) and cystotomy alone (two). In all, 10 patients (23.3%) underwent immediate urological repair at the time of their OBGYN RA surgery. The mean (range) time between OBGYN injury and definitive delayed repair was 23.5 (1–297) months. Four patients had undergone prior failed repair: two open VVF repairs and two balloon ureteric dilatations with stent placement. In all, 22 ureteric re‐implants (11 with ipsilateral psoas hitch) and 15 uretero‐ureterostomies were performed. Stents were placed in all ureteric cases for a mean (range) of 32 (1–63) days. In all, 10 VVF repairs and two primary cystotomy closures were performed. Drains were placed in 28 cases (57.1%) for a mean (range) of 4.1 (1–26) days. No case required open conversion. Two patients (4.1%) developed ureteric obstruction after RA repair requiring dilatation and stenting. The mean (range) follow‐up of the entire cohort was 16.6 (1–63) months.ConclusionsRA repair of GU injuries during OBGYN surgery is associated with good outcomes, appears safe and feasible, and can be used successfully immediately after injury recognition or as a salvage procedure after prior attempted repair. RA techniques may improve convalescence in a patient population where quick recovery is paramount.
MACROECONOMIC VOLATILITY AND INTERNATIONAL INTEGRATION
Authors: Arespa Marta 
Published: April 2014

ABSTRACTThis paper explores the effects that varying degrees of international openness have on macroeconomic volatility. The analysis is conducted for a two‐symmetric‐country world under three levels of international integration: that of a closed economy, a financial autarky, and full financial integration. Different degrees of trade openness are considered in the form of home biases, while the economy is left vulnerable to total factor productivity and innovation shocks. Full financial integration is found to reduce firm‐size volatility and volatility in the mass of operative firms following a productivity shock and to increase them after an innovation shock. Moreover, the interaction between international sharing of profits and terms of trade transmissions determines the non‐linear behaviour of consumption‐to‐output ratio volatility found in empirical studies.
RAC1 inhibition as a therapeutic target for gefitinib‐resistant non‐small‐cell lung cancer
Authors: Kaneto Naoki , Yokoyama Satoru , Hayakawa Yoshihiro , Kato Shinichiro , Sakurai Hiroaki , Saiki Ikuo 
Published: April 2014

Although epidermal growth factor receptor (EGFR)‐tyrosine kinase inhibitors (EGFR‐TKI), including gefitinib, provide a significant clinical benefit in non‐small‐cell lung cancer (NSCLC) patients, the acquisition of drug resistance has been known to limit the efficacy of EGFR‐TKI therapy. In this study, we demonstrated the involvement of EGF‐EGFR signaling in NSCLC cell migration and the requirement of RAC1 in EGFR‐mediated progression of NSCLC. We showed the significant role of RAC1 pathway in the cell migration or lamellipodia formation by using gene silencing of RAC1 or induction of constitutive active RAC1 in EGFR‐mutant NSCLC cells. Importantly, the RAC1 inhibition suppressed EGFR‐mutant NSCLC cell migration and growth in vitro, and growth in vivo even in the gefitinib‐resistant cells. In addition, these suppressions by RAC1 inhibition were mediated through MEK or PI3K independent mechanisms. Collectively, these results open up a new opportunity to control the cancer progression by targeting the RAC1 pathway to overcome the resistance to EGFR‐TKI in NSCLC patients.
Risk indicators for root caries in institutionalized elders
Authors: Tan Hai Ping , Lo Edward C. M. 
Published: April 2014

AbstractObjectiveTo investigate the risk indicators for root caries in institutionalized elders.MethodsNonfrail elders living in 21 residential elderly homes who had at least 5 teeth with exposed roots were examined in this cross‐sectional study. The dental examinations were conducted by one trained dentist in the elderly homes using a portable clinic light, mouth mirror, and dental explorer. Two‐level logistic regression analyses, one using the presence of decay and the other using decay/filling in the root surface as the dependent variable, were conducted to study the relationship between root caries and a number of selected subject‐level and site‐level factors.ResultsA total of 306 elders with a mean age of 78.8 years were examined. Their mean DS‐root and DFS‐root scores were 1.3 and 2.1, respectively. Their mean root caries index score was 3.92. Results from the regression analyses revealed a positive correlation between the caries status of the root surfaces in the same subject (ICC1=0.37, ICC2=0.29, P < 0.001). Root surfaces with visual plaque, with denture contact, with more gingival recession, and in the upper anterior region were found to have a higher chance of being affected by root caries.ConclusionPresence of plaque, proximity to denture, and gingival recession are important site‐level risk indicators for root caries in institutionalized elders. More attention should be paid to plaque control on exposed root surfaces and avoiding placement of denture components close to roots so as to lower the risk of root caries in elders.
The proportion of cancellous bone as predictive factor for early marginal bone loss around implants in the posterior part of the mandible
Authors: Simons Willem‐Frederik , De Smit Menke , Duyck Joke , Coucke Wim , Quirynen Marc 
Published: April 2014

AbstractAimThis study envisaged to explain early marginal bone loss (first years of function) around implants in the posterior area of the mandible by the local bone quality (ratio cortical vs. cancellous bone).Material and methodsFour hundred and twenty‐three Brånemark MKIII® implants inserted in the posterior region of the mandible were examined, retrospectively, on intra‐oral radiographs taken at abutment connection, and 1 and 3–4 years after loading. The quality of the bone was assessed on cone beam or multi‐slice CTs. The bone quality was determined by the relative proportions of cortical and trabecular bone at the insertion site. Cortical bone was defined as a clearly white structure without a trabecular pattern. Trabecular bone was defined as the structure between the two cortical plates. The width of both structures was measured at 1, 3, 5, and 7 mm away from the crest of the alveolar bone and converted in to relative proportions. Other parameters (smoking, history of periodontitis, dehiscence, pre‐tapping, submerged healing, etc.) were retrieved from the patients record.ResultsAt abutment connection, the mesial and distal marginal bone level was located 0.7 (±0.7) and 0.8 (±0.7) mm apically to the implant–abutment junction. At 1 year and 3–4 years of loading implants placed in a mandible consisting of <30% of cancellous bone had lost 1.49 and 1.83 mm, respectively. Implants placed in jawbone consisting of more than 60% of cancellous bone lost 0.74 and 0.91 mm after 1 year and 3–4 years of loading. The bone‐level changes (both first year as well as after 3–4 years) were significantly less when the implant was placed in sites with a higher proportion of cancellous bone. Other parameters were significantly less important.ConclusionsVery cortical bone could jeopardize the long‐term stability of the marginal bone surrounding implants placed in the posterior region of the mandible. A correlation between marginal bone loss and the proportion of cortical bone was demonstrated around Brånemark® implants. At present, no comparable studies are available, and therefore, it cannot be excluded that similar events take place around other implant systems.
P2X7 Receptor Inhibition Interrupts the Progression of Seizures in Immature Rats and Reduces Hippocampal Damage
Authors: Mesuret Guillaume , Engel Tobias , Hessel Ellen V. , Sanz‐Rodriguez Amaya , Jimenez‐Pacheco Alba , Miras‐Portugal M. Teresa , Diaz‐Hernandez Miguel , Henshall David C. 
Published: April 2014

SummaryAimsEarly‐life seizures, particularly when prolonged, may be harmful to the brain. Current pharmacotherapy is often ineffective; therefore, novel neuro‐ and/or glio‐transmitter systems should be explored for targeting. The P2X7 receptor is a cation‐permeable channel with trophic and excitability effects on neurons and glia which is activated by high amounts of ATP that may be released in the setting of injury after severe seizures. Here, we tested the effects of A‐438079, a potent and selective P2X7 receptor antagonist in a lesional model of early‐life status epilepticus.MethodsSeizures were induced by intra‐amygdala kainic acid in 10‐day‐old rat pups. Electrographic seizure severity, changes to P2X7 receptor expression, inflammatory responses and histological effects were evaluated.ResultsSeizures induced by intra‐amygdala kainic acid increased levels of P2X7 receptor protein and interleukin‐1β and caused significant cell death within the ipsilateral hippocampus. A‐438079 rapidly reached the brain following systemic injection in P10 rats. Intraperitoneal injection of A‐438079 (5 and 15 mg/kg) 60 min after triggering seizures reduced seizure severity and neuronal death within the hippocampus. A‐438079 had superior neuroprotective effects compared with an equally seizure‐suppressive dose of phenobarbital (25 mg/kg).ConclusionsThese results suggest P2X7 receptor antagonists may be suitable as frontline or adjunctive treatments of pediatric status epilepticus or other early‐life seizures, particularly when associated with brain damage.
Heterogeneity of rectus femoris muscle architectural adaptations after two different 14‐week resistance training programmes
Authors: Matta Thiago T. , Nascimento Francisco X. M. B. , Fernandes Igor A. , Oliveira Liliam F. 
Published: April 2014

SummaryPurposeThis study aimed to determine the architectural changes of rectus femoris muscle at distinctive sites of the thigh length after two different 14‐week resistance training programmes.MethodsThirty‐five untrained men were randomly allocated into three different groups: conventional resistance training (n = 12), isokinetic training (n = 12) and control (n = 11). Rectus femoris cross‐sectional area, thickness and fascicle angle at two specific thigh sites (30% and 50% of the length) were assessed before and after 14 weeks of unilateral knee extension exercise or control. The isometric peak torque of the knee extensors was estimated as a muscle strength index.ResultsConventional (30% = 47·4% versus 50% = 14·4%) and isokinetic (30% = 31·8% versus 50% = 11·4%) training induced significant increases on thickness at both rectus femoris sites. While conventional training resulted in substantial increments on cross‐sectional area (30% = 62·1%, 50% = 19·5%), isokinetic training provoked a significant increase only at the distal site (50% = 64·7%). The isometric peak torque increased (22·4 and 29·6%, for conventional and isokinetic groups, respectively) after training independently of the training mode, although no significant changes were observed for any dependent variable in the control group.ConclusionsIn general, the training modes resulted in similar changes on rectus femoris architecture, whereas their magnitude depended on the thigh site.
Combination of racial/ethnic and etiology/disease‐specific factors is associated with lower survival following liver transplantation in African Americans: an analysis from UNOS/OPTN database
Authors: Wong Robert J. , Ahmed Aijaz 
Published: April 2014

AbstractHigher rates of hepatitis C virus (HCV) recurrence and lower response to HCV antiviral therapy contribute to the lower post‐liver transplantation (LT) survival among African Americans with HCV. The current study aims to evaluate race/ethnicity‐specific and etiology‐specific factors contributing to lower post‐LT survival among African Americans in the USA. The 2002–2012 United Network for Organ Sharing registry was utilized to evaluate race/ethnicity‐specific post‐LT survival among patients with HCV, hepatocellular carcinoma (HCC), alcoholic liver disease (ALD), non‐alcoholic steatohepatitis, and cryptogenic cirrhosis. From 2002 to 2012, HCV was the leading indication for LT. While African Americans accounted for 9.5% of all LT during this period, they had the lowest overall and etiology‐specific five‐yr post‐LT survival. On multivariate Cox proportional hazards modeling, African Americans had significantly lower post‐LT survival compared with non‐Hispanic whites among patients with HCV (HR, 1.30; 95% CI, 1.19–1.41), HCC (HR, 1.49; 95% CI, 1.25–1.79), and ALD (HR, 1.52; 95% CI, 1.19–1.94). In conclusion, African Americans had the lowest post‐LT survival among patients with HCV, HCC, and ALD. Race/ethnicity and the etiology of chronic liver disease were observed to have a combined detrimental effect leading to lower survival following LT in African Americans.
Systemic Antioxidants and Lung Function in Asthmatics during High Ozone Season: A Closer Look at Albumin, Glutathione, and Associations with Lung Function
Authors: Khatri Sumita B. , Peabody Jeannie , Burwell Leandrea , Harris Frank , Brown LouAnnE S. 
Published: April 2014

AbstractBackgroundAsthma is a chronic airway inflammatory disease with episodic symptoms of wheezing, chest tightness, cough, and shortness of breath. High ambient ozone levels have been associated with increased airway inflammation and asthma morbidity in prior studies. Mechanisms underlying individual susceptibility to asthma exacerbations from poor air quality are not fully understood.ObjectiveAs part of a panel observational study, we hypothesized that systemic antioxidant ability and antioxidant status may be associated with more stable asthma during high ozone season. Methods: A cross sectional study was performed to evaluate the antioxidant profile in systemic circulation and its associations with clinical parameters in asthmatics and healthy controls during three summers in Atlanta, Georgia.ResultsIn this panel of individuals with and without asthma, we found that although systemic glutathione levels were not different between the groups, serum albumin was significantly lower in the asthmatic group. Albumin also significantly correlated with lung function (%FEV1) and asthma quality of life scores. In a subgroup tested, plasma reduced glutathione (GSH) levels were associated with worse airways obstruction.ConclusionAntioxidants GSH and albumin may have a role in maintaining lung function and asthma stability during times of poor ambient air quality. Clin Trans Sci 2014; Volume #: 1–5