bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treating Parents to Reduce NICU Transmission ofStaphylococcus aureus(TREAT PARENTS) trial: protocol of a multisite randomised, double-blind, placebo-controlled trial
Authors: Milstone Aaron M , Koontz Danielle W , Voskertchian Annie , Popoola Victor O , Harrelson Kathleen , Ross Tracy , Aucott Susan W , Gilmore Maureen M , Carroll Karen C , Colantuoni Elizabeth 
Published: September 2015

IntroductionMore than 33 000 healthcare-associated infections occur in neonatal intensive care units (NICUs) each year in the USA. Parents, rather than healthcare workers, may be a reservoir from which neonates acquireStaphylococcus aureus(S. aureus) colonisation in the NICU.This study looks to measure the effect of treating parents with short course intranasal mupirocin and topical chlorhexidine antisepsis on acquisition ofS. aureuscolonisation and infection in neonates.Methods and analysisThe TREAT PARENTS trial (Treating Parents to Reduce Neonatal Transmission ofS. aureus) is a multicentre randomised, masked, placebo-controlled trial. Shortly after a neonate is admitted to the NICU, parents will be tested forS. aureuscolonisation. If either parent screens positive forS. aureus, then both parents as a pair will be enrolled and randomised to one of the two possible masked treatment arms. Arm 1 will include assignment to intranasal 2% mupirocin plus topical antisepsis with chlorhexidine gluconate impregnated cloths for 5 days. Arm 2 will include assignment to placebo ointment and placebo cloths for skin antisepsis for 5 days. The primary outcome will be neonatal acquisition of anS. aureusstrain that is concordant to the parental baselineS. aureusstrain as determined by periodic surveillance cultures or a culture collected during routine clinical care that growsS. aureus. Secondary outcomes will include neonatal acquisition ofS. aureus, neonatalS. aureusinfection, eradication ofS. aureuscolonisation in parents, natural history ofS. aureuscolonisation in parents receiving placebo, adverse reactions to treatment, feasibility of intervention, and attitudes and behaviour in consented parents. Four hundred neonate-parent pairs will be enrolled.Ethics and disseminationThe study was approved by Johns Hopkins University IRB in June 2014 (IRB number 00092982). Protocol V.7 was approved in November 2014. Findings will be published in peer-reviewed journals.Trial registration numberNCT02223520.
Endovascular treatment of ophthalmic artery aneurysms: ophthalmic artery patency following flow diversion versus coil embolization
Authors: Durst Christopher R , Starke Robert M , Clopton David , Hixson H Robert , Schmitt Paul J , Gingras Jean M , Ding Dale , Liu Kenneth C , Crowley R Webster , Jensen Mary E , Evans Avery J , Gaughen John 
Published: September 2015

Background and purposeThe Pipeline Embolization Device (PED) has been shown to effectively treat complex internal carotid artery aneurysms while maintaining patency of covered side branches. The purpose of this retrospective matched cohort study is to evaluate the effect of flow diversion on the patency of the ophthalmic artery when treating ophthalmic artery aneurysms.MethodsA retrospective review of our prospectively collected institutional database identified 19 ophthalmic artery aneurysms treated with a PED. These were matched according to aneurysm diameter in a 1:2 fashion to ophthalmic artery aneurysms treated via coil embolization, although it is important to note that there was a statistically significance difference in the neck diameter between the two groups (p=0.045). Clinical and angiographic outcomes were recorded and analyzed.ResultsOn follow-up angiography, decreased flow through the ophthalmic artery was observed in 26% of the PED cohort and 0% of the coil embolization cohort (p=0.003). No ophthalmologic complications were noted in either cohort. Complete occlusion at 12 months was more common following PED treatment than coil embolization (74% vs 47%; p=0.089), although lower than reported in previous trials. This may be due to inflow into the ophthalmic artery keeping the aneurysm patent. Retreatments were more common following coil embolization than PED (24% vs 11%), but this was not significant (p=0.304). Permanent morbidity rates were not significantly different between the PED (11%) and coil embolization (3%) cohorts (p=0.255).ConclusionsOur results suggest that ophthalmic artery aneurysms may be adequately and safely treated with either the PED or coil embolization. However, treatment with the PED carries a higher risk of impeding flow to the ophthalmic artery, although this did not result in clinical sequelae in the current study.
Cervical oesophageal perforation by a colostrum tube with metal end‐piece in neonatal calves
Authors: Pardon Bart , Valgaeren Bonnie Rose , Chiers Koen , Saunders Jimmy , Deprez Piet R 
Published: September 2015

In a three‐month period, a Belgian Blue beef herd was confronted with three unexplained mortalities in neonatal calves, characterised by the development of a marked cervical swelling. A fourth case was referred for closer examination. On clinical examination, the animal showed a diffuse cervical swelling with oedema and crepitation, depression, anorexia and muffled lung sounds. A barium contrast‐enhanced radiograph showed diffusion of contrast liquid from the oesophagus into the surrounding tissues, consistent with oesophageal perforation. Postmortem examination showed a fibrino‐necrotising (peri)oesophagitis, tracheitis and myositis, pyothorax, pneumomediastinum and pericardial emphysema. A perforating tear was present in the ventral oesophagus, 15 cm caudal from the larynx. The cause was an inappropriate tubing technique of the farmer and possibly the use of an oesophageal feeder with metal end‐piece.
Circulating microparticles and the risk of thrombosis in inherited deficiencies of antithrombin, protein C and protein S
Authors: Campello Elena , Spiezia Luca , Radu Claudia M. , Bulato Cristiana , Gavasso Sabrina , Tormene Daniela , Woodhams Barry , Valle Fabio Dalla , Simioni Paolo 
Published: September 2015

SummaryMany subjects carrying inherited thrombophilic defects will never experience venous thromboembolism (VTE) while other individuals developed recurrent VTE with no known additional risk factors. High levels of circulating microparticles (MP) have been associated with increased risk of VTE in patients with factor V Leiden and prothrombin G20210A mutation, suggesting a possible contribution of MP in the hypercoagulability of mild genetic thrombophilia. The role of MP as additional risk factor of VTE in carriers of natural clotting inhibitors defects (severe thrombophilia) has never been assessed. Plasma levels of annexin V-MP, endothelial-derived MP (EMP), platelet-derived MP (PMP), tissue factor-bearing MP (TF+) and the MP procoagulant activity (PPL) were measured in 132 carriers of natural anticoagulant deficiencies (25 antithrombin, 63 protein C and 64 protein S defect) and in 132 age and gender-matched healthy controls. Carriers of natural anticoagulant deficiencies, overall and separately considered, presented with higher median levels of annexin V-MP, EMP, PMP, TF+MP and PPL activity than healthy controls (p< 0.001, < 0.001, < 0.01, 0.025 and 0.03, respectively). Symptomatic carriers with a previous episode of VTE had significantly higher median levels of annexin-V MP than those without VTE (p=0.027). Carriers with high levels of annexin V-MP, EMP and PMP had an adjusted OR for VTE of 3.36 (95 % CI, 1.59 to 7.11), 9.26 (95 % CI, 3.55 to 24.1) and 2.72 (95 %CI, 1.16 to 6.38), respectively. Elevated levels of circulating MP can play a role in carriers of mild and severe inherited thrombophilia. The clinical implications of this association remain to be defined.
Genetics of Venous Thrombosis: update in 2015
Authors: Suchon Pierre , Trégouët David-Alexandre , Morange Pierre-Emmanuel 
Published: September 2015

SummaryVenous thrombosis (VT) is a common multifactorial disease with a genetic component that was first suspected nearly 60 years ago. In this review, we document the genetic determinants of the disease, and update recent findings delivered by the application of high-throughput genotyping and sequencing technologies. To date, 17 genes have been robustly demonstrated to harbour genetic variations associated with VT risk: ABO, F2, F5, F9, F11, FGG, GP6, KNG1, PROC, PROCR, PROS1, SERPINC1, SLC44A2, STXBP5, THBD, TSPAN15 and VWF. The common polymorphisms are estimated to account only for a modest part (~5 %) of the VT heritability. Much remains to be done to fully disentangle the exact genetic (and epigenetic) architecture of the disease. A large suite of powerful tools and research strategies can be deployed on the large collections of patients that have already been assembled (and additional are ongoing).
<strong>Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 7. Ricciaceae</strong>
Authors: Perold S. M. 
Published: September 2015

Four Riccia species, namely R. lanceolata, R. okahandjana, R. stricta and R. vulcanicola of the hepatic family Ricciaceae (order Marchantiales) from Rwanda and Zaire are described and illustrated in this report. Riccia lanceolata and R. stricta are new records for Rwanda.
Net Precipitation of Antarctica: Thermodynamical and Dynamical Parts of the Climate Change Signal
Authors: Grieger Jens , Leckebusch Gregor C. , Ulbrich Uwe 
Published: September 2015

Abstract
This paper investigates climate change signals of Southern Hemisphere (SH) moisture flux simulated by three members of one CMIP3 coupled atmosphere–ocean general circulation model (AOGCM) and a multimodel ensemble of CMIP5 simulations. Generally, flux changes are dominated by increased atmospheric moisture due to temperature increase in the future climate projections. An approach is presented to distinguish between thermodynamical and dynamical influences on moisture flux. Furthermore, a physical interpretation of the transport changes due to dynamics is investigated by decomposing atmospheric waves into different length scales and temporal variations. Signals of moisture flux are compared with fluctuations of geopotential height fields as well as climate signals of extratropical cyclones. Moisture flux variability in the synoptic length scale with temporal variations shorter than 8 days can be assigned to the SH storm track. Climate change signals of these atmospheric waves show a distinctive poleward shift. This can be attributed to the climate change signal of extratropical cyclones. Furthermore, the climate change signal of atmospheric waves can be better understood if strong cyclones that intensify especially on the Eastern Hemisphere are taken into account. Antarctic net precipitation is calculated by means of the vertically integrated moisture flux. Future projections show increasing signals of net precipitation, whereas the dynamical part of net precipitation decreases. This can be understood by means of the low-variability component of synoptic-scale waves, which show a decreasing signal, especially off the coast of West Antarctica. This is shown to be due to changing variability of the Amundsen–Bellingshausen Seas low.
Decision-making in time of crisis: cutback management in Estonia
Authors: Savi Riin , Randma-Liiv Tiina 
Published: September 2015

The article investigates the Estonian government's response to the fiscal crisis by looking at the dynamics of the decision-making processes during cutback management from 2008 to 2013 from the dichotomy of centralization–decentralization. The study explores the cutback decision-making by pinpointing the main actors and contextual variables shedding light on the management of fiscal crisis. It is demonstrated that, in general, the fiscal crisis contributed to increasing levels of centralization in governmental decision-making. The crisis decision-making was dominated by centralized political decisions and non-inclusion of the opposition and interest groups. Still, achieving urgent solutions was facilitated by decentralized decisions at the ministerial level, the empowerment of budgetary institutions and the intensive engagement of the civil servants. It has been indicated that the initially short-term procedures to enable cuts and resultant changes in decision-making processes are mostly in effect still in 2014 and thereby influence public administration practices in the long run. Points for practitioners The study shows that cutback management may lead to urgency in governmental decision-making, where centralization facilitates quick decisions. It is also demonstrated that a minority government is able to achieve fiscal adjustment even in a context of high political conflict. The crisis context sets new requirements to the competencies of public servants, as cutback management obliges them to cope with new and very complicated tasks. The article indicates that short-term cuts and changes in decision-making processes intended to alleviate the acute phase of crisis may remain in effect considerably longer than initially planned and thereby influence public administration practices in the long run.
Clinical significance of no-reflow in different stages of primary angioplasty among patients with acute myocardial infarctions
Authors: Jiecheng Peng , Ai-ling Wang 
Published: September 2015

Background: The coronary no-reflow (NR) phenomenon, which is associated with poor clinical outcomes, is usually referred to as a post-percutaneous coronary intervention (PCI) state. NR can occur in different stages of the PCI procedure, not only including the post-stenting stage, but from balloon pre-dilation to pre-stenting. The clinical significance of NR in the different stages of the PCI procedure is unclear. The purpose of the current study was to analyze the clinical and angiographic characteristics, the prognosis for NR patients in the aforementioned two stages and to determine the predictors of NR in the early stage. Methods: Between January 2009 and December 2013, a total of 420 consecutive patients with ST-segment elevation myocardial infarction (STEMI) underwent primary PCI. Sixty-three patients (15%) with NR constituted the study population. The patients were divided into an early NR group and a subsequent NR group. The clinical and angiographic findings were compared between the two groups. Multivariate logistic regression was used to determine the predictors for early NR. The long-term clinical outcomes after PCI were analyzed. Results: Regarding the baseline characteristics, we identified that the early NR group had statistically significant effects on the higher percentage of diabetes mellitus (42.9% vs. 20%), lower admission systolic blood pressure (SBP) (102.2±8.3 mmHg vs. 110.5±7.6 mmHg), higher percentage of Killip classification III (71.4% vs. 45.7%,) and longer reperfusion time (7.1±2.3 h vs. 5.88±2.2 h) compared to the subsequent NR group. There were significant differences between the two groups with respect to the percentage of initial thrombolysis in myocardial infarction (TIMI) flow 0/1 (64.3% vs. 37.1%), target lesion length (31.4±13.6 mm vs. 20.5±17.3 mm) and thrombus score ⩾4 (67.9% vs. 42.9%; p<0.05 for all). Multiple stepwise logistic regression analysis indicated that an admission SBP <100 mmHg (OR=4.580; 95% CI=1.385–15.150; p=0.0130), reperfusion time ⩾6 h (OR=4.978; 95% CI=1.468–16.882; p=0.010) and a thrombus score ⩾4 (OR=2.708; 95% CI=0.833–8.799; p=0.008) were the independent determinants of the early NR. During a 1-year follow-up, the all-cause mortality and overall major adverse cardiac events (MACEs) in the early NR group occurred significantly more often than in the subsequent NR group (28.6% vs. 5.7% and 35.7% vs. 14.3%, respectively, p <0.05). The early NR group had a lower left ventricular ejection fraction (LVEF) (42.5±4.7 vs. 47.8±3.5, p <0.001) and a larger left ventricular end diastolic diameter (LVEDD) (56.0±4.0 vs. 51.5 ±4.7, p=0.001) at the end of the follow-up. Conclusion: Early NR patients during primary PCI have more severe baseline clinical and angiographic characteristics, as well as a poorer long-term prognosis.
The refluxing anterior accessory saphenous vein demonstrates similar clinical severity when compared to the refluxing great saphenous vein
Authors: Schul Marlin W , Schloerke Barrett , Gomes Guilherme Maia 
Published: September 2015

Objective To prospectively compare disease severity in subjects with anterior accessory saphenous vein versus great saphenous vein incompetence with an incompetent saphenofemoral junction. Methods Data were^ collected from 241 subjects and 290 limbs over a six-month period. These subjects were categorized into three groups with primary venous reflux disease, namely anterior accessory saphenous vein, great saphenous vein, and control. Statistical methods including descriptive statistics, student t-tests, and log linear modeling were employed to compare groups and determine predictive features out of the 41 demographic and disease-specific variables collected. Results Subjects in the anterior accessory saphenous vein group and those in the great saphenous vein group demonstrate statistically significant differences as compared to the control group with respect to the following disease-specific features: mean VCSS, presence of C2 and C3 disease. The anterior accessory saphenous vein group also showed statistically significant differences in gender compared to both great saphenous vein and control, as well as mean body mass index compared to the control. Log-linear modeling revealed equivalent disease severity when comparing patients with saphenofemoral junction reflux to the great saphenous vein or anterior accessory saphenous vein. Conclusions Patterns of reflux from the saphenofemoral junction to either the anterior accessory saphenous vein or great saphenous vein possess similar disease severity and commonly suffer complications of venous stasis.
Accuracy of venous thromboembolism assessment and compliance to prophylaxis in a tertiary care center
Authors: Kim Pamela S , Gasparis Antonios P , Probeck Kristan , Elitharp Doreen , Tassiopoulos Apostolos , Labropoulos Nicos 
Published: September 2015

Background Proper assessment of venous thromboembolism (VTE) risk level in hospitalized patients is vital to providing adequate prophylaxis. Clinical decision support (CDS) tools with electronic medical record (EMR) have been used by institutions to improve assessment and prophylaxis. As such, this study was conducted after implementing such a system to compare admitting service (AS) assessment of VTE risk level to the VTE consult service (CS) assessment. In addition, compliance of ordered prophylaxis based on AS assessment was evaluated. Methods At a tertiary care center, we performed a review of randomly selected patients assessed within 18 h of admission for VTE risk over a five-month period. A total of 104 patients were evaluated, four of which were excluded because of VTE presence on admission. Patients were assessed for VTE risk independently, first by the AS, followed by the VTE CS. Prophylaxis orders were then reviewed based on AS assessment compliance to CDS recommendations for prophylaxis based on ACCP guidelines. Results All 100 patients underwent VTE risk assessment within 18 h from admission. The mean age was 63 years. Comparing AS to CS assessment, 13 patients had incorrect assessments ( p < .001). Of these, six patients were under-assessed ( p = .029), and seven patients were over-assessed ( p = .014). Based on AS assessment there were eight patients who had incorrect prophylaxis ordered. Unnecessary exposure to complications due to inappropriate prophylaxis occurred in five patients. Conclusion Despite the use of EMR CDS tools, there continues to be a significant number of patients that are being under-assessed and under-prophylaxed for VTE resulting in exposing patients to potential harm. Quality programs need to be instituted to further improve VTE assessment and prophylaxis.
Single test isolated lupus anticoagulant positivity is associated with increased plasma levels of inflammatory markers and dyslipidemia
Authors: Just Søren Andreas , Nybo Mads , Laustrup Helle , Hansen Inger Marie Jensen , Junker Peter , Vinholt Pernille Just 
Published: September 2015

Objective To investigate whether a single positive test for lupus anticoagulant (LA) is associated with levels of inflammatory markers and traditional cardiovascular risk factors, independent of autoimmune disease, thrombophilia and occurrence of other antiphospholipid antibodies. Methods In a retrospective observational study we included persons referred for thrombophilia testing during 2011−2014. Persons with autoimmune disease, thrombophilia or presence of specific anti-phospholipid antibodies were excluded. Multivariate logistic regression analyses adjusted for age and sex was performed and odds ratios (ORs) with 95% confidence intervals (95% CI) calculated. Results Of 381 individuals tested, 271 fulfilled the criteria, of whom 22 (8%) were LA positive and 249 (92%) LA negative. LA positivity was associated with higher body mass index (BMI) (OR 1.12, 95% CI: 1.03–1.23, p = 0.01); C-reactive protein (OR 1.08 95% CI:1.04–1.11, p < 0.001); fibrinogen (OR 1.51 95% CI: 1.27–1.78, p < 0.001); coagulation factor VIII (FVIII) (OR 1.73 95% CI: 1.01–2.96, p = 0.046), low high density lipoprotein (HDL) (OR 0.03 95% CI: 0.00–0.19, p < 0.001) and high triglyceride (OR 1.81 95% CI: 1.12–2.92, p = 0.02) compared with LA negative individuals. Conclusion This study shows that single test isolated LA positivity is associated with increased levels of inflammatory markers, low HDL cholesterol, elevated triglyceride and high BMI.
The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada
Authors: Wilson Christopher M. , Stiller Christine H. , Doherty Deborah J. , Thompson Kristine A. 
Published: September 2015

Purpose: Little is known regarding the extent to which physical therapy is integrated into Hospice and Palliative Care (HPC). The purpose of this study was to describe perceptions of physical therapists (PTs) regarding their role within HPC or working with patients having life-threatening illnesses and to develop a conceptual framework depicting a PTs role within HPC and factors affecting it. Participants: Ten PTs, 5 from the United States and 5 from Canada, with at least 5 years of physical therapy experience and 5 years working experience with patients having life-threatening illnesses or in HPC. Methods: Demographic data were collected by electronic questionnaire. A semistructured interview was conducted with each participant to investigate their perceptions about the role of PTs in HPC. Data Analysis: Interview results were analyzed for trends between participants, practice settings, regions, and other sociocultural aspects. The constant comparative method of qualitative data analysis was used to identify similarities and differences and to develop themes and concepts relative to the role of PT in HPC. Results: Participants identified their 3 primary roles in HPC: providing patient/family care, serving as an interdisciplinary team member, and fulfilling professional responsibilities outside of direct patient care. They described factors within and outside direct patient care which influenced their roles. Concepts included shifting priorities, care across the continuum, and changing perceptions of PTs within HPC. Clinical Relevance: This study described perceptions of the role of PTs within HPC that may be utilized when coordinating future strategies to appropriately promote and expand the role.
Mechanism of quinine-dependent monoclonal antibody binding to platelet glycoprotein IIb/IIIa
Authors: Bougie Daniel W. , Peterson Julie , Rasmussen Mark , Aster Richard H. 
Published: September 2015

Key PointsDrug-induced modulation of antibody specificity appears to explain the binding of drug-dependent mAbs to αIIb/β3 integrin. Drug-dependent platelet antibodies differ greatly from classic hapten-specific antibodies and may be induced by a quite different mechanism.