bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atrial Fibrillation Burden Estimates Derived from Intermittent Rhythm Monitoring are Unreliable Estimates of the True Atrial Fibrillation Burden
Authors: CHARITOS EFSTRATIOS I. , ZIEGLER PAUL D. , STIERLE ULRICH , ROBINSON DEREK R. , GRAF BERNHARD , SIEVERS HANS‐HINRICH , HANKE THORSTEN 
Published: March 2014

BackgroundEstimates of atrial fibrillation (AF) burden (AFB) derived from intermittent rhythm monitoring (IRM) are increasingly being used as an outcome measure after therapeutic interventions; however, their accuracy has never been validated. The aim of this study was to compare IRM‐derived AFB estimates to the true AFB as measured by implantable continuous monitoring (CM) devices.MethodsRhythm histories from 647 patients (mean AFB: 12 ± 22%; 687 patient·years) with CM devices were analyzed. IRM of various frequencies and durations were simulated and the obtained IRM‐derived AF burdens were compared to the true AFB measured by CM.ResultsThe relative error of the IRM burden estimates was dependent on the IRM length (P < 0.001), frequency of IRM (P < 0.001), the true AFB (P < 0.001), and its temporal aggregation (AF density, P < 0.001). In paroxysmal AF patients, the relative error even with aggressive IRM strategies was >80% of the true AFB. The relative error decreased with higher true AF burdens, lower AF densities, and higher IRM frequency or duration (P < 0.001). However, even in patients with high AF burdens and/or low AF densities, IRM estimates of AFB significantly deviated from the true AFB (relative error >20%, P < 0.001) and resulted in a substantial measurement error.ConclusionIRM‐derived AFB estimates are unreliable estimators of the true AFB. Particularly for paroxysmal AF patients, IRM‐derived AFB estimates should not be used to evaluate outcomes after AF interventions.
Is dexmedetomidine superior to midazolam as a premedication in children? A meta‐analysis of randomized controlled trials
Authors: Sun Yu , Lu Yi , Huang Yan , Jiang Hong 
Published: March 2014

SummaryBackgroundIn the current published literature, there are controversial results regarding the effectiveness of dexmedetomidine compared with midazolam as premedication in children. The aim of this meta‐analysis was to compare the use of dexmedetomidine as a premedication in pediatric patients with that of midazolam.MethodsWe searched for articles published in English that matched the key words ‘dexmedetomidine’, ‘midazolam’, and ‘children’ in the PubMed, Cochrane Library, Ovid, and Google Scholar databases. Additional studies were identified from the reference lists of the retrieved articles. Only prospective randomized controlled trials (RCTs) that compared the use of dexmedetomidine and midazolam as premedications in children were included. The extraction of data from the articles was performed independently by two authors using a predesigned Excel spreadsheet. The relative risks (RRs), weighted mean differences (WMDs), and their corresponding 95% confidence intervals (95% CIs) were calculated for dichotomous and continuous outcome data using the quality effects model of the MetaXL version 1.3 software.ResultsEleven prospective RCTs (829 children) met our criteria. Compared with midazolam, dexmedetomidine premedication was associated with more satisfactory sedation upon parent separation (eight RCTs [679 children]; RR: 1.25; 95% CI: 1.06, 1.46) and upon mask acceptance (seven RCTs [559 children]; RR: 1.17; 95% CI: 1.01, 1.36). During the postoperative period, premedication with dexmedetomidine lowered the numbers of requests for rescue analgesia (six RCTs [477 children]; RR: 0.55; 95% CI: 0.40, 0.74) and lowered the risks of agitation or delirium (seven RCTs with [466 children]; RR: 0.59; 95% CI: 0.40, 0.88), and shivering (three RCTs [192 children]; RR: 0.33; 95% CI: 0.18, 0.61). However, dexmedetomidine premedication reduced systolic blood pressure (three RCTs [242 children]; WMD: −11.47 mm·Hg−1; 95% CI: −13.95, −8.98), mean blood pressure (three RCTs [202 children]; WMD: −5.66 mm·Hg−1; 95% CI: −8.89, −2.43), and heart rate (six RCTs [444 children]; WMD: −12.71 beat·min−1; 95% CI: −14.80, −10.62), and prolonged the onset of sedation (two RCTs [132 children] WMD: 13.78 min; 95% CI: 11.33, 16.23; I2 = 0%) relative to midazolam.ConclusionThis meta‐analysis demonstrated that dexmedetomidine premedication is superior to midazolam premedication in terms of producing satisfactory sedation upon parent separation and mask acceptance. Dexmedetomidine premedication provides clinical benefits that included reducing the requirements for rescue analgesia and reducing agitation or delirium and shivering during the postoperative period. However, the risks of heart rate and blood pressure decreases, and the prolonged onset of sedation associated with dexmedetomidine should be considered.
Comparison of Problems and Unmet Needs of Patients with Advanced Cancer in a European Country and an Asian Country
Authors: Effendy Christantie , Vissers Kris , Osse Bart H. P. , Tejawinata Sunaryadi , Vernooij‐Dassen Myrra , Engels Yvonne 
Published: March 2014

AbstractBackgroundPatients with advanced cancer experience problems and unmet needs. However, we assume that patients with advanced cancer will have more problems and unmet needs in a country with a lower economic status than in an economically stronger country. We studied whether patients with advanced cancer in Indonesia have more problems and unmet needs than a similar group of patients in the Netherlands.MethodsWe performed a cross‐sectional survey. We compared the data for 180 Indonesian and 94 Dutch patients relating to 24 items of the Problems and Needs in Palliative Care‐short version questionnaire. We performed descriptive and χ2 analysis with Bonferroni correction.ResultsThe prevalence of most physical problems, including pain, was similar in the 2 groups. In Indonesia, financial problems were the most common: 70 to 80% vs. 30 to 42% in the Netherlands. In Indonesia, 25 to 50% of the patients reported psychological and autonomy problems versus 55 to 86% in the Netherlands. The Indonesian group had many more unmet needs for each problem (> 54%) than the Dutch group (< 35%).ConclusionApparently, economic and cultural differences hardly influence physical problems. Nonetheless, fewer Indonesian patients reported psychological and autonomy problems than Dutch patients. This difference contradicts our hypothesis. However, we found more unmet needs for professional attention in Indonesia than in the Netherlands, which is compatible with our hypothesis. These simple comparative data provide interesting insights into problems and unmet needs and give rise to our new hypothesis about cultural influences. This hypothesis should be studied in more depth.
Periostin accelerates human malignant melanoma progression by modifying the melanoma microenvironment
Authors: Kotobuki Yorihisa , Yang Lingli , Serada Satoshi , Tanemura Atsushi , Yang Fei , Nomura Shintaro , Kudo Akira , Izuhara Kenji , Murota Hiroyuki , Fujimoto Minoru , Katayama Ichiro , Naka Tetsuji 
Published: March 2014

SummaryGiven no reliable therapy for advanced malignant melanoma, it is important to elucidate the molecular mechanisms underlying the disease progression. Using a quantitative proteomics approach, the ‘isobaric tags for relative and absolute quantitation (iTRAQ)’ method, we identified that the extracellular matrix protein, periostin (POSTN), was highly expressed in invasive melanoma compared with normal skin. An immunohistochemical analysis showed that POSTN was expressed in all invasive melanoma (n = 20) and metastatic lymph node (n = 5) tissue samples, notably restricted in their stroma. In terms of the intercellular regulation of POSTN, we found that there was upregulation of POSTN when melanoma cells and normal human dermal fibroblasts (NHDFs) were cocultured, with restricted expression of TGF‐β1 and TGF‐β3. In a functional analyses, recombinant and NHDF‐derived POSTN significantly accelerated melanoma cell proliferation via the integrin/mitogen‐activated protein kinase (MAPK) signaling pathway in vitro. The size of implanted melanoma tumors was significantly suppressed in POSTN/Rag2 double knockout mice compared with Rag2 knock‐out mice. These results indicate that NHDF‐derived POSTN accelerates melanoma progression and might be a promising therapeutic target for malignant melanoma.
Methylisothiazolinone: A Case of Perianal Dermatitis Caused by Wet Wipes and Review of an Emerging Pediatric Allergen
Authors: Admani Shehla , Matiz Catalina , Jacob Sharon E. 
Published: March 2014

AbstractMethylisothiazolinone (MI) is a preservative found in cosmetic, personal hygiene, and industrial products. It has been characterized as a moderate to strong sensitizer and is an emerging allergen in the pediatric population. We discuss a case of perianal dermatitis in a child caused by contact allergy to MI‐containing wet wipes.
Methodology for Establishing a Population‐Based Birth Cohort Focusing on Couple Fertility and Children's Development, theUpstateKIDSStudy
Authors: Buck Louis Germaine M. , Hediger Mary L. , Bell Erin M. , Kus Christopher A. , Sundaram Rajeshwari , McLain Alexander C. , Yeung Edwina , Hills Elaine A. , Thoma Marie E. , Druschel Charlotte M. 
Published: March 2014

AbstractBackgroundCritical data gaps remain regarding infertility treatment and child development. We assessed the utility of a birth certificate registry for developing a population cohort aimed at answering such questions.MethodsWe utilised theUpstateNewYork livebirth registry (n = 201 063) to select births conceived with (n = 4024) infertility treatment or exposed infants, who were then frequency‐matched by residence to a random sample of infants conceived without (n = 14 455) treatment or unexposed infants, 2008–10. Mothers were recruited at 2–4 months postpartum and queried about their reproductive histories, including infertility treatment for comparison with birth certificate data. Overall, 1297 (32%) mothers of exposed and 3692 of unexposed (26%) infants enrolled.ResultsTwins represented 22% of each infant group. The percentage of infants conceived with/without infertility treatment was similar whether derived from the birth registry or maternal report: 71% none, 16% drugs or intrauterine insemination, and 14% assisted reproductive technologies (ART). Concordant reporting between the two data sources was 93% for no treatment, 88% forART, and 83% for fertility drugs, but differed by plurality. Exposed infants had slightly (P < 0.01) earlier gestations than unexposed infants (38.3 ± 2.8 and 38.7 ± 2.7 weeks, respectively) based upon birth certificates but not maternal report (38.7 ± 2.7 and 38.7 ± 2.9, respectively). Conversely, mean birthweight was comparable using birth certificates (3157 ± 704 and 3194 ± 679 g, respectively), but differed using maternal report (3167 ± 692 and 3224 ± 661, respectivelyP < 0.05).ConclusionsThe birth certificate registry is a suitable sampling framework as measured by concordance with maternally reported infertility treatment. Future efforts should address the impact of factors associated with discordant reporting on research findings.
Evaluation of HLA‐DRB1 imputation using a Finnish dataset
Authors: Vlachopoulou E. , Lahtela E. , Wennerström A. , Havulinna A. S. , Salo P. , Perola M. , Salomaa V. , Nieminen M. S. , Sinisalo J. , Lokki M.‐L. 
Published: March 2014

AbstractOwing to the vast amount of alleles, high‐resolution human leukocyte antigen (HLA) typing is expensive and time‐consuming. Scientists have attempted to develop computational approaches to define HLA alleles with high confidence. We tested the reliability of HLA*IMP and SNP2HLA for imputing HLA‐DRB1 alleles in a Finnish material (n = 161). The per‐individual success rates varied between 16.68% and 25.4% using both softwares. One of the most prominent example was HLA‐DRB1*01:01 allele showing approximately a 30% success rate while being the most common wrongly imputed allele. In Finland, isolation and migration history have shaped the gene pool narrower showing HLA haplotype frequencies typical to the Finnish population when compared to Europeans. The imputation success for HLA‐DRB1 alleles was very low pointing to the importance of population‐specific reference material.
Transient residence of a seropositive organ is sufficient to transfer human cytomegalovirus to a seronegative recipient
Authors: Lumgair H.A. , Rolando N. , O'Beirne J. , Sharma D. , Griffiths P.D. 
Published: March 2014

AbstractMany aspects of the pathogenesis of human cytomegalovirus (HCMV) infection in liver transplantation remain unclear. This study examined the transfer of HCMV from the transient residence of a seropositive organ in seronegative recipients. All subjects receiving >1 orthotopic liver transplant (LT) were identified from an LT database. The patients of interest were HCMV‐seronegative LT recipients who received their first organ from a seropositive donor, and subsequently a second LT from a seronegative donor within 30 days. Of 98 patients identified, 6 met these criteria and 4 developed viremia; in 2 cases, after the seropositive organ was in situ for 28 and 109 h. We can therefore conclude that 28 h is sufficient to allow HCMV to transmit, but the minimum time has not yet been defined.
Exploring intentions to discriminate against patients living with HIV/AIDS among future healthcare providers in Malaysia
Authors: Earnshaw Valerie A. , Jin Harry , Wickersham Jeffrey , Kamarulzaman Adeeba , John Jacob , Altice Frederick L. 
Published: March 2014

AbstractObjectivesStigma towards people living with HIV/AIDS (PLWHA) is strong in Malaysia. Although stigma has been understudied, it may be a barrier to treating the approximately 81 000 Malaysian PLWHA. The current study explores correlates of intentions to discriminate against PLWHA among medical and dental students, the future healthcare providers of Malaysia.MethodsAn online, cross‐sectional survey of 1296 medical and dental students was conducted in 2012 at seven Malaysian universities; 1165 (89.9%) completed the survey and were analysed. Socio‐demographic characteristics, stigma‐related constructs and intentions to discriminate against PLWHA were measured. Linear mixed models were conducted, controlling for clustering by university.ResultsThe final multivariate model demonstrated that students who intended to discriminate more against PLWHA were female, less advanced in their training, and studying dentistry. They further endorsed more negative attitudes towards PLWHA, internalised greater HIV‐related shame, reported more HIV‐related fear and disagreed more strongly that PLWHA deserve good care. The final model accounted for 38% of the variance in discrimination intent, with 10% accounted for by socio‐demographic characteristics and 28% accounted for by stigma‐related constructs.ConclusionsIt is critical to reduce stigma among medical and dental students to eliminate intentions to discriminate and achieve equitable care for Malaysian PLWHA. Stigma‐reduction interventions should be multipronged, addressing attitudes, internalised shame, fear and perceptions of deservingness of care.
Clinical and histological characterization of multifocal, spontaneous, noninfectious alopecia inNorwegian puffin dogs (lundehunds)
Authors: Bergvall Kerstin E. , Shokrai Arman 
Published: March 2014

BackgroundA noninfectious, spontaneous, multifocal alopecia has been recognized inNorwegian puffin dogs.Hypothesis/ObjectivesThis study aimed to report demographic information, history, clinical signs, histopathological features and follow‐up information for alopecicNorwegian puffin dogs fromSweden.Material and methodsA questionnaire was sent out to all members of the breed association. Dogs clinically diagnosed with alopecia and biopsied were allocated to Group A. Dogs reported with alopecia for which histopathology was not available were allocated to Group B.ResultsGroupAincluded 14 dogs (11.7% of the breed population inSweden). Information regarding 72 dogs (60% of the breed population) was collected via questionnaire, and alopecia without histopathology was reported in another five dogs (Group B). Gender distribution was equal. Median age of onset was 1.5 years (range 8 months to 7 years). Multifocal or serpiginous alopecia, follicular plugging, dry skin, slight scaling and pruritus were characteristic. Extensive, widespread alopecia was not seen, and lesions were recorded only in haired skin. A lymphoplasmacytic, mural, isthmus folliculitis/perifolliculitis with follicular and perifollicular mucin was observed. Inflammation did not involve the hair bulb; atrophy was sometimes present. The inflammation sometimes extended to sebaceous glands, resulting in atrophy and absence of glands. Follow‐up ranged from 6 months to 12 years (mean 3.2 years). Spontaneous remission was rare. Estrus was associated with worsening of the disease or relapse. Oral prednisolone reduced pruritus but was not effective in resolving clinical lesions. All dogs treated with ciclosporin went into remission.Conclusions and clinical importanceThis is the first report of mural, mucinotic, isthmus folliculitis alopecia inNorwegian puffin dogs.
Feline eosinophilic dermatoses: a retrospective immunohistochemical and ultrastructural study of extracellular matrix remodelling
Authors: Porcellato Ilaria , Giontella Andrea , Mechelli Luca , Del Rossi Emilia , Brachelente Chiara 
Published: March 2014

BackgroundFeline eosinophilic dermatoses (FEDs) are common diseases of cats with an unknown pathogenesis. They are histologically characterized by an eosinophilic infiltration and often by the presence of flame figures (FFs) and/or areas of loss of tissue architecture, here termed necrotic foci (NF). It has been postulated that an alteration in the degradation of the extracellular matrix could be responsible for these histological features. Matrix metalloproteinases (MMPs) are a group of proteases that are fundamental in extracellular matrix remodelling.Hypothesis/ObjectivesThe aim of the study was to investigate retrospectively the expression of a subgroup of MMPs, in particular MMP‐2 and MMP‐9 gelatinases, in FEDs. The expression of one of their inhibitors, TIMP‐2, was also investigated in order to establish the role of these molecules in the pathogenesis of FEDs. The ultrastructural characteristics of extracellular matrix in FFs and NF were subsequently assessed.MethodsFifty‐one formalin‐fixed, paraffin‐embedded specimens from cutaneous and mucosal biopsies diagnosed as FEDs were investigated immunohistochemically. Two selected samples were processed for electron microscopy.ResultsThis study revealed an increased expression of MMP‐2 in NF and a decreased expression of this gelatinase in FFs. An imbalance between MMP‐2 and TIMP‐2 was evident using immunohistochemistry. No significative results were observed for MMP‐9 expression. Electron microscopy confirmed the lack of normal collagen fibres in NF, whereas in FFs only occasional, amorphous material was observed among normal collagen fibres.Conclusions and clinical importanceOur study suggests that an imbalance in the expression of matrix metalloproteinases could be responsible for different morphological findings in FEDs. Further studies are needed to assess the role of matrix metalloproteinases in the pathogenesis of FEDs.
Germination response of local Southern European populations of Datura stramonium at a range of constant temperatures
Authors: Loddo D , Sousa E , Masin R , Calha I M , Zanin G , Fernández‐Quintanilla C , Dorado J 
Published: March 2014

SummaryStudies on weed germination are required to develop efficient integrated weed management strategies that should be transferable at wide scale and accurate at local level. To study interpopulation variability, which may hamper this process, three local populations of Datura stramonium were collected in Italy, Portugal and Spain and then cultivated simultaneously in three common gardens under different environmental conditions. Hence, nine seed lots were included in the germination tests performed at a range of constant incubating temperatures. Significant effects of population of origin, cultivation site, incubating temperature and their interaction were detected on mean germination percentage and germination t50. Mean germination percentage varied from 0.0 to 89.7% ± 2.10 SE at 8 and 20°C respectively. Mean germination t50 ranged from 636.1 ± 24.86 SE to 267.0 ± 16.06 SE hours at 12 and 20°C respectively. Seed lots deriving from the Portuguese population presented the lowest germination percentages and highest germination t50 at low incubating temperatures, regardless of the cultivation site. This behaviour could be related to an adaptive process of the Portuguese population to the local environmental conditions, produced by the combination of climate and agronomic management. The presence of high interpopulation variability for D. stramonium could hinder the development of transferable IWM strategies. However, management plans could be proposed at regional scale according to the approach of modifying the patterns of agronomic disturbances to which the local populations have adapted.
Smartphone and tablet apps for concussion road warriors (team clinicians): a systematic review for practical users
Authors: Lee Hopin , Sullivan S John , Schneiders Anthony G , Ahmed Osman Hassan , Balasundaram Arun Prasad , Williams David , Meeuwisse Willem H , McCrory Paul 
Published: March 2014

BackgroundMobile technologies are steadily replacing traditional assessment approaches for the recognition and assessment of a sports concussion. Their ease of access, while facilitating the early identification of a concussion, also raises issues regarding the content of the applications (apps) and their suitability for different user groups.AimTo locate and review apps that assist in the recognition and assessment of a sports concussion and to assess their content with respect to that of internationally accepted best-practice instruments.MethodsA search of international app stores and of the web using key terms such as ‘concussion’, ‘sports concussion’ and variants was conducted. For those apps meeting the inclusion criteria, data were extracted on the platform, intended users and price. The content of each app was benchmarked to the Sport Concussion Assessment Tool 2 (SCAT2) and Pocket SCAT2 using a custom scoring scheme to generate a percentage compliance statistic.Results18 of the 155 apps identified met the inclusion criteria. Almost all (16/18) were available on an iOS platform and only five required a payment to purchase. The apps were marketed for a wide range of intended users from medical professionals to the general public. The content of the apps varied from 0% to 100% compliance with the selected standard, and ‘symptom evaluation’ components demonstrated the highest level of compliance.ConclusionsThe surge in availability of apps in an unregulated market raises concerns as to the appropriateness of their content for different groups of end users. The consolidation of best-practice concussion instruments now provides a framework to inform the development of future apps.