bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incremental Value of Pocket‐Sized Echocardiography in Addition to Physical Examination during Inpatient Cardiology Evaluation: A Multicenter Italian Study (SIEC)
Authors: Di Bello Vitantonio , La Carrubba Salvatore , Conte Lorenzo , Fabiani Iacopo , Posteraro Alfredo , Antonini‐Canterin Francesco , Barletta Valentina , Nicastro Irene , Mariotti Egidio , Severino Sergio , Caso Pio , Benedetto Frank , Savino Ketty , Carerj Scipione ,   SIEC (Italian Society of Cardiovascular Echography)
Published: April 2015

BackgroundWe prospectively assessed the incremental value of a pocket‐sized echocardiography (PSE) device during cardiology consultations, in addition to physical examination, ECG reading, and chest x‐ray.MethodsA total of 443 consecutive patients (53% men), referred for bedside consultations, underwent physical examination, ECG, and CXR, followed by PSE examination. The physician completed a detailed questionnaire (clinical and echocardiographic data, scanning time, abnormal results). Receiver operating characteristic (ROC) curve analysis was generated to test the predictive discrimination value of the different methods. The incremental value of PSE examination compared to clinical visit alone or combined with ECG results was expressed as a global chi‐square value.ResultsThe PSE examination did not influence the definitive diagnosis in only 23.5% of cases, while 25.3% of the diagnoses were confirmed and verified by PSE. The clinical diagnosis was enriched by PSE in 21.9% of cases, and the diagnosis was changed in 26.2%. The area under curve (AUC) of physical examination + ECG results (sensitivity: 80%; specificity: 67%) was significantly higher than physical examination alone (sensitivity: 75%; specificity: 62%) (P < 0.0002), and the AUC of PSE results (sensitivity: 88%; specificity: 86%) was significantly higher than physical examination + ECG results (P < 0.0001). The PSE results, combined with clinical and ECG results, had a significant incremental diagnostic value during cardiology consultation when compared to the clinical visit alone or with ECG results (P < 0.0001).ConclusionsPSE had an incremental diagnostic value during bedside cardiology consultation, increasing the number of appropriate diagnoses and reducing the routine use of echocardiography.
Patients characteristics influencing the longitudinal utilization of steroids in multiple sclerosis – an observational study
Authors: Rommer Paulus S. , Buckow Karoline , Ellenberger David , Friede Tim , Pitschnau‐Michel Dorothea , Fuge Jan , Stüve Olaf , Zettl Uwe K. ,   the German Multiple Sclerosis (MS) Registry of the German National MS Society (DMSG)
Published: April 2015

AbstractBackgroundMultiple Sclerosis is the most common disease in young adults affecting the central nervous system. Disease may progress with acute attacks (relapsing MS) or continuously (progressive MS). Glucocorticosteroids are used in the treatment of acute attacks. The aim of this study was to analyse characteristics of patients with MS, and their influence on current treatment patterns of relapses with glucocorticosteroids.DesignIn 2001, the German National MS Society initiated the German MS‐Registry. Patients with relapsing MS were included (n = 5106) from this registry. Logistic regression models were used to detect trends over time. The likelihood of administration of steroids is modelled in dependence of calendar year and in dependence to confounders in treatment conditions. The sample size allows that odds ratios can be detected with a power of 90% (alpha = 0·05).ResultsAdministration of glucocorticosteroids was influenced by EDSS (P < 0·0001), age (P < 0·0001) and disease duration (P < 0·0001). Therapy administration in an outpatient setting was more likely in patients with higher EDSS (P < 0·0001) and longer disease duration (P < 0·0001). The utilization of glucocorticosteroids increased with higher EDSS for all relapsing patients. Interestingly, all overutilization of glucocorticosteroids decreased over time and was accompanied by a steadily increased administration of emergent therapeutics. Although there are about 70% of registered patients with relapsing MS on immune‐modulatory treatment, almost 60% of them received glucocorticosteroids for treatment of relapses.ConclusionsTreatment patterns with glucocorticosteroids in patients with MS are influenced mainly by EDSS and disease duration. The decline in the utilization of glucocorticosteroids is accompanied by an increase in natalizumab treatment.
Effects of water clarity and other environmental factors on trophic niches of two sympatric piscivores
Authors: Stasko Ashley D. , Johnston Tom A. , Gunn John M. 
Published: April 2015

Summary

Water clarity can have a profound influence on aquatic ecosystem structure and processes via its effects on physical habitat (e.g., thermal regime, macrophyte density) and behavioural responses of biota (e.g., predator avoidance, reaction distances, foraging efficiency). Changes in foraging efficiencies under varying water clarity conditions are well documented for many freshwater piscivores in laboratory studies, but the influence of visual foraging conditions on interspecific trophic dynamics is poorly understood in wild populations, especially within water clarity ranges that are realistic for north‐temperate boreal lakes.

Here, we used stable isotopes of nitrogen (15N/14N) and carbon (13C/12C) in fish muscle tissue to investigate how resource partitioning between two sympatric visual piscivores is related to water clarity and other habitat variables in 28 small (100–200 ha) Boreal Shield lakes. One of the species is adapted for foraging in low subsurface illumination (walleye, Sander vitreus) and the other in high subsurface illumination (smallmouth bass, Micropterus dolomieu).

Trophic niche dimensions of the dark‐adapted predator did not respond significantly to differences in water clarity. In contrast, total isotopic niche space of the light‐adapted predator decreased significantly with increasing water clarity through greater use of pelagic resources and a narrower range of trophic levels, although these relationships were weak.

Niche overlap ranged from 0 to 65%, but was not significantly related to water clarity. Rather, indices of prey availability appeared to be much stronger predictors of trophic interactions. Both species occupied more similar food‐web positions when yellow perch (Perca flavescens) abundance was higher, and had more similar niche size and trophic evenness with decreasing prey fish species richness.

Results indicate that the trophic ecology of predators adapted to foraging in low light conditions is less influenced by water clarity than that of predators adapted to foraging in high light conditions. However, prey availability, rather than the environmental conditions in which foraging occurs, may be a more important driver of resource partitioning among generalists even when light conditions favour one species’ foraging strategy over another.
It's complicated – Factors predicting decisional conflict in prenatal diagnostic testing
Authors: Muller Cécile , Cameron Linda D. 
Published: April 2015

AbstractBackgroundThe technologies currently available to detect the presence of foetal genetic abnormalities are complex, and undergoing prenatal diagnostic testing can have wide‐ranging repercussions. Before individuals can decide with certainty whether or not to take these tests, they first need to grasp the many psychosocial and clinical dimensions of prenatal genetic testing.ObjectiveTo test a model integrating key psychosocial and clinical factors as predictors of decisional conflict in decisions about whether or not to undergo prenatal genetic testing.MethodAdults (n = 457) read one of four hypothetical scenarios asking them to imagine expecting a child and considering the option of a prenatal test able to detect a genetic condition; age of condition onset (birth vs. adulthood) and its curability (no cure vs. curable) were manipulated. Participants completed measures of decisional conflict, perceived benefits from normal results, test response efficacy, condition coherence, child‐related worry, perceived disagreement with the other parent's preference, motivation to comply with doctors' perceived preferences, and parity.ResultsPrenatal testing decisional conflict was positively predicted by perceiving normal results as beneficial, doubting the test's reliability, lacking understanding of the genetic condition, worrying about the health of the foetus, perceiving differences of opinion from partner/spouse, wanting to follow doctors' preferences, and being childless.DiscussionThese results, of growing relevance given the increasing availability of new technologies in pregnancy care, can inform communication strategies that facilitate coupless' decision making.ConclusionThis study provides insights into factors that might complicate prenatal testing decision making.
Morphological MRI Characteristics of Recent Small Subcortical Infarcts
Authors: Gattringer Thomas , Eppinger Sebastian , Pinter Daniela , Pirpamer Lukas , Berghold Andrea , Wünsch Gerit , Ropele Stefan , Wardlaw Joanna M. , Enzinger Christian , Fazekas Franz 
Published: April 2015

Background New imaging criteria for recent small subcortical infarcts have recently been proposed, replacing the earlier term ‘lacunar infarction’, but their applicability and impact on lesion selection is yet unknown. Aims To collect information on the morphologic characteristics and variability of recent small subcortical infarcts on magnetic resonance imaging in regard to lesion location and demographic variables. Methods We identified all patients with acute stroke and cerebral magnetic resonance imaging from 2008 to 2013 in our hospital database and selected those with a single recent small subcortical infarct defined by an estimated maximal axial diameter of 20 mm. Recent small subcortical infarcts were segmented on diffusion-weighted imaging and fluid-attenuated inversion recovery sequence to calculate the largest axial and longitudinal diameter and lesion volume. We assessed morphometric differences of recent small subcortical infarcts regarding location and demographic variables and the impact of different recent small subcortical infarct definitions on lesion selection. Results Three hundred forty-four patients (median age 72; range 25–92 years, 65% male) were selected. Most recent small subcortical infarcts were located in the basal ganglia ( n = 111), followed by pons ( n = 92), thalamus ( n = 77), and centrum semiovale ( n = 64). Quantitative measurements confirmed visual assessment of the axial diameter in 95%. All morphometric variables were strongly intercorrelated and comparable on diffusion-weighted imaging and fluid-attenuated inversion recovery sequence. Recent small subcortical infarcts in the basal ganglia were significantly larger both in the axial and longitudinal direction compared with other regions. Dichotomization of recent small subcortical infarcts according to axial (≤ / >15 mm) or longitudinal (≤ / >20 mm) sizes resulted in different regional frequencies and distributions. Age, gender, and time from stroke onset to magnetic resonance imaging did not influence lesion metrics or the distribution of recent small subcortical infarcts. Conclusions Our study confirms the recent neuroimaging criteria for recent small subcortical infarcts as a practical concept. Definitions of the maximal axial and longitudinal diameter have a significant impact on the frequency and distribution of selected infarcts, which has to be considered for future studies.
Lower Blood Pressure and Gray Matter Integrity Loss in Older Persons
Authors: Foster‐Dingley Jessica C. , Moonen Justine E.F. , van den Berg‐Huijsmans Anne A. , de Craen Anton J.M. , de Ruijter Wouter , van der Grond Jeroen , van der Mast Roos C. 
Published: April 2015

In contrast to middle age, it is unclear whether blood pressure (BP) in older persons is associated with cerebral small vessel disease (cSVD). The authors evaluated the association of BP with signs of cSVD as well as gray and white matter integrity in older persons. In 220 participants aged 75 years and older from the Discontinuation of Antihypertensive Treatment in the Elderly (DANTE) study, cSVD was assessed with conventional magnetic resonance imaging, and microstructural integrity with diffusion tensor and magnetization transfer (MT) imaging. BP measures were not associated with cSVD. However, lower systolic and diastolic BP and mean arterial pressure were associated with decreased gray matter MT ratio peak height and MT ratio in cortical gray matter. Mean arterial pressure was also associated with increased gray matter diffusivity. A lower level of BP was especially associated with worse gray matter integrity. Results suggest that not only upper but preferably lower thresholds of BP values should be observed in older persons.
The effect of the sphingosine‐1‐phosphate analogue FTY720 on atrioventricular nodal tissue
Authors: Egom Emmanuel E. , Kruzliak Peter , Rotrekl Vladimir , Lei Ming 
Published: April 2015

AbstractThe sphingosine‐1‐phosphate (S1P) receptor modulator, fingolimod (FTY720), has been used for the treatment of patients with relapsing forms of multiple sclerosis, but atrioventricular (AV) conduction block have been reported in some patients after the first dose. The underlying mechanism of this AV node conduction blockade is still not well‐understood. In this study, we hypothesize that expression of this particular arrhythmia might be related to a direct effect of FTY720 on AV node rather than a parasympathetic mimetic action. We, therefore, investigated the effect of FTY720 on AV nodal, using in vitro rat model preparation, under both basal as well as ischaemia/reperfusion conditions. We first look at the expression pattern of S1P receptors on the AV node using real‐time PCR. Although all three S1P receptor isoforms were expressed in AVN tissues, S1P1 receptor isoform expression level was higher than S1P2 and S1P3. The effect of 25 nM FTY720 on cycle length (CL) was subsequently studied via extracellular potentials recordings. FTY720 caused a mild to moderate prolongation in CL by an average 9% in AVN (n = 10, P < 0.05) preparations. We also show that FTY720 attenuated both ischaemia and reperfusion induced AVN rhythmic disturbance. To our knowledge, these remarkable findings have not been previously reported in the literature, and stress the importance for extensive monitoring period in certain cases, especially in patients taking concurrently AV node blocker agents.
Cost‐effectiveness of non‐surgical peri‐implantitis treatments
Authors: Listl Stefan , Frühauf Nadine , Dannewitz Bettina , Weis Christiane , Tu Yu‐Kang , Chang Huei‐Ju , Faggion Clovis M. 
Published: April 2015

AbstractAimThe purpose of the present study was to assess the cost‐effectiveness of various alternatives of non‐surgical peri‐implantitis treatment.Materials and MethodsA decision analytical model was constructed and populated with parameter estimates from recent literature for reduction in pocket probing depth (PPD) in response to eight different treatment alternatives. A micro‐costing approach combined with an online expert survey was applied to simulate a decision‐making scenario taking place in Germany. The treatment alternatives providing the most advantageous cost/outcome combinations were identified according to the net benefit criterion. Uncertainties regarding model input parameters were incorporated via simple and probabilistic sensitivity analysis based on Monte Carlo simulation.ResultsIn the base case scenario, debridement alone, Air‐Flow®, debridement combined with PerioChip®, and debridement combined with local antibiotics were identified as treatment strategies with comparably better value for money than Er:YAGlaser monotherapy, Vector™System, debridement combined withCHX, and photodynamic therapy. Sensitivity analysis revealed considerable decision uncertainty corresponding to limited evidence about different treatment alternatives for peri‐implantitis treatment.ConclusionsDerivation of robust treatment recommendations for peri‐implantitis requires more comprehensive and patient‐centred evidence on peri‐implantitis treatments.
Effects of non‐equilibrium plasma in the treatment of ligature‐induced peri‐implantitis
Authors: Shi Qi , Song Ke , Zhou Xincai , Xiong Zilan , Du Tianfeng , Lu Xinpei , Cao Yingguang 
Published: April 2015

AbstractAimTo evaluate the effects of non‐equilibrium plasma in the treatment of ligature‐induced peri‐implantitis in beagle dogs.Materials and MethodsSix beagles received 12 implants installed in the position of the fourth mandibular premolars. Ligature‐induced peri‐implantitis was initiated at 3 months post‐implantation. When approximately 40% of the supporting bone was lost, the ligatures were removed. The implants were subjected to the muco‐periosteal scaling and chlorhexidine irrigation with or without plasma irrigation. Three months later, clinical, radiographic and microbiological analyses were performed. Block biopsies were prepared for micro‐CT and histomorphometric analysis. The primary outcome was the difference in bone healing of peri‐implant sites, and the secondary outcomes included changes in clinical parameters (SBI, PD) and bacterial detection.ResultsAt baseline, no significant differences were observed between the two groups. At 3 months post‐treatment, the plasma group showed a significantly higher bone level than the control group (p < 0.05), a significantly decreased detection of bacteria (Porphyromonas gingivalis and Tannerella forsythia) (p < 0.05), and a significant improvement in clinical examination (p < 0.05).ConclusionsWithin the limits of this study, non‐equilibrium plasma treatment as an adjunct to the conventional therapy is a feasible approach for the treatment of peri‐implantitis.
Developmental differences in intra‐individual variability in children with ADHD and ASD
Authors: van Belle Janna , van Hulst Branko M. , Durston Sarah 
Published: April 2015

BackgroundIntra‐individual variability reflects temporal variation within an individual's performance on a cognitive task. Children with developmental disorders, such as ADHD and ASD show increased levels of intra‐individual variability. In typical development, intra‐individual variability decreases sharply between the ages 6 and 20. The tight link between intra‐individual variability and age has led to the suggestion that it may be marker of neural development. As there is accumulating evidence that ADHD and ASD are characterised by atypical neurodevelopmental trajectories, we set out to explore developmental changes in intra‐individual variability in subjects with ADHD and ASD.MethodWe used propensity score matching to match a cross‐sectional sample of children with ADHD, ASD and control subjects (N = 405, aged 6–19 years old) for age, IQ and gender. We used ex‐Gaussian distribution parameters to characterise intra‐individual variability on fast responses (sigma) and slow responses (tau).ResultResults showed that there was a similar decrease in mean response times with age across groups, and an interaction between age and group for measures of variability, where there was a much lower rate of change in the variability parameters (sigma and tau) for subjects with ASD compared with the other two groups. Subjects with ADHD had higher intra‐individual variability, reflected by both sigma and tau, but the rate of decrease in variability with age was similar to that of the controls.ConclusionThese results suggest that subjects with ADHD, ASD and controls differ in the rate at which intra‐individual variability decreases during development, and support the idea that intra‐individual variability may be a marker of neural development, mimicking the neurodevelopmental changes in these disorders.
The validity, reliability and acceptability of the SAVASI; a new self‐assessment score in vitiligo
Authors: Komen L. , van der Kraaij G.E. , van der Veen J.P.W. , de Rie M.A. , Wolkerstorfer A. 
Published: April 2015

AbstractBackgroundVitiligo is a common depigmenting skin disorder that can influence a patient's quality of life. Although patient‐orientated medicine is an emerging concept, a self‐assessment tool to assess the degree of depigmentation in vitiligo is not yet available. Therefore, we developed the SAVASI, a self‐assessment tool that uses the same basic principles as the VASI.ObjectiveTo assess the validity, reliability and acceptability of the SAVASI.MethodsTo assess the validity of the SAVASI, we compared the scores assessed by the patient with the scores of the VASI assessed by the physician. To assess the intra‐rater reliability, the correlation between the baseline SAVASI and the SAVASI after 2 weeks was calculated. To assess the acceptability, patients indicated the time needed to complete the SAVASI and the patient assessed the difficulty of the questionnaire on a five‐point scale. The Skindex‐29 was used to determine the quality of life. The overestimation of the SAVASI compared to the VASI was calculated by subtracting the VASI scores off from the SAVASI scores.ResultsA high correlation between the VASI and the SAVASI (ICC 0.97, 95% CI: 0.95–0.98) was found in 60 patients. The intra‐rater reliability of the SAVASI (ICC 0.75, 95% CI 0.54–0.87) was adequate in 31 patients. Fifty (83%) of the patients completed the questionnaire within 10 min and only five (8%) of the patients considered the SAVASI hard. We found no correlation between overestimation of the SAVASI score and the Skindex‐29 score.ConclusionThe SAVASI is a valid, reliable and acceptable self‐assessment tool to measure the degree of depigmentation in vitiligo. With the SAVASI the degree of depigmentation can reliably be assessed by the patient themselves which can be useful in large (epidemiological) studies. Furthermore, this could contribute to the patient's disease insight and therapy loyalty.
Protein pheromone expression levels predict and respond to the formation of social dominance networks
Authors: Nelson A. C. , Cunningham C. B. , Ruff J. S. , Potts W. K. 
Published: April 2015

AbstractCommunication signals are key regulators of social networks and are thought to be under selective pressure to honestly reflect social status, including dominance status. The odours of dominants and nondominants differentially influence behaviour, and identification of the specific pheromones associated with, and predictive of, dominance status is essential for understanding the mechanisms of network formation and maintenance. In mice, major urinary proteins (MUPs) are excreted in extraordinary large quantities and expression level has been hypothesized to provide an honest signal of dominance status. Here, we evaluate whether MUPs are associated with dominance in wild‐derived mice by analysing expression levels before, during and after competition for reproductive resources over 3 days. During competition, dominant males have 24% greater urinary MUP expression than nondominants. The MUP darcin, a pheromone that stimulates female attraction, is predictive of dominance status: dominant males have higher darcin expression before competition. Dominants also have a higher ratio of darcin to other MUPs before and during competition. These differences appear transient, because there are no differences in MUPs or darcin after competition. We also find MUP expression is affected by sire dominance status: socially naive sons of dominant males have lower MUP expression, but this apparent repression is released during competition. A requisite condition for the evolution of communication signals is honesty, and we provide novel insight into pheromones and social networks by showing that MUP and darcin expression is a reliable signal of dominance status, a primary determinant of male fitness in many species.