bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular access for incident hemodialysis patients in Catalonia: analysis of data from the Catalan Renal Registry (2000-2011)
Authors: Roca-Tey Ramon , Arcos Emma , Comas Jordi , Cao Higini , Tort Jaume ,   Catalan Society of Nephrology (SCN), Feixas J. , Fontseré N. , Graterol F. , Ibeas J. , Martínez J. , de Arellano M. Ramírez , Sans R. 
Published: June 2015

Purpose Arteriovenous fístula is the best vascular access (VA) for hemodialysis. We analyzed the VA used at first session and the factors associated with the likelihood to start hemodialysis by fistula in 2000-2011. Methods Data of VA type were obtained in 9,956 incident hemodialysis patients from the Catalan Registry. Results Overall, 47.9% of patients initiated hemodialysis with a fistula, 1.2% with a graft, 15.9% with a tunneled catheter and 35% with an untunneled catheter. The percentage of incident patients with fistula and catheter has remained stable at around 50% over the years. The likelihood to start hemodialysis with fistula was significantly lower in females [adjusted odds ratio: 0.69, 95% confidence interval (CI): 0.61-0.75], patients aged 18-44 years (0.78, 95% CI: 0.64-0.94), patients with comorbidity (0.67, 95% CI: 0.60-0.75) and tended to be lower in patients aged over 74 years (0.89, 95% CI: 0.78-1.01). The probability to use fistula was significantly higher in patients with polycystic kidney disease (2.08, 95% CI: 1.63-2.67), predialysis nephrology care longer than 2 years (4.14, 95% CI: 3.63-4.73) and steady chronic kidney disease (CKD) progression (10.97, 95% CI: 8.41-14.32). During 1 year of follow-up, 67.2% and 59.6% of patients using untunneled and tunneled catheter changed to fistula, respectively. Conclusions Starting hemodialysis by fistula was related with nonmodifiable patient characteristics and modifiable CKD practice processes, such as predialysis care duration. Half of the incident patients were exposed annually in Catalonia to potential catheter complications. This scenario can be improved by optimizing the processes of CKD care.
Predictors of difficult pediatric intravenous access in a community Emergency Department
Authors: Petroski Adam , Frisch Adam , Joseph Nicole , Carlson Jestin N. 
Published: June 2015

Background Successful intravenous (IV) placement is important in the care of the acutely ill and injured pediatric patient. There are little data that exist regarding predicators of difficult IV access in pediatric Emergency Department (ED) patients who present to community EDs. Methods We retrospectively analyzed all pediatric charts for the calendar year 2012 from a single community teaching hospital. We identified all cases with patients less than 18 years of age in whom an IV or IV medications were ordered. We defined difficult IV access as those requiring more than one attempt, or those where the IV team was required to place the IV. We identified patient, provider, and procedural characteristics. Data were analyzed using descriptive statistics and univariate logistic regression to determine the odds ratio (OR) for predictors of difficult IV access. Results We identified 652 patients, 607 (93%) without difficult access and 45 with difficult access. Increasing age [OR 0.94 (0.89-0.99) p = 0.017] was associated with decreased odds of difficult IV access. IVs attempted in the hand [OR 3.02 (1.06-8.58) p = 0.039] and lower extremity [OR 7.82 (2.27-26.91) p = 0.001)]) were associated with greater odds of difficult access than the antecubital fossa. Non-black/non-white race [2.37 (1.1-5.12) p = 0.028] was also associated with difficult IV access. Other factors (sex, IV catheter size, and so on) were not associated. Conclusions In this retrospective study of pediatric patients in a community ED, decreasing age, non-black/non-white race, and IV attempt location (hand and lower extremity vs. antecubital fossa) were associated with greater odds of difficult IV access.
Cytology Smears as Diagnostic Material for EGFR Gene Testing in Non-small Cell Lung Cancer
Authors: Powrózek Tomasz , Krawczyk Paweł , Pankowski Juliusz , Reszka Katarzyna , Jakubiak Magdalena , Obrochta Anna , Wojas-Krawczyk Kamila , Buczkowski Jarosław , Milanowski Janusz 
Published: June 2015

Aims and Background Cytology smears can be effectively used for EGFR mutation testing in the qualification of NSCLC patients for EGFR tyrosine kinase inhibitor therapy. However, tissue specimens are preferred for EGFR mutation analysis. The aim of this study was to estimate the effectiveness of the real-time PCR method for EGFR testing in histology and cytology materials obtained simultaneously from NSCLC patients. Methods Fourteen adenocarcinoma patients with EGFR–mutation-positive primary tumor tissues were included in the study. Corresponding cytological smears of metastatic lymph nodes obtained by EBUS-TBNA were examined. EGFR Mutation Analysis Kit (EntroGen, USA) and real-time PCR (m2000rt system, Abbott, USA) were used for EGFR mutation analysis in both types of material. Results In primary tumor tissues, 12 deletions in exon 19 and 2 substitutions in exon 21 (L858R mutation) of the EGFR gene were found. Except for 1 deletion in exon 19, the same EGFR gene mutations were detected in all corresponding cytology samples. The percentage of tumor cells, DNA concentration, percentage of mutated DNA as well as ΔCt values were similar in cytology slides and histology material. In both types of materials, no significant correlations were found between the percentage of tumor cells and the percentage of mutated DNA nor between the DNA concentration and the percentage of mutated DNA. Conclusions We demonstrated the high effectiveness of a sensitive real-time PCR method in EGFR gene mutation detection in cytology smears.
Hepatosplenic T-cell Lymphoma with Aberrant Expression of Serum β-HCG: A Case Report
Authors: Bellodi Andrea , Rivoli Giulia , Arboscello Eleonora , Fornarini Giuseppe , Orcioni Giulio Fraternali , Avenoso Daniele , Miglino Maurizio , Ghio Riccardo 
Published: June 2015

Background Peripheral T-cell lymphomas (PTCL) represent a heterogeneous group of hematologic malignancies frequently presenting at advanced stage of diagnosis. Methods We report a case of PTCL with an uncommon and aggressive onset with disseminated intravascular coagulation (DIC). Results Laboratory findings revealed an aberrant expression of β subunit of human chorionic gonadotropin (β-HCG). Other than for determination of pregnancy, β-HCG is regularly found as a tumor marker in germ cell tumors with trophoblastic differentiation and its aberrant expression has been reported in the literature in other neoplastic conditions only in the context of case reports. Conclusions In hematologic malignancies, β-HCG expression has been described only in sporadic cases. Awareness of this feature could avoid diagnostic delay in such an aggressive disease.
Marriage Patterns and Childbearing: Results From a Quantitative Study in North of Iran
Authors: Taghizadeh Ziba , Behmanesh Fereshteh , Ebadi Abbas 
Published: June 2015

<span style="font-family: Times New Roman; font-size: small;"> </span><p>Social changes have rapidly removed arranged marriages and it seems the change in marriage pattern has played a role in childbearing. On the other hand, there is a great reduction in population in many countries which requires a comprehensive policy to manage the considerable drop in population. To achieve this goal, initially, the factors affecting fertility must be precisely identified. This study aims to examine the role of marriage patterns in childbearing. In this cross-sectional quantitative study, 880 married women 15-49 years old, living in the north of Iran were studied using a cluster sampling strategy. The results showed that there are no significant differences in reproductive behaviors of three patterns of marriage in Bobol city of Iran. It seems there is a convergence in childbearing due to the different patterns of marriage and Policymakers should pay attention to other determinants of reproductive behaviors in demographic planning.</p><p> </p><span style="font-family: Times New Roman; font-size: small;"> </span>
La evaluación de la producción científica: breve análisis crítico
Authors: Giménez-Toledo Elea 
Published: June 2015

Se	realiza una revisión histórica (centrada fundamentalmente en	España, pero con múltiples referencias a otros ámbitos	internacionales) del proceso de evaluación de las producción	científica, especialmente de las publicaciones	periódicas. Se analizan también las alternativas disponibles	en la actualidad, tras una etapa convulsa que ha visto	desaparecer diversos instrumentos para la evaluación de	revistas. Por último se identifican algunas tendencias y	necesidades en el ámbito de la evaluación de publicaciones	científicas que presumiblemente marcaran el desarrollo	futuro de futuros instrumentos y procedimientos
Improving Resident Performance Through a Simulated Rapid Response Team: A Pilot Study
Authors: Burke Peter A. , Vest Michael T. , Kher Hemant , Deutsch Joseph , Daya Sneha 
Published: June 2015

Abstract

Background: The Joint Commission requires hospitals to develop systems in which a team of clinicians can rapidly recognize and respond to changes in a patient’s condition. The rapid response team (RRT) concept has been widely adopted as the solution to this mandate. The role of house staff in RRTs and the impact on resident education has been controversial. At Christiana Care Health System, eligible residents in their second through final years lead the RRTs.

Objective: To evaluate the use of a team-based, interdisciplinary RRT training program for educating and training first-year residents in an effort to improve global RRT performance before residents start their second year.

Methods: This pilot study was administered in 3 phases. Phase 1 provided residents with classroom-based didactic sessions using case-based RRT scenarios. Multiple choice examinations were administered, as well as a confidence survey based on a Likert scale before and after phase 1 of the program. Phase 2 involved experiential training in which residents engaged as mentored participants in actual RRT calls. A qualitative survey was used to measure perceived program effectiveness after phase 2. In phase 3, led by senior residents, simulated RRTs using medical mannequins were conducted. Participants were divided into 5 teams, in which each resident would rotate in the roles of leader, nurse, and respiratory therapist. This phase measured resident performance with regard to medical decision making, data gathering, and team behaviors during the simulated RRT scenarios. Performance was scored by an attending and a senior resident.

Results: A total of 18 residents were eligible (N=18) for participation. The average multiple choice test score improved by 20% after didactic training. The average confidence survey score before training was 3.44 out of 5 (69%) and after training was 4.13 (83%), indicating a 14% improvement. High-quality team behaviors correlated with medical decision making (0.92) more closely than did high-quality data gathering (0.11). This difference narrowed during high-pressure scenarios (0.84 and 0.72, respectively).

Conclusion: Our data suggest that resident training using a team-based, interdisciplinary RRT training program may improve resident education, interdisciplinary team-based dynamics, and global RRT performance. In turn, data gathering and medical decision making may be enhanced, which may result in better patient outcomes during RRT scenarios.
Effects of Osteopathic Manipulative Treatment on Diabetic Gastroparesis
Authors: Van Ravenswaay Valerie J. , Hain Simeon J. , Grasso Sierra , Shubrook Jay H. 
Published: June 2015

Abstract
As the number of diagnoses of diabetes mellitis continues to increase, so does the incidence of diabetic complications, such as gastroparesis. The current case report examines the effect of osteopathic manipulative treatment (OMT) on the symptoms of diabetic gastroparesis in a patient with type 1 diabetes mellitus. After a prescribed regimen of OMT, the patient’s Gastroparesis Cardinal Symptom Index score improved from 13 to 8, and his hospitalization stays decreased from once every 6 to 8 weeks to once in 6 months. After 6 sessions of OMT, the patient experienced a reduction in and subsequent relief of diabetic gastroparesis symptoms and improved quality of life. The role of OMT needs to be further investigated as a cost-effective adjunctive treatment for patients with diabetic gastroparesis.
Assessment of the Postoperative Appearance of the Rotator Cuff Tendon Using Serial Sonography After Arthroscopic Repair of a Rotator Cuff Tear
Authors: Yoo Hye Jin , Choi Ja-Young , Hong Sung Hwan , Kang Yusuhn , Park Jina , Kim Sae Hoon , Kang Heung Sik 
Published: June 2015

ObjectivesThe purpose of this study was to evaluate serial changes in sonographic findings of a rotator cuff tendon after rotator cuff repair.MethodsSixty‐five arthroscopically repaired rotator cuff tears (43 full‐thickness tears and 22 partial‐thickness tears) were retrospectively included in this study. Serial sonographic examinations were performed at 5 weeks, 3 months, and 6 months after surgery. The sonographic findings of the repaired tendon were assessed for a recurrent tear, tendon thickness, morphologic tendon characteristics, vascularity, and bursitis at each time point.ResultsFour recurrent tears occurred within 3 months of surgery. The postoperative tendon thickness decreased from 5 weeks to 6 months after surgery (P = .001). There were significant changes in the morphologic tendon characteristics, including the echo texture, fibrillar pattern, and surface irregularity of the repaired tendon, from 5 weeks to 6 months after surgery (P < .001). Additionally, subacromial‐subdeltoid bursitis and the vascularity of the repaired tendon decreased postoperatively over time.ConclusionsSerial sonography after arthroscopic rotator cuff repair was useful for monitoring the postoperative changes in a repaired tendon. The morphologic appearance of the repaired tendon and peritendinous soft tissue changes improved over time and nearly normalized within 6 months of surgery.
Combination of Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification for Differential Diagnosis of Breast Lesions
Authors: Teke Memik , Göya Cemil , Teke Fatma , Uslukaya Ömer , Hamidi Cihad , Çetinçakmak Mehmet Guli , Hattapoğlu Salih , Alan Bircan , Tekbaş Güven 
Published: June 2015

ObjectivesBreast cancer is the second leading cause of death from cancer in women, and early detection is the key to successful treatment. Unfortunately, even with technological advances, the specificity of imaging modalities is still low. Therefore, we evaluated the value of a newly developed noninvasive technique, acoustic radiation force impulse imaging, for differentiating benign versus malignant breast lesions.MethodsWe prospectively examined 141 breast lesions in 122 patients. All lesions were classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) for mammography, BI‐RADS for sonography, and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA) pattern. Internal and marginal shear wave velocity (SWV) values for the lesions were noted. The sensitivity, specificity, accuracy, and positive and negative predictive values for VTI and Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions) were calculated.ResultsThe marginal SWV values were statistically higher in malignant lesions (mean ± SD, 5.41 ± 1.37 m/s) than benign lesions (2.91 ± 0.88 m/s; P < .001). When the SWV cutoff level was set at 4.07 m/s, and the higher of the internal and marginal values was adopted, the combination of VTI and VTQ showed 95.1% sensitivity, 99.0% specificity, and 97.8% accuracy.ConclusionsBreast Imaging Reporting and Data System category 4 lesions are the main focus of research for early detection of breast cancer. Unfortunately, BI‐RADS category 4 assessment covers a wide range of likelihood of malignancy (2%–95%). This wide range reflects the necessity for a more specific imaging modality. The combination of VTI and VTQ could increase the diagnostic performance of conventional sonography.
Contrast Ultrasound Imaging Does Not Affect Heat Shock Protein 70 Expression in Cholesterol‐Fed Rabbit Aorta
Authors: Smith Brendon W. , Simpson Douglas G. , Miller Rita J. , Erdman John W. , O'Brien William D. 
Published: June 2015

ObjectivesDiagnostic ultrasound imaging is enhanced by the use of circulating microbubble contrast agents (UCAs), but the interactions between ultrasound, UCAs, and vascular tissue are not fully understood. We hypothesized that ultrasound with a UCA would stress the vascular tissue and increase levels of heat shock protein 70 (Hsp70), a cellular stress protein.MethodsMale New Zealand White rabbits (n = 32) were fed a standard chow diet (n = 4) or a 1% cholesterol, 10% fat, and 0.11% magnesium diet (n = 28). At 21 days, 24 rabbits on the cholesterol diet were either exposed to ultrasound (3.2‐MHz f/3 transducer; 2.1 MPa; mechanical index, 1.17; 10 Hz pulse repetition frequency; 1.6 microseconds pulse duration; 2 minutes exposure duration at 4 sites along the aorta) with the UCA Definity (1× concentration, 1 mL/min; Lantheus Medical Imaging, North Billerica, MA) or sham exposed with a saline vehicle injection (n = 12 per group). Four rabbits on the cholesterol diet and 4 on the chow diet served as cage controls and were not exposed to ultrasound or restrained for blood sample collection. Animals were euthanized 24 hours after exposure, and aortas were quickly isolated and frozen in liquid nitrogen. Aorta lysates from the area of ultrasound exposure were analyzed for Hsp70 level by Western blot. Blood plasma was analyzed for cholesterol, Hsp70, and von Willebrand factor, a marker of endothelial function.ResultsPlasma total cholesterol levels increased to an average of 705 mg/dL. Ultrasound did not affect plasma von Willebrand factor, plasma Hsp70, or aorta Hsp70. Restraint increased Hsp70 (P < .001, analysis of variance).ConclusionsRestraint, but not ultrasound with the UCA or cholesterol feeding, significantly increased Hsp70.
Quantification of factors impacting seawater and calcite δ18O during Heinrich Stadials 1 and 4
Authors: Bagniewski Witold , Meissner Katrin J. , Menviel Laurie , Brennan Catherine E. 
Published: June 2015

AbstractWe perform idealized experiments of a Heinrich Stadial using an oxygen‐isotope‐enabled Earth System Climate Model. Our results compare relatively well with the planktic and benthic δ18O records of Heinrich Stadials 1 and 4. We find that changes in surface
can be equally attributed to the “temperature effect” due to fractionation during calcification; the “circulation and climate effect” due to changes in circulation, precipitation, and evaporation; and the “meltwater effect” due to the addition and subsequent advection of depleted fresh water from continental ice sheets. In contrast, the meltwater effect and circulation and climate effect have only a small impact on benthic
during the cessation of the Atlantic Meridional Overturning Circulation (AMOC). Significant temperature changes simulated in both the deep Atlantic and Pacific Oceans substantially influence benthic
during that time. During the AMOC recovery, however, anomalously low
surface waters are advected to the deep Atlantic, thus generating a large (∼0.5‰)
decrease in the deep North Atlantic. This is in contrast to a hypothesis that links such depletion seen in Atlantic sediment cores during the last glacial stadials to deepwater formation caused by brine rejection and sea ice formation.
Deglacial subarctic Pacific surface water hydrography and nutrient dynamics and links to North Atlantic climate variability and atmospheric CO2
Authors: Maier E. , Méheust M. , Abelmann A. , Gersonde R. , Chapligin B. , Ren J. , Stein R. , Meyer H. , Tiedemann R. 
Published: June 2015

AbstractThe glacial‐to‐Holocene evolution of subarctic Pacific surface water stratification and silicic acid (Si) dynamics is investigated based on new combined diatom oxygen (δ18Odiat) and silicon (δ30Sidiat) isotope records, along with new biogenic opal, subsurface foraminiferal δ18O, alkenone‐based sea surface temperature, sea ice, diatom, and core logging data from the NE Pacific. Our results suggest that δ18Odiat values are primarily influenced by changes in freshwater discharge from the Cordilleran Ice Sheet (CIS), while corresponding δ30Sidiat are primarily influenced by changes in Si supply to surface waters. Our data indicate enhanced glacial to mid Heinrich Stadial 1 (HS1) NE Pacific surface water stratification, generally limiting the Si supply to surface waters. However, we suggest that an increase in Si supply during early HS1, when surface waters were still stratified, is linked to increased North Pacific Intermediate Water formation. The coincidence between fresh surface waters during HS1 and enhanced ice‐rafted debris sedimentation in the North Atlantic indicates a close link between CIS and Laurentide Ice Sheet dynamics and a dominant atmospheric control on CIS deglaciation. The Bølling/Allerød (B/A) is characterized by destratification in the subarctic Pacific and an increased supply of saline, Si‐rich waters to surface waters. This change toward increased convection occurred prior to the Bølling warming and is likely triggered by a switch to sea ice‐free conditions during late HS1. Our results furthermore indicate a decreased efficiency of the biological pump during late HS1 and the B/A (possibly also the Younger Dryas), suggesting that the subarctic Pacific has then been a source region of atmospheric CO2.
Modern solar maximum forced late twentieth century Greenland cooling
Authors: Kobashi T. , Box J. E. , Vinther B. M. , Goto‐Azuma K. , Blunier T. , White J. W. C. , Nakaegawa T. , Andresen C. S. 
Published: June 2015

AbstractThe abrupt Northern Hemispheric warming at the end of the twentieth century has been attributed to an enhanced greenhouse effect. Yet Greenland and surrounding subpolar North Atlantic remained anomalously cold in 1970s to early 1990s. Here we reconstructed robust Greenland temperature records (North Greenland Ice Core Project and Greenland Ice Sheet Project 2) over the past 2100 years using argon and nitrogen isotopes in air trapped within ice cores and show that this cold anomaly was part of a recursive pattern of antiphase Greenland temperature responses to solar variability with a possible multidecadal lag. We hypothesize that high solar activity during the modern solar maximum (approximately 1950s–1980s) resulted in a cooling over Greenland and surrounding subpolar North Atlantic through the slowdown of Atlantic Meridional Overturning Circulation with atmospheric feedback processes.