bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic Iron Overload With Oxidative Stress and Inflammation in Human and Murine Abdominal Aortic Aneurysm
Authors: Sawada Hisashi , Hao Hiroyuki , Naito Yoshiro , Oboshi Makiko , Hirotani Shinichi , Mitsuno Masataka , Miyamoto Yuji , Hirota Seiichi , Masuyama Tohru 
Published: April 2015

Objective—
Although iron is an essential element for maintaining physiological function, excess iron leads to tissue damage caused by oxidative stress and inflammation. Oxidative stress and inflammation play critical roles for the development of abdominal aortic aneurysm (AAA). However, it has not been investigated whether iron plays a role in AAA formation through oxidative stress and inflammation. We, therefore, examined whether iron is involved in the pathophysiology of AAA formation using human AAA walls and murine AAA models.

Approach and Results—
Human aortic walls were collected from 53 patients who underwent cardiovascular surgery (non-AAA=34; AAA=19). Murine AAA was induced by infusion of angiotensin II to apolipoprotein E knockout mice. Iron was accumulated in human and murine AAA walls compared with non-AAA walls. Immunohistochemistry showed that both 8-hydroxy-2′-deoxyguanosine and CD68-positive areas were increased in AAA walls compared with non-AAA walls. The extent of iron accumulated area positively correlated with that of 8-hydroxy-2′-deoxyguanosine expression area and macrophage infiltration area in human and murine AAA walls. We next investigated the effects of dietary iron restriction on AAA formation in mice. Iron restriction reduced the incidence of AAA formation with attenuation of oxidative stress and inflammation. Aortic expression of transferrin receptor 1, intracellular iron transport protein, was increased in human and murine AAA walls, and transferrin receptor 1–positive area was similar to areas where iron accumulated and F4/80 were positive.

Conclusions—
Iron is involved in the pathophysiology of AAA formation with oxidative stress and inflammation. Dietary iron restriction could be a new therapeutic strategy for AAA progression.
Comparisons of the Circulation Anomalies Associated with Extreme Heat in Different Regions of Eastern China
Authors: Chen Ruidan , Lu Riyu 
Published: April 2015

Abstract
The circulation associated with extreme heat (EH) typically shows an anomalous anticyclone that enhances temperature through adiabatic heating, but this study indicates obvious spatial variation in eastern China. The EH-related circulation pattern in eastern China can be classified into three categories: typical extratropical pattern, monsoonal pattern, and foehn pattern. EH over northeastern China and eastern north China is characterized by a typical pattern involving an anomalous anticyclone and subsidence, and the air temperature increases throughout almost the entire troposphere. In contrast, EH over the Yangtze River valley and south China is associated with the monsoonal pattern. Over these regions, the air temperature only increases in the lower troposphere as a result of anomalous subsidence and lower humidity that has resulted from a farther north transportation of water vapor by a stronger monsoonal southwesterly. Meanwhile, the air temperature decreases in the upper troposphere because of the decrease of latent heat caused by suppressed precipitation. On the other hand, western north China, with most of its stations located on the eastern leeside of mountains, is obviously influenced by the foehn effect on EH days. The foehn-related northwesterly anomalies bring drier and warmer air from the mountains to sink on the leeside and greatly increase the air temperature in the lower troposphere, particularly near the surface. Therefore, the impacts of monsoon and topography should be taken into consideration when EH-related circulations are discussed over the many regions of eastern China. As a result, the reliable projection of air temperature in these regions under global warming is a challenging problem.
Measuring Individual Differences in the Perfect Automation Schema
Authors: Merritt Stephanie M. , Unnerstall Jennifer L. , Lee Deborah , Huber Kelli 
Published: April 2015

Objective A self-report measure of the perfect automation schema (PAS) is developed and tested. Background Researchers have hypothesized that the extent to which users possess a PAS is associated with greater decreases in trust after users encounter automation errors. However, no measure of the PAS currently exists. We developed a self-report measure assessing two proposed PAS factors: high expectations and all-or-none thinking about automation performance. Method In two studies, participants responded to our PAS measure, interacted with imperfect automated aids, and reported trust. Results Each of the two PAS measure factors demonstrated fit to the hypothesized factor structure and convergent and discriminant validity when compared with propensity to trust machines and trust in a specific aid. However, the high expectations and all-or-none thinking scales showed low intercorrelations and differential relationships with outcomes, suggesting that they might best be considered two separate constructs rather than two subfactors of the PAS. All-or-none thinking had significant associations with decreases in trust following aid errors, whereas high expectations did not. Results therefore suggest that the all-or-none thinking scale may best represent the PAS construct. Conclusion Our PAS measure (specifically, the all-or-none thinking scale) significantly predicted the severe trust decreases thought to be associated with high PAS. Further, it demonstrated acceptable psychometric properties across two samples. Application This measure may be used in future work to assess levels of PAS in users of automated systems in either research or applied settings.
Quality of diagnosis and monitoring of tuberculosis in Northern Ethiopia: medical records-based retrospective study
Authors: Mala George , Spigt Mark G , Gidding Luc G , Blanco Roman , Dinant Geert-Jan 
Published: April 2015

Objectives To determine quality of diagnosis and monitoring of treatment response of patients with smear-negative pulmonary tuberculosis (TB) compared with smear-positive cases in Ethiopia. Methods A retrospective analysis of medical records of newly diagnosed pulmonary TB cases that were registered for taking anti-TB medication and had completed treatment between 2010 and 2012. We evaluated the percentage of cases that were managed according to the International Standards of Tuberculosis Care (ISTC) and compared smear-negative with smear-positive cases. Results We analysed 1168 cases of which 742 (64%) were sputum smear-negative cases. Chest radiography examination at diagnosis and microbiological testing at the end of the intensive phase of treatment was performed in a smaller proportion than in smear-positive TB cases (70% vs. 79%, P value <0.001) and (70% vs. 95%, P value <0.001), respectively. Conclusions Clinical actions recommended in the ISTC are of greatest importance in minimising pitfalls in care of smear-negative TB yet were performed less often in smear-negative than smear-positive TB cases.
A multilevel regression of patient-reported outcome measures after varicose vein treatment in England
Authors: El-Sheikha Joseph 
Published: April 2015

Introduction The relationship between patient and hospital characteristics and their influence on quality of life (QoL) variance following varicose vein treatment is little understood. Whilst Patient-reported outcome measures (PROMs) can record postoperative outcomes, the actual comparison of PROMs between hospitals can be misleading when the clustered nature of varicose vein care is overlooked. Multilevel models can accommodate hierarchical data and therefore can provide a more accurate reflection of the relationship between patients and hospitals when investigating postoperative outcomes. Methods A multilevel model of PROMs was developed to analyse the relationship of patient characteristics (gender, age), postoperative outcomes (complications, postoperative satisfaction, treatment success) and hospital type (operative volume and if private or NHS institution) with the change in Aberdeen Varicose Vein Score (AVVQ) six months after varicose vein treatment. Results Between April 2010 and July 2014, some 24,460 PROMs from 162 hospitals were analysed. Whilst the majority of variance in AVVQ improvement was due to patient factors, a small but statistically significant amount of variance was detected due to differences between hospitals. Multilevel regression revealed that females saw a greater improvement in AVVQ, as did those who reported greater levels of treatment success and satisfaction. Patient age, complications, intervention, readmission, hospital size and hospital type were not significantly associated with AVVQ improvement. Conclusion Although QoL is intrinsically tied to an individual, hospitals can provide a small but potentially important benefit in AVVQ improvement following vein treatment. A patient-centred approach is therefore recommended to optimise patient outcomes.
Does hospital need more hospice beds? Hospital charges and length of stays by lung cancer inpatients at their end of life: A retrospective cohort design of 2002–2012
Authors: Kim Sun Jung , Han Kyu-Tae , Kim Tae Hyun , Park Eun-Cheol 
Published: April 2015

Background: Previous studies found that hospice and palliative care reduces healthcare costs for end-of-life cancer patients. Aim: To investigate hospital inpatient charges and length-of-stay differences by availability of hospice care beds within hospitals using nationwide data from end-of-life inpatients with lung cancer. Design: A retrospective cohort study was performed using nationwide lung cancer health insurance claims from 2002 to 2012 in Korea. Setting and participants: Descriptive and multi-level (patient-level and hospital-level) mixed models were used to compare inpatient charges and lengths of stay. Using 673,122 inpatient health insurance claims, we obtained aggregated hospital inpatient charges and lengths of stay from a total of 114,828 inpatients and 866 hospital records. Results: Hospital inpatient charges and length of stay drastically increased as patients approached death; a significant portion of hospital inpatient charges and lengths of stay occurred during the end-of-life period. According to our multi-level analysis, hospitals with hospice care beds tend to have significantly lower end-of-life hospital inpatient charges; however, length of stay did not differ. Hospitals with more hospice care beds were associated with reduction in hospital inpatient charges within 3 months before death. Conclusion: Higher end-of-life healthcare hospital charges were found for lung cancer inpatients who were admitted to hospitals without hospice care beds. This study suggests that health policy-makers and the National Health Insurance program need to consider expanding the use of hospice care beds within hospitals and hospice care facilities for end-of-life patients with lung cancer in South Korea, where very limited numbers of resources are currently available.
Euthanasia and physician-assisted suicide in dementia: A qualitative study of the views of former dementia carers
Authors: Tomlinson Emily , Spector Aimee , Nurock Shirley , Stott Joshua 
Published: April 2015

Background: Despite media and academic interest on assisted dying in dementia, little is known of the views of those directly affected. Aim: This study explored the views of former carers on assisted dying in dementia. Design: This was a qualitative study using thematic analysis. Setting/participants: A total of 16 former carers of people with dementia were recruited through national dementia charities and participated in semi-structured interviews. Results: While many supported the individual’s right to die, the complexity of assisted dying in dementia was emphasized. Existential, physical, psychological and psychosocial aspects of suffering were identified as potential reasons to desire an assisted death. Most believed it would help to talk with a trained health professional if contemplating an assisted death. Conclusion: Health workers should be mindful of the holistic experience of dementia at the end of life. The psychological and existential aspects of suffering should be addressed, as well as relief of physical pain. Further research is required.
Acute symptomatic complications among patients with advanced cancer admitted to acute palliative care units: A prospective observational study
Authors: Hui David , dos Santos Renata , Reddy Suresh , de Angelis Nascimento Maria Salete , Zhukovsky Donna S , Paiva Carlos Eduardo , Dalal Shalini , Costa Everaldo Donizeti , Walker Paul , Scapulatempo Heloisa Helena , Dev Rony , Crovador Camila Souza , De La Cruz Maxine , Bruera Eduardo 
Published: April 2015

Background: Limited information is available on the symptomatic complications that occur in the last days of life. Aim: We documented the frequency, clinical course, and survival for 25 symptomatic complications among patients admitted to acute palliative care units. Design: Prospective longitudinal observational study. Measurements: Their attending physician completed a daily structured assessment of symptomatic complications from admission to discharge or death. Setting/participants: We enrolled consecutive advanced cancer patients admitted to acute palliative care units at MD Anderson Cancer Center, USA, and Barretos Cancer Hospital, Brazil. Results: A total of 352 patients were enrolled (MD Anderson Cancer Center = 151, Barretos Cancer Hospital = 201). Delirium, pneumonia, and bowel obstruction were the most common complications, occurring in 43%, 20%, and 16% of patients on admission, and 70%, 46%, and 35% during the entire acute palliative care unit stay, respectively. Symptomatic improvement for delirium (36/246, 15%), pneumonia (52/161, 32%), and bowel obstruction (41/124, 33%) was low. Survival analysis revealed that delirium ( p < 0.001), pneumonia ( p = 0.003), peritonitis ( p = 0.03), metabolic acidosis ( p < 0.001), and upper gastrointestinal bleed ( p = 0.03) were associated with worse survival. Greater number of symptomatic complications on admission was also associated with poorer survival ( p < 0.001). Conclusion: Symptomatic complications were common in cancer patients admitted to acute palliative care units, often do not resolve completely, and were associated with a poor prognosis despite active medical management.
Returning to driving after stroke: A systematic review of adherence to guidelines and legislation
Authors: Frith Janet , Hubbard Isobel J , James Carole L , Warren-Forward Helen 
Published: April 2015

Introduction This systematic review aimed to determine whether stroke survivors routinely received return-to-driving education in the acute hospital setting prior to discharge home; and if education was provided, were the restrictions in driving guidelines adhered to. Method A systematic search was conducted of PubMed, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Web of Science, Scopus, Pedro and OTseeker databases for original research reporting findings on the adherence to return-to-driving legislation and clinical guidelines after stroke, and return-to-driving behaviours in stroke survivors up to 1 month post stroke. Results Three studies met the inclusion criteria and reported on a combined total of 252 stroke survivors living in the United Kingdom. Forty-eight per cent of stroke survivors received education on the 1 month driving restriction. A total of 61.4% of participants waited 1 month prior to returning to driving. Conclusion This review found that there is limited literature available on the management of return to driving following acute stroke but there is evidence that education may not be routinely provided in the acute hospital setting and that many stroke survivors could be returning to driving within the 1 month restriction.
Performance of antenatal reflex DNA screening for Down’s syndrome
Authors: Wald Nicholas J , Bestwick Jonathan P 
Published: April 2015

Objective Maternal plasma DNA analysis has a high but imperfect antenatal Down’s syndrome screening performance. We aimed to determine the effect of combining DNA testing with current tests. Methods In our modelled screening protocol, women provide two samples, one serum sample for a Combined test, and a plasma sample for a possible DNA test. Women with a Combined test risk above a specified level have a DNA test using the plasma sample without the need to recall them for another sample and counselling (ie. in a reflex manner). Women with a failed DNA test after a second attempt using a fresh plasma sample have an Integrated test. Screening performance was estimated according to the proportion of women reflexed to DNA testing and compared with universal DNA testing. Results Reflexing 10% of women to a DNA test yields a 91% detection rate (DR) for a 0.025% false-positive rate (FPR) and no failed tests, compared with a 98% DR, 0.2% FPR and a 2.5% test failure rate with universal DNA testing (94% for 0.046% if 20% reflexed). DNA test failure rate has little influence on screening performance Conclusion Reflex DNA testing substantially reduces the FPR with a relatively small loss in detection compared with universal DNA testing, and reduces patient anxiety by avoiding the recall of women for DNA testing.
A qualitative study of sexual minority young people’s experiences of computerised therapy for depression
Authors: Lucassen Mathijs FG , Hatcher Simon , Fleming Theresa M , Stasiak Karolina , Shepherd Matthew J , Merry Sally N 
Published: April 2015

Objective: To describe the experiences of lesbian, gay, bisexual or sexual minority youth who used a form of computerised therapy (Rainbow SPARX) for depression. Methods: 25 adolescents (20 with significant depressive symptoms) who had trialled Rainbow SPARX took part in semi-structured interviews. The general inductive approach was used to analyse interview data. Results: Feedback consisted of five main themes: ‘appealing aspects’; ‘applying it to real life’; ‘things to improve’; ‘aspects that did not appeal’; and ‘other themes’. Young people suggested that there should be more sexuality-specific (‘rainbow’) content in the computer program. Seventeen participants thought computerised therapy helped them feel better or less depressed. Conclusions: Consumer perspectives are increasingly being sought and this user input is especially useful for improving services. Our study provides important in-depth feedback on Rainbow SPARX from the perspective of sexual minority youth, and it highlights that computerised therapies can be successfully modified for groups traditionally under-served by mainstream mental health interventions.
The Hispanic pharmacist: Value beyond a common language
Authors: Cipriano Gabriela C , Andrews Carlota O 
Published: April 2015

Objective: To highlight the added value of bilingual Hispanic pharmacists in the care of Hispanic patients by sharing their patients’ language and culture. Summary: Inability to speak and/or write in the patients’ native language severely impairs our best efforts to deliver good health care. This is a widely recognized cause of non-compliance or less than favorable possible health outcomes in Hispanic patients. What has received less attention, however, is that the ability to speak Spanish alone may not remove completely the barrier for non-compliance among Hispanics. Bilingual Spanish–English pharmacists do not have the language barrier, but if they do not recognize and accept cultural differences, their impact in their patients’ response may still be limited. Conclusion: It is time to recognize the added value of Hispanic pharmacists to Hispanic patients’ health outcomes. Understanding and sharing a culture allows the pharmacist to make medication education and interventions relevant to the patient and spark interest in their own health care. Thus, in caring for the health of our patients, cultural barriers may be more challenging to conquer than language barriers; deep appreciation and acceptance of our patients’ belief system cannot be acquired by just reading about it, having a computerized program, or hiring an interpreter.
Decreasing cost effectiveness of testing for latent TB in HIV in a low TB incidence area
Authors: Capocci Santino , Smith Colette , Morris Stephen , Bhagani Sanjay , Cropley Ian , Abubakar Ibrahim , Johnson Margaret , Lipman Marc 
Published: April 2015

Testing for latent tuberculosis infection (LTBI) in HIV-infected persons in low tuberculosis (TB) incidence areas is often recommended. Using contemporary, clinical data, we report the yield and cost-effectiveness of testing all HIV attendees, two current UK strategies and no LTBI testing.Economic modelling was performed utilising 10-year follow up data from a large HIV clinical cohort. Outcomes were numbers of cases of active TB and incremental cost per quality-adjusted life year (QALY) gained.Between 2000 and 2010, 256 people were treated for TB/HIV co-infection. 72 (28%) occurred ≥3 months after HIV diagnosis and may have been prevented by LTBI testing. Between 2000 and 2005, the incremental cost per QALY gained for the British HIV Association (BHIVA) and UK National Institute of Care Excellence (NICE) strategies, and testing all clinic attendees was €6270, €6998 and €33 473, respectively. These rose to €9332, €32 564 and €74 067, respectively, between 2005 and 2010. Probabilistic sensitivity analysis suggested that at a threshold of €24 000 per additional QALY, the most cost-effective strategies would be NICE or testing all in 2000–2005 and BHIVA during 2005–2010.Both UK testing regimens missed cases but are cost-effective compared with no testing. Using recent data, they all became more expensive, suggesting that alternative or more targeted TB testing strategies must be considered.
Antagonistic implications of sarcopenia and abdominal obesity on physical performance in COPD
Authors: van de Bool Coby , Rutten Erica P.A. , Franssen Frits M.E. , Wouters Emiel F.M. , Schols Annemie M.W.J. 
Published: April 2015

Decreased physical performance due to loss of muscle mass (i.e.sarcopenia) is prevalent in ageing and appears more pronounced in chronic disease. A comprehensive profile of the sarcopenic phenotype in chronic obstructive pulmonary disease (COPD) is not yet available. The aim of the present study was to characterise prevalence, functional implications and predictive value of sarcopenia with or without abdominal obesity in Dutch COPD patients eligible for pulmonary rehabilitation.505 COPD patients (aged 37–87 years; 57% male) underwent assessment of lung function, body composition and physical functioning, before entering pulmonary rehabilitation. Sarcopenia was assessed by appendicular skeletal muscle index (ASMI) and abdominal obesity by android/gynoid percentage fat mass (A/G%FM) using dual energy X-ray absorptiometry.86.5% of patients were sarcopenic and showed lower physical functioning, while coexistent abdominal obesity (78.0%) resulted in higher physical functioning. Implications on endurance were less pronounced in women. The predictive value for physical functioning was higher for the “three-compartment” model (ASMI, bone mineral content and A/G%FM) than the “two-compartment” model (fat-free mass index and fat mass index) or “one-compartment” model (body mass index).In patients eligible for pulmonary rehabilitation, sarcopenia is highly prevalent in all body mass index categories and associated with impaired strength, and in men also with decreased endurance. Abdominal obesity seems to have protective effects on physical functioning. ASMI is a better predictor for physical functioning than fat-free mass index.