bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine versus midazolam for gastrointestinal endoscopy: A meta‐analysis
Authors: Nishizawa Toshihiro , Suzuki Hidekazu , Sagara Seiji , Kanai Takanori , Yahagi Naohisa 
Published: November 2014

Background and AimPatients who undergo gastrointestinal endoscopy often require sedatives such as midazolam and the more recently developed alpha‐2 agonist, dexmedetomidine. To assess the efficacy and safety of dexmedetomidine sedation for gastrointestinal endoscopy, we conducted a systematic review and meta‐analysis of randomized controlled trials comparing dexmedetomidine with midazolam.MethodsWe searched PubMed, the Cochrane library, and the Igaku‐chuo‐zasshi database in order to identify randomized trials eligible for inclusion in our meta‐analysis. Data from the eligible studies were combined to calculate pooled odds ratios (OR) or weighted mean differences (WMD).ResultsWe identified nine randomized trials from the database search. Compared to that of midazolam, the pooled OR for restlessness of dexmedetomidine was 0.078 (95% confidence interval [CI]: 0.013–0.453, P < 0.0001), and there was no significant heterogeneity among the trial results. Dexmedetomidine significantly increased Ramsay sedation score compared with midazolam (WMD: 0.401, 95% CI: 0.110–0.692, P = 0.0069), without significant heterogeneity. Compared with midazolam, the pooled OR for hypoxia, hypotension, and bradycardia with dexmedetomidine sedation were 0.454 (95% CI: 0.098–2.11), 1.370 (95% CI: 0.516–3.637), and 2.575 (95% CI: 0.978–6.785), respectively, with no significant differences detected between the groups.ConclusionThis meta‐analysis shows that dexmedetomidine is a safe and effective sedative agent for gastrointestinal endoscopy, especially endoscopic retrograde cholangiopancreatography and endoscopic submucosal dissection.
Geographic Effects on Intergenerational Income Mobility
Authors: Rothwell Jonathan T. , Massey Douglas S. 
Published: November 2014

AbstractResearch on intergenerational economic mobility often ignores the geographic context of childhood, including neighborhood quality and local purchasing power. We hypothesize that individual variation in intergenerational mobility is partly attributable to regional and neighborhood conditions—most notably access to high‐quality schools. Using restricted Panel Study of Income Dynamics and census data, we find that neighborhood income has roughly half the effect on future earnings as parental income. We estimate that lifetime household income would be $635,000 dollars higher if people born into a bottom‐quartile neighborhood would have been raised in a top‐quartile neighborhood. When incomes are adjusted to regional purchasing power, these effects become even larger. The neighborhood effect is two‐thirds as large as the parental income effect, and the lifetime earnings difference increases to $910,000. We test the robustness of these findings to various assumptions and alternative models, and replicate the basic results using aggregated metropolitan‐level statistics of intergenerational income elasticities based on millions of Internal Revenue Service records.
Combining Coronary with Carotid and Cerebrovascular Angiography Using Prospective ECG Gating and Iterative Reconstruction with 256‐slice CT
Authors: Zhang Jin‐Ling , Liu Bai‐Lu , Zhao Yan‐Ming , Liang Hong‐Wei , Wang Guo‐Kun , Wan Yong , Huang Ya‐Hua , Shen Bao‐Zhong 
Published: November 2014

ObjectiveTo investigate the image quality and radiation dose of combined coronary and carotid/cerebrovascular angiography with ECG gating and iterative reconstruction using 256‐slice CT compared with the findings with the two examinations performed separately.Patients and MethodsOne hundred sixty‐five consecutive patients underwent a single‐injection single‐pass combination of coronary and carotid/cerebrovascular CT angiography (group A), coronary CT angiography alone (group B), or carotid/cerebrovascular CT angiography alone (group C). We assessed the image quality of the combined and separate examinations and calculated the respective effective radiation doses. We evaluated the differences in the proportions of image quality grade between the combination and single‐examination groups. Diagnostic performance of the combined scanning for detecting significant vascular stenosis has been compared with reference digital subtraction angiography (DSA) in the patient subgroup of group A.ResultsThere was no significant difference in age, body mass index (BMI), or gender distribution among the 3 groups (all P > 0.05). But there was significant difference in scan length, DLP, and effective dose among the 3 groups (all P < 0.05). There were no significant differences in the effective radiation dose of coronary scanning between groups A and B (P > 0.05), while the effective radiation dose of carotid/cerebrovascular scanning in group A was significantly lower than that in group C (P < 0.05), and the total effective radiation dose in group A were relatively low (2.21 ± 1.38 mSv). The differences of the proportion of carotid/cerebrovascular image quality grades between groups A and C were not significant (P > 0.05). In a subgroup of group A of 30 patients with DSA, combined computed tomographic angiography successfully detected 56 coronary stenosis on per‐segment basis, and 62 stenosis on carotid and cerebral artery. The sensitivity, specificity, positive and negative predictive value (NPV) of coronary stenosis were 91.80%, 95.60%, 87.50% and 97.21%, respectively. The sensitivity, specificity, positive and NPV of carotid/cerebrovascular stenosis were 93.55%, 94.68%, 92.06% and 95.70%, respectively.ConclusionCombination of coronary and carotid/cerebrovascular angiography with 256‐slice CT scanner with prospective ECG gating and iterative reconstruction produces diagnostic‐quality images of the coronary, carotid, and cerebrovascular systems in a single examination, using less contrast medium and a lower radiation dose than when the two examinations are performed separately. This novel technique has high accuracy in detecting significant stenosis in one image setting.
Effect of acotiamide on gastric emptying in healthy adult humans
Authors: Zai Hiroaki , Matsueda Kei , Kusano Motoyasu , Urita Yoshihisa , Saito Youichi , Kato Hiroki 
Published: November 2014

AbstractBackgroundAcotiamide is a first‐in‐class drug that is used to treat functional dyspepsia (FD). It is considered that acotiamide acts as an antagonist on muscarinic autoreceptors in the enteric nervous system and inhibits acetylcholinesterase activity. We examined the effect of acotiamide on gastric emptying in healthy adult humans.Materials and methodsTwelve healthy adult males were enrolled in this double‐blind crossover study. Acotiamide or placebo was administered orally in the 12 subjects 30 min before ingestion of a nutritional liquid meal (400 Kcal/400 mL). Six of the 12 participants took 100 mg of acotiamide or placebo, and six of the 12 participants took 300 mg of acotiamide or placebo in a double‐blind crossover fashion. All subjects underwent measurement of gastric emptying by the 13C breath test.ResultsAfter the meal with placebo was ingested, the %dose/h curve ascended. The %dose/h curve after a meal with 100 or 300 mg of acotiamide ascended in an identical manner compared with the results with placebo. No significant differences were observed at any studied time point, and there were no significant changes in gastric emptying parameters (gastric emptying coefficient, t‐1/2ex and t‐lag ex).ConclusionsA single administration of 100 or 300 mg of acotiamide did not affect gastric emptying after a liquid meal in healthy adult humans. Acotiamide has profound effects on restoring delayed gastric emptying and impaired accommodation in patients with FD but may have no effect on gastric emptying in healthy subjects. Such pharmacological actions have not been observed in previous gastroprokinetic studies.
DPPIV (CD26) as a novel stem cell marker in Ph+ chronic myeloid leukaemia
Authors: Valent Peter , Sadovnik Irina , Ráčil Zdeněk , Herrmann Harald , Blatt Katharina , Cerny‐Reiterer Sabine , Eisenwort Gregor , Lion Thomas , Holyoake Tessa , Mayer Jiří 
Published: November 2014

AbstractThe concept of leukaemic stem cells (LSCs) has been developed to explain the complex cellular hierarchy and biology of leukaemias and to screen for pivotal targets that can be employed to improve drug therapies through LSC eradication in these patients. Some of the newly discovered LSC markers seem to be expressed in a disease‐specific manner and may thus serve as major research tools and diagnostic parameters. A useful LSC marker in chronic myeloid leukaemia (CML) appears to be CD26, also known as dipeptidylpeptidase IV. Expression of CD26 is largely restricted to CD34+/CD38− LSCs in BCR/ABL1+ CML, but is not found on LSCs in other myeloid or lymphoid neoplasms, with the exception of lymphoid blast crisis of CML, BCR/ABL1p210+ acute lymphoblastic leukaemia, and a very few cases of acute myeloid leukaemia. Moreover, CD26 usually is not expressed on normal bone marrow (BM) stem cells. Functionally, CD26 is a cytokine‐targeting surface enzyme that may facilitate the mobilization of LSCs from the BM niche. In this article, we review our current knowledge about the biology and function of CD26 on CML LSCs and discuss the diagnostic potential of this new LSC marker in clinical haematology.
Multiple skeletal metastases from a penile squamous cell carcinoma in a horse
Authors: Nelson B. B. , Edmondson E. F. , Sonis J. M. , Frank C. B. , Valdés‐Martínez A. , Leise B. S. 
Published: November 2014

SummaryA 21‐year‐old gelding with ventral abdominal and preputial oedema was evaluated for right hindlimb lameness. Partial phallectomy had been performed 3 years prior for treatment of squamous cell carcinoma. Regional analgesia did not localise the source of lameness and nuclear scintigraphy was recommended. The results of the scan revealed severe increased radiopharmaceutical uptake in the proximal femur. Radiographic and ultrasound examinations were inconclusive. The horse was discharged with recommendations of stall confinement and a 2 week course of nonsteroidal anti‐inflammatory drugs. Four weeks later the horse presented for an inability to elevate his neck and persistent hindlimb lameness. The owner elected humane euthanasia. Post mortem examination revealed metastatic squamous cell carcinoma in the proximal femur and fifth cervical vertebrae consistent with metastasis from the penile squamous cell carcinoma. To the authors’ knowledge, multiple site bone metastasis of squamous cell carcinoma has not been reported previously in the horse.
Pharmacokinetics, phenotype and product choice in haemophilia B: how to strike a balance?
Authors: Berntorp E. , Dolan G. , Hermans C. , Laffan M. , Santagostino E. , Tiede A. 
Published: November 2014

SummaryAt the 7th Annual Congress of the European Association for Haemophilia and Allied Disorders (EAHAD) held in Brussels, Belgium, in February 2014, Pfizer sponsored a satellite symposium entitled:“Pharmacokinetics, phenotype and product choice in haemophilia B: How to strike a balance?”Co‐chaired by Cedric Hermans (Cliniques Universitaires Saint Luc, Brussels, Belgium) and Mike Laffan (Imperial College, London, UK), the symposium provided an opportunity to debate whether pharmacokinetic (PK) parameters are good surrogates for clinical efficacy for haemophilia B in clinical practice, consider the perceptions and evidence of disease severity, and examine how these considerations can inform approaches to balancing the potential risks and benefits of the currently available treatment options for haemophilia B. PK parameters are routinely measured in clinical practice and are a requirement of regulatory bodies to demonstrate the clinical efficacy of products; however, the relationship between measured PK parameters and clinical efficacy is yet to be determined, an issue that was debated by Gerry Dolan (University Hospital, Queen's Medical Centre, Nottingham, UK) and Erik Berntorp (Lund University, Malmö Centre for Thrombosis and Haemostasis, Malmö, Sweden). Elena Santagostino (Universita degli Studi di Milano, Milano, Italy) reviewed how differing perceptions on the severity of haemophilia B compared with haemophilia A may have an impact on clinical decision‐making. Finally, Andreas Tiede (Hannover Medical School, Hannover, Germany), examined the considerations for balancing the potential risks and benefits of the currently available treatment options for haemophilia B. Although the pathophysiology of haemophilia B has been widely studied and is largely understood, continued investigation and discussion around the optimal management course and appropriate therapeutic choice is warranted.
Late Holocene coral reef environment recorded in Tridacnidae shells from archaeological sites in Okinawa‐jima, subtropical southwestern Japan
Authors: Asami Ryuji , Konishi Mika , Tanaka Kentaro , Uemura Ryu , Furukawa Masahide , Shinjo Ryuichi 
Published: November 2014

AbstractSeasonally resolved records of carbon and oxygen isotopic composition (δ18O) in fossil shells of giant clams (Tridacnidae) recovered from the Kogachibaru Shell Mound (26°26′N, 127°49′E) and the Second Aragusuku‐Shichabaru Ruin (26°18′N, 127°46′E) in Okinawa‐jima, southwestern Japan, were investigated to reconstruct subtropical coral reef environments of the past. The samples, mainly composed of aragonite shells with limited amounts of diagenetically‐altered calcite cements, were selected for geochemical analyses. The radiocarbon dating of the samples for stable isotope analyses yields about 4000 yr cal. BP for the Kogachibaru Shell Mound and about 1900–1700 yr cal. BP for the Second Aragusuku‐Shichabaru Ruin, respectively, that correspond to the early and middle Shell Mound periods in Okinawa‐jima. These show good agreement with the respective ages inferred from excavation. The shell δ18O values roughly show seasonal variations, coincident with the occurrence of annual growth bands. Applying corrections for the effect of diagenetic alteration, the averages of annual, summer, and winter δ18O values of fossil shells were significantly lower (by 0.1–0.7‰) than those of aragonite theoretically precipitated in present‐day coral reef water of Okinawa‐jima. These results demonstrate that annual mean seawater temperature and salinity at the sites where the Tridacnida spp. lived were about 1–3°C higher and/or about 1–2 lower than at present. This variation cannot be fully explained by global climate change, sea level change, and topographic growth of coral reef. Therefore, it is likely that the giant clams lived in extremely small and/or closed coral‐reef lagoons with less water circulation where seawater is highly susceptible to insolation‐induced temperature increase and input of fresh water; the effect could be enhanced by the fisheries lifestyle that stonewalling would be constructed at shallow waters through the use of tidal variation during the early and middle Shell Mound period in Okinawa‐jima.
Effect of ozone treatment on physicochemical properties of waxy rice flour and waxy rice starch
Authors: Ding Wenping , Wang Yuehui , Zhang Wei , Shi Yongcheng , Wang Donghai 
Published: November 2014

SummaryThe effect of ozone treatment on physicochemical properties of waxy rice flour and waxy rice starch was investigated. Results showed that ozone treatment increased the pasting viscosity of waxy rice flour. Compared with untreated waxy rice flour, the peak viscosities of waxy rice flour for 0.5, 1 and 2 h of ozone treatments were increased by 27.4%, 32.8% and 45.5%, respectively. The alpha‐amylase in waxy rice flour was inactivated during the treatment. The gelatinisation temperature and enthalpy of waxy rice flour were kept unchanged after the treatment. For waxy rice starch, pasting viscosity, swelling power and molecular weight were increased after 0.5 h of treatment, but decreased as treatment time extended. The ozone treatment decreased gelatinisation temperature and enthalpy of waxy rice starch.
Effect of proteins on the formation of starch–lipid complexes during extrusion cooking of wheat flour with the addition of oleic acid
Authors: De Pilli Teresa , Legrand Jack , Derossi Antonio , Severini Carla 
Published: November 2014

SummaryThe formation of starch–lipid complexes plays an important role in extruded products. The effect of gluten proteins on thermal conditions at which the starch–lipid complexes formed during extrusion cooking of wheat flour with the addition of oleic acid was evaluated, considering wheat starch as a reference. The presence of gluten proteins in wheat flour extrudates brought about a reduction of the formation of starch–lipid complexes compared to blend of wheat starch and oleic acid extruded at the same operating conditions (melting enthalpy: 0.4 vs. 1.6 kJ kg−1). Moreover, the lubricant effect of oleic acid observed during extrusion of wheat starch (low values of specific mechanical energy and residence time) was not found during extrusion of wheat flour with addition of oleic acid because of the interaction between gluten proteins and oleic acid. This research points out the importance of proteins on biopolymer modifications and their effect on extrudate quality.
Dynamic monitoring of the shelf life of Cobia (Rachycentron canadum): a study on the applicability of a smart photochromic indicator
Authors: Brizio Ana P. B. R. , Gonzaga Junior Marcondes A. , dos Santos Fogaça Fabíola H. , Prentice Carlos 
Published: November 2014

SummaryTo ensure the marketing of fresh fish‐based products, it is necessary to develop fast methods that assess its freshness in real time. This study therefore evaluated the applicability of a photochromic time–temperature indicator (TTI) to monitor the time and temperature history during the period of validity of the whole fish of the cobia specimen stored in ice. The TTI response was both visibly interpreted as well as adaptable to measurement using suitable equipment. The results showed that the smart indicator activated during 6 s of ultraviolet light showed a similar rate of deterioration of the analysed product visual response, proving to be a dynamic shelf life indicator that can assure consumers the ultimate quality point of the entire cobia easily, cheaply and accurately.
Chronic obstructive pulmonary disease case finding by community pharmacists: a potential cost-effective public health intervention
Authors: Wright David , Twigg Michael , Thornley Tracey 
Published: November 2014

Abstract

Objectives
This study aims to pilot a community pharmacy chronic obstructive pulmonary disease (COPD) case finding service in England, estimating costs and effects.

Methods
Patients potentially at risk of COPD were screened with validated tools. Smoking cessation was offered to all smokers identified as potentially having undiagnosed COPD. Cost and effects of the service were estimated.

Key findings
Twenty-one community pharmacies screened 238 patients over 9 months. One hundred thirty-five patients were identified with potentially undiagnosed COPD; 88 were smokers. Smoking cessation initiation provided a project gain of 38.62 life years, 19.92 quality-adjusted life years and a cost saving of £392.67 per patient screened.

Conclusions
COPD case finding by community pharmacists potentially provides cost-savings and improves quality of life.
Characteristics favouring a delayed disposition decision in the emergency department
Authors: Perimal‐Lewis L. , Hakendorf P. H. , Thompson C. H. 
Published: November 2014

AbstractBackgroundThe working hours of a hospital affects efficiency of care within the emergency department (ED). Understanding the influences on ED time intervals is crucial for process redesign to improve ED patient flow.AimTo assess characteristics that affect patients' transit through an ED.MethodsRetrospective cohort study from 2004 to 2010 of 268 296 adult patients who presented to the ED of an urban tertiary‐referral Australian teaching hospital.ResultsAfter adjustment for Australasian Triage Scale (ATS) category, every decade increase in age meant patients spent an additional 2 min in the ED waiting to be seen (P < 0.001) and an extra 29‐min receiving treatment (P < 0.001). For every additional 10 patients in the ED, the ‘waiting time’ (WT) phase duration increased by 20 min (P < 0.001) and the ‘Assessment and Treatment Time’ (ATT) phase duration increased by 26 min (P < 0.001). When patients arrived outside working hours, the WT phase duration increased by 20 min (P < 0.001). When seen outside working hours, the ATT phase duration increased by 34.5 min (P < 0.001).ConclusionExtrinsic to the patients themselves and in addition to ED overcrowding, the working hours of the hospital affected efficiency of care within the ED. Not only should the whole of the hospital be involved in improving efficient and safe transit of patients through an ED, but the whole of the day and every day of the week deserve attention.
Echocardiographic and electrocardiographic findings in patients with obesity hypoventilation syndrome
Authors: Alawami M. , Mustafa A. , Whyte K. , Alkhater M. , Bhikoo Z. , Pemberton J. 
Published: November 2014

AbstractBackgroundObesity is a risk factor for both sleep‐related breathing disorders (SRBD), including obesity hypoventilation syndrome (OHS) and cardiovascular diseases (CVD). The development of CVD in patients with SRBD is usually attributed to the fact that most patients are obese in addition to conventional cardiovascular risk factors.AimsThis study aims to measure the prevalence of certain CVD in patients with OHS in the Auckland region and highlight the importance of the effects of SRBD on the heart.MethodsA dataset of all patients with a formal diagnosis of OHS that were under active follow up was compiled from Auckland District Health Board Sleep Disordered Breathing Service. Clinical notes were retrospectively reviewed for echocardiogram reports, blood pressure measurements and electrocardiograms.ResultsForty‐seven patients were included in the present study. The median age was 60 years, 24 were female (51%), 20 (42.5%) had diabetes, mean HbA1C was 53.5 mmol/mol, mean systolic blood pressure was 127 mmHg, mean body mass index was 49 kg/m2, mean forced expiratory volume in 1 s was 1.7 L, mean estimated glomerular filtration was 71 mL/min/1.73 m2 and there was anti‐hypertensive use in 31 (65.9%) patients. Thirty‐three patients had poor quality echocardiography views (70.2%). Left ventricular systolic and diastolic function was impaired in 8 (25%) and 18 (60%) respectively. Right ventricular dysfunction and pulmonary hypertension was present in 19 (63.3%) and 13 (52%) respectively. Sixteen patients (34%) had recurrent atrial or ventricular arrhythmias.ConclusionThere appears to be a high prevalence of right ventricular impairment, pulmonary hypertension, left ventricle hypertrophy, diastolic dysfunction and arrhythmias in patients with OHS. These findings would appear to be higher than expected in obese patients without OHS. A larger prospective matched cohort study would be needed to confirm the clinical significance of these findings.