bluuebunny/crossref_metadata_2025_split huggingface dataset:
External Validation of the Risk Assessment Model of the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) for Medical Patients in a Tertiary Health System
Authors: Rosenberg David , Eichorn Ann , Alarcon Mauricio , McCullagh Lauren , McGinn Thomas , Spyropoulos Alex C. 
Published: November 2014

Background

Hospitalized medical patients are at risk for venous thromboembolism (
VTE
). Universal application of pharmacological thromboprophylaxis has the potential to place a large number of patients at increased bleeding risk. In this study, we aimed to externally validate the International Medical Prevention Registry on Venous Thromboembolism (
IMPROVE) VTE
risk assessment model in a hospitalized general medical population.

Methods and Results

We identified medical discharges that met the
IMPROVE
protocol. Cases were defined as hospital‐acquired
VTE
and confirmed by diagnostic study within 90 days of index hospitalization; matched controls were also identified. Risk factors for
VTE were
based on the
IMPROVE risk assessment model
(aged >60 years, prior
VTE
, intensive care unit or coronary care unit stay, lower limb paralysis, immobility, known thrombophilia, and cancer) and were measured and assessed. A total of 19 217 patients met the inclusion criteria. The overall
VTE
event rate was 0.7%. The
IMPROVE risk assessment model
identified 2 groups of the cohort by
VTE
incidence rate: The low‐risk group had a
VTE
event rate of 0.42 (95%
CI
0.31 to 0.53), corresponding to a score of 0 to 2, and the at‐risk group had a
VTE
event rate of 1.29 (95%
CI
1.01 to 1.57), corresponding to a score of ≥3. Low‐risk status for VTE encompassed 68% of the patient cohort. The area under the receiver operating characteristic curve was 0.702, which was in line with the derivation cohort findings.

Conclusions

The
IMPROVE VTE
risk assessment model validation cohort revealed good discrimination and calibration for both the overall
VTE
risk model and the identification of low‐risk and at‐risk medical patient groups, using a risk score of ≥3. More than two thirds of the entire cohort had a score ≤2.
Identifying a Barotropic Growth Mechanism in East Pacific Tropical Cyclogenesis Using Adjoint-Derived Sensitivity Gradients
Authors: Hoover Brett T. 
Published: November 2014

Abstract
The eastern Pacific tropical cyclone basin is typified by a low-level westerly jet with the main development region residing on its northern, cyclonic-shear side. The persistent meridional shear of the zonal flow associated with the jet allows for the possibility of barotropic conversion of energy from the mean state into the kinetic energy of vortices—possibly contributing to tropical cyclogenesis, but this is difficult to quantify by perturbing the model based on intuition since there is no guarantee that perturbations will favorably interact with the jet to facilitate cyclogenesis.
Here, sensitivity gradients of vortex intensity through cyclogenesis are calculated for a set of cases spanning from 2004 to 2010 and are interpreted dynamically to determine which cases have sensitivities describing structures that can grow barotropically from the low-level jet. The adjoint model is run with adiabatic physics linearized about a basic state that contains moist convection. Optimal perturbations derived from these sensitivities are inserted into the model to observe the impact. Roughly 34% of observed cases exhibited structures in sensitivity to zonal flow that strongly imply barotropic growth, while about 21% exhibited no such structures. The remainder (roughly 45%) exhibit some reliance on barotropic growth. Cases with sensitivities exhibiting strong barotropic growth structures are typified by low-level westerly jets with larger meridional shear. In these cases, optimal perturbations require less initial energy to increase vortex intensity by a specified amount, the energy is more strongly focused at jet level, and the localized energy growth rate of perturbations is most efficient.
Clinical Implication of Highly Sensitive Detection of the BRAFV600E Mutation in Fine-Needle Aspirations According to the Thyroid Bethesda System in Patients With Conventional Papillary Thyroid Carcinoma
Authors: Seo Jae Young , Choi Jong Rak , Moon Hee Jung , Kim Eun-Kyung , Han Kyung Hwa , Kim Hyunki , Kwak Jin Young 
Published: November 2014

Background: We investigated the additional diagnostic yield of the mutation test and evaluated the frequency of the BRAF mutation in conventional PTC (cPTC) according to ultrasound (US) features and the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based on the BRAFV600E mutation status. Materials and Methods: During the study period, 279 patients who underwent FNA with an additional BRAFV600E mutation test were diagnosed as cPTC after surgery. We analyzed the association between the mutation and several clinical factors. Results: Of the 279 cPTCs, 250 (89.6%) had the BRAFV600E mutation. The BRAF mutation test was helpful in diagnosing an additional 19% (53/279) of cPTCs. The frequency of the BRAF mutation in cPTCs with suspicious US features was higher than that of cPTCs with negative US features regardless of the BSRTC. Conclusions: Suspicious US features may be helpful in deciding whether an additional BRAFV600E mutation test should be done in thyroid nodules with indeterminate cytology.
Effects of apocynin, an NADPH oxidase inhibitor, on levels of ADMA, MPO, iNOS and TLR4 induced by myocardial ischemia reperfusion
Authors: Uysal A , Sahna E , Ozguler IM , Burma O , Ilhan N 
Published: November 2014

Purpose: In this study, the effects of apocynin, an NADPH oxidase inhibitor, on the levels of inducible nitric oxide synthase (iNOS) and the toll-like receptor 4 (TLR4), which are inflammatory mediators in myocardial ischemia-reperfusion (MIR) injury, and myeloperoxidase (MPO), which is the indicator of neutrophil infiltration and the endogenous nitric oxide synthase inhibitor asymmetric dimethyl arginine (ADMA) increasing with oxidative stress were investigated. Methods: MIR injury was accomplished by the application of occlusion for 30 minutes and reperfusion for 120 minutes in the left anterior descending artery (LAD). In the study, 21 Sprague-Dawley male rats were divided into three groups: a sham group (n = 7); a MIR group (n = 7); and a MIR + apocynin treatment group (n = 7, before the procedure, an intraperitoneal administration of 10 mg/kg of apocynin for 15 days). After reperfusion, iNOS, TLR4, MPO and ADMA levels in myocardial tissue were measured by ELISA. Results: While myocardial TLR4, MPO and ADMA levels increased in the MIR group, these parameters were found to be decreased significantly in the group treated with apocynin. Although iNOS levels showed an increase in the MIR group compared to the sham group and a reduction in the MIR+apocynin group, there was no statistically significant difference between the groups. Discussion: In our study, the effect of the treatment of apocynin in MIR on ADMA, MPO, iNOS and TLR4 levels in myocardial tissue was shown for the first time. It is thought that apocynin treatment may show a protective effect in MIR injury by affecting oxidative stress (ADMA) and inflammatory parameters (iNOS, MPO).
The Effect of Donor Age on Structural and Mechanical Properties of Allograft Tendons
Authors: Swank Katherine R. , Behn Anthony W. , Dragoo Jason L. 
Published: November 2014

Background: Allograft tendons are commonly used in surgical ligament reconstruction. While it is commonly accepted that donor age will affect mechanical properties of graft tissue, the apparent age threshold is unknown. Hypothesis: Donor age will significantly influence the structural and mechanical properties of tibialis posterior allograft tendons. Study Design: Controlled laboratory study. Methods: A total of 550 allograft posterior tibialis tendons were examined. Linear stiffness, ultimate tensile force, ultimate displacement, tensile modulus, ultimate tensile strength, and ultimate tensile strain were calculated for specimens from donors in each of 6 age groups: 15-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years. Both first- and second-order polynomial regressions were performed to determine the correlation between structural and mechanical properties and age. Welch analyses of variance with Games-Howell post hoc tests were performed to facilitate comparisons among age groups. Results: All parameters displayed a weak correlation with age, with the highest R2 term being 0.063 for ultimate tensile strength. Linear stiffness, ultimate tensile force, and tensile modulus displayed almost no correlation with age. Ultimate tensile strength increased slightly with age up to 40-49 years and then decreased with further increases in age. Slight decreases in ultimate displacement and ultimate tensile strain were observed with increasing age. Numerous statistically significant differences were observed between age groups for each outcome parameter; however, the magnitudes of the differences between age groups are relatively small (<15%) for all outcome parameters. Conclusion: Age explained at most 6% of the variation in structural and mechanical properties of tibialis posterior allograft tendons. Clinical Relevance: Posterior tibialis tendons from all age groups displayed structural properties superior to the native anterior cruciate ligament, with higher stiffness and ultimate force, and less displacement to failure. Although statistically significant differences in structural and mechanical properties were observed between age groups, the magnitudes of the differences are small and most likely not clinically relevant. The age of the donor will not likely affect the suitability of a graft for use in surgical reconstruction.
Imaging of Physeal Injury
Authors: Jawetz Shari T. , Shah Parina H. , Potter Hollis G. 
Published: November 2014

Context: As the intensity of youth participation in athletic activities continues to rise, the number of overuse injuries has also increased. A subset of overuse injuries involves the physis, which is extremely susceptible to injury. This paper aims to review the utility of the various imaging modalities in the diagnosis and management of physeal injuries in the skeletally immature population. Evidence Acquisition: A search for the keywords pediatric, physis, growth plate, x-ray, computed tomography, magnetic resonance imaging, and overuse injury was performed using the PubMed database. No limits were set for the years of publication. Articles were reviewed for relevance with an emphasis on the imaging of growth plate injuries. Study Design: Retrospective literature review. Level of Evidence: Level 4. Results: Three major imaging modalities (radiographs, computed tomography, and magnetic resonance imaging) complement each other in the evaluation of pediatric patients with overuse injuries. However, magnetic resonance imaging is the only modality that offers direct visualization of the physis, and it also offers the best soft tissue contrast for evaluating the other periarticular structures for concomitant injury. Conclusion: Imaging has an important role in the diagnosis of physeal injuries, and the information it provides has a tremendous impact on the subsequent management of these patients.
Serum Cartilage Oligomeric Matrix Protein Levels in Collegiate Soccer Athletes over the Duration of an Athletic Season
Authors: Mateer Jessica L. , Hoch Johanna M. , Mattacola Carl G. , Butterfield Timothy A. , Lattermann Christian 
Published: November 2014

Objective: The primary objective of this study was to measure serum cartilage oligomeric matrix protein (sCOMP) levels weekly in a group of collegiate soccer athletes over the duration of a spring soccer season and 2 weeks following the conclusion of the season while documenting minutes of exercise participation as a measure of exercise intensity. Design: A repeated-measures study design was employed. A volunteer sample of 6 female soccer athletes participated in this study. Serum samples were collected on 10 separate occasions, 1 week prior to the start of the season (baseline), once a week during the 8-week season (PX1-PX8), and once a week for 2 weeks following the conclusion of the season (postseason; PS1 and PS2). Minutes of participation were documented following all spring soccer activities for each week. Once all samples were collected, sCOMP concentrations were determined using a commercially available enzyme-linked immunosorbent assay. Results: The results of Friedman test revealed a significant effect for time ( P = 0.003). Post hoc analysis revealed no significant differences between baseline and practice or postseason levels. A qualitative analysis of the sCOMP levels and minutes indicated higher sCOMP levels occurred when the athletes’ participation in soccer-related activities was higher. Conclusions: Qualitatively, our findings suggest that as minutes of participation increased, sCOMP levels increased. However, no statistically significant differences were identified. We speculate these increases were an increase in cartilage turnover and an interesting observation related to increases in physical activity. However, the implications are unclear as there was a return to near baseline levels.
Transcriptome profiling shows gene regulation patterns in a flavonoid pathway in response to exogenous phenylalanine in Boesenbergia rotunda cell culture
Authors: Md-Mustafa Noor Diyana , Khalid Norzulaani , Gao Huan , Peng Zhiyu , Alimin Mohd Firdaus , Bujang Noraini , Ming Wong Sher , Mohd-Yusuf Yusmin , Harikrishna Jennifer A , Othman Rofina Yasmin 
Published: November 2014

Abstract

Background
Panduratin A extracted from Boesenbergia rotunda is a flavonoid reported to possess a range of medicinal indications which include anti-dengue, anti-HIV, anti-cancer, antioxidant and anti-inflammatory properties. Boesenbergia rotunda is a plant from the Zingiberaceae family commonly used as a food ingredient and traditional medicine in Southeast Asia and China. Reports on the health benefits of secondary metabolites extracted from Boesenbergia rotunda over the last few years has resulted in rising demands for panduratin A. However large scale extraction has been hindered by the naturally low abundance of the compound and limited knowledge of its biosynthetic pathway.

Results
Transcriptome sequencing and digital gene expression (DGE) analysis of native and phenylalanine treated Boesenbergia rotunda cell suspension cultures were carried out to elucidate the key genes differentially expressed in the panduratin A biosynthetic pathway. Based on experiments that show increase in panduratin A production after 14 days post treatment with exogenous phenylalanine, an aromatic amino acid derived from the shikimic acid pathway, total RNA of untreated and 14 days post-phenylalanine treated cell suspension cultures were extracted and sequenced using next generation sequencing technology employing an Illumina-Solexa platform. The transcriptome data generated 101, 043 unigenes with 50, 932 (50.41%) successfully annotated in the public protein databases; including 49.93% (50, 447) in the non-redundant (NR) database, 34.63% (34, 989) in Swiss-Prot, 24,07% (24, 316) in Kyoto Encyclopedia of Genes and Genomes (KEGG) and 16.26% (16, 426) in Clusters of Orthologous Groups (COG). Through DGE analysis, we found that 14, 644 unigenes were up-regulated and 14, 379 unigenes down-regulated in response to exogenous phenylalanine treatment. In the phenylpropanoid pathway leading to the proposed panduratin A production, 2 up-regulated phenylalanine ammonia-lyase (PAL), 3 up-regulated 4-coumaroyl:coenzyme A ligase (4CL) and 1 up-regulated chalcone synthase (CHS) were found.

Conclusions
This is the first report of Boesenbergia rotunda de novo transcriptome data that could serve as a reference for gene or enzyme functional studies in the Zingiberaceae family. Although enzymes that are directly involved in the panduratin A biosynthetic pathway were not completely elucidated, the data provides an overall picture of gene regulation patterns leading to panduratin A production.
Effect of annealing temperature on wettability of TiO2 nanotube array films
Authors: Yang Lei , Zhang Miao , Shi Shiwei , Lv Jianguo , Song Xueping , He Gang , Sun Zhaoqi 
Published: November 2014

Abstract
Highly ordered TiO2 nanotube array (TN) films were prepared by anodization of titanium foil in a mixed electrolyte solution of glycerin and NH4F and then annealed at 200°C, 400°C, 600°C, and 800°C, respectively. The samples were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), water contact angle (WCA), and photoluminescence (PL). It was found that low temperature (below 600°C) has no significant influence on surface morphology, but the diameter of the nanotube increases from 40 to 50 nm with increasing temperature. At 800°C, the nanotube arrays are completely destroyed and only dense rutile film is observed. Samples unannealed and annealed at 200°C are amorphous. At 400°C, anatase phase appears. At 600°C, rutile phase appears. At 800°C, anatase phase changes into rutile phase completely. The wettability of the TN films shows that the WCAs for all samples freshly annealed at different temperatures are about 0°. After the annealed samples have been stored in air for 1 month, the WCAs increase to 130°, 133°, 135°, 141°, and 77°, respectively. Upon ultraviolet (UV) irradiation, they exhibit a significant transition from hydrophobicity to hydrophilicity. Especially, samples unannealed and annealed at 400°C show high photoinduced hydrophilicity.
Real-time and nested polymerase chain reaction in the diagnosis of multifocal serpiginoid choroiditis caused by Mycobacterium tuberculosis - a case report
Authors: Shetty Sachin B , Biswas Jyotirmay , Murali Sowmiya 
Published: November 2014

Abstract

Background
The term multifocal serpiginoid choroiditis (MSC) has been proposed for the infective variant of serpiginous choroiditis (SC) to distinguish it from typical SC believed to be autoimmune related. The role of Mycobacterium tuberculosis (MTb) in MSC has been studied by conventional polymerase chain reaction (PCR). However, the use of real-time PCR (RT-PCR) and nested PCR (N-PCR) in MSC has not been reported. This paper aims to highlight the usefulness of PCR in identifying MTb as a causative agent for MSC leading to its correct treatment with anti-tubercular therapy (ATT).

Findings
A young male with a family history of tuberculosis (TB) presented with a history of diminution of vision (DOV) since 3 months in his right eye (RE). He gave similar history in his left eye (LE) since 3 years. His fundus findings were suggestive of MSC. His high-resolution computed tomography (HRCT) chest and Quanti-FERON TB gold results were positive for MTb. These suggested TB to be the likely cause for MSC. This was confirmed by a positive N-PCR report of his aqueous specimen. Further RT-PCR was done to quantify the bacillary load before starting therapy. He was advised 9 months of ATT with 6 weeks of oral steroids. At last follow-up, the RE showed better healing than the LE with fewer chorioretinal scars and a better visual acuity.

Conclusions
RT and N-PCR for MTb are useful in establishing a tuberculous etiology in MSC. Coupled with a good response to ATT, these tests justify the use of ATT in MSC with a PCR-confirmed MTb report.
Dynamic gene expressions of peripheral blood mononuclear cells in patients with acute exacerbation of chronic obstructive pulmonary disease: a preliminary study
Authors: Wu Xiaodan , Sun Xiaoru , Chen Chengshui , Bai Chunxue , Wang Xiangdong 
Published: November 2014

Abstract
Introduction
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a serious event that is responsible for the progress of the disease, increases in medical costs and high mortality.

Methods
The aim of the present study was to identify AECOPD-specific biomarkers by evaluating the dynamic gene expression profiling of peripheral blood mononuclear cells (PBMCs) from patients with AECOPD on days 1, 3 and 10 after hospital admission and to compare the derived data with data from healthy controls or patients with stable COPD.

Results
We found that 14 genes were co–differentially upregulated and 2 downregulated greater than 10-fold in patients with COPD or AECOPD compared with the healthy individuals. Eight co–differentially upregulated genes and six downregulated genes were identified as a panel of AECOPD-specific genes. Downregulation of TCF7 in PBMCs was found to be associated with the severity of COPD. Dynamic changes of Aminolevulinate-delta-synthase 2 and carbonic anhydrase I had similar patterns of Digital Evaluation Score System scores and may serve as potential genes of interest during the course of AECOPD.

Conclusion
Thus, our findings indicate a panel of altered gene expression patterns in PBMCs that can be used as AECOPD-specific dynamic biomarkers to monitor the course of AECOPD.
Physician-related barriers to communication and patient- and family-centred decision-making towards the end of life in intensive care: a systematic review
Authors: Visser Mieke , Deliens Luc , Houttekier Dirk 
Published: November 2014

Abstract
Introduction
Although many terminally ill people are admitted to an intensive care unit (ICU) at the end of life, their care is often inadequate because of poor communication by physicians and lack of patient- and family-centred care. The aim of this systematic literature review was to describe physician-related barriers to adequate communication within the team and with patients and families, as well as barriers to patient- and family-centred decision-making, towards the end of life in the ICU. We base our discussion and evaluation on the quality indicators for end-of-life care in the ICU developed by the Robert Wood Johnson Foundation Critical Care End-of-Life Peer Workgroup.

Method
Four electronic databases (MEDLINE, Embase, CINAHL and PsycINFO) were searched, using controlled vocabulary and free text words, for potentially relevant records published between 2003 and 2013 in English or Dutch. Studies were included if the authors reported on physician-related and physician-reported barriers to adequate communication and decision-making. Barriers were categorized as being related to physicians’ knowledge, physicians’ attitudes or physicians’ practice. Study quality was assessed using design-specific tools. Evidence for barriers was graded according to the quantity and quality of studies in which the barriers were reported.

Results
Of 2,191 potentially relevant records, 36 studies were withheld for data synthesis. We determined 90 barriers, of which 46 were related to physicians’ attitudes, 24 to physicians’ knowledge and 20 to physicians’ practice. Stronger evidence was found for physicians’ lack of communication training and skills, their attitudes towards death in the ICU, their focus on clinical parameters and their lack of confidence in their own judgment of their patient’s true condition.

Conclusions
We conclude that many physician-related barriers hinder adequate communication and shared decision-making in ICUs. Better physician education and palliative care guidelines are needed to enhance knowledge, attitudes and practice regarding end-of-life care. Patient-, family- and health care system–related barriers need to be examined.