bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shortcomings of Maternity Care in Serbia
Authors: Arsenijevic Jelena , Pavlova Milena , Groot Wim 
Published: March 2014

AbstractBackgroundMaternity care in Serbia is an integrated part of the centralized health care system inherited from the former Yugoslavia. Childbirth is often perceived as a medical event instead of a physiological process. This paper examines quality and access indicators, and patient payments for maternity care in Serbia.MethodsWe apply a method of triangulation using data collected through three sources: online questionnaires filled in by mothers who delivered in one of the maternity wards in Serbia in the period 2000–2008, research publications, and official guidelines. To compare the qualitative data from all three sources, we apply framework analysis.ResultsThe results show a good network of maternity wards in Serbia. On the other hand, many women who gave birth in maternity wards in Serbia indicate problems with the treatment they received. The existence of informal patient payments and so‐called “special connections” make the position of Serbian women in maternity wards vulnerable, especially when they have neither connections nor the ability to pay. Poor communication and bedside manner of medical staff (obstetricians, other physicians, midwives, and nurses) during the birth process are also frequently reported.DiscussionActions should be taken to improve bedside manners of medical staff. In addition, the government should consider the involvement of private practitioners paid by the national insurance fund to create competition and decrease the need for informal payments and “connections.”
Symmetry‐Aware Template Deformation and Fitting
Authors: Kurz C. , Wu X. , Wand M. , Thormählen T. , Kohli P. , Seidel H.‐P. 
Published: March 2014

AbstractIn this paper, we propose a new method for reconstructing 3D models from a noisy and incomplete 3D scan and a coarse template model. The main idea is to maintain characteristic high‐level features of the template that remain unchanged for different variants of the same type of object. As invariants, we chose the partial symmetry structure of the template model under Euclidian transformations, i.e. we maintain the algebraic structure of all reflections, rotations and translations that map the object partially to itself. We propose an optimization scheme that maintains continuous and discrete symmetry properties of this kind while registering a template against scan data using a deformable iterative closest points (ICP) framework with thin‐plate‐spline regularization. We apply our new deformation approach to a large number of example data sets and demonstrate that symmetry‐guided template matching often yields much more plausible reconstructions than previous variants of ICP.
Validation of the European Group for Blood and Marrow Transplantation (EBMT) risk score in patients receiving allogeneic hematopoietic stem cell transplantation at a single center in Japan
Authors: Numata Ayumi , Tanaka Masatsugu , Matsumoto Kenji , Takasaki Hirotaka , Tachibana Takayoshi , Fujimaki Katsumichi , Sakai Rika , Fujisawa Shin , Tomita Naoto , Fujita Hiroyuki , Maruta Atsuo , Ishigatsubo Yoshiaki , Kanamori Heiwa 
Published: March 2014

AbstractWe validated the European Group for Blood and Marrow Transplantation (EBMT) risk score in 273 consecutive adult patients receiving allogeneic hematopoietic stem cell transplantation between 2000 and 2010 at our center. The patients were divided into four groups according to the EBMT risk score: low risk (LR, score 0–2), intermediate risk‐1 (IR‐1, score 3), intermediate risk‐2 (IR‐2, score 4), and high risk (HR, score 5–7). The five‐yr overall survival of the LR (n = 65), IR‐1 (n = 67), IR‐2 (n = 70), and HR (n = 71) groups was 72%, 57%, 41%, and 25%, respectively (p < 0.001). The five‐yr transplant‐related mortality rates were 16%, 30%, 25%, and 36%, respectively (p = 0.07). The five‐yr cumulative incidence of relapse was 20%, 18%, 37%, and 41%, respectively (p < 0.001). In the subgroup analysis, the prognostic value of the EBMT risk score was confirmed in patients undergoing myeloablative conditioning (MAC), but not in those undergoing reduced‐intensity conditioning (RIC). The results suggest that the EBMT risk score is a useful tool to predict transplant outcome for patients undergoing MAC, but not for those undergoing RIC and may be beneficial for stratifying patients in clinical studies.
Utility of immune monitoring in heart transplant recipients on everolimus‐based immune suppression
Authors: Ben Gal Tuvia , Israeli Moshe , Yaari Victoria , Hasdai David , Matz Israel , Yussim Alexander , Battler Alexander , Klein Tirza , Medalion Benjamin 
Published: March 2014

AbstractBackgroundEverolimus provides effective immune suppression (IS) after heart transplant (HTx). Its pharmacologic properties differentiate everolimus from other IS drugs. A non‐invasive immune monitoring (IM) assay test appears to predict the immune state in HTx recipients on standard calcineurin‐inhibitor‐based IS. The utility of IM in HTx recipients on everolimus‐based IS was evaluated.MethodsBetween June 2005 and June 2011, 34 adult HTx recipients followed up at our center received everolimus and had 381 IM assays that were performed at six months to 16‐yr post‐transplant. Results of the IM assay were correlated with infection and rejection episodes that occurred during the IM testing.ResultsIn the everolimus‐based IS group, there were 18 infectious episodes and four rejection episodes. The average IM score was significantly lower during infection than at steady state (188 ± 122 vs. 338 ± 137 ng/mL ATP, p < 0.001) and not significantly different during rejection when compared with steady state (430 ± 132 vs. 338 ± 137 ng/mL ATP, p = 0.5).ConclusionsThe non‐invasive IM assay predicts infectious risk in HTx recipients on everolimus‐based IS. Its inconclusive association with rejection was probably due to the small number of rejections. Serial longitudinal IM may allow proper adjustment of everolimus doses.
Sharing of Grant Funds between Academic Institutions and ­Community Partners in Community‐Based Participatory Research
Authors: Cain Katrice D. , Theurer Jacqueline R. , Sehgal Ashwini R. 
Published: March 2014

AbstractObjectivesTo determine how grant funds are shared between academic institutions and community partners in community‐based participatory research (CBPR).MethodsReview of all 62 investigator‐initiated R01 CBPR grants funded by the National Institutes of Health from January 2005 to August 2012. Using prespecified criteria, two reviewers independently categorized each budget item as being for an academic institution or a community partner. A third reviewer helped resolve any discrepancies.ResultsAmong 49 evaluable grants, 68% of all grant funds were for academic institutions and 30% were for community partners. For 2% of funds, it was unclear whether they were for academic institutions or for community partners. Community partners’ share of funds was highest in the categories of other direct costs (62%) and other personnel (48%) and lowest in the categories of equipment (1%) and indirect costs (7%).ConclusionsA majority of CBPR grant funds are allocated to academic institutions. In order to enhance the share that community partners receive, funders may wish to specify a minimum proportion of grant funds that should be allocated to community partners in CBPR projects.
Assessing diabetic foot osteomyelitis remission with white blood cell SPECT/CT imaging
Authors: Vouillarmet J. , Morelec I. , Thivolet C. 
Published: March 2014

AbstractAimsDiabetic foot osteomyelitis is an important risk factor of lower limb amputation. Antibiotic therapy is often effective in preventing surgery. However, the duration of antibiotic therapy is difficult to define in the absence of a marker to diagnose osteomyelitis remission at the end of the treatment. In this study, we assessed the diagnostic performance of white blood cell SPECT/CT imaging for evaluating osteomyelitis remission.Patients and methodsTwenty‐nine out of 42 episodes of diabetic foot osteomyelitis seen between December 2009 and April 2012 had radiographs, a three‐phase bone scintigraphy and a white blood cell SPECT/CT at the end of antibiotic therapy. They were treated with antibiotics alone and considered in clinical remission. White blood cell SPECT/CT results were considered positive when abnormal uptake in the osteomyelitis location was identified. Osteomyelitis remission was defined by the absence of an osteomyelitis relapse after 12 months’ follow‐up.ResultsA negative white blood cell SPECT/CT was seen for 22 episodes of osteomyelitis. All of them were in remission. A positive white blood cell SPECT/CT was observed for seven episodes. A relapse occurred in five episodes (71.5%) after a median duration of 4 months (2–7 months). Sensitivity, specificity, positive predictive value and predictive negative value in predicting osteomyelitis relapse after the discontinuation of antibiotic treatment were, respectively, for radiographs 80%, 33%, 20% and 89%; for three‐phase bone scintigraphy 100%, 12.5%, 15.5% and 100%; and for the white blood cell SPECT/CT 100%, 91.5%, 71.5% and 100%.ConclusionNegative uptake on white blood cell SPECT/CT is a good marker for diagnosis of diabetic foot osteomyelitis remission and might be very useful in guiding antibiotic therapy.
Differences in the HbA1c‐lowering efficacy of glucagon‐like peptide‐1 analogues between Asians and non‐Asians: a systematic review and meta‐analysis
Authors: Kim Y. G. , Hahn S. , Oh T. J. , Park K. S. , Cho Y. M. 
Published: March 2014

AimsTo compare the HbA1c‐lowering efficacy of glucagon‐like peptide‐1 (GLP‐1) analogues between Asians and non‐Asians with type 2 diabetes.MethodsWe searched randomized controlled trials from MEDLINE, EMBASE, LILACS, CENTRAL and ClinicalTrials.gov. Studies described in English were included if the treatment duration was 12 weeks or more, information about ethnicity and baseline HbA1c values were available and a GLP‐1 analogue was compared with a placebo. For the ethnic comparison, we divided the studies into Asian‐dominant studies (≥50% Asian participants) and non‐Asian‐dominant studies (<50% Asian participants).ResultsAmong the 837 searched studies, 15 trials were included for the meta‐analysis. The weighted mean difference of HbA1c with GLP‐1 analogues was −1.16% [95% confidence interval (CI) −1.48, −0.85] in the Asian‐dominant studies and −0.83% (95% CI −0.97, −0.70) in the non‐Asian‐dominant studies. The between‐group difference was −0.32% (95% CI −0.64, −0.01; p = 0.04). The relative risk (RR) with 95% CIs for achieving the target HbA1c ≤7.0% tended to be greater in the Asian‐dominant studies [RR 5.7 (3.8, 8.7)] than in the non‐Asian‐dominant studies [RR 2.8 (2.4, 3.3)]. Body weight changes were similar between the two groups. Hypoglycaemia tended to be more common in Asian‐dominant studies (RR 2.8 [2.3, 3.5]) than in non‐Asian‐dominant studies (RR 1.5 [1.2, 1.8]), but severe hypoglycaemia was very rare in both groups.ConclusionGLP‐1 analogues lower HbA1c more in Asian‐dominant studies than in non‐Asian‐dominant studies. Further studies are warranted to explore the potential mechanisms of the ethnic difference.
Chronic metformin treatment improves post‐stroke angiogenesis and recovery after experimental stroke
Authors: Venna Venugopal R. , Li Jun , Hammond Matthew D. , Mancini Nickolas S. , McCullough Louise D. 
Published: March 2014

AbstractMetformin is currently the first‐line treatment drug for type 2 diabetes. Metformin is a well‐known activator of AMP‐activated protein kinase (AMPK). In experimental studies, metformin has been shown to exert direct vascular effects by increasing vascular endothelial growth factor expression and improving microvascular density. As stroke is the leading cause of long‐term disability and angiogenesis is implicated as an important mechanism in functional recovery, we hypothesized that chronic metformin treatment would improve post‐stroke functional recovery by enhancing functional microvascular density. For this study, C57BL/6N male mice were subjected to a 60‐min middle cerebral artery occlusion, and were given 50 mg/kg/day metformin beginning 24 h post‐stroke for 3 weeks. Behavioral recovery was assessed using adhesive‐tape removal and the apomorphine‐induced turning test. The role of angiogenesis was assessed by counting vessel branch points from fluorescein‐conjugated lectin‐perfused brain sections. Importantly even if metformin treatment was initiated 24 h after injury it enhanced recovery and significantly improved stroke‐induced behavioral deficits. This recovery occurred in parallel with enhanced angiogenesis and with restoration of endogenous cerebral dopaminergic tone and revascularization of ischemic tissue. We assessed if the effects on recovery and angiogenesis were mediated by AMPK. When tested in AMPK α‐2 knockout mice, we found that metformin treatment did not have the same beneficial effects on recovery and angiogenesis, suggesting that metformin‐induced angiogenic effects are mediated by AMPK. The results from this study suggest that metformin mediates post‐stroke recovery by enhancing angiogenesis, and these effects are mediated by AMPK signaling.
Case‐based reasoning for predicting the success of therapy
Authors: Janssen Rosanne , Spronck Pieter , Arntz Arnoud 
Published: March 2014

AbstractFor patients with mental health problems, various treatments exist. Before a treatment is assigned to a patient, a team of clinicians must decide which of the available treatments has the best chance of succeeding. This is a difficult decision to make, as the effectiveness of a treatment might depend on various factors, such as the patient's diagnosis, background and social environment. Which factors are the predictors for successful treatment is mostly unknown. In this article, we present a case‐based reasoning approach for predicting the effect of treatments for patients with anxiety disorders. We investigated which techniques are suitable for implementing such a system to achieve a high level of accuracy. For our evaluation, we used data from a professional mental healthcare centre. Our application correctly predicted the success factor of 65% of the cases, which is significantly higher than the prediction of the baseline of 55%. Under the condition that the prediction was based on only cases with a similarity of at least 0.62, the success rate of 80% of the cases was predicted correctly. These results warrant further development of the system.
Differential subtypes of diabetic older adults diagnosed with Alzheimer's disease
Authors: Sakurai Takashi , Kawashima Shuji , Satake Shosuke , Miura Hisayuki , Tokuda Haruhiko , Toba Kenji 
Published: March 2014

AimThe clinical management of diabetic elderly patients with Alzheimer's disease (AD) is hindered by several difficulties. The present study aimed to clarify the clinical characteristics and pathophysiological properties of AD in diabetic older adults.MethodsA total of 91 patients with type 2 diabetes mellitus and 161 non‐diabetic individuals who were diagnosed with AD were recruited. Diabetic patients were classified into two groups with glycated hemoglobin (HbA1c) <7.0% or ≥7.0%. The demographics, cognition, daily‐life function, metabolic changes, treatment, and behavioral and psychological symptoms of dementia (BPSD), as well as brain pathophysiology, were compared among the three groups.ResultsPatients with higher HbA1c had increased diabetic vascular complications and impaired activities of daily living with decreased levels of serum high‐molecular‐weight adiponectin and 25‐hydroxyvitamin D. Although cognitive status was similar among the three groups, BPSD, including apathy, overeating and excessive daytime sleeping appeared to be increased in the patients with HbA1c ≥7.0%. The frequency of apolipoprotein E4 carriers and of posterior cerebral hypoperfusion (AD‐pattern) on single‐photon emission computed tomography in poorly controlled diabetic subjects was similar to that in non‐diabetic AD patients, whereas diabetic patients with HbA1c <7.0% included fewer apolipoprotein E4 carriers and fewer patients with an AD pattern on single‐photon emission computed tomography.ConclusionSubtypes of older diabetic patients with AD were identified based on clinical features and brain pathophysiology. Physical and psychological complications of dementia are prevalent in patients with higher HbA1c. It seems likely that difficulties in the management of diabetes with AD are due not only to non‐adherence to diabetes treatment, but also several symptoms and pathophysiological characteristics of dementia. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 62–70.
Association of grip strength and related indices with independence of activities of daily living in older adults, investigated by a newly‐developed grip strength measuring device
Authors: Matsui Yasumoto , Fujita Remi , Harada Atsushi , Sakurai Takashi , Nemoto Tetsuya , Noda Nobuo , Toba Kenji 
Published: March 2014

AimTo investigate the association of grip strength and activities of daily living independence in older adults, using a newly‐developed grip strength measuring device.MethodsPatients who visited the clinic for memory disorders at the National Center for Geriatrics and Gerontology (142 men and 205 women, mean age 74.8 ± 8.8 years) were included in the present study. Their strength during gripping performance is described in detail, and following the indices were calculated: maximum strength (MS), response time (RT), time to MS, time to reach turning point (TP), strength at TP, inclination from start to TP, time from TP to reach MS, inclination from TP to MS and ratio of strength (TP/MS). Barthel Index (BI), total scores and scores of each subclass were used for evaluating activities of daily living independence. MS was compared between the independent and dependent groups. Correlations, using partial Pearson's coefficient adjusted for age, and Mini‐Mental State Examination total score were analyzed between indices and BI by sex, side, and age groups.ResultsMS was significantly higher in the independent group. MS and RT were significantly related with BI total and certain subclasses in both hands, TP/MS was significantly related in the right hand of either sex, and strength at TP was significantly related in both hands in women and in the left hand in men. Time to reach TP was particularly correlated in both hands and time from TP to reach MS in the right hand, in men. The correlation of indices varied by sex, hand side and age group, especially in men aged in their 70s, and in women aged less than 70 years and women aged in their 80s.ConclusionMS was shown to be useful, but some of the newly defined indices, such as RT, strength at TP, and elements regarding before and after TP until reaching MS, were also suggested to be useful. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 77–86.
Lipoprotein‐associated phospholipase A2 and cardiovascular disease risk in HIV infection
Authors: Ross Eckard A , Longenecker CT , Jiang Y , Debanne SM , Labbato D , Storer N , McComsey GA 
Published: March 2014

ObjectivesHIV‐infected patients on antiretroviral therapy (ART) have an increased cardiovascular disease (CVD) risk as a result of heightened inflammation and immune activation, despite at times having normal lipids and few traditional risk factors. Biomarkers are needed to identify such patients before a clinical event. Lipoprotein‐associated phospholipase A2 (Lp‐PLA2) predicts CVD events in the general population. This study investigated the relationship between Lp‐PLA2 and markers of CVD risk, systemic inflammation, immune activation, and coagulation in HIV infection.MethodsOne hundred subjects on stable ART with normal fasting low‐density lipoprotein (LDL) cholesterol were enrolled in the study. Plasma Lp‐PLA2 concentrations were measured by enzyme‐linked immunosorbent assay (ELISA; > 200 ng/mL was considered high CVD risk). Subclinical atherosclerosis, endothelial function, inflammation, immune activation and fasting lipids were also evaluated.ResultsThe median age of the patients was 47 years and 77% were male. Median (range) Lp‐PLA2 was 209 (71–402) ng/mL. Fifty‐seven per cent of patients had Lp‐PLA2 concentrations > 200 ng/mL. Lp‐PLA2 was positively correlated with soluble markers of inflammation or immune activation (tumour necrosis factor receptor‐II, intercellular and vascular cellular adhesion molecules, and CD14; all R = 0.3; P < 0.01), and negatively correlated with coagulation markers (D‐dimer and fibrinogen; both R = −0.2; P < 0.04). Lp‐PLA2 was not correlated with lipids, coronary artery calcium score, or flow‐mediated vasodilation, but trended towards a significant correlation with carotid intima‐media thickness (R = 0.2; P = 0.05).ConclusionsIn this population with stable ART and normal LDL cholesterol, Lp‐PLA2 was in the high CVD risk category in the majority of subjects. Lp‐PLA2 appears to be associated with inflammation/immune activation, but also with anti‐thrombotic effects. Lp‐PLA2 may represent a valuable early biomarker of CVD risk in HIV infection before subclinical atherosclerosis can be detected.
Effects of sugar‐free chewing gum sweetened with xylitol or maltitol on the development of gingivitis and plaque: a randomized clinical trial
Authors: Keukenmeester RS , Slot DE , Rosema NAM , Van Loveren C , Van der Weijden GA 
Published: March 2014

AbstractObjectiveThe objective of this study was to test the effect of sugar‐free chewing gum sweetened with xylitol or maltitol compared to the use of a gum base or no gum on gingivitis and plaque scores under both brushing and non‐brushing circumstances.MethodsThe design of the study was a four‐group, double‐blinded, randomized controlled study with a 3‐week duration. In each group, the participants did not brush the teeth in the lower jaw designated to develop experimental gingivitis, while maintaining normal oral hygiene procedures in the upper jaw. After professional dental prophylaxis, the participants were allocated into one of four groups (xylitol, maltitol, gum base or no gum). Chewing gum was used five times a day for 10 min.Results220 participants completed the study and provided evaluable data. The increase in bleeding on marginal probing (BOMP) and plaque scores (PS) in the non‐brushed (lower) jaw with experimental gingivitis was significant in all groups (P < 0.001). As compared to the gum base, the increase in BOMP in the xylitol and maltitol group was significantly lower. In the brushed upper jaw, no significant changes for BOMP were observed from the baseline to the end point of the study, and there were no significant differences in BOMP and PS between the groups.ConclusionIn circumstances where regular brushing is performed, no effect of chewing gum was observed on bleeding and plaque scores. In the absence of brushing, chewing xylitol or maltitol gum provided a significant inhibitory effect on gingivitis scores compared to chewing gum base. The difference when compared to the group not using gum was not significant.
Strategies for improving antibiotic use in Qatar: a survey of pharmacists' perceptions and experiences
Authors: Pawluk Shane , Black Emily , El-Awaisi Alla 
Published: March 2014

Abstract

Objectives
The objectives of this study were to identify antimicrobial stewardship activities in Qatar, identify pharmacist involvement in activities and summarize perceived barriers for implementation of antimicrobial stewardship programs (ASPs).

Methods
A cross-sectional survey was developed based on study objectives and completed by pharmacists in Qatar.

Key findings
Most hospital settings have implemented components of ASP. Lack of infectious disease specialists and training of healthcare providers was the most common barrier to implementation or expansion of ASP identified in the hospital and community settings respectively.

Conclusion
Pharmacists report some components of ASP have been implemented; however, barriers must be overcome to further expand ASPs.