bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thrombotic thrombocytopenic purpura during pregnancy versus imitator of preeclampsia
Authors: Gasparri Maria Luisa , Bellati Filippo , Brunelli Roberto , Perrone Giuseppina , Pecorini Francesco , Papadia Andrea , Meloni Giovanna , Trisolini Silvia Maria , Gozzer Maria , Domenici Lavinia , Lecce Francesca , Benedetti Panici Pierluigi 
Published: August 2015

BACKGROUNDThrombotic thrombocytopenic purpura (TTP) is a severe disorder affecting the microcirculation of multiple organs due to a systemic endothelial cell injury secondary to a deficiency in ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 motif, member 13) activity. TTP is a rare complication of pregnancy with a poor prognosis and high fetal mortality, especially when it occurs during the first trimester. Recent data have supported that effective treatment of TTP is plasma therapy. Unfortunately a major problem remains in the delay in diagnosis due to confounding factors between other “imitators of preeclampsia.” Rapid and readily available laboratory testing to quickly diagnose TTP is desperately needed to improve care and to save mother and future child life.CASE REPORTWe describe a rare case of successful pregnancy after TTP manifestations occurring in the first trimester; most importantly, our experience represents the first case of atypical manifestation due to neurologic and kidney manifestations preceding laboratory assay alterations.RESULTSWe treated a patient with plasma replacement of 30 mL/kg/day and daily plasmapheresis in combination with continuous infusion of fresh‐frozen plasma 10 mL/kg/day. The response of clinical manifestation immediately improved. At 30 weeks, the patient had multiple episodes of high blood pressure and concomitant decrease of hemoglobin and platelet count, so a cesarean section was immediately performed. She delivered a healthy female baby.CONCLUSIONEarly diagnosis by ADAMTS13 activity, occasionally occurring before clinical manifestations, aided us in promptly administering commended and life‐saving treatments.
The chloride–bicarbonate exchanger pendrin is increased in the kidney of the pregnant rat
Authors: West Crystal A. , Verlander Jill W. , Wall Susan M. , Baylis Chris 
Published: August 2015

New Findings

What is the central question of this study?
Pregnancy requires a robust plasma volume expansion driven by renal sodium retention. In the late‐pregnant kidney, the aldosterone‐responsive epithelial Na+ channel is increased, whereas the sodium–chloride cotransporter is decreased. Pendrin has been shown to support sodium reabsorption in the distal nephron and compensate for loss of the sodium–chloride cotransporter. We investigated the expression and abundance of pendrin in the pregnant kidney.

What is the main finding and its importance?
Pendrin protein, apical localization and thiazide sensitivity are increased in pregnancy. This implicates a possible role for pendrin in supporting the renal sodium chloride reabsorption and plasma volume expansion of pregnancy.

Pregnancy is characterized by cumulative plasma volume expansion as a result of renal sodium retention, driven by activation of aldosterone. We previously reported that the abundance and activity of the aldosterone‐responsive epithelial Na+ channel is increased, whereas the sodium–chloride cotransporter (NCC) is decreased in the kidney of the late‐pregnant rat. The chloride–bicarbonate exchanger pendrin is also aldosterone responsive and has been shown to support activity of the aldosterone‐responsive epithelial Na+ channel and compensate for the loss of NCC. Additionally, pendrin coupled to the sodium‐dependent chloride–bicarbonate exchanger (NDCBE) mediates thiazide‐sensitive sodium reabsorption in the cortical collecting duct. In this study, we investigated pendrin and NDCBE transcript expression, pendrin protein abundance, pendrin cellular localization and thiazide sensitivity in virgin, mid‐pregnant and late‐pregnant rats to test the hypothesis that increased pendrin activity might occur in pregnancy. By RT‐PCR, NDCBE and pendrin mRNA expression was unchanged from virgins, whereas pendrin protein abundance determined by Western blotting was increased in both mid‐ and late‐pregnant rats. The apical localization of pendrin was also increased in late‐pregnant rats compared with virgins by immunohistochemistry. Pregnant rats displayed an increased natriuretic response to hydrochlorothiazide compared with virgins. Given that NCC expression is decreased in late pregnancy, an increased thiazide sensitivity may be due to inhibition of upregulated pendrin–NDCBE‐coupled sodium reabsorption. Thus, increased pendrin in pregnant rats may compensate for the decreased NCC and aid in the renal sodium chloride reabsorption of pregnancy.
Polymyxin B in Combination with Antimicrobials Lacking
In Vitro
Activity versus Polymyxin B in Monotherapy in Critically Ill Patients with Acinetobacter baumannii or Pseudomonas aeruginosa Infections
Authors: Rigatto Maria Helena , Vieira Fabiane J. , Antochevis Laura C. , Behle Tainá F. , Lopes Natane T. , Zavascki Alexandre P. 
Published: August 2015

ABSTRACT

There is no clinical evidence supporting the use of polymyxin B in combination with another antimicrobial for infections caused by extensively drug-resistant
Acinetobacter baumannii
or
Pseudomonas aeruginosa
isolates. We developed a cohort study of patients in two intensive care units from teaching hospitals to evaluate treatment with intravenous polymyxin B for ≥48 h for severe
A. baumannii
or
P. aeruginosa
infections. Covariates potentially associated with 30-day mortality were evaluated in a Cox proportional hazards model. A total of 101 patients were included; 33 (32.7%) were treated with polymyxin B in combination with an antimicrobial lacking
in vitro
activity and 68 (67.3%) with polymyxin B in monotherapy. The overall 30-day mortality was 59.4% (60 patients), comprising 42.4% (14 of 33) and 67.6% (46 of 68) in combination and monotherapy groups, respectively (
P
= 0.03). The mortality rates were 18.5/1,000 patient days and 36.4/1,000 patient days in the combination and monotherapy groups, respectively (
P
= 0.02). Combination therapy was independently associated with lower 30-day mortality (hazard ratio, 0.33; 95% confidence interval, 0.17 to 0.64;
P
= 0.001). Creatinine clearance of ≥60 ml/min was also a protective factor, while a higher acute physiology and chronic health evaluation (APACHE II) score and polymicrobial infection were associated with increased mortality. The results did not change after adding a propensity score for prescribing combination therapy into the model. The protective effect remained when only combination with β-lactam or carbapenem was considered and in both subgroups of patients: those with
A. baumannii
infection and those with lower respiratory tract infections. To our knowledge, this is the first clinical study to show a benefit of combination over monotherapy with polymyxin B for severe extensively drug-resistant
A. baumannii
or
P. aeruginosa
infections.
Southern Dietary Pattern Is Associated With Hazard of Acute Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Authors: Shikany James M. , Safford Monika M. , Newby P. K. , Durant Raegan W. , Brown Todd M. , Judd Suzanne E. 
Published: August 2015

Background—
The association of overall diet, as characterized by dietary patterns, with risk of incident acute coronary heart disease (CHD) has not been studied extensively in samples including sociodemographic and regional diversity.

Methods and Results—

We used data from 17 418 participants in Reasons for Geographic and Racial Differences in Stroke (REGARDS), a national, population-based, longitudinal study of white and black adults aged ≥45 years, enrolled from 2003 to 2007. We derived dietary patterns with factor analysis and used Cox proportional hazards regression to examine hazard of incident acute CHD events – nonfatal myocardial infarction and acute CHD death – associated with quartiles of consumption of each pattern, adjusted for various levels of covariates. Five primary dietary patterns emerged: Convenience, Plant-based, Sweets, Southern, and Alcohol and Salad. A total of 536 acute CHD events occurred over a median (interquartile range) 5.8 (2.1) years of follow-up. After adjustment for sociodemographics, lifestyle factors, and energy intake, highest consumers of the Southern pattern (characterized by added fats, fried food, eggs, organ and processed meats, and sugar-sweetened beverages) experienced a 56% higher hazard of acute CHD (comparing quartile 4 with quartile 1: hazard ratio, 1.56; 95% confidence interval, 1.17–2.08;
P
for trend across quartiles=0.003). Adding anthropometric and medical history variables to the model attenuated the association somewhat (hazard ratio, 1.37; 95% confidence interval, 1.01–1.85;
P
=0.036).

Conclusions—
A dietary pattern characteristic of the southern United States was associated with greater hazard of CHD in this sample of white and black adults in diverse regions of the United States.
Monte Carlo Singular Spectrum Analysis (SSA) Revisited: Detecting Oscillator Clusters in Multivariate Datasets
Authors: Groth Andreas , Ghil Michael 
Published: August 2015

Abstract
Singular spectrum analysis (SSA) along with its multivariate extension (M-SSA) provides an efficient way to identify weak oscillatory behavior in high-dimensional data. To prevent the misinterpretation of stochastic fluctuations in short time series as oscillations, Monte Carlo (MC)–type hypothesis tests provide objective criteria for the statistical significance of the oscillatory behavior. Procrustes target rotation is introduced here as a key method for refining previously available MC tests. The proposed modification helps reduce the risk of type-I errors, and it is shown to improve the test’s discriminating power. The reliability of the proposed methodology is examined in an idealized setting for a cluster of harmonic oscillators immersed in red noise. Furthermore, the common method of data compression into a few leading principal components, prior to M-SSA, is reexamined, and its possibly negative effects are discussed. Finally, the generalized Procrustes test is applied to the analysis of interannual variability in the North Atlantic’s sea surface temperature and sea level pressure fields. The results of this analysis provide further evidence for shared mechanisms of variability between the Gulf Stream and the North Atlantic Oscillation in the interannual frequency band.
Climatology of Daily Precipitation and Extreme Precipitation Events in the Northeast United States
Authors: Agel Laurie , Barlow Mathew , Qian Jian-Hua , Colby Frank , Douglas Ellen , Eichler Timothy 
Published: August 2015

Abstract
This study examines U.S. Northeast daily precipitation and extreme precipitation characteristics for the 1979–2008 period, focusing on daily station data. Seasonal and spatial distribution, time scale, and relation to large-scale factors are examined. Both parametric and nonparametric extreme definitions are considered, and the top 1% of wet days is chosen as a balance between sample size and emphasis on tail distribution. The seasonal cycle of daily precipitation exhibits two distinct subregions: inland stations characterized by frequent precipitation that peaks in summer and coastal stations characterized by less frequent but more intense precipitation that peaks in late spring as well as early fall. For both subregions, the frequency of extreme precipitation is greatest in the warm season, while the intensity of extreme precipitation shows no distinct seasonal cycle. The majority of Northeast precipitation occurs as isolated 1-day events, while most extreme precipitation occurs on a single day embedded in 2–5-day precipitation events. On these extreme days, examination of hourly data shows that 3 h or less account for approximately 50% of daily accumulation. Northeast station precipitation extremes are not particularly spatially cohesive: over 50% of extreme events occur at single stations only, and 90% occur at only 1–3 stations concurrently. The majority of extreme days (75%–100%) are related to extratropical storms, except during September, when more than 50% of extremes are related to tropical storms. Storm tracks on extreme days are farther southwest and more clustered than for all storm-related precipitation days.
The Multidisciplinary Team Conference’s Decision on M-Staging in Patients with Gastric- and Gastroesophageal Cancer is not Accurate without Staging Laparoscopy
Authors: Strandby R. B. , Svendsen L. B. , Fallentin E. , Egeland C. , Achiam M. P. 
Published: August 2015

Background: The implementation of the multidisciplinary team conference has been shown to improve treatment outcome for patients with gastric- and gastroesophageal cancer. Likewise, the staging laparoscopy has increased the detection of patients with disseminated disease, that is, patients who do not benefit from a surgical resection. The aim of this study was to compare the multidisciplinary team conference’s decision in respect of M-staging with the findings of the following staging laparoscopy. Methods: Patients considered operable and resectable within the multidisciplinary team conference in the period 2010–2012 were retrospectively reviewed. Patient data were retrieved by searching for specific diagnosis and operation codes in the in-house system. The inclusion criteria were as follows: biopsy-verified cancer of the esophagus, gastroesophageal junction or stomach, and no suspicion of peritoneal carcinomatosis or liver metastases on multidisciplinary team conference before staging laparoscopy. Furthermore, an evaluation with staging laparoscopy was required. Results: In total, 222 patients met the inclusion criteria. Most cancers were located in the gastroesophageal junction, n = 171 (77.0%), and most common with adenocarcinoma histology, n = 196 (88.3%). The staging laparoscopy was M1-positive for peritoneal carcinomatosis in eight patients (16.7%) with gastric cancer versus nine patients (5.3%) with gastroesophageal junction cancer. Furthermore, liver metastases were evident in zero patients (0.0%) and four patients (2.3%) with gastric- and gastroesophageal junction cancer, respectively. The staging laparoscopy findings regarding peritoneal carcinomatosis were significantly different between gastric- and gastroesophageal junction cancers, p = 0.01. No significant differences were found regarding T-/N-stage or histological tumor characteristics between the positive- and negative-staging laparoscopy group. Conclusion: The M-staging of the multidisciplinary team conference without staging laparoscopy lacks accuracy concerning peritoneal carcinomatosis. Staging laparoscopy remains an essential part of the preoperative detection of disseminated disease in patients with gastric- and gastroesophageal cancer.
Use of hand‐held Doppler ultrasound examination by podiatrists: a reliability study
Authors: Tehan Peta Ellen , Chuter Vivienne Helaine 
Published: August 2015

AbstractBackgroundHand held Doppler examination is a frequently used non‐invasive vascular assessment utilised by podiatrists. Despite this, the reliability of hand‐held Doppler has not been thoroughly investigated. Given the importance of Doppler in completing a vascular assessment of the lower limb, it is essential to determine the reliability of the interpretation of this testing method in practicing podiatrists.MethodsThis was a multi‐centre inter and intra‐rater reliability study. Four podiatrists (the raters) participated in this study, two public and two private practitioners. Three aspects of Doppler use were examined; (i) use of Doppler (i.e., technique and interpretation), (ii) interpretation of Doppler audio sounds, and (iii) interpretation of visual Doppler waveforms (i.e., tracings). Participants meeting current guidelines for vascular screening attended two testing sessions, 1 week apart at either the private practice (n = 32), or the public practice (n = 31). To assess use of Doppler, the raters evaluated the Doppler waveforms that they collected, rating them as mono‐phasic or multi‐phasic. To assess Doppler audio sounds and visual Doppler waveforms, raters were required to evaluate 30 audio recordings of Doppler sounds and 30 waveform tracings, respectively, that were previously recorded and chosen at random by the researchers. Cohen's kappa (κ) statistics were used to calculate inter and intra‐rater reliability using SPSS version 19.ResultsUse of Doppler demonstrated the lowest reliability for both pairs of clinicians (inter‐rater reliability κ 0.20 to 0.24 and intra‐rater reliability κ 0.27 to 0.42). The public podiatrists showed higher reliability in audio interpretation (inter‐tester reliability κ 0.61, intra‐tester reliability κ 1.00) compared to the private podiatrists (inter‐tester reliability κ 0.31, intra‐tester reliability κ 0.53). Evaluation of Doppler waveform tracings demonstrated highest reliability, with inter‐rater reliability ranging from κ 0.77 to 0.90 and intra‐rater reliability from κ 0.81 to 1.00.ConclusionsThere is a need for ongoing education for podiatrists using Doppler in clinical practice, as the reliability for the clinical use of the Doppler was low. This indicates that technique could be an issue. There is also a need to further evaluate if hand‐held Doppler equipment, using the examinations that we evaluated, is suitable for use in the contexts examined in this study.
Cancer Incidence and Mortality in Patients Treated Either With RAI or Thyroidectomy for Hyperthyroidism
Authors: Ryödi Essi , Metso Saara , Jaatinen Pia , Huhtala Heini , Saaristo Rauni , Välimäki Matti , Auvinen Anssi 
Published: August 2015

Context:
Some previous studies have suggested increased cancer risk in hyperthyroid patients treated with radioactive iodine (RAI). It is unclear whether the excess cancer risk is attributable to hyperthyroidism, its treatment, or the shared risk factors of the two diseases.

Objective:
The objective was to assess cancer morbidity and mortality in hyperthyroid patients treated with either RAI or surgery.

Patients:
We identified 4334 patients treated surgically for hyperthyroidism in Finland during 1986–2007 from the Hospital Discharge Registry and 1814 patients treated with RAI for hyperthyroidism at Tampere University Hospital. For each patient, three age- and gender-matched controls were chosen. Information on cancer diagnoses was obtained from the Cancer Registry. The follow-up began 3 months after the treatment and ended at cancer diagnosis, death, emigration, or the common closing date (December 31, 2009).

Results:
The overall cancer incidence was not increased among the hyperthyroid patients compared to their controls (rate ratio [RR], 1.05; 95% confidence interval [CI], 0.96–1.15). However, the risk of cancers of the respiratory tract (RR, 1.46; 95% CI, 1.05–2.02) and the stomach (RR, 1.64; 95% CI, 1.01–2.68) was increased among the patients. The overall cancer mortality did not differ between the patients and the controls (RR, 1.08; 95% CI, 0.94–1.25). The type of treatment did not affect the overall risk of cancer (hazard ratio for RAI vs thyroidectomy, 1.03; 95% CI, 0.86–1.23) or cancer mortality (hazard ratio, 1.04; 95% CI, 0.91–1.21).

Conclusions:
In this cohort of Finnish patients with hyperthyroidism treated with thyroidectomy or RAI, the overall risk of cancer was not increased, although an increased risk of gastric and respiratory tract cancers was seen in hyperthyroid patients. Based on this large-scale, long-term follow-up study, the increased cancer risk in hyperthyroid patients is attributable to hyperthyroidism and shared risk factors, not the treatment modality.
Zinc-containing bioactive glasses for bone regeneration, dental and orthopedic applications
Authors: Balasubramanian Preethi , Strobel Leonie A. , Kneser Ulrich , Boccaccini Aldo R. 
Published: August 2015

AbstractZinc is a vital and beneficial trace element found in the human body. Though found in small proportions, zinc performs a variety of functions in relation to the immune system, cell division, fertility and the body growth and maintenance. In particular, zinc is proven to be a necessary element for the formation, mineralization, development and maintenance of healthy bones. Considering this attractive attributes of zinc, recent research has widely focused on using zinc along with silicate-based bioactive glasses for bone tissue engineering applications. This paper reviews relevant literature discussing the significance of zinc in the human body, along with its ability to enhance antibacterial effects, bioactivity and distinct physical, structural and mechanical properties of bioactive glasses. In this context, even if the present analysis is not meant to be exhaustive and only representative studies are discussed, literature results confirm that it is essential to understand the properties of zinc-containing bioactive glasses with respect to their in vitro biological behavior, possible cytotoxic effects and degradation characteristics to be able to effectively apply these glasses in bone regeneration strategies. Topics attracting increasing research efforts in this field are elaborated in detail in this review, including a summary of the structural, physical, biological and mechanical properties of zinc-containing bioactive glasses. This paper also presents an overview of the various applications in which zinc-containing bioactive glasses are considered for use as bone tissue scaffolds, bone filling granules, bioactive coatings and bone cements, and advances and remaining challenges are highlighted.
Modular user interface design for integrated surgical workplaces
Authors: Benzko Julia , Krause Lisa , Janß Armin , Marschollek Björn , Merz Paul , Dell’Anna Jasmin , Radermacher Klaus 
Published: August 2015

AbstractSevere bottlenecks in usability and human technology interaction (HTI) of existing surgical workplaces and operating room (OR) equipment can occur today: lack of space, cable as trip hazard, communication problems between sterile and non-sterile staff, and operating errors in the handling of the medical devices. In fact, risks that are caused by poor usability can be critical, and studies show that most are preventable. This issue gets even more challenging in the context of open-OR networks regarding consistent and usable integration of user interfaces (UIs) of independently designed systems in one integrated surgical work system. In this work, a concept of generic UI profiles for the modular integration of a UI has been developed and first prototypes have been implemented. The concept is essentially based on the approach of device profiles developed in the context of the Bundesministerium für Bildung und Forschung project OR.NET (
Response of Prairie cordgrass (Spartina pectinata Link) to a residual effect of municipal sewage sludge application
Authors: Helios Waldemar , Malarz Władysław , Kozak Marcin , Kotecki Andrzej 
Published: August 2015

Abstract
The objective of our study was to assess the residual effect of sewage sludge on the growth and yield of Prairie cordgrass and the content of crude ash, macroelements and heavy metals in the plant biomass. Field trials conducted in the years 2011 to 2013 focused on the assessment of the impact of municipal sewage sludge applied from 2008 to 2010on the growth and yield of Prairie cordgrass. The experiments followed the split-plot design with two variables: the rate of sewage sludge (DM-dry matter) at 0, 1.4, 2.8 and 4.2 t ha-1, corresponding to nitrogen fertilization with: 0, 50, 100, 150 kg ha-1, and the harvest time - fall and winter. The total dose of sewage sludge applied in 2008−2010 was 0, 4.2, 8.4 and
12.6 t DM ha-1, which corresponded to the total dose of nitrogen fertilization: 0, 150, 300 and 450 kg ha-1, respectively. The municipal sewage sludge at a rate of
8.4 t DM ha-1, compared to the Control, significantly increased the number of leaves per plant, the leaf and culm matter, the number of shoots per 1 m2, the dry matter yield, crude ash deposition and uptake of macroelements and heavy metals.