bluuebunny/crossref_metadata_2025_split huggingface dataset:
Four mild but refractory cases of pemphigus foliaceus successfully treated with intravenous immunoglobulin
Authors: Kawakami Tamihiro , Koga Hiroshi , Saruta Hiroshi , Ueda Akihiro , Inoue Yoshihiko , Soma Yoshinao , Ishii Norito , Hashimoto Takashi 
Published: October 2013

AbstractIntravenous immunoglobulin (IVIG) is a potential second line of therapy for pemphigus, with increasing evidence of its effectiveness and safety, although oral corticosteroids remain the first treatment for pemphigus. IVIG is usually applied in severe cases of pemphigus, particularly pemphigus vulgaris (PV). Pemphigus foliaceus (PF) caused by immunoglobulin PF autoantibodies to desmoglein 1 (Dsg1) is usually milder than PV. However, PF cases are occasionally resistant to corticosteroids and require long‐term treatment to control the disease, leading to various adverse effects. IVIG was used in patients with relatively mild PF, who were resistant to therapies with corticosteroids and dapsone. We assessed the disease severity by Pemphigus Disease Area Index (PDAI) and measured anti‐Dsg1 antibody indices by enzyme‐linked immunosorbent assay, before and 4 months after IVIG. Four Japanese female PF patients (57.3 ± 8.6 years) were treated with a single cycle of IVIG (400 mg/kg per day for five consecutive days) in combination with the previous therapies. Within 1–2 months of addition of IVIG, all PF cases showed remarkable improvement of skin lesions, and PDAI also markedly decreased. For 2 years after IVIG, no apparent exacerbation was observed. Anti‐Dsg1 antibody indices decreased in all cases during the 2 years. IVIG could be a potential treatment for not only severe cases of PV but also mild and refractory cases of PF. IVIG may trigger the shift from intractable condition to remission via non‐pathogenic anti‐Dsg1 antibodies or some mechanisms excluding anti‐Dsg1 antibody.
Interspecific variation in the size‐dependent resprouting ability of temperate woody species and its adaptive significance
Authors: Shibata Rei , Shibata Mitsue , Tanaka Hiroshi , Iida Shigeo , Masaki Takashi , Hatta Fumika , Kurokawa Hiroko , Nakashizuka Tohru 
Published: October 2013

Summary

Resprouting of woody species after above‐ground damage may help plants to persist longer at a given site and quickly reoccupy disturbed sites, thereby strongly influencing forest dynamics. Resprouting has been discussed from two adaptation perspectives: recovery from damage by catastrophic disturbance and survival in frequently disturbed shaded understorey. However, few studies have comprehensively dealt with both adaptation types to understand resprouting strategies.

To understand the adaptive significance of resprouting, we assessed the size dependence of resprouting ability after stem clipping for 24 deciduous broad‐leaved species, including shrubs, sub‐canopy and canopy trees, in a cool‐temperate forest in Japan. The community assembly includes species adapted to past catastrophic disturbances (e.g. fire, logging) and to stable forest with intermittent treefall (currently the dominant disturbance). We correlated resprouting ability with life‐history strategies based on demographic parameters and plant functional traits, such as leaf mass per area (LMA), leaf toughness and wood density.

All the studied species could resprout in juveniles, and resprouting ability increased as stump size increased. Most sub‐canopy and canopy trees lost their ability to resprout after attaining a particular stump size, whereas shrub species retained the ability to resprout throughout their lifetimes.

The relative growth rate, LMA and foliar nitrogen did not greatly influence the resprouting ability of a species. In contrast, species with smaller maximum size, lower leaf toughness and lower wood density had better juvenile resprouting ability. This better resprouting ability may have evolved because these characteristics make them more vulnerable to shaded understorey. However, species with larger maximum size and lower leaf toughness retained their ability to resprout to a larger size.

Synthesis. A better resprouting ability is related to the ability to survive frequent disturbances, in juveniles, which are characteristics of both forest understorey and frequent fire or drought. To retain resprouting ability until grown seems to be an adaptation to survive infrequent large disturbances. Light‐demanding species, which generally have better resprouting ability than shade‐tolerants both in juveniles and adults, are adapted to disturbances of various scale and frequency; however, shade‐tolerants could survive well in the understorey due to a combination of stronger physical defences and resprouting ability.
Pilot testing a self‐administered dietary assessment website with school‐age children and adolescents under laboratory and free‐living conditions
Authors: Probst Yasmine , Cufer Sarah , Lin Shannon 
Published: October 2013

AbstractAimTo evaluate the experiences and data of children using the DietAdvice website in a controlled and a free‐living environment.MethodsObservational pilot study under laboratory conditions with face‐to‐face interviews and a community‐based nutrition and exercise intervention program. The laboratory trial consisted of n = 17 children (aged 9–16 years) and the intervention program consisted of n = 34 adolescents (aged 12–16 years). Thematic analysis of observation/interview notes and χ2 tests and independent samples t‐tests (P < 0.05) to compare responses and mean times, respectively, between age groups (group 1 (primary school): 9–12 years; group 2 (secondary school/adolescent): 13–16 years). Frequency and time of use analyses for the intervention group with comparisons to group 2 of the laboratory observation.ResultsChildren had an intermediate (41.2%) or advanced level (58.8%) of computer knowledge and used computers 5.29 ± 2.31 days. There were no significant differences between age groups and time taken to complete website sections, observable behaviours and required assistance. A total of 71% of children found the website easy to complete and understand, yet expressed confusion to complete amount/frequency of food eaten (71%). Adolescents did not appear to be interested in using the website when it was an optional component of their participation. The adolescents in the intervention took one hour and 41 minutes to use the website.ConclusionChildren and adolescents have the required abilities to use the DietAdvice website; however, improvements to the website to engage their interests may further assist completion. Research into how these age groups report the foods eaten using an electronic medium is also needed.
Hand bone mineral density reference values in a Turkish healthy female population
Authors: Alioglu Kenan , Dogu Beril , Sirzai Hulya , Yilmaz Figen , Kuran Banu 
Published: October 2013

AbstractAimIn this study we aimed at identifying the bone mineral density (BMD) reference values of hands, according to age, measured by dual‐energy X‐ray absorptiometry (DEXA) and assessing the correlation of these values with lumbar and femoral BMD values.MethodA total of 403 healthy women aged between 20 and 70 participated in our study. All BMD measurements are performed by DEXA method on both hands, anteroposterior lumbar spine (L2–L4) and right femur (femoral neck, total femur) regions. BMD results of all the patients were divided to 10‐year age categories and evaluated in five subgroups in total (20–30 to 61–70).ResultsAmong the 10‐year age categories we found both dominant and non‐dominant hand peak bone mass values in the 31–40 years age group (0.423 ± 0.039 g/cm², 0.410 ± 0.043 g/cm², respectively). Statistically significant positive correlation was defined between dominant and non‐dominant hand BMD values and L2‐L4 spine, femur neck and total femur values (for dominant hand r = 0.636, P = 0.0001; r = 0.645, P = 0.0001; r = 0.623; P = 0.0001; for non‐dominant hand r = 0.624, P = 0.0001; r = 0.637, P = 0.0001, r = 0.623, P = 0.0001, respectively). Regarding the relationship of age and menopause with BMD results, a negative statistical relationship was observed among dominant and non‐dominant hand, L2‐L4 spine, femoral neck and total femur BMD values (P = 0.0001).ConclusionOur study has provided hand BMD reference values in women aged between 20–70 years; further studies are needed to investigate the role of these values in identifying diseases causing osteoporosis in the hand and in evaluating treatment.
Induction of proliferation and pro‐inflammatory cytokine production in rheumatoid arthritis peripheral blood mononuclear cells by a 65 KDa chondrocyte membrane‐specific, constitutive target autoantigen (CH65)
Authors: Alsalameh Rayya J. , Casey Rachael C. , Mollenhauer Jürgen , Kalden Joachim R. , Burmester Gerd R. , Alsalameh Saifeddin M. 
Published: October 2013

AbstractObjectiveTo analyze proliferation and pro‐inflammatory cytokine production of peripheral blood mononuclear cells (PBMC) from rheumatoid arthritis (RA) patients following stimulation with a purified chondrocyte membrane‐associated autoantigen (CH65).MethodsCH65 was highly purified from bovine chondrocyte membranes by solubilization and ion exchange chromatography. PBMC of RA patients (n = 37; 28 seropositive, nine seronegative) and non‐arthritic donors (n = 20) were isolated by ficoll centrifugation and used in cell proliferation assays. The levels of interleukin (IL)‐1, tumo necrosis factor (TNF) and IL‐6 produced after stimulation with CH65 were determined by enzyme‐linked immunosorbent assay (ELISA). Statistical analysis was performed using Mann–Whitney U‐test and Spearman rank test and the software SPSS 13.0TM (SPSS Inc.; Chicago, IL, USA).ResultsPeripheral blood mononuclear cells exhibited a strong proliferative response to purified CH65 in approximately 50% of the RA patients (seropositive > seronegative), with a maximum reactivity at 0.15 or 0.30 μg/mL culture medium. In contrast, PBMC from normal donors did not show a proliferative response to CH65 at any dose. The proliferative response in RA patients peaked at days 7–9 and returned to control levels at day 13, indicating an antigen‐driven process. CH65‐stimulated RA PBMC produced moderate to high amounts of IL‐1, TNF and IL‐6. This was comparable to the response after exposure to isolated whole chondrocyte membranes or purified collagen type II.ConclusionThese results demonstrate a significant cellular immune response to CH65 protein in RA patients. Given the high similarity between bovine and human CH65, the results suggest a pathogenetic involvement of this molecule as a cartilage‐specific potential target autoantigen in RA.
Derivation of an Abbreviated Instrument For Use in Emergency Department Low Back Pain Research: The Five‐item Roland Morris Questionnaire
Authors: Friedman Benjamin W. , Schechter Clyde B. , Mulvey Laura , Esses David , Bijur Polly E. , John Gallagher E. 
Published: October 2013

AbstractObjectivesLow back pain (LBP) is a common reason for emergency department (ED) visits in the United States. Pain and functional outcomes after ED visits for LBP tend to be poor. ED‐based clinical LBP research is hampered by complexity of available outcome instruments, which can be time‐consuming to administer. The purpose of this investigation was to determine if a shorter version of the well‐validated and commonly used Roland Morris Disability Questionnaire (RMDQ) would retain the original 24‐item instrument's ability to assess functional outcomes accurately in ED patients with LBP.MethodsThe authors used deidentified data obtained from a prospective LBP cohort study, which enrolled 674 patients during index ED visits for LBP, and followed them by telephone 1 week and 3 months later. Five items were selected from the original 24 items of the RMDQ using regression techniques. Internal consistency of the abbreviated scale was measured using Cronbach's alpha. The strength of association between the five‐item scale (RM5) and the parent scale was determined at baseline, 1 week, and 3 months. The association between change in the parent scale and change in the RM5 and the change in RM5 that was most closely associated with a minimum clinically significant difference on the RMDQ were also determined.ResultsThe Cronbach's alpha for the RM5 was 0.88 (95% confidence interval [CI] = 0.87 to 0.89) at baseline, 0.96 (95% CI = 0.96 to 0.96) at 7 days, and 0.97 (95% CI = 0.97 to 0.97) at 3 months. The Pearson correlation coefficient for the RM5 versus the parent scale was 0.93 (R2 = 0.86) at baseline, 0.98 (R2 = 0.96) at 1 week, and 0.98 (R2 = 0.96) at 3 months. The correlations between change from baseline in the abbreviated scale and the parent scale were 0.95 (R2 = 0.90) and 0.96 (R2 = 0.92) at 7 days and 3 months, respectively. A one‐point change in the RM5 has a sensitivity of 96% (95% CI = 93% to 98%) and a specificity of 92% (95% CI = 89% to 94%) for the minimum clinically significant change on the RMDQ.ConclusionsAn abbreviated five‐item version of the RMDQ was developed. Pending independent validation, this shortened instrument should streamline ED‐based low back pain research.
U.S. Trends in Computed Tomography Use and Diagnoses in Emergency Department Visits by Patients With Symptoms Suggestive of Pulmonary Embolism, 2001–2009
Authors: Feng Lisa B. , Pines Jesse M. , Yusuf Hussain R. , Grosse Scott D. 
Published: October 2013

AbstractObjectivesUsing computed tomography (CT) to evaluate patients with chest symptoms is common in emergency departments (EDs). This article describes recent trends of CT use in U.S. EDs for patients presenting with symptoms common to acute pulmonary embolism (PE).MethodsThe 2001–2009 National Hospital Ambulatory Medical Care Survey (NHAMCS), a nationally representative survey of U.S. ED encounters, was used for data collection. Patients with at least one of three complaints (chest pain, dyspnea, or hemoptysis) were categorized into the chest symptom study (CSS) group. The yearly increases in CT use for the complaints were tabulated first, then linear regression analysis was used to calculate average rates of increases in CT use between 2001 and 2007, the years where CT use increased, for the overall population and among specific subgroups. The ratios of the number of visits when CT was ordered and there was a target diagnosis relative to the total number of visits with CT in the CSS group (diagnosis/CT ratio) were calculated for PE and pneumonia.ResultsAnnual CT rates for the CSS group increased from 2.6% in 2001 to 13.2% in 2007, subsequently leveling off at approximately 12.5% in 2008 and 2009. The average growth rate of CT use for the CSS group was 28.1% (95% confidence interval [CI] = 20.9% to 35.7%) per year between 2001 and 2007. Testing rates for all subgroups increased. The lowest growth rate was among Hispanic patients, whose CT rates grew 14.2% (95% CI = 5.7% to 23.5%) per year. The highest growth rate was in nonurban hospitals, at 43.1% (95% CI = 15.2% to 77.8%) per year. Patients triaged as nonurgent received the fewest CTs, compared to those who should be seen in 2 hours or less. With regard to sources of payment, the self‐pay subgroup experienced the highest rate of increase at 35.1% (95% CI = 18.6% to 53.9%). The PE diagnosis/CT ratio from 2002 to 2009 was 2.7% for the CSS group. The pneumonia diagnosis/CT ratio grew from 5.8% in 2002 to 2005 to 7.8% in 2006 to 2009.ConclusionsComputed tomography use in ED visits by patients with chest symptoms increased dramatically from 2001 to 2007 and seems to have leveled off in subsequent years. The low PE diagnosis‐to‐CT ratio suggests that EDs may need to promote evidence‐based use of CT.
Negative Predictive Value of Acetaminophen Concentrations Within Four Hours of Ingestion
Authors: Froberg Blake A. , King Kerry J. , Kurera Theomal D. , Monte Andrew A. , Prosser Jane M. , Walsh Steven J. , Riffenburgh Robert H. , Rusyniak Daniel E. , Tanen David A. 
Published: October 2013

AbstractObjectivesThe objective was to ascertain whether acetaminophen (APAP) concentrations less than 100 μg/mL obtained between 1 and 4 hours after acute ingestion accurately predict a nontoxic 4‐hour concentration.MethodsThe authors performed a multicenter, prospective cohort study involving five emergency departments (EDs) participating in the ToxIC Research Network. Data were collected from May 2009 to December 2011. Patients with APAP concentrations <100 μg/mL drawn between 1 and 4 hours after acute ingestions, and concentrations drawn 4 or more hours after ingestions, were included in the study. Exclusion criteria included initial concentration >100 μg/mL, initial APAP concentration drawn prior to 1 hour, two undetectable APAP concentrations, the second concentration drawn prior to 4 hours, and unknown time of ingestion. Toxic concentrations 4 or more hours after ingestion were defined as concentrations that plotted above the 150 μg/mL line on the Rumack‐Matthew nomogram.ResultsData were collected on 83 patients who met inclusion criteria. Of the 83 patients with APAP concentrations <100 μg/mL between 1 and 4 hours, one patient (1.2%) had a ≥ 4‐hour toxic concentration. Negative predictive value (NPV) for an APAP concentration <100 μg/mL obtained between 1 and 4 hours after an acute ingestion was 98.8% (95% confidence interval [CI] = 93.5% to 99.8%).ConclusionsAn APAP concentration of <100 μg/mL obtained between 1 and 4 hours after ingestion has a high NPV for excluding toxic ingestion. We do not recommend reliance on concentrations obtained between 1 and 4 hours to exclude toxicity, because of a potential false‐negative rate of 6.5%.
Intranasal Ketamine for Analgesia in the Emergency Department: A Prospective Observational Series
Authors: Andolfatto Gary , Willman Elaine , Joo Daniel , Miller Philip , Wong Wai‐Ben , Koehn Martha , Dobson Raea , Angus Eric , Moadebi Susanne 
Published: October 2013

AbstractObjectivesThe objective was to examine the feasibility, effectiveness, and adverse effect profile of intranasal ketamine for analgesia in emergency department (ED) patients.MethodsThis was a prospective observational study examining a convenience sample of patients aged older than 6 years experiencing moderate or severe pain, defined as a visual analog scale (VAS) score of 50 mm or greater. Patients received 0.5 to 0.75 mg/kg intranasal ketamine. Pain scores were recorded on a standard 100‐mm VAS by trained investigators at baseline, then every 5 minutes for 30 minutes, and then every 10 minutes for an additional 30 minutes. The primary outcome was the number and proportion of patients experiencing clinically significant reductions in VAS pain scores, defined as VAS reductions of 13 mm or more, within 30 minutes. Secondary outcomes included the median reduction in VAS, the median time required to achieve a 13 mm reduction in VAS, vital sign changes, and adverse events. Continuous data are reported with medians and interquartile ranges (IQRs). The Wilcoxon signed‐ranks test was used to assess changes in VAS scores. Adverse effects are reported with proportions and 95% confidence intervals (CIs).ResultsForty patients were enrolled with a median age of 47 years (IQR = 36 to 57 years; range = 11 to 79 years) for primarily orthopedic injuries. A reduction in VAS of 13 mm or more within 30 minutes was achieved in 35 patients (88%). The median change in VAS at 30 minutes was 34 mm (44%). Median time required to achieve a 13 mm VAS reduction was 9.5 minutes (IQR = 5 to 13 minutes; range = 5 to 25 minutes). No serious adverse effects occurred. Minor adverse effects included dizziness (21 patients, 53%; 95% CI = 38% to 67%), feeling of unreality (14 patients, 35%; 95% CI = 22% to 50%), nausea (four patients, 10%; 95% CI = 4% to 23%), mood change (three patients, 8%; 95% CI = 3% to 20%), and changes in hearing (one patient, 3%; 95% CI = 0% to 13%). All adverse effects were transient and none required intervention. There were no changes in vital signs requiring clinical intervention.ConclusionsIntranasal ketamine reduced VAS pain scores to a clinically significant degree in 88% of ED patients in this series. Adverse effects were minor and transient. Intranasal ketamine may have a role in the provision of effective, expeditious analgesia to ED patients.
How Do Founder CEOs Create Value?
Authors: Johnson William C. , Yi Sangho 
Published: October 2013

AbstractWe examine the value impact of founder CEOs and explore possible mechanisms whereby founder CEOs' unique characteristics affect their firms' value and long‐term market performance. We find that founder CEOs' status is positively related to market valuation and long‐term stock performance of firms. Furthermore, a lower likelihood of involuntary turnover for founder CEOs is positively associated with market valuation. We also find that CEOs are most likely to generate positive abnormal returns when protected from takeover markets. Our paper suggests that founder CEOs create value by strengthening a firm's stakeholder relationships and alleviating information asymmetry in financial markets, when other certifying entities do not participate in initial public offerings.
How Does Diversification Impact Bank Stability? The Role of Globalization, Regulations, and Governance Environments
Authors: Hsieh Meng‐Fen , Chen Pei‐Fen , Lee Chien‐Chiang , Yang Shih‐Jui 
Published: October 2013

AbstractThis paper examines the impact of bank diversification on stability, using bank‐level data for 22 Asian countries over the period from 1995 to 2009. We empirically investigate whether country characteristics, economic structure, regulatory and governance environments, and globalization have affected the degree of banking stability in Asia. This study takes on two measures for banking diversification ‐ asset and income diversities ‐ and adopts a broad set of variables as a proxy for bank stability. We apply dynamic panel data techniques and show different results from the U.S. and Europe. Our results first reveal that in Asia asset diversity is not sufficient enough to improve bank stability. However, bank stability can be enhanced through a strategy of income diversity. Second, a higher degree of globalization decreases bank stability through income diversity, but stability rises through asset diversity. Third, a country with a higher level of corporate governance reduces the agency problem, thus further increasing stability through diversity. Finally, a country with a higher level of economic development will support asset diversity so that banks can obtain higher profit accompanied by lower risk.