bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined use of Intravenous and Topical Tranexamic Acid following Cementless Total Hip Arthroplasty: A Randomised Clinical Trial
Authors: Xie Jinwei , Ma Jun , Yue Chen , Kang Pengde , Pei Fuxing 
Published: October 2015

Purpose This study was designed to compare the efficacy and safety of the combined use of tranexamic acid (TXA) with the intravenous (IV) or local use alone in total hip arthroplasty (THA). Methods 210 patients were randomised to a IV group, a local group or a combined group. Participants received 1.5 g IV-TXA in the IV group, 3 g local TXA in the local group, or 1 g IV-TXA combined with 2 g local TXA in the combined group. The primary outcomes were total blood loss (TBL), maximum haemoglobin drop, and the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE). Results TBL was (776.75 ± 188.95) ml in the combined group, which was significantly lower than in the IV group or the local group (p = 0.015, p = 0.001 respectively). Likewise, the mean values of maximum hemoglobin drop in the combined, IV, and local groups were 2.98 ± 0.78, 3.36 ± 0.78, and 3.89 ± 0.72 g/dL, respectively, with a significant intergroup difference (p<0.001 for all). Asymptomatic DVT was detected in 1 patient of the IV group, and 2 patients of the combined group with the use of ultrasound. There were no episodes of PE, and no significant differences were seen between groups in terms of complications. Conclusions Combined use of intravenous TXA and local TXA in primary unilateral THA can effectively decrease total blood loss and increase postoperative haemoglobin levels without influencing complication rates. It is suggested that this combined TXA regimen is more effective in decreasing blood loss in cementeless THA than intravenous or local administration alone.
Comparative Expression Analysis of Putative Cancer Stem Cell Markers CD44 and ALDH1A1 in Various Skin Cancer Subtypes
Authors: Erfani Elham , Roudi Raheleh , Rakhshan Azadeh , Sabet Mehrdad Nasrollahzadeh , Shariftabrizi Ahmad , Madjd Zahra 
Published: October 2015

Introduction Skin cancers, particularly melanoma, are initiated and maintained by a subpopulation of tumor cells expressing stemness markers that are called cancer stem cells (CSCs). This study aimed to evaluate the expression levels and clinicopathological significance of the putative CSC markers CD44 and ALDH1A1 in patients with skin cancer. Methods The expression levels of CD44 and ALDH1A1 were investigated in 107 skin cancer specimens including 58 (54%) basal cell carcinomas (BCC), 37 (35%) squamous cell carcinomas (SCC), and 12 (11%) melanomas using the tissue microarray (TMA) technique. The correlation of the expression levels of these markers and clinicopathological parameters was then analyzed. Results The expression levels of CD44 and ALDH1A1 were significantly higher in melanoma patients than patients with SCC or BCC (p<0.001 and p = 0.002, respectively). A higher level of CD44 expression was more often found in melanoma tumor cells with a higher rate of recurrence (p = 0.029) and in SCC cases with ulceration (p = 0.01), while there was no significant correlation between ALDH1A1 expression and other clinicopathological parameters. Similarly, coexpression of CD44 and ALDH1A1 (CD44high/ALDH1A1high) was significantly observed in melanoma samples (p<0.001). Conclusions These findings suggest that a CD44high/ALDH1A1high phenotype in melanoma and a CD44high phenotype in SCC can be considered candidates for targeted therapy of skin cancers aiming at CSCs.
TERT Promoter Mutations in Soft Tissue Sarcomas
Authors: Campanella Nathália C. , Penna Valter , Abrahão-Machado Lucas Faria , Cruvinel-Carloni Adriana , Ribeiro Guilherme , Soares Paula , Scapulatempo-Neto Cristovam , Reis Rui M. 
Published: October 2015

Introduction Oncogenic hotspot mutations in the promoter region of the TERT gene have been identified in several cancer types as being associated with a worse outcome. Additionally, a polymorphism (rs2853669) in the TERTpromoter region was reported to modify the survival of TERT-mutated patients. Our aim is to determine the frequency of c.-124 C>T and c.-146 C>T TERT mutations and to genotype the rs2853669 polymorphism in a series of 68 soft tissue sarcomas (STS) comprising 22 histological subtypes. Methods PCR was performed, followed by direct sequencing of a fragment of TERT containing the hotspots and the rs2853669. Results We found TERTmutations in 4/68 (5.9%) STSs including 1 pleomorphic liposarcoma (1/1), 1 dedifferentiated liposarcoma (1/1) and 2 myxoid liposarcomas (2/9). The variant C allele of rs2853669 was found in 54.8% (34/62) of all STSs and in 75% (3/4) of TERT-mutated cases. TERT mutations were associated with younger age, and the C allele of the rs2853669 was associated with high histological grade (2 and 3). No association was found between TERT mutation status or rs2853669 genotype and patient prognosis. Conclusions We showed that TERT promoter mutation is not a recurrent event in STS and is present in particular histological subtypes.
Factors Associated with Pain during Vascular Access Intervention Therapy
Authors: Muromiya Yasuto , Nagai Kojiro , Yokota Narushi , Okada Daigo , Suenaga Takehiro , Ueda Yuka , Kawahara Kana , Kanayama Hiroomi , Minakuchi Jun , Tsuchida Kenji 
Published: October 2015

Objective The objective of this study is to investigate and compare factors associated with pain during vascular access intervention therapy. Subjects and methods Fifty patients provided informed consent to participate in a survey of pain by questionnaire after receiving dialysis treatment at our hospital. Balloons for use during the procedure were chosen at random in this prospective randomized control study. A numeric rating scale (NRS) was used for pain assessment. Results A semi-compliant balloon caused significantly worse pain as compared with the other types of balloons (NRS, 7.67 ± 1.57 vs. 6.02 ± 1.89; p<0.05). There was no correlation between maximum inflation pressure and pain, or between age and pain, and no difference between diabetic and non-diabetic patients. A comparison among vascular dilation locations, as well as a comparison of AVF with AVG also revealed no significant differences. Conclusions The reason for severe pain with use of the semi-compliant balloon as compared with the other types might have been due to its characteristics during inflation, as increased diameter leads to an increase in pressure. Mismatching of balloon diameter to vascular diameter may also increase pain.
Vascular Access for Long-Term Hemodialysis/Hemodiafiltration Patients
Authors: Yokota Narushi , Nagai Kojiro , Okada Daigo , Muromiya Yasuto , Suenaga Takehiro , Ueda Yuka , Kawahara Kana , Kanayama Hiro-omi , Minakuchi Jun , Tsuchida Kenji 
Published: October 2015

Purpose We investigated the characteristics of patients who received long-term hemodialysis/hemodiafiltration (HD/HDF) treatment for over 30 years at our group of hospitals and type of vascular access (VA) used. Subjects and methods As of August 2014, 950 patients were receiving HD/HDF treatment at one of our hospitals. Of those, we investigated 41 (4.3%) undergoing long-term treatment in regard to their characteristics and VA type. The items subjected to analysis were sex, primary illness, age at time of dialysis initiation, present age, duration (years) of HD/HDF, type of arteriovenous fistula (AVF) and arteriovenous graft (AVG), history of surgery and AVF persistence rate. Results The subjects consisted of 22 men and 19 women, and their mean HD/HDF duration was 33.4 ± 2.8 years. For primary illness, the majority (n = 31) had chronic glomerulonephritis. The age at time of dialysis initiation was 31.7 ± 7.76 years and present age was 64.5 ± 7.65 years. They had received 3.8 VA surgeries. For present VA type, 23 patients (56.0%) had an AVF and 13 (31.7%) an AVG, while 4 AVF patients (9.7%) had a history of AVG use. One patient (2.4%) had a superficialized artery. The mean HD/HDF duration of the 13 AVG patients was 7 years and the longest was 18 years. AVF persistence rate estimated by the Kaplan-Meier method was 75% at 30 years after dialysis initiation. Conclusions The present results suggest that the ratio of patients with AVG increased with prolonged HD/HDF treatment. AVG has a higher probability of complications and lower patency as compared to AVF, thus careful management is needed. On the other hand, AVG contributes more to a good long prognosis, as it offers efficient dialysis. In cases of vascular deterioration due to long-term hemodialysis, it is inevitable to change from AVF to AVG, thus the ratio of AVG patients is expected to increase in cases of long-term HD/HDF.
De zaak van Sinterklaas
Authors: Bijnaar A. , Maris C.W. 
Published: October 2015

De zaak van Sinterklaas: Zwarte Piet staat terecht
In De zaak van Sinterklaas: Zwarte Piet staat terecht bespreken Aspha Bijnaar en Cees Maris de maatschappelijke en juridische controverses rond Zwarte Piet vanuit het rechtsfilosofische ideaal van de liberale rechtsstaat. Ze betogen dat Zwarte Piet is besmet met het racisme van het koloniale verleden. Wegens het belang van de uitingsvrijheid moet de overheid discriminerende uitingen niet verbieden, maar met argumenten tegenspreken. Een neutrale rechtsstaat mag zelf niet discrimineren: Sinterklaasevenementen waarbij overheidsinstellingen direct zijn betrokken, moeten vrij zijn van racistische smetten.
Medical and Economic Impact of a Free Student-Run Podiatric Medical Clinic
Authors: Hua Natalie T. , Shih Chia-Ding , Tran David 
Published: October 2015

Background
Data from the free student-run podiatric medical clinic at Clínica Tepati at the University of California, Davis, were used to analyze medical and economic impacts on health-care delivery and to extrapolate the economic impact to the national level. Clínica Tepati also provides an excellent teaching environment and services to the uninsured Hispanic population in the Greater Sacramento area.

Methods
In this analysis, we retrospectively reviewed patient medical records for podiatric medical encounters during 15 clinic days between November 2010 and February 2012. The economic impact was evaluated by matching diagnoses and treatments with Medicare reimbursement rates using International Classification of Diseases codes, Current Procedural Terminology codes, and the prevailing Medicare reimbursement rates.

Results
Sixty-three podiatric medical patients made 101 visits during this period. Twenty patients returned to the clinic for at least one follow-up visit or for a new medical concern. Thirty-nine different diagnoses were identified, and treatments were provided for all 101 patient encounters/visits. Treatments were limited to those within the clinic's resources. This analysis estimates that $17,332.13 worth of services were rendered during this period.

Conclusions
These results suggest that the free student-run podiatric medical clinic at Clínica Tepati had a significant medical and economic impact on the delivery of health care at the regional level, and when extrapolated, nationally as well. These student-run clinics also play an important role in medical education settings.
Reduction in Size and Number of Plantar Verrucae in Human Immunodeficiency Virus–Infected Individuals After the Implementation of Highly Active Antiretroviral Therapy
Authors: Afesllari Endri , Miller Timothy J. , Huchital Michael J. , King Christy M. , Johnston James S. , Barbosa Peter 
Published: October 2015

Background
Implementation of highly active antiretroviral therapy (HAART) significantly increased the life expectancy of those living with human immunodeficiency virus (HIV). Except for prevalence, scientific reports regarding clinical manifestations of plantar verrucae in the post-HAART era are lacking. The objective of this study was to compare clinical manifestations of plantar verrucae between HIV-infected and noninfected individuals and then to compare these findings with those observed before the implementation of HAART.

Methods
Nineteen patients with plantar verrucae (ten with HIV and nine without HIV) were examined to determine the size, number, and clinical type of verrucae present. The two groups were first compared with each other and then with previously collected data from a similar analysis conducted in 1995, before the implementation of HAART. Statistical significance was determined using the Fisher exact test or the Wilcoxon rank sum test.

Results
No significant differences were observed in the size, number, or clinical type of verrucae between HIV-negative and HIV-positive patients. Compared with the 1995 data, there was a significant decrease in the number of verrucae lesions per individual and a nonsignificant decrease in the average size of verrucae in HIV-positive patients.

Conclusions
Study results indicate that the implementation of HAART has impacted the clinical manifestations of plantar verrucae in HIV-positive individuals. Further analyses with a larger number of patients are required to confirm and substantiate these findings.
Perceived Stress and Coffee and Energy Drink Consumption Predict Poor Sleep Quality in Podiatric Medical Students
Authors: Sawah Mohomad Al , Ruffin Naeemah , Rimawi Mohammad , Concerto Carmen , Aguglia Eugenio , Chusid Eileen , Infortuna Carmenrita , Battaglia Fortunato 
Published: October 2015

Background
A cross-sectional survey administered to first- and second-year podiatric medical students aimed to investigate the effect of coffee intake, energy drink consumption, and perceived stress on sleep quality in medical students during their preclinical studies.

Methods
Ninety-eight of 183 students contacted (53.6%) completed a questionnaire comprising standard instruments measuring sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness scale), and perceived stress (ten-item Perceived Stress Scale). Furthermore, we investigated coffee and energy drink consumption. Logistic regression was conducted to identify factors associated with poor sleep quality and the relation between sleep quality and academic performance (grade point average).

Results
High prevalences of poor sleep quality, excessive daytime sleepiness, and perceived stress were reported. In addition, higher odds of developing poor sleep quality were associated with coffee and energy drink intake, perceived stress, and excessive daytime sleepiness. The total Pittsburgh Sleep Quality Index score was inversely correlated with grade point average.

Conclusions
First- and second-year podiatric medical students have poor sleep quality. Further research is needed to identify effective strategies to reduce stress and decrease coffee and energy drink intake to minimize their negative effect on sleep quality and academic performance in podiatric medical students.
Abrupt termination of Marine Isotope Stage 16 (Termination VII) at 631.5 ka in Santa Barbara Basin, California
Authors: Dean Walter E. , Kennett James P. , Behl Richard J. , Nicholson Craig , Sorlien Christopher C. 
Published: October 2015

AbstractThe Marine Isotope Stage 16–15 boundary (Termination VII) is the first deglacial warming step of the late Quaternary following the mid‐Pleistocene transition (MPT), when 41 kyr climatic cycles shifted to strong 100 kyr cycles. The detailed structure of this important climatic event has remained unknown until now. Core MV0508‐19JPC from Santa Barbara Basin, California, contains a decadal‐scale climatic and geochemical sediment record of 4000 years duration that includes the early part of this deglacial episode. This record reveals that the climatic shift during the early deglacial occurred rapidly (<700 years), in a progression of three abrupt warming steps. The onset of Marine Isotope Stage (MIS) 15 was remarkably abrupt with 4–5°C sea surface warming in ~50 years. The deglacial sequence contains the well‐dated Lava Creek tephra (631.3 ± 4 ka) from Yellowstone Caldera used to date the onset of Termination VII at 631.5 ka. The late MIS 16 and early MIS 15 interval exhibits multiple decadal‐scale negative excursions in δ13C of planktic foraminifera, likely the result of repeated discharges of methane from methane hydrates associated with both ocean warming and low sea level. A warm interstadial that interrupts late MIS 16 is marked by elevated concentrations of redox‐sensitive elements indicating sulfidic, oxygen‐deficient bottom and pore‐waters, and elevated concentrations of total organic carbon and Cd, reflecting increased surface productivity. Unlike younger sediments on the California margin, these indicators of increased productivity and low dissolved oxygen do not consistently correspond with each other or with preserved laminations, possibly reflecting instability of a still evolving ocean‐atmosphere system following the MPT.
Evaluation of simplified evaporation duct refractivity models for inversion problems
Authors: Saeger J. T. , Grimes N. G. , Rickard H. E. , Hackett E. E. 
Published: October 2015

AbstractTo assess a radar system's instantaneous performance on any given day, detailed knowledge of the meteorological conditions is required due to the dependency of atmospheric refractivity on thermodynamic properties such as temperature, water vapor, and pressure. Because of the significant challenges involved in obtaining these data, recent efforts have focused on development of methods to obtain the refractivity structure inversely using radar measurements and radar wave propagation models. Such inversion techniques generally use simplified refractivity models in order to reduce the parameter space of the solution. Here the accuracy of three simple refractivity models is examined for the case of an evaporation duct. The models utilize the basic log linear shape classically associated with evaporation ducts, but each model depends on various parameters that affect different aspects of the profile, such as its shape and duct height. The model parameters are optimized using radiosonde data, and their performance is compared to these atmospheric measurements. The optimized models and data are also used to predict propagation using a parabolic equation code with the refractivity prescribed by the models and measured data, and the resulting propagation patterns are compared. The results of this study suggest that the best log linear model formulation for an inversion problem would be a two‐layer model that contains at least three parameters: duct height, duct curvature, and mixed layer slope. This functional form permits a reasonably accurate fit to atmospheric measurements as well as embodies key features of the profile required for correct propagation prediction with as few parameters as possible.
Leaky nitrogen cycle in pristine African montane rainforest soil
Authors: Rütting Tobias , Cizungu Ntaboba Landry , Roobroeck Dries , Bauters Marijn , Huygens Dries , Boeckx Pascal 
Published: October 2015

AbstractMany pristine humid tropical forests show simultaneously high nitrogen (N) richness and sustained loss of bioavailable N forms. To better understand this apparent upregulation of the N cycle in tropical forests, process‐based understanding of soil N transformations, in geographically diverse locations, remains paramount. Field‐based evidence is limited and entirely lacking for humid tropical forests on the African continent. This study aimed at filling both knowledge gaps by monitoring N losses and by conducting an in situ15N labeling experiment in the Nyungwe tropical montane forest in Rwanda. Here we show that this tropical forest shows high nitrate (NO3−) leaching losses, confirming findings from other parts of the world. Gross N transformation rates point to an open soil N cycle with mineralized N nitrified rather than retained via immobilization; gross immobilization of NH4+and NO3−combined accounted for 37% of gross mineralization, and plant N uptake is dominated by ammonium (NH4+). This study provided new process understanding of soil N cycling in humid tropical forests and added geographically independent evidence that humid tropical forests are characterized by soil N dynamics and N inputs sustaining bioavailable N loss.
North Atlantic meridional overturning circulation variations from GRACE ocean bottom pressure anomalies
Authors: Landerer Felix W. , Wiese David N. , Bentel Katrin , Boening Carmen , Watkins Michael M. 
Published: October 2015

AbstractConcerns about North Atlantic Meridional Overturning Circulation (NAMOC) changes imply the need for a continuous, large‐scale observation capability to detect changes on interannual to decadal time scales. Here we present the first measurements of Lower North Atlantic Deep Water (LNADW) transport changes using only time‐variable gravity observations from Gravity Recovery and Climate Experiment (GRACE) satellites from 2003 until now. Improved monthly gravity field retrievals allow the detection of North Atlantic interannual bottom pressure anomalies and LNADW transport estimates that are in good agreement with those from the Rapid Climate Change‐Meridional Overturning Circulation and Heatflux Array (RAPID/MOCHA). Concurrent with the observed AMOC transport anomalies from late 2009 through early 2010, GRACE measured ocean bottom pressures changes in the 3000–5000 m deep western North Atlantic on the order of 20 mm‐H2O (200 Pa), implying a southward volume transport anomaly in that layer of approximately −5.5 sverdrup. Our results highlight the efficacy of space gravimetry for observing AMOC variations to evaluate latitudinal coherency and long‐term variability.
Effects of long‐term fluid injection on induced seismicity parameters and maximum magnitude in northwestern part of The Geysers geothermal field
Authors: Kwiatek Grzegorz , Martínez‐Garzón Patricia , Dresen Georg , Bohnhoff Marco , Sone Hiroki , Hartline Craig 
Published: October 2015

AbstractThe long‐term temporal and spatial changes in statistical, source, and stress characteristics of one cluster of induced seismicity recorded at The Geysers geothermal field (U.S.) are analyzed in relation to the field operations, fluid migration, and constraints on the maximum likely magnitude. Two injection wells, Prati‐9 and Prati‐29, located in the northwestern part of the field and their associated seismicity composed of 1776 events recorded throughout a 7 year period were analyzed. The seismicity catalog was relocated, and the source characteristics including focal mechanisms and static source parameters were refined using first‐motion polarity, spectral fitting, and mesh spectral ratio analysis techniques. The source characteristics together with statistical parameters (b value) and cluster dynamics were used to investigate and understand the details of fluid migration scheme in the vicinity of injection wells. The observed temporal, spatial, and source characteristics were clearly attributed to fluid injection and fluid migration toward greater depths, involving increasing pore pressure in the reservoir. The seasonal changes of injection rates were found to directly impact the shape and spatial extent of the seismic cloud. A tendency of larger seismic events to occur closer to injection wells and a correlation between the spatial extent of the seismic cloud and source sizes of the largest events was observed suggesting geometrical constraints on the maximum likely magnitude and its correlation to the average injection rate and volume of fluids present in the reservoir.