bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Aortic Dissection Hospitalizations, Interventions, and Outcomes Among Medicare Beneficiaries in the United States, 2000–2011
Authors: Mody Purav S. , Wang Yun , Geirsson Arnar , Kim Nancy , Desai Mayur M. , Gupta Aakriti , Dodson John A. , Krumholz Harlan M. 
Published: October 2014

Background—
The epidemiology of aortic dissection (AD) has not been well described among older persons in the United States. It is not known whether advancements in AD care over the last decade have been accompanied by changes in outcomes.

Methods and Results—
The Inpatient Medicare data from 2000 to 2011 were used to determine trends in hospitalization rates for AD. Mortality rates were ascertained through corresponding vital status files. A total of 32 057 initial AD hospitalizations were identified. The overall hospitalization rate for AD remained unchanged at 10 per 100 000 person-years. For 30-day and 1-year mortality associated with AD, the observed rate decreased from 31.8% to 25.4% (difference, 6.4%; 95% confidence interval [CI], 6.2–6.5; adjusted, 6.4%; 95% CI, 5.7–6.9) and from 42.6% to 37.4% (difference, 5.2%; 95% CI, 5.1–5.2; adjusted, 6.2%; 95% CI, 5.3–6.7), respectively. For patients undergoing surgical repair for type A dissections, the observed 30-day mortality decreased from 30.7% to 21.4% (difference, 9.3%; 95% CI, 8.3–10.2; adjusted, 7.3%; 95% CI, 5.8–7.8) and the observed 1-year mortality decreased from 39.9% to 31.6% (difference, 8.3%; 95% CI, 7.5–9.1%; adjusted, 8.2%; 95% CI, 6.7–9.1). The 30-day mortality decreased from 24.9% to 21% (difference, 3.9%; 95% CI, 3.5–4.2; adjusted, 2.9%; 95% CI, 0.7–4.4) and 1-year decreased from 36.4% to 32.5% (difference, 3.9%; 95% CI, 3.3–4.3; adjusted, 3.9%; 95% CI, 2.5–6.3) for surgical repair of type B dissection.

Conclusions—
Although AD hospitalization rates remained stable, improvement in mortality was noted, particularly in patients undergoing surgical repair.
Restoration of Impaired Endothelial Myocyte Enhancer Factor 2 Function Rescues Pulmonary Arterial Hypertension
Authors: Kim Jongmin , Hwangbo Cheol , Hu Xiaoyue , Kang Yujung , Papangeli Irinna , Mehrotra Devi , Park Hyekyung , Ju Hyekyung , McLean Danielle L. , Comhair Suzy A. , Erzurum Serpil C. , Chun Hyung J. 
Published: October 2014

Background—
Pulmonary arterial hypertension (PAH) is a progressive disease of the pulmonary arterioles, characterized by increased pulmonary arterial pressure and right ventricular failure. The cause of PAH is complex, but aberrant proliferation of the pulmonary artery endothelial cells (PAECs) and pulmonary artery smooth muscle cells is thought to play an important role in its pathogenesis. Understanding the mechanisms of transcriptional gene regulation involved in pulmonary vascular homeostasis can provide key insights into potential therapeutic strategies.

Methods and Results—
We demonstrate that the activity of the transcription factor myocyte enhancer factor 2 (MEF2) is significantly impaired in the PAECs derived from subjects with PAH. We identified MEF2 as the key cis-acting factor that regulates expression of a number of transcriptional targets involved in pulmonary vascular homeostasis, including microRNAs 424 and 503, connexins 37, and 40, and Krűppel Like Factors 2 and 4, which were found to be significantly decreased in PAH PAECs. The impaired MEF2 activity in PAH PAECs was mediated by excess nuclear accumulation of 2 class IIa histone deacetylases (HDACs) that inhibit its function, namely HDAC4 and HDAC5. Selective, pharmacological inhibition of class IIa HDACs led to restoration of MEF2 activity in PAECs, as demonstrated by increased expression of its transcriptional targets, decreased cell migration and proliferation, and rescue of experimental pulmonary hypertension models.

Conclusions—
Our results demonstrate that strategies to augment MEF2 activity hold potential therapeutic value in PAH. Moreover, we identify selective HDAC IIa inhibition as a viable alternative approach to avoid the potential adverse effects of broad spectrum HDAC inhibition in PAH.
Consciousness Level and Off‐Hour Admission Affect Discharge Outcome of Acute Stroke Patients: A J‐ASPECT Study
Authors: Kamitani Satoru , Nishimura Kunihiro , Nakamura Fumiaki , Kada Akiko , Nakagawara Jyoji , Toyoda Kazunori , Ogasawara Kuniaki , Ono Junichi , Shiokawa Yoshiaki , Aruga Toru , Miyachi Shigeru , Nagata Izumi , Matsuda Shinya , Miyamoto Yoshihiro , Iwata Michiaki , Suzuki Akifumi , Ishikawa Koichi B. , Kataoka Hiroharu , Morita Kenichi , Kobayashi Yasuki , Iihara Koji 
Published: October 2014

Background
Poor outcomes have been reported for stroke patients admitted outside of regular working hours. However, few studies have adjusted for case severity. In this nationwide assessment, we examined relationships between hospital admission time and disabilities at discharge while considering case severity.

Methods and Results

We analyzed 35 685 acute stroke patients admitted to 262 hospitals between April 2010 and May 2011 for ischemic stroke (IS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). The proportion of disabilities/death at discharge as measured by the modified Rankin Scale (
mRS
) was quantified. We constructed 2 hierarchical logistic regression models to estimate the effect of admission time, one adjusted for age, sex, comorbidities, and number of beds; and the second adjusted for the effect of consciousness levels and the above variables at admission. The percentage of severe disabilities/death at discharge increased for patients admitted outside of regular hours (22.8%, 27.2%, and 28.2% for working‐hour, off‐hour, and nighttime;
P
<0.001). These tendencies were significant in the bivariate and multivariable models without adjusting for consciousness level. However, the effects of off‐hour or nighttime admissions were negated when adjusted for consciousness levels at admission (adjusted OR, 1.00 and 0.99; 95% CI, 1.00 to 1.13 and 0.89 to 1.10;
P
=0.067 and 0.851 for off‐hour and nighttime, respectively, versus working‐hour). The same trend was observed when each stroke subtype was stratified.

Conclusions
The well‐known off‐hour effect might be attributed to the severely ill patient population. Thus, sustained stroke care that is sufficient to treat severely ill patients during off‐hours is important.
Help-seeking behaviour and adolescent self-harm: A systematic review
Authors: Rowe Sarah L , French Rebecca S , Henderson Claire , Ougrin Dennis , Slade Mike , Moran Paul 
Published: October 2014

Objective: Self-harm is common in adolescence, but most young people who self-harm do not seek professional help. The aim of this literature review was to determine (a) the sources of support adolescents who self-harm access if they seek help, and (b) the barriers and facilitators to help-seeking for adolescents who self-harm. Method: Using a pre-defined search strategy we searched databases for terms related to self-harm, adolescents and help-seeking. Studies were included in the review if participants were aged 11–19 years. Results: Twenty articles met criteria for inclusion. Between a third and one half of adolescents who self-harm do not seek help for this behaviour. Of those who seek help, results showed adolescents primarily turned to friends and family for support. The Internet may be more commonly used as a tool for self-disclosure rather than asking for help. Barriers to help-seeking included fear of negative reactions from others including stigmatisation, fear of confidentiality being breached and fear of being seen as ‘attention-seeking’. Few facilitators of help-seeking were identified. Conclusions: Of the small proportion of adolescents who seek help for their self-harm, informal sources are the most likely support systems accessed. Interpersonal barriers and a lack of knowledge about where to go for help may impede help-seeking. Future research should address the lack of knowledge regarding the facilitators of help-seeking behaviour in order to improve the ability of services to engage with this vulnerable group of young people.
Concussion Management in United States College Sports
Authors: Baugh Christine M. , Kroshus Emily , Daneshvar Daniel H. , Filali Naji A. , Hiscox Michael J. , Glantz Leonard H. 
Published: October 2014

Background: In 2010, the National Collegiate Athletic Association (NCAA) adopted its Concussion Policy and Legislation, which applies to more than 450,000 collegiate athletes annually. To date, there has been no examination of school-level compliance with the NCAA Concussion Policy. Purpose: To examine whether stakeholders at NCAA schools report that their school has a concussion management plan and whether existing plans are consistent with the NCAA policy. Also examined were stakeholders’ perceptions regarding concussion management at their institution and possible areas for improvement. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Surveys were sent by e-mail to coaches, sports medicine clinicians, and compliance administrators at all 1066 NCAA member institutions. Surveys asked population-specific questions about institutional concussion management. Individuals (N = 2880) from 907 unique schools participated in this survey. Results: Most respondents (n = 2607; 92.7%) indicated their school had a concussion management plan. Most schools had all (82.1%) or some (15.2%) respondents indicate a concussion management plan was present. When asked to indicate all individuals who could have final responsibility for returning athletes to play after a concussion, 83.4% selected team doctor, 72.8% athletic trainer, 31.0% specialist physician, 6.8% coach, and 6.6% athlete. Most respondents (76.1%) indicated that their institution had a process for annual athlete concussion education; 91.2% required athletes to acknowledge their responsibility to report concussion symptoms. Nearly all respondents (98.8%) thought their school’s concussion management plan protected athletes “well” or “very well.” Top categories suggested for improvement included better coach education (39.7%), increasing sports medicine staffing (37.2%), and better athlete education (35.2%). Conclusion: Although a large majority of respondents indicated that their school has a concussion management plan, improvement is needed. Compliance with specified components (eg, annual athlete education) lags behind the presence of the plan itself, and stakeholders had suggestions for areas in which improvements are needed. Increasing scientific evidence supporting the seriousness of concussion underscores the need for the NCAA to use its regulatory capabilities to ensure that athletes’ brains are safe.
Hypothermia in Adult ICUs
Authors: Niven Daniel J. , Stelfox Henry T. , Laupland Kevin B. 
Published: October 2014

Background: This study examined whether hypothermia (< 36.0°C) incidence among critically ill patients varied over time, the determinants of change, and the associated risk for ICU mortality. Methods: Interrupted time series analysis among adults admitted to ICUs in Calgary, Canada over 8.5 years. Changes in the incidence of hypothermia within the first 24 hours of ICU admission were modelled using segmented regression. Results: Among 15,291 first admissions to ICU, hypothermia incidence decreased from 29% to 21% during the study period. Implementation of a new temporal artery thermometer (TAT) was associated with the majority of the decrease in incidence (10%; 95% CI 7.1-13%; P < .0001). However, subgroup analysis revealed important differences between medical and surgical patients. Hypothermia incidence decreased among surgical patients before TAT implementation (0.4% per quarter, 95% CI 0.1-0.7%, P = .009), but not after, whereas in medical patients, the incidence increased after (1.0% per quarter, 95% CI 0.6-1.4%, P < .0001) but not before TAT implementation. Segmented logistic regression suggested that increases in the proportion of patients with non-traumatic neurologic admission diagnoses were associated with hypothermia incidence among medical patients, whereas there was no measurable clinical factor associated with the observed time trends among surgical patients. Hypothermia at ICU admission was independently associated with ICU mortality in medical and surgical patients throughout the entire study. Conclusion: The incidence of hypothermia at ICU admission was dependent on medical versus surgical status, and the method of non-invasive temperature measurement, but was persistently associated with ICU mortality.
Photothermal stress triggered by near infrared-irradiated carbon nanotubes promotes bone deposition in rat calvarial defects
Authors: Yanagi Tsukasa , Kajiya Hiroshi , Kawaguchi Minoru , Kido Hirofumi , Fukushima Tadao 
Published: October 2014

The bone regenerative healing process is often prolonged, with a high risk of infection particularly in elderly and diseased patients. A reduction in healing process time usually requires mechanical stress devices, chemical cues, or laser/thermal therapies. Although these approaches have been used extensively for the reduction of bone healing time, the exact mechanisms involved in thermal stress-induced bone regeneration remain unclear. In this study, we investigated the effect of optimal hyperthermia on rat calvarial defects in vivo and on osteogenesis in vitro. Photothermal stress stimulation was carried out using a new photothermal device, composed of an alginate gel including in carbon nanotubes and their irradiator with near-infrared light. Photothermal stress (15 min at 42℃, every day), trigged by near-infrared-induced carbon nanotube, promoted bone deposition in critical-sized calvarial defects compared with nonthermal stress controls. We recently reported that our novel DNA/protamine complex scaffold induces bone regeneration in calvarial defects. In this study, photothermal stress upregulated bone deposition in DNA/protamine-engrafted calvarial defects. Furthermore, photothermal stress significantly induced expression of osteogenic related genes in a time-dependent manner, including alkaline phosphatase, osterix, and osteocalcin. This was observed in DNA/protamine cells, which were expanded from regenerated tissue engrafted into the DNA/protamine scaffold, as well as in human MG63 preosteoblasts. In summary, this novel carbon nanotube-based photothermal stress approach upregulated expression of osteogenic-related genes in preosteoblasts, resulting in promotion of mineral deposition for enhanced bone repair.
Technology and its ethics in nursing and caring journals
Authors: Korhonen Eila-Sisko , Nordman Tina , Eriksson Katie 
Published: October 2014

Background: Over the past 20 years, the impact of technology has increased significantly in health care. The diversity of technology is growing and its knowledge scattered. The concept of technology is ambiguous in caring and nursing sciences and its ethics remains unidentified. Aim: To find evidence on how the concept of technology and its ethics are defined in caring and nursing sciences and practice. The purpose of this study is to describe and summarize the concept of technology and its ethics in the past nursing and caring literature. Method: The integrative literature review of the past nursing and caring literature. The data were collected from caring and nursing journal articles from 2000 to 2013 focusing on technology and its ethics.The results were summarized and themed. Results: Technology as a concept has three implications. First, technology is devices and products, including ICT and advanced, simple and assistive technology. Second, technology refers to a process consisting of methods for helping people. Third, technology as a service indicates the production of care by technology. The ethics of technology has not been established as a guiding principle. Some studies excluded ethical reflection completely. Many studies discussed the ethics of technology as benefits such as improved communication and symptoms management, and the simple use of e-health services whilst others remained critical presenting ethical problems such as unwillingness and the inability to use technology, or conflicts with human aspects or questions of inequality. Conclusion: In conclusion, this study indicates that technology as a concept is described diversely. The relation between technology and ethics is not a truism. Despite some evidence, more is needed to promote ethical care when using technology.
Management of antidepressant-induced sexual dysfunction
Authors: Keks Nicholas A , Hope Judy , Culhane Christine 
Published: October 2014

Objective: Antidepressant-induced sexual dysfunction is a common, troublesome complication of antidepressant treatment that patients often fail to report, which can have major consequences, including non-adherence to treatment with resultant relapse of depressive illness. The aim of this paper is to review the extent, causation and evidence-based management of antidepressant-induced sexual dysfunction to inform clinical practice. Conclusions: The preponderance of evidence suggests that antidepressant s can be divided into high risk (selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors) and low risk (agomelatine, bupropion, moclobemide and reboxetine) categories with regard to propensity for antidepressant-induced sexual dysfunction, although there is disagreement, particularly about mirtazapine, and methodological issues militate against definitive findings. Antidepressant-induced sexual dysfunction is dose-dependent to an extent, but patient vulnerability factors are also relevant. There are significant differences in antidepressant-induced sexual dysfunction between men and women. It is important to ask antidepressant -treated patients about sexual dysfunction as few self-report; this may well contribute to antidepressant non-adherence. Consider using an antidepressant with low risk of antidepressant-induced sexual dysfunction for initial treatment. When antidepressant-induced sexual dysfunction has developed, try to persuade the patient to wait in case tolerance develops. Then consider changing to a lower risk or use of high/low risk antidepressant combinations but pharmacological expertise is required. Adjunctive sildenafil can help in both sexes.
Chronic use of maropitant for the management of vomiting and inappetence in cats with chronic kidney disease: a blinded, placebo-controlled clinical trial
Authors: Quimby Jessica M , Brock William T , Moses Kelsey , Bolotin David , Patricelli Kayla 
Published: October 2014

Objectives Maropitant is commonly used for acute vomiting. A pharmacokinetic and toxicity study in cats indicated that longer term usage appears safe. The aim of this study was to assess the efficacy of maropitant for management of chronic vomiting and inappetence associated with feline chronic kidney disease (CKD). Methods Forty-one cats with stable International Renal Interest Society Stage II or III CKD, no known concurrent illness, and a complaint of chronic vomiting and inappetence attributed to CKD were enrolled in a randomized, placebo-controlled, blinded clinical study. A complete blood count, serum biochemistry, urinalysis, urine culture, T4 and blood pressure were required for entry. Maropitant was administered at a dose of 4 mg orally (median 1.1 mg/kg, range 0.6–2.9 mg/kg) daily for 2 weeks. Owners kept daily logs of vomiting incidence, appetite and activity scores. Physical examination, weight, body condition score and serum biochemistry were performed before and after the trial period. Mann–Whitney statistics were used to compare treatment groups. Results Thirty-three cats successfully completed the trial: 21 cats received the drug (nine Stage II cats, 12 Stage III cats) and 12 cats received placebo (seven Stage II cats, five Stage III cats). There was a statistically significant decrease in vomiting in cats with CKD that received maropitant ( P <0.01). Cats that received maropitant did not have statistically significant differences in appetite scores, activity scores, weight or serum creatinine compared with placebo. Conclusions and relevance Maropitant was demonstrated to palliate vomiting associated with CKD, and may be helpful in the nutritional management of cats with CKD.
The scope of private practice amongst consultant urologists in the UK and Ireland – a BAUS Workforce survey
Authors: Payne SR , Joyce AD 
Published: October 2014

Introduction: A 2012 workforce survey of consultant members of the British Association of Urological Surgeons (BAUS) found that up to 75% of members participated in private practice. This survey specifically addresses the scope of private practice and members’ attitudes towards the private health industry (PHI). Methods: An online survey of all consultant members of BAUS was undertaken in May 2013. Questions were asked about how many had a private practice, how much time they devoted to it, about their relationship with insurers and their expectation of BAUS’s role within private health care. Results: A total of 47.2% responded to the survey, of whom 76.3% have a private practice. Among the respondents, 73.6% work as individual practitioners and 61% spend <6 hours a week practicing clinically. Adverse relationships with the PHI were significantly worse for those working in private practice alone, in consortia, and for those members working as sole practitioners who were consultants of <10 years standing. More than 85% thought that a unified voice would improve relationships with the purchasers of private health care. Conclusions: This survey confirms the breadth of private practice amongst UK urologists and demonstrates how they practice privately. It helps identify that they do have concerns regarding their contractual and financial relationships with the PHI.
Rap1-GTP–interacting adaptor molecule (RIAM) is dispensable for platelet integrin activation and function in mice
Authors: Stritt Simon , Wolf Karen , Lorenz Viola , Vögtle Timo , Gupta Shuchi , Bösl Michael R. , Nieswandt Bernhard 
Published: October 2014

Key Points
We describe the first knockout mouse model for RIAM. In contrast to previous studies using cell culture approaches, platelets from RIAM-null mice show normal integrin activation and function.
Percent plans, automatic admissions, and college outcomes
Authors: Daugherty Lindsay , Martorell Paco , McFarlin Isaac 
Published: October 2014

Abstract
Access to selective universities is highly coveted because of the perception that attending one provides opportunities otherwise difficult to obtain. To broaden access to the state’s flagship universities in a manner that does not rely on conventional affirmative action, Texas passed the Top Ten Percent Plan in 1997, which guarantees automatic admission to any public university in the state to students in the top decile of their high school class. We estimate the effect of eligibility for automatic admissions on college choice and persistence for students in a diverse urban school district. Regression discontinuity estimates show that eligibility for guaranteed admissions has a substantial impact on enrollments at Texas flagship universities and increases the number of semesters enrolled at flagships. The increase in flagship enrollments appears to displace enrollments in private universities but has no effect on overall college enrollment or the quality of college attended. The effects are concentrated in schools that have high college-sending rates (relative to other schools in the district), suggesting that automatic admissions may have little effect on students in the most disadvantaged schools.

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