bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why do young children die in the UK? A comparison with Sweden
Authors: Tambe Parag , Sammons Helen M , Choonara Imti 
Published: August 2015

BackgroundThe UK has a high child mortality rate, whereas Sweden's is lower (under-five mortality rates of five and three, respectively, in 2011).We therefore wished to compare causes of death in young children aged <5 years in the two countries.MethodsUnder-five mortality data were obtained from the Office of National Statistics for each of the individual countries within the UK for 3 years (2006–2008). Data for Sweden for the same period were obtained from the National Board of Health and Welfare. Causes of death were compared statistically using χ2 test.ResultsThere were a total of 14 104 and 1036 deaths aged <5 years in the UK and Sweden, respectively, between 2006 and 2008. The total numbers of live births during the same period were 2 295 964 and 315 884, respectively. The overall mortality rate in the UK was 614 per 100 000 children which was significantly higher than that in Sweden (328; p<0.001). The mortality rates for the three main causes of death in the UK (prematurity, congenital malformations and infections) were 138.5, 112.1 and 63.9, respectively, per 100 000 children. The mortality rates for the same three conditions in Sweden were 10.1, 88.6 and 34.8, respectively. They were all significantly more frequent in the UK than in Sweden (p<0.001), as were the majority of the disorders. Treatable infections, such as pneumonia, meningitis and septicaemia, in both neonates and young children had significantly higher mortality rates in the UK than in Sweden (p<0.001).ConclusionsIn order to reduce the mortality rate in the UK, we need to try and reduce the causes of prematurity. Additionally, the care of children with treatable infections should be reviewed to understand ways in which to reduce the differences in mortality seen.
Trends in admission and death rates due to paediatric head injury in England, 2000–2011
Authors: Marlow Robin , Mytton Julie , Maconochie Ian K , Taylor Hazel , Lyttle Mark D 
Published: August 2015

BackgroundThe number of children admitted to hospital is increasing year on year, with very short-stay admissions doubling in the last decade. Childhood head injury accounts for half a million emergency department attendances in the UK every year. The National Institute for Health and Care Excellence (NICE) has issued three iterations of evidence-based national guidance for head injury since 2003.ObjectivesTo assess if any changes in the rates of admission, death or causes of head injury could be temporally associated with the introduction of sequential national guidelines by longitudinal analysis of the epidemiology of paediatric head injury admissions in England from 2000 to 2011.MethodsRetrospective analysis of English Hospital Episode Statistics data of children under the age of 16 years old admitted to hospital with the discharge diagnosis of head injury.ResultsThe number of hospital admissions with paediatric head injury in England rose by 10% from 34 150 in 2000 to 37 430 in 2011, with the proportion admitted for less than 1 day rising from 38% to 57%. The main cause of head injury was falls (42–47%). Deaths due to head injury decreased by 52% from 76 in 2000 to 40 in 2011. Road traffic accidents were the main cause of death in the year 2000 (67%) but fell to 40% by 2011. In 2000, children who were admitted or died from head injuries were more than twice as likely to come from the most deprived homes compared with least deprived homes. By 2011, the disparity for risk of admission had narrowed, but no change was seen for risk of death.ConclusionsTemporal relationships exist between implementation of NICE head injury guidance and increased admissions, shorter hospital stay and reduced mortality. The underlying cause of this association is likely to be multifactorial.
After the diabetes care trial ends, now what? A 1-year follow-up of the RxING study
Authors: Al Hamarneh Yazid N , Sauriol Luc , Tsuyuki Ross T 
Published: August 2015

IntroductionThere is strong evidence that pharmacist care improves patients’ glycaemic control. However, the sustainability and durability of such interventions beyond the research period is not known. RxING was the first trial of pharmacist prescribing in diabetes and it showed an improvement in glycated haemoglobin (HbA1c) of 1.8% over 6 months.Objective1° objective: To evaluate glycaemic control in the RxING study patients 12 months after the end of the formal study follow-up. 2° objective: To assess the patients’ risk of cardiovascular events in the next 10 years.MethodsWe contacted the participating pharmacists to check if the patients who participated in the RxING study are still taking insulin, the dose of insulin they are taking, and their HbA1c. There were no mandated follow-up visits with the pharmacist after the study completion.ResultsA total of 100 patients with poorly controlled type 2 diabetes were enrolled in the original RxING study; 93 of them completed the study, while 83 participated in the 12-month follow-up. Seventy-five patients were still taking insulin, with the average dose increasing from 31.1 units (SD 18.4) at study completion to 37.4 units (SD 30.8) (95% CI −13.3 to 0.88, p=0.085). HbA1c was reduced from 9.1% (SD 1) at baseline to 7.3% (SD 0.9) at study completion (95% CI 1.4 to 2, p <0.001), and increased to 8.1% (SD 1.3) 12 months later (95% CI −1.1 to −0.5, p <0.001 vs study completion).ConclusionsTwelve months after completing the intervention, approximately half of the glycaemic control gains were lost. This highlights the importance of structured follow-up with the pharmacist in this patient population.Trial registration numberclinicaltrials.gov; Identifier:NCT01335763.
Safe staffing for nursing in emergency departments: evidence review
Authors: Recio-Saucedo Alejandra , Pope Catherine , Dall'Ora Chiara , Griffiths Peter , Jones Jeremy , Crouch Robert , Drennan Jonathan 
Published: August 2015

ObjectiveGetting staffing levels wrong in hospitals is linked to excess mortality and poor patient experiences but establishing the safe nurse staffing levels in the emergency department (ED) is challenging because patient demand is so variable. This paper reports a review conducted for the National Institute for Health and Care Excellence (NICE) which sought to identify the research evidence to inform UK nursing workforce planning.DesignWe searched 10 electronic databases and relevant websites for English language studies published from 1994. Studies included reported a direct measure of nurse staffing relative to an activity measure (eg, attendances, patient throughput) or an estimate of nurse staffing requirements. Randomised or non-randomised trials, prospective or retrospective observational, cross-sectional or correlational studies, interrupted time-series, and controlled before and after studies were considered.ResultsWe identified 16 132 items via databases and 2193 items through manual and other searching. After title/abstract screening (by one reviewer, checked by a second) 55 studies underwent full assessment by the review team. 18 studies met the inclusion criteria for the NICE review, however 3 simulation studies that reported simulated rather than measured outcomes are not reported here.ConclusionsThe evidence is weak but indicates that levels of nurse staffing in the ED are associated with patients leaving without being seen, ED care time and patient satisfaction. Lower staffing is associated with worse outcomes. There remain significant gaps and in particular a lack of evidence on the impact of staffing on direct patient outcomes and adequate economic analyses to inform decisions about nurse staffing. Given that an association between nurse staffing levels and patient outcomes on inpatient wards has been demonstrated, this gap in the evidence about nurse staffing in EDs needs to be addressed.
Surgical narrowing of the preputial orifice for treatment of recurrent penile prolapse in a degu (Octodon degus)
Authors: Calvo Carrasco Daniel , Abou‐Zahr Tariq 
Published: August 2015

Paraphimosis and penile prolapse have been described in hystricomorph rodents. Commonly the cause is a ring of fur or debris, found at the base of the penis, especially in chinchillas. Other causes described include infection, trauma and irritation. In dogs, preputial reconstruction is used to narrow the preputial orifice. In this case, a degu was seen for recurrent penile prolapse. An excessively wide preputial orifice was the presumptive aetiology. A simple surgical technique for prevention of persistent penile prolapse is described. The technique involves narrowing the preputial orifice without risking iatrogenic damage to the penis or urethra with a simple suture to approximate both sides of the mucosa on the ventral aspect of the distal preputial orifice. No recurrence or micturition problems were seen 18 months following surgery.
A Predictive Model for the Elastic Properties of a Collagen-Hydroxyapatite Porous Scaffold for Multi-Layer Osteochondral Substitutes
Authors: Gastaldi Dario , Parisi Gianluca , Lucchini Riccardo , Contro Roberto , Bignozzi Simone , Ginestra Paola S. , Filardo Giuseppe , Kon Elisaveta , Vena Pasquale 
Published: August 2015

Damaged articular cartilage can be substituted by porous scaffolds exhibiting tailored mechanical properties and with a suited layer-based design. Reliable predictive models are able to provide a structure–property relationship in the design phase is still an open issue which is of prominent relevance. In this paper, a bottom-up homogenization approach is presented having the purpose to determine the elastic properties of each single layer of a osteochondral porous three-layers scaffold: a top cartilage chondral layer and two mineralized layers: an intermediate and a subchondral bone layer. For the cartilage top layer, dry and wet conditions are considered; while, for intermediate and bone layers only dry conditions are considered. The homogenization model is based on the porosity of each layer and on the elastic properties of the constituent materials, i.e., water, hydroxyapatite (HA) and collagen. The elastic moduli predicted for the mineralized layers are compared with available literature results. The model results obtained on the cartilage layers are validated through flat punch micro-indentation tests carried out on wet and dry samples.The results have shown that the elastic modulus of the mineralized layers is of the order of magnitude of few GPa; whereas, the elastic modulus of the cartilage layer which exhibits porosity higher than 90% is as low as 50 kPa and 300 kPa in wet and dry conditions, respectively. The above results show that the knowledge of the mechanical properties of the basic constituents which are universally known and the porosity of the layers are sufficient information to obtain a reliable prediction of the elastic properties of both mineralized layers and of cartilage layers.
The cost-utility of dabigatran etexilate compared with warfarin in treatment and extended anticoagulation of acute VTE in the UK
Authors: Jugrin Anamaria Vera , Ustyugova Anastasia , Urbich Michael , Sunderland Tom , Lamotte Mark 
Published: August 2015

SummaryThe relative efficacy and safety of dabigatran etexilate and warfarin have been evaluated in two head-to-head, phase III, treatment of acute venous thromboembolism (VTE) trials, and one extended prophylaxis trial, in patients with high risk of recurrent VTE. Dabigatran etexilate demonstrated similar efficacy to warfarin, and was associated with a reduced risk of major or clinically relevant bleeds. Based on results of these trials, and real-life disease prognosis following discontinuation of anticoagulation treatment, we evaluated the cost-utility of dabigatran etexilate compared with warfarin in six months anticoagulation, and in extended, up to 24 months anticoagulation, in patients with acute VTE, acute deep-vein thrombosis (DVT) or acute, symptomatic, pulmonary embolism (PE). Costs were analysed from the perspective of the National Health Services (NHS) and Public Social Services (PSS) in England and Wales. Outcomes were quantified in quality-adjusted life years (QALY). The estimated incremental, lifetime cost/QALY gain following acute, symptomatic VTE (DVT or PE) was £1,252/QALY when dabigatran etexilate or warfarin were administered for up to six months treatment. In treatment of acute, symptomatic PE and in DVT respective ratios were £1,767/QALY and £1,075/QALY. In extended, up to 24 months anticoagulation, dabigatran etexilate projected costs/QALY of £8,242/QALY, when compared with warfarin. Results obtained herein were robust across a number of sensitivity analyses and suggest dabigatran etexilate to be a cost-effective alternative to current standard of care when evaluated in six months treatment and in extended anticoagulation following acute VTE (DVT and/or PE).
Cell painting with an engineered EPCR to augment the protein C system
Authors: Bouwens Eveline A. M. , Stavenuiter Fabian , Mosnier Laurent O. 
Published: August 2015

SummaryThe protein C (PC) system conveys beneficial anticoagulant and cytoprotective effects in numerous in vivo disease models. The endothelial protein C receptor (EPCR) plays a central role in these pathways as cofactor for PC activation and by enhancing activated protein C (APC)-mediated protease-activated receptor (PAR) activation. During inflammatory disease, expression of EPCR on cell membranes is often diminished thereby limiting PC activation and APC’s effects on cells. Here a caveolae-targeting glycosylphosphatidylinositol (GPI)-anchored EPCR (EPCR-GPI) was engineered to restore EPCR’s bioavailability via “cell painting.” The painting efficiency of EPCR-GPI on EPCR-depleted endothelial cells was time- and dose-dependent. The EPCR-GPI bioavailability after painting was long lasting since EPCR surface levels reached 400 % of wild-type cells after 2 hours and remained > 200 % for 24 hours. EPCR-GPI painting conveyed APC binding to EPCR-depleted endothelial cells where EPCR was lost due to shedding or shRNA. EPCR painting normalised PC activation on EPCR-depleted cells indicating that EPCR-GPI is functional active on painted cells. Caveolin-1 lipid rafts were enriched in EPCR after painting due to the GPI-anchor targeting caveolae. Accordingly, EPCR painting supported PAR1 and PAR3 cleavage by APC and augmented PAR1-dependent Akt phosphorylation by APC. Thus, EPCR-GPI painting achieved physiological relevant surface levels on endothelial cells, restored APC binding to EPCR-depleted cells, supported PC activation, and enhanced APC-mediated PAR cleavage and cytoprotective signalling. Therefore, EPCRGPI provides a novel tool to restore the bioavailability and functionality of EPCR on EPCR- depleted and -deficient cells.
Gallstone Disease and the Risk of Ischemic Heart Disease
Authors: Lv Jun , Qi Lu , Yu Canqing , Guo Yu , Bian Zheng , Chen Yiping , Yang Ling , Shen Jie , Wang Shanqing , Li Mingqiang , Liu Yongmei , Zhang Libo , Chen Junshi , Chen Zhengming , Li Liming 
Published: August 2015

Objective—
Gallstone disease (GSD) is related to multiple cardiovascular risk factors; the present study was to prospectively examine the association between GSD and ischemic heart disease (IHD).

Approach and Results—

We examined the association of GSD with IHD among 199 292 men and 288 081 women aged 30−79 years in the China Kadoorie Biobank study. Participants with cancer, heart disease, and stroke at baseline were excluded. Cox proportional hazards regression model was used to estimate the association of GSD with IHD. The prevalence of self-reported GSD was 3.7% in men and 7.3% in women at baseline. During 3 431 124 person-years of follow-up between 2004 and 2013 (median, 7.2 years), we documented 10 245 incident IHD cases in men and 14 714 in women. As compared with men without GSD at baseline, the multivariate-adjusted hazard ratio for IHD was 1.11 (95% confidence interval, 1.02−1.22) for men with GSD; the respective hazard ratio was 1.27 (95% confidence interval, 1.20−1.34) in women and 1.23 (95% confidence interval, 1.17−1.28) in the whole cohort. The sex difference in IHD risk associated with GSD was statistically significant (
P
=0.009 for interaction with sex). In addition, we found that the association between GSD and IHD was stronger in nonhypertensive than in hypertensive women (
P
<0.001 for interaction).

Conclusions—
In this large prospective study, the presence of GSD was associated with an increased risk of incident IHD, independent of other risk factors of cardiovascular disease. Our findings suggest novel prevention strategy to mitigate heart disease through improvement of gastrointestinal health.
Differential Genetic Effects on Statin-Induced Changes Across Low-Density Lipoprotein–Related Measures
Authors: Chu Audrey Y. , Giulianini Franco , Barratt Bryan J. , Ding Bo , Nyberg Fredrik , Mora Samia , Ridker Paul M. , Chasman Daniel I. 
Published: August 2015

Background—
Statin therapy influences not only low-density lipoprotein (LDL) cholesterol levels but also LDL-related biomarkers, including non–high-density lipoprotein cholesterol (non–HDL-C), apolipoprotein B, total number of LDL particles, and mean LDL particle size. Recent studies have identified many genetic loci influencing circulating lipid levels and statin-induced LDL cholesterol reduction. However, it is unknown how these genetic variants influence statin-induced changes in LDL subfractions and non–HDL-C.

Methods and Results—
One hundred sixty candidate single-nucleotide polymorphisms for effects on circulating lipid levels or statin-induced LDL-cholesterol lowering were tested for association with response of LDL subfractions and non–HDL-C to rosuvastatin or placebo for 1 year among 7046 participants from the Justification for Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial. Of the 51 single-nucleotide polymorphisms associated with statin response for ≥1 of the LDL subfractions or non–HDL-C, 20 single-nucleotide polymorphisms could be clustered according to effects predominantly on LDL particle size, predominantly on LDL particle number, and on apolipoprotein B but not on LDL cholesterol or non–HDL-C.

Conclusions—
These differential associations point to pathways of LDL response to statin therapy and possibly to mechanisms of statin-dependent cardiovascular disease risk reduction.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00239681.
Effect of High‐Calcium Diet on Coronary Artery Disease in Ossabaw Miniature Swine With Metabolic Syndrome
Authors: Phillips‐Eakley Alyssa K. , McKenney‐Drake Mikaela L. , Bahls Martin , Newcomer Sean C. , Radcliffe John S. , Wastney Meryl E. , Van Alstine William G. , Jackson George , Alloosh Mouhamad , Martin Berdine R. , Sturek Michael , Weaver Connie M. 
Published: August 2015

Background
Calcium is a shortfall essential nutrient that has been a mainstay of osteoporosis management. Recent and limited findings have prompted concern about the contribution of calcium supplementation to cardiovascular risk. A proposed mechanism is through the acceleration of coronary artery calcification. Determining causality between calcium intake and coronary artery calcification has been hindered by a lack of sensitive methodology to monitor early vascular calcium accumulation. The primary study aim was to assess the impact of high calcium intake on coronary artery calcification using innovative calcium tracer kinetic modeling in Ossabaw swine with diet‐induced metabolic syndrome. Secondary end points (in vitro wire myography, histopathology, intravascular ultrasound) assessed coronary disease.

Methods and Results

Pigs (n=24; aged ≈15 months) were fed an atherogenic diet with adequate calcium (0.33% by weight) or high calcium (1.90% from calcium carbonate or dairy) for 6 months. Following 5 months of feeding, all pigs were dosed intravenously with
41
Ca, a rare isotope that can be measured in serum and tissues at a sensitivity of 10
−18
mol/L by accelerator mass spectrometry. Kinetic modeling evaluated early coronary artery calcification using
41
Ca values measured in serial blood samples (collected over 27 days) and coronary artery samples obtained at sacrifice. Serum disappearance of
41
Ca and total coronary artery
41
Ca accumulation did not differ among groups. Secondary end points demonstrated no treatment differences in coronary artery disease or function.

Conclusion
There was no detectable effect of high calcium diets (from dairy or calcium carbonate) on coronary artery calcium deposition in metabolic syndrome swine.
Point-of-Care Testing of Coagulation in Patients Treated With Non–Vitamin K Antagonist Oral Anticoagulants
Authors: Ebner Matthias , Peter Andreas , Spencer Charlotte , Härtig Florian , Birschmann Ingvild , Kuhn Joachim , Wolf Martin , Winter Natalie , Russo Francesca , Zuern Christine S. , Blumenstock Gunnar , Ziemann Ulf , Poli Sven 
Published: August 2015

Background and Purpose—
Specific coagulation assays for non–vitamin K antagonist oral anticoagulants (NOAC) are relatively slow and often lack availability. Although specific point-of-care tests (POCT) are currently not available, NOAC are known to affect established coagulation POCT. This study aimed at determining the diagnostic accuracy of the CoaguChek POCT to rule out relevant concentrations of rivaroxaban, apixaban, and dabigatran in real-life patients.

Methods—
We consecutively enrolled 60 ischemic stroke patients newly started on NOAC treatment and obtained blood samples at 6 prespecified time points. Samples were tested using the CoaguChek POCT, laboratory-based coagulation assays (prothrombin time and activated partial thromboplastin time, anti-Xa test and Hemoclot), and liquid chromatography–tandem mass spectrometry for direct determination of NOAC concentrations.

Results—

Three hundred fifty-six blood samples were collected. The CoaguChek POCT strongly correlated (
r
=0.82
P
<0.001) with rivaroxaban concentrations but did not accurately detect dabigatran or apixaban. If used to estimate the presence of low rivaroxaban concentrations, POCT was superior to predictions based on normal prothrombin time and activated partial thromboplastin time values even if sensitive reagents were used. POCT-results ≤1.0 predicted rivaroxaban concentrations <32 and <100 ng/mL with a specificity of 90% and 96%, respectively.

Conclusions—
If anti-Xa test is not available, we propose the use of the CoaguChek POCT to guide thrombolysis decisions after individual risk assessment in rivaroxaban-treated patients having acute ischemic stroke.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02371044.