bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of Optic Nerve Sheath Diameter Measured on Initial Brain Computed Tomography as an Early Neurologic Outcome Predictor After Cardiac Arrest
Authors: Hwan Kim Yong , Ho Lee Jun , Kun Hong Chong , Won Cho Kwang , Hoon Yeo Jung , Ju Kang Mun , Weon Kim Yang , Yul Lee Kyoung , Joo Kim Jin , Youn Hwang Seong 
Published: October 2014

AbstractObjectivesFew parameters are available to predict neurologic outcome of post–cardiac arrest patients in the early stage of treatment. Optic nerve sheath diameter (ONSD) has been used to indirectly assess intracranial pressure. This study evaluated whether ONSD, an additional parameter in initial brain computed tomography (CT) scans, can be an early predictor of neurologic outcome in post–cardiac arrest patients.MethodsA total of 112 cardiac arrest patients between November 2012 and October 2013 were identified. Ninety‐eight comatose cardiac arrest patients were evaluated with brain CT. Of these patients, after exclusion of patients whose brain CT scans were done too late or with poor baseline neurology (Cerebral Performance Category [CPC] ≥ 3), 91 patients were included for this study. The parameters of initial brain CT, i.e., gray matter‐to‐white matter ratio (GWR) and ONSD, were measured after clinical care as part of a retrospective reanalysis of images. ONSD on brain CT was bilaterally measured 3 mm behind the eyeball at fixed window width and level and averaged to yield the mean value. The performance of ONSD to predict poor neurologic outcome (CPC = 3 to 5) was analyzed using multiple logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and cross‐tabulations.ResultsTwenty‐three patients showed good neurologic outcomes at hospital discharge. Mean (±SD) ONSD was 5.6 (±0.3) mm in the good outcome group versus 6.3 (±0.5) mm in the poor outcome group (p < 0.001). After basic clinical covariates were controlled for, i.e., age, Glasgow Coma Scale (GCS) score (3 vs. 4–15), and time from collapse to return of spontaneous circulation (ROSC), ONSD (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1 to 3.9) and GWR (OR = 0.6; 95% CI = 0.4 to 0.9) were found to be significant factors for predicting poor neurologic outcome. ROC curve analysis showed that ONSD and GWR had areas under the ROC curve of 0.931 (95% CI = 0.87 to 0.98) and 0.922 (95% CI = 0.86 to 0.97), respectively. Combining the cutoff values of ONSD (6.21 mm, sensitivity = 56%; 95% CI = 43% to 68%) and GWR (1.23, sensitivity = 84%; 95% CI = 73% to 92%) to have 100% specificities, the sensitivity was improved to 92% (95% CI = 84% to 98%). Intrarater and interrater intraclass correlation coefficients between the investigators measuring ONSD were 0.888 and 0.833, respectively.ConclusionsOptic nerve sheath diameter on initial brain CT correlated closely with the neurologic outcome of hypoxic ischemic encephalopathy and had good reliability. Additional prospective work may be justified evaluating the standardization and diagnostic performance in real time use as a predictive tool for neurologic outcome following cardiac arrest.
Using Publication Metrics to Highlight Academic Productivity and Research Impact
Authors: Carpenter Christopher R. , Cone David C. , Sarli Cathy C. 
Published: October 2014

AbstractThis article provides a broad overview of widely available measures of academic productivity and impact using publication data and highlights uses of these metrics for various purposes. Metrics based on publication data include measures such as number of publications, number of citations, the journal impact factor score, and the h‐index, as well as emerging metrics based on document‐level metrics. Publication metrics can be used for a variety of purposes for tenure and promotion, grant applications and renewal reports, benchmarking, recruiting efforts, and administrative purposes for departmental or university performance reports. The authors also highlight practical applications of measuring and reporting academic productivity and impact to emphasize and promote individual investigators, grant applications, or department output.
Hospital and Emergency Department Factors Associated With Variations in Missed Diagnosis and Costs for Patients Age 65 Years and Older With Acute Myocardial Infarction Who Present to Emergency Departments
Authors: Wilson Michael , Welch Jonathan , Schuur Jeremiah , O'Laughlin Kelli , Cutler David 
Published: October 2014

AbstractObjectivesThe objective was to measure the variation in missed diagnosis and costs of care for older acute myocardial infarction (AMI) patients presenting to emergency departments (EDs) and to identify the hospital and ED characteristics associated with this variation.MethodsUsing 2004–2005 Medicare inpatient and outpatient records, the authors identified a cohort of AMI patients age 65 years and older who presented to the ED for initial care. The primary outcome was missed diagnosis of AMI, i.e., AMI hospital admission within 7 days of an ED discharge for a condition suggestive of cardiac ischemia. Costs were defined as Medicare hospital payments for all services associated with and immediately resulting from the ED evaluation. The effect of ED and hospital characteristics on quality and costs were estimated using multilevel models with hospital random effects.ResultsThere were 371,638 AMI patients age 65 and older included in the study, of whom 4,707 were discharged home from their initial ED visits and subsequently admitted to the hospital. The median unadjusted hospital‐level missed diagnosis percentage was 0.52% (interquartile range [IQR] = 0 to 3.45%). ED characteristics protective of adverse outcomes include higher ED chest pain acuity (adjusted odds ratio [aOR] = 0.23, 99% confidence interval [CI] = 0.19 to 0.27) and American Board of Emergency Medicine (ABEM) certification (aOR = 0.60, 99% CI = 0.50 to 0.73). Protective hospital characteristics include larger hospital size (aOR = 0.46, 99% CI = 0.37 to 0.57) and academic status (aOR = 0.74, 99% CI = 0.58 to 0.94). All of these characteristics were associated with higher costs as well.ConclusionsThe proportion of missed AMI diagnoses and cost of care for patients age 65 years and older presenting to EDs with AMI varies across hospitals. Hospitals with more board‐certified emergency physicians (EPs) and higher average acuity are associated with significantly higher quality. All hospital characteristics associated with better ED outcomes are associated with higher costs.
Association of Medicare and Medicaid Insurance With Increasing Primary Care–treatable Emergency Department Visits in the United States
Authors: Pukurdpol Paul , Wiler Jennifer L. , Hsia Renee Y. , Ginde Adit A. 
Published: October 2014

AbstractObjectivesPolicymakers have increasingly focused on emergency department (ED) utilization for primary care–treatable conditions as a potentially avoidable source of rising health care costs. The objective was to determine the association of health insurance type and arrival time, as indicators of limited availability of primary care, with primary care–treatable classification of ED visits.MethodsThis was a retrospective analysis of a nationally representative sample of 241,167 ED visits from the 1997 to 2009 National Hospital Ambulatory Medical Care Surveys (NHAMCS). Probabilities of ED visits being primary care–treatable were categorized based on the primary International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) code. The association of health insurance type and arrival time was determined with the average probability of the primary diagnosis being primary care–treatable using multivariable linear regression.ResultsCompared to privately insured visits, Medicaid visits had a 1.7% (95% confidence interval [CI] = 1.2% to 2.2%) and uninsured visits a 2.4% (95% CI = 1.9% to 3.0%) higher probability of primary care–treatable classification, while Medicare visits had a 1.4% (95% CI = 0.7% to 2.0%) lower probability during the overall study period. Compared to business hours, weekend visits had a 1.5% (95% CI = 1.0% to 2.0%) higher probability of being primary care–treatable during the overall study period. From 1997 to 2009, the overall adjusted probability of ED visits being primary care–treatable increased by 0.19% (95% CI = 0.10 to 0.28) per year. This probability increased at a rate of 0.52% per year for Medicare visits (95% CI = 0.38% to 0.65%), more than double that of Medicaid visits (0.25% per year, 95% CI = 0.13% to 0.37%). By contrast, there was no significant change from 1997 to 2009 in the average probability of ED visits being primary care–treatable by privately insured (0.05% per year, 95% CI = –0.07 to 0.16) or uninsured (0.00% per year, 95% CI = –0.12 to 0.13) individuals.ConclusionsThese findings add to prior work that implicates insurance type and arrival time in the variation of primary care–treatable ED visits. Although primary care–treatable classification of ED visits was most associated with uninsured or Medicaid visits, this classification increased most rapidly among Medicare visits during the study period.
A short dermoscopy training increases diagnostic performance in both inexperienced and experienced dermatologists
Authors: Chevolet Ines , Hoorens Isabelle , Janssens Astrid , Speeckaert Reinhart , Van Geel Nanja , Van Maele George , Vossaert Katrien , Brochez Lieve 
Published: October 2014

AbstractDermoscopy is a clinical tool known to improve the early detection of melanoma and other malignancies of the skin, but only for experienced users. Our aim was to evaluate the effect of short (3‐hour) dermoscopy training sessions in both residents and practicing dermatologists. The training improved diagnostic accuracy for both melanocytic and nonmelanocytic neoplasms of the skin and the observed effect was the highest for residents but was also significant for more experienced practicing dermatologists.
Familial testicular germ cell tumors (FTGCT) – overview of a multidisciplinary etiologic study
Authors: Greene M. H. , Mai P. L. , Loud J. T. , Pathak A. , Peters J. A. , Mirabello L. , McMaster M. L. , Rosenberg P. , Stewart D. R. 
Published: October 2014

SummaryThis Review summarizes the cumulative results of the National Cancer Institute Clinical Genetics Branch Multidisciplinary Etiologic Study of Familial Testicular Germ Cell Tumors (FTGCT). Initiated 12 years ago, this protocol enrolled 724 subjects from 147 unrelated families with either ≥2 affected men (n = 90) with TGCT or a proband with bilateral TGCT and a negative family history for this cancer (n = 57). Data were collected directly from 162 subjects evaluated at the NIH Clinical Center, and 562 subjects provided information from their home communities (Field Cohort). The primary study aims included (i) ascertaining, enrolling eligible FTGCT kindred, (ii) characterizing the clinical phenotype of multiple‐case families, (iii) identifying the underlying genetic mechanism for TGCT susceptibility in families, (iv) evaluating counseling, psychosocial, and behavioral issues resulting from membership in an FTGCT family, and (v) creating an annotated biospecimen repository to permit subsequent translational research studies. Noteworthy findings include (i) documenting the epidemiologic similarities between familial and sporadic TGCT, (ii) demonstrating significantly younger age‐at‐diagnosis for familial vs. sporadic TGCT, (iii) absence of a dysmorphic phenotype in affected family members, (iv) shifting the focus of gene discovery from a search for rare, highly penetrant susceptibility variants to the hypothesis that multiple, more common, lower penetrance genes underlie TGCT genetic risk, (v) implicating testicular microlithiasis in FTGCT risk, and (vi) observing that aberrant methylation may contribute to FTGCT risk. A clinically based, biospecimen‐intensive, multidisciplinary research strategy has provided novel, valuable insights into the etiology of FTGCT, and created a research resource which will support FTGCT clinical and laboratory studies for years to come.
Allogeneic haematopoietic stem cell transplantation for infant acute lymphoblastic leukaemia with KMT2A (MLL) rearrangements: a retrospective study from the paediatric acute lymphoblastic leukaemia working group of the Japan Society for Haematopoietic Cell Transplantation
Authors: Kato Motohiro , Hasegawa Daiichiro , Koh Katsuyoshi , Kato Keisuke , Takita Junko , Inagaki Jiro , Yabe Hiromasa , Goto Hiroaki , Adachi Souichi , Hayakawa Akira , Takeshita Yasufumi , Sawada Akihisa , Atsuta Yoshiko , Kato Koji 
Published: October 2014

SummaryAllogeneic haematopoietic stem cell transplantation (HSCT) is still considered to play an important role as a consolidation therapy for high‐risk infants with acute lymphoblastic leukaemia (ALL). Here, we retrospectively analysed outcomes of HSCT in infants with ALL based on nationwide registry data of the Japan Society for Haematopoietic Cell Transplantation. A total of 132 allogeneic HSCT for infant ALL with KMT2A (MLL) gene rearrangements, which were performed in first complete remission (CR1), were analysed. The 5‐year overall survival rate after transplantation was 67·4 ± 4·5%). Although recent HSCT (after 2004) had a trend toward better survival, no statistical correlation was observed between outcomes and each factor, including age at diagnosis, initial leucocyte count, cytogenetics, donor types or conditioning of HSCT. Myeloablative conditioning with total body irradiation did not provide a better survival (60·7 ± 9·2%) over that with busulfan (BU; 67·8 ± 5·7%). Two of the 28 patients treated with irradiation, but none of the 90 BU‐treated patients, developed a secondary malignant neoplasm. In conclusion, allogeneic HSCT using BU was a valuable option for infant ALL with KMT2A rearrangements in CR1.
Thalidomide‐prednisone maintenance following autologous stem cell transplant for Multiple Myeloma: effect on thrombin generation and procoagulant markers in NCIC CTG MY.10
Authors: Kovacs Michael J. , Davies Gwynivere A. , Chapman Judy‐Anne W. , Bahlis Nizar , Voralia Michael , Roy Jean , Kouroukis C. Tom , Chen Christine , Belch Andrew , Reece Donna , Zhu Liting , Meyer Ralph M. , Shepherd Lois , Stewart Keith A. 
Published: October 2014

SummaryVenous thromboembolism (VTE) has an increased incidence in patients with multiple myeloma (MM), especially during chemotherapy. Mechanisms including upregulation of procoagulant factors, such as factor VIII, have been postulated. The National Cancer Institute of Canada Clinical Trials Group MY.10 phase III clinical trial compared thalidomide‐prednisone to observation for 332 patients with MM post‐autologous stem cell transplantation (ASCT), with a primary endpoint of overall survival and various secondary endpoints including the incidence of VTE. One hundred and fifty‐three patients had biomarker data, including D‐dimer, factor VIII and thrombin anti‐thrombin (TAT) levels collected post‐ASCT at baseline and 2 months after intervention investigating in‐vivo thrombin generation. Differences between the time‐points included a significant reduction over time in D‐dimer, factor VIII and TAT levels in the observation group and sustained elevation of D‐dimer, significant increase in factor VIII and reduction in TAT levels in the thalidomide‐prednisone group. Eight VTE events were reported in this subset of study patients, all in the thalidomide‐prednisone arm, with a trend to increase in D‐dimer levels over time in those patients with VTE. This study provides physiological and clinical evidence for an increased risk of VTE associated with thalidomide‐prednisone maintenance therapy post‐ASCT for MM.
The interactive effects of mortality salience and political orientation on moral judgments
Authors: Bassett Jonathan F. , Van Tongeren Daryl R. , Green Jeffrey D. , Sonntag Michael E. , Kilpatrick Harrison 
Published: October 2014

In two studies, the authors examined how threat induced by reminders of mortality would moderate the effect of political orientation on moral judgments. In Study 1, university students (n = 113) categorized their political orientation, were randomly assigned to complete a fear of death or public speaking scale, and then completed a moral foundations questionnaire. In Study 2, university students (n = 123) rated their political orientations, were randomly assigned to write about their own death or dental pain, and then completed a moral foundations questionnaire. In both studies, mortality salience intensified the moral differences between liberals and conservatives. These findings were primarily the result of the reactions of liberals, who responded to mortality salience with increased ratings of the fairness/cheating virtue in Study 1 and the care/harm virtue in Study 2.
Extending the translational potential of targeting NO/cGMP‐regulated pathways in the CVS
Authors: Papapetropoulos Andreas , Hobbs Adrian J , Topouzis Stavros 
Published: October 2014

The discovery of NO as both an endogenous signalling molecule and as a mediator of the cardiovascular effects of organic nitrates was acknowledged in 1998 by the Nobel Prize in Physiology/Medicine. The characterization of its downstream signalling, mediated through stimulation of soluble GC (sGC) and cGMP generation, initiated significant translational interest, but until recently this was almost exclusively embodied by the use of PDE5 inhibitors in erectile dysfunction. Since then, research progress in two areas has contributed to an impressive expansion of the therapeutic targeting of the NO‐sGC‐cGMP axis: first, an increased understanding of the molecular events operating within this complex pathway and second, a better insight into its dys‐regulation and uncoupling in human disease. Already‐approved PDE5 inhibitors and novel, first‐in‐class molecules, which up‐regulate the activity of sGC independently of NO and/or of the enzyme's haem prosthetic group, are undergoing clinical evaluation to treat pulmonary hypertension and myocardial failure. These molecules, as well as combinations or second‐generation compounds, are also being assessed in additional experimental disease models and in patients in a wide spectrum of novel indications, such as endotoxic shock, diabetic cardiomyopathy and Becker's muscular dystrophy. There is well‐founded optimism that the modulation of the NO‐sGC‐cGMP pathway will sustain the development of an increasing number of successful clinical candidates for years to come.Linked ArticlesThis article is part of a themed section on Pharmacology of the Gasotransmitters. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-6
Tool Using
Authors: Kahrs Björn A. , Lockman Jeffrey J. 
Published: October 2014

AbstractResearch on the development of tool use in children has often emphasized the cognitive bases of this achievement, focusing on the choice of an artifact, but has largely neglected its motor foundations. However, research across diverse fields, from evolutionary anthropology to cognitive neuroscience, converges on the idea that the actions that embody tool use are also critical for understanding its ontogenesis and phylogenesis. In this article, we highlight findings across these fields to show how a deeper examination of the act of tool using can inform developmental accounts and illuminate what makes human tool use unique.
Randomized controlled trial of asthma risk with paracetamol use in infancy – a feasibility study
Authors: Riley J. , Braithwaite I. , Shirtcliffe P. , Caswell‐Smith R. , Hunt A. , Bowden V. , Power S. , Stanley T. , Crane J. , Ingham T. , Weatherall M. , Mitchell E. A. , Beasley R. 
Published: October 2014

SummaryBackgroundThere is non‐experimental evidence that paracetamol (acetaminophen) use may increase the risk of developing asthma. However, numerous methodological issues need to be resolved before undertaking a randomized controlled trial to investigate this hypothesis.ObjectiveTo establish the feasibility of a randomized controlled trial of liberal paracetamol as usually given by parents/guardians vs. a comparator (restricted paracetamol in accordance with WHO guidelines, ibuprofen or placebo), and childhood asthma risk.MethodsQuestionnaires were completed by parents/guardians of infants admitted to Wellington Hospital with bronchiolitis to assess views about comparator treatments. Subsequently, infants of parents/guardians who provided informed consent were randomized to restricted or liberal paracetamol use for 3 months with paracetamol use recorded.ResultsOf 120 eligible participants, 72 (60%) parents/guardians completed the questionnaire. Ibuprofen, restricted paracetamol and placebo were acceptable to 42 (58%), 29 (40%) and 9 (12%) parents/guardians, respectively. 36 (30%) infants were randomized to restricted or liberal paracetamol. Paracetamol use was greater for the liberal vs. restricted group for reported [Hodges–Lehmann estimator of difference 0.94 mg/kg/day (95% CI 0.2–3.52), P = 0.02] and measured use [Hodges–Lehmann estimator of difference 2.11 mg/kg/day (95% CI 0.9–4.18), P = 0.004]. The median reported and measured use of paracetamol was 2.0‐fold and 3.5‐fold greater in the liberal vs. restricted group.Conclusions and Clinical RelevanceAlthough separation in paracetamol dosing is likely to be achieved with a liberal vs. restricted paracetamol regime, ibuprofen is the preferred comparator treatment in the proposed RCT of paracetamol use and risk of asthma in childhood.
Local and systemic effects of cat allergen nasal provocation
Authors: Scadding G. W. , Eifan A. , Penagos M. , Dumitru A. , Switzer A. , McMahon O. , Phippard D. , Togias A. , Durham S. R. , Shamji M. H. 
Published: October 2014

SummaryBackgroundCat allergen is widely distributed in homes and schools; allergic sensitization is common.ObjectiveTo develop a model of cat allergen nasal challenge to establish dose–response and time–course characteristics and investigate local and systemic biomarkers of allergic inflammation.MethodsNineteen cat‐allergic individuals underwent titrated nasal challenge, range 0.243 to 14.6 μg/mL Fel d1, and matched diluent‐only provocation. Clinical response to 8 h was assessed by symptom scores and peak nasal inspiratory flow (PNIF). Nasal fluid was collected using polyurethane sponges and analysed by ImmunoCAP and multiplex assays. Whole blood flow cytometry for basophil surface CD63, CD107a, and CD203c was carried out at baseline and 6 h post‐challenge.ResultsA dose–response to allergen was seen in symptom scores and PNIF, maximal at 10 000 BU/mL (4.87 μg/mL Fel d1), P < 0.0001 vs. diluent. Nasal fluid tryptase was elevated at 5 min after challenge (P < 0.05 vs. diluent); eotaxin, IL‐4, ‐5, ‐9, and ‐13 were increased at 8 h (P < 0.05 to P < 0.0001 vs. diluent); TSLP was undetectable; IL‐10, IL‐17A, and IL‐33 were unchanged compared to diluent challenge. Nasal fluid IL‐5 and IL‐13 correlated inversely with PNIF after challenge (IL‐5, r = −0.79, P < 0.0001; IL‐13, r = −0.60, P = 0.006). Surface expression of CD63 and CD107a was greater at 6 h than at baseline, both in the presence (both P < 0.05) and absence (CD63, P < 0.01; CD107a, P < 0.05) of in vitro allergen stimulation; no changes were seen on diluent challenge day.ConclusionsCat allergen nasal challenge produces local and systemic Th2‐driven inflammatory responses and has potential as a surrogate outcome measure in clinical trials.