bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased erythrocytic osmotic fragility in anemic domestic shorthair and purebred cats
Authors: Tritschler Claudia , Mizukami Keijiro , Raj Karthik , Giger Urs 
Published: May 2015

Objectives Increased erythrocytic osmotic fragility and splenomegaly have been reported in anemic Abyssinian and Somali cats. Here we report on this condition in anemic domestic shorthair cats and two other breeds, and describe common features of the clinicopathological profiles, management and outcomes. Methods Anemic cats, other than Abyssinians and Somalis, were included. The erythrocytic osmotic fragility test was performed, known causes of anemia were excluded, the illness was followed and medical records were reviewed. Results Twelve neutered cats were first found to be anemic between 0.5 and 9.0 years of age. Pallor, lethargy, inappetence, pica, weight loss and splenomegaly were commonly observed. A moderate-to-severe macrocytic and hypochromic anemia with variable regeneration was noted. Infectious disease screening, direct Coombs’ and pyruvate kinase DNA mutation test results were negative. Freshly drawn blood did not appear hemolysed but became progressively lysed during storage at 4°C. The sigmoid osmotic fragility curves were moderately to severely right shifted, indicating erythrocytic fragility at 20°C. Cross-correction studies indicated an intrinsic red cell effect rather than plasma effect. Most cats were treated with immunosuppressive doses of prednisolone and doxycycline, with variable responses. Five cats with recurrent or persistent anemia responded well to splenectomy. However, two had occasional recurrence of severe anemia: one was found to be Bartonella vinsonii-positive during one episode and responded to azithromycin and prednisolone, while the other cat had two episodes of severe anemia of unknown cause. Finally, six cats were euthanized within 1 month and 7 years after initial presentation. Histopathology of six spleens revealed mainly congestion and extramedullary hematopoiesis. Conclusions and relevance Similarly to Abyssinian and Somali cats, domestic shorthair and cats of other breeds can also develop severe erythrocytic osmotic fragility with anemia and splenomegaly, which should be considered as a differential diagnosis in anemic cats.
Using Storytelling Theatrics for Leadership Training
Authors: Boje David M. , Rosile Grace Ann , Saylors Jillian , Saylors Rohny 
Published: May 2015

The Problem How can leaders learn to use power in ways that minimize oppression and resistance, and instead are more liberating? As perceived oppression leads to resistance, leaders who are untrained in these power dynamics may enact oppressive behaviors and trigger resistance without awareness or intention to do so. The Solution This article describes a leadership training process we call storytelling theatrics. These storytelling theatrics formats explore power dynamics in multi-voiced scenarios that incorporate many perspectives. This method gives participants a voice in their own learning and creates actors instead of auditors. It brings hidden sources of oppression to center stage, to fully explore more liberating possibilities for both followers and leaders. Leaders can minimize repression and resistance if they understand, uncover, and confront these expressions of power. The Stakeholders Organizational leaders as well as their followers are stakeholders in this embodied theatrical training. This intervention creates benefit for both leaders and followers, because both are potentially oppressed by power dynamics.
Use of an Anastomotic Coupling Device for the Creation of Spliced Autogenous Grafts in Lower Extremity Revascularization
Authors: Golas Alyssa R. , Jacoby Adam , Karwowski John K. , Spector Jason A. 
Published: May 2015

Introduction: Despite a recent rise in popularity of endovascular techniques, open bypass surgery is still required for treating many lower extremity vascular lesions. Greater saphenous vein (GSV) of adequate length and caliber for successful infrainguinal lower extremity bypass is unavailable in 15% to 45% of patients. To overcome limitations imposed by absent vein due to prior use, short vessel length, or sclerotic segments, both alternate (ie, basilic and cephalic) and GSV conduits may be “spliced” together in series via venovenostomy. Although vascular surgeons typically perform a hand-sewn venovenostomy, device-based venous coupling has been performed by plastic surgeons for many years. We therefore sought to review our experience with venous coupling for segmental lower extremity bypass graft assembly. Methods: A retrospective review was performed in all patients who underwent lower extremity revascularization using autogenous vein grafts spliced together with the Synovis (Birmingham, Alabama) anastomotic coupler at a single institution over a 5-year period. Results: The anastomotic coupler device was used on 5 patients for 7 venovenostomies. The mean age of patients was 66 years, and the mean follow-up period was 751 days. Two patients were lost to follow-up, while 2 other patients died of causes unrelated to their lower extremity bypass. The average time to perform venovenostomy was 3 minutes. Three patients developed stenosis of their composite graft at a site other than the venovenostomy, who were successfully treated with either angioplasty or bypass revision. One-year primary and primary-assisted patency rates were 50% and 75%, respectively. Conclusions: Given the known benefits of the anastomotic coupling device when used for venous anastomoses in microsurgical reconstruction, transition of this device to the vascular surgery realm represents a logical progression. Although small, our series demonstrates that the anastomotic coupler can successfully be used for the formation of spliced autogenous grafts for lower extremity revascularization in the absence of adequate GSV.
Fully Implantable Arterial Blood Glucose Device for Metabolic Research Applications in Rats for Two Months
Authors: Brockway Robert , Tiesma Scott , Bogie Heather , White Kimberly , Fine Megan , O’Farrell Libbey , Michael Mervyn , Cox Amy , Coskun Tamer 
Published: May 2015

Background: Chronic continuous glucose monitoring options for animal research have been very limited due to various technical and biological challenges. We provide an evaluation of a novel telemetry device for continuous monitoring of temperature, activity, and plasma glucose levels in the arterial blood of rats for up to 2 months. Methods: In vivo testing in rats including oral glucose tolerance tests (OGTTs) and intraperitoneal glucose tolerance tests (IPGTTs) and ex vivo waterbath testing were performed to evaluate acute and chronic sensor performance. Animal studies were in accordance with the guidelines for the care and use of laboratory animals and approved by the corresponding animal care and use committees (Data Sciences International, Eli Lilly). Results: Results demonstrated the ability to record continuous measurements for 75 days or longer. Bench testing demonstrated a high degree of linearity over a range of 20-850 mg/dL with R2 = .998 for linear fit and .999 for second order fit (n = 8 sensors). Evaluation of 6 rats over 28 days with 52 daily and OGTT test strip measurements each resulted in mean error of 3.8% and mean absolute relative difference of 16.6%. Conclusions: This device provides significant advantages in the quality and quantity of data that can be obtained relative to existing alternatives such as intermittent blood sampling. These devices provide the opportunity to expand the understanding of both glucose metabolism and homeostasis and to work toward improved therapies and cures for diabetes.
Race influences warfarin dose changes associated with genetic factors
Authors: Limdi Nita A. , Brown Todd M. , Yan Qi , Thigpen Jonathan L. , Shendre Aditi , Liu Nianjun , Hill Charles E. , Arnett Donna K. , Beasley T. Mark 
Published: May 2015

Key Points
The influence of known genetic variants on warfarin dose differs by race. Race-specific pharmacogenetic algorithms, rather than race-adjusted algorithms, should be used to guide warfarin dosing.
High-dose cytarabine does not overcome the adverse prognostic value of CDKN2A and TP53 deletions in mantle cell lymphoma
Authors: Delfau-Larue Marie-Hélène , Klapper Wolfram , Berger Françoise , Jardin Fabrice , Briere Josette , Salles Gilles , Casasnovas Olivier , Feugier Pierre , Haioun Corinne , Ribrag Vincent , Thieblemont Catherine , Unterhalt Michael , Dreyling Martin , Macintyre Elizabeth , Pott Christiane , Hermine Olivier , Hoster Eva 
Published: May 2015

Key PointsCDKN2A and TP53 deletions remain of bad prognostic value in younger MCL patients treated according to the current standard of care. CDKN2A and TP53 deletions have independent deleterious effects and should be considered for treatment decisions in addition to MIPI and Ki-67 index.
Biomarkers of oxidative stress following continuous positive airway pressure withdrawal: data from two randomised trials
Authors: Stradling John R. , Schwarz Esther I. , Schlatzer Christian , Manuel Ari R. , Lee Regent , Antoniades Charalambos , Kohler Malcolm 
Published: May 2015

There is conflicting evidence whether intermittent hypoxia in obstructive sleep apnoea (OSA) influences oxidative stress. We hypothesised that withdrawal of continuous positive airway pressure (CPAP) from patients with OSA would raise markers of oxidative stress.59 patients with CPAP-treated moderate-to-severe OSA (oxygen desaturation index (ODI) >20 events·h−1) were randomised 1:1 to either stay on CPAP (n=30) or change to sham CPAP (n=29) for 2 weeks. Using samples from two similar studies at two sites, we measured early morning blood malondialdehyde (MDA, a primary outcome in one study and a secondary outcome in the other), lipid hydroperoxides, total antioxidant capacity, superoxide generation from mononuclear cells and urinary F2-isoprostane. We also measured superoxide dismutase as a marker of hypoxic preconditioning. “Treatment” effects (sham CPAPversusCPAP) were calculatedvialinear regression.Sham CPAP provoked moderate-to-severe OSA (mean ODI 46 events·h−1), but blood markers of oxidative stress did not change significantly (MDA “treatment” effect (95% CI) −0.02 (−0.23 to +0.19) μmol·L−1). Urinary F2-isoprostane fell significantly by ∼30% (−0.26 (−0.42 to −0.10) ng·mL−1) and superoxide dismutase increased similarly (+0.17 (+0.02 to +0.30) ng·mL−1).We found no direct evidence of increased oxidative stress in patients experiencing a return of their moderate-to-severe OSA. The fall in urinary F2-isoprostane and rise in superoxide dismutase implies that hypoxic preconditioning may have reduced oxidative stress.
Obstructive sleep apnoea in the elderly: role of continuous positive airway pressure treatment
Authors: Martínez-García Miguel Ángel , Chiner Eusebi , Hernández Luis , Cortes Jose Pascual , Catalán Pablo , Ponce Silvia , Diaz Jose Ramón , Pastor Ester , Vigil Laura , Carmona Carmen , Montserrat Josep Maria , Aizpuru Felipe , Lloberes Patricia , Mayos Mercedes , Selma Maria José , Cifuentes Jose Fernando , Muñoz Alvaro 
Published: May 2015

Almost all the information about the effect of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnoea (OSA) comes from clinical trials involving only middle-aged patients. The objective of this study was to assess the effect of CPAP treatment in elderly patients with severe OSA on clinical, quality-of-life and neurocognitive spheres.We performed an open-label, randomised, multicentre clinical trial in a consecutive clinical cohort of 224 elderly (≥70 years old) patients with confirmed severe OSA (apnoea–hypopnea index ≥30) randomised to receive CPAP (n=115) or no CPAP (n=109) for 3 months. A sleep study was performed by either full polysomnography or respiratory polygraphy. CPAP titration was performed by an autoCPAP device. The primary endpoint was quality of life (Quebec Sleep Questionnaire) and secondary endpoints included sleep-related symptoms, presence of anxiety/depression, office-based blood pressure and some neurocognitive tests.The mean±sdage was 75.5±3.9 years. The CPAP group achieved a greater improvement in all quality-of-life domains (p<0.001; effect size: 0.41–0.98), sleep-related symptoms (p<0.001; effect size 0.31–0.91) as well as anxiety (p=0.016; effect size 0.51) and depression (p<0.001; effect size: 0.28) indexes and some neurocognitive tests (digit symbol test (p=0.047; effect size: 0.20) and Trail Making Test A (p=0.029; effect size: 0.44)) in an intention-to-treat analysis.In conclusion, CPAP treatment resulted in an improvement in quality of life, sleep-related symptoms, anxiety and depression indexes and some neurocognitive aspects in elderly people with severe OSA.
Pleural irrigation trial (PIT): a randomised controlled trial of pleural irrigation with normal salineversusstandard care in patients with pleural infection
Authors: Hooper Clare E. , Edey Anthony J. , Wallis Anthony , Clive Amelia O. , Morley Anna , White Paul , Medford Andrew R.L. , Harvey John E. , Darby Mike , Zahan-Evans Natalie , Maskell Nick A. 
Published: May 2015

Pleural infection is increasing in incidence. Despite optimal medical management, up to 30% of patients will die or require surgery. Case reports suggest that irrigation of the pleural space with saline may be beneficial.A randomised controlled pilot study in which saline pleural irrigation (three times per day for 3 days) plus best-practice management was compared with best-practice management alone was performed in patients with pleural infection requiring chest-tube drainage. The primary outcome was percentage change in computed tomography pleural fluid volume from day 0 to day 3. Secondary outcomes included surgical referral rate, hospital stay and adverse events.35 patients were randomised. Patients receiving saline irrigation had a significantly greater reduction in pleural collection volume on computed tomography compared to those receiving standard care (median (interquartile range) 32.3% (19.6–43.7%) reductionversus15.3% (−5.5–28%) reduction) (p<0.04). Significantly fewer patients in the irrigation group were referred for surgery (OR 7.1, 95% CI 1.23–41.0; p=0.03). There was no difference in length of hospital stay, fall in C-reactive protein, white cell count or procalcitonin or adverse events between the treatment groups, and no serious complications were documented.Saline irrigation improves pleural fluid drainage and reduces referrals for surgery in pleural infection. A large multicentre randomised controlled trial is now warranted to evaluate its effects further.
The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease
Authors: Gimeno-Santos Elena , Raste Yogini , Demeyer Heleen , Louvaris Zafeiris , de Jong Corina , Rabinovich Roberto A. , Hopkinson Nicholas S. , Polkey Michael I. , Vogiatzis Ioannis , Tabberer Maggie , Dobbels Fabienne , Ivanoff Nathalie , de Boer Willem I. , van der Molen Thys , Kulich Karoly , Serra Ignasi , Basagaña Xavier , Troosters Thierry , Puhan Milo A. , Karlsson Niklas , Garcia-Aymerich Judith 
Published: May 2015

No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD.Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts.236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled “amount” and “difficulty”. After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test–retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r<0.3) with unrelated constructs, providing evidence for construct validity.Daily and clinical visit “PROactive physical activity in COPD” instruments are hybrid tools combining a short patient-reported outcome questionnaire and two activity monitor variables which provide simple, valid and reliable measures of physical activity in COPD patients.
Palliative care needs in COPD patients with or without cancer: an epidemiological study
Authors: Meffert Cornelia , Hatami Isaak , Xander Carola , Becker Gerhild 
Published: May 2015

Chronic obstructive pulmonary disease (COPD) is a growing cause of morbidity and mortality worldwide. However, many patients with severe COPD do not receive adequate palliative care. The main goals of our study were to identify the percentage of hospital patients with palliative care needs, particularly those who suffer from COPD.Data were collected prospectively from inpatients at the University Medical Centre Freiburg (Freiburg, Germany). Based on the World Health Organization definition of palliative care, the treating physician reported for each patient discharged whether the patient had palliative care needs or not. Data from 39 849 patients could be analysed, of which 1455 were suffering from COPD.Of all COPD patients, 9.1% had palliative care needs. In COPD patients with palliative care needs, hospital stay was significantly longer (13.7versus10.3 days) than in the group without palliative care needs, and significantly more patients died during their hospital stay (8.3%versus3.7%). The presence of metastases was the highest risk factor for developing palliative care needs (OR 4.18). Furthermore, a main diagnosis of COPD implied an increased probability of palliative care needs (OR 1.87).Our results show that COPD patients have a high risk of developing palliative care needs. Further efforts are required to provide palliative care to COPD patients.
The effect of age on muscle characteristics of the abductor hallucis in people with hallux valgus: a cross‐sectional observational study
Authors: Aiyer Ashok , Stewart Sarah , Rome Keith 
Published: May 2015

AbstractBackgroundThe abductor hallucis muscle plays an important role in maintaining alignment of the first metatarsophalangeal joint. The aims of this study were (1) to determine differences in abductor hallucis muscle characteristics in people with hallux valgus between three age groups (20–44 years, 45–64 years, and 65+ years); and (2) to determine the association between age and abductor hallucis size and quality.MethodsCharacteristics of the abductor hallucis muscle were measured in 96 feet with hallux valgus using musculoskeletal ultrasound. Muscle characteristics included width, thickness, cross‐sectional area and echo‐intensity. A one‐way ANCOVA was conducted to compare the mean muscle characteristic values between the three age groups while adjusting for hallux valgus severity as a covariate. A Bonferroni post‐hoc was used to adjust for multiple testing (p < 0.0167). Spearman's rho correlation coefficient was used to determine the association between age and the abductor hallucis muscle parameters.ResultsThere was a significant difference in dorso‐plantar thickness (p = 0.003) and cross‐sectional area (p = 0.008) between the three age groups. The Bonferroni post hoc analysis revealed a significant difference in mean thickness and mean cross‐sectional area between the 20–44 age group (p = 0.003) and the 65+ age group (p = 0.006). No significant differences were noted between the three age groups for medio‐lateral width (p > 0.05) or echo‐intensity (p > 0.05). Increasing age was significantly associated with a reduction in dorso‐plantar thickness (r = −0.27, p = 0.008) and cross‐sectional area (r = −0.24, p = 0.019) but with small effect sizes. There was no significant correlation between age and medio‐lateral width (r = −0.51, p = 0.142) or echo intensity (r =0.138, p =0.179).ConclusionIncreasing age is associated with a greater reduction in size of the abductor hallucis muscle in people with hallux valgus. People over the age of 65 years old with hallux valgus display a significant reduction in abductor hallucis muscle size compared to those aged less than 45 years old. This is consistent with age‐related changes to skeletal muscle.
The effect of weight change on changes in breast density measures over menopause in a breast cancer screening cohort
Authors: Wanders Johanna Olga Pauline , Bakker Marije Fokje , Veldhuis Wouter Bernard , Peeters Petra Huberdina Maria , van Gils Carla Henrica 
Published: May 2015

Abstract
Introduction
High weight and high percentage mammographic breast density are both breast cancer risk factors but are negatively correlated. Therefore, we wanted to obtain more insight into this apparent paradox.

Methods
We investigated in a longitudinal study how weight change over menopause is related to changes in mammographic breast features. Five hundred ninety-one participants of the EPIC-NL cohort were divided into three groups according to their prospectively measured weight change over menopause: (1) weight loss (more than −3.0 %), (2) stable weight (between −3.0 % and +3.0 %), and (3) weight gain (more than 3.0 %). SPSS GLM univariate analysis was used to determine both the mean breast measure changes in, and the trend over, the weight change groups.

Results
Over a median period of 5 years, the mean changes in percent density in these groups were −5.0 % (95 % confidence interval (CI) −8.0; −2.1), −6.8 % (95 % CI −9.0; −4.5), and −10.2 % (95 % CI −12.5; −7.9), respectively (P-trend = 0.001). The mean changes in dense area were −16.7 cm2 (95 % CI −20.1; −13.4), −16.4 cm2 (95 % CI −18.9; −13.9), and −18.1 cm2 (95 % CI −20.6; −15.5), respectively (P-trend = 0.437). Finally, the mean changes in nondense area were −6.1 cm2 (95 % CI −11.9; −0.4), −0.6 cm2 (95 % CI −4.9; 3.8), and 5.3 cm2 (95 % CI 0.9; 9.8), respectively (P-trend < 0.001).

Conclusions
Going through menopause is associated with a decrease in both percent density and dense area. Owing to an increase in the nondense tissue, the decrease in percent density is largest in women who gain weight. The decrease in dense area is not related to weight change. So the fact that both high percent density and high weight or weight gain are associated with high postmenopausal breast cancer risk can probably not be explained by an increase (or slower decrease) of dense area in women gaining weight compared with women losing weight or maintaining a stable weight. These results suggest that weight and dense area are presumably two independent postmenopausal breast cancer risk factors.