bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical clinical presentation of a subset of patients with anti-RNA polymerase III - non-scleroderma cases associated with dominant RNA polymerase I reactivity and nucleolar staining
Authors: Ceribelli Angela , Krzyszczak Malgorzata E , Li Yi , Ross Steven J , Chan Jason YF , Chan Edward KL , Burlingame Rufus W , Webb Tyler T , Bubb Michael R , Sobel Eric S , Reeves Westley H , Satoh Minoru 
Published: July 2011

Abstract
Introduction
Anti-RNA polymerase III (RNAP III) antibodies are highly specific markers of scleroderma (systemic sclerosis, SSc) and associated with a rapidly progressing subset of SSc. The clinical presentation of anti-RNAP III positive patients, onset of Raynaud's phenomenon (RP) and SSc in unselected patients in a rheumatology clinic were evaluated.

Methods
Autoantibodies in sera from 1,966 unselected patients (including 434 systemic lupus erythematosus (SLE), 119 SSc, 85 polymyositis/dermatomyositis (PM/DM)) in a rheumatology clinic were screened by radioimmunoprecipitation. Anti-RNAP III positive sera were also tested by immunofluorescence antinuclear antibodies and anti-RNAP III ELISA. Medical records of anti-RNAP III positive patients were reviewed.

Results
Among 21 anti-RNAP III positive patients, 16 met the American College of Rheumatology (ACR) SSc criteria at the initial visit but 5 did not; diagnoses were vasculitis, early polyarthritis, renal failure with RP, interstitial lung disease, and Sjögren's syndrome. The first two patients developed rapidly progressive diffuse SSc. An additional case presented with diffuse scleroderma without RP and RP developed two years later. Anti-RNAP III antibodies in these 6 cases of atypical clinical presentation were compared with those in 15 cases of typical (SSc with RP) cases. Anti-RNAP III levels by ELISA were lower in the former group (P = 0.04 by Mann-Whitney test) and 3 of 6 were negative versus only 1 of 15 negative in the latter (P < 0.05 by Fisher's exact test). Three cases of non-SSc anti-RNAP III positive patients had predominant reactivity with RNAP I with weak RNAP III reactivity and had a strong nucleolar staining. Three anti-RNAP III patients, who did not have RP at the initial visit, developed RP months later. Scleroderma developed prior to RP in 5 out of 16 (31%) in the anti-RNAP III group, but this was rare in patients with other autoantibodies. The interval between the onset of RP to scleroderma was short in anti-RNAP III positive patients.

Conclusions
Anti-RNAP III antibodies are highly specific for SSc; however, a subset of anti-RNAP III positive patients do not present as typical SSc. The interval between RP and scleroderma in this group is short, and 31% of patients developed scleroderma prior to RP in this group. Anti-RNAP III positive patients may not present as typical SSc and detecting anti-RNAP III may have predictive value.
Adiposity and Hot Flashes in Midlife Women: A Modifying Role of Age
Authors: Thurston Rebecca C. , Santoro Nanette , Matthews Karen A. 
Published: July 2011

AbstractBackground:The nature of the relationship between adiposity and hot flashes has been debated, but it has not been examined using physiological measures of hot flashes. We examined associations between body size/composition and physiologically assessed hot flashes among women with hot flashes.Methods:A subcohort of women in the Study of Women's Health Across the Nation (n = 52; 25 African-American and 27 non-Hispanic Caucasian; ages, 54 to 63 yr) who reported hot flashes, had their uterus and ovaries, and were not taking medications impacting hot flashes were recruited in 2008–2009. Women completed anthropometric measures [bioimpedance analysis of total percentage of body fat, body mass index (BMI), waist circumference], a blood draw (estradiol, SHBG, FSH, dehydroepiandrosterone sulfate), and 4 d of ambulatory sternal skin conductance monitoring with diary (physiological and reported hot flashes, respectively). Associations between anthropometrics and hot flashes were estimated with generalized estimating equations with covariates age, race, and anxiety.Results:Higher BMI (odds ratio, 0.97; 95% confidence interval, 0.94–0.99; P &lt; 0.05) and waist circumference (odds ratio, 0.98; 95% confidence interval, 0.97–0.99; P &lt; 0.01) were associated with fewer physiological hot flashes. Interactions by age (P &lt; 0.05) indicated that inverse associations of body fat, BMI, and waist circumference with hot flashes were most apparent among the oldest women in the sample. Estradiol and SHBG reduced but did not eliminate age-related variations in relations between body size/composition and hot flashes.Conclusion:Higher adiposity was associated with fewer physiological hot flashes among older women with hot flashes. A modifying role of age must be considered in understanding the role of adiposity in hot flashes.
Comparing the USA, UK and 17 Western countries’ efficiency and effectiveness in reducing mortality
Authors: Pritchard Colin , Wallace Mark S 
Published: July 2011

Objectives To test the hypothesis that the USA healthcare system was superior to the NHS and 17 other Western countries in reducing feasible mortality rates over the period 1979–2005. Design Economic inputs into healthcare, GDP health expenditure (GDPHE) were compared with clinical outputs, i.e. total ‘adult’ (15–74 years) and ‘older’ (55–74 years) mortality rates based upon three-year average mortality rates for 1979–81 vs. 2003–2005. A cost-effective ratio was calculated by dividing average GDPHE into reduced mortality rates over the period. Setting Nineteen Western countries’ mortality rates compared between 1979–2005. Participants Mortality of people by age and gender. Main outcome measures A cost-effective ratio to measure efficiency and effectiveness of healthcare systems in reducing mortality rates. Chi-square tested any differences between the USA, UK and other Western countries. Results Input: The USA had the highest current and average GDPHE; the UK was 10th highest but joint 16th overall, still below the Western countries’ average. Output: Every country's mortality rate fell substantially; but 15 countries reduced their mortality rates significantly more than the US, while UK ‘adult’ and ‘older’ mortality rates fell significantly more than 12 other countries. Cost-effectiveness: The USA GDPHE: mortality rate ratio was 1:205 for ‘adults’ and 1:515 for ‘older’ people, 16 Western countries having bigger ratios than the US; the UK had second greatest ratios at 1:593 and 1:1595, respectively. The UK ratios were >20% larger than 14 other countries. Conclusions In cost-effective terms, i.e. economic input versus clinical output, the USA healthcare system was one of the least cost-effective in reducing mortality rates whereas the UK was one of the most cost-effective over the period.
Early Dynamic Change in High-Sensitivity Cardiac Troponin T in the Investigation of Acute Myocardial Infarction
Authors: Aldous Sally J , Richards A Mark , Cullen Louise , Than Martin P 
Published: July 2011

BACKGROUND
The definition of acute myocardial infarction (AMI) requires a rise and/or fall in troponin with 1 or more results ≥99th percentile of the reference range. How much troponin must change has not been specified. We ascertained whether dynamic changes (δ) in high-sensitivity troponin T (hs-TnT) improved diagnostic and prognostic test performance in the emergency department.

METHODS
We recruited 939 patients with symptoms suggestive of acute coronary syndrome (without ST elevation). hs-cTnT was measured at 0 h and 2 h after presentation. End-points were admission diagnosis of AMI and 1-year adverse events (composite of death, AMI, revascularization).

RESULTS
Diagnostic specificity of 0–2-h hs-cTnT for AMI (incurred by 200 patients) improved from 79.8% (78.8%–80.5%) by using the 99th percentile alone to 94.2% (92.9%–95.4%) when we also included a δ ≥20%, but diagnostic sensitivity decreased from 94.5% (90.7%–96.9%) to 49.5% (44.6%–53.9%). With the inclusion of those patients with a δ ≥20% when 0–2-h hs-cTnT was &lt;99th percentile, in addition to any with concentrations ≥99th percentile, diagnostic sensitivity increased to 97.5% (94.4%–98.9%). hs-cTnT ≥99th percentile predicted adverse events (incurred by 111 patients), adjusted hazard ratio 1.9 (1.2–2.8), whereas a δ ≥20% did not, hazard ratio 1.1 (0.7–1.7).

CONCLUSIONS
Diagnostic specificity of hs-cTnT improved with the use of a δ ≥20% in those patients with concentrations ≥99th percentile, but at a cost of a large reduction in sensitivity. Diagnostic sensitivity improved with the use of a δ ≥20% in patients with 0–2-h concentrations &lt;99th percentile. Both approaches may be required for optimum rule-in and rule-out strategies, respectively. The δ criteria seem to be less useful for medium-term risk stratification.
Quality Error Rates in Point-of-Care Testing
Authors: O'Kane Maurice J , McManus Paul , McGowan Noel , Lynch PL Mark 
Published: July 2011

BACKGROUNDAlthough a theoretical consideration suggests that point-of-care testing (POCT) might be uniquely vulnerable to error, little information is available on the quality error rate associated with POCT. Such information would help inform risk/benefit analyses when one considers the introduction of POCT.METHODSThis study included 1 nonacute and 2 acute hospital sites. The 2 acute sites each had a 24-h central laboratory service. POCT was used for a range of tests, including blood gas/electrolytes, urine pregnancy testing, hemoglobin A1c (Hb A1c), blood glucose, blood ketones, screening for drugs of abuse, and urine dipstick testing. An established Quality Query reporting system was in place to log and investigate all quality errors associated with POCT. We reviewed reports logged over a 14-month period.RESULTSOver the reporting period, 225 Quality Query reports were logged against a total of 407 704 POCT tests. Almost two-thirds of reports were logged by clinical users, and the remainder by laboratory staff. The quality error rate ranged from 0% for blood ketone testing to 0.65% for Hb A1c testing. Two-thirds of quality errors occurred in the analytical phase of the testing process. These errors were all assessed as having no or minimal adverse impact on patient outcomes; however, the potential adverse impact was graded higher.CONCLUSIONSThe quality error rate for POCT is variable and may be considerably higher than that reported previously for central laboratory testing.
Spectroscopic and Molecular Modeling Studies of the Inclusion Complex of TNBAB with β-cyclodextrin in Aqueous Solution
Authors: Yang Zhenyu , Gao Chunzhi , Wang Hongming , Gu Ningyu , Zhang Rongbin , Zhang Ning 
Published: July 2011

Abstract
In this investigation, a novel surfactant (N, N, N-trimethyl-4-(5-(octyloxy) naphthalene-1-yloxy) butan-1-aminium bromide, TNBAB) with a naphthalene chromophore moiety was designed and synthesized. The UV, fluorescence and 1H NMR measurements and molecular modeling have been carried out at 298.2 K for TNBAB + H2O, and TNBAB +
β-CD + H2O systems. The stoichoimetry, stability constant and potential energy surface for the inclusion complex of TNBAB and β-CD have been determined. The results of UV and fluorescence suggested that β-CD formed strong complex with TNBAB, the stoichoimetry was found to be almost 1:1, and the inclusion constants obtained are larger than 2.1×104 L mol-1. 1H NMR and molecular modeling studies indicated β-CD and TNBAB could form a two different inclusion complexes (Fig. 9), the two part of the aliphatic chain (one including partly naphthalene nucleus) were encapsulated in the cavity of the β-CD through hydrophobic interaction, respectively.
Design of a modified linear quadratic regulator for vibration control of suspension systems
Authors: Yildirim Ş. , Kalkat M. , Uzmay İ. , Husi G. 
Published: July 2011

Abstract
This paper is concerned with the construction of a prototype active vehicle suspension system for a one-wheel car model by using a modified Linear Quadric Regulator (LQR). The experimental system is approximately described by a non-linear system with two degrees of freedom subject to excitation from a road profile. The active control at the suspension location is designed by using feedback constant gain controller structure. The experimental results show that the active suspension system with LQR more improves the control performance than standard PID controller. On the other hand, the results improved that the modified LQR has superior performance for controlling suspension systems in real time.
On-site monitoring in a passive house
Authors: Csoknyai T. , Talamon A. 
Published: July 2011

Abstract
In the beginning of August 2009 a long-term monitoring started in a recently built passive house near Isaszeg. The first results were presented in the last year's conference. The present paper gives an overview about a whole-year data evaluation focusing on energy consumption. During the first year of building occupancy three types of heat suppliers and two types of heat exchangers in the ventilation systems were applied and monitored, thus different heating options could be compared.
Investigation of the flatness of rolled aluminium sheet
Authors: Pálinkás S. , Tóth J. 
Published: July 2011

Abstract
A lot of problems arise even recently concerning the control of flatness and profile of rolled strip in industrial circumstances. In the course of planning of the cold-rolling technology of geometrically true strip that is exempt of internal deformation stresses — i.e. flatness strip — it is necessary to take into consideration the elastic and thermal deformation of working rolls, the basic sheet-metal forming of rolls, the existing crown of basic material as well as the wearing of the rolls. A measurement method by which the shape of strip can exactly be measured is necessary for performing the control. In the present phase of my research work, a measurement device has been developed by means of which the given problem can be solved for the time being in experimental circumstances.
Petroleum Scarcity and Public Health: Considerations for Local Health Departments
Authors: Barnett Daniel J. , Parker Cindy L. , Caine Virginia A. , McKee Mary , Shirley Lillian M. , Links Jonathan M. 
Published: July 2011

Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and public health.Local health departments represent a critical yet highly vulnerable component of the public health infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local public health service approaches.We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential Public Health Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts.
Adolescent Well-Being in Washington State Military Families
Authors: Reed Sarah C. , Bell Janice F. , Edwards Todd C. 
Published: July 2011

Objectives. We examined associations between parental military service and adolescent well-being. Methods. We used cross-sectional data from the 2008 Washington State Healthy Youth Survey collected in public school grades 8, 10, and 12 (n = 10 606). We conducted multivariable logistic regression analyses to test associations between parental military service and adolescent well-being (quality of life, depressed mood, thoughts of suicide). Results. In 8th grade, parental deployment was associated with higher odds of reporting thoughts of suicide among adolescent girls (odds ratio [OR] = 1.66; 95% confidence interval [CI] = 1.19, 2.32) and higher odds of low quality of life (OR = 2.10; 95% CI = 1.43, 3.10) and thoughts of suicide (OR = 1.75; 95% CI = 1.15, 2.67) among adolescent boys. In 10th and 12th grades, parental deployment was associated with higher odds of reporting low quality of life (OR = 2.74; 95% CI = 1.79, 4.20), depressed mood (OR = 1.50; 95% CI = 1.02, 2.20), and thoughts of suicide (OR = 1.64; 95% CI = 1.13, 2.38) among adolescent boys. Conclusions. Parental military deployment is associated with increased odds of impaired well-being among adolescents, especially adolescent boys. Military, school-based, and public health professionals have a unique opportunity to develop school- and community-based interventions to improve the well-being of adolescents in military families.
Workplace Social Capital and All-Cause Mortality: A Prospective Cohort Study of 28 043 Public-Sector Employees in Finland
Authors: Oksanen Tuula , Kivimäki Mika , Kawachi Ichiro , Subramanian S. V. , Takao Soshi , Suzuki Etsuji , Kouvonen Anne , Pentti Jaana , Salo Paula , Virtanen Marianna , Vahtera Jussi 
Published: July 2011

Objectives. We examined the association between workplace social capital and all-cause mortality in a large occupational cohort from Finland. Methods. We linked responses of 28 043 participants to surveys in 2000 to 2002 and in 2004 to national mortality registers through 2009. We used repeated measurements of self- and coworker-assessed social capital. We carried out Cox proportional hazard and fixed-effects logistic regressions. Results. During the 5-year follow-up, 196 employees died. A 1-unit increase in the mean of repeat measurements of self-assessed workplace social capital (range 1–5) was associated with a 19% decrease in the risk of all-cause mortality (age- and gender-adjusted hazard ratio [HR] = 0.81; 95% confidence interval [CI] = 0.66, 0.99). The corresponding point estimate for the mean of coworker-assessed social capital was similar, although the association was less precisely estimated (age- and gender-adjusted HR = 0.77; 95% CI = 0.50, 1.20). In fixed-effects analysis, a 1-unit increase in self-assessed social capital across the 2 time points was associated with a lower mortality risk (odds ratio = 0.81; 95% CI = 0.55, 1.19). Conclusions. Workplace social capital appears to be associated with lowered mortality in the working-aged population.
Arthritis, Occupational Class, and the Aging US Workforce
Authors: Caban-Martinez Alberto J. , Lee David J. , Fleming Lora E. , Tancredi Daniel J. , Arheart Kristopher L. , LeBlanc William G. , McCollister Kathryn E. , Christ Sharon L. , Louie Grant H. , Muennig Peter A. 
Published: July 2011

Objectives. The working poor sometimes delay retirement to survive. However, their higher risk of disease and disability threatens both their financial survival and their ability to work through the retirement years. We used the burden of disease attributable to arthritis by occupational class to illustrate the challenges faced by the older poor. Methods. We merged data from the National Health Interview Survey, Medical Expenditure Panel Survey, and the National Death Index into a single database. We then calculated and compared age- and occupational class–specific quality-adjusted life years (QALYs) between workers with and without arthritis by using unabridged life tables. Results. White-collar workers have a higher overall health-related quality of life than do other workers, and suffer fewer QALYs lost to arthritis at all ages. For instance, whereas 65-year-old white-collar workers without arthritis look forward to 17 QALYs of future life, blue-collar workers with arthritis experience only 11, and are much less likely to remain in the workforce than are those in service, farming, or white-collar jobs. Conclusions. To meet the needs of the aging workforce, more extensive health and disability insurance will be needed.
Peak Oil, Urban Form, and Public Health: Exploring the Connections
Authors: Kaza Nikhil , Knaap Gerrit-Jan , Knaap Isolde , Lewis Rebecca 
Published: July 2011

We assessed the relationships between peak oil and urban form, travel behavior, and public health.Peak oil will affect the general economy, travel behavior, and urban form through income and substitution effects; however, because of the wide range of substitution possibilities, the impacts are likely to be gradual and relatively small. Furthermore, we suggest that changes in travel behavior and increases in urban density will have both favorable and unfavorable effects on public health.To mitigate the adverse impacts and to maximize the positive effects of peak oil, we recommend that careful attention should be paid to urban design and public health responses for a range of urbanization patterns.
Informing the National Public Health Accreditation Movement: Lessons From North Carolina's Accredited Local Health Departments
Authors: Davis Mary V. , Cannon Margaret M. , Stone David O. , Wood Brittan W. , Reed Joy , Baker Edward L. 
Published: July 2011

To advance understanding of public health accreditation, we analyzed data on the North Carolina Local Health Department Accreditation program. We surveyed accredited health departments on barriers to and supports of accreditation preparation, performance on accreditation standards, and benefits and improvements after accreditation. All 48 accredited agencies responded to the survey. All agencies improved policies to prepare for accreditation and met most accreditation standards. Forty-six percent received local funds for accreditation preparation. The most common barrier to accreditation preparation was time and schedule limitations (79%). Fifty percent of agencies acted on suggestions for improvement, and 67% conducted quality improvement activities. Benefits of accreditation included improvements in local partnerships. Agencies of all sizes conducted accreditation activities, were successfully accredited, and experienced benefits resulting from accreditation.
Racial and Ethnic Differences in Mortality among Individuals with Chronic Kidney Disease
Authors: Jolly Stacey E. , Burrows Nilka Ríos , Chen Shu-Cheng , Li Suying , Jurkovitz Claudine T. , Norris Keith C. , Shlipak Michael G. 
Published: July 2011

Summary

Background and objectives
Chronic kidney disease (CKD) is prevalent in minority populations and racial/ethnic differences in survival are incompletely understood.

Design, setting, participants, & measurements
Secondary analysis of Kidney Early Evaluation Program participants from 2000 through 2008 with CKD, not on dialysis, and without previous kidney transplant was performed. Self-reported race/ethnicity was categorized into five groups: non-Hispanic white, African American, Asian, American Indian/Alaska Native, and Hispanic. CKD was defined as a urinary albumin to creatinine ratio of ≥30 mg/g among participants with an estimated GFR (eGFR) ≥60 ml/min per 1.73 m2 or an eGFR of <60 ml/min per 1.73 m2. The outcome was all-cause mortality. Covariates used were age, sex, obesity, diabetes, hypertension, albuminuria, baseline eGFR, heart attack, stroke, smoking, family history, education, health insurance, geographic region, and year screened.

Results
19,205 participants had prevalent CKD; 55% (n = 10,560) were White, 27% (n = 5237) were African American, 9% (n = 1638) were Hispanic, 5% (n = 951) were Asian, and 4% (n = 813) were American Indian/Alaska Native. There were 1043 deaths (5.4%). African Americans had a similar risk of death compared with Whites (adjusted Hazard Ratio (AHR) 1.07, 95% CI 0.90 to 1.27). Hispanics (AHR 0.66, 95% CI 0.50 to 0.94) and Asians (AHR 0.63, 95% CI 0.41 to 0.97) had a lower mortality risk compared with Whites. In contrast, American Indians/Alaska Natives had a higher risk of death compared with Whites (AHR 1.41, 95% CI 1.08 to 1.84).

Conclusions
Significant differences in mortality among some minority groups were found among persons with CKD detected by community-based screening.