bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep-Disordered Breathing in Acute Ischemic Stroke and Transient Ischemic Attack: Effects on Short- and Long-Term Outcome and Efficacy of Treatment with Continuous Positive Airways Pressure – Rationale and Design of the SAS Care Study
Authors: Cereda Carlo W. , Petrini Liliane , Azzola Andrea , Ciccone Alfonso , Fischer Urs , Gallino Augusto , Györik Sandor , Gugger Matthias , Mattis Johannes , Lavie Lena , Limoni Costanzo , Nobili Lino , Manconi Mauro , Ott Sebastian , Pons Marco , Bassetti Claudio L. 
Published: July 2012

Objectives Sleep-disordered breathing represents a risk factor for cardiovascular morbidity and mortality and negatively affects short-term and long-term outcome after an ischemic stroke or transient ischemic attack. The effect of continuous positive airways pressure in patients with sleep-disordered breathing and acute cerebrovascular event is poorly known. The SAS CARE 1 study assesses the effects of sleep-disordered breathing on clinical evolution, vascular functions, and markers within the first three-months after an acute cerebrovascular event. The SAS CARE 2 assesses the effect of continuous positive airways pressure on clinical evolution, cardiovascular events, and mortality as well as vascular functions and markers at 12 and 24 months after acute cerebrovascular event. Methods SAS CARE 1 is an open, observational multicenter study in patients with acute cerebrovascular event acutely admitted in a stroke unit: a sample of 200 acute cerebrovascular event patients will be included. Vascular functions and markers (blood pressure, heart rate variability, endothelial function by peripheral arterial tonometry and specific humoral factors) will be assessed in the acute phase and at three-months follow-up. SAS CARE 2 will include a sample of patients with acute cerebrovascular event in the previous 60–90 days. After baseline assessments, the patients will be classified according to their apnea hypopnea index in four arms: non-sleep-disordered breathing patients (apnea hypopnea index <10), patients with central sleep-disordered breathing, sleepy patients with obstructive apnea hypopnea index ≥20, which will receive continuous positive airways pressure treatment, nonsleepy patients with obstructive sleep-disordered breathing (apnea hypopnea index ≥20), which will be randomized to receive continuous positive airways pressure treatment or not. Conclusions The SAS CARE study will improve our understanding of the clinical sleep-disordered breathing in patients with acute cerebrovascular event and the feasibility/efficacy of continuous positive airways pressure treatment in selected patients with acute cerebrovascular event and sleep-disordered breathing.
Comprehensive Stroke Units: A Review of Comparative Evidence and Experience
Authors: Chan Daniel K. Y. , Cordato Dennis , O'Rourke Fintan , Chan Daniel L , Pollack Michael , Middleton Sandy , Levi Chris 
Published: July 2012

Background Stroke unit care offers significant benefits in survival and dependency when compared to general medical ward. Most stroke units are either acute or rehabilitation, but comprehensive (combined acute and rehabilitation) model (comprehensive stroke unit) is less common. Aim To examine different levels of evidence of comprehensive stroke unit compared to other organized inpatient stroke care and share local experience of comprehensive stroke units. Methods Cochrane Library and Medline (1980 to December 2010) review of English language articles comparing stroke units to alternative forms of stroke care delivery, different types of stroke unit models, and differences in processes of care within different stroke unit models. Different levels of comparative evidence of comprehensive stroke units to other models of stroke units are collected. Results There are no randomized controlled trials directly comparing comprehensive stroke units to other stroke unit models (either acute or rehabilitation). Comprehensive stroke units are associated with reduced length of stay and greatest reduction in combined death and dependency in a meta-analysis study when compared to other stroke unit models. Comprehensive stroke units also have better length of stay and functional outcome when compared to acute or rehabilitation stroke unit models in a cross-sectional study, and better length of stay in a ‘before-and-after’ comparative study. Components of stroke unit care that improve outcome are multifactorial and most probably include early mobilization. A comprehensive stroke unit model has been successfully implemented in metropolitan and rural hospital settings. Conclusions Comprehensive stroke units are associated with reductions in length of stay and combined death and dependency and improved functional outcomes compared to other stroke unit models. A comprehensive stroke unit model is worth considering as the preferred model of stroke unit care in the planning and delivery of metropolitan and rural stroke services.
Cigarette smoking as a risk factor for influenza‐associated mortality: evidence from an elderly cohort
Authors: Wong Chit M. , Yang Lin , Chan King P. , Chan Wai M. , Song Liang , Lai Hak K. , Thach Thuan Q. , Ho Lai M. , Chan Kwok H. , Lam Tai H. , Peiris Joseph S. M. 
Published: July 2012

Please cite this paper as: Wong et al. (2012) Cigarette smoking as a risk factor for influenza‐associated mortality: evidence from an elderly cohort. Influenza and Other Respiratory Viruses 7(4), 531–539.Background  The effects of individual lifestyle factors on the mortality risk after influenza infection have not been explored.Objectives  In this study, we assessed the modifying effects of cigarette smoking on mortality risks associated with influenza in a cohort of Hong Kong elders with a follow‐up period of 1998–2009.Methods  We used the Cox proportional hazards model with time‐dependent covariates of weekly proportions of specimens positive for influenza (termed as influenza virus activity), to calculate the hazard ratio of mortality associated with a 10% increase in influenza virus activity for never, ex‐ and current smokers. Other individual lifestyle and socioeconomic factors as well as seasonal confounders were also added into the models.Results  The overall hazard ratio associated with influenza was 1·028 (95% confidence interval, 1·006, 1·051) for all natural cause mortality and 1·035 (1·003, 1·068) for cardiovascular and respiratory mortality. We found that influenza‐associated hazard ratio was greater in current and ex‐smokers than in never smokers for mortality of all natural causes, cardiovascular and respiratory diseases.Conclusions  The findings suggest that smoking might increase influenza‐associated mortality risks among elders.
Seroprevalence of Hepatitis E Virus in Humans and Geographically Matched Food Animals in Egypt
Authors: El‐Tras W. F. , Tayel A. A. , El‐Kady N. N. 
Published: July 2012

SummaryThe aim of current study was to investigate the epidemiology of Hepatitis E virus (HEV) in humans and geographically matched food animals as a novel zoonotic assessment in Egypt. Blood samples were collected from patients who had a history of jaundice and attended to fever and general hospitals. Animal blood samples were collected from cows, buffaloes, sheep and goats convenient to HEV seropositive humans. Enzyme Immuno Assay (EIA) protocol was used to determine IgG anti‐HEV. Sex and pregnancy were investigated as potential risk factors for HEV infection. Of 134 examined humans, 51 (38.1%) were positive for IgG anti‐HEV. The males showed 26.8% seropositivity while the recorded female seropositivity was 50.8%, with a significant difference at P = 0.005, Odds Ratio (OR) = 0.35 at 95% confidence interval (CI): 0.17–0.73. There was a significant difference at P = 0.02 between seropositivity in pregnant (25%) and non‐pregnant women (59.6%); OR was 0.23 (95% CI: 0.06–0.81). Anorexia was the most common symptom whereas paraesthesia and back pain were the least within icteric seropositive HEV humans. Hepatitis E virus seropositivity was recorded in 21.6%, 14%, 4.4% and 9.4% from examined cows, buffaloes, sheep and goats, respectively. The infected food animals were convenient to positive HEV humans who may declare the epidemiological picture of potential zoonotic HEV.
Cohort study examining long‐term respiratory health, career duration and racing performance in racehorses that undergo left‐sided prosthetic laryngoplasty and ventriculocordectomy surgery for treatment of left‐sided laryngeal hemiplegia
Authors: MASON B. J. , RIGGS C. M. , COGGER N. 
Published: July 2012

SummaryReasons for performing study:The risk of respiratory conditions, such as inflammatory airway disease (IAD) and exercise‐induced pulmonary haemorrhage (EIPH), are thought to be higher in racehorses that undergo prosthetic laryngoplasty with ventriculocordectomy (PLVC) surgery to treat left‐sided laryngeal hemiplegia (LLH) than in racehorses with normal laryngeal function. However, this has not been investigated formally owing to the difficulty of obtaining reliable follow‐up data.Objectives:To determine the incidence of respiratory conditions (IAD and EIPH), duration of racing career, number of starts and number of starts for which stakes money was earned in racehorses that had undergone PLVC surgery to treat LLH, compared with racehorses that did not have LLH or undergo any laryngeal surgery.Methods:A retrospective cohort study design was used, with surgical, clinical and race data of Thoroughbred racehorses obtained from the time of importation until retirement. The surgical cohort consisted of racehorses that had undergone PLVC for LLH and met specific inclusion criteria. Every surgical case was matched, according to trainer, year of import into Hong Kong and pre‐import international handicap rating, to 2 unexposed racehorses.Results:Respiratory conditions, such as excessive tracheal mucus and epistaxis due to severe EIPH, were significantly increased in the surgical cohort, compared with the matched unexposed cohort (P values <0.001 and <0.004, respectively). Racing career duration in the surgical cohort was significantly shorter than in the unexposed cohort, which was primarily due to retirement because of epistaxis. The number of race starts was fewer in the surgical than in the unexposed cohort after surgery/matching, but the number of starts for which stakes money was earned was not significantly different.Conclusions and potential relevance:Owners and trainers should be advised that racehorses with LLH that undergo PLVC surgery are at an increased risk of respiratory conditions (IAD and severe EIPH), which is likely to shorten their racing career compared to racehorses with normal laryngeal function. Racing performance in terms of race starts was significantly less in racehorses that had undergone PLVC surgery; however, the number of starts for which stakes money was earned was similar to those racehorses that were unexposed.
Biomarkers of exposure to polycyclic aromatic hydrocarbons (PAHs) and DNA damage: a cross-sectional pilot study among roofers in South Florida
Authors: Serdar Berrin , Lee David , Dou Zihong 
Published: July 2012

ObjectiveThe main goal of this pilot study was to assess the technical and logistic feasibility of a future study. The research hypothesis is that occupational exposures to polycyclic aromatic hydrocarbons (PAHs) are associated with increased risk of DNA damage among roofers who work with hot asphalt.DesignThis is a cross-sectional pilot study.SettingThe study included roofers from four different construction sites in Miami-Dade County, Florida.Participants19 roofers were recruited (six Hispanics and 13 African–Americans, all male), all of whom were eligible (no history of cancer and no history of chronic diseases of kidneys or liver). All participants provided pre-shift samples and 18 provided post-shift samples. Samples of one participant were excluded from the final analyses as they were considered unreliable.ResultsLevels of urinary PAH metabolites increased during 6 h of work. Linear regression models of post-shift metabolites included their pre-shift levels, post-shift urinary creatinine levels (for models of 1-OHPyr and 9-OHPhe), and skin burn due to contact with hot asphalt (for models of 1-OHPyr and 1-OHNap). Pre-shift levels of urinary 8-OHdG were not associated with any of the variables considered. For post-shift levels of 8-OHdG, however, post-shift 1-OHPyr (95% CI 0.091 to 0.788) and use of protective gloves (95% CI −1.57 to −0.61) during work explained 86.8% of its variation. Overall, highest levels of urinary PAH metabolites and of 8-OHdG were observed among workers who reported having skin burn and who did not use gloves during work.ConclusionsUrinary 1-OHPyr is a promising predictor of oxidative DNA damage among roofers. Work-related skin burn and use of protective gloves appear to influence PAH exposure and DNA damage levels in this group, suggesting the importance of dermal absorption.
High expression of L-type amino acid transporter 1 (LAT1) predicts poor prognosis in pancreatic ductal adenocarcinomas
Authors: Yanagisawa Nobuyuki , Ichinoe Masaaki , Mikami Tetuo , Nakada Norihiro , Hana Kiyomi , Koizumi Wasaburo , Endou Hitoshi , Okayasu Isao 
Published: July 2012

Background and aimsMolecular target therapy against L-type amino acid transporter 1 (LAT1) is unique and expected to be developed soon. LAT1 expression was investigated in pancreatic cancer as a prognostic predictor.MethodsSurgically resected pancreatic ductal adenocarcinomas (PDAC, n=66) were investigated using immunohistochemistry. For reference, intraductal papillary mucinous carcinomas (IPMC, including intraductal papillary mucinous neoplasm (IPMN) with high-grade dysplasia or with an associated invasive carcinoma, n=13) and adenomas (IPMA, including IPMN with low- and intermediate-grade dysplasia, n=5) were also examined.ResultsLAT1 expression scores increased from PDAC to IPMA to IPMC. Kaplan–Meier analysis showed significant differences between LAT1-high and -low scores in PDAC. Even in each Ki-67-labelling index (LI) low and high PDAC group (cut off 40%), high LAT1 expression could also predict poor prognosis. Multivariable analysis showed that LAT1 expression, Ki-67 LI, tumour differentiation and size were individual prognostic factors.ConclusionsLAT1 aberrant overexpression in PDAC predicts poor prognosis, independent of Ki-67 LI, and offers a potential target for future anticancer therapy with its inhibitors.
After treat-to-target: can a targeted ultrasound initiative improve RA outcomes?
Authors: Wakefield Richard J , D'Agostino Maria Antonietta , Naredo Esperanza , Buch Maya H , Iagnocco Annamaria , Terslev Lene , Ostergaard Mikkel , Backhaus Marina , Grassi Walter , Dougados Maxime , Burmester Gerd R , Saleem Benazir , de Miguel Eugenio , Estrach Cristina , Ikeda Kei , Gutierrez Marwin , Thompson Robert , Balint Peter , Emery Paul 
Published: July 2012

Abstract
For patients with rheumatoid arthritis (RA), remission can be achieved with tight control of inflammation and early use of disease modifying agents. The importance of remission as an outcome has been recently highlighted by European League Against Rheumatism recommendations. However, remission when defined by clinical remission criteria (disease activity score, simplified disease activity index, etc) does not always equate to the complete absence of inflammation as measured by new sensitive imaging techniques such as ultrasound (US). There is evidence that imaging synovitis is frequently found in these patients and associated with adverse clinical and functional outcomes. This article reviews the data regarding remission, ultrasound imaging and outcomes in patients with RA to provide the background to a consensus statement from an international collaboration of ultrasonographers and rheumatologists who have recently formed a research network - the Targeted Ultrasound Initiative (TUI) group. The statement proposes that targeting therapy to PD activity provides superior outcomes compared with treating to clinical targets alone and introduces the rationale for a new randomised trial using targeted ultrasound in RA.
Subclinical Thyroid Dysfunction and the Risk of Heart Failure Events
Authors: Gencer Baris , Collet Tinh-Hai , Virgini Vanessa , Bauer Douglas C. , Gussekloo Jacobijn , Cappola Anne R. , Nanchen David , den Elzen Wendy P.J. , Balmer Philippe , Luben Robert N. , Iacoviello Massimo , Triggiani Vincenzo , Cornuz Jacques , Newman Anne B. , Khaw Kay-Tee , Jukema J. Wouter , Westendorp Rudi G.J. , Vittinghoff Eric , Aujesky Drahomir , Rodondi Nicolas 
Published: July 2012

Background—
American College of Cardiology/American Heart Association guidelines for the diagnosis and management of heart failure recommend investigating exacerbating conditions such as thyroid dysfunction, but without specifying the impact of different thyroid-stimulation hormone (TSH) levels. Limited prospective data exist on the association between subclinical thyroid dysfunction and heart failure events.

Methods and Results—

We performed a pooled analysis of individual participant data using all available prospective cohorts with thyroid function tests and subsequent follow-up of heart failure events. Individual data on 25 390 participants with 216 248 person-years of follow-up were supplied from 6 prospective cohorts in the United States and Europe. Euthyroidism was defined as TSH of 0.45 to 4.49 mIU/L, subclinical hypothyroidism as TSH of 4.5 to 19.9 mIU/L, and subclinical hyperthyroidism as TSH <0.45 mIU/L, the last two with normal free thyroxine levels. Among 25 390 participants, 2068 (8.1%) had subclinical hypothyroidism and 648 (2.6%) had subclinical hyperthyroidism. In age- and sex-adjusted analyses, risks of heart failure events were increased with both higher and lower TSH levels (
P
for quadratic pattern <0.01); the hazard ratio was 1.01 (95% confidence interval, 0.81–1.26) for TSH of 4.5 to 6.9 mIU/L, 1.65 (95% confidence interval, 0.84–3.23) for TSH of 7.0 to 9.9 mIU/L, 1.86 (95% confidence interval, 1.27–2.72) for TSH of 10.0 to 19.9 mIU/L (
P
for trend <0.01) and 1.31 (95% confidence interval, 0.88–1.95) for TSH of 0.10 to 0.44 mIU/L and 1.94 (95% confidence interval, 1.01–3.72) for TSH <0.10 mIU/L (
P
for trend=0.047). Risks remained similar after adjustment for cardiovascular risk factors.

Conclusion—
Risks of heart failure events were increased with both higher and lower TSH levels, particularly for TSH ≥10 and <0.10 mIU/L.
Training Australian general practitioners in rural public health: Impact, desirability and adaptability of hybrid problem-based learning
Authors: Gladman Justin , Perkins David 
Published: July 2012

Context and Objective: Australian rural general practitioners (GPs) require public health knowledge. This study explored the suitability of teaching complex public health issues related to Aboriginal health by way of a hybrid problem-based learning (PBL) model within an intensive training retreat for GP registrars, when numerous trainees have no PBL experience. Methods: A mixed method evaluation. Pre-training surveys on PBL experience and post-training semi-structured telephone interviews exploring the impact of the model and its desirability. Thematic and discourse analysis of interview statements, coded independently by two researchers. Results: Seventeen GP trainees and four tutors participated. Six main themes emerged: experience; PBL impact; learning modalities; educational needs; educational expectations; and educational planning. Discussion: No discernable differences were identified between Australian and international graduates, the knowledge impact of the hybrid model or desirability of the problem. While scabies offers a suitable scenario to explore rural public health complexities, a tension regarding the desire for intensive learning and PBL format needs to be addressed to increase trainees’ satisfaction. A reduction in the number of PBL sessions, PBL instruction and highly structured PBL groups will assist. Trainees value mixed modality education, including PBL, so a tailored hybrid PBL is worth consideration.
Enhanced polyurethanes based on different polycarbonatediols
Authors: Costa Victor , Nohales Andres , Félix Paula , Guillem Carmen , Gómez Clara Maria 
Published: July 2012

Segmented thermoplastic polyurethanes (PUs) were prepared from 4,4′-diphenylmethane diisocyanate (MDI), 1,4-butanediol (BD) and different macrodiols with a molar mass of 1000. Properties of those PUs based on polycarbonatediol (PCD) were compared with their homologous based on polyesterdiol and polyetherdiol as macrodiols. The proportion used in this study was macrodiol:BD:MDI = 1:2:3, in mole ratio. The hard segment weight percentage is 48 wt% for different PUs. Thermogravimetric analysis, differential scanning calorimetry, differential mechanical analysis, Fourier transform infrared-attenuated total reflection spectroscopy, as well as mechanical properties and retention on flexural properties tests were employed to characterize the physicochemical, thermal and mechanical properties of different PUs. Comparison of PUs based on PCD, ester and ether macrodiols indicates a better miscibility, higher hard segment–soft segment interactions and durability for the ones based on PCD. It is especially noticeable that the transparency of the films obtained with PCD as macrodiols as well as their good tensile strength and performance to standard durability tests, in comparison with those based on polyester and polyether. This trend could be related with a better miscibility caused by the highest hard segment–soft segment interactions favored by the presence of the carbonate groups.
The Influence of Diabetes on a Clinician-Rated Assessment of Depression in Adults With Type 1 Diabetes
Authors: Tanenbaum Molly L. , Gonzalez Jeffrey S. 
Published: July 2012

Purpose The purpose of the study was to examine the role of diabetes and diabetes-related distress within clinician-administered depression interviews of adults with type 1 diabetes. Methods This mixed-methods study coded responses to a structured clinical interview of depressive symptom severity administered to adults with type 1 diabetes (n = 34; 65% female; 56% white, 38% African American, 27% Hispanic). Pearson correlations and t tests assessed relationships between interview-based and self-reported ratings of diabetes-related distress and depression. Results Among participants endorsing depressive symptoms in the interview, 73% mentioned diabetes as a contributing factor. Themes emerged relating to (1) a link between diabetes symptoms and distress, including problems with appetite, sleep, concentration, and social relationships; (2) overlapping symptoms between diabetes and depression; and (3) the perceived interconnectedness of mood and blood glucose levels. Clinician-assessed depression ratings were strongly associated with self-reported ratings of depression and self-reported diabetes-related distress. Interview-based diabetes-related distress was significantly associated with self-reported diabetes-related distress. Those with a diagnosis of major depressive disorder (44%) reported more diabetes-related distress. Conclusions Results suggest that diabetes may influence the evaluation of depression, even in standardized clinical interviews administered by trained professionals, the gold standard of assessment. Findings highlight a need for improved conceptualization and measurement of distress in individuals with diabetes to distinguish between symptoms caused by illness burden and those indicating a psychiatric disorder.