bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early neurological outcomes according to CHADS2 score in stroke patients with non‐valvular atrial fibrillation
Authors: Hong H. J. , Kim Y. D. , Cha M.‐J. , Kim J. , Lee D. H. , Lee H. S. , Nam C. M. , Nam H. S. , Heo J. H. 
Published: September 2011

Background and purpose: A higher CHADS2 score or CHA2DS2‐VASc score is associated with an increased risk of ischaemic stroke in patients with non‐valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels.Methods:  In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low‐risk (CHADS2 score of 0–1), moderate‐risk (CHADS2 score 2–3), or high‐risk group (CHADS2 score ≥4). CHA2DS2‐VASc score was divided into four groups including 0–1, 2–3, 4–5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS2 score or CHA2DS2‐VASc score in stroke patients with NVAF.Results:  The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high‐risk group [9.5, interquartile range (IQR) 4–18], followed by moderate‐risk (8, IQR 2–17) and low‐risk group (6, IQR 2–15) (P = 0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA2DS2‐VASc score. During hospitalization, those in the high‐risk group or higher CHA2DS2‐VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS2 score or CHA2DS2‐VASc score increased. Multivariate analysis showed being in the high‐risk group was independently associated with END (OR 2.129, 95% CI 1.013–4.477).Conclusions:  Our data indicate that patients with NVAF and higher CHADS2 score or CHA2DS2‐VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.
Simvastatin enhances the antihypertensive effect of ramipril in hypertensive hypercholesterolemic animals and patients. Possible role of nitric oxide, oxidative stress, and high sensitivity C‐reactive protein
Authors: Abdel‐Zaher Ahmed O. , Elkoussi Alaa Eldin A. , Abudahab Lotfy H. , Elbakry Mohammed H. , Elsayed Elsayed Abu‐Elwafa 
Published: September 2011

AbstractIn this study, the effects of simvastatin on the blood pressure and on the antihypertensive activity of ramipril in hypertensive hypercholesterolemic animals and patients were evaluated. In hypertensive hypercholesterolemic animals, repeated administration of simvastatin slightly but significantly decreased the systolic blood pressure, enhanced its progressive reductions induced by repeated administration of ramipril and corrected the compromised lipid profile. Concomitantly, repeated administration of simvastatin, ramipril or simvastatin in combination with ramipril to these animals, increased nitric oxide (NO) production and decreased the elevated serum malondialdehyde (MDA) and high sensitivity C‐reactive protein (hs‐CRP) levels. The effects of combined treatment were greater than those of simvastatin or ramipril alone. In hypertensive hypercholesterolemic patients, repeated administration of ramipril decreased systolic and diastolic blood pressure, increased NO production, and decreased the elevated serum MDA and hs‐CRP levels. Addition of simvastatin to ramipril therapy enhanced these effects and corrected the compromised lipid profile. Simvastatin but not ramipril inhibited the contractile responses of isolated aortic rings induced by angiotensin 11. l‐arginine and acetylcholine enhanced, while l‐NAME inhibited effects of simvastatin, and simvastatin in combination with ramipril on these contractile responses. These findings suggest that simvastatin exerts antihypertensive effect and enhances the antihypertensive effect of ramipril in hypertensive hypercholesterolemic animals and patients. In addition to its cholesterol‐lowering effect, the ability of simvastatin to ameliorate endothelial dysfunction through increasing NO bioavailability and through suppression of oxidative stress and vascular inflammation and its ability to enhance the effect of ramipril on these parameters may play a pivotal role in these effects.
Levofloxacin‐induced rhabdomyolysis in a hemodialysis patient
Authors: Gupta Ankur , Guron Nita , Harris Michael , Bell Robert 
Published: September 2011

AbstractRhabdomyolysis is a well‐known complication of various drug therapies. We report a case of levofloxacin‐induced rhabdomyolysis requiring hospitalization in a hemodialysis patient. Physicians should be aware of the risk of this potentially severe adverse drug reaction.
The definition of a haemodynamic significant duct in randomized controlled trials: a systematic literature review
Authors: Zonnenberg Inge , de Waal Koert 
Published: September 2011

AbstractAim:  A patent ductus arteriosus (PDA) is associated with morbidity in preterm infants. Treatment is prescribed for a haemodynamically significant duct (HSDA), but its definition varies. We systematically reviewed the clinical and ultrasound criteria used for the definition of an HSDA.Methods:  PubMed and the Cochrane library were searched for randomized trials evaluating ductal treatment. The included studies were explored, and we categorized clinical and ultrasound criteria used to define an HSDA.Results:  Sixty‐seven trials were included in our review. Forty‐two were placebo‐controlled trials, and 25 were comparative trials. The diagnosis of the PDA was made by clinical examination, followed by ultrasound in most trials. Most trials used clinical and ultrasound criteria to define an HSDA, but there was a wide variety in criteria and cut‐offs used. Of the clinical criteria, a murmur or hyperdynamic circulation was most used, and of the ultrasound criteria, the left‐atrium‐to‐aorta ratio (LA/Ao ratio) was most used.Conclusion:  We found a wide variety in the definition of an HSDA. This finding implies that comparison of studies is difficult. International consensus should be reached on the definition of an HSDA, which will make future studies more comparable.
Oral status in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease
Authors: Holmén Anette , Strömberg Ella , Hagman‐Gustafsson Marie‐Louise , Wårdh Inger , Gabre Pia 
Published: September 2011

doi: 10.1111/j.1741‐2358.2011.00507.xOral status in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal diseaseObjectives:  The aim of this study was to compare the prevalence of edentulous subjects, caries and periodontal disease among the home‐dwelling elderly with moderate and substantial needs of support for daily living.Materials and method:  A sample of 302 randomly selected elderly with moderate or substantial needs of supportive care were examined in Sweden. Several oral clinical variables were registered: number of teeth, dentures, caries, probing pocket depth, gingival bleeding and Eichner’s index.Results:  Both in general and in oral health, the differences were small when comparing elderly with moderate and substantial care needs for daily living. Those with substantial needs had more caries lesions (p < 0.01) and more gingival bleeding (p < 0.05), while the number of teeth and prevalence of edentulous subjects did not differ in relation to the need of daily support. The elderly had, on average, 9.8–11.7 teeth, one‐third of whom had no natural teeth. According to Eichner’s index, half of the elderly in both groups had no opposing tooth contacts. Fifty‐five per cent used dentures.Conclusions:  Elderly people with needs of supportive care have lost many teeth before they become dependent. Health promotion should be a priority in early ageing populations to prevent oral diseases and tooth loss.
The PTPN22*R620W polymorphism does not confer genetic susceptibility to antiphospholipid syndrome in the Spanish population
Authors: Castro‐Marrero J. , Balada E. , Vilardell‐Tarrés M. , Ordi‐Ros J. 
Published: September 2011

SummaryIn this work, we proposed to determine the association of the PTPN22*R620W SNP with primary antiphospholipid syndrome (PAPS) in a case–control association study of Spanish Caucasian individuals. A total of 81 PAPS patients were compared with 81 blood‐donor healthy control subjects. PTPN22 SNP (R620W) genotyping was performed by using a polymerase chain reaction–restricted fragment length polymorphism assay. No statistically significant differences were found between control subjects and PAPS patients for the PTPN22*R620W genotypes (P = 0.214). No statistically significant differences were found according to either the presence or absence of antiphospholipid antibodies or the clinical manifestations associated to PAPS. Our results indicate that this functional PTPN22*R620W polymorphism is not associated to PAPS; it seems not to be a risk factor in our Spanish population. The effect of the PTPN22 SNP on clinical manifestations and presence of antiphospholipid antibodies in APS warrants further investigations.
Development of a Methodology for the Assessment of Vulnerability Related to Wildland Fires Using a Multi‐Criteria Evaluation
Authors: GALIANA‐MARTÍN LUIS , KARLSSON OSKAR 
Published: September 2011

AbstractIn the geography of risk, vulnerability may be defined as a physical characteristic that describes the tendency of a territory to suffer damage as a result of the occurrence of certain phenomena. According to this synthetic definition, there are two main components of vulnerability in the context of wildland fires. The first is internal, and is related to the effects of fires on the value of the affected assets affected and their capacity for recovery. The second is external, and is related to the characteristics of fires and the ability of society to deal with the hazards of wildland fires. The aim of the present study is to develop an assessment of spatial vulnerability in the context of wildland fires, at a scale appropriate for planning (1/25 000), in a mountainous region of the Spanish Mediterranean coast (Sierra Calderona). The proposed methodology entailed the definition of a synthetic index associated with the management of the risk of wildland fires, which was made up of significant factors such as the difficulty of extinction, the need for forest defence, the need for civil protection, and territorial value. To define and calculate the factors, variables and indicators that reflected aspects of the components of vulnerability (such as exposure, sensitivity, and the capacity to fight fires) were used. These were combined in a hierarchical structure, each having its own cartographical representation. Geographical information systems and multi‐criteria evaluation were then used to provide a successful framework for the analysis of vulnerability in relation to wildland fires. The cartographical outputs of the various components of the index are of particular interest to the planning of certain activities (e.g. forest, wildland fire, and civil protection), all of which are directly involved in the management of risk. In turn, the final synthetic index provides comprehensive spatial information that is useful for spatial planning and also enables the assessment of potential future land use in view of its usefulness in simulations.
Variability in Operative Management of Proximal Humerus Fractures
Authors: Boykin Robert E. , Jawa Andrew , O'Brien Travis , Higgins Laurence D. , Warner Jon J. P. 
Published: September 2011

Background Controversy exists regarding the best methods for the operative management of proximal humerus fractures. We hypothesized that trauma surgeons perform the majority of these procedures and that there is variability in the type of fixation used at our institutions based on the type of fellowship training. Methods A retrospective review of 177 consecutive operative closed proximal humerus fractures was conducted. All images were classified based on the Neer system, including: simple (two-part surgical neck or isolated tuberosity) or complex (three- or four-part). Choice of fixation was determined based on surgeon subspecialty. Results One-hundred and nine procedures were performed by trauma, 45 by shoulder, and 17 by hand. Thirty-eight percent (67/177) were simple and 62% (110/177) were complex. A significant difference was only found in blade plating of two-part surgical neck fractures ( p < 0.05) and the management of tuberosity fractures ( p < 0.05). Analysis of complex fractures showed a significant difference in the rate of arthroplasty ( p < 0.05). Discussion Trauma surgeons perform the majority of procedures on proximal humerus fractures, although at a similar rate to shoulder surgeons. A significant difference in management was found with regard to the utilization of blade plating, arthroplasty and the management of tuberosity fractures.
THE PREDICTABILITY OF STOCK MARKET RETURNS IN SOUTH AFRICA: PARAMETRIC VS. NON‐PARAMETRIC METHODS
Authors: BONGA‐BONGA LUMENGO , MWAMBA MUTEBA 
Published: September 2011

AbstractThis paper compares the forecasting performance of a sub‐class of univariate parametric and non‐parametric models in predicting stock market returns in South Africa. To account for conditional heteroskedasticity in stock returns data, the non‐parametric model is generated by the conditional heteroskedastic non‐linear autoregressive (NAR) model, while the parametric model is produced by the generalised autoregressive conditional heteroskedastic in mean (GARCH‐M) model. The results of the paper show that the NAR as a non‐parametric model performs better than the GARCH‐M model in short‐term forecasting horizon, and this indicates the importance of a distribution‐free model in predicting stock returns in South Africa.
Anticipating the Species Jump: Surveillance for Emerging Viral Threats
Authors: Flanagan M. L. , Parrish C. R. , Cobey S. , Glass G. E. , Bush R. M. , Leighton T. J. 
Published: September 2011

SummaryZoonotic disease surveillance is typically triggered after animal pathogens have already infected humans. Are there ways to identify high‐risk viruses before they emerge in humans? If so, then how and where can identifications be made and by what methods? These were the fundamental questions driving a workshop to examine the future of predictive surveillance for viruses that might jump from animals to infect humans. Virologists, ecologists and computational biologists from academia, federal government and non‐governmental organizations discussed opportunities as well as obstacles to the prediction of species jumps using genetic and ecological data from viruses and their hosts, vectors and reservoirs. This workshop marked an important first step towards envisioning both scientific and organizational frameworks for this future capability. Canine parvoviruses as well as seasonal H3N2 and pandemic H1N1 influenza viruses are discussed as exemplars that suggest what to look for in anticipating species jumps. To answer the question of where to look, prospects for discovering emerging viruses among wildlife, bats, rodents, arthropod vectors and occupationally exposed humans are discussed. Finally, opportunities and obstacles are identified and accompanied by suggestions for how to look for species jumps. Taken together, these findings constitute the beginnings of a conceptual framework for achieving a virus surveillance capability that could predict future species jumps.
Validation of a cranial injection technique of the medial femorotibial joint in the horse
Authors: Down S. S. , Munroe G. A. , Murray R. C. 
Published: September 2011

SummaryA cranial technique for entry of the medial femorotibial (MFT) joint in the horse was validated. It was hypothesised that the frequency of correct placement into the MFT joint using the described cranial technique would be similar to using a standard medial approach. Twenty‐four limbs from 15 horses were injected with a latex mixture. Limbs with stifle joint effusion and/or known stifle pathology were grouped separately to those without. When effusion/pathology was not present the medial technique (93%) was almost twice as successful as the cranial technique (53%), including when extremes of size were removed from the population. With the presence of femoropatellar or medial femorotibial effusion, the cranial technique (20%) was 5 times less successful than using the medial technique (100%). When extremes of size were removed from the population of horses with effusion, the success of the cranial technique was marginally improved (33%). When an ‘average size’ of horse is used with or without joint effusion, the cranial technique is successful in entering the MFT joint in approximately 50% of cases, and may hence be of use in a fractious animal without sedation, a stallion, or in the presence of a wound/skin infection at the site of the medial needle entrance.
Review of injection techniques targeting the sacroiliac region in horses
Authors: Engeli E. , Haussler K. K. 
Published: September 2011

SummaryLocal anaesthetic techniques and diagnostic imaging tools are currently used in conjunction with thorough physical and lameness examinations to diagnose sacroiliac disease (SID) in the horse. The deep and inaccessible location of the sacroiliac joint (SIJ), however, often renders diagnostic imaging modalities, such as radiography, nuclear scintigraphy and ultrasonography, unreliable in identifying sacroiliac problems. The equine clinician therefore often has to rely on positive results of local anaesthetic techniques to confirm a diagnosis of SID. Regional infiltration techniques have been described but result in a diffuse distribution of large volumes of local anaesthetic solution throughout the entire lumbosacroiliac region, which is nonspecific to the SIJ and has the potential to produce false positive results. Several periarticular injection approaches to the SIJ have recently been described. A combination of periarticular SIJ injections with the use of modest amounts of local anaesthetic solution provides increased SIJ specificity, but may lead to false negative results in cases where the pain originates from surrounding soft tissues. This article clarifies terminology related to sacroiliac injections, reviews current injection techniques, highlights the advantages and disadvantages of each approach, and investigates injectate volume considerations.
Antibodies to Streptococcus pneumoniae Capsular Polysaccharide Enhance Pneumococcal Quorum Sensing
Authors: Yano Masahide , Gohil Shruti , Coleman J. Robert , Manix Catherine , Pirofski Liise-anne 
Published: September 2011

ABSTRACT

The use of pneumococcal capsular polysaccharide (PPS)-based vaccines has resulted in a substantial reduction in invasive pneumococcal disease. However, much remains to be learned about vaccine-mediated immunity, as seven-valent PPS-protein conjugate vaccine use in children has been associated with nonvaccine serotype replacement and 23-valent vaccine use in adults has not prevented pneumococcal pneumonia. In this report, we demonstrate that certain PPS-specific monoclonal antibodies (MAbs) enhance the transformation frequency of two different
Streptococcus pneumoniae
serotypes. This phenomenon was mediated by PPS-specific MAbs that agglutinate but do not promote opsonic effector cell killing of the homologous serotype
in
vitro
. Compared to the autoinducer, competence-stimulating peptide (CSP) alone, transcriptional profiling of pneumococcal gene expression after incubation with CSP and one such MAb to the PPS of serotype 3 revealed changes in the expression of competence (
com
)-related and bacteriocin-like peptide (
blp
) genes involved in pneumococcal quorum sensing. This MAb was also found to induce a nearly 2-fold increase in CSP2-mediated bacterial killing or fratricide. These observations reveal a novel, direct effect of PPS-binding MAbs on pneumococcal biology that has important implications for antibody immunity to pneumococcus in the pneumococcal vaccine era. Taken together, our data suggest heretofore unsuspected mechanisms by which PPS-specific antibodies could affect genetic exchange and bacterial viability in the absence of host cells.

IMPORTANCE
Current thought holds that pneumococcal capsular polysaccharide (PPS)-binding antibodies protect against pneumococcus by inducing effector cell opsonic killing of the homologous serotype. While such antibodies are an important part of how pneumococcal vaccines protect against pneumococcal disease, PPS-specific antibodies that do not exhibit this activity but are highly protective against pneumococcus in mice have been identified. This article examines the effect of nonopsonic PPS-specific monoclonal antibodies (MAbs) on the biology of
Streptococcus pneumoniae
. The results showed that in the presence of a competence-stimulating peptide (CSP), such MAbs increase the frequency of pneumococcal transformation. Further studies with one such MAb showed that it altered the expression of genes involved in quorum sensing and increased competence-induced killing or fratricide. These findings reveal a novel, previously unsuspected mechanism by which certain PPS-specific antibodies exert a direct effect on pneumococcal biology that has broad implications for bacterial clearance, genetic exchange, and antibody immunity to pneumococcus.
Lean thinking transformation of the unsedated upper gastrointestinal endoscopy pathway improves efficiency and is associated with high levels of patient satisfaction
Authors: Hydes Theresa , Hansi Navjyot , Trebble Timothy M 
Published: September 2011

BackgroundUpper gastrointestinal (UGI) endoscopy is a routine healthcare procedure with a defined patient pathway. The objective of this study was to redesign this pathway for unsedated patients using lean thinking transformation to focus on patient-derived value-adding steps, remove waste and create a more efficient process. This was to form the basis of a pathway template that was transferrable to other endoscopy units.MethodsA literature search of patient expectations for UGI endoscopy identified patient-derived value. A value stream map was created of the current pathway. The minimum and maximum time per step, bottlenecks and staff–staff interactions were recorded. This information was used for service transformation using lean thinking. A patient pathway template was created and implemented into a secondary unit. Questionnaire studies were performed to assess patient satisfaction.ResultsIn the primary unit the patient pathway reduced from 19 to 11 steps with a reduction in the maximum lead time from 375 to 80 min following lean thinking transformation. The minimum value/lead time ratio increased from 24% to 49%. The patient pathway was redesigned as a ‘cellular’ system with minimised patient and staff travelling distances, waiting times, paperwork and handoffs. Nursing staff requirements reduced by 25%. Patient-prioritised aspects of care were emphasised with increased patient–endoscopist interaction time. The template was successfully introduced into a second unit with an overall positive patient satisfaction rating of 95%.ConclusionLean thinking transformation of the unsedated UGI endoscopy pathway results in reduced waiting times, reduced staffing requirements and improved patient flow and can form the basis of a pathway template which may be successfully transferred into alternative endoscopy environments with high levels of patient satisfaction.