bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Presentation and Management of Histoplasmosis in Older Adults
Authors: Ledtke Christopher , Tomford J. Walton , Jain Anil , Isada Carlos M. , van Duin David 
Published: January 2012

ObjectivesTo describe the influence of age on clinical features of histoplasmosis.DesignRetrospective single‐center cohort study.SettingLarge tertiary care center.ParticipantsAll individuals who met criteria for probable or proven histoplasmosis between 1998 and 2008.MeasurementsParticipants were divided into the following categories of histoplasmosis: acute pulmonary, chronic pulmonary, asymptomatic, disseminated, and other. Correcting for immune status, the influence of age at diagnosis on presentation, diagnosis, imaging, treatment, and all‐cause mortality was evaluated.ResultsIn 347 participants with histoplasmosis, a number of characteristics were associated with age when evaluating participants according to diagnostic category. An age‐associated increase in asymptomatic histoplasmosis was observed (P < .001). In symptomatic pulmonary histoplasmosis, older adults were less likely to present with chest pain (P < .001) and less likely to have hilar lymphadenopathy on imaging (P = .04). Lower rates of seropositivity with older age were seen in asymptomatic (P = .04) but not other forms of histoplasmosis. Cavitary disease was associated with older age in chronic pulmonary histoplasmosis (P = .05). Treatment did not change with age. All‐cause mortality at 6 months was 4% and was associated with older age (P = .02).ConclusionAlthough most studied characteristics of histoplasmosis were similar, notable age‐related differences were present. Chronic cavitary disease and asymptomatic histoplasmosis were more common with older age. In acute histoplasmosis, the lack of chest pain and hilar lymphadenopathy may hinder diagnosis in older adults.
Serum 25‐Hydroxyvitamin D, Transitions Between Frailty States, and Mortality in Older Adults: The Invecchiare in Chianti Study
Authors: Shardell Michelle , D'Adamo Christopher , Alley Dawn E. , Miller Ram R. , Hicks Gregory E. , Milaneschi Yuri , Semba Richard D. , Cherubini Antonio , Bandinelli Stefania , Ferrucci Luigi 
Published: January 2012

ObjectivesTo assess whether serum 25‐hydroxyvitamin D (25(OH)D) concentrations relate to transitions between the states of robustness, prefrailty, and frailty and to mortality in older adults.DesignThe Invecchiare in Chianti (InCHIANTI) Study, a prospective cohort study.SettingTuscany, Italy.ParticipantsAdults aged 65 and older (N = 1,155).MeasurementsSerum 25(OH)D concentrations measured at baseline; frailty state (robust, prefrail, frail) assessed at baseline and 3 and 6 years after enrollment; and vital status determined 3 and 6 years after enrollment.ResultsThe median (interquartile range) 25(OH)D concentration was 16.0 ng/mL (10.4–25.6 ng/mL; multiply by 2.496 to convert to nmol/L). Prefrail participants with 25(OH)D levels less than 20 ng/mL were 8.9% (95% confidence interval (CI) = 2.5–15.2%) more likely to die, 3.0% (95% CI = −5.6–14.6%) more likely to become frail, and 7.7% (95% CI = −3.5–18.7%) less likely to become robust than prefrail participants with 25(OH)D levels of 20 ng/mL or more. In prefrail participants, each 5‐ng/mL decrement of continuous 25(OH)D was associated with 1.46 times higher odds of dying (95% CI = 1.18–2.07) and 1.13 higher odds of incident frailty (95% CI = 0.90–1.39) than with recovery of robustness. Transitions from robustness or frailty were not associated with 25(OH)D levels.ConclusionResults provide evidence that prefrailty is an “at risk” state from which older adults with high 25(OH)D levels are more likely to recover than to decline, but high 25(OH)D levels were not associated with recovery from frailty. Thus, 25(OH)D levels should be investigated as a potential therapy to treat prefrailty and prevent further decline.
Post‐Secular Turkey
Authors: GÖLE NILÜFER 
Published: January 2012

For 500 years the West was on the rise, culminating in Globalizaiton 1.0—the open system of trade, information flows and the spread of technology on the terms and in the image of the West. The benefits of that system over the last 30 years have led to the rise of the emerging economies. As a result we are entering the new era of Globalization 2.0 characterized by new forms of non‐Western modernity and the interdependence of plural identities. The advent of this new era has been hastened by the fiscal and financial crisis in Europe and the United States.Turkey, with its Islamic‐oriented democracy that has become a template for the liberated peoples of the Arab Spring, and China, with its effective neo‐Confucian form of governance, are the most sharply defined new players in this multi‐polar and multi‐dimensional world.In this section, one of Turkey's most insightful sociologists examines the post‐secular transformation of that nation. One of China's more provocative philosophers proposes a hybrid model that combines what has been learned from the experience of Western and Chinese governance in a way that “enhances democracy” in both systems.
Globalization 2.0
Authors: LI ERIC X. 
Published: January 2012

For 500 years the West was on the rise, culminating in Globalizaiton 1.0—the open system of trade, information flows and the spread of technology on the terms and in the image of the West. The benefits of that system over the last 30 years have led to the rise of the emerging economies. As a result we are entering the new era of Globalization 2.0 characterized by new forms of non‐Western modernity and the interdependence of plural identities. The advent of this new era has been hastened by the fiscal and financial crisis in Europe and the United States.Turkey, with its Islamic‐oriented democracy that has become a template for the liberated peoples of the Arab Spring, and China, with its effective neo‐Confucian form of governance, are the most sharply defined new players in this multi‐polar and multi‐dimensional world.In this section, one of Turkey's most insightful sociologists examines the post‐secular transformation of that nation. One of China's more provocative philosophers proposes a hybrid model that combines what has been learned from the experience of Western and Chinese governance in a way that “enhances democracy” in both systems.
The G20 Is the Key Forum for Adjusting Global Power Shift
Authors: KISSINGER HENRY 
Published: January 2012

For 500 years the West was on the rise, culminating in Globalizaiton 1.0—the open system of trade, information flows and the spread of technology on the terms and in the image of the West. The benefits of that system over the last 30 years have led to the rise of the emerging economies. As a result we are entering the new era of Globalization 2.0 characterized by new forms of non‐Western modernity and the interdependence of plural identities. The advent of this new era has been hastened by the fiscal and financial crisis in Europe and the United States.Turkey, with its Islamic‐oriented democracy that has become a template for the liberated peoples of the Arab Spring, and China, with its effective neo‐Confucian form of governance, are the most sharply defined new players in this multi‐polar and multi‐dimensional world.In this section, one of Turkey's most insightful sociologists examines the post‐secular transformation of that nation. One of China's more provocative philosophers proposes a hybrid model that combines what has been learned from the experience of Western and Chinese governance in a way that “enhances democracy” in both systems.
Adapting to Changes in Design Requirements Using Set‐Based Design
Authors: McKENNEY THOMAS A. , KEMINK LAUREN F. , SINGER DAVID J. 
Published: January 2012

AbstractShip design is a highly intensive and complex process mainly due to the large number of components and competing requirements. With advancement in technology, design, and evaluation processes, more emphasis has been placed on obtaining not just a feasible design, but also an optimal one. Advanced design methods such as set‐based design (SBD) can provide a structured approach to evaluating the design space in order to make accurate and informed decisions toward a more globally optimal design. This paper presents the general application of the SBD process for US Naval vessels as well as a specialized focus on changes in design requirements. Specifically, the two main objectives are an evaluation of how delaying decisions using SBD could cause higher adaptability to changes later in the design process and development of a tradeoff space for evaluating reduced sets. A design experiment that simulated cycles of the SBD process was developed and implemented to provide insight into this objective. The different stages of the experiment included determining intersections between design components in the design space, narrowing variable sets to eliminate infeasible regions, and evaluating the effects of changing design requirements.
Set‐Based Design and the Ship to Shore Connector
Authors: MEBANE WALTER L. , CARLSON CRAIG M. , DOWD CHRIS , SINGER DAVID J. , BUCKLEY MICHAEL E. 
Published: January 2012

AbstractThe Ship to Shore Connector (SSC), a replacement for the Landing Craft, Air Cushion (LCAC), is the first government‐led design of a ship in over 15 years. This paper will discuss the changes that a government‐led design presents to the design approach, including schedule, organization structure, and design methodology. While presenting challenges, a government‐led design also afforded the opportunity to implement a new technique for assessing various systems and ship alternatives, set‐based design (SBD). The necessity for implementing SBD was the desire to design SSC from a blank sheet of paper and the need for a replacement craft in a short time frame. That is, the LCACs need to be replaced and consequently the preliminary design phase of the SSC program will only be 12 months. This paper will describe SBD and how it was applied to the SSC, the challenges that the program faced, and an assessment of the new methodology, along with recommendations that future design programs should consider when adopting this approach.
Desmoplastic trichoepithelioma with perineural involvement: a series of seven cases
Authors: Jedrych Jaroslaw , Leffell David , McNiff Jennifer M. 
Published: January 2012

Desmoplastic trichoepithelioma (DTE) is a benign follicular tumor occurring most commonly within facial skin of young and middle‐aged women, morphologically characterized by a superficial dermal proliferation of basaloid cells growing in narrow strands embedded in a desmoplastic stroma associated with small keratinizing cysts. DTE must be distinguished from other benign epithelial proliferations such as syringoma, microcystic adnexal carcinoma and infiltrating basal cell carcinoma. Among morphological features useful in that distinction, perineural involvement is considered a feature indicative of malignancy. We present a series of seven DTEs with otherwise typical presentation and morphology, nevertheless showing epithelium present in the perineural spaces of adjacent small dermal nerves. Patients ranged in age from 14 to 66 years (mean 44 years). All seven tumors were restricted to dermis, showed strands of basaloid epithelium in desmoplastic stroma and contained CK20‐positive cells. Additionally, five of five examined tumors displayed diffuse expression of p75 neurotrophin receptor. Five patients were followed up clinically (follow‐up time range: 2 months–4 years). No tumor recurrence was observed in any of these patients. We postulate that perineural involvement is an unusual feature of DTE that should not be equated with malignancy or lead to unnecessary over‐treatment.Jedrych J, Leffell D, McNiff JM. Desmoplastic trichoepithelioma with perineural involvement: a series of seven cases.
Undernutrition in Nepalese children: a biochemical and haematological study
Authors: Ghosh Arijit , Chowdhury Sutanu Dutta , Ghosh Tusharkanti 
Published: January 2012

AbstractAim:  This study was undertaken to assess the nutritional status of 6–10 years old Nepalese children by measuring some haematological and biochemical parameters.Methods:  Nutritional status was assessed by height‐for‐age z‐score. Total count of red blood corpuscles (TC of RBC), packed cell volume, haemoglobin concentration, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration were measured. Biochemical parameters such as serum iron, total iron‐binding capacity (TIBC), serum ferritin, serum transferrin, transferrin saturation (TS) and serum albumin were also measured. Serum folate and vitamin B12 were measured in well‐nourished and undernourished children.Results:  TC of RBC, serum iron, serum ferritin, TS and serum albumin of stunted children were significantly lower (p < 0.05) than that of well‐nourished children. MCV, MCH, TIBC and serum transferrin of stunted children were significantly higher (p < 0.05) than that of well‐nourished children. Serum folate and vitamin B12 values of stunted children were significantly lower (p < 0.001) than that of well‐nourished children.Conclusion:  A mild iron deficiency was found in stunted Nepalese children. The serum ferritin has been identified as a sensitive marker for measurement of iron status in surveyed children. A deficiency of serum protein, serum folate and vitamin B12 was also found in the undernourished Nepalese children.
Benefits of Early Tracheostomy in Ventilated Stroke Patients? Current Evidence and Study Protocol of the Randomized Pilot Trial SETPOINT (Stroke-Related Early Tracheostomy Vs. Prolonged Orotracheal Intubation in Neurocritical Care Trial)
Authors: Bösel Julian , Schiller Petra , Hacke Werner , Steiner Thorsten 
Published: January 2012

Rationale Ventilated intensive care patients with ischemic or hemorrhagic strokes have a poor prognosis. Early tracheostomy has led to advantages in selected groups of non-cerebrovascular intensive care patients, including shorter ventilation time, shorter intensive care unit length of stay, and reduced complications. It is completely unclear whether ventilated stroke patients might benefit from early tracheostomy, too. Aim Stroke-related Early Tracheostomy vs. Prolonged Orotracheal Intubation in Neurocritical care Trial (SETPOINT) is a pilot trial aiming to investigate the safety, feasibility, and potential benefits of early tracheostomy vs. prolonged intubation (and possibly late tracheostomy) in patients with severe ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. The primary objective is to compare early tracheostomy and prolonged intubation with respect to the intensive care unit – length of stay and the time until the start of rehabilitation in these patients. Design SETPOINT is a prospective, randomized, controlled, outcome observer-blinded, monocenter trial. Patients with severe ischemic stroke, intracerebral or subarachnoid hemorrhage requiring intubation and ventilation are eligible. After passing predefined criteria, enrolled patients are randomized to either percutaneous tracheostomy within the first three-days from intubation or to weaning/extubation attempts or percutaneous tracheostomy between days 7 and 14 from intubation (n = 30 per group). Study outcomes The primary end-point is the intensive care unit length of stay. Secondary end-points are functional outcome and mortality at discharge and after six-months, duration to transferability, duration of ventilation, duration and quality of weaning from respirator, need of analgesia and sedation, procedure-related complications, frequency of pneumonia and sepsis, and costs of treatment. Discussion To clarify the potential benefit of early tracheostomy in critical care ventilated stroke patients, a randomized multicenter trial in a larger patient population is clearly needed. If this monocentric pilot gives promising safety, feasibility, and benefit results, such a multicenter trial will be planned. The results will have a relevant direct impact on the critical care of stroke.
Systematic Review and Meta-Analysis of the Efficacy of Statins in Experimental Stroke
Authors: Baryan Hardaman K. , Allan Stuart M. , Vail Andy , Smith Craig J. 
Published: January 2012

Background and purpose Statins are postulated as candidate drugs for the treatment of acute stroke. The aim of this study was to critically appraise the evidence for the efficacy of statins administered after the onset of experimental focal cerebral ischemia. Methods We undertook a systematic review and meta-analysis of animal studies reporting the efficacy of any statin administered following middle cerebral artery occlusion. The primary outcome measure was infarct volume. Assessment of study quality and range of evidence were undertaken, and prespecified sub-group analyses were performed. Results Eighteen published studies describing outcome in 472 animals were identified. Statins reduced infarct volume by 11·2% (95% confidence interval 8·1% to 14·3%, P < 0·001) and improved the neurological severity score by 0·7 points (95% confidence interval 0·4 to 1·1, P < 0·0001). Efficacy was evident up to three-hours post-middle cerebral artery occlusion. Median study quality score was 7 of 13 (interquartile range, 4 to 11). No studies tested efficacy in aged, female, or hypertensive animals; or in species other than rodents. Conclusions These findings suggest that statins administered after middle cerebral artery occlusion have modest efficacy. Effects of potential sources of bias are considered likely to reduce the estimated effect from this review.
Higher Carotid Intima Media Thickness Predicts Extracranial Vascular Events and Not Stroke Recurrence among Transient Ischemic Attack Patients
Authors: Purroy Francisco , Montserrat Josep , Begué Robert , Gil Maria Isabel , Quílez Alejandro , Sanahuja Jordi , Brieva Luis , Pardina Marina , Piñol-Ripoll Gerard 
Published: January 2012

Background Increased common carotid artery intima-media thickness has been associated with an increased risk of vascular ischemic events. We investigated the relationship between common carotid artery intima-media thickness and extracranial vascular events (coronary heart disease and peripheral arterial disease) or stroke recurrence in a cohort of transient ischemic attack patients from the REGITELL registry. Methods High-resolution B-mode ultrasonographic measurements of the common carotid artery intima-media thickness were performed in a series of 283 consecutive transient ischemic attack patients. Clinical, neuroimaging, ultrasonographic, and etiological data were collected. Patients were followed prospectively for six-months or more. Extracranial vascular events and stroke recurrence were recorded. Results Fifteen extracranial vascular events (12 coronary heart disease and three peripheral arterial disease) and 29 recurrent strokes occurred during a median follow-up period of 12·3 months. Patients who experienced extracranial vascular events had significantly ( P < 0·001) higher common carotid artery intima-media thickness values (1·087 (standard deviation 0·189) mm) than subjects who were free of extracranial vascular events (0·887 (standard deviation 0·195) mm). Nevertheless, common carotid artery intima-media thickness was not found to correlate with stroke recurrence. Cox proportional hazards multivariate analyses identified hypercholesterolemia (hazard ratio 6·87, 95% confidence interval: 1·93–24·39, P = 0·003) and common carotid artery intima-media thickness >0·939 mm (hazard ratio 8·90, 95% confidence interval: 2·00–39·49, P = 0·004) as independent predictors of extracranial vascular events after transient ischemic attack. Almost one of every three patients with hypercholesterolemia and high common carotid artery intima-media thickness had extracranial vascular events. Conclusions An elevated common carotid artery intima-media thickness value was associated with a higher long-term risk of extracranial vascular events but no with stroke recurrence. Hypercholesterolemia was the main risk factor for extracranial vascular events. The combination of hypercholesterolemia and common carotid artery intima-media thickness >0·939 mm justify the establishment of aggressive therapies and the study of subclinical coronary heart disease and peripheral arterial disease.
Mechanism and Efficiency of Cell Death of Type II Photosensitizers: Effect of Zinc Chelation†
Authors: Pavani Christiane , Iamamoto Yassuko , Baptista Maurício S. 
Published: January 2012

AbstractA series of meso‐substituted tetra‐cationic porphyrins, which have methyl and octyl substituents, was studied in order to understand the effect of zinc chelation and photosensitizer subcellular localization in the mechanism of cell death. Zinc chelation does not change the photophysical properties of the photosensitizers (all molecules studied are type II photosensitizers) but affects considerably the interaction of the porphyrins with membranes, reducing mitochondrial accumulation. The total amount of intracellular reactive species induced by treating cells with photosensitizer and light is similar for zinc‐chelated and free‐base porphyrins that have the same alkyl substituent. Zinc‐chelated porphyrins, which are poorly accumulated in mitochondria, show higher efficiency of cell death with features of apoptosis (higher MTT response compared with trypan blue staining, specific acridine orange/ethidium bromide staining, loss of mitochondrial transmembrane potential, stronger cytochrome c release and larger sub‐G1 cell population), whereas nonchelated porphyrins, which are considerably more concentrated in mitochondria, triggered mainly necrotic cell death. We hypothesized that zinc‐chelation protects the photoinduced properties of the porphyrins in the mitochondrial environment.
Analysis of polymorphisms of TNF‐α, LT‐α, IL‐10, IL‐12 and CTLA‐4 in patients with warm autoimmune haemolytic anaemia
Authors: D’ABRONZO L. S. , BARROS M. M. O. , BORDIN J. O. , FIGUEIREDO M. S. 
Published: January 2012

SummaryIntroduction:  Autoimmune haemolytic anaemia (AIHA) is defined as the increased destruction of red blood cells (RBCs) in the presence of anti‐RBC autoantibodies and/or complement. Its pathogenesis is multifactorial and includes changes in mechanisms of cytokine production and functionality. A number of recent studies have implicated cytokines polymorphisms in the pathogenesis of autoimmune diseases. The aim of this study was to determine the frequency of polymorphisms of tumour necrosis factor alpha (TNF‐α), lymphotoxin‐α (LT‐α), interleukin 10 (IL‐10), interleukin 12 (IL‐12) and cytotoxic T‐lymphocyte antigen‐4 (CTLA‐4) in patients with AIHA in comparison with healthy individuals.Methods:  The study population consisted of 17 patients with AIHA and 40 healthy controls. The polymorphisms for TNF‐α−308, LT‐α +252, IL‐10 −592, IL‐12 +1188 and CTLA‐4 +49 were examined by polymerase chain reaction followed by specific restriction enzyme digestion.Results:  There was no significant difference in the phenotypic distributions of polymorphisms of the TNF‐α, IL‐10, IL‐12 and CTLA‐4 between the patients and controls. Compared with healthy controls, patients with AIHA had a significant higher frequency of LT‐α (+252) AG phenotype (41%vs. 13%; P = 0.032).Conclusion:  In this study, no significant differences on the frequency of TNF‐α, IL‐10, IL‐12 and CTLA‐4 polymorphisms between patients with AIHA and controls was found, suggesting that the targeted polymorphisms do not influence on the emergence and evolution of the disease. However, the LT‐α +252 polymorphism might have an effect for AIHAI development, suggesting that further studies are necessary to clear up this question.