bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organized Blood Pressure Control Programs to Prevent Stroke in Australia
Authors: Cadilhac Dominique A. , Carter Rob , Thrift Amanda G. , Dewey Helen M. 
Published: February 2012

Background and Purpose—
High blood pressure (BP) is the most important modifiable stroke risk factor. Worldwide high BP in many people is uncontrolled or people are unaware of their BP status. We aimed to assess whether a program of organized multidisciplinary care and medication would be cost-effective for improving BP control for the prevention of stroke.

Methods—
A novel aspect was to simulate the intervention to match recent primary care initiatives (eg, new Medicare reimbursement items) to ensure policy relevance. Current practice and additional costs of each intervention were included using the best available evidence. The differences in the cost per quality-adjusted life year (QALY) gained for the interventions were compared against current practice. Cost-effectiveness was defined as cost per QALY gained was less than Australian dollars (AUD) 50 000 (societal perspective; reference year 2004). The robustness of estimates was assessed with probabilistic multivariable uncertainty analysis.

Results—
For primary prevention, the median cost per QALY gained was AUD11 068 (95% uncertainty interval AUD5201 to AUD18 696) in those aged 75 years or older and was AUD17 359 (95% uncertainty interval AUD10 516 to AUD26 036) in those aged 55 to 84 years with ≥15% absolute risk of stroke. Primary prevention interventions were not cost-effective if aged younger than 50 years. The median cost per QALY gained for secondary prevention was AUD1811 and AUD4704, depending on which medications were modeled.

Conclusions—
Organized care for BP control targeted at specific populations offers excellent value over current practice. Organized care for secondary prevention provided the greatest benefits and strongest cost-effectiveness. Translation into clinical practice requires improved use of relevant Medicare policy in Australia.
Risk Factors and Outcome of Patients With Symptomatic Intracranial Stenosis Presenting With Lacunar Stroke
Authors: Khan Amir , Kasner Scott E. , Lynn Michael J. , Chimowitz Marc I. 
Published: February 2012

Background and Purpose—
We hypothesized that patients with intracranial stenosis with lacunar stroke presentations would face lower risks of recurrent stroke than those with index nonlacunar strokes, and that their recurrent strokes would predominantly be lacunar.

Methods—
We analyzed subjects enrolled with an index stroke into the Warfarin Aspirin Symptomatic Intracranial Disease (WASID) trial. The index stroke was classified as lacunar or nonlacunar. The primary end point was recurrent ischemic stroke. Cox proportional hazard models were generated with stratification for severity of stenosis.

Results—
Three hundred forty-seven subjects were enrolled after an index stroke; 38 were lacunar and 309 were nonlacunar. Over a mean follow-up of 1.8 years, there was no significant difference in stroke recurrence between patients whose index stroke was lacunar (7 of 38 [18%]) versus nonlacunar (69 of 309 [22%]; hazard ratio, 0.79; 95% CI, 0.36–1.71). Furthermore, no significant differences were found when groups were stratified by 50% to 69% stenosis (hazard ratio, 0.50; 95% CI, 0.12–2.1) and ≥70% stenosis (hazard ratio, 0.87; 95% CI, 0.34–2.2). Of the 7 recurrent strokes in patients whose index stroke was lacunar, all 7 were nonlacunar and 3 were in the territory of the stenotic artery.

Conclusions—
In patients with symptomatic intracranial stenosis, the risk of recurrent stroke was similar in patients who presented with lacunar and nonlacunar strokes, and recurrent strokes in patients presenting with lacunar stroke were typically nonlacunar. These findings suggest that the pathophysiology of these strokes is related to the stenosis rather than small vessel disease. Patients presenting with lacunar strokes should be included in trials investigating secondary prevention for symptomatic intracranial stenosis.
Depression Screening in Stroke
Authors: Turner Alyna , Hambridge John , White Jennifer , Carter Gregory , Clover Kerrie , Nelson Louise , Hackett Maree 
Published: February 2012

Background and Purpose—
Screening tools for depression and psychological distress commonly used in medical settings have not been well validated in stroke populations. We aimed to determine the accuracy of common screening tools for depression or distress in detecting caseness for a major depressive episode compared with a clinician-administered structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as the gold standard.

Methods—
Seventy-two participants ≥3 weeks poststroke underwent a diagnostic interview for major depressive episode and completed the Patient Health Questionnaire-2 and -9, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, Distress Thermometer, and Kessler-10. Internal consistency, sensitivity, specificity, likelihood ratios, and posttest probabilities were calculated. Each measure was validated against the gold standard using receiver operating characteristic curves with comparison of the area under the curve for all measures.

Results—

Internal consistency ranged from acceptable to excellent for all measures (Cronbach α=0.78–0.94). Areas under the curve (95% CI) for the Patient Health Questionnaire-2, Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale depression and total score, Beck Depression Inventory-II, and Kessler-10 ranged from 0.80 (0.69–0.89) for the Kessler-10 to 0.89 (0.79–0.95) for the Beck Depression Inventory-II with no significant differences between measures. The Distress Thermometer had an area under the curve (95% CI) of 0.73 (0.61–0.83), significantly smaller than the Beck Depression Inventory-II (
P
<0.05).

Conclusions—
Apart from the Distress Thermometer, selected scales performed adequately in a stroke population with no significant difference between measures. The Patient Health Questionnaire-2 would be the most useful single screen given free availability and the shortest number of items.
Process-Based Decomposition of the Global Surface Temperature Response to El Niño in Boreal Winter
Authors: Deng Yi , Park Tae-Won , Cai Ming 
Published: February 2012

Abstract
This paper reports an attribution analysis that quantifies addible contributions to the observed temperature anomalies from radiative and nonradiative processes in terms of both amplitude and spatial pattern for the two most prominent surface temperature patterns in an El Niño winter. One is the El Niño SST pattern consisting of warming SST anomalies over the eastern equatorial Pacific basin surrounded by cooling SST anomalies in the western and subtropical Pacific, and the other is a tripole surface temperature anomaly characteristic of a positive Pacific–North American (PNA) teleconnection pattern. The decomposition of the observed temperature anomalies is achieved with the coupled atmosphere–surface climate feedback-responses analysis method (CFRAM), which is formulated utilizing energy balance in the atmosphere–surface columns and linearization of radiative energy perturbation.
Out of the mean amplitude of 0.78 K of the El Niño SST pattern, the oceanic dynamics and heat storage term alone contributes to 2.34 K. Water vapor feedback adds another 1.6 K whereas both cloud and atmospheric dynamical feedbacks are negative, reducing the mean amplitude by 2.02 and 1.07 K, respectively. Atmospheric dynamical feedback contributes more than 50% (0.73 K) of the mean amplitude (1.32 K) of the PNA surface temperature pattern. Water vapor and surface albedo feedbacks contribute 0.34 and 0.13 K, respectively. The surface processes, including oceanic dynamics in the North Pacific, heat storage anomalies, and surface sensible/latent heat flux anomalies of ocean and land also contribute positively to the PNA surface temperature pattern (about 0.14 K). Cloud and ozone feedback, although very weak, act to oppose the PNA surface temperature anomaly.
Ultrasound as a Primary Evaluation Tool of Bone Stress Injuries in Elite Track and Field Athletes
Authors: Papalada Agapi , Malliaropoulos Nikolaos , Tsitas Kostas , Kiritsi Olga , Padhiar Nat , Del Buono Angelo , Maffulli Nicola 
Published: February 2012

Background: Little is known about therapeutic ultrasound (TUS) to diagnose bone stress injuries. Hypothesis: Therapeutic ultrasound is an accurate, cost-efficient alternative to other imaging methods for primary assessment of bone stress injuries. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: One hundred thirteen elite track and field athletes (mean age, 20.1 years; range, 17-28 years) underwent TUS and magnetic resonance imaging (MRI) for clinical suspicion of a bone stress injury. A 5-stage MRI grading system was used to classify bone stress injuries. Sensitivity, specificity, accuracy, and positive and negative predictive values of TUS were calculated using MRI as the standard for diagnosis. Results: At MRI, of 113 assessed patients, 3 (2.7%) had grade 0 injuries, 12 (10.6%) had grade 1, 15 (13.3%) had grade 2, 77 (68.2%) had grade 3, and 6 (5.3%) had grade 4. At TUS, no injury was detected in 22 of 113 patients: 2 with grade 0 injury, 8 with grade 1, 8 with grade 2, and 4 with grade 3. Using MRI as the gold standard, TUS showed 81.8% sensitivity, 66.6% specificity, 99.0% positive predictive value, 13.4% negative predictive value, and 81.4% accuracy. Conclusion: Therapeutic ultrasound is a reproducible procedure that is reliable to diagnose bone stress injuries.
Report on a Systematic Review of the Efficacy and Clinical Effectiveness of Group Analysis and Analytic/Dynamic Group Psychotherapy
Authors: Blackmore Chris , Tantam Digby , Parry Glenys , Chambers Eleni 
Published: February 2012

This article reports on a systematic review to assess the efficacy and clinical effectiveness of group analysis and analytic/dynamic (A/D) group psychotherapy. Systematic literature searches were undertaken; 34 primary studies and 19 reviews met the inclusion criteria and their data was extracted. Of the primary studies, the randomized controlled trials provided evidence for the efficacy and clinical effectiveness of group therapy approaches in a range of clinical problems, but not for specific benefits of any particular theoretical approach. The controlled studies and observational studies gave support for the use of group psychotherapy in a variety of conditions. The review of reviews confirms that group therapies in general are more effective than wait list or standard care controls. Methodological challenges encountered and recommendations for further research are presented, along with a more detailed discussion of the implications of the review for the research community.
Effects of exposure to low-level lead on spatial learning and memory and the expression of mGluR1, NMDA receptor in different developmental stages of rats
Authors: Wang Xin-Mei , Liu Wen-Jun , Zhang Rong , Zhou Yi-Kai 
Published: February 2012

The effect of different periods of lead exposure on deficits of learning and memory is still unclear. In this study, we conduct in vivo experiment to investigate the critical stages when lead induced neurotoxicity in rats and its underlying mechanisms in some critical stages. Rats were exposed to 0.2% mg/ml lead acetate solution via drinking water during gestation, lactation and ablactation periods. Behavior deficits were found in gestation and lactation. N-Methyl-d-aspartate (NMDA) receptor subunit 2A (NR2A) increased during gestation both in hippocampus and cerebral cortex compared to the control group; in all treatment groups NR2B decreased in hippocampus and in cerebral cortex during the lactation period. Meanwhile, in hippocampus metabotropic glutamate receptor 1 (mGluR1) decreased during gestation and lactation periods but increased during the ablactation period. These observations suggest that exposure to lead in gestation and lactation periods could cause neurobehavioral deficits which extend to adulthood, and lactation was a more sensitive period for lead exposure. Furthermore, the abnormal expression of NMDA receptor 2 (NMDAR 2) subunits and mGluR1 are likely to be associated with the impairment.
Determination of the genotoxic effects of Convolvulus arvensis extracts on corn (Zea mays L.) seeds
Authors: Sunar Serap , Yildirim Nalan , Aksakal Ozkan , Agar Guleray 
Published: February 2012

In this research, the methanolic extracts of Convolvulus arvensis were tested for genotoxic and inhibitor activity on the total soluble protein content and the genomic template stability against corn Zea mays L. seed. The methanol extracts of leaf, stem and root of C. arvensis were diluted to 50, 75 and 100 μl concentrations and applied to corn seed. The total soluble protein and genomic template stability results were compared with the control. The results showed that especially 100 μl extracts of diluted leaf, stem and root had a strong inhibitory activity on the genomic template stability. The changes occurred in random amplification of polymorphic DNA (RAPD) profiles of C. arvensis extract treatment included variation in band intensity, loss of bands and appearance of new bands compared with control. Also, the results obtained from this study revealed that the increase in the concentrations of C. arvensis extract increased the total soluble protein content in maize. The results suggested that RAPD analysis and total protein analysis could be applied as a suitable biomarker assay for the detection of genotoxic effects of plant allelochemicals.
Inhibitory effects of tiotropium on rhinovirus infection in human airway epithelial cells
Authors: Yamaya Mutsuo , Nishimura Hidekazu , Hatachi Yukimasa , Yasuda Hiroyasu , Deng Xue , Sasaki Takahiko , Kubo Hiroshi , Nagatomi Ryoichi 
Published: February 2012

Infection by rhinoviruses (RVs) causes exacerbations of chronic obstructive pulmonary disease (COPD). The long-acting anti-cholinergic agent tiotropium reduces the frequency of COPD exacerbations, but the inhibitory effects of tiotropium on the COPD exacerbations induced by RVs are unclear. Likewise, the effects of tiotropium on RVs infection remain to be studied.To examine the effects of tiotropium on RV infection and RV infection-induced airway inflammation, human tracheal epithelial cells were infected with a major group RV, type 14 RV (RV14).RV14 infection increased the viral titre and the amount of pro-inflammatory cytokines, including interleukin (IL)-1β and -6, in supernatant fluids and the amount of RV14 RNA in cells. Tiotropium reduced RV14 titres, RNA and cytokine concentrations, and susceptibility to RV14 infection. Tiotropium reduced the expression of intercellular adhesion molecule (ICAM)-1, the receptor for RV14, and the number of cellular acidic endosomes, which allow RV14 RNA to enter the cytoplasm. Tiotropium inhibited the activation of nuclear factor-κB proteins, including p50 and p65, in the nuclear extracts, and it increased the cytosolic amount of inhibitory κB-α.Tiotropium may inhibit RV14 infection by reducing the levels of ICAM-1 and acidic endosomes and may also modulate airway inflammation in rhinovirus infection.
Pulmonary hypertension in lymphangioleiomyomatosis: characteristics in 20 patients
Authors: Cottin Vincent , Harari Sergio , Humbert Marc , Mal Hervé , Dorfmüller Peter , Jaïs Xavier , Reynaud-Gaubert Martine , Prevot Grégoire , Lazor Romain , Taillé Camille , Lacronique Jacques , Zeghmar Sabrina , Simonneau Gérald , Cordier Jean-François ,   the Groupe d'Etudes et de Recherche sur les Maladies “Orphelines” Pulmonaires (GERM“O”P)
Published: February 2012

This retrospective, multicentre study evaluated patients with lymphangioleiomyomatosis (LAM) and pre-capillary pulmonary hypertension (PH) by right heart catheterisation.It was conducted in 20 females with a mean±sdage of 49±12 yrs and a mean±sdtime interval between LAM and PH diagnoses of 9.2±9.8 yrs. All, except for one patient, were receiving supplemental oxygen. 6-min walking distance was mean±sd340±84 m. Haemodynamic characteristics were: mean pulmonary artery pressure (PAP) 32±6 mmHg, cardiac index 3.5±1.1 L·min−1·m−2and pulmonary vascular resistance (PVR) 376±184 dyn·s·cm−5. Mean PAP was >35 mmHg in only 20% of cases. The forced expiratory volume in 1 s was 42±25%, carbon monoxide transfer factor was 29±13%, and arterial oxygen tension (Pa,O2) was 7.4±1.3 kPa in room air. Mean PAP and PVR did not correlate withPa,O2. In six patients who received oral pulmonary arterial hypertension (PAH) therapy, the PAP decreased from 33±9 mmHg to 24±10 mmHg and the PVR decreased from 481±188 dyn·s·cm−5to 280±79 dyn·s·cm−5. The overall probability of survival was 94% at 2 yrs.Pre-capillary PH of mild haemodynamic severity may occur in patients with LAM, even with mild pulmonary function impairment. PAH therapy might improve the haemodynamics in PH associated with LAM.
Dietary patterns and respiratory symptoms in pre-school children: the Generation R Study
Authors: Tromp Ilse I.M. , Kiefte-de Jong Jessica C. , de Vries Jeanne H. , Jaddoe Vincent W.V. , Raat Hein , Hofman Albert , de Jongste Johan C. , Moll Henriette A. 
Published: February 2012

Overall diet in early childhood may affect the development of respiratory symptoms. This study examined whether childhood dietary patterns are associated with respiratory symptoms in Dutch pre-school children, and whether this association could be explained by energy intake.A prospective cohort study was performed in 2,173 children aged ≤4 yrs. Data on asthma-related symptoms were obtained by questions from the age-adapted version of the "International Study of Asthma and Allergies in Childhood" questionnaires. Data on respiratory tract infections, defined as episodes of physician attended fever with respiratory symptoms, was obtained by questionnaire. Principal components analysis was used to develop dietary patterns at 14 months of age.Compared with low adherence, high adherence to the “Western” dietary pattern was significantly associated with frequent wheeze at 3 yrs of age (relative risk (RR) 1.39, 95% CI 1.02–1.89) and frequent shortness of breath (RR 1.44, 95% CI 1.03–2.01) and respiratory tract infections (RR 1.54, 95% CI 1.08–2.19) at 4 yrs of age. However, this association was partially explained by energy intake.A “Western” diet may increase the risk of frequent respiratory symptoms at 3 and 4 yrs of age. In some measure, this association was explained by energy intake.
Atorvastatin in Pulmonary Arterial Hypertension (APATH) study
Authors: Zeng Wei-Jie , Xiong Chang-Ming , Zhao Lan , Shan Guang-Liang , Liu Zhi-Hong , Xue Fang , Gu Qing , Ni Xin-Hai , Zhao Zhi-Hui , Cheng Xian-Sheng , Wilkins Martin R. , He Jian-Guo 
Published: February 2012

Statins have been shown to both prevent and attenuate pulmonary hypertension in animal models. This study investigates the potential therapeutic benefits of atorvastatin as an affordable treatment for pulmonary hypertension patients.220 patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) were randomised, double-blind, to receive atrovastatin 10 mg daily or matching placebo in addition to supportive care.At 6 months, 6-min walk distance decreased by 16.6 m in the atorvastatin group and 14.1 m in the placebo group. The mean placebo-corrected treatment effect was -2.5 m (95% CI: -38–33; p=0.96), based on intention to treat. A small nonsignificant increase in pulmonary vascular resistance and fall in cardiac output was seen in both treatment groups. There was no significant difference in the proportion of patients who improved, remained stable or showed a deterioration in World Health Organization functional class between atorvastatin and placebo treatments. Nine patients died in the atorvastatin group and 11 in the placebo group. Serum cholesterol levels fell significantly on atorvastatin treatment. Discontinuation rates were 23.2% and 26.9% on atorvastatin and placebo, respectively.Atorvastatin 10 mg daily has no beneficial effect on the natural history of PAH or CTEPH over 6 months.
Cost and cost-effectiveness of multidrug-resistant tuberculosis treatment in Estonia and Russia
Authors: Floyd Katherine , Hutubessy Raymond , Kliiman Kai , Centis Rosella , Khurieva Nina , Jakobowiak Wieslaw , Danilovits Manfred , Peremitin Genadi , Keshavjee Salmaan , Migliori Giovanni Battista 
Published: February 2012

Evidence on the cost and cost-effectiveness of treatment of multidrug-resistant tuberculosis (MDR-TB) is limited, and no published data are available from former Soviet Union countries, where rates of MDR-TB are highest globally.We evaluated the cost and cost-effectiveness of MDR-TB treatment in Estonia and Russia (Tomsk Oblast), comparing cohorts enrolled on treatment according to World Health Organization (WHO) guidelines in 2001 and 2002 with cohorts treated in previous years. Costs were assessed from a health system perspective in 2003 US$; effects were measured as cures, deaths averted and disability-adjusted life-years (DALYs) averted.Cure rates when WHO guidelines were followed were 61% (90 out of 149) in Estonia and 76% (76 out of 100) in Tomsk Oblast, with a cost per patient treated of US$8,974 and US$10,088, respectively. Before WHO guidelines were followed, cure rates were 52% in Estonia and 15% in Tomsk Oblast; the cost per patient treated was US$4,729 and US$2,282, respectively. Drugs and hospitalisation accounted for 69–90% of total costs. The cost per DALY averted by treatment following WHO guidelines was US$579 (range US$297–US$902) in Estonia and US$429 (range US$302–US$546) in Tomsk Oblast.Treatment of patients with MDR-TB can be cost-effective, but requires substantial additional investment in tuberculosis control in priority countries.
Reduced larger von Willebrand factor multimers at dawn in OSA plasmas reflect severity of apnoeic episodes
Authors: Koyama Noriko , Matsumoto Masanori , Tamaki Shinji , Yoshikawa Masanori , Fujimura Yoshihiro , Kimura Hiroshi 
Published: February 2012

Plasma von Willebrand factor (VWF), produced in and released from vascular endothelial cells by various stimuli including hypoxia, induces platelet aggregation under high shear stress and plays dual pivotal roles in haemostasis and thrombosis within arterioles, which are regulated by the size of vWF multimers (VWFMs).Patients with obstructive sleep apnoea (OSA) have increased risk of thrombotic cardiovascular events, but the pathogenesis is unclear. We examined the relationship between VWF and OSA by measuring VWF antigen (VWF:Ag), VWFMs, VWF collagen binding activity (VWF:CB) and a disintegrin-like, metalloproteinase, and thrombospiondin type 1 motifs 13. A total of 58 OSA patients were enrolled. Blood samples were collected before sleep, after sleep, and after one night of nasal continuous positive airway pressure therapy.Based on VWFM analysis, OSA patients were classified into three groups; consistently normal VWFMs (group 1, n=29), increased high molecular weight (HMW)-VWFMs at 06:00 h (group 2, n=18), and decreased or absent HMW-VWFMs at 06:00 h (group 3, n=11). Patients in group 3 had significantly worse apnoea/hypopnoea index; VWF:CB followed a similar pattern. We observed a significant decrease in platelet count between 21:00 h and 06:00 h in OSA patients, potentially associated with reduced larger VWFMs together with decreased VWF:Ag levels. Severe OSA may contribute to an arterial pro-thrombotic state.