bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case‐study of the experiences of junior medical officers in the emergency departments of a metropolitan hospital and rural hospital
Authors: Bonney Andrew , Mullan Judy , Hammond Athena , Burns Pippa , Yeo Georgia , Thomson Brett , Flynn Sharon , Carrigan Tom 
Published: November 2019

AbstractObjectiveIncreased exposure to post‐graduate rural medical training is associated with increased likelihood of future rural practice. Training rotations in rural emergency departments provide a possible avenue for such exposure, but have been under‐investigated. This study aimed to compare junior medical officers' emergency department experiences in a metropolitan and a rural hospital to inform rural health workforce initiatives.DesignMixed‐method case‐study design.SettingTwo 10‐week periods in the respective emergency departments.ParticipantsFour junior medical officers at the rural site and 22 junior medical officers at the metropolitan hospital.Main outcome measuresCaseloads extracted from electronic medical records and training experience.ResultsData were collected over 142 days. The average number of patients seen per day, per junior medical officer, was significantly higher at the rural hospital emergency department (7.2 patients per day) in comparison with the metropolitan hospital (4.3 patients per day). Junior medical officers at the rural hospital saw relatively more lower acuity patients. The seven junior medical officers who were interviewed provided consistently positive responses regarding their training experiences in both locations. This was particularly evident in the rural hospital and was attributed to one‐on‐one supervision.ConclusionsMost junior medical officers agreed that their expectations for support and learning opportunities were met and/or exceeded. However, junior medical officers reported feeling more supported at the rural hospital due to direct contact and communication with senior medical officers. Placement in a smaller hospital emergency department did not disadvantage the junior medical officers' training in this case‐study and provided a positive rural training experience. These findings support workforce policies which encourage rural hospital emergency department training.
Time to computed tomography: does this affect trauma patient outcomes? A retrospective analysis at an Australian major trauma centre
Authors: Ng Cedric L. H. , Kim Jason , Dobson Ben , Campbell Don , Wullschleger Martin 
Published: November 2019

BackgroundComputed tomography (CT) is an essential diagnostic tool for severe multi‐trauma patients. International guidelines recommend an optimal time of 1 h from arrival. The aim of this study was to determine the time interval from arrival at the emergency department to CT for all trauma patients and the effects on in‐hospital mortality and hospital length of stay.MethodsRetrospective study of all patients who triggered a trauma call and underwent CT scanning at the Gold Coast University Hospital from January 2016 to December 2017. Exclusion criteria were scans performed at peripheral hospitals or performed more than 5 h after arrival to emergency department.ResultsOne thousand six hundred and nineteen eligible trauma patients were admitted over the study period and underwent CT scanning. Median time to CT was found to be 43 min. CTs done within 1 h compared to those done after 1 h from emergency department arrival were found to have a higher mean injury severity score (11 ± 10 versus 9 ± 9, P = 0.003), a longer mean hospital length of stay (9 ± 21 versus 7 ± 13 days, P = 0.012) and no difference in mortality rates (2.2% versus 2.1%, P = 1.000). Age, injury severity score and intubation status were identified as independent predictors for longer hospital length of stay and higher mortality while time to CT did not. Injury severity score was shown to be an independent predictor of time to CT.ConclusionOur time to CT scanning is well within the timeframe recommended by international guidelines. Early CT scanning may also improve outcomes in severely injured trauma patients.
Dynamic measurement of centering forces on transvalvular cannulas
Authors: Stoiber Martin , Aigner Philipp , Grasl Christian , Röhrich Michael , Moscato Francesco , Schima Heinrich 
Published: November 2019

AbstractIn heart failure therapy, minimally invasive devices (transcatheter valves, catheter‐based cannulas or pumps) are increasingly used. The interaction with the valve is of special importance as valve damage, backflow, and thrombus formation are known complications. Therefore, the aim of this in vitro study was to characterize the forces acting on different sized transvalvular cannulas at various transvalvular pressures for four different valves. In a pulsatile setup radial and tangential forces on transvalvular cannulas were measured for bioprosthetic, artificial pericardial tissue, fresh, and fixated porcine valves. The cannula position was varied from a central position to the wall in 10° rotational steps for the whole circular range and the use of different cannula diameters (4, 6, and 8 mm) and transvalvular pressures (40‐100 mmHg). Centering forces of four different aortic valve types were identified and the three leaflets were visible in the force distribution. At the mid of the cusps and at the largest deflection the forces were highest (up to 0.8 N) and lowest in the commissures (up to 0.2 N). Whereas a minor influence of the cannula diameter was found, the transvalvular pressure linearly increased the forces but did not alter the force patterns. Centering forces that act on transvalvular cannulas were identified in an in vitro setup for several valves and valve types. Lowest centering forces were found in the commissures and highest forces were found directly at the cusps. At low pressures, low centering forces and an increased cannula movement can be expected.
Molecular and phenotypical investigation of ciprofloxacin resistance among Campylobacter jejuni strains of human origin: high prevalence of resistance in Turkey
Authors: Ilktac Mehmet , Ongen Betigul , Humphrey Thomas J. , Williams Lisa K. 
Published: November 2019

Campylobacteriosis is one of the most frequently reported zoonoses worldwide. The well‐documented increase in the ciprofloxacin resistance has increased the importance of rapid detection of the resistance. The incidence of ciprofloxacin resistance was investigated using real‐time PCR. Identification of one hundred and fifty‐eight strains was performed by PCR. Minimum inhibitory concentration (MIC) of ciprofloxacin was determined by Epsilometer test. Following the confirmation of the efficiencies of singleplex real‐time PCR methods using two different probes, a cytosine to thymine point mutation at codon 86 was detected by allelic discrimination. Of the 158 strains, 114 (72.2%) were determined to be resistant to ciprofloxacin. The MIC50 and the MIC90 of ciprofloxacin were found to be 8 and ≥32 mg/L, respectively. By real‐time PCR, the presence of the mutation was confirmed in all, but one, resistant strains and the absence of the mutation was demonstrated in all, but one, susceptible strains. The rate of resistance is high among C. jejuni strains and ciprofloxacin should not be used in the treatment of such infections in Turkey. A cytosine to thymine mutation is the most frequently detected mechanism for the resistance. Real‐time PCR can be used for the quick screening of the resistance.
spoT‐mediated stringent response influences environmental and nutritional stress tolerance, biofilm formation and antimicrobial resistance in Klebsiella pneumoniae
Authors: Davis Rochell T. , Brown Paul D. 
Published: November 2019

Klebsiella pneumoniae is an important opportunistic pathogen with significant potential for virulence and multidrug resistance. Treatment failure often occurs because the pathogen may couple virulence and drug resistance with the stringent response. This study assessed the role of the spoT gene in environmental and nutritional stress tolerance, exopolysaccharide capsule production and biofilm formation. spoT mutants were constructed using the lambda red recombinase technique, and mutant and wild‐type (WT) strains were exposed to limiting concentrations of carbon (glucose), phosphate and aminoacid, and environmental stresses of ethanol, salt and heat. Cell viability, capsule production and cell length were assessed as well as the ability to grow biofilm under antibiotic pressure using gentamicin and ceftazidime. spoT mutants were more susceptible to stresses versus WT; the reverse was true for survival during biofilm susceptibility assay (p < 0.05), especially when carbon and phosphate were present. spoT mutants were elongated and lacked a capsule versus WT and non‐starved strains. The inability to produce capsule in mutants before and after starvation was likely a general effect of spoT mutation. These data suggest that the spoT‐mediated stringent response is important for K. pneumoniae in conditions of nutrient limitation, environmental stress and antimicrobial pressure.
Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti‐TNF or conventional therapy: results of the European CONCEIVE study
Authors: Moens Annick , van der Woude C. Janneke , Julsgaard Mette , Humblet Evelien , Sheridan Juliette , Baumgart Daniel C. , Gilletta De Saint‐Joseph Cyrielle , Nancey Stéphane , Rahier Jean‐François , Bossuyt Peter , Cremer Anneline , Dewit Sophie , Eriksson Carl , Hoentjen Frank , Krause Thomas , Louis Edouard , Macken Elisabeth , Milenkovic Zoran , Nijs Jochen , Posen Annelies , Van Hootegem Anneleen , Van Moerkercke Wouter , Vermeire Séverine , Bar‐Gil Shitrit Ariella , Ferrante Marc 
Published: November 2019

SummaryBackgroundWomen with inflammatory bowel diseases (IBD) often receive biologicals during pregnancy to maintain disease remission. Data on outcome of vedolizumab‐exposed pregnancies (VDZE) are sparse.AimsTo assess pregnancy and child outcomes of VDZE pregnancies and to compare these results to anti‐TNF exposed (TNFE) or both immunomodulatory and biologic unexposed (CON IBD) pregnancies.MethodsA retrospective multicentre case‐control observational study was performed.ResultsVDZE group included 79 pregnancies in 73 IBD women. The TNFE and CON IBD group included 186 pregnancies (162 live births) in 164 IBD women and 184 pregnancies (163 live births) in 155 IBD women, respectively. At conception, cases more often had active disease ([VDZE: 36% vs TNFE: 17%, P = .002] and [VDZE: 36% vs CON IBD: 24%, P = .063]). No significant difference in miscarriage rates were found between groups (VDZE and TNFE: 16% vs 13%, P = .567; VDZE and CON IBD: 16% vs 10%, P = .216). In live‐born infants, median gestational age and birthweight were similar between groups. Median Apgar score at birth was numerically equal. Prematurity was similar in the VDZE group compared to the control groups, even when correcting for disease activity during pregnancy. The frequency of congenital anomalies was comparable between groups as were the percentages of breastfed babies. During the first year of life, no malignancies were reported and infants' infection risk did not significantly differ between groups.ConclusionNo new safety signal was detected in VDZE pregnancies although larger, prospective studies are required for confirmation.
Effects of rice feeding on growth performance and protein (amino acids) metabolism in weanling piglets
Authors: Tasaka Yusuke , Tachihara Kanako , Kagawa Ryutaro , Takada Ryozo 
Published: November 2019

AbstractWe investigated the effects of rice feeding on growth performance and protein (amino acids) metabolism of weanling piglets. In all, 16 weanling piglets with an average initial weight of 7.5 kg were divided into two groups. One group was fed a corn‐soybean meal‐based diet, and the other was fed a rice‐soybean meal diet, containing around 46% of corn or rice, respectively. A two‐week growth trial was conducted. The average daily gain (p = .025) and feed efficiency (p = .011) in rice‐fed piglets were significantly higher than those in corn‐fed piglets. Liver lysine‐ketoglutarate reductase activity tended to be lower (p = .073) in rice‐fed piglets than in corn‐fed piglets. Plasma urea nitrogen concentration in rice‐fed piglets was significantly lower than that in corn‐fed piglets. Plasma glucose and insulin concentrations were significantly higher in rice‐fed piglets than in corn‐fed piglets. Plasma‐free valine, isoleucine, and tryptophan concentrations were significantly higher in rice‐fed piglets than in corn‐fed piglets. In contrast, plasma histidine concentration was significantly lower in rice‐fed piglets than in corn‐fed piglets. Overall, these results show that rice feeding improves the growth performance and affects the protein (amino acids) metabolism in weanling piglets.
The virtually mature B‐type natriuretic peptide (BNP1‐32) is a precursor for the more effective BNP1‐30
Authors: Schwiebs Anja , Wang Yong , Moore Andrew M. , Zhu Xudong , Pankow Kristin , Siems Wolf‐Eberhard , Walther Thomas 
Published: November 2019

Background and PurposeThe B‐type natriuretic peptide (BNP1‐32) exerts vasorelaxing and cardioprotective activity. BNP is used as a biomarker for the diagnosis of cardiopathological conditions and recombinant BNP1‐32 as a drug for the treatment of such. BNP1‐32 has a short half‐life and thus, similar to other vasoactive peptides like angiotensin II and bradykinin, can be enzymatically truncated forming bioactive metabolites. We aimed to investigate the metabolism of BNP1‐32 in the mouse lung, to identify potential new BNP metabolites and to disclose their biological activity compared to the BNP1‐32, in vitro and in vivo.Experimental ApproachUsing HPLC and MS, we identified a new BNP metabolite, BNP1‐30, in the lung being generated by endothelin‐converting enzyme‐1.Key ResultsBNP1‐30 is more efficient in stimulating the guanylyl cyclase (GC) receptor A and, in contrast to BNP1‐32, is also able to profoundly stimulate the GC‐B. In vivo, BNP1‐30 reduced the mean arterial BP of normotensive mice after acute infusion significantly more than BNP1‐32. In a model of severe hypertension, a 3‐day infusion of BNP1‐30 was able to reduce systolic BP by 30 mmHg and to improve markers of heart failure, while BNP1‐32 was without significant effect.Conclusions and ImplicationsOur results suggest that BNP1‐32 is the precursor for the biologically more active BNP1‐30 leading to a fundamental extension of the natriuretic peptide system. Due to expanded activity, BNP1‐30 might be a promising treatment option for cardiovascular diseases. Furthermore, its potency as a new diagnostic marker of specific cardiac diseases should be evaluated.
Business Collaboration within the Nazi War Machine: Corporations and the State in the Austrian Semiperiphery
Authors: Lo Clarence Y.H. 
Published: November 2019

AbstractThe military strength of German National Socialism was based on the collaboration of large corporations with the Nazi state. Business provided capital, loans, taxes, managerial expertise and production for war industries. I elaborate four ideal‐typical modes of business collaboration. Each mode is illustrated by a case study of a German corporation that acquires an Austrian firm: Krupp (traditional mode); the Reichswerke state conglomerate (coercive); Deutsche Bank (managerial nationalist); and IG Farben (competitive investment mode). The first and the last modes occurred when the state was highly dependent on large businesses for the economic requisites of war. The acquired firms in the Austrian semiperiphery contributed to Nazi war mobilization, as they exploited labor and resources from the peripheral regions of southeastern Europe. Patterns of the state's resource dependency on business led to bargaining interactions between state and business, over time shaping the mix between state and private ownership of war industry.
Vasodilator oxyfedrine inhibits aldehyde metabolism and thereby sensitizes cancer cells to xCT‐targeted therapy
Authors: Otsuki Yuji , Yamasaki Juntaro , Suina Kentaro , Okazaki Shogo , Koike Naoyoshi , Saya Hideyuki , Nagano Osamu 
Published: November 2019

AbstractThe major cellular antioxidant glutathione (GSH) protects cancer cells from oxidative damage that can lead to the induction of ferroptosis, an iron‐dependent form of cell death triggered by the aberrant accumulation of lipid peroxides. Inhibitors of the cystine‐glutamate antiporter subunit xCT, which mediates the uptake of extracellular cystine and thereby promotes GSH synthesis, are thus potential anticancer agents. However, the efficacy of xCT‐targeted therapy has been found to be diminished by metabolic reprogramming that affects redox status in cancer cells. Identification of drugs for combination with xCT inhibitors that are able to overcome resistance to xCT‐targeted therapy might thus provide the basis for effective cancer treatment. We have now identified the vasodilator oxyfedrine (OXY) as a sensitizer of cancer cells to GSH‐depleting agents including the xCT inhibitor sulfasalazine (SSZ). Oxyfedrine contains a structural motif required for covalent inhibition of aldehyde dehydrogenase (ALDH) enzymes, and combined treatment with OXY and SSZ was found to induce accumulation of the cytotoxic aldehyde 4‐hydroxynonenal and cell death in SSZ‐resistant cancer cells both in vitro and in vivo. Microarray analysis of tumor xenograft tissue showed cyclooxygenase‐2 expression as a potential biomarker for the efficacy of such combination therapy. Furthermore, OXY‐mediated ALDH inhibition was found to sensitize cancer cells to GSH depletion induced by radiation therapy in vitro. Our findings thus establish a rationale for repurposing of OXY as a sensitizing drug for cancer treatment with agents that induce GSH depletion.
Bone tissue formation around two titanium implant surfaces placed in bone defects filled with bone substitute material or blood clot: A pilot study
Authors: Trento Guilherme dos Santos , Spin‐Neto Rubens , Bassi Ana Paula Farnezi , Okamoto Roberta , Gabrielli Marisa Aparecida Cabrini , Pereira‐Filho Valfrido Antonio 
Published: November 2019

AbstractObjectivesThe objective of this study was to evaluate the peri‐implant bone tissue formation around titanium implants with different surface treatments, placed in bone defects filled or not with bone substitute material (BSM).Materials and MethodsTen animals were divided into two groups according to implant surface treatment. In each tibia, a bone defect was created followed by the placement of one implant. On the left tibia, the defect was filled with blood clot (BC), and on the right tibia, the defect was filled with biphasic hydroxyapatite/β‐tricalcium‐phosphate (HA/TCP) generating four subgroups: BC‐N: blood clot and porous surface; BC‐A: blood clot and porous‐hydrophilic surface; HA/TCP‐N: BSM and porous surface; HA/TCP‐A: BSM and porous‐hydrophilic surface. The animals were submitted to euthanasia 60 days after implant installation. After light‐curing resin inclusion, the blocks containing the implant and the bone tissue were stained and evaluated by means of histomorphometry to assess the percentages of bone implant contact (% BIC). Data was normally distributed and the group differences were examined using the parametric tests of Two‐Way ANOVA.ResultsThe BC‐A group presented the higher mean value of BIC (46.43%). The HA/TCP‐A group presented the higher mean value of BIC. The porous‐hydrophilic surfaces presented better results of BIC when compared to the porous surface in both conditions of defect filling. No statistically significant differences were found among all groups (95% confidence interval and P < .05).ConclusionAccording to histomorphometric analysis, after 60‐days in a rabbit model, hydrophilic and hydrophobic surfaces have the same behavior in the presence or absence of HA/TCP.
Changes in health‐related quality of life with intensive behavioural therapy combined with liraglutide 3.0 mg per day
Authors: Chao Ariana M. , Wadden Thomas A. , Walsh Olivia A. , Gruber Kathryn A. , Alamuddin Naji , Berkowitz Robert I. , Tronieri Jena S. 
Published: November 2019

SummaryThis study examined the effects of intensive behavioural therapy (IBT) for obesity (IBT‐alone), IBT plus liraglutide 3.0 mg/day (IBT‐liraglutide), and IBT‐liraglutide combined with 12 weeks of a portion‐controlled diet (Multicomponent) on changes in general health‐related (HR) quality of life (QoL) and weight‐related QoL. Adults with obesity (79.3% female; 54.0% white; 44.7% black; mean age = 47.6 ± 11.8 years and body mass index = 38.4 ± 4.9 kg/m2) were randomized to IBT‐alone (n = 50), IBT‐liraglutide (n = 50) or Multicomponent (n = 50). General HRQoL was measured with the Short Form‐36 (SF‐36), and weight‐related QoL was assessed with the Impact of Weight on Quality of Life‐Lite scale. At week 52, participants in the three groups lost 6.1 ± 1.3%, 11.5 ± 1.3% and 11.8 ± 1.3% of initial body weight, respectively. Both liraglutide‐treated groups were significantly more likely than IBT‐alone to achieve clinically meaningful improvements in total weight‐related QoL. They also both achieved greater improvements than IBT‐alone in weight‐related public distress and in general mental health, as measured by the SF‐36 mental component summary score. Independent of treatment group, greater categorical weight loss was associated with greater improvements in several domains of both general and weight‐related QoL. The addition of liraglutide to IBT appeared to improve aspects of both general HRQoL and weight‐related QoL.
Changes in the commercial brand of tacrolimus lead to subtherapeutic trough levels and acute rejection in renal transplant recipients
Authors: Arreola‐Guerra José Manuel , Alberú Josefina , Chew‐Wong Alfredo , Macias Dulce Maria , Hernández‐Rosales Jesus , Zuñiga‐Macías Leslie , Delgadillo‐Castañeda Rodolfo , Ricalde‐Ríos Guadalupe , Haro‐Alcalde Fabian , Villafán‐Bernal J. Rafael , Ramos‐Medellín Carmen L. , Reyes‐Acevedo Rafael 
Published: November 2019

AbstractBackgroundThe vigilance of tacrolimus (TAC) trough levels is an essential part of renal transplant follow up. Reduced TAC trough levels and high variability are related to adverse outcomes. The aim of this study was to evaluate the impact of brand changes on tacrolimus (TAC) subtherapeutic (SubT) trough levels, acute rejection (AR), and kidney function.MethodsThis is a prospective, observational cohort study of renal transplant recipients, between January 2016 and October 2018. Tacrolimus trough levels and brand used by the patient were both registered at every consult. Tacrolimus values ≤3.5 ng/mL were considered SubT.Results445 patients were included. The median number of TAC brand changes was 2 (IQR, 1‐4). Patients were grouped according to the number of brand changes: Group 1 = 0 (n = 107), Group 2 = 1‐4 (n = 236), and Group 3 = ≥5 (n = 102). Patients with the greatest number of brand changes had a greater proportion and number of SubT TAC trough levels (Group 1 = 36.4%, average 0.53; Group 2 = 39.8%, average 0.65, Group 3 = 59.8%, average 1.17, P < .001) and AR (Group 1 = 0.9%, Group 2 = 11%, Group 3 = 14.7%, P < .001). On multivariate analysis, SubT levels and the number of brand changes were related to AR.ConclusionsIn Mexico, changes in TAC brand are associated with an elevated frequency of SubT levels. Brand changes and SubT levels are independently associated with acute rejection. The supply policies on TAC brands in Mexico require revision to avoid changing brands as much as possible.