bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective single‐centre analysis of diagnostic approach to adult‐onset haemophagocytic lymphohistiocytosis
Authors: Lee Wei‐I. , Talaulikar Dipti , Cook Matthew C. 
Published: May 2020

AbstractBackgroundHaemophagocytic lymphohistiocytosis (HLH) is a rare disorder with a poor prognosis characterised by substantial immune activation leading to end‐organ failure. In childhood, genetic defects that impair cytotoxic function of natural killer cells and T cells. (HLH) are often identified. In adults, clinical manifestations are similar to those observed in children but the aetiology is often unclear.AimsTo evaluate whether poor prognosis for adult HLH is in part due to lack of awareness of the disorder, which results in incomplete investigation and failure to implement timely treatment.MethodsWe performed a retrospective case series of adult‐onset HLH in a tertiary hospital in Australia. We evaluated clinical characteristics, treatment and outcome, and related these to application of standard diagnostic criteria for HLH.ResultsIn our centre, incomplete assessment of HLH criteria was common. Serum ferritin was the criterion most commonly assessed. Hyperferritinaemia ≥10 000 μg/L was highly sensitive in detecting patients with adult‐onset HLH; however, the majority of patients who had hyperferritinaemia ≥10 000 μg/L did not have adult‐onset HLH.ConclusionThe present study highlights the importance of comprehensive application of diagnostic criteria to improve accuracy and timelines of the diagnosis of adult onset HLH.
Evaluation of calling criteria for the rapid response system utilising single versus multiple physiological parameter disturbances
Authors: Shoaib Muhammad , Chalmers Leanne , Richards Tobias , Carison John , Leman Peter 
Published: May 2020

AbstractBackgroundThe Adult Deterioration Detection System for Medical Emergency Team (MET) activation is widely used and includes single parameter (SP‐MET) and multiple parameter (MP‐MET) disturbances. Whether the patient characteristics, interventions and outcomes differ for SP‐MET compared with MP‐MET is uncertain.AimsTo describe MET interventions and outcomes of SP versus MP MET in the Acute Medical Unit (AMU) of a tertiary care hospital.MethodsRetrospective audit over 6 months comparing SP‐MET and MP‐MET groups.ResultsSP‐MET constituted 64.1% (168) of 262 AMU MET calls, most commonly for hypotension (35.5%) and tachycardia (14.1%). There were no significant differences in demographic and disease characteristics between the two groups. Common interventions included fluid/electrolyte replacement in 139 (52%), oxygen therapy in 46 (17%) and non‐invasive ventilation in 33 (13%) patients. After MET intervention, 82.4% patients stayed on the ward, 8.4% died/were palliated, 6.5% were transferred to the Intensive Care Unit (ICU) and 2.7% patients required urgent transfer to the theatre for intervention. SP‐MET patients were more likely to remain on the ward (88.7% vs 71.3%; P = 0.001), receive ward‐based interventions (85.1% vs 61.7%; P < 0.001) and less likely to experience death/palliation (4.2% vs 16%, P = 0.001) compared with the MP‐MET group. MP‐MET were independently associated with negative outcomes (OR 3.10; 95% CI 1.60–6.00).ConclusionSP‐MET identify a cohort of patients at lower risk of requiring escalation of care and ICU admission. Given the resource intensity of MET activation, further research is warranted to determine whether alternative response strategies are appropriate for selected SP disturbances.
The effects of 11‐ketotestosterone implants on transcript levels of gonadotropin receptors, and foxl2 and dmrt1 genes in the Previtellogenic ovary of cultured beluga (Huso huso)
Authors: Rahdari Abdolali , Khoshkholgh Majidreza , Yarmohammadi Mahtab , Ortiz‐Zarragoitia Maren , Lokman Pieter Mark , Akhavan Sobhan R. , de Cerio Oihane Diaz , Cancio Ibon , Falahatkar Bahram 
Published: May 2020

AbstractThe in vivo effect of 11‐ketotestosterone (11KT) on transcript levels of the gonadotropin receptors (fshr and lhr) and sex differentiation‐related genes (dmrt1 and foxl2) was examined in the ovaries of immature female beluga. For this purpose, six fish were treated with implants containing 2.5 mg 11KT and a placebo group of six females of the same age and gametogenic stage were given a blank implant. The implants were intraperitoneally inserted into 4‐year‐old females at the previtellogenic stage (mean body weight 5580 ± 165 g) and maintained under culture conditions for 8 weeks. Ovary samples for gene expression analysis of lhr, fshr, dmrt1 and foxl2 were collected by biopsy at 3 and 8 weeks post implantation. Diameters of oocytes increased in response to 11KT treatment, both at 3 and at 8 weeks post implantation, but no obvious changes were evident in cytology. Three weeks of 11KT treatment did not affect target gene expression, but a tendency for a time‐dependent decrease of lhr and dmrt1 mRNA levels was observed in both treatment and placebo groups. By 8 weeks of treatment, however, 11KT implants provoked the upregulation of fshr and foxl2 transcript levels. Furthermore, lhr and dmrt1 transcript abundances recovered by 8 weeks of exposure in both blank‐ and 11KT‐implanted beluga. These results suggest that 11KT, either directly or indirectly, may affect gametogenesis and regulate some key components of the reproductive axis in female beluga.
Architectural and ultrastructural features of tessellated calcified cartilage in modern and extinct chondrichthyan fishes
Authors: Maisey John G. , Denton John S. S. , Burrow Carole , Pradel Alan 
Published: May 2020

AbstractTessellated calcified cartilage (TCC) is a distinctive kind of biomineralized perichondral tissue found in many modern and extinct chondrichthyans (sharks, rays, chimaeroids and their extinct allies). Customarily, this feature has been treated somewhat superficially in phylogenetic analyses, often as a single “defining” character of a chondrichthyan clade. TCC is actually a complex hard tissue with numerous distinctive attributes, but its use as a character complex for phylogenetic analysis has not yet been optimized. This study attempts to improve this situation by presenting new terminology for certain aspects of tesseral architecture, including single‐monolayered, multiple‐monolayered, polylayered and voussoir tesserae; new histological data, including thin sections of TCC in several Palaeozoic taxa, and new proposals for ways in which various characters and states (many of which are defined here for the first time) could be applied in future phylogenetic analyses of chondrichthyan fishes. It can be concluded that many, but not all, of the unique attributes of modern TCC evolved by the Early Devonian (ca. 400 before present (bp)). The globular calcified cartilage reported in Silurian sinacanthids and the so‐called subtessellated perichondral biomineralization (with irregular and ill‐defined geometries of a layer or layers of calcified cartilage blocks) of certain extinct “acanthodians” (e.g.,Climatius,Ischnacanthus,Cheiracanthus) could represent evolutionary precursors of TCC, which seems to characterize only part of the chondrichthyan total group. It is hypothesized that heavily biomineralized “layer‐cake” TCC in certain Palaeozoic chondrichthyans perhaps served a dual physiological role, as a phosphate sink and in providing increased skeletal density in very large (>7 m) Devonian‐Permian marine sharks such as ctenacanths and as an adaptation to calcium‐deficient environments among Permo‐Carboniferous non‐marine sharks such as xenacanths. By contrast, the equivalent tissue in modern elasmobranchs probably serves only to reinforce regions of cartilage (mostly in the jaws) subjected to high loading. It is also noted that much of the variation observed in tesseral architecture (including localized remodelling), ultrastructure and histology in modern and extinct chondrichthyans is confined to the perichondrally facing cap zone (where Type‐1 collagen matrix predominates in modern TCC), whereas the main body of the tessera (where Type‐2 collagen matrix predominates) exhibits comparatively little evidence of remodelling and histological or structural variation.
Guillain‐Barré syndrome during SARS‐CoV‐2 pandemic: A case report and review of recent literature
Authors: Scheidl Erika , Canseco Daniel Diez , Hadji‐Naumov Aleksandar , Bereznai Benjamin 
Published: May 2020

AbstractAcute demyelinating inflammatory polyneuropathy (AIDP) is the most common type of Guillain‐Barré syndrome (GBS) in Europe, following several viral and bacterial infections. Data on AIDP‐patients associated with SARS‐CoV‐2 (coronavirus‐2) infection are scarce. We describe the case of a 54‐years‐old Caucasian female patient with typical clinical and electrophysiological manifestations of AIDP, who was reported positive with PCR for SARS‐CoV‐2, 3 weeks prior to onset of the neurological symptoms. She did not experience a preceding fever or respiratory symptoms, but a transient loss of smell and taste. At the admission to our neurological department, a progressive proximally pronounced paraparesis, areflexia, and sensory loss with tingling of all extremities were found, which began 10 days before. The modified Erasmus Giullain‐Barré Syndrome outcome score (mEGOS) was 3/9 at admission and 1/12 at day 7 of hospitalization. The electrophysiological assessment proved a segmental demyelinating polyneuropathy and cerebrospinal fluid examination showed an albuminocytologic dissociation. The neurological symptoms improved significantly during treatment with immunoglobulins. Our case draws attention to the occurrence of GBS also in patients with COVID‐19 (coronavirus disease 2019), who did not experience respiratory or general symptoms. It emphasizes that SARS‐CoV‐2 induces immunological processes, regardless from the lack of prodromic symptoms. However, it is likely that there is a connection between the severity of the respiratory syndrome and further neurological consequences.
Chlorellavulgaris microalgae and/or copper supplementation enhanced feed intake, nutrient digestibility, ruminal fermentation, blood metabolites and lactational performance of Boer goat
Authors: Kholif Ahmed E. , Hamdon Hatem A. , Kassab Ayman Y. , Farahat Eman S. A. , Azzaz Hossam H. , Matloup Osama H. , Mohamed Ashraf G. , Anele Uchenna Y. 
Published: May 2020

AbstractThe associative effects of Chlorella vulgaris microalgae and copper (Cu) supplementation on feed utilisation and lactational performance in goats were evaluated. Thirty‐two lactating Boer goats (34.8 ± 1.7 kg body weight) were used to evaluate the supplementation of C. vulgaris microalgae at 10 g/day (AL treatment), 9 mg of Cu/kg diet (CU treatment) or a mixture of both AL and CU treatments (ALCU treatment) on feed intake, nutrient digestibility, ruminal fermentation, blood metabolites and lactation performance of Boer goat milk yield and composition. Treatments did not affect feed intake; however, AL, ALCU and CU treatments increased (p < .001) nutrient digestibility. Treatment effect on ruminal pH, ammonia‐N or propionate was marginal, but AL and ALCU treatments increased (p < .01) acetate, acetate/propionate ratio and total volatile fatty acids. Treatments increased (p < .001) serum glucose and Cu concentrations. Additionally, ALCU and AL treatments increased (p < .001) daily milk yield, energy corrected milk production, concentrations of ash, energy content, fat, lactose, solids not fat, total solids and milk (feed) efficiency. Conversely, the CU treatment decreased (p < .001) the concentration of all milk components, without affecting milk (feed) efficiency. Additionally, AL and ALCU treatments decreased (p < .05) the concentrations of saturated fatty acids by 2.4% and 4%, respectively, but increased (p < .05) the concentrations of total unsaturated fatty acids (UFAs) by 5.4% and 9.8%, respectively, mono‐UFA by 5.2% and 9.8%, respectively, and conjugated linoleic acid concentrations by 9.3% and 7.4% respectively. In conclusion, supplementation of the diet of lactating Boer goats with C. vulgaris microalgae with or without copper enhanced nutrient digestibility, ruminal fermentation, milk production, milk efficiency and milk nutritive value. Copper supplementation had minimal effects; therefore, its use as a supplement in the presence of C. vulgaris microalgae to the diet of lactating Boer goats is recommended.
Elevated liver stiffness without histological evidence of liver fibrosis in rural Ugandans
Authors: Tibuakuu Martin , Jjingo Caroline , Kirk Gregory Dale , Thomas David Lee , Gray Ronald , Ssempijja Victor , Nalugoda Fred , Serwadda David , Ocama Ponsiano , Opio Christopher Kenneth , Kleiner David Erwin , Quinn Thomas Charles , Reynolds Steven James 
Published: May 2020

AbstractLiver fibrosis may be assessed noninvasively with transient electrography (TE). Data on the performance of TE for detecting liver fibrosis in sub‐Saharan Africa are limited. We evaluated the diagnostic accuracy of TE by performing liver biopsies on persons with liver fibrosis indicated by TE. We enrolled HIV‐infected and HIV‐uninfected participants with TE scores consistent with at least minimal disease (liver stiffness measurement [LSM]≥7.1 kPa). Biopsies were performed and staged using the Ishak scoring system. A concordant result was defined using accepted thresholds for significant fibrosis by TE (LSM ≥ 9.3 kPa) and liver biopsy (Ishak score ≥ 2). We used modified Poisson regression methods to quantify the univariate and adjusted prevalence risk ratios (PRR) of the association between covariates and the concordance status of TE and liver biopsy in defining the presence of liver fibrosis. Of 131 participants with valid liver biopsy and TE data, only 5 participants (3.8%) had Ishak score ≥ 2 of whom 4 had LSM ≥ 9.3 kPa (sensitivity = 80%); of the 126 (96.2%) with Ishak score < 2, 76 had LSM < 9.3 kPa (specificity = 61%). In multivariable analysis, discordance was associated with female gender (adjPRR = 1.80, 95%CI 1.1‐2.9; P = .019), herbal medicine use (adjPRR 1.64, 95% CI = 1.0‐2.5; P = .022), exposure to lake or river water (adjPRR 2.05, 95% CI = 1.1‐3.7; P = .016), and current smoking (adjPRR 1.72, 95%CI 1.0‐2.9; P = .045). These data suggest that TE among rural Ugandans has low specificity for detection of histologically confirmed liver fibrosis. Caution should be exercised when using this tool to confirm significant liver fibrosis.
Intraspecific responses to climate reveal nonintuitive warming impacts on a widespread thermophilic conifer
Authors: Patsiou Theofania S. , Shestakova Tatiana A. , Klein Tamir , di Matteo Giovanni , Sbay Hassan , Chambel Mª Regina , Zas Rafael , Voltas Jordi 
Published: May 2020

Summary

Many ecologically important forest trees from dry areas have been insufficiently investigated for their ability to adapt to the challenges posed by climate change, which hampers the implementation of mitigation policies. We analyzed 14 common‐garden experiments across the Mediterranean which studied the widespread thermophilic conifer Pinus halepensis and involved 157 populations categorized into five ecotypes.

Ecotype‐specific tree height responses to climate were applied to projected climate change (2071–2100 ad), to project potential growth patterns both locally and across the species' range.

We found contrasting ecotypic sensitivities to annual precipitation but comparatively uniform responses to mean temperature, while evidence of local adaptation for tree height was limited to mesic ecotypes. We projected intriguing patterns of response range‐wide, implying either height inhibition or stimulation of up to 75%, and deduced that the ecotype currently experiencing more favorable (wetter) conditions will show the largest inhibition. Extensive height reductions can be expected for coastal areas of France, Greece, Spain and northern Africa.

Our findings underline the fact that intraspecific variations in sensitivity to precipitation must be considered when projecting tree height responses of dry forests to future climate. The ecotype‐specific projected performances call for management activities to ensure forest resilience in the Mediterranean through, for example, tailored deployment strategies.
Promoting medication adherence from the perspective of adolescent and young adult kidney transplant recipients, parents, and health care professionals: A TAKE‐IT TOO study
Authors: Nguyen Christina , Dew Mary Amanda , Irizarry Taya , McNulty Mary , Rennick Janet , Knäuper Bärbel , Descoteaux Annie , Grenier Audrey , Jeannot Lovemine , Foster Bethany J. , DeVito Dabbs Annette J. ,   all TAKE‐IT TOO Investigators
Published: May 2020

AbstractMedication non‐adherence is an important factor limiting allograft survival after kidney transplantation in AYA. Some interventions, including the TAKE‐IT, showed some success in promoting adherence but the potential for scalability and use in routine clinical practice is limited. We applied user‐centered design to gather the perspectives of recipients, parents, and health professionals concerning their needs, challenges, and potential intervention strategies to design an optimal, multi‐component medication adherence intervention. The qualitative study was conducted at four Canadian and three American kidney transplant programs. Separate focus groups for recipients, parents, and health professionals were convened to explore these stakeholders' perspectives. Directed content analysis was employed to identify themes that were shared vs distinct across stakeholders. All stakeholder groups reported challenges related to taking medications on time in the midst of their busy schedules and the demands of transitioning toward independence during adolescence. The stakeholders also made suggestions for the multi‐component behavioral intervention, including an expanded electronic pillbox and companion website, education materials, and customized digitized features to support shared responsibility and communication among recipients, parents, and health professionals. Several suggestions regarding the functionality and features of the potential intervention reported in this early stage will be explored in more depth as the iterative process unfolds. Our approach to actively involve all stakeholders in the process increases the likelihood of designing an adherence intervention that is truly user‐informed and fit for the clinical setting.
Eplet incompatibility in pediatric renal transplantation
Authors: Rãchişan Andreea Liana , Dubois Valerie , Ranchin Bruno , Sellier‐Leclerc Anne‐Laure , Bertholet Thomas Aurelia , Cochat Pierre , Bacchetta Justine 
Published: May 2020

AbstractEplet incompatibility appears to be a better predictor of the de novo appearance of DSA post‐Tx than HLA antigen matching in adults. We evaluated the HLA Matchmaker® software (version 2.1) in our pediatric cohort to predict the appearance of DSA post‐Tx. We included 70 pediatric patients (26 girls, 10 living donors, mean age 11.2 ± 3.9 years) after a first R‐Tx (January 2010‐August 2016), without prior immunization, having complete HLA typing (A, B, C, DRB1 and DQB1) and DSA follow‐up for at least one year. The mean of HLA and eplet incompatibilities was 4.7 ± 1.3 and 15.5 ± 6.1, respectively, with a correlation coefficient r2 between these two variables of 0.34 (P < .001). The eplet load was 12.8 ± 5.0 in living donors vs 15.9 ± 6.2 in deceased donors (P = NS), 12.6 ± 6.1 in preemptive R‐Tx (n = 14) vs 16.3 ± 5.9 for non‐preemptive R‐Tx (P = .04). Seven patients (10%) developed DSA during the 3.5 ± 1.2 years post‐Tx. The eplet load was 13.7 ± 5.5 for those who developed DSA vs 15.7 ± 6.1 for the others (P = NS). In our single‐center series of pediatric R‐Tx with good HLA matching and lower eplet load than previously published series, eplet incompatibilities do not predict the development of DSA. The question of the HLA matching requirement and the daily interest of the HLA Matchmaker® software to help select the grafts remain open.
Pediatric kidney transplantation in Egypt: Results of 10‐year single‐center experience
Authors: Fadel Fatina I. , Bazaraa Hafez M. , Badawy Hesham , Morsi Hany A. , Saadi Gamal , Abdel Mawla Mohamed A. , Salem Amr Mohamed , Abd Alazem Eman Abobakr , Helmy Rasha , Fathallah Mohamed Gamal , Ramadan Yasmin , Fahmy Yosra Aboelnaga , Sayed Shaimaa , Eryan Eman Fathy , Atia Fatma Mohammad , ElGhonimy Mohamed , Shoukry Ahmed I. , Shouman Ahmed M. , Ghonima Waleed , Salah Eldin Mohamed , Soaida Sherif M. , Ismail Wesam , Salah Doaa M. 
Published: May 2020

AbstractPediatric kidney transplantation is a multidisciplinary therapy that needs special consideration and experience. In this study, we aimed to present CUCH experience; over a 10‐year period, as a specialized center of kidney transplantation in children. We studied 148 transplantations performed at a single center from 2009 to 2018. Pretransplant and follow‐up data were collected and graft/patient survival rates were evaluated. A total of 48 patients developed at least one rejection episode during 688 patient‐years of follow‐up. Infections, recurrence of original disease, and malignancy were the most important encountered medical complications (20%, 2%, and 1.4%, respectively). One‐year patient survival was 94.1%, while graft and patient survival was 91.9%. Graft/patient survival at 5, 7, and 9 years was 90%, 77%, and 58%, respectively. Infections were the main cause (69%) of mortality. Death with a functioning graft and CR were the main causes of graft loss (48% and 33%, respectively). Pediatric kidney transplantation in Egypt is still a challenging yet successful experience. Rejections and infections are the most frequent complications. Short‐term outcomes surpass long‐term ones and graft survival rates are similar to the international standard.
Contemporary Policy Challenges in Protecting the Homeland
Authors: Eller Warren S. , Wandt Adam S. 
Published: May 2020

The terrorist attacks of 2001 served as a triggering event for the inception of a policy domain focused on homeland security, and with it came a body of research substantively concentrated on public policy addressing the unique challenges presented in the emerging policy domain. Since naissance, policy issues addressing homeland security have been both disparate and highly salient creating a literature that covers topics ranging from measuring vulnerability of populations to denial of service attacks on medical facilities. This article reviews the literature for a description of what Homeland Security policy is (or is not), where the research in public policy broadly defined has improved knowledge or practice, aspects of the policy domain that require development, and the challenges associated with research in this area. We find that broadly speaking, the most productive areas of inquiry in this domain are those that have the least uncertainty—those that migrated as a mature area of research, those based on objective measures, and those with identifiable origins.