bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propofol for implantable cardioverter defibrillator implantation in patients with Brugada syndrome
Authors: Kwon Hye‐Mee , Kim Sung‐Hoon , Park Se‐Ung , Rhim Jin‐Ho , Park Hee‐Sun , Kim Wook‐Jong , Nam Gi‐Byoung 
Published: April 2018

AbstractAimsAvoiding propofol in patients with Brugada syndrome has been suggested because of the theoretical risk of provoking ventricular arrhythmias, although propofol may be selected for conscious sedation during electrophysiological procedures in catheterization laboratories. This study aimed to document periprocedural electrocardiographic changes and adverse events in patients with Brugada syndrome undergoing implantable cardioverter defibrillator (ICD) implantation using propofol sedation.MethodsWe reviewed the clinical data of 53 consecutive patients who underwent ICD implantation during 1998–2011. Sedation was achieved by combining propofol with either midazolam or fentanyl, and a bolus propofol dose (0.5–1 mg/kg) was administered to induce deep sedation. Periprocedural events, including arrhythmias, defibrillations, and hyperthermia episodes, were evaluated, and electrocardiogram (ECG) variables were measured. The need for emergency anesthetic support/intubation and incidence of perioperative complications or mortality were analyzed.ResultsProcedure time and cumulative propofol dose for each patient was 125.2 (42.8) min and 204.6 (212.7) mg, respectively. During deep sedation, blood pressure, heart rate, and oxygen saturation were significantly decreased (P < 0.001) such that eight (15.1%) patients required manual ventilation and one (1.9%) needed atropine injection. No significant ECG changes were observed. Only two (3.7%) patients showed newly developed ST elevation in the anterior precordial lead, whereas three (5.6%) had isolated premature ventricular contractions.ConclusionICD implantation without significant ECG changes or adverse outcomes is feasible under propofol sedation in patients with Brugada syndrome. However, because of significant hemodynamic changes and respiratory compromise, close monitoring and meticulous propofol dose titration is warranted.
A dicistronic precursor encoding miR398 and the legume‐specific miR2119 coregulates CSD1 and ADH1 mRNAs in response to water deficit
Authors: De la Rosa Carlos , Covarrubias Alejandra Alicia , Reyes José Luis 
Published: April 2018

AbstractPlant microRNAs are commonly encoded in transcripts containing a single microRNA precursor. Processing by DICER‐LIKE 1 and associated factors results in the production of a small RNA, followed by its incorporation into an AGO‐containing protein complex to guide silencing of an mRNA possessing a complementary target sequence. Certain microRNA loci contain more than one precursor stem‐loop structure, thus encoding more than one microRNA in the same transcript. Here, we describe a unique case where the evolutionary conserved miR398a is encoded in the same transcript as the legume‐specific miR2119. The dicistronic arrangement found in common bean was also observed in other legumes. In Phaseolus vulgaris, mature miR398 and miR2119 are repressed in response to water deficit, and we demonstrate that both are functional as they target the mRNAs for CSD1 and ADH1, respectively. Our results indicate that the repression of miR398 and miR2119 leads to coordinated up‐regulation of CSD1 and ADH1 mRNAs in response to water deficit in common bean and possibly in other legumes. Furthermore, we show that miRNA directed CSD1 and ADH1 mRNAs up‐regulation also occurs when common bean plants are exposed to flooding, suggesting that plant redox status and fermentation metabolism must be closely coordinated under different adverse conditions.
Understanding Local Service Delivery Arrangements: Are the ICMA ASD Data Reliable?
Authors: Lamothe Meeyoung , Lamothe Scott , Bell Elizabeth 
Published: April 2018

Abstract
The authors utilize the two latest ICMA Profile of Local Government Service Delivery Choices surveys to investigate whether the service provision and delivery arrangement information reported in the surveys accurately represents reality and, if not, what factors contribute to generating incorrect or unreliable survey responses. Interviews with practitioners are used to better understand both the accuracy of the survey responses and improvements that could be made to the survey instrument. Results suggest that the ICMA ASD survey data are highly erratic, with more than 70 percent of the cases (N = 70) investigated containing some inaccuracies. A qualitative analysis shows that the majority of the errors appear to be caused by the lack of a clear definition of service provision or by the service titles being too vague or too broad, both of which likely lead to discretion in interpreting survey questions and thus inconsistent answers by individual respondents over time.
Clinical outcome of dental procedures among renal transplant recipients
Authors: Caliento Rubens , Sarmento Dmitry José de Santana , Kobayashi‐Velasco Solange , de Sá Stella Núbia Coelho , Shibutani Patrícia Pinheiro , Gallotini Marina 
Published: April 2018

ABSTRACTAimsTo compare outcomes of dental procedures among a group of renal transplant recipients who had received antibiotic prophylaxis (AP) before the procedure and another group that had not received AP.Methods and ResultsThe records of all renal transplant patients treated at the Special Care Dentistry Center (SCDC) were assessed. Dental procedures documented in the records were classified as invasive or noninvasive. All dental procedures performed were compiled, and the prescription or nonprescription of prophylactic antibiotics, and the incidence and description of postoperative complications after invasive procedures were recorded. Eighty‐seven records were evaluated. Out of 190 invasive procedures all were simple dental extractions, 107 (56.3%) were preceded by AP; out of 242 noninvasive procedures, 14 (5.7%) were preceded by AP. A lack of uniformity on the type and dose of the antibiotic prescribed was observed. Four postoperative complications after invasive procedures (dental extraction) were noted and in 2 cases the procedures were preceded by AP.ConclusionThis retrospective study showed no difference in postextraction outcomes between renal transplant recipients who received and who did not receive AP before dental extractions.
Clinical outcomes after colopexy through left ventral paramedian incision in 156 thoroughbred broodmares with large colon disorders (1999‐2015)
Authors: Broyles Alecsya H. , Hopper Scott A. , Woodie J. Brett , Ruggles Alan J. 
Published: April 2018

AbstractObjectiveTo describe a technique for colopexy via a left ventral paramedian incision and report postoperative clinical outcomes.Study DesignRetrospective case series.AnimalsOne hundred fifty‐six thoroughbred broodmares treated with a colopexy through a left ventral paramedian incision between 1999 and 2015.MethodsMedical records were reviewed for postoperative complications and survival to discharge. The survival rate at 1 year after surgery was based on the medical record, progeny record, or client telephone conversation. Progeny records were reviewed to assess reproductive performance. T tests, χ2tests, logistic regression, and Kaplan–Meier survival curves were used to identify prognostic factors.ResultsThe rates of postoperative recurrence of large colon volvulus and colon rupture were 1.2% and 3%, respectively. Ninety‐three percent of mares that were treated were discharged alive from the hospital, and 78% were alive 1 year after surgery. The diagnosis of 1 of the following complications increased the risk of death within 1 year: systemic inflammatory response syndrome (SIRS), diarrhea, and/or thrombophlebitis (odds ratio [OR] 4.76). Sixty‐six percent of mares that were pregnant at the time of colopexy and discharged alive from the hospital produced a live foal. The percentage of live foals produced each year that the mare was bred after colopexy was 67%.ConclusionThoroughbred mares treated with colopexy via a left paramedian incision had a good prognosis for survival and continued use as a broodmare. SIRS, diarrhea, or jugular thrombophlebitis affected long‐term survival in this population.Clinical significanceColopexy via a left paramedian incision is a suitable alternative to colopexies requiring a second incision or creating adhesions between the colon and the linea alba in thoroughbred mares.
Operator inequalities involving Khatri-Rao Sums and Moore-Penrose inverses
Authors: Ploymukda Arnon , Chansangiam Pattrawut 
Published: April 2018

We establish relations between the Khatri-Rao sum of Hilbert space operators and ordinary products, powers, ordinary inverses, and Moore-Penrose inverses in terms of inequalities. In particular, such relations hold for the tensor sum of operators and the Khatri-Rao sum of complex matrices.
Effect of H2O/SiO2 Molar Ratio on Direct Synthesis of ZSM-5 from Bangka’s Kaolin Without Pretreatment
Authors: Hartanto Djoko , Iqbal Rendy Muhamad , Shahbihi Wahyu Erizky , Santoso Eko , Fansuri Hamzah , Iryani Ani 
Published: April 2018

The influence of the molar ratio H2O/SiO2 in the synthesis directly from Bangka Belitung’s Kaolin has been studied by performing synthesis of ZSM-5 with a variation of the molar ratio H2O/SiO2 is different at 15, 25, 30, and 35. Weighing 3.980 g Bangka’s kaolin are added other material so obtained molar composition 10Na2O: 120SiO2: 2Al2O3: 1800-4200H2O, and 1% of silicalite seed, subsequent hydrothermal process of 175°C for 24 hours. The result of solids was analyzed by X-ray diffraction (XRD) and Fourier Transform Infrared (FTIR) and SEM EDX to the analyzed morphology of ZSM-5 crystal. The synthesis of ZSM-5 was directly optimum with molar ratio H2O/SiO2 of 30 having the highest cristallinity and largest crystal size of 59.44% and 3.795 µm, respectively.
Whole-Genome Sequencing of Recent Listeria monocytogenes Isolates from Germany Reveals Population Structure and Disease Clusters
Authors: Halbedel Sven , Prager Rita , Fuchs Stephan , Trost Eva , Werner Guido , Flieger Antje 
Published: April 2018

ABSTRACT

Listeria monocytogenes
causes foodborne outbreaks with high mortality. For improvement of outbreak cluster detection, the German consiliary laboratory for listeriosis implemented whole-genome sequencing (WGS) in 2015. A total of 424 human
L. monocytogenes
isolates collected in 2007 to 2017 were subjected to WGS and core-genome multilocus sequence typing (cgMLST). cgMLST grouped the isolates into 38 complexes, reflecting 4 known and 34 unknown disease clusters. Most of these complexes were confirmed by single nucleotide polymorphism (SNP) calling, but some were further differentiated. Interestingly, several cgMLST cluster types were further subtyped by pulsed-field gel electrophoresis, partly due to phage insertions in the accessory genome. Our results highlight the usefulness of cgMLST for routine cluster detection but also show that cgMLST complexes require validation by methods providing higher typing resolution. Twelve cgMLST clusters included recent cases, suggesting activity of the source. Therefore, the cgMLST nomenclature data presented here may support future public health actions.
Convergent Metabolic Specialization through Distinct Evolutionary Paths in Pseudomonas aeruginosa
Authors: La Rosa Ruggero , Johansen Helle Krogh , Molin Søren 
Published: April 2018

ABSTRACT

Evolution by natural selection under complex and dynamic environmental conditions occurs through intricate and often counterintuitive trajectories affecting many genes and metabolic solutions. To study short- and long-term evolution of bacteria
in vivo
, we used the natural model system of cystic fibrosis (CF) infection. In this work, we investigated how and through which trajectories evolution of
Pseudomonas aeruginosa
occurs when migrating from the environment to the airways of CF patients, and specifically, we determined reduction of growth rate and metabolic specialization as signatures of adaptive evolution. We show that central metabolic pathways of three distinct
Pseudomonas aeruginosa
lineages coevolving within the same environment become restructured at the cost of versatility during long-term colonization. Cell physiology changes from naive to adapted phenotypes resulted in (i) alteration of growth potential that particularly converged to a slow-growth phenotype, (ii) alteration of nutritional requirements due to auxotrophy, (iii) tailored preference for carbon source assimilation from CF sputum, (iv) reduced arginine and pyruvate fermentation processes, and (v) increased oxygen requirements. Interestingly, although convergence was evidenced at the phenotypic level of metabolic specialization, comparative genomics disclosed diverse mutational patterns underlying the different evolutionary trajectories. Therefore, distinct combinations of genetic and regulatory changes converge to common metabolic adaptive trajectories leading to within-host metabolic specialization. This study gives new insight into bacterial metabolic evolution during long-term colonization of a new environmental niche.

IMPORTANCE
Only a few examples of real-time evolutionary investigations in environments outside the laboratory are described in the scientific literature. Remembering that biological evolution, as it has progressed in nature, has not taken place in test tubes, it is not surprising that conclusions from our investigations of bacterial evolution in the CF model system are different from what has been concluded from laboratory experiments. The analysis presented here of the metabolic and regulatory driving forces leading to successful adaptation to a new environment provides an important insight into the role of metabolism and its regulatory mechanisms for successful adaptation of microorganisms in dynamic and complex environments. Understanding the trajectories of adaptation, as well as the mechanisms behind slow growth and rewiring of regulatory and metabolic networks, is a key element to understand the adaptive robustness and evolvability of bacteria in the process of increasing their
in vivo
fitness when conquering new territories.
Scoliosis in association with the 22q11.2 deletion syndrome: an observational study
Authors: Homans Jelle F , Baldew Vyaas G M , Brink Rob C , Kruyt Moyo C , Schlösser Tom P C , Houben Michiel L , Deeney Vincent F X , Crowley Terrence B , Castelein René M , McDonald-McGinn Donna M 
Published: April 2018

ObjectiveThe 22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion syndrome in humans. It is characterised by wide phenotypic variability, including congenital heart disease (CHD), immunodeficiency and scoliosis. However, little is known regarding the prevalence and characteristics of scoliosis in patients with 22q11.2DS. The objective of this study is to assess the prevalence of scoliosis, its characteristics and the association with CHD in patients with 22q11.2DS.DesignThis prevalence study is based on physical examination and questionnaires of the world’s largest 22q11.2DS longitudinal collected database (n=1393, Children’s Hospital of Philadelphia) and was augmented with the scoliosis prevalence based on radiography in a smaller cohort (cross-sectional, University Medical Center Utrecht).PatientsPatients with a laboratory-confirmed 22q11.2 deletion who visited the specialised outpatient clinics were considered for inclusion.Main outcome measures(1) The prevalence of scoliosis, (2) its association with CHD, and (3) the similarity between 22q11.2DS curve patterns and adolescent idiopathic scoliosis (AIS) curve patterns.ResultsWithin the Philadelphia cohort, the prevalence of scoliosis in patients older than 16 years (n=317) was 48% (n=152). A similar prevalence (49%) was shown for the younger Utrecht cohort (n=97). The occurrence of scoliosis was not associated with the presence of CHD. Sixty-three per cent of patients with scoliosis had a scoliotic curve pattern that resembled AIS.ConclusionsClinicians should be aware that scoliosis is highly prevalent (48%–49%) in association with 22q11.2DS, irrespective of other clinical features (eg, the presence of CHD). Furthermore, 22q11.2DS may provide insights into the causes of AIS.
Distribution and determinants of pneumonia diagnosis using Integrated Management of Childhood Illness guidelines: a nationally representative study in Malawi
Authors: Uwemedimo Omolara T , Lewis Todd P , Essien Elsie A , Chan Grace J , Nsona Humphreys , Kruk Margaret E , Leslie Hannah H 
Published: April 2018

BackgroundPneumonia remains the leading cause of child mortality in sub-Saharan Africa. The Integrated Management of Childhood Illness (IMCI) strategy was developed to standardise care in low-income and middle-income countries for major childhood illnesses and can effectively improve healthcare worker performance. Suboptimal clinical evaluation can result in missed diagnoses and excess morbidity and mortality. We estimate the sensitivity of pneumonia diagnosis and investigate its determinants among children in Malawi.MethodsData were obtained from the 2013–2014 Service Provision Assessment survey, a census of health facilities in Malawi that included direct observation of care and re-examination of children by trained observers. We calculated sensitivity of pneumonia diagnosis and used multilevel log-binomial regression to assess factors associated with diagnostic sensitivity.Results3136 clinical visits for children 2–59 months old were observed at 742 health facilities. Healthcare workers completed an average of 30% (SD 13%) of IMCI guidelines in each encounter. 573 children met the IMCI criteria for pneumonia; 118 (21%) were correctly diagnosed. Advanced practice clinicians were more likely than other providers to diagnose pneumonia correctly (adjusted relative risk 2.00, 95% CI 1.21 to 3.29). Clinical quality was strongly associated with correct diagnosis: sensitivity was 23% in providers at the 75th percentile for guideline adherence compared with 14% for those at the 25th percentile. Contextual factors, facility structural readiness, and training or supervision were not associated with sensitivity.ConclusionsCare quality for Malawian children is poor, with low guideline adherence and missed diagnosis for four of five children with pneumonia. Better sensitivity is associated with provider type and higher adherence to IMCI. Existing interventions such as training and supportive supervision are associated with higher guideline adherence, but are insufficient to meaningfully improve sensitivity. Innovative and scalable quality improvement interventions are needed to strengthen health systems and reduce avoidable child mortality.
Should total calcium be adjusted for albumin? A retrospective observational study of laboratory data from central Norway
Authors: Lian Ingrid Alsos , Åsberg Arne 
Published: April 2018

ObjectivesAlbumin-adjusted total calcium is often used as a surrogate marker for free calcium to evaluate hypocalcaemia or hypercalcaemia. Many adjustment formulas based on simple linear regression models have been published, and continue to be used in spite of questionable diagnostic accuracy. In the hope of finding a more pure albumin effect on total calcium, we used multiple linear regression models to adjust for other relevant variables. The regression coefficients of albumin were used to construct local adjustment formulas, and we tested whether the diagnostic accuracy was improved compared with previously published formulas and unadjusted calcium.DesignA retrospective hospital laboratory data study.Data sourcesThe local hospital laboratory data system.SettingNorway, 2006–2015.Participants6549 patients above 2 years of age, where free calcium standardised at pH 7.40, total calcium, creatinine, albumin and phosphate had been analysed in a single blood draw, including hospitalised patients and patients from outpatient clinics and general practice.Main outcome measuresDiagnostic accuracy by Harrell’s c and receiver operating characteristic curve analysis, using free calcium standardised at pH 7.40 as a gold standard, in subgroups with estimated glomerular filtration rate (eGFR) ≥60 or <60 mL/min/1.73 m2.ResultsIn the subgroup with eGFR <60 mL/min/1.73 m2, the Harrell’s c of unadjusted total calcium (0.801) was significantly larger than those of the local formulas (0.790, p=0.002) and the best formula taken from literature (0.791, p=0.004). In the subgroup with eGFR ≥60 mL/min/1.73 m2, no significant differences were found between these three formulas.ConclusionsOur study shows that the diagnostic accuracy ofunadjustedtotal calcium is superior to several commonly used adjustment formulas, and we suggest that the use of such formulas should be abandoned in clinical practice. If the clinician does not trust total calcium to reflect the calcium status of the patient, free calcium should be measured.
Long-term benzodiazepine use in patients taking antidepressants in a public health setting in Brazil: a cross-sectional study
Authors: Fulone Izabela , Silva Marcus Tolentino , Lopes Luciane Cruz 
Published: April 2018

ObjectiveThe aims of the study were to investigate the prevalence of long-term use of benzodiazepines in patients taking antidepressants and to identify the risk factors associated with the prolonged use of benzodiazepines.DesignCross-sectional study.SettingPublic health system in Brazil.ParticipantsOutpatients using antidepressants from January 2008 to December 2009 were included. The data were obtained from pharmacy databases and medical records. All individuals in the database were included in the study and were classified into two categories: (1) patients who had not used benzodiazepines combined with antidepressants or had combined the use of antidepressants with benzodiazepines for a short period (up to 4 weeks), and (2) those who used antidepressants plus benzodiazepines for a longer period (more than 4 weeks).Main outcome measureThe outcome measure is prolonged use of benzodiazepines (more than 4 weeks). We conducted a multivariate analysis to identify the factors associated with prolonged use of benzodiazepines.ResultsForty per cent of the 870 patients evaluated had prolonged use of benzodiazepines (more than 4 weeks). The risk factors associated with prolonged use were age above 35 years (prevalence ratio (PR): 2.18, 95% CI 1.55 to 3.06, P<0.001), female sex (PR: 1.47, 95% CI 1.07 to 2.02, P=0.019), diagnosis at least 3 years prior (PR: 2.1, 95% CI 1.6 to 2.8, P<0.001), use of selective serotonin reuptake inhibitor antidepressants (PR: 1.7, 95% CI 1.3 to 2.2, P<0.001) and having a prescription from a psychiatrist (PR: 6.5, 95% CI 3.2 to 13.2, P<0.001).ConclusionsProlonged use of benzodiazepines occurs more frequently in women, adults diagnosed several years earlier, users of selective serotonin reuptake inhibitor antidepressants and those who received a prescription from a psychiatrist. Education of clinicians, especially with regard to these populations, may decrease the overuse and misuse of benzodiazepines.