bluuebunny/crossref_metadata_2025_split huggingface dataset:
SITUPS: a new tool for oral case presentation in the paediatric emergency department
Authors: Sofou Kalliopi , Bry Kristina 
Published: February 2019

AbstractAimWe developed a new case presentation technique, SITUPS, and studied its impact on the patient presentations by medical students at a paediatric emergency department. The students’ opinions about the usefulness of the technique were also assessed.MethodsThe students saw patients both before and after introduction to SITUPS. Their presentations were analysed by the clinical instructor using a student assessment form. The students filled in a 15‐item questionnaire about their opinion of SITUPS as a learning tool.ResultsTwenty‐eight students were evaluated both without and with SITUPS in a total of 78 presentations. Using SITUPS, the students gave more complete case presentations without increasing the presentation time. The main areas of improvement were discussing differential diagnoses, proposing a management plan, and identifying where they lacked knowledge and needed to ask the instructor questions. The students found SITUPS particularly helpful in identifying family and social issues of significance, thinking of relevant questions to ask the patient and the family, and thinking through differential diagnoses.ConclusionWe propose a new case presentation technique, SITUPS, for use at the paediatric emergency department. With the help of SITUPS, the medical students gave more complete case presentations in a time‐effective manner.
Adjuvant potential of selegiline in treating acute toxicity of aluminium phosphide in rats
Authors: Maleki Adeleh , Hosseini Mir‐Jamal , Rahimi Nastaran , Abdollahi Alireza , Akbarfakhrabadi Amir , Javadian Nina , Amiri Shayan , Behnoush Behnam , Dehpour Ahmad Reza 
Published: February 2019

AbstractAluminium phosphide (AlP) is a highly toxic substance with a high mortality rate and no effective antidote. Once exposed to the moisture and acidic conditions of the stomach, AlP releases toxic phosphine (PH3) gas, which results in severe toxicity in poisoned subjects. Selegiline is a monoamine oxidase inhibitor with antioxidant and anti‐apoptotic properties, which is mostly prescribed for the treatment of mood disorders and Parkinson's disease. Since AlP has detrimental effects on cardiac physiology and mitochondrial function, we tested the protective effects of acute selegiline treatment on cardiac mitochondrial function, redox status and electrocardiographic parameters in rats after AlP poisoning. To do this, AlP was given to rats by gavage to induce toxicity. Selegiline was injected intraperitoneally in the treatment groups 1 hour after AlP poisoning. Selegiline treatment after AlP intoxication was not associated with a significant difference in the mortality rate of animals. However, selegiline reduced oxidative stress (decreased the reactive oxygen species and malondialdehyde) and increased glutathione in the cardiac tissue of rats exposed to AlP. Further, the mitochondrial membrane potential (ΔΨm) collapse reversed after treatment with selegiline. Selegiline also improved the electrocardiographic (ECG) parameters and enhanced heart rate. The histopathological evaluation revealed that selegiline eliminated the inflammation and injuries induced by AlP in the stomach and duodenum, as well as cardiac tissue. In conclusion, selegiline treatment can ameliorate the AlP‐induced cardiac and gastrointestinal injuries in rats via boosting redox status and mitochondrial function with no significant effect on survival. We suggest that using selegiline, apart from other clinical treatments, may improve the quality of treatment process for AlP toxicity.
Hospital‐based maternity care practitioners’ perceptions of doulas
Authors: Neel Kira , Goldman Roberta , Marte Denise , Bello Gisel , Nothnagle Melissa B. 
Published: February 2019

AbstractIntroductionA birth doula provides continuous informational, physical, and emotional support during pregnancy, labor, and immediately postpartum. Existing data on the benefits of doulas, especially for low‐resource, high‐need patients, do not address how and why individual practitioners decide to recommend this model of care. This project aims to describe best practices of integrating doulas into hospital‐based maternity care teams to facilitate access to this evidence‐based service for improving maternal health outcomes.MethodsSemi‐structured interviews using open‐ended questions were conducted in person with 47 maternity care practitioners—OB/GYNs, family medicine physicians, RNs, and nurse‐midwives—across three hospitals. Interview analysis was conducted using the Template Organizing Style qualitative analysis approach.ResultsResults demonstrated varied support for doula care given practitioners’ experiences. Positive experiences centered on doulas’ supportive role and strong relationships with patients. Some conflicts between practitioners and doulas may stem from a cross‐cultural divide between mainstream obstetric/physician culture and a natural birth “counter culture.” Suggestions to facilitate good working relationships centered on three overlapping themes: mutual respect between doulas and hospital staff, education about doulas’ training, and clarification of roles on maternity care teams especially among staff with overlapping roles.ConclusionsAmong maternity care practitioners, some frustration, anger, and resentment persist with respect to work with doulas. Adequate staff training in the doula model of care, explicit role definition, and increasing practitioner exposure to doulas may promote effective integration of doulas into hospital maternity care teams.
Identification of novel oncogenic events occurring early in prostate carcinogenesis using purified autologous malignant and non‐malignant prostate epithelial cells
Authors: Sluka Pavel , Pezaro Carmel , Wardan Hady , Sengupta Shomik , Davis Ian D. 
Published: February 2019

ObjectiveTo interrogate enriched prostate cancer cells and autologous non‐malignant prostate epithelial cells from men with localized prostate cancer, in order to identify early oncogenic pathways.Patients and MethodsWe collected malignant and matched non‐malignant prostatectomy samples from men with adenocarcinoma involving two or more contiguous areas in only one lobe of the prostate. Tissue samples from both lobes were subjected to digestion and single‐cell suspensions were prepared. Epithelial cell adhesion molecule‐positive cells from cancerous and contralateral non‐malignant (control) samples were isolated using magnetic beads, ensuring uniform populations were obtained for each donor. Unbiased RNA sequencing analysis was used to measure gene expression and for detection of transcribed mutations or splice variants that were over‐ or under‐represented in malignant prostate epithelial cells relative to autologous control prostate epithelial cells.ResultsFrom five patient samples we identified 17 genes that were altered in prostate cancer epithelial cells, with 82% of genes being downregulated. Three genes, TDRD1, ANGTL4, and CLDN3, were consistently upregulated in malignant tissue. Malignant cells from three of the five patients showed evidence of upregulated ERG signalling, however, only one of these contained a TMPRSS2‐ERG rearrangement. We did not identify mutations, gene rearrangements, or splice variants that were consistent amongst the patients.ConclusionsEvents occurring early in prostate cancer oncogenesis in these samples were characterized by a predominant downregulation of gene expression along with upregulation of TDRD1, ANGTL4 and CLDN3. No consistent mutations or splice variants were observed, but upregulation of ERG signalling was seen both in the presence and absence of the classic TMPRSS2‐ERG rearrangement.
Segmental resection of distal ureter with termino‐terminal ureteric anastomosis vs bladder cuff removal and ureteric re‐implantation for upper tract urothelial carcinoma: results of a multicentre study
Authors: Abrate Alberto , Sessa Francesco , Sebastianelli Arcangelo , Preto Mirko , Olivero Alberto , Varca Virginia , Benelli Andrea , Campi Riccardo , Sessa Maurizio , Pavone Carlo , Serretta Vincenzo , Vella Marco , Brunocilla Eugenio , Serni Sergio , Trombetta Carlo , Terrone Carlo , Gregori Andrea , Lissiani Andrea , Gontero Paolo , Schiavina Riccardo , Gacci Mauro , Simonato Alchiede 
Published: February 2019

ObjectivesTo compare overall (OS), cancer‐specific (CSS), recurrence‐free survival (RFS) and postoperative renal function amongst patients with upper tract urothelial carcinoma (UTUC) of the distal (lower lumbar and pelvic) ureter, electively treated with segmental resection and termino‐terminal anastomosis (TT) vs bladder cuff removal and ureteric re‐implantation (RR).Patients and methodsA multicentre retrospective study, including 84 patients diagnosed with UTUC of the distal ureter and treated with TT or RR, is presented. The primary endpoint was to compare TT and RR in terms of OS, CSS and RFS. As a secondary outcome, we compared the postoperative creatinine values as an index of renal function in the two groups.ResultsOf 521 patients with UTUC, 65 (77.4%) and 19 (22.6%) patients underwent RR and TT, respectively. Pre‐ and postoperative characteristics were not statistically different between the two groups. The median follow‐up period was 22.7 months. Patients treated with TT and those treated with RR did not have significantly different 5‐year OS, CSS or RFS (73.7% vs 92.3%, P = 0.052; 94.7% vs 95.4%, P = 0.970: and 63.2% vs 53.9%, P = 0.489, respectively). No difference in postoperative creatinine variation emerged in association with the surgical technique (P = 0.411).ConclusionPatients treated with TT or RR for UTUC showed comparable OS, CSS, RFS and postoperative renal function. Our data suggest that bladder cuff removal is not imperative in the treatment of distal ureteric UTUC, and TT can be a safe solution in selected cases.
Ciliary kinesins beyond IFT: Cilium length, disassembly, cargo transport and signalling
Authors: Reilly Madeline Louise , Benmerah Alexandre 
Published: February 2019

AbstractCilia and flagella are microtubule‐based antenna which are highly conserved among eukaryotes. In vertebrates, primary and motile cilia have evolved to exert several key functions during development and tissue homoeostasis. Ciliary dysfunction in humans causes a highly heterogeneous group of diseases called ciliopathies, a class of genetic multisystemic disorders primarily affecting kidney, skeleton, retina, lung and the central nervous system. Among key ciliary proteins, kinesin family members (KIF) are microtubule‐interacting proteins involved in many diverse cellular functions, including transport of cargo (organelles, proteins and lipids) along microtubules and regulating the dynamics of cytoplasmic and spindle microtubules through their depolymerising activity. Many KIFs are also involved in diverse ciliary functions including assembly/disassembly, motility and signalling. We here review these ciliary kinesins in vertebrates and focus on their involvement in ciliopathy‐related disorders.
Forward stratigraphic modelling of sediment pathways and depocentres in salt‐influenced passive‐margin basins: Lower Cretaceous, central Scotian Basin
Authors: Sangster Christopher , Piper David J. W. , Hawie Nicolas , Pe‐Piper Georgia , Saint‐Ange Francky 
Published: February 2019

AbstractSource‐to‐sink studies and numerical modelling software are increasingly used to better understand sedimentary basins, and to predict sediment distributions. However, predictive modelling remains problematic in basins dominated by salt tectonics. The Lower Cretaceous delta system of the Scotian Basin is well suited for source‐to‐sink studies and provides an opportunity to apply this approach to a region experiencing active salt tectonism. This study uses forward stratigraphic modelling software and statistical analysis software to produce predictive stratigraphic models of the central Scotian Basin, test their sensitivity to different input parameters, assess proposed provenance pathways, and determine the distribution of sand and factors that control sedimentation in the basin. Models have been calibrated against reference wells and seismic surfaces, and implement a multidisciplinary approach to define simulation parameters. Simulation results show that previously proposed provenance pathways for the Early Cretaceous can be used to generate predictive stratigraphic models, which simulate the overall sediment distribution for the central Scotian Basin. Modelling confirms that the shaly nature of the Naskapi Member is the result of tectonic diversion of the Sable and Banquereau rivers and suggests additional episodic diversion during the deposition of the Cree Member. Sand is dominantly trapped on the shelf in all units, with transport into the basin along salt corridors and as a result of turbidity current flows occurring in the Upper Missisauga Formation and Cree Member. This led to sand accumulation in minibasins with a large deposit seawards of the Tantallon M‐41 well. Sand also appears to bypass the basin via salt corridors which lead to the down‐slope edge of the study area. Sensitivity analysis suggests that the grain size of source sediments to the system is the controlling factor of sand distribution. The methodology applied to this basin has applications to other regions complicated by salt tectonics, and where sediment distribution and transport from source‐to‐sink remain unclear.
Food avoidance strategies in eosinophilic oesophagitis
Authors: Cianferoni Antonella , Shuker Michelle , Brown‐Whitehorn Terri , Hunter Hannah , Venter Carina , Spergel Jonathan M. 
Published: February 2019

SummaryEosinophilic oesophagitis (EoE) is a chronic disease associated with significant morbidity that can result in permanent fibrosis and stricture formation. Given the complexity, a multidisciplinary approach is recommended to manage these patients. In the majority of children with EoE not responsive to proton‐pump inhibitor (PPI), inflammation is driven by sensitivity to foods and treatment with an elimination diet can be effective. Foods most commonly identified to trigger EoE in children are milk and wheat, but egg, soy, meats and grains can also be triggers. Foods can be eliminated using a step‐down or step‐up approach. If the goal is to achieve quick remission, elemental diet or six food elimination diets are the most effective. A step‐up approach starting from a 1‐2 food elimination diet and increasing the number of foods based on a personalized dietary approach is recommended if the goal is to achieve remission using the least number of endoscopies and with increased acceptability to the patient. Children with EoE on elimination diets require frequent monitoring of growth and nutrition, as well as screening for symptoms of EoE, allergy and mindfulness regarding psychosocial impact of chronic disease on the family and child. Current research focused on tools to select patients who mostly will benefit from dietary treatment, identify relevant food allergens, obtain oesophageal tissue non‐invasively and induce tolerance will greatly improve the treatment of EoE.
Rapid spread of mannan to the immune system, skin and joints within 6 hours after local exposure
Authors: Hagert C , Siitonen R , Li X-G , Liljenbäck H , Roivainen A , Holmdahl R 
Published: February 2019

Summary
Psoriasis (Ps), psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are common diseases dependent on environmental factors that activate the immune system in unknown ways. Mannan is a group of polysaccharides common in the environment; they are potentially pathogenic, because at least some of them induce Ps-, PsA- and RA-like inflammation in mice. Here, we used positron emission tomography/computed tomography to examine in-vivo transport and spread of mannan labelled with fluorine-18 [18F]. The results showed that mannan was transported to joints (knee) and bone marrow (tibia) of mice within 6 h after intraperitoneal injection. The time it took to transport mannan, and its presence in blood, indicated cellular transport of mannan within the circulatory system. In addition, mannan was filtered mainly through the spleen and liver. [18F]fluoromannan was excreted via kidneys, small intestine and, to some extent, the mouth. In conclusion, mannan reaches joints rapidly after injection, which may explain why mannan-induced inflammatory disease is targeted to these tissues.
Presence of intragraft B cells during acute renal allograft rejection is accompanied by changes in peripheral blood B cell subsets
Authors: Heidt S , Vergunst M , Anholts J D H , Swings G M J S , Gielis E M J , Groeneweg K E , Witkamp M J , de Fijter J W , Reinders M E J , Roelen D L , Eikmans M , Claas F H J 
Published: February 2019

Summary
B cells have various functions, besides being plasma cell precursors. We determined the presence of intragraft B cells at time of acute rejection (AR) and looked for correlates of B cell involvement in peripheral blood. Renal biopsies at time of AR or stable graft function were analysed for the presence of B cells and B cell-related gene expression, as well as C4d staining. Peripheral blood B cell subset distribution was analysed at various time-points in patients with AR and controls, alongside serum human leucocyte antigen (HLA) antibodies. AR was accompanied by intragraft CD20+ B cells, as well as elevated CD20 (MS4A1) and CD19 gene expression compared to controls. B cell infiltrates were proportional to T cells, and accompanied by the chemokine pair C-X-C motif chemokine ligand 13 (CXCL13)–C-X-C motif chemokine receptor 5 (CXCR5) and B cell activating factor (BAFF). Peripheral blood memory B cells were decreased and naive B cells increased at AR, in contrast to controls. While 22% of patients with AR and 5% of controls showed de-novo donor-specific antibodies (DSA), all biopsies were C4d-negative. These results suggest a role for B cells in AR by infiltrating the graft alongside T cells. We hypothesize that the shift in peripheral blood B cell composition is related to the graft infiltration at time of AR.
The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism
Authors: Öz Ahmet , Çınar Tufan , Hayıroğlu Mert İlker , Avşar Şahin , Keskin Muhammed , Orhan Ahmet Lütfüllah 
Published: February 2019

AbstractIntroduction and ObjectivesPrior studies demonstrated that plasma osmolality may have a predictive value for in‐hospital mortality in patients with heart failure and acute coronary syndrome. In addition, plasma glucose and blood urea nitrogen (BUN) levels, the components of plasma osmolality, have been shown to be an important contributor for in‐hospital mortality in acute pulmonary embolism (APE) patients. Hence, the objective of the current study is to evaluate the effect of plasma osmolality upon admission with in‐hospital mortality in patients with APE.MethodsA total of 245 consecutive intermediate or high risk APE patients were enrolled into the study. The study population was divided into three tertile groups (T1, T2 and T3) based on the increased plasma osmolality. The in‐hospital mortality was the primary end‐point.ResultsAfter adjusting for all risk factors, in‐hospital mortality was significantly higher in the T3 group compared to T1 and T2 groups (OR: 3.6, 95% CI: 1.3 to 18.8, P < .001). In addition, the incidence of asystolia, hypotension and cardiogenic shock were significantly higher in the T3 group. An area under the receiver operating characteristic curve value of plasma osmolality for the in‐hospital mortality was 0.76 with sensitivity 67.2% and specificity 74.1% 95% CI: (0.66‐0.87, P < .001).ConclusionThis is the first study to demonstrate that elevated levels of plasma osmolality may have a predictive value for in‐hospital mortality in APE patients. Our findings are novel and deserve further studies whether the treatment of higher plasma osmolality may reduce the risk of in‐hospital mortality in APE patients.
Plasmacytoid dendritic cells in granulomatous variant of mycosis fungoides
Authors: Fernandez‐Flores Angel , Cassarino David S. 
Published: February 2019

AbstractIntroductionGranulomatous mycosis fungoides (MF) is a rare variant in which granulomas are associated with other typical signs of MF. Its prognosis is worse than that of classical MF. Plasmacytoid dendritic cells (PDCs) are a subset of interferon‐producing dendritic cells that link the innate and the adaptative immune responses. They have also been related to tolerance to certain tumors such as melanoma.Materials and methodsIn this article, we examined for the presence of CD123+ PDC in six cases of granulomatous MF from our archives.ResultsWe found clusters of 10 or more positive cells in three of six cases of granulomatous MF (two women and a man, in their sixth and seventh decade). Although in two of these three cases the granulomatous response was extensive, in the other, it only represented 10% of the infiltrate of the biopsy. In all three cases, the granulomas were epithelioid, sarcoidal type.ConclusionsCD123+ PDC can be identified in granulomatous MF. The pathogenic and prognostic role of this finding requires further clarification.
The additive role of echocardiography in the screening for sudden death
Authors: Tamariz Leonardo , Goldberger Jeffrey J. , Palacio Ana , Chen Gordon , Dawkins Elissa , Forbes Emancia , Tajiri Thiago , Ghany Reyan 
Published: February 2019

BackgroundA clinically based sudden cardiac death (SCD) risk score has predictive value. Echocardiographic parameters predict SCD. Our aim was to evaluate the effect of adding echocardiographic parameters to the clinical SCD risk score for the prediction of all‐cause mortality.MethodsWe conducted a retrospective cohort of screening echocardiograms performed on primary care patients. We calculated the SCD risk score and added the left ventricular (LV) mass index, LV hypertrophy, diastolic dysfunction, and LV ejection fraction (EF). We calculated the c‐statistic, net reclassification index (NRI), and Hosmer‐Lemeshow chi‐square for the SCD score alone or combined with each echocardiographic parameter in predicting all‐cause mortality.ResultsWe included 6447 primary care patients who underwent a screening echocardiogram and had a SCD score. The c‐statistic of the SCD score for mortality was 0.61; 95% CI 0.58–0.62 and the c‐statistic for the score combined with LV mass index increased to 0.64; 95% CI 0.63–0.65 and for the score combined with LVEF, the c‐statistic was 0.64;95% CI 0.63–0.67. When diastolic dysfunction and LV hypertrophy were added to the SCD score, the c‐statistic did not significantly change (P > 0.05). The NRI for the addition of LV mass index and LVEF was 0.52 ± 0.02, and the Hosmer‐Lemeshow statistic was nonsignificant (P > 0.05).ConclusionsAdding LV mass index or LVEF to the SCD risk score improves the ability to predict mortality, but in the primary care setting, the improvement is small and underscores the challenge of SCD prediction and prevention in the community.