bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric community‐acquired bacteraemia, pneumococcal invasive disease and antibiotic resistance fell after the pneumococcal conjugate vaccine was introduced
Authors: Berger Yael , Adler Amos , Ariel Tenenbaum , Rokney Assaf , Averbuch Diana , Grisaru‐Soen Galia 
Published: December 2018

AbstractAimThis study examined the impact of the routine pneumococcal conjugate vaccination (PCV) on childhood community‐acquired bacteraemia (CAB) and antibiotic resistance patterns in Israeli children.MethodsIsrael added the PCV vaccine to its national immunisation programme in July 2009. We retrospectively analysed the medical records of all patients with CAB under 18 years at three children's hospitals in Tel Aviv and Jerusalem from 2007 to 2015. The microbiological data, clinical presentation, pneumococcal serotype distribution, antibiotic susceptibility and outcomes of infections were compared before and after the vaccine was introduced.ResultsThere were 511 904 emergency department visits and 125 922 children were hospitalised. Of those, 238 had CAB before vaccination was introduced (mean age 17 months) and 316 had CAB after the introduction (mean age 21 months). Emergency department presentations for CAB fell from 141.8 to 91.8 per 100 000 visits: a relative risk reduction (RRR) of 35%. Hospitalisations for CAB decreased from 430 to 337 per 100 000 admissions: an RRR of 22%. Hospitalisations due to Staphylococcus aureus increased significantly and penicillin nonsusceptible blood Streptococcus pneumoniae isolates decreased significantly.ConclusionIntroducing national pneumococcal conjugate vaccination significantly changed the epidemiology of CAB, with reduced antibiotic‐resistant Streptococcus pneumoniae and increased hospitalisation rates for Staphylococcus aureus infections.
Mitophagy imbalance in cardiomyocyte ischaemia/reperfusion injury
Authors: Li Yu‐zhen , Wu Xu‐dong , Liu Xiu‐hua , Li Pei‐feng 
Published: December 2018

AbstractThe rhythmic contraction of cardiomyocytes consumes a lot of energy. 90% of ATP in cardiomyocytes is produced by mitochondria. Maintenance of a healthy population of mitochondria by mitophagy is critical for cardiomyocyte survival and normal function. Mitophagy refers to selective removal of damaged mitochondria by autophagy mechanism. The process of mitophagy must be restricted to dysfunctional mitochondria and maintained at a balanced level. Disruption in the balance inevitably leads to cardiomyocyte injury and dysfunction. Accumulating evidence suggests that mitophagy plays a pivotal role in ischaemia/reperfusion‐induced cardiomyocyte injury. In this review, we focus on the current understanding of mitophgy in cardiomyocyte function, the implications for cardiomyocyte injury in response to ischaemia/reperfusion as well as their underlying potential mechanisms.
Changes in spatial structures of plant communities lead to functional homogenization in an urban forest park
Authors: Bergeron Alexandre , Lavoie Claude , Domon Gérald , Pellerin Stéphanie 
Published: December 2018

AbstractAimsWe investigated whether biotic homogenization of plant communities occurs over three decades in a small urban protected forest, and what the possible drivers are underlying the observed changes.LocationA 96 ha temperate forest, Montréal, Canada.MethodsWe surveyed vegetation and explanatory variables (ecological conditions, disturbances, spatial structure) in 62 plant communities in 1980 and 2011. We collected plant attributes to identify functional groups (FGs). We evaluated changes in beta diversity using tests for homogeneity of multivariate dispersions. We used space–time interaction models to assess changes in FGs spatial structures. We used multivariate analyses to identify relationship between spatial patterns and explanatory variables, and variation partitioning analyses to identify the drivers involved in beta diversity changes.ResultsBeta diversity declined only in the herb–shrub communities. About 35% of their FGs had significantly changed their spatial distribution over time. Those that contracted their distribution were mainly composed of plants with wind‐dispersed seeds or with low to intermediate vegetative propagation capabilities, while those that expanded were plants with fleshy fruits or extensive vegetative propagation capabilities. In 1980, communities were structured into small isolated clumps, while in 2011, clumps expanded and coalesced near disturbed areas. In 1980, the spatial assembly processes relied essentially on endogenous factors while in 2011 exogenous factors, such as disturbances, became more influential. Multivariate analyses suggested that edge effect, past agricultural disturbances, and beaver activities facilitated the decrease of beta diversity (homogenization process).ConclusionsThe homogenization of herb–shrub communities likely resulted from changes in their clumped spatial structure. FGs with the most adapted attributes to disperse under urban forest conditions were those that expanded spatially. Structural changes seem to have begun with an unpredictable stage governed by dispersal limitation processes, followed by a predictable stage mostly driven by land‐use legacy and disturbances.
Withholding and withdrawing treatment for cost‐effectiveness reasons: Are they ethically on par?
Authors: Sandman Lars , Liliemark Jan 
Published: December 2018

AbstractIn healthcare priority settings, early access to treatment before reimbursement decisions gives rise to problems of whether negative decisions for cost‐effectiveness reasons should result in withdrawing treatment, already accessed by patients. Among professionals there seems to be a strong attitude to distinguish between withdrawing and withholding treatment, viewing the former as ethically worse. In this article the distinction between withdrawing and withholding treatment for reasons of cost effectiveness is explored by analysing the doing/allowing distinction, different theories of justice, consequentialist and virtue perspectives. The authors do not find any strong reasons for an intrinsic difference, but do find some reasons for a consequentialist difference, given present attitudes. However, overall, such a difference does not, all things considered, provide a convincing reason against withdrawal, given the greater consequentialist gain of using cost‐effective treatment. As a result, patients should be properly informed when given early access to treatment, that such treatment can be later withdrawn following a negative reimbursement decision.
Oxytocin therapy in hypopituitarism: Challenges and opportunities
Authors: Bhargava Raghav , Daughters Katie L. , Rees Aled 
Published: December 2018

SummaryPatients with hypopituitarism display impaired quality of life and excess morbidity and mortality, despite apparently optimal pituitary hormone replacement. Oxytocin is a neuropeptide synthesized in the anterior hypothalamus which plays an important role in controlling social and emotional behaviour, body weight and metabolism. Recent studies have suggested that a deficiency of oxytocin may be evident in patients with hypopituitarism and craniopharyngioma, and that this may be associated with deficits in cognitive empathy. Preliminary data hint at potential benefits of oxytocin therapy in improving these deficits and the accompanying metabolic disturbances that are common in these conditions. However, several challenges remain, including an incomplete understanding of the regulation and mechanisms of action of oxytocin, difficulties in accurately measuring oxytocin levels and in establishing a diagnosis of oxytocin deficiency, and a need to determine both the optimal mode of administration for oxytocin therapy and an acceptable safety profile with long‐term use. This review considers the data linking oxytocin to the neuropsychological and metabolic disturbances evident in patients with craniopharyngioma and hypopituitarism, and describes the challenges that need to be overcome before replacement therapy can be considered as a therapeutic option in clinical practice.
Poorly differentiated thyroid cancer in the context of the revised 2015 American Thyroid Association Guidelines and the Updated American Joint Committee on Cancer/Tumor‐Node‐Metastasis Staging System (eighth edition)
Authors: Walczyk Agnieszka , Kopczyński Janusz , Gąsior‐Perczak Danuta , Pałyga Iwona , Kowalik Artur , Chrapek Magdalena , Hejnold Maria , Góźdź Stanisław , Kowalska Aldona 
Published: December 2018

SummaryObjectivePoorly differentiated thyroid cancer (PDTC) is a rare, but aggressive thyroid cancer (TC) and a main cause of death from non‐anaplastic follicular cell‐derived TC. Assessing the risk of PDTC‐related death and the risk of recurrence is important for clinicians. The recent American Thyroid Association (ATA) 2015 guidelines and the updated 8th edition of the American Joint Committee on Cancer/Tumor‐Node‐Metastasis (AJCC/TNM) staging system should support clinicians in the management approach to PDTC patients.PatientsForty‐six consecutive PDTC patients treated in a single oncologic centre, 2000‐2017.MeasurementsRetrospective analysis of TNM stage, initial risk, response‐to‐therapy categories, follow‐up and final disease status incorporating the ATA 2015 criteria and the 8th AJCC/TNM staging system. Disease‐specific survival (DSS) using the Kaplan‐Meier method.ResultsOf the 46 PDTC 21 (45.6%) were ATA high risk (HR), 22 (47.8%), 17 (37%) and seven (15.2%) were TNM stages I, II, and III‐IV, respectively. During a median follow‐up of 55.5 months, two (4.3%) patients were recurrent, 18 (39.1%) died of PDTC. The 5‐/10‐year DSS were 65/57%, respectively. According to the AJCC/TNM, the 5‐/10‐year DSS of I, II, and III‐IV stage were 83/83%; 77/55%, and 0/0%, respectively. According to the 2015 ATA initial risk, the 5‐/10‐year DSS were 91/72% for ATA intermediate risk and 38/38% for ATA HR patients.ConclusionsIn PDTC patients, the updated AJCC/TNM staging system accurately predicts a high risk of death in stage III‐IV, whereas it seems to be inadequate for predicting a very low or low risk of death expected for differentiated TC in stage I‐II. The ATA initial HR may be also used to predict a high risk of PDTC‐related death.
Addressing the empty pelvic syndrome following total pelvic exenteration: does mesh reconstruction help?
Authors: Lee P. , Tan W. J. , Brown K G. M. , Solomon M. J. 
Published: December 2018

AbstractAimPerineal wound complications and pelvic abscesses remain a major source of morbidity after total pelvic exenteration. The void created in the pelvis after these multi‐visceral resections leads to fluid accumulation and translocation of bowel within the pelvic cavity, which may increase the risk of pelvic abscess, perineal fluid discharge with perineal wound dehiscence and prolonged ileus. This study describes a novel technique using degradable synthetic mesh with overlying omentum to preclude small bowel and fill the empty space after total pelvic exenteration, and aimed to investigate the rate of pelvic abscess and perineal wound‐related complications in this group.MethodTen patients who underwent total pelvic exenteration followed by implantation of degradable synthetic mesh at a quaternary referral centre were identified and included. The mesh was moulded to the contours of the bony pelvis at the level of the pubic symphysis anteriorly and inferior to the sacral promontory posteriorly. The data on the number of postoperative perineal wound‐related complications including pelvic abscesses were collected.ResultsThere was no perioperative mortality. Five patients (50%) developed postoperative complications. One patient developed an abscess inferior to the mesh that required surgical drainage and another had a pre‐sacral collection that was successfully managed conservatively. Two patients developed intra‐abdominal collections requiring percutaneous drainage. Median length of stay was 20 days (range 16–35). No perineal hernia or entero‐perineal fistula was detected in any patient either clinically or radiologically at a median follow‐up of 7 months.ConclusionDegradable synthetic mesh reconstruction following exenterative surgery may reduce postoperative complications related to the perineal wound.
Hidden morbidity: The results of a collaborative community chronic obstructive pulmonary disease screening initiative
Authors: Crooks Michael G. , Thompson Joanne L. , Cummings Helena , Watkins Karen , Jackson Nicola , Platten Shaneen , Evans Cheryl , Faruqi Shoaib 
Published: December 2018

AbstractChronic obstructive pulmonary disease (COPD) often goes unrecognised resulting in people living with the disease without a diagnosis. We investigated the characteristics, symptom burden and flow of participants in a community COPD screening initiative. Screening was undertaken during four events over 2‐weeks. Participants completed symptom questionnaires and FEV‐1/FEV‐6 measurement. Patients with FEV‐1 <80% predicted or FEV‐1 ≥ 80% predicted and FEV‐1/FEV‐6 <0.72 were considered ‘screen‐positive’ and invited to attend a 1‐stop diagnostic clinic. Two hundred and fifty‐seven individuals participated (mean ± SD age 58 ± 16, 24% current smokers). Seventy‐seven were screen‐positive with 27 ultimately attending a 1‐stop clinic and 18 having confirmed COPD. The CAT score of participants with COPD was 19.3 ± 11.4. Two‐thirds had moderate airflow obstruction on spirometry. The diagnosis rate in this screening initiative was comparable to trials of systematic case finding. Further research is required to explore the broader clinical impact of COPD screening.
Marijuana use in transplantation: A call for clarity
Authors: Levi Marilyn E. , Montague Brian T. , Thurstone Christian , Kumar Deepali , Huprikar Shirish S. , Kotton Camille N. ,   the Executive Committee of the Infectious Diseases Community of Practice of the American Society of Transplantation
Published: December 2018

AbstractTransplant centers have varying policies for marijuana (MJ) use in donors, transplant candidates, and recipients. Rationales for these differences range from concerns for fungal complications, impaired adherence, and drug interactions. This paper reviews the current status of MJ policies and practices in transplant centers and results of a survey sent to the American Society of Transplantation (AST) membership by the Executive Committee of the AST Infectious Diseases Community of Practice.The purpose of the survey was to compare policies and concerns of MJ use to actual observed complications. Of the 3321 surveys sent, 225 members (8%) responded. Transplant centers varied in their approval processes, differing even in organ types within the same institutions. Furthermore, there was discordance among transplant centers in their perceived risks of marijuana use as opposed to complications actually observed. An increasing number of states continue to legalize medical and recreational MJ resulting in widespread availability. Further research is needed to assess the validity of concerns for complications of MJ use in potential donors and recipients. Ultimately, standardized guidelines should be established based on studies and evidence‐based criteria to assist transplant programs in their policies around the use of cannabis in their donors and recipients.
Severe hypertension is an independent risk factor for posterior reversible encephalopathy syndrome post‐hematopoietic cell transplantation in children with thalassemia major
Authors: Li Xin‐Yu , Huang Ke , Zhou Dun‐Hua , Li Yang , Xu Hong‐Gui , Weng Wen‐Jun , Xu Lu‐Hong , Fang Jian‐Pei 
Published: December 2018

AbstractBackgroundPosterior reversible encephalopathy syndrome (PRES) is an increasingly recognized serious complication of cyclosporine A (CSA) and tacrolimus (TAC) use in hematopoietic cell transplantation (HCT) recipients.ProcedureA retrospective study was carried out, including 84 cases of HCT for TM from January 2012 to January 2017. Eleven cases were diagnosed with PRES.ResultsThe cumulative incidence of PRES was 13.4% (95% confidence interval (CI) 9.7%‐17.2%). The median onset time of the symptoms was 63 [20, 143] days after transplantation. Lumber puncture found that CSF was normal. Univariate analysis showed that patients who received methylprednisolone (MP) (OR = 10.629 95% CI, 1.360‐83.071, P = 0.024), female patients (OR = 4.275, 95% CI, 1.154‐15.843, P = 0.032), patients who had severe hypertension (OR = 5.162, 95% CI, 1.042 to 25.559, P = 0.029) had significantly higher risks of PRES. Multivariate analysis showed that severe hypertension (hazard ratio [HR], 12.793; 95% CI, 1.477 to 110.813; P  = 0.021), and Pesaro class 3 (HR, 3.367; 95% CI, 1.210 to 9.368; P  =  0.020) were associated with PRES.ConclusionsThe severe hypertension is an independent risk factor for PRES post‐HCT in children with thalassemia major. Patients of Pesaro class 3 may benefit from optimum control of blood pressure post‐HCT for prophylaxis of PRES.
Outcomes after lung transplantation for patients with occupational lung diseases
Authors: Joubert Kyla D. , Awori Hayanga J. , Strollo Diane C. , Lendermon Elizabeth A. , Yousem Samuel A. , Luketich James D. , Ensor Christopher R. , Shigemura Norihisa 
Published: December 2018

AbstractOccupational lung diseases (OLD) including silicosis, asbestosis, and pneumoconiosis progress to end stage lung disease requiring lung transplantation (LT). Prognosis and treatment of OLDs are poorly understood and a paucity of data exists regarding LT outcomes. Additionally, transplant operative complexity for patients with OLD is high. A single center retrospective review of all single and bilateral LT recipients between May 2005 and Oct 2016 was performed. Patients were grouped by OLD, and nearest neighbor matching was performed at a ratio of 1:3 cases to controls. Thirty cases were matched to 88 controls. Seventeen patients (57%) with OLD required intraoperative support with either extra‐corporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (P = 0.02), and 5 (17%) required delayed chest closure (P = 0.05) which was more frequent than matched controls. In addition, operative time was significantly longer in patients with OLD (P = 0.03). Despite these factors, there were no significant differences in immediate post‐operative outcomes including mechanical ventilator support, post‐operative ECMO, and tracheostomy. Chronic lung allograft dysfunction and long‐term survival were also similar between cases and controls. OLDs should not preclude LT. The operation should be performed at experienced centers.
Metabolic and proteomic signatures of hypoglycaemia in type 2 diabetes
Authors: Halama Anna , Kahal Hassan , Bhagwat Aditya M. , Zierer Jonas , Sathyapalan Thozhukat , Graumann Johannes , Suhre Karsten , Atkin Stephen L. 
Published: December 2018

AimsTo determine the biochemical changes that underlie hypoglycaemia in a healthy control group and in people with type 2 diabetes (T2D).Materials and methodsWe report a hypoglycaemic clamp study in seven healthy controls and 10 people with T2D. Blood was withdrawn at four time points: at baseline after an overnight fast; after clamping to euglycaemia at 5 mmol/L; after clamping to hypoglycaemia at 2.8 mmol/L; and 24 hours later, after overnight fast. Deep molecular phenotyping using non‐targeted metabolomics and the SomaLogic aptamer‐based proteomics platform was performed on collected samples.ResultsA total of 955 metabolites and 1125 proteins were identified, with significant alterations in >90 molecules. A number of metabolites significantly increased during hypoglycaemia, but only cortisol, adenosine‐3′,5′‐cyclic monophosphate (cyclic AMP), and pregnenolone sulphate, were independent of insulin. By contrast, identified protein changes were triggered by hypoglycaemia rather than insulin. The T2D group had significantly higher levels of fatty acids including 10‐nonadecenoate, linolenate and dihomo‐linoleate during hypoglycaemia compared with the control group. Molecules contributing to cardiovascular complications such as fatty‐acid‐binding protein‐3 and pregnenolone sulphate were altered in the participants with T2D during hypoglycaemia. Almost all molecules returned to baseline at 24 hours.ConclusionsThe present study provides a comprehensive description of molecular events that are triggered by insulin‐induced hypoglycaemia. We identified deregulated pathways in T2D that may play a role in the pathophysiology of hypoglycaemia‐induced cardiovascular complications.
Transcriptional control of synaptic components by the clock machinery
Authors: Hannou Lydia , Roy Pierre‐Gabriel , Ballester Roig Maria Neus , Mongrain Valérie 
Published: December 2018

AbstractCircadian rhythms are generated in mammals by a central clock located in the suprachiasmatic nucleus of the hypothalamus, which regulates the homeostasis of many biological processes. At the molecular level, the regulation of circadian rhythms is under the control of transcriptional‐translational feedback loops composed of clock factors, including transcription factors. In the brain, synaptic plasticity has been shown to vary with a 24‐h rhythm. Also, when measured at a given time‐of‐day, synaptic plasticity has been observed to be disrupted by dysregulation of clock factors. This could suggest a regulation of synaptic functions by the clock machinery. Interestingly, many studies provide support for direct and indirect transcriptional regulation by core clock factors, including rhythmic gene expression, for a variety of synaptic components. Indeed, the gene of several neuropeptides, neurotransmitter regulators, receptors and transporters, ion channels, vesicle proteins, and adhesion and scaffolding molecules present evidence to be clock‐controlled. We here present, while considering different regions of the mammalian brain, an overview of the extent of the transcriptional control of synaptic components by the clock machinery.
Periodic patterns in Rodentia: Development and evolution
Authors: Johnson Matthew R. , Barsh Gregory S. , Mallarino Ricardo 
Published: December 2018

AbstractMammalian periodic pigment patterns, such as spots and stripes, have long interested mathematicians and biologists because they arise from non‐random developmental processes that are programmed to be spatially constrained, and can therefore be used as a model to understand how organized morphological structures develop. Despite such interest, the developmental and molecular processes underlying their formation remain poorly understood. Here, we argue that Arvicanthines, a clade of African rodents that naturally evolved a remarkable array of coat patterns, represent a tractable model system in which to dissect the mechanistic basis of pigment pattern formation. Indeed, we review recent insights into the process of stripe formation that were obtained using an Arvicanthine species, the African striped mouse (Rhabdomys pumilio), and discuss how these rodents can be used to probe deeply into our understanding of the factors that specify and implement positional information in the skin. By combining naturally evolved pigment pattern variation in rodents with classic and novel experimental approaches, we can substantially advance our understanding of the processes by which spatial patterns of cell differentiation are established during embryogenesis, a fundamental question in developmental biology.