bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective, observational study of cerebrovascular autoregulation and its association with delirium following cardiac surgery
Authors: Chan B. , Aneman A. 
Published: October 2018

SummaryThis aim of this prospective observational cohort study was to evaluate any association between postoperatively impaired cerebrovascular autoregulation and the onset of delirium following cardiac surgery. Previous studies have shown that impaired intra‐operative cerebrovascular autoregulation during cardiopulmonary bypass is associated with delirium. However, postoperative changes in cerebrovascular autoregulation and its association with delirium have not been investigated. One‐hundred and eight consecutive adult cardiac surgical patients without baseline cognitive dysfunction or aphasia were included in the study. Cerebrovascular autoregulation was assessed by the Pearson correlation between near‐infrared spectroscopy‐derived cerebral tissue oxygen saturation and mean arterial pressure to derive the tissue oximetry index. Cerebrovascular autoregulation was monitored for a minimum of 90 min on postoperative day 0 and postoperative day 1. Delirium was assessed throughout intensive care unit admission using the confusion assessment method for the intensive care unit. We observed delirium in 24 of the 108 patients studied. The mean (SD) tissue oximetry index was higher in delirious patients on postoperative day 0 compared with non‐delirious patients; 0.270 (0.199) vs. 0.180 (0.142), p = 0.044, but not on postoperative day 1; 0.130 (0.160) vs. 0.150 (0.130), p = 0.543. All patients showed improvement in tissue oximetry index on postoperative day 1 compared with postoperative day 0. Logistic regression analysis demonstrated tissue oximetry index on postoperative day 0 to be independently associated with delirium; odds ratio 1.05 (95%CI1.01–1.10), p = 0.043. In conclusion, we found an association between impaired cerebrovascular autoregulation, measured by near‐infrared spectroscopy, and delirium in the early postoperative period.
Placental inflammation, lifestyle, maternal and early child sensitisation to allergens – the assessment of lifestyle and allergic disease during infancy birth cohort
Authors: Papadogiannakis Nikos , Joerink Maaike , Rindsjö Erika , Scheynius Annika , Alm Johan 
Published: October 2018

AbstractAimTo investigate (i) whether maternal sensitisation to allergens, and lifestyle can influence the risk of acute and chronic inflammation of the placenta, in the forms of chorioamnionitis and villitis, respectively, and (ii) whether these placental inflammations are associated with the outcome of sensitisation for the child during preschool age.MethodsPlacentas from term uncomplicated pregnancies (n = 275) in the assessment of lifestyle and allergic disease during infancy study were analysed for the presence of acute chorioamnionitis and chronic villitis. Stepwise logistic regression was performed to estimate the relative risk of placental inflammation in relation to maternal allergic sensitisation and lifestyle, and the association between placental inflammation and sensitisation of the child up to five years of age.ResultsParity and delivery at home were independently associated with chorioamnionitis, home delivery only with the low grade. Maternal allergic sensitisation was associated with increased risk of villitis in the bivariable model, however, not in the multivariable model. No significant associations were detected between placental inflammation and the outcome of sensitisation to allergens at five years of age.ConclusionOur data do not support the hypothesis that the increased risk for sensitisation of a child when the mother is allergic is mediated via placental inflammation.
The Influence of Metacognitive Beliefs on Sleeping Difficulties in Older Adults
Authors: Sella Enrico , Cellini Nicola , Miola Laura , Sarlo Michela , Borella Erika 
Published: October 2018

BackgroundSleep has a crucial role in physical and mental health across the lifespan. In addition to an excessive intrusive sleep‐related cognitive activity, another factor that may influence sleep quality in old age is sleep‐related metacognitive activity, such as metacognitive beliefs about sleeping difficulties, and night‐time thought control strategies. Here, we aimed to assess the relationship between sleep‐related metacognitive beliefs, thought control strategies, excessive intrusive cognitive activities, such as dysfunctional beliefs about sleep, or objective and/or perceived sleep disruptions in elderly people.MethodSleep‐related metacognitive beliefs, thought control strategies, and dysfunctional beliefs related to sleep and perceived sleeping difficulties were assessed with several questionnaires in 50 older adults with no symptoms of dementia, depression, or insomnia. Objective measures of sleep were also collected over 7 days of actigraphic recordings.ResultsRegression analyses showed that subjective sleeping difficulties were explained by sleep‐related metacognitive activity, and particularly by metacognitive beliefs about sleeping difficulties. Interestingly, objective sleep measures were not associated with metacognitive activity. In addition, self‐reported poor sleepers had stronger metacognitive beliefs about sleeping difficulties and a longer sleep onset latency than self‐reported good sleepers.ConclusionsThe present findings underscore the influence of metacognitive activity, and sleep‐related metacognitive beliefs in particular, on the perception of sleeping difficulties in older adults.
Prevalence and incidence of prescription opioid analgesic use in Australia
Authors: Lalic Samanta , Ilomäki Jenni , Bell J. Simon , Korhonen Maarit Jaana , Gisev Natasa 
Published: October 2018

AimsThe aims of the current study were to determine the prevalence and incidence of prescription opioid analgesic use in Australia and compare the characteristics of people with and without cancer initiating prescription opioid analgesics.MethodsA retrospective population‐based study was conducted using the random 10% sample of adults who were dispensed prescription opioid analgesics in Australia between July 2013 and June 2017 through the Pharmaceutical Benefits Scheme. Poisson regression was used to calculate rate ratios (RR) for opioid prevalence and incidence. The characteristics of people initiating opioids, including type of opioid initiated, total oral morphine equivalents dispensed, prescriber speciality, medical comorbidities, and past analgesic and benzodiazepine use, were compared for people with and without cancer.ResultsOpioid prevalence increased {RR = 1.006 [95% confidence interval (CI) 1.004, 1.008]}, while incidence decreased [RR = 0.977 (95% CI 0.975,0.979)] from 2013/2014 to 2016/2017. There were between 287 677 and 307 772 prevalent users each year. In total, 769 334 adults initiated opioids between 2013/2014 and 2016/2017, and half of these initiations were by general practitioners. Initiation with a strong opioid occurred in 55.8% of those with cancer and 28.2% of those without cancer.ConclusionRates of opioid use have remained high since 2013, with approximately 3 million adults using opioids and over 1.9 million adults initiating opioids each year. Between 2013 and 2017, opioid prevalence has slightly increased but incidence has decreased. People without cancer account for the majority of opioid use and are more likely to be initiated on short‐acting and weak opioids. Initiation of strong opioids has increased over time, reinforcing concerns about increased use and the harms associated with strong opioids in the community.
Vicariance and dispersal in southern hemisphere freshwater fish clades: a palaeontological perspective
Authors: Capobianco Alessio , Friedman Matt 
Published: October 2018

ABSTRACTWidespread fish clades that occur mainly or exclusively in fresh water represent a key target of biogeographical investigation due to limited potential for crossing marine barriers. Timescales for the origin and diversification of these groups are crucial tests of vicariant scenarios in which continental break‐ups shaped modern geographic distributions. Evolutionary chronologies are commonly estimated through node‐based palaeontological calibration of molecular phylogenies, but this approach ignores most of the temporal information encoded in the known fossil record of a given taxon. Here, we review the fossil record of freshwater fish clades with a distribution encompassing disjunct landmasses in the southern hemisphere. Palaeontologically derived temporal and geographic data were used to infer the plausible biogeographic processes that shaped the distribution of these clades. For seven extant clades with a relatively well‐known fossil record, we used the stratigraphic distribution of their fossils to estimate confidence intervals on their times of origin. To do this, we employed a Bayesian framework that considers non‐uniform preservation potential of freshwater fish fossils through time, as well as uncertainty in the absolute age of fossil horizons. We provide the following estimates for the origin times of these clades: Lepidosireniformes [125–95 million years ago (Ma)]; total‐group Osteoglossomorpha (207–167 Ma); Characiformes (120–95 Ma; a younger estimate of 97–75 Ma when controversial Cenomanian fossils are excluded); Galaxiidae (235–21 Ma); Cyprinodontiformes (80–67 Ma); Channidae (79–43 Ma); Percichthyidae (127–69 Ma). These dates are mostly congruent with published molecular timetree estimates, despite the use of semi‐independent data. Our reassessment of the biogeographic history of southern hemisphere freshwater fishes shows that long‐distance dispersals and regional extinctions can confound and erode pre‐existing vicariance‐driven patterns. It is probable that disjunct distributions in many extant groups result from complex biogeographic processes that took place during the Late Cretaceous and Cenozoic. Although long‐distance dispersals likely shaped the distributions of several freshwater fish clades, their exact mechanisms and their impact on broader macroevolutionary and ecological dynamics are still unclear and require further investigation.
The synergistic anticancer effect of formosanin C and polyphyllin VII based on caspase‐mediated cleavage of Beclin1 inhibiting autophagy and promoting apoptosis
Authors: Cui Jingxia , Man Shuli , Cui Nina , Yang Li , Guo Qianbei , Ma Long , Gao Wenyuan 
Published: October 2018

AbstractObjectivesDrug combination has a promising and potential development prospect in the treatment of various cancers. The objective of this study is to investigate the synergistic mechanisms of polyphyllin VII (PVII) and formosanin C (FC) in lung cancer.Materials and methodsThe combination of FC and PVII influenced on the apoptosis, autophagy, and the relative signalling pathways were analysed in lung cancer cells.ResultsThe combination of FC and PVII demonstrated a concentration‐ dependent growth inhibition in human lung cancer cells. The combination index (CI) obtained from four lung cancer cells was smaller than 1. This synergistic antitumour effect was based on the increase of their single proapoptotic effect but inhibiting FC‐induced autophagy in NCI‐H460 cells. FC and PVII activated proapoptotic elements like cleaved‐caspase‐3, ‐8, and ‐9 to induce Beclin1 cleaved into Beclin1‐C which suppressed FC‐triggered autophagy and enhanced apoptosis.ConclusionsFormosanin C and PVII showed a synergistic antitumour effect on lung cancer cells. The findings would provide the foundation for the use of combination drugs in the future.
Islam and the Middle East in Texas Textbooks
Authors: Balcı Tamer 
Published: October 2018

AbstractThis article covers how the history of Islam and the Middle East is covered in the latest K‐12 Texas textbooks. The study examines three world histories, four world cultures and geography and six American history textbooks published by major publishers. This article demonstrates that Islamophobic attempts to present Islam as a violent religion has been successful in Texas textbooks. On the other hand, the “Islam spread by sword” narrative is contradicted by the same textbooks with a recognition of non‐Muslim communities that have lived in the Islamic world throughout Islamic history. The study aims to guide publishers and educators before the next cycle of textbook renewal is initiated in 2019–2010.
Spontaneous rupture of right aortic sinus of Valsalva leading to massive cystic dissection of interventricular septum and complete heart block
Authors: Fennich Hala , Doghmi Nawal , Rim Fagouri , Belhaj Saad , Cheikhi Fatima , Cherti Mohamed 
Published: October 2018

AbstractThe interventricular septal dissection is an uncommon, and is occasionally associated with sinus of Valsalva aneurysm. A spontaneous dissection with a normal sinus of Valsalva is extremely rare and is mostly a result of a congenital defect. We report the case of a 23‐year‐old male admitted for complete heart block and presenting as an incidental finding during the TTE multiple and huge cystic‐like mass in the interventricular septum (IVS) which is the TTE characteristic of IVS dissection. Most patients remain asymptomatic until the anatomical and hemodynamic changes lead to complications like: severe aortic regurgitation with heart failure and conduction abnormalities. Although transthoracic echocardiogram (TTE) has been the first‐line imaging modality for such findings, cardiac computed tomography (CT) and magnetic resonance imaging have been increasingly used as supplemental or confirmatory tests. The imaging modalities showed a perforation of right sinus of Valsalva causing the expansion of the dissection to the apex. The patient underwent surgical repair with satisfying results. In conclusion, we report an extremely rare clinical case of spontaneous dissection of the interventricular septum using multiple imaging techniques and with a successful surgery.
Assessment of fluid responsiveness by inferior vena cava diameter variation in post‐pneumonectomy patients
Authors: Wang Yan , Jiang Yinghou , Wu Hongning , Wang Runfeng , Wang Ying , Du Cheng 
Published: October 2018

AimFirst, the inferior vena cava dilatation index (DIVC) was measured by ultrasound, and then the reliability of DIVC as an indicator to predict volume responsiveness in patients undergoing mechanical ventilation after pneumonectomy was evaluated.MethodsPulse indicator continuous cardiac output (Picco) as gold standard was performed to sedated mechanically ventilated post‐pneumonectomy patients in intensive care unit of Nanjing Thoracic Hospital from August 2014 to December 2016. Meanwhile, ultrasound measurement to inferior vena cava (IVC) diameter at the end inspiration (Dmax) and the end of expiration (Dmin) was performed. DIVC = (Dmax − Dmin)/Dmin. Above values were recorded at baseline and then after fluid resuscitation challenge (7 mL/kg hydroxyethyl starch). An increase in cardiac index of more than 15% was used as the standard for fluid responsiveness. Patients were divided into responsive group and non‐responsive group. A receiver operating characteristic (ROC) curve was then used to determine the sensitivity and specificity of DIVC in predicting fluid responsiveness after pneumonectomy.ResultsEighteen patients were enrolled. 10 patients were divided into responsive group and eight in non‐responsive group. DIVC in responsive group was significantly higher than in non‐responsive group (P < 0.01). By setting DIVC ≥ 15% as a measure of fluid responsiveness, sensitivity was 81.8% and specificity was 85.7%.ConclusionDIVC is a reliable indicator of capacity responsiveness in mechanically ventilated post‐pneumonectomy patients.
Use of team‐based learning pedagogy for predoctoral teaching and learning
Authors: Park Sang E. , Salihoglu‐Yener Esra , Fazio Sara B. 
Published: October 2018

AbstractPurposeThe purpose of the study was to describe the development and implementation of a Team‐based Learning (TBL) educational model in a predoctoral education course to assess its effectiveness in promoting student learning as measured by knowledge acquisition and student satisfaction.MethodsAn interprofessional education course used the TBL structure for the second‐year dental students, in which students had an opportunity to first work on the questions individually and then in groups. Each instruction session began with a readiness assurance test (RAT), which students were asked to complete in two formats: each student answered on their own, then each team worked on the same questions to arrive at a consensus decision followed by a team‐based application exercise.ResultsA significant difference existed in which team scores were higher than individual scores and on average, the teams scored higher than when students worked alone. Student feedback showed a strong preference of TBL over the traditional lecture format. Students found that the sessions helped them to understand the clinical cases from the perspective of other health care fields in this pedagogical approach.ConclusionThe TBL methods facilitated an interactive learning environment to promote student‐centred learning in a predoctoral education course and the teams performed better in correct evaluation compared with the individual students.
Purinergic modulation of neuronal activity in the rat prepositus hypoglossi nucleus
Authors: Sugioka Miho , Saito Yasuhiko 
Published: October 2018

AbstractIn the nervous system, adenosine 5′‐trisphosphate (ATP) functions as a neurotransmitter and binds to ionotropic P2X receptors and metabotropic P2Y receptors. Although ATP receptors are expressed in the prepositus hypoglossi nucleus (PHN), which is a brainstem structure involved in controlling horizontal gaze, it is unclear whether ATP indeed affects the activity of PHN neurons. In this study, we investigated the effects of ATP on spontaneous firing of PHN neurons using whole‐cell recordings in rat brainstem slices. Bath application of ATP increased or decreased the spontaneous firing rate of the neurons in a dose‐dependent manner, indicating that ATP indeed affects PHN neuronal activity. To clarify the mechanisms of the ATP effects, we investigated the current responses of PHN neurons to a local application of ATP. The ATP application induced a fast inward (FI) current, a slow inward (SI) current, and/or a slow outward (SO) current in the neurons. The agonists of P2X and P2Y receptors induced FI and SI currents, respectively. The SO currents were not induced by the ATP agonists but were induced by adenosine, which may be extracellularly converted from ATP by ectonucleotidases. An antagonist of adenosine P1 (A1) receptors abolished the adenosine‐induced SO currents and bath application of adenosine decreased the spontaneous firing rate of all PHN neurons tested. These results indicate that PHN neurons express functional purinoceptors and show that the FI, SI, and SO currents were mediated via P2X, P2Y, and A1 receptors, respectively.
Epilepsy surgery in Panama: Establishment of a successful hybrid program as a model for small middle‐income countries
Authors: Kuzniecky Ruben , Baez Carmen , Aranda Guzmán , Hidalgo Eveline Teresa , Grover Ameeta , Orillac Cordelia , Zelenka Yvonne , Weiner Howard L. 
Published: October 2018

SummaryObjectiveThe majority of the 65 million people worldwide with epilepsy live in low‐ and middle‐income countries. Many of these countries have inadequate resources to serve the large patient population affected by epilepsy. Panama is a middle‐income country that currently has only 2 facilities that can provide basic epilepsy services and no epilepsy surgery services. To address this need, a group of Panamanian physicians partnered with U.S. epilepsy health care providers to test a hybrid epilepsy surgery program, combining resources and expertise.MethodsFrom 2011 to 2017, a multidisciplinary team of neurologists, neurosurgeons, and an electroencephalography (EEG) technician from the United States traveled to Panama 6 times and, in collaboration with the local team, performed surgical procedures for intractable epilepsy at the national children's hospital. Resective surgeries were performed with intraoperative electrocorticography and/or implantation of subdural and depth electrodes and extra‐operative monitoring. Cost was calculated using Panama government data.ResultsTwenty‐seven children with intractable epilepsy were surgically treated. Fifteen children are seizure‐free (Engle class I), 11 children are Engel II, and one child is Engel III. No major morbidity or mortality occurred, with only one postoperative infection. The average cost of treatment was calculated at $9850 per patient.SignificanceThis program is a model for creating a multinational and multi‐institutional collaboration to provide surgical epilepsy treatment in a middle‐income country without an adequate infrastructure. To be successful, this collaboration needed to address medical, technical, and cultural challenges. This partnership helps to alleviate some of the present need for surgical epilepsy services while laying the groundwork for the development of a future local independent epilepsy surgery program.
Improvement of the yield and flavour quality of sesame oil from aqueous extraction process by moisture conditioning before roasting
Authors: Xu Tao , Yang Ruijin , Hua Xiao , Zhao Wei , Tong Yanjun , Zhang Wenbin 
Published: October 2018

SummaryThis study was to investigate the effect of conditioning and heat‐treatments on the yield and quality of sesame oil. Confocal laser scanning microscopy (CLSM) and transmission electron microscopy (TEM) were used to explore the microstructure of sesame cotyledon cells. It was found that cell microstructure and oil body membrane of sesame seeds underwent high‐pressure steaming pretreatment (HPS), roasting pretreatment (RP), moisture‐conditioning plus roasting pretreatment (MRP) was all damaged. All these thermal treatments, especially MRP, contributing to increased oil yield from 45.85 (untreated) to 91.69%. Furthermore, RP or MRP yielded a higher content of sesamol than untreated sesame, whereas sesamin and seasamolin content, fatty acid composition, acid value and peroxide value showed no significant changes (P > 0.05) between heat‐treatments. MRP increased the type and content of volatile compounds, which was beneficial to the strong nut‐like aroma. Additionally, MRP had a positive effect on oxidative oil stability (induction time of 10.80 h) with respect to untreated oil (7.82 h).