bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐operative management of isolated single abdominal stab wound: is it safe?
Authors: Lee Hong Xiang , Hauser Matthew , Jog Shivangi , Bautz Peter , Dobbins Christopher 
Published: May 2018

BackgroundThis is a retrospective review of prospectively collected data on our hospital, a Level 1 trauma centre, where stable patients with single abdominal stab wounds are considered for non‐operative (conservative) management if they fulfil the criteria with the aid of computed tomography. The aim is to review our current approach in managing these patients.MethodsPatients' data were obtained from January 2005 to June 2016. All injuries classed as assault or self‐harm by sharp object in Injury Severity Score body region 4 were included. Patients were excluded from this study if they had haemodynamic instability, peritonism, significant findings on computed tomography, intoxicated, sustained head injury, sedated and intubated or evisceration of bowel, impalement of the stabbed object, potential thoraco‐abdominal injury and multiple stab wounds. The patients were divided into non‐operative and delayed operative groups for analysis.ResultsOne hundred and sixty‐six of the 313 patients who presented with abdominal stab wounds matched our criteria. One hundred and sixty‐three patients (98.2%) from the non‐operative group were discharged without complications following period of observation, while three patients underwent operative intervention following trial of non‐operative management. The mean length of stay for the successful non‐operative group and the group which required delayed operative intervention were 2.8 and 6 days, respectively. No morbidity or mortality was recorded in either group.ConclusionOur observational study showed that in a Level 1 trauma centre, patients with single anterior abdominal stab wound and normal vital signs can potentially be safely managed with non‐operative approach provided that these patients are cooperative for close observation.
Impact of serious mental illness on surgical patient outcomes
Authors: McBride Kate E. , Solomon Michael J. , Young Jane M. , Steffens Daniel , Lambert Tim J. , Glozier Nick , Bannon Paul G. 
Published: May 2018

BackgroundPeople with comorbid mental illness have poorer health status and disparate access to healthcare. Several studies internationally have reported mixed findings regarding the association between mental illness and surgical patient outcomes. This study examines the surgical outcomes in people with decompensated serious mental illness (SMI) within the setting of the Australian universal healthcare system.MethodsRetrospective cohort study involving elective overnight surgical patients aged 18 years and above who attended a large public tertiary referral hospital in Sydney, Australia, between 2010 and 2014. Patients were identified using ICD‐10‐AM diagnosis codes. Outcomes measure including in‐hospital mortality, post‐operative complications, morbidity, admission and time in intensive care, length and cost of hospitalization, discharge destination and 28‐day re‐admission rates were examined.ResultsOf 23 343 surgical patient admissions, 451 (2%) patients had decompensated comorbid SMI with a subset of 47 (0.2%) having a specific psychotic illness. Patients with SMI comorbidity had significantly higher in‐hospital mortality (2% versus 0%), post‐operative complications (22% versus 8%), total comorbidity (7.6 versus 3.4 secondary codes), admissions (29% versus 9%) and time in intensive care (34.6 h versus 5.0 h), stay in hospital (12.2 days versus 4.6 days), admission costs ($24 162 versus $12 336), re‐admission within 28 days (14% versus 10%) and discharges to another facility (11% versus 3%).ConclusionPatients with comorbid SMI had significantly worse surgical outcomes and incur much higher costs compared with the general surgical population. These results strongly highlight that specific perioperative interventions are needed to proactively improve the identification, management and outcomes for these disadvantaged patients.
Nightscapes of Play: Enjoyment of Architecture and Urban Space through Bicycling
Authors: Morhayim Lusi 
Published: May 2018

AbstractAnti‐automobile, anti‐capitalist, and pro‐environmental worldviews are known to shape bicyclists’ right to the city demands. This research uncovers another layer of their radical engagement with the city: playful enjoyment of architectural structures and urban space, using the case study of Midnight Mystery Ride, a community bicycle ride taking place in the middle of the night once a month in several cities around the world. Through theoretical lenses of play and rhythmanalysis, I argue that bicyclists at night take over spaces built with exchange vale in mind and introduce use value in the same spaces. Interviews with bicyclists demonstrate how their unconventional use of space questions separation from natural rhythms and nature. I demonstrate that their nighttime use of the city is also a critique of how urban space is organised largely for profit and discipline and of how the human and playful potential of urban space are not fully realised.
Comparative optimism in older adults’ future health expectations
Authors: Vanderzanden Karen , Ruthig Joelle C. 
Published: May 2018

ObjectivesDespite a common belief that health declines with age, many older adults remain optimistic about their future health. However, the longitudinal impact of personal and comparatively optimistic future health estimates (FHEs) is unclear.MethodAmong 408 older adults (Mage = 70.32 years), this study identified the prevalence, source, and two‐year stability of comparatively optimistic FHEs; examined demographic, psychosocial, and health correlates of comparative FHEs; and assessed the role of comparative FHEs in predicting eight‐year survival odds.ResultsNearly half of participants were comparatively optimistic due to interpersonal pessimism more so than personal optimism. Regarding stability, comparative optimism declined over the two‐year period. Being younger and having more perceived control, dispositional optimism, and recent positive emotions were associated with better FHEs for oneself and a similar other. Beyond effects of age, gender, relationship status, and dispositional optimism, optimistic personal FHEs predicted eight‐year survival odds.ConclusionsFindings have implications for predicting survival and advancing the conceptual understanding of comparative FHEs.
Statement of contribution

What is already known on the subject?

Previous research has demonstrated that older adults tend to believe diminished health accompanies increasing age. Despite this notion, older adults remain comparatively optimistic about their health.

What does this study add?

The longitudinal results of the current study indicated that nearly half of participants were categorized as comparative optimists, primarily due to interpersonal pessimism.

The current study demonstrated that there is little distinction between personal FHEs and those for a similar other in terms of demographic, psychosocial, and health correlates.

The current study identified factors that predicted eight‐year survival among older adults, such as being female, younger, in a committed relationship, and better personal FHEs.
Loss of protein phosphatase 6 in mouse keratinocytes enhances K‐rasG12D‐driven tumor promotion
Authors: Kurosawa Koreyuki , Inoue Yui , Kakugawa Yoichiro , Yamashita Yoji , Kanazawa Kosuke , Kishimoto Kazuhiro , Nomura Miyuki , Momoi Yuki , Sato Ikuro , Chiba Natsuko , Suzuki Mai , Ogoh Honami , Yamada Hidekazu , Miura Koh , Watanabe Toshio , Tanuma Nobuhiro , Tachi Masahiro , Shima Hiroshi 
Published: May 2018

Here, we address the function of protein phosphatase 6 (PP6) loss on K‐ras‐initiated tumorigenesis in keratinocytes. To do so, we developed tamoxifen‐inducible double mutant (K‐rasG12D‐expressing and Ppp6c‐deficient) mice in which K‐rasG12D expression is driven by the cytokeratin 14 (K14) promoter. Doubly‐mutant mice showed early onset tumor formation in lips, nipples, external genitalia, anus and palms, and had to be killed by 3 weeks after induction by tamoxifen, while comparably‐treated K‐rasG12D‐expressing mice did not. H&E‐staining of lip tumors before euthanasia revealed that all were papillomas, some containing focal squamous cell carcinomas. Immunohistochemical analysis of lips of doubly‐mutant vs K‐rasG12D mice revealed that cell proliferation and cell size increased approximately 2‐fold relative to K‐rasG12D‐expressing mutants, and epidermal thickness of lip tissue greatly increased relative to that seen in K‐rasG12D‐only mice. Moreover, AKT phosphorylation increased in K‐rasG12D‐expressing/Ppp6c‐deficient cells, as did phosphorylation of the downstream effectors 4EBP1, S6 and GSK3, suggesting that protein synthesis and survival signals are enhanced in lip tissues of doubly‐mutant mice. Finally, increased numbers of K14‐positive cells were present in the suprabasal layer of doubly‐mutant mice, indicating abnormal keratinocyte differentiation, and γH2AX‐positive cells accumulated, indicating perturbed DNA repair. Taken together, Ppp6c deficiency enhances K‐rasG12D‐dependent tumor promotion.
Evaluation of the basophil activation test and skin prick testing for the diagnosis of sesame food allergy
Authors: Appel M. Y. , Nachshon L. , Elizur A. , Levy M. B. , Katz Y. , Goldberg M. R. 
Published: May 2018

SummaryBackgroundThe prevalence of sesame food allergy (SFA) has increased over recent years, with the potential of anaphylactic reactions upon exposure. Oral food challenge (OFC) remains the diagnostic standard, yet its implementation may be risky. Commercial skin prick tests (SPT) have a low sensitivity. Investigation of alternate diagnostic methods is warranted.ObjectiveTo evaluate the utility of SPT and the basophil activation test (BAT) for SFA diagnosis.MethodsEighty‐two patients with suspected SFA completed an open OFC to sesame or reported a recent confirmed reaction. Patients were administered skin prick tests (SPT) with commercial sesame seed extract (CSSE) and a high protein concentration sesame extract (HPSE) (100 mg/mL protein). Whole blood from 80 patients was stimulated with sesame seed extract (40‐10 000 ng/mL protein) for BAT), assessing CD63 and CD203c as activation markers.ResultsSixty patients (73%) had IgE‐mediated reactions to sesame, and 22 (27%) did not react. Receiver operating characteristic (ROC) curve analysis demonstrated an area under the curve (AUC) of 0.87 for HPSE‐SPT and 0.66 for CSSE‐SPT. At 1000 ng/mL of sesame protein, induction of CD63 and CD203c was weakly but significantly associated with OFC eliciting dose by rank (Spearman's rho = −.42 (P < .01) and −.35 (P < .05) for CD63 and CD203c, respectively). By ROC analysis, the AUC was 0.86 for CD63 and was 0.81 for CD203c sesame‐induced basophil expression. Using HPSE‐SPT as a first test to definitively diagnose (n = 24) or rule‐out (n = 5) SFA and BAT as a second test to diagnose the remainder results in the correct classification of 73 of 80 (91%) patients, leaving one false negative and 4 false positive patients. Two BAT non‐responders remain unclassified by this algorithm.Conclusions & Clinical RelevanceWhile prospective cohort validation is necessary, joint utilization of BAT and SPT with HPSE extract may obviate the need for OFC in most SFA patients.
Diagnostic approach to low‐renin hypertension
Authors: Monticone Silvia , Losano Isabel , Tetti Martina , Buffolo Fabrizio , Veglio Franco , Mulatero Paolo 
Published: May 2018

SummaryRenin‐angiotensin‐aldosterone system (RAAS) plays a crucial role in maintaining water and electrolytes homoeostasis, and its deregulation contributes to the development of arterial hypertension. Since the historical description of the “classical” RAAS, a dramatic increase in our understanding of the molecular mechanisms underlying the development of both essential and secondary hypertension has occurred. Approximatively 25% of the patients affected by arterial hypertension display low‐renin levels, a definition that is largely arbitrary and depends on the investigated population and the specific characteristics of the assay. Most often, low‐renin levels are expression of a physiological response to sodium‐volume overload, but also a significant number of secondary hereditary or acquired conditions falls within this category. In a context of suppressed renin status, the concomitant examination of plasma aldosterone levels (which can be inappropriately elevated, within the normal range or suppressed) and plasma potassium are essential to formulate a differential diagnosis. To distinguish between the different forms of low‐renin hypertension is of fundamental importance to address the patient to the proper clinical management, as each subtype requires a specific and targeted therapy. The present review will discuss the differential diagnosis of the most common medical conditions manifesting with a clinical phenotype of low‐renin hypertension, enlightening the novelties in genetics of the familial forms.
Experimental autoimmune neuritis
Authors: Fujioka Toshiki 
Published: May 2018

AbstractExperimental autoimmune (allergic) neuritis (EAN), which is induced in various animal strains by immunization with peripheral nerve constituents, has been recognized as an animal model of human immune‐mediated neuritis; that is, Guillain–Barré syndrome or chronic inflammatory demyelinating neuritis. At first, EAN was reported in rabbits, and soon thereafter, in mice and rats. Various antigens relating to the peripheral nervous system (PNS) have also been reported. Symptomatic characteristics of EAN are quite similar despite different strains/antigens; that is, acute, self‐limiting, monophasic flaccid paralysis. However, modification of the antigen or administration of immune suppressants to EAN animals are able to induce chronic, relapsing demyelinating neuropathy. The cellular response and humoral kinetics, such as cytokine/chemokine/cell adhesion molecules in PNS of EAN animals, have been extensively studied. In the early 1990s, the dichotomy of type 1 T helper cells and type 2 T helper cells cellular response, along with the cytokine/chemokine milieu in EAN were investigated robustly; thereafter, type 17 T helper cells and regulating T cells followed. This sequence is very similar to what had been observed in human multiple sclerosis and experimental autoimmune encephalomyelitis, an animal model for multiple sclerosis and somewhat counterpart of EAN. However, the PNS and central nervous system have several differences in respect to their cellular components, thus, the immune response that appears in EAN has some unique aspects. Investigation of these differences, and the mechanism of recovery and regeneration of PNS might provide us with better therapeutic options for PNS diseases, especially inflammatory neuropathy.
Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children
Authors: Xu Qiuqin , Sun Ling , Zhou Wanping , Tang Yunjia , Ding Yueyue , Huang Jie , Wang Hui , Hou Cui , Lv Haitao 
Published: May 2018

ObjectivesThe aim of this study was to clarify the influence of the ASD closure by occluder device on right ventricular acute and long‐term changes in longitudinal systolic strains, by evaluating right ventricular wall deformation in children using speckle tracking echocardiography (STE).Methods and MaterialsWe enrolled 30 children with ASDs and 40 controls in our study. The Amplatzer atrial defect occluder was used to close the ASDs. Transthoracic echocardiographic examinations were performed at 3 points in time: the day before closure, 1 day after closure, and 3 months after closure. The dimensions of the right atrium (RA) and the right ventricle (RV) were measured in apical four‐chamber view. RV segmental longitudinal systolic strains (SLSs) and global longitudinal systolic strain (GLS) were obtained by two‐dimensional STE.ResultsBefore ASD closure, the RV SLSs and GLS were significantly higher than those of the controls. At 1 day after closure, the diameters of RA and RV decreased. All the RV SLSs and GLS decreased accordingly and were lower than the control values. At 3 months after closure, the apical free wall strain, all segments of septal strains, and GLS increased significantly compared with the values obtained at 1 day after closure. The diameters of the RA and RV decreased further as well. There were no significant differences in the strains compared with the control values, except for the free wall basal strain.ConclusionsTranscatheter device closure of ASDs improves RV strain indices and RV function recover to normal over 3 months.
Isolated premature restriction or closure of foramen ovale in fetuses: Echocardiographic characteristics and outcome
Authors: Gu Xiaoyan , Zhang Ye , Han Jiancheng , Liu Xiaowei , Ge Shuping , He Yihua 
Published: May 2018

BackgroundPremature restriction or closure of foramen ovale (FO) in otherwise structurally normal hearts may be associated with right ventricular dilation, tricuspid regurgitation, pericardial effusion, heart failure, even poor perinatal outcomes. Data about these rare conditions are lacking.MethodsWe retrospectively reviewed the echocardiographic records of 9704 fetuses seen from 2010 to 2014 in Beijing Anzhen Hospital, a regional and national referral center, to ascertain the presence of restriction or closure of FO. We collected the fetal echocardiography and perinatal outcome data for this group of fetuses with restriction or closure of FO.ResultsIn this large, single‐institution cohort (n = 9704), 6707 fetuses seen between 23 and 37 weeks of gestation had normal heart structures; of these, 60 (0.89%) had restrictive FO (rFO) and 5 (0.07%) had closure of FO (cFO). Fetal echocardiographic images showed right atrial dilation in 48 (73.84%), right ventricular dilation in 38 (58.46%), tricuspid regurgitation in 19 (29.23%), and pericardial effusion in 10 (15.38%). Also in this group, 50 (83.3%) with rFO and 4 (80.0%) with cFO had follow‐up data. No prenatal deaths occurred in either the rFO or the cFO group, but the neonatal mortality included 1 in the rFO group and 2 in the cFO group.ConclusionPremature rFO/cFO are rare in fetuses with otherwise structurally normal hearts. The fetal echocardiographic characteristics include right atrial and ventricular dilated, tricuspid regurgitation, and pericardial effusion. Most fetuses had a good outcome, although there was an association between rFO, especially cFO, with neonatal morality and complications (prematurity, maternal preeclampsia and placental abruption, hydrops fetalis, and necrotizing enterocolitis with perforation).
Reference values and correlates of right atrial volume in healthy adults by two‐dimensional echocardiography
Authors: Ferrara Francesco , Gargani Luna , Ruohonen Saku , Vriz Olga , Scalese Marco , Russo Valentina , Marra Alberto M. , Stanziola Anna Agnese , Cittadini Antonio , D’Andrea Antonello , Naeije Robert , Bossone Eduardo 
Published: May 2018

BackgroundRight atrial (RA) volume is an important parameter in the evaluation of patients with pulmonary hypertension. Aim of this study was to define reference ranges for RA volume by two‐dimensional echocardiography (2DE) in healthy adults.MethodsA total of 596 healthy subjects [mean age 45.7 ± 14.6 years, range 18–88 years; 60.1% women] underwent a transthoracic echocardiography. In addition, a meta‐analysis was performed of published studies measuring RA volume in healthy subjects, using 2DE single plane area‐length (A‐L) and/or method of disks (MOD) at end‐systole in apical four‐chamber view.ResultsIn our cohort, RA volume was higher in men than women but did not vary with age. Body surface area (BSA), stroke volume (SV), and tricuspid annular plane systolic excursion (TAPSE) were the only independent variables associated with RA volume (β coefficient 0.569, 0.123, and 0.131, respectively; all P < .001). In the pooled analysis, normalized RA volume was 25.7 ± 7.0 mL/m2 in men and 21.2 ± 5.8 mL/m2 in women for A‐L, 21.6 ± 5.6 mL/m2 in men and 18.2 ± 5.4 mL/m2 in women for MOD (all P values < .0001). The upper limit was about 36 mL/m2 in men and 31 mL/m2 in women for A‐L and 31 mL/m2 in men and 27 mL/m2 in women for MOD.ConclusionsRA volume was found to be higher in men but not influenced by age. It was mainly correlated with larger BSA, indices of preload (SV) and RV longitudinal function (TAPSE). A statistically significant difference was found between A‐L and MOD.
Echocardiographic parameters to identify sickle cell patients with cardio‐pathology
Authors: Chiadika Simbo , Lim‐Fung Mary , Llanos‐Chea Fiorella , Serauto Canache Astrid , Yang Wei , Paruthi Christina , Zhang Xu , McPherson David D. , Idowu Modupe 
Published: May 2018

BackgroundSickle cell disease (SCD) affects millions of people and causes chronic hemolytic anemia leading to vasculopathies such as pulmonary hypertension and abnormalities in cardiac function that increase complications and mortality. It is therefore crucial to identify cardiac abnormalities in SCD. We aimed to assess the prevalence of echocardiographic parameters in SCD to help identify cardiopulmonary risk.MethodsNinety‐one patients (53% male), median age of 30, body surface area (BSA) of 1.79 m2, hemoglobin of 8.8 g/dL, and creatinine of 0.7 mg/dL identified. We retrospectively measured laboratory and echocardiographic parameters in patients with SCD : left ventricular (LV) dimensions, LV ejection fraction (LVEF), LV Myocardial Performance Index (MPI), LV Mass Index (MI), Left Atrial Volume Index (LAVI), Tricuspid Regurgitation Velocity (TRV), tricuspid annular plane systolic excursion (TAPSE), right heart dimensions.ResultsPrevalence of left heart abnormalities was 32%: increased LV end‐diastolic diameter (EDD), 78%: LV MPI, 21%: diastolic dysfunction, 38%: decreased LVEF, 24%: increased LVMI, and 47%: increased LAVI. Right heart abnormalities were 39%: TAPSE, 38%: increased TRV, and 59%: increased pulmonary systolic pressure (PASP). Multivariate logistic regression analysis was significant for increased LVMI and LAVI in those with hemoglobin ≤8 g/dL (odds ratio (OR) 7.4, 95% confidence interval (CI) 2.23–24.6, P = .001) and (OR 3.32, 95% CI 1.18–9.33, P = .023).ConclusionsWe confirmed increased prevalence of abnormal LVEDD, LVMI, diastolic function, LAVI, and PASP in SCD. In addition, we identified abnormal LV MPI (78%), TAPSE (29%). These parameters may be useful and readily accessible echocardiographic prognostic tools in this population.