bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gly m 5/Gly m 8 fusion component as a potential novel candidate molecule for diagnosing soya bean allergy in Japanese children
Authors: Maruyama Nobuyuki , Sato Sakura , Cabanos Cerrone , Tanaka Akira , Ito Komei , Ebisawa Motohiro 
Published: July 2018

SummaryBackgroundSoya bean is a major food allergen in children. Component‐resolved diagnostics has improved the accuracy of diagnosing immunoglobulin E (IgE)‐mediated food allergies.ObjectiveWe aimed to develop a novel component for the diagnosis of soya bean allergy using recombinant technology.MethodsJapanese paediatric patients with suspected soya bean allergy (n = 91) were included, and symptomatic (n = 40) and asymptomatic (n = 51) cases were divided through oral food challenge testing. Specific IgE (sIgE) antibodies to each recombinant allergen component were analysed by enzyme‐linked immunosorbent assay, and the diagnostic performances of the components were assessed by area under the receiver operating characteristic curves (AUC).ResultsAmong the recombinant components, sIgE antibody levels to Gly m 8 showed the highest AUC (0.706). A combination of Gly m 8 and α’ subunit of Gly m 5, improved the diagnostic performance of the single components. Moreover, the N‐terminal extension region of α’ subunit of Gly m 5, which has low cross‐reactivity among the vicilins, showed higher diagnostic performance (AUC 0.695) than the full‐length α’ subunit of Gly m 5 (AUC 0.613). Based on these findings, we developed a fusion protein of Gly m 8 plus the extension region of α’ subunit of Gly m 5; this fusion protein was very efficient for diagnosing soya bean allergy (AUC 0.801).ConclusionA fusion protein of Gly m 8 and the extension region of α’ subunit of Gly m 5 could potentially diagnose soya bean allergy in paediatric patients. Fusion proteins may be useful for producing novel allergen components with improved diagnostic value.
Inter‐related effects of insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic inflammation in PCOS
Authors: Shorakae Soulmaz , Ranasinha Sanjeeva , Abell Sally , Lambert Gavin , Lambert Elisabeth , de Courten Barbora , Teede Helena 
Published: July 2018

SummaryObjectiveInsulin resistance, hyperandrogenism, sympathetic dysfunction and chronic low‐grade inflammation may act together in a vicious cycle in the pathophysiology of PCOS. However, the inter‐relationships of these components are not fully understood. We aimed to study these mechanisms in the pathophysiology of PCOS.Participants and methodsPremenopausal women with PCOS (Rotterdam diagnostic criteria) and without PCOS were recruited from a community setting into a cross‐sectional substudy within a randomized control trial. Insulin resistance (fasting insulin and glucose), hyperandrogenism (testosterone, sex hormone‐binding globulin [SHBG] and Free Androgen Index [FAI]), muscle sympathetic nerve activity (MSNA) and markers of chronic low‐grade inflammation (high sensitivity C‐reactive protein [hs‐CRP] and high molecular weight adiponectin [HMW‐adiponectin]) were measured.ResultsForty‐nine women with PCOS (mean age 30 ± 6 mean BMI 29 ± 5) and 23 controls (mean age 29 ± 8 mean BMI 33 ± 7) with included in this analysis. MSNA and testosterone level were most significantly associated with PCOS status, after adjustment for age and BMI. In women with PCOS, markers of sympathetic activity correlated inversely with HMW‐adiponectin and HMW‐adiponectin correlated inversely with FAI. Testosterone and FAI both correlated positively with insulin resistance in women PCOS.ConclusionSympathetic dysfunction and hyperandrogenism are significantly associated with PCOS. Chronic low‐grade inflammation potentially mediates the effect of sympathetic dysfunction on hyperandrogenism and insulin resistance.
Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients
Authors: Brown C. J. , Gentles J. Q. , Phang T. P. , Karimuddin A. A. , Raval M. J. 
Published: July 2018

AbstractAimTransanal endoscopic microsurgery (TEM) is the current treatment of choice for rectal adenomas and early rectal cancer. Postoperative admission to hospital is common but possibly unnecessary. Our objective was to analyse predictors and outcomes of TEM patients having same day discharge (TEM‐D) compared with those who were admitted to hospital (TEM‐A).MethodAt St Paul's Hospital (SPH), demographic, surgical, pathological and follow‐up data have been collected prospectively since TEM was started in 2007. Trends in admission and readmission rates were analysed using the Cochran–Armitage trend test, and predictors of admission were analysed using univariate and multivariate logistic regressions.ResultsBetween 2007 and 2016, 500 patients were treated by TEM at SPH. The overall admission rate was 29% (145/500), but this decreased to 19% in the last 3 years of the study (P < 0.001). The readmission rate was 5.2% (n = 26/500) and did not change significantly over the study period (P = 0.30). Reasons for admission included the following: surgeon discretion/monitoring (35%), urinary retention (26%), haemorrhage (10%), breach of peritoneal cavity (7%), infection (7%) and other (15%). The most common reasons for readmission were haemorrhage (54%, n = 14), pain (19%, n = 5) and infection (12%, n = 3). Factors associated with admission were as follows: tumour height (OR 1.09, 1.02–1.17), prolonged operative time (OR 1.25, 1.14–1.37), unsutured surgical defect (OR 1.99, 1.22–3.25) and surgeon experience (OR 4.62, 2.75–7.77).ConclusionOutpatient TEM is safe and carries a low risk of readmission. In centres with an outpatient TEM strategy, predictors of hospital admission include proximal tumours, prolonged surgical time and open management of the surgical defect.
Spawning aggregations act as a bottleneck influencing climate change impacts on a critically endangered reef fish
Authors: Asch Rebecca G. , Erisman Brad 
Published: July 2018

AbstractAimMost projections of how climate change will affect species distributions and phenology are based on a species’ most conspicuous life stage. However, not all life stages are equally sensitive to temperature. Among fishes, spawning adults often have narrower thermal tolerances than other life stages and may constrain population responses to climate change. We tested this hypothesis using data on Nassau Grouper (Epinephelus striatus), an endangered coral reef fish.LocationGreater Caribbean.MethodsSpecies distribution models of spawning and nonspawning adults were compared to determine which environmental variables exerted the greatest influence on grouper distribution. We calculated the thermal niche and ecological niche breadth of both life stages. An earth system model was applied to project how species distribution and phenology shift under two climate change scenarios.ResultsSea surface temperature and seasonal temperature gradients affected the distribution of both spawning and nonspawning adults, but these life stages differed in their preferred temperatures and reaction to oceanic currents. While the two life stages exhibited similar ecological niche breadth, the thermal niche of spawners was narrower. By 2081–2100, potential spawning habitat was projected to decline under a business‐as‐usual scenario by 82% relative to 1981–2000, whereas suitable habitat for nonspawners decreased by 46%. Poleward shifts in latitude occurred 3.8–4.2 times faster for spawners than nonspawners. These changes were attributed to rising temperatures, whereas hydrographical changes did not have a substantial impact. Spawning phenology changed little, with a slight contraction in spawning season but a large reduction in spawning probability across all months.Main ConclusionsA narrow thermal tolerance range among spawning fishes indicates that this life stage may be a bottleneck constraining responses to climate change. Future research should consider the reaction of each life stage to changing conditions. Conservation of E. striatus should take shifting distribution and phenology into account, as climate effects may exacerbate population declines due to fishing and reduce the efficacy of conservation measures.
Tolerance traits related to climate change resilience are independent and polygenic
Authors: Healy Timothy M. , Brennan Reid S. , Whitehead Andrew , Schulte Patricia M. 
Published: July 2018

AbstractThe resilience of organisms to climate change through adaptive evolution is dependent on the extent of genetically based variation in key phenotypic traits and the nature of genetic associations between them. For aquatic animals, upper thermal tolerance and hypoxia tolerance are likely to be a important determinants of sensitivity to climate change. To determine the genetic basis of these traits and to detect associations between them, we compared naturally occurring populations of two subspecies of Atlantic killifish,Fundulus heteroclitus, that differ in both thermal and hypoxia tolerance. Multilocus association mapping demonstrated that 47 and 35 single nucleotide polymorphisms (SNPs) explained 43.4% and 51.9% of variation in thermal and hypoxia tolerance, respectively, suggesting that genetic mechanisms underlie a substantial proportion of variation in each trait. However, no explanatory SNPs were shared between traits, and upper thermal tolerance varied approximately linearly with latitude, whereas hypoxia tolerance exhibited a steep phenotypic break across the contact zone between the subspecies. These results suggest that upper thermal tolerance and hypoxia tolerance are neither phenotypically correlated nor genetically associated, and thus that rates of adaptive change in these traits can be independently fine‐tuned by natural selection. This modularity of important traits can underpin the evolvability of organisms to complex future environmental change.
A comparative study of various modalities in the treatment of keloids
Authors: Aggarwal Archit , Ravikumar Banavase C. , Vinay K. Nirvanappa , Raghukumar Sonia , Yashovardhana D. P. 
Published: July 2018

AbstractIntroductionTreatment of keloids is a challenge as a result of paucity of effective treatment modalities, significant side effects, and their recurrent nature. In this study, various treatment modalities were compared to search for a treatment option with maximum efficacy and minimum side effects.MethodsOne hundred patients were recruited into five treatment groups of 20 patients in each. Intralesional triamcinolone acetonide, intralesional triamcinolone acetonide with hyaluronidase, intralesional verapamil hydrochloride, intralesional radiofrequency, and intralesional radiofrequency with triamcinolone acetonide were the different modalities received. The treatment in groups 1, 2, and 3 were given at 3‐week intervals for 8 times or till complete flattening, whichever was earlier. In groups 4 and 5, treatment was given at six weekly intervals for 4 times or till complete flattening. For statistical comparison, all patients were followed up at three weekly intervals.ResultsIn total, 16, 16, 15, 17, and 16 patients completed the study in groups 1, 2, 3, 4, and 5, respectively. Treatment modalities in groups 1, 2, and 5 were more or less equally efficacious with clearance rate of 75, 68.75, and 75% respectively, whereas groups 3 and 4 had clearance rate of 0 and 11.76%, respectively (P value <0.01, Chi‐square test).ConclusionIntralesional triamcinolone acetonide, intralesional triamcinolone acetonide with hyaluronidase, and intralesional radiofrequency with triamcinolone acetonide are effective modalities for the treatment of keloids. However, intralesional triamcinolone acetonide with hyaluronidase fares better than other two as far as safety is concerned with least side effects.
Cross‐sex hormone therapy in Australia: the prescription patterns of clinicians experienced in adult transgender healthcare
Authors: Bretherton Ingrid , Thrower Emily , Grossmann Mathis , Zajac Jeffrey D. , Cheung Ada S. 
Published: July 2018

AbstractBackgroundDespite increasing demand for transgender healthcare, guidelines for cross‐sex hormone therapy are based on low‐level evidence only. As most data are based on international expert opinions, interpretations and practices vary significantly.AimsTo aid the development of Australian clinical guidelines, we aimed to identify cross‐sex hormone therapy prescribing patterns among medical practitioners experienced in adult transgender healthcare.MethodsWe conducted an anonymous online survey of experienced hormone prescribers who were members of the Australian and New Zealand Professional Association for Transgender Health (ANZPATH).ResultsWe received 35 responses from 43 individuals listed with ANZPATH. Mental health assessments prior to commencement of hormonal therapy were recommended by 80% of prescribers. The preferred first‐line masculinising hormone therapy was intramuscular testosterone undecanoate (46% of respondents). The most commonly prescribed feminising agents were oral estradiol valerate (first line in 71.4%), with either spironolactone or cyproterone acetate. Most respondents (>90%) targeted sex steroid reference ranges of the affirmed gender, and 71.4% reviewed individuals every 2–3 months in the first year. Better training for doctors was seen as the most pressing priority for government funding, and 79.3% supported the development of local Australian‐based guidelines.ConclusionsExperienced hormone prescribers in Australia largely use medication regimens and monitor sex steroid levels and potential adverse effects of sex hormone therapy in accordance with broad, subjective recommendations listed in international guidelines. Additional practitioner training is necessary, and local Australian‐based guidelines would offer specific, relevant guidance to clinicians in the initiation and monitoring of cross‐sex hormone therapy for adult transgender individuals.
Outcomes of cinacalcet withdrawal in Australian dialysis patients
Authors: Ruderman Irene , Holt Stephen G. , Kirkland Geoffrey S. , Maslen Sophie , Hawley Carmel M. , Oliver Veronica , Krishnasamy Rathika , Gray Nicholas A. , Talaulikar Girish S. , Nelson Craig L. , Rajaram Yogeshwar , Gock Hilton , Au Eric , Elder Grahame J. , Mainra Rahul , Toussaint Nigel D. 
Published: July 2018

AbstractBackgroundSecondary hyperparathyroidism (SHPT) in chronic kidney disease is associated with cardiovascular and bone pathology. Measures to achieve parathyroid hormone (PTH) target values and control biochemical abnormalities associated with SHPT require complex therapies, and severe SHPT often requires parathyroidectomy or the calcimimetic cinacalcet. In Australia, cinacalcet was publicly funded for dialysis patients from 2009 to 2015 when funding was withdrawn following publication of the EVOLVE study, which resulted in most patients on cinacalcet ceasing therapy. We examined the clinical and biochemical outcomes associated with this change at Australian renal centres.AimTo assess changes to biochemical and clinical outcomes in dialysis patients following cessation of cinacalcet.MethodsWe conducted a retrospective study of dialysis patients who ceased cinacalcet after August 2015 in 11 Australian units. Clinical outcomes and changes in biochemical parameters were assessed over a 24‐ and 12‐month period, respectively, from cessation of cinacalcet.ResultsA total of 228 patients was included (17.7% of all dialysis patients from the units). Patients were aged 63 ± 15 years with 182 patients on haemodialysis and 46 on peritoneal dialysis. Over 24 months following cessation of cinacalcet, we observed 26 parathyroidectomies, 3 episodes of calciphylaxis, 8 fractures and 50 deaths. Eight patients recommenced cinacalcet, meeting criteria under a special access scheme. Biochemical changes from baseline to 12 months after cessation included increased levels of serum PTH from 54 (interquartile range 27–90) pmol/L to 85 (interquartile range 41–139) pmol/L (P < 0.0001), serum calcium from 2.3 ± 0.2 mmol/L to 2.5 ± 0.1 mmol/L (P < 0.0001) and alkaline phosphatase from 123 (92–176) IU/L to 143 (102–197) IU/L (P < 0.0001).ConclusionSignificant increases in serum PTH, calcium and alkaline phosphatase occurred over a 12‐month period following withdrawal of cinacalcet. Longer‐term follow up will determine if these biochemical and therapeutic changes are associated with altered rates of parathyroidectomies and cardiovascular mortality and morbidity.
Relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients
Authors: Yong Kenneth , Mori Trevor , Chew Gerard , Beilin Lawrence J. , Puddey Ian , Watts Gerald , Dogra Gursharan , Boudville Neil , Lim Wai 
Published: July 2018

AbstractBackgroundDiastolic dysfunction (DD) is an important cause of cardiovascular disease (CVD) mortality in chronic kidney disease (CKD) patients. Non‐traditional risk factors, such as arterial stiffness and inflammation, are implicated in the pathogenesis of DD in CKD patients.AimTo determine the association between inflammatory markers (interleukin (IL)‐12, IL‐18, highly sensitive C‐reactive protein (hsCRP)) and non‐invasive markers of arterial stiffness (24‐h pulse pressure (PP)) with DD in stages 3–4 CKD patients.MethodsWe performed a sub‐analysis of 78 non‐diabetic stages 3–4 CKD subjects to determine the relationship between 24‐h PP, IL‐12, IL‐18 and hsCRP with DD.ResultsDD was present in 38 subjects (49%). Subjects with DD were significantly older (61.0 ± 1.9 vs 50.2 ± 2.0 years; P < 0.001) and had higher 24‐h PP (48(95% confidence interval 45, 52) vs 43(95% confidence interval 41, 45) mmHg; P < 0.005); 24‐h PP was associated with DD (P = 0.02), but this was no longer significant after adjustment for age (P = 0.31). Serum IL‐12, IL‐18 and hsCRP levels were not significantly different between subjects with or without DD.ConclusionAsymptomatic subclinical DD was present in 50% of a cohort of stages 3–4 CKD patients but was not associated with IL‐12, IL‐18 or hsCRP. The association between 24‐h PP and DD was no longer apparent following adjustment for age, but given the small sample size, our findings will need to be explored in larger‐sized cohorts of individuals with moderate‐stage CKD.
Why is change a challenge in acute mental health wards? A cross‐sectional investigation of the relationships between burnout, occupational status and nurses’ perceptions of barriers to change
Authors: Laker Caroline , Cella Matteo , Callard Felicity , Wykes Til 
Published: July 2018

AbstractChanges in UK psychiatric wards have been difficult to implement. Specific areas of nursing staff resistance remain unclear. Previous healthcare research suggests that burnout is common and that managers’ regard changes more positively than direct care staff. We will therefore examine whether burnout and workforce characteristics influence psychiatric nurses’ perceptions of barriers to change. Psychiatric nurses (N = 125) completed perceptions measures of ‘barriers to change’ (VOCALISE: subscales included ‘powerlessness, confidence and demotivation’); and ‘burnout’ (Maslach Burnout Inventory: subscales included ‘emotional exhaustion, personal accomplishment and depersonalization ‘). Staff characteristics, such as length of employment, occupational status, education, ethnicity, gender and age, were also collected. Correlations between these measures informed random‐effects regression models, which were conducted to predict the barriers to change score and to explore differential effects in the subscales of VOCALISE. Perceptions of barriers to change (VOCALISE) were correlated with burnout (r = 0.39), occupational status (r = −0.18) and age (r = 0.22). Burnout (Coef. β: 10.52; P > 0.001) and occupational status (Coef. β: −4.58; P = 0.05) predicted VOCALISE. Emotional exhaustion (Coef. β: 0.18; P < 0.001) and low personal accomplishment (Coef. β: 0.21; P = 0.001) predicted powerlessness. Emotional exhaustion predicted low motivation regarding changes (Coef. β: 0.11; P = 0.005). Low confidence predicted high levels of depersonalization (Coef β: 0.23; P = 0.01). Direct care staff expressed significantly more powerlessness (Coef. β: −2.60; P = 0.02) and significantly less confidence (Coef. β: −3.07; P = 0.002) than managers. For changes to be successful in psychiatric wards, burnout will need to be addressed. Future change strategies may consider involving direct care staff to improve perceptions of barriers to change.
The effect of a self‐help psychoeducation programme for people with coronary heart disease: A randomized controlled trial
Authors: Wang Wenru , Lim Jian Yang , Lopez Violeta , Wu Vivien Xi , Lee Chi‐Hang , He Hong‐Gu , Jiang Ying 
Published: July 2018

AbstractAimTo examine the effect of a self‐help psychoeducation program for people with coronary heart disease in Singapore.BackgroundCardiac rehabilitation has shown benefits for mitigating many cardiac risk factors and can lead to improvement in health‐related quality of life and psychological well‐being in people with heart disease. However, traditional hospital‐based cardiac rehabilitation faces substantial challenges. A self‐management cardiac rehabilitation program offers an avenue to increase uptake and empowers patients to manage their condition at home.DesignA two‐arm, randomized controlled trial.MethodsA total of 129 patients with coronary heart disease were recruited from an outpatient clinic in a public hospital in Singapore from April 2015–January 2016. They were randomly assigned to the intervention group or the control group. Participants in the intervention group received the 4‐week home‐based self‐help psychoeducation program. Outcomes were measured at baseline and at 4 weeks and 16 weeks from the baseline.ResultsThere were no significant differences in health‐related quality of life, psychological status (i.e., perceived stress level, anxiety, and depression levels), or cardiac physiological risk parameters between the intervention and the control groups immediately after the program or at different time points. There was also no significant difference in unplanned health service use at the 16 week posttest point between the two groups.ConclusionsThis study did not find any significant effect of our program on outpatients with coronary heart disease. Nonetheless, findings on participant characteristics may offer healthcare professionals valuable insights to help facilitate future development of an effective cardiac rehabilitation program catered to outpatients with coronary heart disease.Trial registrationThe study has been registered with ISRCTN registry. The trial registration number is ISRCTN15839687.