bluuebunny/crossref_metadata_2025_split huggingface dataset:
The conflict mindset: How internal conflicts affect self‐regulation
Authors: Kleiman Tali , Enisman Maya 
Published: April 2018

AbstractInternal conflicts are inherent to individuals' everyday experience. In this paper, we present the idea of the “conflict mindset.” We argue that internal conflicts evoke a unique information processing strategy that builds on the simultaneous accessibility of two (or more) conflicting alternatives. Once a conflict is activated, the procedure underlying it is primed and can be applied to any relevant subsequent judgment that need not overlap in content with the conflict that originally gave rise to the mindset. We present research demonstrating that the conflict mindset broadens cognitive scope, as well as serves a proactive function for resolving subsequent conflicts. We further describe both intra‐personal and inter‐personal implications of the conflict mindset on an array of variables. We briefly discuss other mindsets that share common features with the conflict mindset, elaborate on the uniqueness of the conflict mindset compared to other cognitive and motivational processes, and present lingering questions and future directions.
Improving quality of care for patients with iron deficiency anemia presenting to the emergency department
Authors: Khadadah Fatima , Callum Jeannie , Shelton Dominick , Lin Yulia 
Published: April 2018

BACKGROUNDPatients presenting to the emergency department (ED) with iron deficiency anemia (IDA) are underrecognized, undertreated with iron, and overtransfused. A 3‐month audit of red blood cell (RBC) transfusions at the Sunnybrook Health Sciences Centre ED in 2013 showed that only 53% of transfusions for IDA were appropriate. The aim of this quality improvement project was to increase the rate of appropriate transfusion to greater than 80%.STUDY DESIGN AND METHODSSince November 2013, several quality improvement interventions have been implemented, including educational presentations, development of an algorithm on IDA management in the ED, and development of an ED IDA toolkit. The primary outcome was appropriateness of RBC transfusions per month. The process measure was monthly intravenous (IV) iron use in IDA patients managed exclusively by ED staff. Balancing measures included IV iron use according to the algorithm and undertransfusion.RESULTSOver a 24‐month period beginning January 2014, assessment of 193 units transfused in the ED showed an improvement of RBC appropriateness to 91% (range 50%‐100%). IV iron use increased from one dose in the 3‐month audit to an average of 2.6 and 4.7 per month in 2014 and 2015, respectively. IV iron use did not follow the algorithm in 19% (18 of 93) of cases: 12 were given to patients with less severe iron deficiency or bleeding.CONCLUSIONImproved RBC transfusion appropriateness for IDA in the ED can be achieved and maintained with the implementation of simple educational and practical interventions.
Efficacy of D– red blood cell transfusion and rituximab therapy in autoimmune hemolytic anemia with anti‐D and panreactive autoantibodies arising after hematopoietic stem cell transplant
Authors: Minakawa Keiji , Ohto Hitoshi , Yasuda Hiroyasu , Saito Shunichi , Kawabata Kinuyo , Ogawa Kazuei , Nollet Kenneth E. , Ikeda Kazuhiko 
Published: April 2018

BACKGROUNDAutoimmune hemolytic anemia (AIHA) is caused by autoantibodies to red blood cells (RBCs), which can be panreactive and/or specific to Rh/other blood group antigens. We report a severe case of AIHA after bone marrow transplantation (BMT) due to autoanti‐D triggered by reactivation of Epstein‐Barr virus (EBV) infection. A combined strategy of D– RBC transfusion and administration of anti‐CD20 monoclonal antibody (MoAb) resolved the hemolysis.CASE REPORTA 33‐year‐old male underwent allogeneic BMT from an ABO‐identical and HLA‐matched unrelated male donor. Five months later, while having mild chronic graft‐versus‐host disease, he manifested AIHA, with a hemoglobin (Hb) level of 5.1 g/dL on AIHA Day 2 (Posttransplant Day 156) and was refractory to D+ RBCs, with a Hb level of 2.4 g/dL on AIHA Day 6. Anti‐D–like autoantibodies (titer 1280, subclass immunoglobulin G1, monocyte monolayer assay 28.7%) and panreactive (titer 40) were identified. Changing the RBC transfusion strategy to D– increased his Hb level to 6.7 g/dL on Day 10. Administration of anti‐CD20 MoAb mitigated EBV‐related B‐cell proliferation and reduced anti‐D autoantibody titer to 320 by Day 16 with normalized Hb concentration after 6 months.CONCLUSIONIn severe AIHA, when standard treatment and regular RBC transfusions are ineffective, transfusion of RBCs lacking the target antigen(s) of autoantibodies and administration of anti‐CD20 MoAb should be considered.
Peripartum management of HLA alloimmune platelet refractoriness
Authors: Peña Jeremy Ryan , Sudhof Leanna , O'Brien Barbara 
Published: April 2018

BACKGROUNDPlatelet (PLT) refractoriness presents a challenging problem for transfusion support, especially in the perioperative setting, where there is urgency for human leukocyte antigen (HLA)‐compatible units, yet identification and provision of compatible PLT concentrates requires time.CASE REPORTA 22‐year‐old G3P1 woman with thrombocytopenia due to aplastic anemia, likely autoimmune, presented in her third trimester for peripartum care and newly diagnosed HLA alloimmune PLT refractoriness. Despite early planning, the patient developed bleeding requiring urgent delivery. Notably, the patient also developed strong allele‐specific HLA antibody, precluding the use of HLA‐matched PLTs.RESULTSUsing full‐range HLA testing services and multidisciplinary physician planning, several HLA‐compatible PLT concentrates were procured to support her peripartum bleeding.CONCLUSIONWe describe what appears to be the first reported case of management of transfusion support of PLT refractoriness peripartum. Although complicated by allele‐specific HLA antibodies, using a combination of acceptable low‐level antibodies and crossmatching we successfully identified HLA‐compatible PLT concentrates resulting in posttransfusion PLT count increments.
Evaluation of the value of staining hair samples with a modified Wright–Giemsa stain and/or showing illustrated guidelines for the microscopic diagnosis of dermatophytosis in cats
Authors: Căpitan Rareş , Schievano Carlo , Noli Chiara 
Published: April 2018

BackgroundDirect examination of the hair is a simple diagnostic test for the diagnosis of dermatophytosis; training is needed to use this test.Hypothesis/ObjectivesTo evaluate whether use of modified Wright–Giemsa blue stain and/or photographic images of infected and uninfected hairs improved the user's ability to identify infected or uninfected hairs.AnimalsTen cats with, and 10 cats without, dermatophytosis due to Microsporum canis (n = 20).Materials and methodsTwenty unstained and 20 stained hair samples from each group (n = 40) were anonymized and examined by veterinarians using a light microscope. Participants recorded samples as “infected” or “uninfected”. Participants were then shown and allowed to use photographic images while examining the same 40 samples.ResultsWithout staining, investigators correctly identified 12.7 ± 4 of the 20 samples (mean ± SD) and with staining 13.6 (±3). After illustrative guidelines were shown, they correctly identified a mean of 16.9 (±2.5) unstained slides and 15.8 (±2.3) stained slides. “Illustrated guidelines” and “hair infection” significantly increased the probability of a correct answer, whereas “staining” did not. Logistic regression determined that “study participant”, “illustrated guidelines” (OR = 2.6) and “hair infection” (OR = 2.1) had a significant influence on the results, whereas “staining” did not. Sensitivity and specificity of direct examination were 70.5% and 56%, respectively, compared with culture status.Conclusions and clinical importanceWhen examining hairs for the presence or absence of infected dermatophyte hairs, diagnostic accuracy was improved when observers used illustrated guides compared with just examining stained slides.
Chlamydia muridarum Genital and Gastrointestinal Infection Tropism Is Mediated by Distinct Chromosomal Factors
Authors: Morrison Sandra G. , Giebel Amanda M. , Toh Evelyn C. , Spencer Horace J. , Nelson David E. , Morrison Richard P. 
Published: April 2018

ABSTRACT

Some members of the genus
Chlamydia
, including the human pathogen
Chlamydia trachomatis
, infect multiple tissues, including the genital and gastrointestinal (GI) tracts. However, it is unknown if bacterial targeting to these sites is mediated by multifunctional or distinct chlamydial factors. We previously showed that disruption of individual large clostridial toxin homologs encoded within the
Chlamydia muridarum
plasticity zone were not critical for murine genital tract infection. Here, we assessed whether cytotoxin genes contribute to
C. muridarum
GI tropism. Infectivity and shedding of wild-type (WT)
C. muridarum
and three mutants containing nonsense mutations in different cytotoxin genes,
tc0437
,
tc0438
, and
tc0439
, were compared in mouse genital and GI infection models. One mutant, which had a nonsense mutation in
tc0439
, was highly attenuated for GI infection and had a GI 50% infectious dose (ID
50
) that was 1,000 times greater than that of the WT. GI inoculation with this mutant failed to elicit anti-chlamydial antibodies or to protect against subsequent genital tract infection. Genome sequencing of the
tc0439
mutant revealed additional chromosomal mutations, and phenotyping of additional mutants suggested that the GI attenuation might be linked to a nonsense mutation in
tc0600
. The molecular mechanism underlying this dramatic difference in tissue-tropic virulence is not fully understood. However, isolation of these mutants demonstrates that distinct chlamydial chromosomal factors mediate chlamydial tissue tropism and provides a basis for vaccine initiatives to isolate chlamydia strains that are attenuated for genital infection but retain the ability to colonize the GI tract and elicit protective immune responses.
Hepatitis B Virus Core Protein Dephosphorylation Occurs during Pregenomic RNA Encapsidation
Authors: Zhao Qiong , Hu Zhanying , Cheng Junjun , Wu Shuo , Luo Yue , Chang Jinhong , Hu Jianming , Guo Ju-Tao 
Published: April 2018

ABSTRACT
Hepatitis B virus (HBV) core protein consists of an N-terminal assembly domain and a C-terminal domain (CTD) with seven conserved serines or threonines that are dynamically phosphorylated/dephosphorylated during the viral replication cycle. Sulfamoylbenzamide derivatives are small molecular core protein allosteric modulators (CpAMs) that bind to the heteroaryldihydropyrimidine (HAP) pocket between the core protein dimer-dimer interfaces. CpAM binding alters the kinetics and pathway of capsid assembly and can result in the formation of morphologically “normal” capsids devoid of viral pregenomic RNA (pgRNA) and DNA polymerase. In order to investigate the mechanism underlying CpAM inhibition of pgRNA encapsidation, we developed an immunoblotting assay that can resolve core protein based on its phosphorylation status and demonstrated, for the first time, that core protein is hyperphosphorylated in free dimers and empty capsids from both mock-treated and CpAM-treated cells but is hypophosphorylated in pgRNA- and DNA-containing nucleocapsids. Interestingly, inhibition of pgRNA encapsidation by a heat shock protein 90 (HSP90) inhibitor prevented core protein dephosphorylation. Moreover, core proteins with point mutations at the wall of the HAP pocket, V124A and V124W, assembled empty capsids and nucleocapsids with altered phosphorylation status. The results thus suggest that core protein dephosphorylation occurs in the assembly of pgRNA and that interference with the interaction between core protein subunits at dimer-dimer interfaces during nucleocapsid assembly alters not only capsid structure, but also core protein dephosphorylation. Hence, inhibition of pgRNA encapsidation by CpAMs might be due to disruption of core protein dephosphorylation during nucleocapsid assembly.

IMPORTANCE
Dynamic phosphorylation of HBV core protein regulates multiple steps of viral replication. However, the regulatory function was mainly investigated by phosphomimetic mutagenesis, which disrupts the natural dynamics of core protein phosphorylation/dephosphorylation. Development of an immunoblotting assay capable of resolving hyper- and hypophosphorylated core proteins allowed us to track the phosphorylation status of core proteins existing as free dimers and the variety of intracellular capsids and to investigate the role of core protein phosphorylation/dephosphorylation in viral replication. Here, we found that disruption of core protein interaction at dimer-dimer interfaces during nucleocapsid assembly (by CpAMs or mutagenesis) inhibited core protein dephosphorylation and pgRNA packaging. Our work has thus revealed a novel function of core protein dephosphorylation in HBV replication and the mechanism by which CpAMs, a class of compounds that are currently in clinical trials for treatment of chronic hepatitis B, induce the assembly of empty capsids.
Efficacy and safety of pulmonary application of corticosteroids in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis
Authors: Delara Mahin , Chauhan Bhupendrasinh F , Le Mê-Linh , Abou-Setta Ahmed M , Zarychanski Ryan , ’tJong Geert W 
Published: April 2018

BackgroundSystemic corticosteroids as the frontline treatment of respiratory distress syndrome (RDS) in preterm infants are associated with adverse effects on growth and neurodevelopmental outcome, but the pulmonary administration of steroids may help prevent the development of bronchopulmonary dysplasia (BPD) without these side effects.ObjectivesTo evaluate the efficacy and safety of pulmonary application of corticosteroids in preterm infants with RDS.MethodsMEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, the WHO’s International Clinical Trials Registry and grey literature were searched with no restriction on date and language of publication from inception to May 2016. Using a random-effect model, we pooled data from randomised controlled trials (RCTs) comparing inhaled or endotracheal corticosteroids with the standard of care, placebo or no other intervention in preterm infants with RDS.ResultsWe identified 873 potential citations and included 12 unique RCTs. Pulmonary corticosteroid therapy was associated with a significant reduction in the composite outcome of BPD or death (relative risk (RR) 0.85, 95% CI 0.76 to 0.96). Pulmonary application of corticosteroids significantly reduced the incidence of patent ductus arteriosus (PDA) (RR 0.82, 95% CI 0.74 to 0.92) and pneumonia (RR 0.57, 95% CI 0.35 to 0.92). There was no evidence of a significant difference regarding the risk of neurodevelopmental impairment or other side effects.ConclusionsPulmonary administration of corticosteroids reduces the incidence of BPD or death, pneumonia, PDA without causing any major side effects in preterm infants with RDS.
Patient safety climate in general public hospitals in China: differences associated with department and job type based on a cross-sectional survey
Authors: Zhou Ping , Bai Fei , Tang Hui-qin , Bai Jie , Li Min-qi , Xue Di 
Published: April 2018

ObjectiveThis study analysed differences in the perceived patient safety climate among different working departments and job types in public general hospitals in China.DesignCross-sectional survey.SettingEighteen tertiary hospitals and 36 secondary hospitals from 10 areas in Shanghai, Hubei Province and Gansu Province, China.ParticipantsOverall, 4753 staff, including physicians, nurses, medical technicians and managers, were recruited from March to June 2015.Main outcome measureThe Patient Safety Climate in Healthcare Organisations (PSCHO) tool and the percentages of ‘problematic responses’ (PPRs) were used as outcome measures. Multivariable two-level random intercept models were applied in the analysis.ResultsA total of 4121 valid questionnaires were collected. Perceptions regarding the patient safety climate varied among departments and job types. Physicians responded with relatively more negative evaluations of ‘organisational resources for safety’, ‘unit recognition and support for safety efforts’, ‘psychological safety’, ‘problem responsiveness’ and overall safety climate. Paediatrics departments, intensive care units, emergency departments and clinical auxiliary departments require more attention. The PPRs for ‘fear of blame and punishment’ were universally significantly high, and the PPRs for ‘fear of shame’ and ‘provision of safe care’ were remarkably high, especially in some departments. Departmental differences across all dimensions and the overall safety climate primarily depended on job type.ConclusionsThe differences suggest that strategies and measures for improving the patient safety climate should be tailored by working department and job type.
Medical overuse in the Iranian healthcare system: a systematic review protocol
Authors: Arab-Zozani Morteza , Pezeshki Mohammad Zakaria , Khodayari-Zarnaq Rahim , Janati Ali 
Published: April 2018

IntroductionLack of resources is one of the main problems of all healthcare systems. Recent studies have shown that reducing the overuse of medical services plays an important role in reducing healthcare system costs. Overuse of medical services is a major problem in the healthcare system, and it threatens the quality of the services, can harm patients and create excess costs for patients. So far, few studies have been conducted in this regard in Iran. The main objective of this systematic review is to perform an inclusive search for studies that report overuse of medical services in the Iranian healthcare system.Method and analysisAn extensive search of the literature will be conducted in six databases including PubMed, Embase, Scopus, Web of Science, Cochrane and Scientific Information Database using a comprehensive search strategy to identify studies on overuse of medical care. The search will be done without time limit until the end of 2017, completed by reference tracking, author tracking and expert consultation. The search will be conducted on 1 February 2018. Any study that reports an overuse in a service based on a specific standard will be included in the study. Two reviewers will screen the articles based on the title, abstract and full text, and extract data about type of service, clinical area and overuse rate. Quality appraisal will be assessed using the Joanna Briggs Institute checklist. Potential discrepancies will be resolved by consulting a third author.Ethics and disseminationRecommendations will be made to the Iranian MOHME (Ministry of Health and Medical Education) in order to make better evidence-based decisions about medical services in the future.PROSPERO registration numberCRD42017075481
Study protocol for the SARON trial: a multicentre, randomised controlled phase III trial comparing the addition of stereotactic ablative radiotherapy and radical radiotherapy with standard chemotherapy alone for oligometastatic non-small cell lung cancer
Authors: Conibear John , Chia Brendan , Ngai Yenting , Bates Andrew Tom , Counsell Nicholas , Patel Rushil , Eaton David , Faivre-Finn Corinne , Fenwick John , Forster Martin , Hanna Gerard G , Harden Susan , Mayles Philip , Moinuddin Syed , Landau David 
Published: April 2018

IntroductionFollowing growing evidence to support the safety, local control (LC) and potential improvement in overall survival (OS) in patients with oligometastatic non-small cell lung cancer (NSCLC) that have been treated with local ablative therapy such as stereotactic ablative radiotherapy (SABR) and stereotactic radiosurgery (SRS), we initiate the SARON trial to investigate the impact and feasibility of adding SABR/SRS and radical radiotherapy (RRT) following standard chemotherapy on OS.Methods and analysisSARON is a large, randomised controlled, multicentre, phase III trial for patients with oligometastatic EGFR, ALK and ROS1 mutation negative NSCLC (1–3 sites of synchronous metastatic disease, one of which must be extracranial). 340 patients will be recruited over 3 years from approximately 30 UK sites and randomised to receive either standard platinum-doublet chemotherapy only (control arm) or standard chemotherapy followed by RRT/SABR to their primary tumour and then SABR/SRS to all other metastatic sites (investigational arm). The primary endpoint is OS; the study is powered to detect an improvement in median survival from 9.9 months in the control arm to 14.3 months in the investigational arm with 85% power and two-sided 5% significance level. The secondary endpoints are LC, progression-free survival, new distant metastasis-free survival, toxicity and quality of life. An early feasibility review will take place after 50 randomised patients. Patients requiring both conventional thoracic RT to the primary and SABR to a thoracic metastasis will be included in a thoracic SABR safety substudy to assess toxicity and planning issues in this subgroup of patients more thoroughly.Ethics and disseminationAll participants are given a SARON patient information sheet and required to give written informed consent. Results will be submitted for presentation at local and international conferences and expected to be published in a peer-reviewed journal.Trial registration numberNCT02417662.Sponsor referenceUCL/13/0594.
Systematic review and meta-analysis of diabetes mellitus, cardiovascular and respiratory condition epidemiology in sexual minority women
Authors: Meads Catherine , Martin Adam , Grierson Jeffrey , Varney Justin 
Published: April 2018

ObjectiveSexual minority women (SMW) experience higher chronic disease risk factors than heterosexual counterparts. However, it was unclear if these risks translate into higher physical condition rates. This systematic review evaluates cardiovascular disease (CVD), hypertension, respiratory disease and diabetes mellitus in SMW.MethodsA protocol was registered with the Prospero database (CRD42016050299). Included were studies reporting mortality, incidence or prevalence of the above-listed conditions in SMW compared with heterosexual women. Databases (platforms) searched from 2010 to December 2016 were Medline (Ovid), Embase (Elsevier), Cumulative Index to Nursing and Allied Health Literature (Elsevier), PsycINFO (Ovid), Social Policy and Practice (Ovid), Cochrane CENTRAL (Cochrane Library), Science Citation Index (Web of Science), and CAB Abstracts (Ovid). Search terms included Medical Subject Heading (MeSH) terms and text words. Extensive additional searches were conducted in specialist academic journals and websites. Two reviewers checked study eligibility. One independently extracted data and assessed quality, checked by a second reviewer, with disagreements resolved through discussion. The Critical Appraisal Skills Programme cohort checklist was used to assess risk of bias. Meta-analysis was conducted where more than four studies reported the same outcomes, with Comprehensive Meta-Analysis software, using adjusted ORs (AORs) and random-effects models. Heterogeneity was assessed using I2test.ResultsIdentified were 23 103 citations, 692 full texts screened and 16 studies included (in 18 papers). One reported mortality (from Denmark), none incidence and 15 prevalence (14 USA, 1 Australia). Same-sex cohabiting women had higher mortality rates compared with opposite-sex cohabiting women in CVD (HR=1.37 (95% CI 1.22 to 1.54)) and respiratory disease (HR=2.10 (95% CI 1.74 to 2.53)). AOR meta-analyses of seven studies showed higher asthma rates in lesbians (OR=1.44 (95% CI 1.27 to 1.64), I2=0%) and bisexual women (OR=1.64 (95% CI 1.41 to 1.89), I2=0%) but no differences for CVD (5 studies), hypertension (5 studies) or diabetes mellitus (7 studies).ConclusionsThese new health estimates require further confirmatory epidemiological studies, and investigation into potential environmental, hormonal, physiological, psychological or genetic causes. This would be supported by routine collection of sexual identity measures in population-level epidemiological surveys.