bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolonged therapy with the anticonvulsant carbamazepine leads to increased plasma clearance of fentanyl
Authors: Nozari Ala , Akeju Oluwaseun , Mirzakhani Hooman , Eskandar Emad , Ma Zhijun , Hossain M D Amin , Wang Qingping , Greenblatt David J , Martyn J A Jeevendra 
Published: February 2019

Abstract

Objectives
Fentanyl is a potent analgesic that accounts for an increasing number of overdose deaths in the United States. This study tested whether altered pharmacokinetics plays a pivotal role in the increased fentanyl dose requirements in patients receiving the enzyme-inducing anticonvulsant, carbamazepine.

Methods
Neurosurgical patients receiving carbamazepine for &gt;6 weeks (N = 11) or no carbamazepine (N = 6, controls) received a single bolus dose of fentanyl (200 μg) intravenously. Plasma was collected before and for up to 9 h after the bolus. Fentanyl concentrations were measured using liquid chromatography–mass spectrometry. Pharmacokinetic variables were derived from plasma concentration–time curves best fitted to a two-compartment model.

Key findings
Fentanyl clearance was significantly higher in the carbamazepine group compared to controls (mean ± SD: 20.1 ± 6.8 vs 13.2 ± 4.8 ml/min per kg, P &lt; 0.05), and area under the plasma concentration curve (AUC) was significantly lower (150 ± 65 vs 233 ± 70 ng/ml × min, P &lt; 0.02). Volume of distribution was larger in the carbamazepine group, but the difference was not statistically significant (5.4 ± 3.1 vs 3.6 ± 1.2 l/kg, P &gt; 0.15). The terminal elimination half-life did not differ between the two groups.

Conclusions
Chronic carbamazepine therapy leads to increased fentanyl clearance and decreased AUC, which may result in decreased duration of therapeutic plasma concentrations of fentanyl and an increased dose requirement. Assuming that carbamazepine does not change fentanyl pharmacodynamics, patients on chronic carbamazepine therapy may require more frequent or higher fentanyl doses to maintain therapeutic plasma concentrations.
Echocardiographic indices and severity of mitral regurgitation in dogs with preclinical degenerative mitral valve disease
Authors: Larouche‐Lebel Éva , Loughran Kerry A. , Oyama Mark A. 
Published: February 2019

AbstractBackgroundDescribing severity of mitral regurgitation (MR) in dogs with degenerative mitral valve disease (DMVD) is challenging.Hypothesis/ObjectivesMitral regurgitant fraction (RF), effective regurgitant orifice area (EROA), and the ratio of mitral regurgitant to aortic flow (QMR:QAo) can be calculated from routine echocardiographic measurements and provide additional information regarding MR severity.AnimalsFifty‐seven dogs with preclinical DMVD including 36 without and 21 with cardiomegaly.MethodsProspective observational study. The expected relationships among RF, EROA, and QMR:QAo and 1‐dimensional measurements including left atrium to aortic root diameter ratio (LA:Ao) and normalized left ventricular internal dimension at end‐diastole (LVIDdN) were mathematically derived and calculated using echocardiographic data from the study population. Nonlinear goodness of fit was determined by calculation of the root mean standard error. The correlations between 1‐dimensional and multidimensional indices were analyzed using receiver operating characteristic curves.ResultsThe relationships among RF, EROA, QMR:QAo, and both LA:Ao and LVIDdN were curvilinear, and the multidimensional indices differentiated MR of variable severity. By contrast, 1‐dimensional measurements were insensitive to MR severity until RF equaled or exceeded 50%. Regurgitant fraction ≥50%, EROA to body surface area ≥0.347 and QMR:QAo ≥0.79 were strongly associated with LA:Ao ≥1.6 and LVIDdN ≥1.7.Conclusions and Clinical ImportanceRegurgitant fraction, EROA, and QMR:QAo quantify MR severity in dogs with preclinical DMVD in a manner that 1‐dimensional measurements do not.
Evaluation of resistive index of the prostate and bladder sonomorphologic parameters as replacements for urodynamics to predict bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia
Authors: Garg Gaurav , Sankhwar Satya Narayan , Goel Apul , Pandey Siddharth , Sharma Deepanshu , Parihar Anit 
Published: February 2019

ObjectiveThis study investigated whether the resistive index (RI) of prostate and bladder sonomorphologic parameters (total prostate volume [TPV], detrusor wall thickness [DWT], intraprostatic protrusion [IPP]) can be used instead of urodynamic studies (UDS) to predict bladder outlet obstruction (BOO) in benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS).MethodsMen aged ≥50 years with clinical BPH/LUTS were prospectively enrolled included. Basic evaluations, measurement of sonomorphologic parameters, and UDS were performed in accordance with the International Continence Society's Good Urodynamics Practices protocol.ResultsData of 240 patients were divided into two groups based on the BOO index(BOOI). Group 1 consisted of patients negative for BOO (BOOI <40), whereas Group 2 consisted of patients positive for BOO (BOOI > 40). Patient age, International Prostate Symptom Score (IPSS), quality of life score and post‐void residual volume were comparable between the two groups, whereas significant differences were evident in peak flow rate, TPV, DWT, RI, and IPP (P < 0.01 for all). Pearson correlation analysis revealed a significant correlation between BOOI and DWT (r = 0.198, P = 0.002), IPP (r = 0.450, P = 0.000), and RI (r = 0.334, P = 0.000). Multiple regression analysis revealed a significant correlation between BOOI and IPP (β = 0.382, P = 0.000) and RI (β = 0.226, P = 0.000). Receiver operating characteristic analysis showed that the area under curve was 0.785 for RI (95% confidence interval [CI] 0.703–0.867, P < 0.001) and 0.905 for IPP (95% CI 0.850–0.961, P < 0.001). At a cut‐off value of 7.5 mm for IPP, the sensitivity was 86.9%, specificity was 83.3% and positive predictive value was 92.41%.ConclusionIPP and RI may be the best non‐invasive predictors for BOO in selected patients with LUTS/BPH.
Structural basis of transcriptional regulation by the HigA antitoxin
Authors: Schureck Marc A. , Meisner Jeffrey , Hoffer Eric D. , Wang Dongxue , Onuoha Nina , Ei Cho Shein , Lollar Pete , Dunham Christine M. 
Published: February 2019

SummaryBacterial toxin–antitoxin systems are important factors implicated in growth inhibition and plasmid maintenance. Type II toxin–antitoxin pairs are regulated at the transcriptional level by the antitoxin itself. Here, we examined how the HigA antitoxin regulates the expression of the Proteus vulgaris higBA toxin–antitoxin operon from the Rts1 plasmid. The HigBA complex adopts a unique architecture suggesting differences in its regulation as compared to classical type II toxin–antitoxin systems. We find that the C‐terminus of the HigA antitoxin is required for dimerization and transcriptional repression. Further, the HigA structure reveals that the C terminus is ordered and does not transition between disorder‐to‐order states upon toxin binding. HigA residue Arg40 recognizes a TpG dinucleotide in higO2, an evolutionary conserved mode of recognition among prokaryotic and eukaryotic transcription factors. Comparison of the HigBA and HigA‐higO2 structures reveals the distance between helix‐turn‐helix motifs of each HigA monomer increases by ~4 Å in order to bind to higO2. Consistent with these data, HigBA binding to each operator is twofold less tight than HigA alone. Together, these data show the HigB toxin does not act as a co‐repressor suggesting potential novel regulation in this toxin–antitoxin system.
A new way to determine correct depth of central venous catheter insertion using a real‐time ultrasound‐guided insertion technique in pediatric patients
Authors: Yamamoto Tomohiro , Schindler Ehrenfried 
Published: February 2019

AbstractBackgroundSeveral formulae or methods are reported to predict the ideal central venous catheter insertion depth. However, they are complicated and often unsuitable in cases requiring rapid management.AimsThis study aimed to determine a simple and practical method to predict the ideal central venous catheter insertion depth after the real‐time ultrasound‐guided right internal jugular vein, or left or right supraclavicular approach in pediatric patients.MethodPediatric patients with congenital heart diseases who underwent cardiovascular surgery between July 2015 and February 2018 in the German Pediatric Heart Center Sankt Augustin were enrolled. Body height, body weight, patient age (months), and central venous catheter insertion depth were retrieved from the anesthesia records. Ideal central venous catheter insertion depth was calculated by measuring the distance between the level of the carina tracheae and the central venous catheter tip on the first postoperative chest radiograph. The relationships of body height, body weight, and patient age (months) to ideal central venous catheter insertion depth for the right internal jugular, left supraclavicular, and right supraclavicular approaches were investigated.ResultsBody height was the best parameter, providing the best coefficients of determination as well as the simplest relationship. Based on analysis for ideal central venous catheter insertion depth for every 10‐cm increase in body height, there was an ideal central venous catheter insertion depth for each body height, independent of the anesthesiologist's experience with the approach used. Whereas ideal central venous catheter insertion depths for the right internal jugular vein approach and the left supraclavicular approach showed no significant difference, ideal central venous catheter insertion depth for the right supraclavicular approach was significantly shorter than that of the other two approaches.ConclusionThis study successfully determined a visually simple and practical bar graph to predict the ideal central venous catheter depth inserted using only the real‐time ultrasound‐guided insertion technique for the right internal jugular vein, left supraclavicular, and right supraclavicular approaches.
Linear porokeratosis associated with Bardet‐Biedl syndrome: A case report
Authors: Tappel Anna C. , Tiwari Nitin , Zlotoff Barrett 
Published: February 2019

AbstractThis case report presents a 17‐year‐old boy with Bardet‐Biedl syndrome (BBS) and a long‐standing hyperpigmented eruption on the left trunk and upper extremity, clinically and histologically consistent with linear porokeratosis (LP). BBS patients frequently require solid organ transplant, and subsequent immunosuppression places them at especially high risk for malignant transformation of premalignant skin lesions such as LP. Although BBS affects multiple organ systems, there are only a handful of case reports detailing associated cutaneous involvement, and, to our knowledge, this is the first reported case of linear porokeratosis occurring in patient with BBS.
Increased neural sensitivity to self‐relevant stimuli in major depressive disorder
Authors: Benau Erik M. , Hill Kaylin E. , Atchley Ruth Ann , O’Hare Aminda J. , Gibson Linzi J. , Hajcak Greg , Ilardi Stephen S. , Foti Dan 
Published: February 2019

AbstractThe current research examined how individuals with depression process emotional, self‐relevant stimuli. Across two studies, individuals with depression and healthy controls read stimuli that varied in self‐relevance while EEG data were recorded. We examined the late positive potential (LPP), an ERP component that captures the dynamic allocation of attention to motivationally salient stimuli. In Study 1, participants read single words in a passive‐viewing task. Participants viewed negative, positive, or neutral words that were either normative or self‐generated. Exploratory analyses indicated that participants with depression exhibited affective modulation of the LPP for self‐generated stimuli only (both positive and negative) and not for normative stimuli; healthy controls exhibited similar affective modulation of the LPP for both self‐relevant and normative stimuli. In Study 2, using a separate sample and a different task, stimuli were provided within the context of sentence stems referring to the self or other people. Participants with depression were more likely to endorse negative self‐referent sentences and reject positive ones compared to healthy controls. Depressed participants also exhibited an increased LPP to negative stimuli compared to positive or neutral stimuli. Together, these two studies suggest that depression is characterized by relatively increased sensitivity to affective self‐relevant stimuli, perhaps in the context of a broader reduction in emotional reactivity to stimuli that are not self‐relevant. Thus, depression may be characterized by a more nuanced pattern based on the degree of stimulus self‐relevance than either a global decrease or increase in reactivity to affective stimuli.
Cyberattacks at the Grass Roots: American Local Governments and the Need for High Levels of Cybersecurity
Authors: Norris Donald F. , Mateczun Laura , Joshi Anupam , Finin Tim 
Published: February 2019

AbstractThis article examines data from the first‐ever nationwide survey of cybersecurity among American local governments. The data show that these governments are under constant or near‐constant cyberattack, yet, on average, they practice cybersecurity poorly. While nearly half reported experiencing cyberattacks at least daily, one‐third said that they did not know whether they were under attack, and nearly two‐thirds said that they did not know whether their information systems had been breached. Serious barriers to their practice of cybersecurity include a lack of cybersecurity preparedness within these governments and a lack of adequate funding for it. The authors make recommendations to local governments to improve their cybersecurity practice and to scholars for additional research into local government cybersecurity, an area that, to date, has largely been neglected by researchers from the social sciences and computer science.
Pedagogy of regulation: Strategies and instruments to supervise learning from adverse events
Authors: Kok Josje , Leistikow Ian , Bal Roland 
Published: February 2019

AbstractDiverse scholars have argued that standards and performance measurements are “instruments of control” that have a profound influence on the day‐to‐day lives of individuals and organizations, causing constitutive effects. Regulatory bodies increasingly use standards to oversee and monitor the regulated. This paper discusses the Dutch Health and Youth Care Inspectorate's use of both standards and a performance measurement system introduced to monitor how Dutch hospitals investigate and learn from serious adverse events. Rather than focusing on how standards affect regulated practices and organizations, our study examines how the use of these instruments affects the standard maker, that is, the Inspectorate. We explore how the Inspectorate's work practices, standards, and coupled performance measurement system influence its regulatory pedagogy, reviewing practices, and decisionmaking. We conclude that standards and performance measurement systems are not by definition “instruments of control” as their constitutive effects are (under)determined by the relationships in which they are enacted.
Glacial sequence stratigraphy of ANDRILL‐1B core reveals a dynamic subpolar Antarctic Ice Sheet in Ross Sea during the late Miocene
Authors: Rosenblume Justin A. , Powell Ross D. 
Published: February 2019

AbstractThe Upper Miocene interval of the AND‐1B sediment core is a muddy ca 300 m thick succession of glacimarine strata that was recovered from the McMurdo sector of the Ross Ice Shelf, Antarctica. This succession comprises lithofacies consistent with those formed in modern polythermal glacial systems with large volumes of subglacial meltwater. In particular, meltwater‐associated facies and iceberg‐rafted debris suggest that these late Miocene glacial systems were similar to subpolar glaciers like those in Svalbard today. Modern subpolar systems in Svalbard accumulate sediments at rates of ca 50 to 100 mm a−1 within ca 1 km of their grounded tidewater cliffs in waters up to hundreds of metres deep. Here, the rifted tectonic setting and glacio‐isostatic load of the Antarctic Ice Sheet enhanced accommodation for this succession. Based on these interpretations, the glacial sequence stratigraphic model of Powell & Cooper (2002) is applied to the study interval in an effort to better understand ice dynamics during this time. Base level is defined as the grounding line (where the ice sheet is grounded on the sea floor) and the surface that projects basinward (a correlative conformity). Glacial sequence stratigraphic description of the sediment core reveals 10 glacial sequences bounded by glacial erosion surfaces and two lower‐ranked glacial sequences bounded by correlative conformities. These glacial sequences occur in regular fining‐upward stratigraphic patterns and consist of two distinct styles of glacial retreat: packages with grounding‐line fan deposits and those without them. Lastly, in an effort to fill the gap between the middle Miocene and Plio‐Pleistocene climate histories of Antarctica, comparison of the AND‐1B Upper Miocene interval with the obliquity curve reveals one glacial–interglacial cycle and identifies erosion surfaces along which significant time may be missing.
The devil is in the detail: Discrepancy between soil organic carbon stocks estimated from regional and local data sources in Flanders, Belgium
Authors: Ottoy Sam , Vanierschot Laura , Dondeyne Stefaan , Vancampenhout Karen , Hermy Martin , Van Orshoven Jos 
Published: February 2019

AbstractStorage of soil organic carbon (SOC) is an essential function of ecosystems underpinning the delivery of multiple services to society. Regional SOC stock estimates often rely on data collected during land‐use‐specific inventory schemes with varying sampling depth and density. Using such data requires techniques that can deal with the associated heterogeneity. As the resulting SOC assessments are not calibrated for the local scale, they could suffer from oversimplification of landscape processes and heterogeneity. This might especially be the case for sandy regions where typical historical land use practices and soil development processes determine SOC storage. The aims of this study were (a) to combine four land‐use‐specific SOC stock assessments to estimate the total stock in Flanders, Belgium, and (b) to evaluate the applicability of this regional‐scale estimate at the local scale. We estimated the SOC stock in the upper 100 cm of the unsealed area in Flanders (887,745 ha) to be 111.67 Mt OC, or 12.6 ± 5.65 kg OC m−2 on average. In general, soils under (semi‐) natural land‐use types, for example forests, store on average more organic carbon than under agriculture. However, overall agricultural soils store the largest amounts of SOC due to their vast spatial extent. Zooming in on a sandy location study (13.55 km2) revealed the poor performance of the regional estimates, especially where Histosols occurred. Our findings show that a greater spatial sampling density is required when SOC stock estimates are needed to inform carbon‐aware land management rather than to provide for regional reporting.
A longer duration of red blood cell storage is associated with a lower hemoglobin increase after blood transfusion: a cohort study
Authors: Rydén Jenny , Clements Mark , Hellström‐Lindberg Eva , Höglund Petter , Edgren Gustaf 
Published: February 2019

BACKGROUNDRBC concentrates are commonly stored for up to 42 days but there has been conflicting evidence on the effect of storage duration and clinical outcomes. Most clinical studies have focused on possible associations between duration of storage time and risk for adverse outcomes, including mortality. Recent clinical trials did not find any such associations, but fewer studies have addressed whether storage time affects component efficacy. The main aim of this study was to determine the effect of RBC storage time on hemoglobin increment in transfused patients.STUDY DESIGN AND METHODSTransfusion data on a cohort of patients with myelodysplastic syndromes were linked to hemoglobin measurements taken between 2 days before and 28 days after a transfusion episode. We applied a mixed‐effect linear regression model, accounting for patient characteristics and time from transfusion to next hemoglobin measurement, to study the effect of RBC storage on the hemoglobin increment.RESULTSThe study population consisted of 225 patients who received 6437 RBC units. Compared to units stored less than 5 days, transfusion of blood units stored 5 to 9, 10 to 19, 20 to 29, or 30 or more days resulted in hemoglobin increases that were 0.83 (95% confidence interval [CI], 0.24–1.41), 0.92 (95% CI, 0.34–1.51), 1.33 (95% CI, 0.65–2.02) and 1.51 (95% CI, 0.58–2.43) g/L lower, respectively, per RBC unit. Results were consistent in sensitivity analyses.CONCLUSIONSLonger RBC storage was associated with a smaller increase in hemoglobin concentration after transfusion. Although statistically significant, the effect was modest, and its clinical relevance in subgroups of patients should be investigated in prospective clinical trials.
Companion hamsters with cutaneous lesions; a retrospective study of 102 cases at two university veterinary teaching hospitals (1985–2018)
Authors: White Stephen D. , Bourdeau Patrick J , Brément Thomas , Bruet Vincent , Gimenez‐Acosta Carmen , Guzman David S.‐M. , Paul‐Murphy Joanne , Hawkins Michelle G. 
Published: February 2019

BackgroundHamsters are popular companion animals which may present to veterinarians for treatment of skin diseases. Most descriptions of dermatoses in hamsters have primarily been in case reports and in text books.Hypothesis/ObjectivesTo document skin diseases and their prevalence in companion hamsters examined in northern California, USA, and Nantes, France, and to investigate predilections for the most common conditions documented in medical records over a 33 year or 15 year period, respectively.AnimalsOne hundred and one hamsters from two hospital populations.Methods and materialA computerized search of medical records of all hamsters seen at the School of Veterinary Medicine at UC‐Davis in California, USA, from 1 January 1985 to 1 January 2018, was performed using the key search words “skin” and “dermatitis”. The medical records of all hamsters presenting to the Ecole Nationale Vétérinaire, Nantes, from 1 September 1998 to 1 December 2013, were reviewed for skin diseases. The presence of lesions noted in key search words for the California records were used as inclusion guidelines for both institutions. Cases of suspected mammary neoplasia were excluded.ResultsOf the 65 hamsters seen in California, 34 (54%) had skin disease; of a total of 164 hamsters in Nantes, 67 (41%) had skin disease. Nodules were the most common lesions noted by both institutions.Conclusions and clinical importanceCutaneous conditions in companion hamsters are common. Clinicians should include a dermatological examination when examining these rodents.