bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histone deacetylase activity is required for Botrylloides leachii whole body regeneration
Authors: Zondag Lisa , Clarke Rebecca , Wilson Megan J. 
Published: June 2019

The colonial tunicate Botrylloides leachii is exceptional at regenerating from a piece of vascular tunic after loss of all adults from the colony. Previous transcriptome analyses indicate a brief period of healing before regeneration of a new adult (zooid) in as little as 8-10 days. However, there is little understanding of how the resulting changes to gene expression, required to drive regeneration, are initiated and how the overall process is regulated. Rapid changes to transcription often occur in response to chromatin changes, mediated by histone modifications such as histone acetylation. Here, we investigated a group of key epigenetic modifiers, histone deacetylases (HDAC) that are known to play an important role in many biological processes such as development, healing and regeneration.
Through our transcriptome data, we identified and quantified the expression levels of HDAC and histone acetyltransferase (HAT) enzymes during whole body regeneration (WBR). To determine if HDAC activity is required for WBR, we inhibited its action using valproic acid (VPA) and Trichostatin A (TSA). HDAC inhibition prevented the final morphological changes normally associated with WBR and resulted in aberrant gene expression. B. leachii genes including Slit2, TGF-β, Piwi and Fzd4 all showed altered mRNA levels upon HDAC inhibition in comparison to the control samples. Additionally, atypical expression of Bl_Piwi was found in immunocytes upon HDAC inhibition.
Together, these results show that HDAC function, specifically HDAC I/IIa class enzymes, are vital for B. leachii to undergo WBR successfully.
Metabolic syndrome among adults with type 2 diabetes in a Saudi teaching hospital: A comparative prevalence study using WHO and ATP III definitions
Authors: Ghamri Ranya A. , Alamri Sultan H. 
Published: June 2019

Objective: Metabolic syndrome (MetS) has become a global health concern and is a reliable predictor of long-term adverse health outcomes. This study aimed to determine the prevalence of MetS and its components in a group of Saudi adults with type 2 diabetes using the World Health Organization (WHO) and Adult Treatment Panel (ATP) III definitions, and to examine agreement between both definitions.
Methods: This cross-sectional study included adults with type 2 diabetes who were followed up at the family medicine and endocrinology clinics of King Abdulaziz University Hospital (KAUH) from January to March 2018. An interview-administered questionnaire was designed to collect demographic data, anthropometric measurements, and medical history. We used the 1999 WHO and 2001 ATP III definitions for diagnosing MetS.
Results: The study included 155 diabetes patients. The overall prevalence of MetS components (three of more components) among patients was 80% according to the WHO criteria and 85.8% according to the ATP III criteria. The kappa statistics demonstrated good agreement between both definitions (κ = 0.751, p < 0.001). The sensitivity and specificity of diagnosing MetS using the WHO versus ATP III criteria were 92.5% and 95.5%, respectively. There was weak positive association between the number of MetS components and the number of diabetic complications.
Conclusions: MetS was highly prevalent among Saudi adults with type 2 diabetes regardless of the diagnostic criteria. It is, therefore, imperative that clinicians identify MetS in this patient population and educate them on the importance of adherence to treatment and therapeutic lifestyle changes.
doi: https://doi.org/10.12669/pjms.35.4.199
How to cite this:Ghamri RA, Alamri SH. Metabolic syndrome among adults with type 2 diabetes in a Saudi teaching hospital: A comparative prevalence study using WHO and ATP III definitions. Pak J Med Sci. 2019;35(4):1087-1092. doi: https://doi.org/10.12669/pjms.35.4.199
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Electrolyte imbalance in critically ill paediatric patients
Authors: Naseem Faizia , Saleem Ayesha , Mahar Imtiaz Ahmed , Arif Fehmina 
Published: June 2019

Objective: To determine the frequency and outcome of electrolyte imbalance in seriously ill children admitted in Paediatric Intensive Care Unit (PICU) of a public sector hospital in Karachi.
Methods: All children between the ages of one month to 12 years admitted in PICU from May 2017 to October 2017 were included. Blood samples were drawn to determine the baseline sodium, potassium, calcium, magnesium and phosphorous and followed 24 hourly or earlier, if needed (Those who had imbalance at admission or on subsequent repeat labs as per protocol).
Results: A total of 101 children were included in the study. Electrolyte imbalance was seen in 84%. A single electrolyte imbalance was noted in 30.58%. Hypocalcemia was the most frequent abnormality noted in 57.6%. Among the total expiries during the study period 91% had electrolyte imbalance. Mortality within 48 hours and duration of stay was also increased in these patients.
Conclusion: Electrolyte imbalance is an important prognostic indicator in critically ill patients.
doi: https://doi.org/10.12669/pjms.35.4.286
How to cite this:Naseem F, Saleem A, Mahar IA, Arif F. Electrolyte imbalance in critically ill paediatric patients. Pak J Med Sci. 2019;35(4):1093-1098. doi: https://doi.org/10.12669/pjms.35.4.286
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Tympanoplasty Type-I using tragal perichondrium graft: Our experience
Authors: Wahid Fazali , Nagra Sajid Rashid 
Published: June 2019

Objective: To determine the efficacy of tragal perichondrium graft used in tympanoplasty Type-I at a tertiary care hospital.
Methods: This descriptive case-series study was performed at the department of E.N.T, Head and Neck Surgery, Medical Teaching Institution/Lady Reading Hospital (MTI/LRH), Peshawar, Pakistan from June 2017 to May 2018. After approved from IREB, a well informed consent was taken. Pure Tone Audiometry (PTA) was performed before surgery and post-operatively at three and six months interval. The mean ± SD Air-Bone Gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). Chi-square (X2) test of significance was used taking confidence interval at 95%. The p-value ≤0.05 was considered significant.
Results: Total patients were 36; male 21 (58.3%), female 15(41.7%) with male: female ratio of 1.4:1. Mean ± SD age was 27.14 ± 7.49 years (Range 15 – 50Years). Tympanic membrane perforation was commonly found on right side 22 (61.1%), predominantly involving anterioinferior site 19 (52.8%) and medium sized perforation outnumbered 22 (61.1%). Mean pre-operative air-conduction of 49.72 dB was significantly reduced to 18.27 dB with pvalue of <0.05. Similarly the pre-operative mean air bone gap on PTA of 45.63 ± 8.35dB was also reduced to statistically significant level of 7.41 ± 3.51 dB on post-operative PTA with p-value of <.05. Graft was taken up well in 34 cases (94.4%).
Conclusion: Tragal perichondrial graft is an effective grafting material used for tympanoplasty due to its possessing qualities.
doi: https://doi.org/10.12669/pjms.35.4.421
How to cite this:Wahid FI, Nagra SR. Tympanoplasty type I using tragal perichondrium graft: Our experience. Pak J Med Sci. 2019;35(4):1076-1080. doi: https://doi.org/10.12669/pjms.35.4.421
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
210Po and 210Pb concentration in zooplankton of the Syrian coastal waters (eastern Mediterranean Sea)
Authors: AL-MASRI MOHAMMAD SAID , MAMISH SAMER , ABDEL-HALEEM MOHAMMAD , HANI DURGHAM HANI 
Published: June 2019

210Po and 210Pb activity concentrations and their concentration ratio (CR) in marine zooplankton collected for the first time from the Syrian coastal waters (the eastern Mediterranean Sea) have been determined. The average activity concentrations of 210Po and 210Pb were 243±36 and 26.4±4.3 Bqkg-1 dw. The 210Po/210Pb activity ratio was found to be more than one in all zooplankton samples with an average of 9.2 (8.4 to 10), which indicates that the accumulation of 210Po in zooplankton does not come from the decay of the 210Pb only, and reflects a preferential bioaccumulation of 210Po over 210Pb. In addition, the Concentration Ratio (CR) for 210Po and 210Pb reached 104 and 103, respectively. This study will contribute to the radioecological reference database for zooplankton in the Mediterranean Sea.
First description of a new worm bait fishery in the NW Mediterranean Sea
Authors: BAETA MARC , NAVARRETE AROA , BALLESTEROS MANUEL 
Published: June 2019

Most commercial clam stocks in the NW Mediterranean Sea have collapsed over the last few decades and, as a result, most clam dredge fishermen have been forced to leave the fishing sector. Recently, in order to sustain their economic activity, some fishermen have modified dredges to target sea worms to sell as bait for recreational fisheries. This study provides the first information about this new worm bait fishery on the Catalan Maresme coast (NE Spain). The local administration has regulated only a few aspects of the fishery: users (2 boats), geographical limits (40 km; between 0-7 m depth), fishing time (6:00-14:00) and dredge design (the same as those used for smooth clams but with interior structures to retain worms and an open back). Fishing activity takes place throughout the year. Fishermen target three worm bait species: Sigalion squamosus, Ophelia neglecta and Halla parthenopeia. A mean of 233.37 individuals of S. squamosus, 167.93 of O. neglecta and 2.17 of H. parthenopeia are gathered per boat and day. Worm baits are sold directly to local recreational fishing shops as a quality product at the highest prices on the market. This fishery has a high social and economic value for the Maresme coast, helping to maintain small-scale fishermen jobs with an economic benefit similar to clam fishing.
Reducing Unneeded Clinical Variation in Sepsis and Heart Failure Care to Improve Outcomes and Reduce Cost: A Collaborative Engagement with Hospitalists in a MultiState System
Authors: Yurso Michael , Box Brent , Burgon Trever , Hauck Loran , Tagg Krystyna , Clem Kathleen , Paculdo David , Acelajado M Czarina , Tamondong‐Lachica Diana , Peabody John W 
Published: June 2019

OBJECTIVETo (1) measure hospitalist care for sepsis and heart failure patients using online simulated patients, (2) improve quality and reduce cost through customized feedback, and (3) compare patient‐level outcomes between project participants and nonparticipants.METHODSWe conducted a prospective, quasi‐controlled cohort study of hospitalists in eight hospitals matched with comparator hospitalists in six nonparticipating hospitals across the AdventHealth system. We provided measurement and feedback to participants using Clinical Performance and Value (CPV) vignettes to measure and track quality improvement. We then compared length of stay (LOS) and cost results between the two groups.RESULTS107 providers participated in the study. Over two years, participants improved CPV scores by nearly 8% (P < .001), with improvements in utilization of the three‐hour sepsis bundle (46.0% vs 57.7%; P = .034) and ordering essential medical treatment elements for heart failure (58.2% vs 72.1%; P = .038). In study year one, average LOS observed/expected (O/E) rates dropped by 8% for participants, compared to 2.5% in the comparator group, equating to an additional 570 hospital days saved among project participants. In study year two, cost O/E rates improved from 1.16 to 0.98 for participants versus 1.14 to 1.01 in the comparator group. Based on these improvements, we calculated total cost savings of $6.2 million among study participants, with $3.8 million linked to system‐wide improvements and an additional $2.4 million in savings attributable to this project.CONCLUSIONSCPV case simulation‐based measurement and feedback helped drive improvements in evidence‐based care that translated into lower costs and LOS, above‐and‐beyond other improvements at AdventHealth.
Nurse Responses to Physiologic Monitor Alarms on a General Pediatric Unit
Authors: Schondelmeyer Amanda C , Daraiseh Nancy M , Allison Brittany , Acree Cindi , Loechtenfeldt Allison M , Timmons Kristen M , Mangeot Colleen , Brady Patrick W 
Published: June 2019

BACKGROUNDHospitalized children generate up to 152 alarms per patient per day outside of the intensive care unit. In that setting, as few as 1% of alarms are clinically important. How nurses make decisions about responding to alarms, given an alarm's low specificity for detecting clinical deterioration, remains unclear.OBJECTIVEOur objective was to describe how bedside nurses think about and act upon monitor alarms for hospitalized children.DESIGN, SETTING, PARTICIPANTSThis was a qualitative study that involved the direct observation of nurses working on a general pediatric unit at a large children's hospital.MEASUREMENTSWe used a structured tool that included predetermined categories to assess nurse responses to monitor alarms. Data on alarm frequency and type were pulled from bedside monitors.RESULTSWe conducted 61.3 patient‐hours of observation with nine nurses, in which we documented 207 nurse responses to patient alarms. For 67% of alarms heard outside of the room, the nurse decided not to respond without further assessment. Nurses most commonly cited reassuring clinical context (eg, medical team in room), as the rationale for alarm nonresponse. The nurse deemed clinical intervention necessary in only 14 (7%) of the observed responses.CONCLUSIONNurses rely on clinical and contextual details to determine how to respond to alarms. Few of the alarm responses in our study resulted in a clinical intervention. These findings suggest that multiple system‐level and educational interventions may be necessary to improve the efficacy and safety of continuous monitoring.
Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene
Authors: Clement N. D. , Bardgett M. , Merrie K. , Furtado S. , Bowman R. , Langton D. J. , Deehan D. J. , Holland J. 
Published: June 2019

Objectives Our primary aim was to describe migration of the Exeter stem with a 32 mm head on highly crosslinked polyethylene and whether this is influenced by age. Our secondary aims were to assess functional outcome, satisfaction, activity, and bone mineral density (BMD) according to age. Patients and Methods A prospective cohort study was conducted. Patients were recruited into three age groups: less than 65 years (n = 65), 65 to 74 years (n = 68), and 75 years and older (n = 67). There were 200 patients enrolled in the study, of whom 115 were female and 85 were male, with a mean age of 69.9 years (sd 9.5, 42 to 92). They were assessed preoperatively, and at three, 12 and, 24 months postoperatively. Stem migration was assessed using Einzel-Bild-Röntgen-Analyse (EBRA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), EuroQol-5 domains questionnaire (EQ-5D), short form-36 questionnaire (SF-36,) and patient satisfaction were used to assess outcome. The Lower Extremity Activity Scale (LEAS), Timed Up and Go (TUG) test, and activPAL monitor (energy expelled, time lying/standing/walking and step count) were used to assess activity. The BMD was assessed in Gruen and Charnley zones. Results Mean varus/valgus tilt was -0.77⁰ and axial subsidence was -1.20 mm. No significant difference was observed between age groups (p ⩾ 0.07). There was no difference according to age group for postoperative WOMAC (p ⩾ 0.11), HHS (p ⩾ 0.06), HOOS (p ⩾ 0.46), EQ-5D (p ⩾ 0.38), patient satisfaction (p ⩾ 0.05), or activPAL (p ⩾ 0.06). Patients 75 years and older had a worse SF-36 physical function (p = 0.01) and physical role (p = 0.03), LEAS score (p < 0.001), a shorter TUG (p = 0.01), and a lower BMD in Charnley zone 1 (p = 0.02). Conclusion Exeter stem migration is within normal limits and is not influenced by age group. Functional outcome, patient satisfaction, activity level, and periprosthetic BMD are similar across all age groups. Cite this article: N. D. Clement, M. Bardgett, K. Merrie, S. Furtado, R. Bowman, D. J. Langton, D. J. Deehan, J. Holland. Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene: Does age influence functional outcome, satisfaction, activity, stem migration, and periprosthetic bone mineral density? Bone Joint Res 2019;8:275–287. DOI: 10.1302/2046-3758.86.BJR-2018-0300.R1.
UM NOVO OLHAR SOBRE AS SÚMULAS VINCULANTES: A APROXIMAÇÃO ENTRE COMMON LAW E CIVIL LAW E OS HARD CASES
Authors: Oliveira Neuza Vitoria de Andrade 
Published: June 2019

O presente artigo é fruto de uma pesquisa cimentada na investigação da possível aproximação entre os dois sistemas de ordenamento jurídico consolidados ao longo da história, o common law, predominante em países de tradição anglo-saxônica como os Estados Unidos e a Inglaterra e o civil law que é o sistema jurídico mais disseminado no mundo ocidental e baseado no direito romanístico, adotado no Brasil, e com influência da atividade do jurisdicional, principalmente após o advento da Súmula Vinculante pelo ordenamento jurídico pátrio através da Emenda Constitucional nº 45/2004, permitindo suceder se essa aproximação está ensejando mudanças de paradigmas nos sistemas investigados e quais seriam as consequências e reflexos desta, primordialmente no que diz respeito aos hard cases (casos difíceis).
Acute Dermato-Lymphangio-Adenitis Following Administration of Infliximab for Crohn's Disease
Authors: Liyanage I.K. , Niriella M.A. , de Silva A.P. , de Silva N. , de Silva H.J. 
Published: June 2019

ABSTRACT
Tumor necrosis factor-α inhibitor (TNF-α) is frequently used for Crohn's disease and other autoimmune conditions. Increased risk of infection is an accepted adverse effect of TNF-α, and routine screening for potential infections are carried out before initiation of therapy. We report the case of a patient who developed a localized painful swelling near the injection site, which was diagnosed as acute dermato-lymphangio-adenitis due to filarial infection. This adds to the limited number of case reports on parasitic complications following TNF-α therapy.
Eosinophilic Cholangitis Without Biliary Stricture After the Treatment of Eosinophilic Esophagitis
Authors: Tanaka Shunta , Sakai Arata , Masuda Atsuhiro , Ashina Shigeto , Yamakawa Kouhei , Tsujimae Masahiro , Kurosawa Manabu , Satou Yuu , Nakano Ryouta , Tanaka Takeshi , Yamada Yasutaka , Ikegawa Takuya , Fujigaki Seiji , Kobayashi Takashi , Tanaka Shinwa , Shiomi Hideyuki , Kodama Yuzo 
Published: June 2019

ABSTRACT
Eosinophilic cholangitis (EC) is an uncommon, benign, self-limiting disease, which typically causes bile duct stricture with eosinophil infiltration. We report the case of a 70-year-old woman who presented with abdominal pain diagnosed with EC after treatment for eosinophilic esophagitis. All previous reported cases of EC had bile duct stricture seen on magnetic resonance cholangiopancreatography or cholangiogram during endoscopic retrograde cholangiopancreatography, but only wall thickness of the common bile duct was noted in our case. Although rare, EC should be considered when wall thickening of the bile duct is observed, even without stricture.
Concurrent Placements of a Duodenal-Jejunal Bypass Liner and an Intragastric Balloon Among Severely Obese Patients: A Case Series
Authors: Sartoretto Adrian , Marinos George , Sui Zhixian 
Published: June 2019

ABSTRACT
The duodenal-jejunal bypass liner and the intragastric balloon are endoscopically deployed devices used in the treatment of obesity and diabetes. These devices use differing mechanisms of action, and concurrent use may lead to improved efficacy. Three obese patients who suffered from weight loss plateau with the liner had the intragastric balloon inserted concurrently. All 3 patients reported subsequent significant weight loss. None of the patients reported any symptom that indicate the interference between the devices. This is the first case series in humans of successfully combining 2 independent endoscopic bariatric therapies to overcome weight loss plateau in the primary treatment of obesity.
Colonic Mucosubmucosal Elongated Polyp in the Sigmoid Colon on Surveillance Colonoscopy
Authors: Fan Xiaowen , Hershman Melissa , Levi Gabriel , Weisberg Ilan 
Published: June 2019

ABSTRACT
Colonic mucosubmucosal elongated polyp (CMSEP) is a newly designated colorectal polyp. It has unique endoscopic features of a worm- or drumstick-shaped appearance. Histologically, it is composed of normal colonic mucosa and expanded submucosa with a prominent vascular component and no significant inflammation. CMSEP is usually detected incidentally on screening colonoscopy or colonoscopy for other causes. Differential diagnoses that need to be considered include mucosal prolapse syndrome, filiform polyposis, hamartomatous polyp, colon leiomyoma, inverted diverticulum, and residual stalk of a pedunculated adenoma. We present a case of CMSEP on surveillance colonoscopy and literature review.
Clinicopathologic and Racial/Ethnic Differences of Colorectal Cancer Among Adolescents and Young Adults
Authors: Holowatyj Andreana N. , Lewis Mark A. , Pannier Samantha T. , Kirchhoff Anne C. , Hardikar Sheetal , Figueiredo Jane C. , Huang Lyen C. , Shibata David , Schmit Stephanie L. , Ulrich Cornelia M. 
Published: June 2019

OBJECTIVES:
Despite overall reductions in colorectal cancer burden, incidence rates continue to rise among younger patients, and causes remain unknown. We examined differences in clinicopathologic and racial/ethnic characteristics within the adolescent and young adult (AYA) population diagnosed with colorectal cancer in the United States.

METHODS:
Using the National Cancer Institute's Surveillance, Epidemiology, and End Results program data, we identified individuals diagnosed with first primary colorectal cancer between ages 15 and 39 years from 2010 to 2015. Adjusted multivariable logistic regression models were used to quantify clinicopathologic and racial/ethnic differences across age at onset subgroups (15–19, 20–24, 25–29, 30–34, and 35–39 years).

RESULTS:
We identified 5,350 AYA patients diagnosed with colorectal cancer. Of note, 28.6% of AYA cases were diagnosed with right-sided tumors (cecum to transverse colon). The proportion of right-sided colorectal cancers differed significantly by age group at diagnosis (38.3% vs 27.3% of AYAs aged 15–19 vs 35–39 years, respectively; P trend = 0.01). Proportions of cases with mucinous adenocarcinoma and signet ring cell carcinoma histopathologic subtypes significantly increased with younger age at onset (P trends = 0.01 and 0.03, respectively). Differences in clinical stage were observed across AYA age groups, with stage II disease increasing with younger age (P trend = 0.01). The proportion of Hispanic AYAs was higher within younger patients, accounting for 21.0% of the AYA population aged 35–39 years up to 28.3% of 15–19-year-old individuals (P trend = 0.003).

DISCUSSION:
Within the AYA population, colorectal cancers differ by clinicopathologic and racial/ethnic characteristics. Further investigation of the clinical and biologic diversity of colorectal cancers that partially underlie age- and race-related differences in cancer susceptibility and outcomes is warranted.