bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial ecology of mountain glacier ecosystems: biodiversity, ecological connections and implications of a warming climate
Authors: Hotaling Scott , Hood Eran , Hamilton Trinity L. 
Published: April 2017

SummaryGlacier ecosystems are teeming with life on, beneath, and to a lesser degree, within their icy masses. This conclusion largely stems from polar research, with less attention paid to mountain glaciers that overlap environmentally and ecologically with their polar counterparts in some ways, but diverge in others. One difference lies in the susceptibility of mountain glaciers to the near‐term threat of climate change, as they tend to be much smaller in both area and volume. Moreover, mountain glaciers are typically steeper, more dependent upon basal sliding for movement, and experience higher seasonal precipitation. Here, we provide a modern synthesis of the microbial ecology of mountain glacier ecosystems, and particularly those at low‐ to mid‐latitudes. We focus on five ecological zones: the supraglacial surface, englacial interior, subglacial bedrock–ice interface, proglacial streams and glacier forefields. For each, we discuss the role of microbiota in biogeochemical cycling and outline ecological and hydrological connections among zones, underscoring the interconnected nature of these ecosystems. Collectively, we highlight the need to: better document the biodiversity and functional roles of mountain glacier microbiota; describe the ecological implications of rapid glacial retreat under climate change and resolve the relative contributions of ecological zones to broader ecosystem function.
Do State Continuing Medical Education Requirements for Physicians Improve Clinical Knowledge?
Authors: Vandergrift Jonathan L. , Gray Bradley M. , Weng Weifeng 
Published: April 2017

ObjectiveTo evaluate the effect of state continuing medical education (CME) requirements on physician clinical knowledge.Data SourcesSecondary data for 19,563 general internists who took the Internal Medicine Maintenance of Certification (MOC) examination between 2006 and 2013.Study DesignWe took advantage of a natural experiment resulting from variations in CME requirements across states over time and applied a difference‐in‐differences methodology to measure associations between changes in CME requirements and physician clinical knowledge. We measured changes in clinical knowledge by comparing initial and MOC examination performance 10 years apart. We constructed difference‐in‐differences estimates by regressing examination performance changes against physician demographics, county and year fixed effects, trend–state indicators, and state CME change indicators.Data CollectionPhysician data were compiled by the American Board of Internal Medicine. State CME policies were compiled from American Medical Association reports.Principal FindingsMore rigorous CME credit‐hour requirements (mostly implementing a new requirement) were associated with an increase in examination performance equivalent to a shift in examination score from the 50th to 54th percentile.ConclusionsAmong physicians required to engage in a summative assessment of their clinical knowledge, CME requirements were associated with an improvement in physician clinical knowledge.
Comparison of safety and efficacy of image‐guided enema reduction techniques for paediatric intussusception: A review of the literature
Authors: Chew Renny , Ditchfield Michael , Paul Eldho , Goergen Stacy K 
Published: April 2017

SummaryThere is variable international practice regarding the technique used for image‐guided enema reduction in paediatric intussusception. A recent meta‐analysis found pneumatic reduction to be more effective than hydrostatic techniques. Clinical practice variation may impact on perforation rates, ionizing radiation exposure and requirement for surgery. The aim of this study was to review the literature regarding the efficacy and safety of fluoroscopically guided pneumatic reduction (FGPR) compared to ultrasound (US) guided intussusception reduction (USGIR) techniques for paediatric intussusception treatment. Articles were identified by searching OVID Medline on 21/02/14 and by scanning retrieved articles reference lists. The search was repeated on 30/09/15. Systematic reviews (SR) were appraised with the PRISMA critical appraisal tool. Primary studies underwent a separate critical appraisal process. Successful reductions and perforations per attempt were calculated for each study. Pooled estimates of proportions were calculated for each of these dichotomous outcomes. A SR and 42 primary studies were included in the review. No randomised control trial (RCT) study was included. Non‐randomised comparative studies and non‐comparative studies suggest that hydrostatic reduction under US control has a similar efficacy and safety profile to pneumatic reduction under fluoroscopic control, but USGIR data are dominated by a single large, non‐comparative study performed in China. US‐guided intussusception reduction should be considered an alternative to FGPR as it has similar efficacy and safety, and affords no ionised radiation exposure. However, RCT data are required to inform practice.
Comparison of Emergency Department Patients to Inpatients Receiving a Pulmonary Embolism Response Team (PERT) Activation
Authors: Deadmon Erin K. , Giordano Nicholas J. , Rosenfield Kenneth , Rosovsky Rachel , Parry Blair Alden , Al‐Bawardy Rasha Fahad , Chang Yuchiao , Kabrhel Christopher 
Published: April 2017

AbstractObjectivesThe development of pulmonary embolism response teams (PERTs) has been widely adopted nationally with the goal of providing multidisciplinary care to patients with high‐risk PE. Most PERT activations originate from the emergency department (ED), while others are from the intensive care unit (ICU) or inpatient floors. It is unclear if ED PERT activations differ from non‐ED PERT activation in terms of presentation, management, and outcome.MethodsWe enrolled a consecutive cohort of patients for whom PERT was activated at an urban academic medical center. We compared three groups of PERT activations based on whether the activation originated from the ED, ICU, or a non‐ICU inpatient floor. We compared these groups in terms of the proportion of PERT activations that occurred during day, evening, or weekend hours and the proportion of confirmed PE. We also compared PE severity, treatment, and outcomes across locations. We tested differences using chi‐square tests, with a two‐tailed p‐value of <0.05 considered statistically significant.ResultsWe enrolled 561 patients, of whom 449 (79.5%) had confirmed PE. The mean ± SD age of patients with confirmed PE was 61 ± 17 years, and 300 (53.5%) were male. Activations from the ED (n = 283, 88.4%) or floor (n = 100, 74.6%) were more likely to be for confirmed PE than activations from the ICU (n = 63, 58.9%; p < 0.0001). There was a statistical difference in the time of day of PERT activation with the ED having more activations during night hours than the ICU or floors (p = 0.004). Most activations for confirmed, massive PE originated from the ICU (n = 41, 65.1%), followed by the ED (n = 82, 29%) and inpatient floors (n = 22, 22%; p < 0.0001). Most activations from the ED (n = 155, 54.8%) and floors (n = 55, 55%) were for submassive PE. The use of thrombolysis or thrombectomy was more common among ICU patients (n = 18, 33.3%), followed by ED patients (n = 53, 19.6%) and then floor patients (n = 8, 8.2%). Mortality and major bleeding events were most common among ICU patients and similar among ED and floor patients.ConclusionsPulmonary embolism response team activations from different clinical locations differ in terms of patient presentation, PE confirmation, treatments, and outcomes. PERTs should be customized to support the different needs of each clinical area.
The involuntary nature of binge drinking: goal directedness and awareness of intention
Authors: Doñamayor Nuria , Strelchuk Daniela , Baek Kwangyeol , Banca Paula , Voon Valerie 
Published: April 2017

AbstractBinge drinking represents a public health issue and is a known risk factor in the development of alcohol use disorders. Previous studies have shown behavioural as well as neuroanatomical alterations associated with binge drinking. Here, we address the question of the automaticity or involuntary nature of the behaviour by assessing goal‐directed behaviour and intentionality. In this study, we used a computational two‐step task, designed to discern between model‐based/goal‐directed and model‐free/habitual behaviours, and the classic Libet clock task, to study intention awareness, in a sample of 31 severe binge drinkers (BD) and 35 matched healthy volunteers. We observed that BD had impaired goal‐directed behaviour in the two‐step task compared with healthy volunteers. In the Libet clock task, BD showed delayed intention awareness. Further, we demonstrated that alcohol use severity, as reflected by the alcohol use disorders identification test, correlated with decreased conscious awareness of volitional intention in BD, although it was unrelated to performance on the two‐step task. However, the time elapsed since the last drinking binge influenced the model‐free scores, with BD showing less habitual behaviour after longer abstinence. Our findings suggest that the implementation of goal‐directed strategies and the awareness of volitional intention are affected in current heavy alcohol users. However, the modulation of these impairments by alcohol use severity and abstinence suggests a state effect of alcohol use in these measures and that top‐down volitional control might be ameliorated with alcohol use cessation.
Suvorexant, an orexin/hypocretin receptor antagonist, attenuates motivational and hedonic properties of cocaine
Authors: Gentile Taylor A. , Simmons Steven J. , Barker David J. , Shaw Jessica K. , España Rodrigo A. , Muschamp John W. 
Published: April 2017

AbstractOrexins (‘hypocretins’) are peptides produced by neurons of the hypothalamus that project to structures implicated in reward and emotion processing. Converging evidence demonstrates functional roles of orexin signaling in arousal, sleep/wakefulness and motivated behaviors for natural and drug rewards. Suvorexant, a dual orexin receptor antagonist, recently received approval from the US Food and Drug Administration to treat insomnia. In Experiment 1, rats self‐administered cocaine under a progressive‐ratio schedule of reinforcement and the effects of suvorexant on motivation to self‐administer cocaine were measured. In Experiment 2, the effects of suvorexant on cocaine reward were assessed by using a place conditioning paradigm, and 50‐kHz ultrasonic vocalizations were also recorded to track changes in hedonic reactivity to cocaine. To rule out potentially confounding effects of suvorexant‐induced somnolence, locomotor activity was also measured. In Experiment 3, the effects of suvorexant on cocaine‐evoked elevations in ventral striatal dopamine were examined. Data reveal that suvorexant (i) reduced the number of cocaine infusions earned during progressive‐ratio self‐administration; (ii) attenuated initial positive hedonic reactivity to cocaine and prevented cocaine place preference; (iii) did not affect cocaine‐induced hyperlocomotion and (iv) reduced cocaine‐induced elevations in extracellular ventral striatal dopamine. The present study examined the therapeutic potential of suvorexant in rodent models of cocaine use disorder. These results contribute toward a growing literature supporting therapeutic roles of orexin receptor antagonists in treating substance use disorders.
A paradigm for examining stress effects on alcohol‐motivated behaviors in participants with alcohol use disorder
Authors: McCaul Mary E. , Wand Gary S. , Weerts Elise M. , Xu Xiaoqiang 
Published: April 2017

AbstractAlthough epidemiological research has shown an increase in drinking following stressors and trauma, limited paradigms have been validated to study the relationship between stress and drinking in the human laboratory. The current study developed a progressive ratio (PR) operant procedure to examine the effects of psychosocial stress on alcohol craving and several alcohol‐motivated behaviors in persons with alcohol use disorder. Current heavy, nontreatment‐seeking drinkers (N = 30) were media‐recruited and completed a comprehensive assessment of recent drinking, mood and health. Participants were admitted to the clinical research unit and underwent 4‐day, physician‐monitored alcohol abstinence. On days 4 and 5, participants underwent the Trier Social Stress Test or a neutral session in random order followed by the alcohol‐motivated response (AMR) procedure in which subjects worked for money or alcohol under a PR operant procedure. Subjects received earned money vouchers or alcohol at the conclusion of the session. The Trier Social Stress Test increased alcohol craving and rate of responding and decreased the number of changeovers between alcohol versus money reinforcers on the PR schedule. There was a positive relationship between alcohol craving and drinks earned during the stress session. This novel paradigm provides an experimental platform to examine motivation to drink without confounding by actual alcohol ingestion during the work session, thereby setting the stage for future studies of alcohol interventions.
Comparative analysis between RQ‐PCR and digital droplet PCR of BCL2/IGH gene rearrangement in the peripheral blood and bone marrow of early stage follicular lymphoma
Authors: Cavalli Marzia , De Novi Lucia Anna , Della Starza Irene , Cappelli Luca Vincenzo , Nunes Vittorio , Pulsoni Alessandro , Del Giudice Ilaria , Guarini Anna , Foà Robin 
Published: April 2017

SummaryBCL2/IGH rearrangements were analysed by polymerase chain reaction (PCR) at diagnosis in paired peripheral blood (PB) and bone marrow (BM) samples from 67 patients with stage I/II follicular lymphoma (FL). Real time quantitative PCR (RQ‐PCR) and digital droplet PCR (ddPCR) were performed in cases with a major breakpoint region (MBR+) at diagnosis and after localized radiotherapy and rituximab administration in order to investigate the applicability of ddPCR. The overall ddPCR/RQ‐PCR concordance was 81·9% (113/138 samples) and 97·5% in the 40/138 with quantifiable disease (RQ‐PCR≥10−5). At baseline, ddPCR allowed the recovery of a MBR+ marker in 8/18 (44·4%) samples that resulted MBR‐negative/minor cluster region‐negative/minor BCL2‐negative by qualitative PCR. Moreover, the tumour burden at diagnosis significantly predicted progression‐free survival (PSF) only when quantified by ddPCR. Paired PB and BM samples analysis demonstrated a high concordance in the detection of BCL2/IGH+ cells by qualitative and quantitative methods; in particular, 40/62 samples were positive by ddPCR (25 PB+/BM+; 9 PB+/BM−; 6 PB−/BM+), with 34/40 (85%) identified by the study of PB only. In conclusion, in localized FL, ddPCR is a promising tool for monitoring minimal residual disease (MRD) that is at least comparable to RQ‐PCR and potentially more accurate. PB is a suitable source for serial BCL2/IGH MRD assessments, regardless of the methodology utilized.
Eliminating malignant cells from cryopreserved ovarian tissue is possible in leukaemia patients
Authors: Soares Michelle , Saussoy Pascale , Maskens Mathilde , Reul Hélène , Amorim Christiani A. , Donnez Jacques , Dolmans Marie‐Madeleine 
Published: April 2017

SummaryReimplantation of cryopreserved ovarian tissue (OT) can successfully restore ovarian function in young cancer patients after gonadotoxic treatment. However, for patients with leukaemia, there is a risk of malignant cell transmission. Our objective was to evaluate minimal disseminated disease in OT from leukaemia patients and test a follicle isolation technique to obtain disease‐free follicle suspensions. Cryopreserved OT from 12 leukaemia patients was thawed and analysed by histology and long‐term xenografting in immunosuppressed mice. In 10 patients, follicles were isolated from OT, and polymerase chain reaction (PCR) was performed on tissue, digested ovarian suspensions and isolated follicle suspensions to investigate leukaemic cell presence. Mean patient age was 17·1 years. An average of 3·2 follicles were isolated per mm² of cortex. Xenografting of OT induced leukaemic masses in 2/12 mice. PCR identified leukaemic cell presence in 66% of OT. Malignant cells were also detected in digested ovarian suspensions. However, none of the follicle samples (>2300 follicles tested) showed any malignant cell presence after washing. This study demonstrates that it is possible to recover large numbers of viable follicles from cryopreserved OT of leukaemia patients. All isolated and washed follicle suspensions tested negative for leukaemic cells, giving leukaemia patients genuine hope of fertility restoration.
How I manage children with neutropenia
Authors: Dale David C. 
Published: April 2017

SummaryNeutropenia, usually defined as a blood neutrophil count <1·5 × 109/l, is a common medical problem for children and adults. There are many causes for neutropenia, and at each stage in life the clinical pattern of causes and consequences differs significantly. I recommend utilizing the age of the child and clinical observations for the preliminary diagnosis and primary management. In premature infants, neutropenia is quite common and contributes to the risk of sepsis with necrotizing enterocolitis. At birth and for the first few months of life, neutropenia is often attributable to isoimmune or alloimmune mechanisms and predisposes to the risk of severe bacterial infections. Thereafter when a child is discovered to have neutropenia, often associated with relatively minor symptoms, it is usually attributed to autoimmune disorder or viral infection. The congenital neutropenia syndromes are usually recognized when there are recurrent infections, the neutropenia is severe and there are congenital anomalies suggesting a genetic disorder. This review focuses on the key clinical finding and laboratory tests for diagnosis with commentaries on treatment, particularly the use of granulocyte colony‐stimulating factor to treat childhood neutropenia.
Sodium‐glucose co‐transporter (SGLT)2 and SGLT1 renal expression in patients with type 2 diabetes
Authors: Solini Anna , Rossi Chiara , Mazzanti Chiara M. , Proietti Agnese , Koepsell Hermann , Ferrannini Ele 
Published: April 2017

AimTo quantify the expression of sodium‐glucose co‐transporter (SGLT)2 and SGLT1, their cognate basolateral transporters, GLUT2 and GLUT1, and the transcriptional regulator of SGLTs in renal tissue obtained from people with T2DM and a group of well‐matched people without diabetes.MethodsWe measured SGLT2 and SGLT1 expression in unaffected renal tissue from 19 people with T2DM and 20 people without diabetes, matched for age and estimated glomerular filtration rate (controls), undergoing unilateral nephrectomy. Expression of SGLT2 and SGLT1, as well as that of GLUT2 and GLUT1, was quantified using real‐time and digital PCR; an affinity‐purified antibody against human SGLT2 was used to localize SGLT2 by immunohistochemistry.Results
SGLT2 expression was higher in control than T2DM tissue (median [interquartile range] target/β‐actin 1.62 [2.02] vs 0.67 [0.61]; P < .0001), and SGLT1 trended in the same direction (0.98 [1.19] vs 0.44 [0.48]; P = .08). Immunohistochemistry clearly localized SGLT2 to the tubular brush‐border membranes, and was semi‐quantitatively stronger in control than T2DM tissue (5.0 [1.0] vs 4.0 [1.0] score units; P = .043). GLUT2 (control vs T2DM: 1.00 [0.69] vs 0.49 [0.36]) and GLUT1 expression (control vs T2DM: 0.86 [0.73] vs 0.35 [0.30]; P = .0007 for both) were closely correlated with those of the respective SGLT partner. Hypoxia‐inducible factor 1α, more abundant in control than T2DM tissue, might be a transcription factor involved in the modulation of SGLT2 expression.ConclusionsIn whole renal tissue, expressions of SGLT2/GLUT2 and SGLT1/GLUT1 are coupled and slightly lower in typical people with T2DM as compared with well‐matched people without diabetes.
Effect of dehydration and rehydration intervals on fracture resistance of reattached tooth fragments using a multimode adhesive
Authors: Poubel Déborah L. N. , Almeida Júlio César F. , Dias Ribeiro Ana P. , Maia Guilherme B. , Martinez Jesús Maurício G. , Garcia Fernanda Cristina P. 
Published: April 2017

AbstractBackground/AimsThe tooth fragment bonding technique, frequently used to restore traumatized teeth, may be affected by dehydration/rehydration periods. The aim of this study was to evaluate the effects of different dry and wet storage intervals on multimode adhesive bonding between reattached fragments and teeth.Materials and MethodsEighty‐four bovine incisors were fractured and randomized into groups (n=12). After teeth fracturing, each specimen was assigned to one of the following groups: G0: control group (sound tooth); GA1 and GA2: 1‐h dehydration and a 15‐min or 24‐hours rewetting period, respectively; GB1 and GB2: 24‐hours dehydration and a 15‐minutes or 24‐hours rewetting period, respectively; and GC: 1‐hour (GC1) or 24‐hours (GC2) dehydration period only. Tooth fragments were then reattached using a multimode adhesive in a self‐mode technique with a flowable resin composite. The fracture resistance was evaluated in a universal testing machine under a compressive load (1 mm/min−1). Data were submitted to two‐way analysis of variance and post hoc Tukey test (5%).ResultsNo significant interaction between dehydration and rehydration intervals was observed (P>.05). Only the step of rehydration significantly affected the reattachment strength when compared to the groups submitted only to dehydration, regardless of the interval (15 minutes or 24 hours).ConclusionRehydrating a tooth fragment for 15 minutes before bonding with a multimode adhesive maintained sufficient moisture to increase reattachment strength.
The major miR‐31 target genes STK40 and LATS2 and their implications in the regulation of keratinocyte growth and hair differentiation
Authors: Luan Liming , Shi Jianyun , Yu Zhengquan , Andl Thomas 
Published: April 2017

AbstractEmerging evidence indicates that even subtle changes in the expression of key genes of signalling pathways can have profound effects. MicroRNAs (miRNAs) are masters of subtlety and generally have only mild effects on their target genes. The microRNA miR‐31 is one of the major microRNAs in many cutaneous conditions associated with activated keratinocytes, such as the hyperproliferative diseases psoriasis, non‐melanoma skin cancer and hair follicle growth. miR‐31 is a marker of the hair growth phase, and in our miR‐31 transgenic mouse model it impairs the function of keratinocytes. This leads to aberrant proliferation, apoptosis, and differentiation that results in altered hair growth, while the loss of miR‐31 leads to increased hair growth. Through in vitro and in vivo studies, we have defined a set of conserved miR‐31 target genes, including LATS2 and STK40, which serve as new players in the regulation of keratinocyte growth and hair follicle biology. LATS2 can regulate growth of keratinocytes and we have identified a function of STK40 that can promote the expression of key hair follicle programme regulators such as HR, DLX3 and HOXC13.