bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute encephalopathy with biphasic seizures and late reduced diffusion in Kawasaki disease
Authors: Shiba Takeshi , Hamahata Keigo , Yoshida Akira 
Published: December 2017

AbstractHerein we describe the case of a 7‐month‐old girl with Kawasaki disease (KD) in whom status epilepticus with fever developed on day 3 and cluster of seizures on day 6 of illness, followed by severe disturbance of consciousness afterward. Diffusion‐weighted magnetic resonance imaging on day 6 of illness showed diffuse high signals in the bilateral subcortical white matter, while electroencephalogram indicated low‐voltage slow waves. This indicated acute encephalopathy with biphasic seizures and late reduced diffusion (AESD); severe neurological sequelae remained. This is the first report of AESD as a complication of KD.
Prelisting predictions of early postoperative survival in infant heart transplantation using classification and regression tree analysis
Authors: Chen Ching Kit , Manlhiot Cedric , Mital Seema , Schwartz Steven M. , Van Arsdell Glen S. , Caldarone Christopher , McCrindle Brian W. , Dipchand Anne I. 
Published: December 2017

AbstractInfants listed for heart transplantation experience high waitlist and early post‐transplant mortality, and thus, optimal allocation of scarce donor organs is required. Unfortunately, the creation and validation of multivariable regression models to identify risk factors and generate individual‐level predictions are challenging. We sought to explore the use of data mining methods to generate a prediction model. CART analysis was used to create a model which, at the time of listing, would predict which infants listed for heart transplantation would survive at least 3 months post‐transplantation. A total of 48 infants were included; 13 died while waiting, and six died within 3 months of heart transplant. CART analysis identified RRT, blood urea nitrogen, and hematocrit as terminal nodes with alanine transaminase as an intermediate node predicting death. No patients listed on RRT (n = 10) survived and only three of 12 (25%) patients listed on ECLS survived >3 months post‐transplant. CART analysis overall accuracy was 83%, with sensitivity of 95% and specificity 76%. This study shows that CART analysis can be used to generate accurate prediction models in small patient populations. Model validation will be necessary before incorporation into decision‐making algorithms used to determine transplant candidacy.
Hopelessness as a Predictor of Suicide Ideation in Depressed Male and Female Adolescent Youth
Authors: Wolfe Kristin L. , Nakonezny Paul A. , Owen Victoria J. , Rial Katherine V. , Moorehead Alexandra P. , Kennard Beth D. , Emslie Graham J. 
Published: December 2017

We examined hopelessness as a predictor of suicide ideation in depressed youth after acute medication treatment. A total of 158 depressed adolescents were administered the Children's Depression Rating Scale‐Revised (CDRS‐R) and Columbia Suicide Severity Rating Scale (C‐SSRS) as part of a larger battery at baseline and at weekly visits across 6 weeks of acute fluoxetine treatment. The Beck Hopelessness Scale (BHS) was administered at baseline and week 6. A negative binomial regression model via a generalized estimating equation analysis of repeated measures was used to estimate suicide ideation over the 6 weeks of acute treatment from baseline measure of hopelessness. Depression severity and gender were included as covariates in the model. The negative binomial analysis was also conducted separately for the sample of males and females (in a gender‐stratified analysis). MeanCDRS‐R total scores were 60.30 ± 8.93 at baseline and 34.65 ± 10.41 at week 6. Mean baseline and week 6BHSscores were 9.57 ± 5.51 and 5.59 ± 5.38, respectively. Per the C‐SSRS, 43.04% and 83.54% reported having no suicide ideation at baseline and at week 6, respectively. The analyses revealed that baseline hopelessness was positively related to suicide ideation over treatment (p = .0027), independent of changes in depression severity. This significant finding persisted only for females (p = .0024). These results indicate the importance of early identification of hopelessness.
Basal and stress‐induced salivary testosterone variation across the menstrual cycle and linkage to motivation and muscle power
Authors: Cook C. J. , Kilduff L. P. , Crewther B. T. 
Published: December 2017

This study investigated salivary testosterone (sal‐T) variation across the menstrual cycle in female athletes, at different competitive levels, and its association with motivation and neuromuscular power. Six elite and 16 non‐elite female athletes were monitored on days 7 (D7), 14 (D14), and 21 (D21) across 3 menstrual cycles for basal sal‐T concentrations and self‐appraised motivation to train and compete. Two further measures were taken on D7, D14, and D21 across 2 menstrual cycles: (1) the sal‐T response (delta change) to a physical stress test and (2) peak power (PP) response to a 6‐second cycle sprint following a post‐activation potentiation (PAP) stimulus. Basal sal‐T concentrations increased by 17 ± 27% from D7 to D14 before decreasing by −25 ± 43% on D21 (P < .05), but this result was biased by elite females with higher sal‐T (>102%) who showed larger menstrual changes. Motivation, sal‐T reactivity to stress, and the PP responses to a PAP stimulus also varied by testing day (P < .05), in parallel with basal sal‐T and in favor of the elite group. Furthermore, stronger within‐subject relationships (P < .001) between basal sal‐T and motivation emerged in the elites (r = .70‐.75) vs the non‐elite group (r = .41‐.50). In conclusion, menstrual cycle changes in sal‐T were more obvious in high‐performing female athletes with higher sal‐T concentrations. This was accompanied by greater training motivation, a more pronounced sal‐T response to a physical stressor and greater neuromuscular power in the elite group. These results support observations that female athletes with higher T are more represented at elite levels of performance.
Impact of grassland contract policy on soil organic carbon losses from alpine grassland on the Qinghai–Tibetan Plateau
Authors: Cao J. , Gong Y. , Yeh E. T. , Holden N. M. , Adamowski J. F. , Deo R. C. , Liu M. , Zhou J. , Zhang J. , Zhang W. , Zhang S. , Sheng D. , Yang S. , Xu X. , Li M. , Feng Q. 
Published: December 2017

AbstractCarbon storage in the soils on the Qinghai–Tibetan Plateau plays a very important role in the global carbon budget. In the 1990s, a policy of contracting collective grasslands to smaller units was implemented, resulting in a change from the traditional collective grassland management to two new management patterns: a multi‐household management pattern (MMP: grassland shared by several households without enclosures) and a single‐household management pattern (SMP: grassland enclosed and used by only one household). In 2016, 50 MMP and 54 SMP winter pastures on the Qinghai–Tibetan Plateau were sampled to assess the differences in soil organic carbon (SOC) between the two management patterns. Results showed that average SOC was significantly greater under MMP than under SMP, with an estimated 0.41 Mg C/ha/yr lost due to SMP following the new grassland contract. Based on the government's grassland policy, four grassland utilization scenarios were developed for both summer and winter pastures. We found that if the grassland were managed under SMP, likely C losses ranged between 0.31 × 107 and 6.15 × 107 Mg C/yr across the Qinghai–Tibetan Plateau relative to MMP, which more closely resembles pre‐1990s grassland management. Previous estimates of C losses have only considered land use change (with cover change) and ignored the impacts driven by land management pattern changes (without cover change). The new data suggest that C losses from the Qinghai–Tibetan Plateau are greater than previously estimated, and therefore that the grassland contract policy should be reviewed and SMP households should be encouraged to reunite into the MMP. These findings have potential implications for land management strategies not only on the Qinghai–Tibetan Plateau but also other grazing regions globally where such practices may exist.
Psychometric Testing of the Personal Workplace Safety Instrument for Emergency Nurses
Authors: Burchill Christian N. , Bena James , Polomano Rosemary C. 
Published: December 2017

ABSTRACTBackgroundPatient‐visitor violence (PVV) committed against nurses is a worldwide problem. Registered nurses in emergency departments (EDs) are particularly susceptible. The frequency and severity of PVV against emergency nurses (ENs) internationally is well documented. Little is known about factors that make ENs feel safe from PVV.AimExamine the psychometric properties of the Personal Workplace Safety Instrument for Emergency Nurses (PWSI‐EN), developed to measure ENs’ perceptions of safety from PVV.MethodsInstrument development was based on a literature review, input from ENs, and expert opinion. An online version of the PWSI‐EN was distributed to a convenience sample of ENs practicing in EDs across the United States. Psychometric testing included measures of internal consistency reliability, construct validity to support subscales, and comparisons on demographic variables.ResultsThree‐hundred and five (N = 305) ENs from 16 hospitals responded to the original 31‐item PWSI‐EN. Based on item analysis and exploratory factor analysis (EFA), the instrument was reduced to 23 items with Cronbach's α = .912. EFA delineated six subscales relevant to perception of safety from PVV with factor loadings from .342 to .879. Low to moderate subscale correlations showed a degree of independence for concept domains. Known groups approach for construct validity revealed statistically significant differences (p < .05) for five subscales and the total score between community and academic or teaching hospitals. Hospital type, organizational confidence, and fear for patient safety were significant predictors of greater perceptions of safety from PVV.Linking Evidence to ActionThe PWSI‐EN is a valid and reliable survey instrument to assess EN perceptions of safety. ED and hospital leaders can use this instrument to determine specific areas to focus efforts in order to improve ENs’ perception of safety from PVV. Researchers exploring interventions aimed at improving perceptions of safety from PVV for ENs may find the PWSI‐EN useful.
Tempol augments the blunted cutaneous microvascular thermal reactivity in healthy young African Americans
Authors: Hurr Chansol , Patik Jordan C. , Kim KiYoung , Christmas Kevin M. , Brothers R. Matthew 
Published: December 2017

New Findings
What is the central question of this study?
The purpose was to determine whether there is a difference between African Americans and Caucasians in cutaneous microvascular function and whether this difference is attributable to elevated oxidative stress.

What is the main finding and its importance?
The main finding is that African Americans have an attenuated cutaneous vasodilatation during local heating relative to Caucasians that is restored with local infusion of the superoxide dismutase mimetic, tempol. This suggests that superoxide mediates microvascular dysfunction and might contribute to the greater prevalence of cardiovascular disease in this population.

AbstractAfrican Americans (AA) have elevated risk for cardiovascular disease relative to other populations. We hypothesized that the cutaneous hyperaemic response to local heating is reduced in young AA relative to Caucasian Americans (CA) and that this is attributable to elevated oxidative stress. As such, ascorbic acid (a global antioxidant) and tempol (a superoxide dismutase mimetic) would improve this response in AA. Microdialysis fibres received lactated Ringer solution (control), 10 mm ascorbic acid or 10 μm 4‐hydroxy‐2,2,6,6‐tetramethylpiperidine‐1‐oxyl (tempol) at a rate of 2.0 μl min−1. Cutaneous vascular conductance (CVC) was calculated as the red blood cell flux divided by mean arterial pressure. Data were presented as a percentage of maximal CVC (%CVCmax) induced by 44°C heating plus sodium nitroprusside. Twenty‐four (12 AA, 12 CA) young (23 ± 4 years old) subjects participated. During 39°C heating, the %CVCmax was lower in AA at the control (CA, 65 ± 20% versus AA, 47 ± 15%; P < 0.05) and ascorbic acid sites (CA, 73 ± 14% versus AA: 49 ± 17%; P < 0.01). At the tempol site, there were no differences between groups. This was followed by infusion of 10 mm l‐NAME at all sites to assess the contribution of nitric oxide to vasodilatation during local heating. The contribution of nitric oxide was lower in AA relative to CA at 39°C; however, this was restored with tempol. These data suggest that: (i) cutaneous vasodilatation in response to local heating is blunted in AA relative to CA; and (ii) elevated superoxide generation attenuates nitric oxide‐mediated cutaneous vasodilatation in AA.
Workflow interruptions and stress atwork: a mixed-methods study among physicians and nurses of a multidisciplinary emergency department
Authors: Weigl Matthias , Beck Joana , Wehler Markus , Schneider Anna 
Published: December 2017

ObjectivesDealing with multiple workflow interruptions is a major challenge in emergency department (ED) work. This study aimed to establish a taxonomy of workflow interruptions that takes into account the content and purpose of interruptive communication. It further aimed to identify associations of workflow interruptions with ED professionals’ work stress.DesignCombined data from expert observation sessions and concomitant self-evaluations of ED providers.SettingED of an academic community hospital in Germany.ParticipantsMultidisciplinary sample of ED physicians and nurses. 77 matched observation sessions of interruptions and self-evaluations of work stress were obtained on 20 randomly selected days.Outcome measuresED professionals’ stress evaluations were based on standardised measures. ED workload data on patient load, patient acuity and staffing were included as control variables in regression analyses.ResultsOverall mean rate was 7.51 interruptions/hour. Interruptions were most frequently caused by ED colleagues of another profession (27.1%; mean interruptions/hour rate: 2.04), by ED colleagues of the same profession (24.1%; 1.81) and by telephone/beeper (21%; 1.57). Concerning the contents of interruption events, interruptions most frequently occurred referring to a parallel case under care (30.3%, 2.07), concerning the current case (19.1%; 1.28), or related to coordination activities (18.2%, 1.24). Regression analyses revealed that interruptive communication related to parallel cases significantly increased ED providers’ stress levels (β=0.24, P=0.03). This association remained significant after controlling for ED workload.DiscussionInterruptions that refer to parallel cases under care were associated with increased stress among ED physicians and nurses. Our approach to distinguish between sources and contents of interruptions contributes to an improved understanding of potential benefits and risks of workflow interruptions in ED work environments. Despite some limitations, our findings add to future research on the implications of interruptions for effective and safe patient care and work in complex and dynamic care environments.
Wild type Kirsten rat sarcoma is a novel microRNA-622-regulated therapeutic target for hepatocellular carcinoma and contributes to sorafenib resistance
Authors: Dietrich Peter , Koch Andreas , Fritz Valerie , Hartmann Arndt , Bosserhoff Anja Katrin , Hellerbrand Claus 
Published: December 2017

ObjectiveSorafenib is the only effective therapy for advanced hepatocellular carcinoma (HCC). Combinatory approaches targeting mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK)- and phosphatidylinositol-4,5-bisphosphate-3-kinase (PI3K)/protein-kinase B(AKT) signalling yield major therapeutic improvements. RAS proteins regulate both RAF/MAPK and PI3K/AKT signalling. However, the most important RAS isoform in carcinogenesis, Kirsten rat sarcoma (KRAS), remains unexplored in HCC.DesignHuman HCC tissues and cell lines were used for expression and functional analysis. Sorafenib-resistant HCC cells were newly generated. RNA interference and the novel small molecule deltarasin were used for KRAS inhibition both in vitro and in a murine syngeneic orthotopic HCC model.ResultsExpression of wild type KRAS messenger RNA and protein was increased in HCC and correlated with extracellular-signal regulated kinase (ERK) activation, proliferation rate, advanced tumour size and poor patient survival. Bioinformatic analysis and reporter assays revealed that KRAS is a direct target of microRNA-622. This microRNA was downregulated in HCC, and functional analysis demonstrated that KRAS-suppression is the major mediator of its inhibitory effect on HCC proliferation. KRAS inhibition markedly suppressed RAF/ERK and PI3K/AKT signalling and proliferation and enhanced apoptosis of HCC cells in vitro and in vivo. Combinatory KRAS inhibition and sorafenib treatment revealed synergistic antitumorigenic effects in HCC. Sorafenib-resistant HCC cells showed elevated KRAS expression, and KRAS inhibition resensitised sorafenib-resistant cells to suppression of proliferation and induction of apoptosis.ConclusionsKRAS is dysregulated in HCC by loss of tumour-suppressive microRNA-622, contributing to tumour progression, sorafenib sensitivity and resistance. KRAS inhibition alone or in combination with sorafenib appears as novel promising therapeutic strategy for HCC.
Evaluation of the relative effectiveness of the 2017 updated Manchester scoring system for predicting BRCA1/2 mutations in a Southeast Asian country
Authors: Chew Winston , Moorakonda Rajesh Babu , Courtney Eliza , Soh Hazel , Li Shao Tzu , Chen Yanni , Shaw Tarryn , Allen John Carson , Evans Dafydd Gareth R , Ngeow Joanne 
Published: December 2017

BackgroundGermline mutations in the BRCA1 and BRCA2 genes have significant clinical implications for both risk-reducing and early surveillance management. The third and most recent revision of the Manchester scoring system (MSS3) used to distinguish patients indicated for germline BRCA1/2 testing included further adjustments for triple negative breast cancer, high-grade serous ovarian cancer and human epidermal growth factor 2 (HER2) receptor status. This study aims to evaluate the relative effectiveness of MSS3 in a Southeast Asian population.MethodsAll patients in our centre were tested using next-generation sequencing (NGS) panels that included full gene sequencing as well as coverage for large deletions/duplications in BRCA1/2. We calculated MSS1-3 scores for index patients between 2014 and 2017 who had undergone BRCA1/2 genetic testing and recorded their genetic test results. MSS1-3 outcomes were compared using receiver operating characteristic analysis, while associations with predictors were investigated using Fisher’s exact test and logistics regression. Calculations were performed using Medcalc17.ResultsOf the 330 included patients, 47 (14.2%) were found to have a germline mutation in BRCA1 or BRCA2. A positive HER2 receptor was associated with a lower likelihood of a BRCA1/2mutation (OR=0.125, 95% CI 0.016 to 0.955; P=0.007), while high-grade serous ovarian cancer was conversely associated with an increased likelihood of a BRCA1/2 mutation (OR=5.128, 95% CI 1.431 to 18.370; P=0.012). At the 10% threshold, 43.0% (142/330) of patients were indicated for testing under MSS3, compared with 35.8% (118/330) for MSS1% and 36.4% (120/330) for MSS2. At the 10% threshold, MSS3 sensitivity was 91.5% and specificity 65.0%, significantly better than the previous MSS1 (P=0.037) and MSS2 (P=0.032) models.ConclusionOur results indicate that the updated MSS3 outperforms previous iterations and relative to the Manchester population, is just as effective in identifying patients with BRCA1/2 mutations in a Southeast Asian population.
Type II pneumocyte proliferation in vitro: problems and future directions
Authors: Uhal Bruce D. , Flowers Kevin M. , Rannels D. Eugene 
Published: December 2017

In adult animals, the type II pneumocyte is progenitor of both the type I and type II alveolar epithelium. In primary culture, however, the fate of this cell is uncertain. Type II cells in culture lose their differentiated properties and eventually resemble type I cells, but a lack of specific markers has complicated the characterization of the phenotype acquired in vitro. Furthermore, limited proliferation of these cells in vitro has precluded definition of the relationship between type II cell proliferation and differentiation. Recent work in this laboratory has involved the correlation of flow cytometric cell cycle analysis with phenotype markers. Initial results indicate that isolation of type II cells induces cell cycle block similar to that sustained by other cell types in response to stress. In addition, preliminary evaluation of phenotype suggests that traditional markers become ambiguous beyond the 1st day of primary culture. These results raise concern related to the interpretation of experiments conducted in vitro. This report discusses the implications of these findings and directions for future work. alveolar epithelium; bromodeoxyuridine; cell cycle block; flow cytometry; lung injury
Time course of mechanical efficiency during afterloaded contractions in isolated cardiac muscle
Authors: Peterson Jon N. , Alpert Norman R. 
Published: December 2017

The time course of mechanical efficiency during working contractions in rabbit papillary muscle is presented. Efficiency is found to remain relatively constant during the working portion of the twitch, when the muscle is contracting against a constant load. As afterload was decreased, efficiency increased to 65 ± 11% (mean ± SE, n = 3) at 10% developed force at maximum length. This is in contrast to muscle work, which reached a peak of 3.0 ± 0.3 (n = 6) mJ/g at 50% developed force at maximum length. heart; initial heat; rabbit; working contractions
Energy-linked functional alterations in experimental cardiomyopathies
Authors: Kapelko V. I. , Veksler V. I. , Popovich M. I. , Ventura-Clapier R. 
Published: December 2017

Changes in high-energy phosphate content and cardiac contractile function of isolated rat hearts as well as changes in Ca2+ sensitivity and mitochondrial respiration of myocardial skinned fibers were assessed in hereditary cardiomyopathies and in cardiomyopathies induced by chronic treatment with adriamycin or norepinephrine, by autoimmunization, by diabetes, or by creatine deficiency. The sum of ATP and phosphocreatine contents as well as cardiac output at standard load conditions was substantially lower in almost all groups. The common features of cardiac pump failure were mild bradycardia, elevated left ventricular (LV) diastolic pressure, and stiffness that limited cardiac contractile adaptation to volume or resistance loads. The LV diastolic stiffness at maximal functional load was inversely correlated with high-energy phosphate content. Increased myofibrillar sensitivity to Ca2+ and defective function of mitochondrial creatine kinase were found in skinned myocardial fibers. These results suggested that both increased myofibrillar Ca2+ sensitivity and energy deficiency within myofibrils may contribute to increased myocardial stiffness. Increased stiffness limits LV filling but facilitates pressure development, which partly compensates for decreased contractility of cardiomyopathic hearts. cardiac contractile function; high-energy phosphates; isolated heart; myocardial stiffness