bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe bleeding diatheses in an elderly patient with combined type autoantibody against factor XIII A subunit; novel approach to the diagnosis and classification of anti‐factor XIII antibodies
Authors: Kun M. , Szuber N. , Katona É. , Pénzes K. , Bonnefoy A. , Bécsi B. , Erdődi F. , Rivard G. E. , Muszbek L. 
Published: March 2017

IntroductionAcquired factor XIII (FXIII) deficiency due to autoantibody is a rare, severe bleeding diathesis. Its laboratory diagnosis and classification represents a difficult task.AimIntroduction of novel approaches into the diagnosis and characterization of anti‐FXIII autoantibody and demonstration of their use in the diagnosis of a patient with autoimmune FXIII deficiency.MethodsFactor XIII activity, FXIII antigen levels and the titre of anti‐FXIII‐A antibody were monitored throughout the course of the disease. FXIII activity was measured by ammonia release assay; FXIII‐A2B2 complex, total and free FXIII‐B concentrations were determined by ELISAs. The binding constant for the interaction of the autoantibody with recombinant FXIII‐A2 (rFXIII‐A2) and FXIII‐A2B2 was determined by surface plasmon resonance (SPR). The inhibitory capacity of IgG was expressed as the concentration exerting 50% inhibition of FXIII activation/activity (IC50). The truncation of FXIII‐A by thrombin was monitored by western blotting. The inhibition of Ca2+ ‐induced FXIII activation and active FXIII (FXIIIa) were assessed by FXIII activity assay.ResultsThe antibody bound to rFXIII‐A2 and FXIII‐A2B2 with high affinity and accelerated the decay of supplemented FXIII concentrate. An IC50 value of 170.1 μg IgG·mL−1 indicated effective FXIII neutralization. The main neutralizing effect of the autoantibody was the inhibition of FXIIIa. After 2 months, due to combined therapeutic modalities, the autoantibody disappeared and FXIII activity significantly elevated.ConclusionThe anti‐FXIII‐A autoantibody exerted a combined effect including inhibition of FXIIIa and acceleration of FXIII decay in the plasma. IC50 and binding constant determinations added important information to the characterization of the autoantibody.
Target plasma factor levels for personalized treatment in haemophilia: a Delphi consensus statement
Authors: Iorio A. , Iserman E. , Blanchette V. , Dolan G. , Escuriola Ettingshausen C. , Hermans C. , Negrier C. , Oldenburg J. , Reininger A. , Rodriguez‐Merchan C. , Spannagl M. , Valentino L. A. , Young G. , Steinitz‐Trost K. N. , Gringeri A. 
Published: March 2017

BackgroundProphylactic replacement with factor concentrate is the optimal treatment for persons with severe haemophilia to avoid or minimize bleeding. This ultimately prevents or reduces joint disease and improves life expectancy and quality of life towards values matching those in the normal population. However, uncertainty still exists around the optimal regimens to be prescribed for prophylaxis. An increasing number of treating physicians and patients are showing interest in patient‐tailored approaches to prophylaxis, which aim to harmonize the prophylaxis regimen with the patients’ bleeding phenotype, levels of physical activity and a variety of other variables.MethodsA modified Delphi technique was adopted to generate consensus. The expert panel met in person to set the objectives, be trained on the Delphi technique and agree on the desired level of consensus. Three iterations were used to identify the targets, the scenarios and their combinations.ResultsTwenty‐eight scenarios and eight target levels were identified and used to issue recommendations. The panel reached the desired level of consensus on positive or negative recommendations. Areas where consensus was not reached were identified and proposed as areas for future research. Prospective assessment of the validity of most of the proposed targets is recommended.ConclusionsWe have generated, by expert consensus, target plasma levels of factor concentrate to be used to tailor treatment for persons with haemophilia.
A prospective evaluation of levofloxacin‐based triple therapy for refractory Helicobacter pylori infection in Australia
Authors: Katelaris Peter H. , Katelaris Anthea L. 
Published: March 2017

AbstractBackgroundFirst‐line Helicobacter pylori eradication failure is a common and challenging problem.AimTo assess the efficacy of salvage levofloxacin‐based triple therapy in Australia.MethodsProspective patients referred after prior treatment failure(s) were prescribed esomeprazole 40 mg, amoxicillin 1 g and levofloxacin 500 mg each twice daily for 10 days. All patients received detailed written and verbal adherence support. Outcome assessment was by
13C‐urea breath test and/or histology and urease test.ResultsIn 150 consecutive, evaluable patients (66% female, mean age 54 ± 14 years; six smokers), the main indications for treatment were peptic ulcer disease (17%), increased gastric cancer risk (20%), symptoms (35%) and other risk reduction (28%). The median number of previous treatments was 2 (range 1–7). Eradication of H. pylori was achieved in 90% (intention to treat (ITT)) and 91% (per‐protocol (PP)) of patients. The eradication rate did not differ according to the type or number of prior treatments: 93% when ≤2 (n = 107) compared with 84% after three or more prior treatments (n = 43; P = 0.13) or with age, ethnicity or indication for treatment but it was higher in females (ITT 94 vs 82%, P = 0.04). Adherence was excellent (95%). No serious adverse effects were observed; mild adverse effects were reported in 11%. No primary levofloxacin resistance was observed in 20 concurrent cases.ConclusionThe efficacy and safety of this levofloxacin‐based triple therapy suggests it should be used as a salvage regimen in this region. Randomised comparative trials are unlikely to be done but these data compare favourably with local data for other salvage therapies.
Purebreeding of Red Maasai and crossbreeding with Dorper sheep in different environments in Kenya
Authors: Zonabend König E. , Strandberg E. , Ojango J.M.K. , Mirkena T. , Okeyo A.M. , Philipsson J. 
Published: March 2017

SummaryThe aim of this article was to study opportunities for improvement of the indigenous and threatened Red Maasai sheep (RM) in Kenya, by comparing purebreeding with crossbreeding with Dorper sheep (D) as a terminal breed, in two different environments (Env. A and a harsher Env. B), assuming different levels of genotype‐by‐environment interaction (G × E). Breeding goals differed between environments and breeds. Four scenarios of nucleus breeding schemes were stochastically simulated, with the nucleus in Env. A. Overall, results showed an increase in carcass weight produced per ewe by more than 10% over 15 years. Genetic gain in carcass weight was 0.17 genetic SD/year (0.2 kg/year) across scenarios for RM in the less harsh Env. A. For survival and milk yield, the gain was lower (0.04–0.05 genetic SD/year). With stronger G × E, the gain in the commercial tier for RM in the harsher Env. B became increasingly lower. Selection of females also within the commercial tier gave slightly higher genetic gain. The scenario with purebreeding of RM and a subnucleus in Env. B gave the highest total income and quantity of meat. However, quantity of meat in Env. A increased slightly from having crossbreeding with D, whereas that in Env. B decreased. A simple and well‐designed nucleus breeding programme would increase the genetic potential of RM. Crossbreeding of RM with D is not recommended for harsh environmental conditions due to the large breed differences expected in that environment.
Association between diabetes mellitus/hyperglycaemia and peri‐implant diseases: Systematic review and meta‐analysis
Authors: Monje Alberto , Catena Andres , Borgnakke Wenche S. 
Published: March 2017

AbstractAimThis systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri‐implant diseases (peri‐implant mucositis and peri‐implantitis).Materials and MethodsElectronic and manual literature searching was conducted. An a priori case definition for peri‐implantitis was used as an inclusion criterion to minimize risk of bias. The Newcastle‐Ottawa Scale was used for quality assessment; random effect models were applied; and results were reported according to the PRISMA Statement.ResultsTwelve studies were eligible for qualitative and seven of them for quantitative analyses. Meta‐analyses detected the risk of peri‐implantitis was about 50% higher in diabetes than in non‐diabetes (RR = 1.46; 95% CI: 1.21–1.77 and OR = 1.89; 95% CI: 1.31–2.46; z = 5.98; p < .001). Importantly, among non‐smokers, those with hyperglycaemia had 3.39‐fold higher risk for peri‐implantitis compared with normoglycaemia (95% CI: 1.06–10.81). Conversely, the association between diabetes and peri‐implant mucositis was not statistically significant (RR = 0.92; 95% CI: 0.72–1.16 and OR = 1.06; 95% CI: 0.84–1.27; z = 1.06, p = .29).ConclusionsWithin its limits that demand great caution when interpreting its findings, this systematic review suggests that diabetes mellitus/hyperglycaemia is associated with greater risk of peri‐implantitis, independently of smoking, but not with peri‐implant mucositis.
Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment
Authors: Graetz Christian , Sälzer Sonja , Plaumann Anna , Schlattmann Peter , Kahl Maren , Springer Claudia , Dörfer Christof , Schwendicke Falk 
Published: March 2017

AbstractAimThis retrospective longitudinal study assessed the risk of and prognostic factors for tooth loss in patients with generalized aggressive periodontitis (GAgP) after periodontal treatment in a university setting.MethodsFifty‐seven patients (1,505 teeth) were examined before (T0) and after active periodontal therapy (APT, T1) as well as after 17.4 ± 4.8 [range: 9–28] years of supportive periodontal therapy (SPT, T2). Descriptive statistics and a Cox‐proportional‐hazards shared‐frailty model were applied.ResultsOverall, 98 and 134 teeth were lost during APT and SPT, respectively, with 0.14 ± 0.18 teeth being lost per patient and year. During SPT, three patients (5%) lost ≥10 teeth, 14 (25%) lost 4–9 teeth, 40 lost 0–3 (70%) teeth, respectively. One‐third (n = 19) of all patients lost no teeth. Mean PPD of the teeth surviving SPT was stable from T1 (3.5 ± 1.1 mm) to T2 (3.4 ± 1.1 mm). Nearly, 84% of all survived teeth showed stable or improved bone level at T2. Risk of tooth loss was significantly increased in active smokers (HR[95% CI]: 4.94[1.91/12.75]), the upper dental arch (1.94[1,16/3.25]), with each mm of residual PPD (1.41[1.29/1.53]), teeth with furcation involvement (FI) (HR 4.00–4.44 for different degrees) and mobility (5.39 [2.06/14.1] for degree III).ConclusionWithin the provided conservative treatment regimen, GAgP patients lost only few teeth.
A survey of clinicians regarding respiratory physiotherapy intervention for intubated and mechanically ventilated patients with community‐acquired pneumonia. What is current practice in Australian ICUs?
Authors: van der Lee Lisa , Hill Anne‐Marie , Patman Shane 
Published: March 2017

AbstractRationale, aims, and objectivesCommunity‐acquired pneumonia (CAP) is a common cause for intensive care unit (ICU) admission resulting in high morbidity and mortality. There is a paucity of evidence regarding respiratory physiotherapy for intubated and mechanically ventilated patients with CAP, and anecdotally clinical practice is variable in this cohort. The aims of this study were to identify the degree of variability in physiotherapy practice for intubated adult patients with CAP and to explore ICU physiotherapist perceptions of current practice for this cohort and factors that influence physiotherapy treatment mode, duration, and frequency.MethodA survey was developed based on common aspects of assessment, clinical rationale, and intervention for intubated and mechanically ventilated patients. Senior ICU physiotherapists across 88 Australian public and private hospitals were recruited.ResultsThe response rate was 72%. Respondents (n = 75) stated their main rationale for providing a respiratory intervention were improved airway clearance (98%, n = 60/61), alveolar recruitment (74%, n = 45/61), and gas exchange (33%, n = 20/61). Respondents estimated that average intervention lasted between 16 and 30 minutes (70% of respondents, n = 41/59) and would be delivered once (44%) or twice (44%) daily. Results indicated large variability in reported practice; however, trends existed regarding positioning in alternate side‐lying (81%, n = 52/64) or affected lung uppermost (83%, n = 53/64) and use of hyperinflation techniques (81%, 52/64). Decisions regarding duration were reported to be based on sputum volume (95%), viscosity (93%) and purulence (88%), cough effectiveness (95%), chest X‐ray (87%), and auscultation (84%). Sixty percent reported that workload and staffing affected intervention duration and frequency. Intervention time was more likely increased when there was greater staffing (P = .03).ConclusionRespiratory physiotherapy treatment varies for intubated patients with CAP. Further research is required to determine what is considered best practice for this patient population.
Restraint Use in Older Adults Receiving Home Care
Authors: Scheepmans Kristien , Dierckx de Casterlé Bernadette , Paquay Louis , Van Gansbeke Hendrik , Milisen Koen 
Published: March 2017

ObjectivesTo determine the prevalence, types, frequency, and duration of restraint use in older adults receiving home nursing care and to determine factors involved in the decision‐making process for restraint use and application.DesignCross‐sectional survey of restraint use in older adults receiving home care completed by primary care nurses.SettingHomes of older adults receiving care from a home nursing organization in Belgium.ParticipantsRandomized sample of older adults receiving home care (N = 6,397; mean age 80.6; 66.8% female).MeasurementsFor each participant, nurses completed an investigator‐constructed and ‐validated questionnaire collecting information demographic, clinical, and behavioral characteristics and aspects of restraint use. A broad definition of restraint was used that includes a range of restrictive actions.ResultsRestraints were used in 24.7% of the participants, mostly on a daily basis (85%) and often for a long period (54.5%, 24 h/d). The most common reason for restraint use was safety (50.2%). Other reasons were that the individual wanted to remain at home longer, which necessitated the use of restraints (18.2%) and to provide respite for the informal caregiver (8.6%). The latter played an important role in the decision and application process. The physician was less involved in the process. In 64.5% of cases, there was no evaluation after restraint use was initiated.ConclusionUse of restraints is common in older adults receiving home care nursing in Belgium. These results contribute to a better understanding of the complexity of use of restraints in home care, a situation that may be even more complex than in nursing homes and acute hospital settings.
RS9, a novel Nrf2 activator, attenuates light‐induced death of cells of photoreceptor cells and Müller glia cells
Authors: Inoue Yuki , Shimazawa Masamitsu , Noda Yasuhiro , Nagano Ryota , Otsuka Tomohiro , Kuse Yoshiki , Nakano Yukimichi , Tsuruma Kazuhiro , Nakagami Yasuhiro , Hara Hideaki 
Published: March 2017

AbstractThe retina is highly sensitive to oxidative stress because of its high consumption of oxygen associated with the phototransductional processes. Recent findings have suggested that oxidative stress is involved in the pathology of age‐related macular degeneration, a progressive degeneration of the central retina. A well‐known environmental risk factor is light exposure, as excessive and continuous light exposure can damage photoreceptors. Nuclear factor‐erythroid 2‐related factor 2 (Nrf2) is a transcriptional factor that controls antioxidative responses and phase 2 enzymes. Thus, we hypothesized that RS9, a specific activator of Nrf2, decreases light‐induced retinal cell death in vivo and in vitro. Nrf2 was detected in the nucleus of the 661W cells exposed to RS9 and also after light exposure, and the Nrf2‐antioxidant response element binding was increased in 661W cells after exposure to RS9. Consequentially, the expression of the phase 2 enzyme's mRNAs of Ho‐1, Nqo‐1, and Gclm genes was increased in 661W cells after exposure to RS9. Furthermore, RS9 decreased the light‐induced death of 661W cells (2500 lux, 24 h), and also reduced the functional damages and the histological degeneration of the nuclei in the outer nuclear layer or the retina in the in vivo studies (8000 lux, 3 h). Heme oxygenase‐1 was increased after light exposure, and Nrf2 was translocated into the nucleus after light exposure in vivo. Silencing of Ho‐1 reduced the protective effects of RS9 against light‐induced death of 661W cells. These findings indicate that RS9 has therapeutic potential for retinal diseases that are aggravated by light exposure.
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Association between serum and oral matrix metalloproteinase‐8 levels and periodontal health status
Authors: Noack B. , Kipping T. , Tervahartiala T. , Sorsa T. , Hoffmann T. , Lorenz K. 
Published: March 2017

Background and ObjectiveMatrix metalloproteinase‐8 (MMP‐8) is involved in a wide range of pathologies including periodontitis and cardiovascular diseases (CVD). The association between periodontitis and CVD has been repeatedly recognized. The aim of the study was to analyze to what extent circulating active MMP‐8 (aMMP‐8) is associated with periodontal disease status and oral fluid aMMP‐8 levels in otherwise healthy subjects.Material and MethodsIn a cross‐sectional study, aMMP‐8 was measured in serum of 59 volunteers, comprising 19 periodontally healthy subjects, 20 patients with gingivitis as well as 20 with periodontitis. All study subjects were characterized regarding aMMP‐8 concentrations in different oral fluids as well as clinically and microbiologically with respect to periodontal disease. aMMP‐8 levels in gingival crevicular fluid were measured using the enzyme‐linked immunosorbent assay. Saliva enzyme levels as well as circulating aMMP‐8 were determined by a time‐resolved immunofluorometric assay. Both methods utilized the same monoclonal antibodies. Correlation and regression analyses were performed to study the potential association between serum aMMP‐8 and oral parameters.ResultsOral aMMP‐8 levels were significantly higher in patients with periodontitis compared to periodontally healthy or gingivitis subjects. Highest serum aMMP‐8 concentration was also found in the periodontitis group. The serum levels correlated significantly with oral aMMP‐8 as well as with clinical parameters in a dose‐dependent manner. These results were confirmed in a multivariate regression analysis. After adjusting for potential confounders, saliva aMMP‐8 concentrations as well as periodontitis severity were significant predictors of serum aMMP‐8.ConclusionThe associations between circulating aMMP‐8 and oral aMMP‐8 as well as periodontal findings in a dose‐dependent manner may contribute to linking periodontal disease with increased CVDsusceptibility.
Biodegradable gelatin/beta‐tricalcium phosphate sponges incorporating recombinant human fibroblast growth factor‐2 for treatment of recession‐type defects: A split‐mouth study in dogs
Authors: Shujaa Addin A. , Akizuki T. , Hoshi S. , Matsuura T. , Ikawa T. , Fukuba S. , Matsui M. , Tabata Y. , Izumi Y. 
Published: March 2017

Background and ObjectiveTissue engineering by using recombinant human (rh) growth factor technology may offer a promising therapeutic approach for treatment of gingival recession. Fibroblast growth factor‐2 (FGF‐2) has shown the ability to promote periodontal regeneration. Gelatin/beta‐tricalcium phosphate (gelatin/β‐TCP) sponges have been developed to control the release of growth factors. The present study evaluated the periodontal regenerative efficacy of rhFGF‐2 by comparing gelatin/β‐TCP sponges incorporated with rhFGF‐2 to the scaffolds alone in artificially created recession‐type defects in dogs.Material and methodsCritically sized buccal gingival recession defects were surgically created on maxillary canine teeth of five dogs. In each animal, defects were randomized to receive either a gelatin/β‐TCP sponge soaked with rhFGF‐2 (gelatin/β‐TCP/rhFGF‐2) or phosphate‐buffered saline (gelatin/β‐TCP). Eight weeks after surgery, biopsy specimens were obtained and subjected to microcomputed tomography and histological analyses.ResultsComplete root coverage was achieved in both groups. Microcomputed tomography revealed significantly greater new bone volume in the gelatin/β‐TCP/rhFGF‐2 group. Histologically, both groups achieved periodontal regeneration; however, gelatin/β‐TCP/rhFGF‐2 sites exhibited more tissue regeneration, characterized by significantly larger amounts of new cementum and new bone. Gelatin/β‐TCP sites featured increased long junctional epithelium and connective tissue attachment. In the gelatin/β‐TCP/rhFGF‐2 sites, new bone exhibited many haversian canals and circumferential lamellae as well as remarkably thick periosteum with blood vascularization and hypercellularity.ConclusionWithin the limitations of this study, rhFGF‐2 in gelatin/β‐TCP sponges exhibits an increased potential to support periodontal wound healing/regeneration in canine recession‐type defects.
Treatment with direct‐acting antiviral agents of hepatitis C virus infection in injecting drug users: A prospective study
Authors: Boglione L. , Mornese Pinna S. , De Nicolò A. , Cusato J. , Cariti G. , Di Perri G. , D'Avolio A. 
Published: March 2017

SummaryIn this prospective study, we evaluated the effectiveness and tolerability of novel therapies against hepatitis C virus (HCV) in a cohort of PWID enrolled at our centre from April 2015 to July 2016. In this analysis, a total of 174 patients were included: eleven (6.3%) were treated with pegylated interferon (PEG‐IFN) and ribavirin (RBV) containing regimens, 163 (93.7%) with IFN‐free treatments. RBV has been used in 70 patients (40.2%); 59 (33.9%) patients were in opioid substitution therapy (OST) with methadone or buprenorphine. Overall, sustained virological response (SVR) has been observed in 162 subject (93.1%), breakthrough (BT) in three (1.7%), relapse in one (0.6%) and dropout in eight (4.6%). Treatment was interrupted for clinical conditions in seven patients: six (3.4%) had hepatic decompensation and one died for hepatocellular carcinoma (HCC). In multivariate analysis, predictive factors of treatment failure were as follows: albumin level below 3 g/dL (OR=7.190; 95% IC=1.236‐41.837; P<.001), MELD score >10 (OR=5.886; 95% IC=1.411‐35.994; P<.001) and years of HCV infection >20 (OR=1.286; 95% IC=0.556‐9.455; P=.016). In conclusion, treatment with DAAs was effective and well tolerated in PWID; cirrhotic subjects with MELD > 10 and albumin low level showed a higher risk of developing serious adverse events and treatment failure.
Can genomic data alone tell us whether speciation happened with gene flow?
Authors: Yang Ming , He Ziwen , Shi Suhua , Wu Chung‐I 
Published: March 2017

AbstractThe allopatric model, which requires a period of geographical isolation for speciation to complete, has been the standard model in the modern era. Recently, “speciation with gene flow” has been widely discussed in relation to the model of “strict allopatry” and the level of DNA divergence across genomic regions. We wish to caution that genomic data by themselves may only permit the rejection of the simplest form of allopatry. Even a slightly more complex and realistic model that starts with subdivided populations would be impossible to reject by the genomic data alone. To resolve this central issue of speciation, other forms of observations such as the sequencing of reproductive isolation genes or the identification of geographical barrier(s) will be necessary.