bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of refractory seizures with phenobarbital, propofol, and medetomidine following congenital portosystemic shunt ligation in a dog
Authors: Heidenreich Dorothee C. , Giordano Paola , Kirby Barbara M. 
Published: December 2015

AbstractObjectiveTo report a case of refractory seizures following congenital portosystemic shunt (CPSS) ligation that regained normal neurologic and hepatic function with novel treatment. Medical care included constant rate infusions (CRI) of propofol and medetomidine in conjunction with phenobarbital and supportive intensive care.Case SummaryA 2‐year‐old neutered male Bichon Frise was diagnosed with a single extrahepatic CPSS based on typical clinical signs, laboratory data, abdominal ultrasound, and computed tomographic angiography. Following initiation of standard medical treatment, a complete surgical ligation of the CPSS was performed. Recovery was uneventful until postligation neurologic dysfunction developed 54 hours after surgery. Seizures were controlled with phenobarbital (6 mg/kg IM q 12 h) and propofol CRI (0.3–0.6 mg/kg/min). Attempts to wean the dog from the propofol CRI resulted in recurrence of seizure activity until the addition of medetomidine CRI (0.016 μg/kg/min) 76 hours after initiation of drug‐induced coma allowed gradual discontinuation of the propofol CRI. The dog regained full neurologic and hepatic function and had no further seizure activity apart from a small number of seizure episodes 5 and 22 months later. Adjustments in antiepileptic treatment resulted in no further neurologic dysfunction at 27‐month follow‐up.New or Unique Information ProvidedThis report highlights the potential benefit of medetomidine CRI for treatment of postattenuation refractory seizures, which to date have proven impossible to predict and difficult to treat with high mortality rates and persistent neurological deficits in surviving animals. Neuroprotective, drug‐sparing, and anti‐hypertensive features of medetomidine might improve outcome in postligation refractory seizures. Further investigation and clinical application of medetomidine CRI may improve outcome in this complication of CPSS attenuation.
Genetic Analysis Reveals the Essential Role of Nitrogen Phosphotransferase System Components in Sinorhizobium fredii CCBAU 45436 Symbioses with Soybean and Pigeonpea Plants
Authors: Li Yue Zhen , Wang Dan , Feng Xue Ying , Jiao Jian , Chen Wen Xin , Tian Chang Fu 
Published: December 2015

ABSTRACT

The nitrogen phosphotransferase system (PTS
Ntr
) consists of EI
Ntr
, NPr, and EIIA
Ntr
. The active phosphate moiety derived from phosphoenolpyruvate is transferred through EI
Ntr
and NPr to EIIA
Ntr
.
Sinorhizobium fredii
can establish a nitrogen-fixing symbiosis with the legume crops soybean (as determinate nodules) and pigeonpea (as indeterminate nodules). In this study,
S. fredii
strains with mutations in
ptsP
and
ptsO
(encoding EI
Ntr
and NPr, respectively) formed ineffective nodules on soybeans, while a strain with a
ptsN
mutation (encoding EIIA
Ntr
) was not defective in symbiosis with soybeans. Notable reductions in the numbers of bacteroids within each symbiosome and of poly-β-hydroxybutyrate granules in bacteroids were observed in nodules infected by the
ptsP
or
ptsO
mutant strains but not in those infected with the
ptsN
mutant strain. However, these defects of the
ptsP
and
ptsO
mutant strains were recovered in
ptsP ptsN
and
ptsO ptsN
double-mutant strains, implying a negative role of unphosphorylated EIIA
Ntr
in symbiosis. Moreover, the symbiotic defect of the
ptsP
mutant was also recovered by expressing EI
Ntr
with or without the GAF domain, indicating that the putative glutamine-sensing domain GAF is dispensable in symbiotic interactions. The critical role of PTS
Ntr
in symbiosis was also observed when related PTS
Ntr
mutant strains of
S. fredii
were inoculated on pigeonpea plants. Furthermore, nodule occupancy and carbon utilization tests suggested that multiple outputs could be derived from components of PTS
Ntr
in addition to the negative role of unphosphorylated EIIA
Ntr
.
Coexistence of Microaerophilic, Nitrate-Reducing, and Phototrophic Fe(II) Oxidizers and Fe(III) Reducers in Coastal Marine Sediment
Authors: Laufer Katja , Nordhoff Mark , Røy Hans , Schmidt Caroline , Behrens Sebastian , Jørgensen Bo Barker , Kappler Andreas 
Published: December 2015

ABSTRACT

Iron is abundant in sediments, where it can be biogeochemically cycled between its divalent and trivalent redox states. The neutrophilic microbiological Fe cycle involves Fe(III)-reducing and three different physiological groups of Fe(II)-oxidizing microorganisms, i.e., microaerophilic, anoxygenic phototrophic, and nitrate-reducing Fe(II) oxidizers. However, it is unknown whether all three groups coexist in one habitat and how they are spatially distributed in relation to gradients of O
2
, light, nitrate, and Fe(II). We examined two coastal marine sediments in Aarhus Bay, Denmark, by cultivation and most probable number (MPN) studies for Fe(II) oxidizers and Fe(III) reducers and by quantitative-PCR (qPCR) assays for microaerophilic Fe(II) oxidizers. Our results demonstrate the coexistence of all three metabolic types of Fe(II) oxidizers and Fe(III) reducers. In qPCR, microaerophilic Fe(II) oxidizers (
Zetaproteobacteria
) were present with up to 3.2 × 10
6
cells g dry sediment
−1
. In MPNs, nitrate-reducing Fe(II) oxidizers, anoxygenic phototrophic Fe(II) oxidizers, and Fe(III) reducers reached cell numbers of up to 3.5 × 10
4
, 3.1 × 10
2
, and 4.4 × 10
4
g dry sediment
−1
, respectively. O
2
and light penetrated only a few millimeters, but the depth distribution of the different iron metabolizers did not correlate with the profile of O
2
, Fe(II), or light. Instead, abundances were homogeneous within the upper 3 cm of the sediment, probably due to wave-induced sediment reworking and bioturbation. In microaerophilic Fe(II)-oxidizing enrichment cultures, strains belonging to the
Zetaproteobacteria
were identified. Photoferrotrophic enrichments contained strains related to
Chlorobium
and
Rhodobacter
; the nitrate-reducing Fe(II) enrichments contained strains related to
Hoeflea
and
Denitromonas
. This study shows the coexistence of all three types of Fe(II) oxidizers in two near-shore marine environments and the potential for competition and interrelationships between them.
Long-Term Relationships: the Complicated Interplay between the Host and the Developmental Stages of Toxoplasma gondii during Acute and Chronic Infections
Authors: Pittman Kelly J. , Knoll Laura J. 
Published: December 2015

SUMMARYToxoplasma gondiirepresents one of the most common parasitic infections in the world. The asexual cycle can occur within any warm-blooded animal, but the sexual cycle is restricted to the feline intestinal epithelium.T. gondiiis acquired through consumption of tissue cysts in undercooked meat as well as food and water contaminated with oocysts. Once ingested, it differentiates into a rapidly replicating asexual form and disseminates throughout the body during acute infection. After stimulation of the host immune response,T. gondiidifferentiates into a slow-growing, asexual cyst form that is the hallmark of chronic infection. One-third of the human population is chronically infected withT. gondiicysts, which can reactivate and are especially dangerous to individuals with reduced immune surveillance. Serious complications can also occur in healthy individuals if infected with certainT. gondiistrains or if infection is acquired congenitally. No drugs are available to clear the cyst form during the chronic stages of infection. This therapeutic gap is due in part to an incomplete understanding of both host and pathogen responses during the progression ofT. gondiiinfection. While many individual aspects ofT. gondiiinfection are well understood, viewing the interconnections between host and parasite during acute and chronic infection may lead to better approaches for future treatment. The aim of this review is to provide an overview of what is known and unknown about the complex relationship between the host and parasite during the progression ofT. gondiiinfection, with the ultimate goal of bridging these events.
Injuries at the Whistler Sliding Center: a 4-year retrospective study
Authors: Stuart C A , Richards D , Cripton P A 
Published: December 2015

BackgroundThe Whistler Sliding Centre (WSC) in British Columbia, Canada, has played host to many events including the 2010 Winter Olympics. This study was performed to better understand sliding sport incident (crash, coming off sled, etc) and injury prevalence and provide novel insights into the effect of slider experience and track-specific influences on injury risk and severity.MethodsTrack documentation and medical records over 4 years (2007 track inception to 2011) were used to form 3 databases, including over 43 200 runs (all sliding disciplines). Statistics were generated relating incident and injury to start location, crash location and slider experience as well as to understand injury characteristics.ResultsOverall injury rate was found to be 0.5%, with more severe injury occurring in <0.1% of the total number of runs. More frequent and severe injuries were observed at lower track locations. Of 2605 different sliders, 73.6% performed 1–29 runs down the track. Increased slider experience was generally found to reduce the frequency of injury. Lacerations, abrasions and contusions represented 52% of all injuries. A fatality represented the most severe injury on the track and was the result of track ejection.ConclusionsBy investigating the influence of start location, incident location and slider experience on incident and injury frequency and severity, a better understanding has been achieved of the inherent risks involved in sliding sports. Incident monitoring, with particular focus on track ejection, should be an emphasis of sliding tracks.
Investigation of the relationship between patient empowerment and glycaemic control in patients with type 2 diabetes: a cross-sectional analysis
Authors: Fitzgerald Maire , O'Tuathaigh Colm , Moran Joe 
Published: December 2015

ObjectiveTo determine whether there is an association between patient empowerment and diabetes management in terms of the primary outcomes of metabolic control as measured by glycaemic control (glycated haemoglobin, HbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC) and triglycerides.DesignRetrospective cross-sectional analysis conducted in 2012.SettingData from Diabetes Federation of Ireland from participants enrolled in the Community Orientated Diabetes Education (CODE) Programme.Participants569 patients diagnosed with type 2 diabetes.ExposuresPatient empowerment levels, as measured by the Diabetes Empowerment Scale-Short Form. Additional information collected included patients’ gender, age, body mass index (BMI), smoking status and number of years with diabetes.Outcome measuresHbA1c, HDL, LDL, TC and triglycerides values.ResultsPartial correlation analyses failed to show any statistically significant relationship between patient empowerment and glycaemic control or other diabetes management variables (HbA1c, p=0.32; HDL, p=0.95; LDL, p=0.77; TC, p=0.49; triglycerides, p=0.77). Logistic regression analysis confirmed that patient empowerment score was not a significant predictor of level of glycaemic control. Time since diagnosis of diabetes was associated with increased HbA1c levels. Age and gender were significant predictors of HDL and LDL levels, while gender and age were associated with changes in TC and triglycerides levels, respectively.ConclusionsNo significant association was found between patient empowerment levels and other measures of diabetes control in this study. Further research into the short-term and long-term outcomes of the empowerment model, at different levels of disease management, and across different settings, is required to evaluate its value in the management of patients with diabetes.
Higher incidence of rheumatoid arthritis in patients with symptomatic osteoarthritis or osteoarthritis-related surgery: a nationwide, population-based, case–control study in Taiwan
Authors: Lu Ming-Chi , Liu Keng-Chang , Lai Ning-Sheng , Koo Malcolm 
Published: December 2015

ObjectivesTo investigate the risk of incident rheumatoid arthritis in patients with symptomatic osteoarthritis or osteoarthritis-related surgery using a nationwide health claims database.DesignA nationwide, population-based, case–control study.SettingTaiwan's National Health Insurance Research Database.ParticipantsA total of 1147 patients (aged 20–100 years) with rheumatoid arthritis and 5735 controls who were frequency-matched for sex, 10-year age interval and year of catastrophic illness certificate application date (index year) were identified.Main outcome measureAll participants were retrospectively traced, up to 14 years prior to their index year, for diagnosis of osteoarthritis or osteoarthritis-related surgery. Multivariate logistic regression analyses were conducted to quantify the association between rheumatoid arthritis and osteoarthritis.ResultsThe risks of rheumatoid arthritis were significantly higher in patients with symptomatic osteoarthritis (adjusted OR=5.24, p<0.001) and osteoarthritis-related surgery (adjusted OR=2.27, p<0.001).ConclusionsThis large nationwide, population-based, case–control study showed a higher risk of rheumatoid arthritis in Taiwanese patients with symptomatic osteoarthritis. Our findings were consistent with the hypothesis that osteoarthritis might be a triggering factor of rheumatoid arthritis in environment-sensitised and genetically susceptible individuals.
Lung cancer treatment rates and the role of the lung cancer nurse specialist: a qualitative study
Authors: Tod Angela Mary , Redman Judy , McDonnell Ann , Borthwick Diana , White John 
Published: December 2015

ObjectivesThis qualitative study examines how the Lung Cancer Nurse Specialist (LCNS) role operates and why they may be able to increase access to treatment.Setting4 Hospital NHS Foundation Trusts in England.DesignA multiple case study design using semistructured interviews, observation and Framework Analysis techniques.ParticipantsFour LCNSs, comprised the ‘cases’. Twenty four clinicians who worked with the LCNS participated in individual interviews. Six LCNSs took part in a group interview and 60 lung cancer multidisciplinary team (MDT) members and co-ordinators were observed in the MDT meeting.ResultsThe LCNS is crucial within the MDT and can act as a catalyst to patient access to treatment. The study identified the clinical activity (assessment, managing symptoms, psychological support and information provision) and role characteristics that can facilitate treatment access. These characteristics are the LCNS's presence across the patient pathway, acting as the ‘hub’ of the MDT, maintaining a holistic patient focus and working to an advanced level of practice. The findings indicate how factors may have a cumulative impact on treatment access.ConclusionsIf UK patient with lung cancer survival rates are to improve in line with comparable countries, we need to employ every advantage. This study demonstrates how the LCNS role may open doors to positive patient outcomes, including treatment. Further research is required to explore patients’ experiences, decision-making and attitudes to treatment.
Is there a relationship between surgical case volume and mortality in congenital heart disease services? A rapid evidence review
Authors: Preston L , Turner J , Booth A , O'Keeffe C , Campbell F , Jesurasa A , Cooper K , Goyder E 
Published: December 2015

ObjectiveTo identify and synthesise the evidence on the relationship between surgical volume and patient outcomes for adults and children with congenital heart disease.DesignEvidence synthesis of interventional and observational studies.Data sourcesMEDLINE, EMBASE, CINAHL, Cochrane Library and Web of Science (2009–2014) and citation searching, reference lists and recommendations from stakeholders (2003–2014) were used to identify evidence.Study selectionQuantitative observational and interventional studies with information on volume of surgical procedures and patient outcomes were included.Results31 of the 34 papers identified (91.2%) included only paediatric patients. 25 (73.5%) investigated the relationship between volume and mortality, 7 (20.6%) mortality and other outcomes and 2 (5.9%) non-mortality outcomes only. 88.2% were from the US, 97% were multicentre studies and all were retrospective observational studies. 20 studies (58.8%) included all congenital heart disease conditions and 14 (41.2%) single conditions or procedures. No UK studies were identified. Most studies showed a relationship between volume and outcome but this relationship was not consistent. The relationship was stronger for single complex conditions or procedures. We found limited evidence about the impact of volume on non-mortality outcomes. A mixed picture emerged revealing a range of factors, in addition to volume, that influence outcome including condition severity, individual centre and surgeon effects and clinical advances over time.ConclusionsThe heterogeneity of findings from observational studies suggests that, while a relationship between volume and outcome exists, this is unlikely to be a simple, independent and directly causal relationship. The effect of volume on outcome relative to the effect of other, as yet undetermined, health system factors remains a complex and unresolved research question.
Adipose derived mesenchymal stem cell therapy in the treatment of isolated knee chondral lesions: design of a randomised controlled pilot study comparing arthroscopic microfracture versus arthroscopic microfracture combined with postoperative mesenchymal stem cell injections
Authors: Freitag Julien , Ford Jon , Bates Dan , Boyd Richard , Hahne Andrew , Wang Yuanyuan , Cicuttini Flavia , Huguenin Leesa , Norsworthy Cameron , Shah Kiran 
Published: December 2015

IntroductionThe management of intra-articular chondral defects in the knee remains a challenge. Inadequate healing in areas of weight bearing leads to impairment in load transmission and these defects predispose to later development of osteoarthritis. Surgical management of full thickness chondral defects include arthroscopic microfracture and when appropriate autologous chondrocyte implantation. This latter method however is technically challenging, and may not offer significant improvement over microfracture. Preclinical and limited clinical trials have indicated the capacity of mesenchymal stem cells to influence chondral repair. The aim of this paper is to describe the methodology of a pilot randomised controlled trial comparing arthroscopic microfracture alone for isolated knee chondral defects versus arthroscopic microfracture combined with postoperative autologous adipose derived mesenchymal stem cell injections.Methods and analysisA pilot single-centre randomised controlled trial is proposed. 40 participants aged 18–50 years, with isolated femoral condyle chondral defects and awaiting planned arthroscopic microfracture will be randomly allocated to a control group (receiving no additional treatment) or treatment group (receiving postoperative adipose derived mesenchymal stem cell treatment). Primary outcome measures will include MRI assessment of cartilage volume and defects and the Knee Injury and Osteoarthritis Outcome Score. Secondary outcomes will include further MRI assessment of bone marrow lesions, bone area and T2 cartilage mapping, a 0–10 Numerical Pain Rating Scale, a Global Impression of Change score and a treatment satisfaction scale. Adverse events and cointerventions will be recorded. Initial outcome follow-up for publication of results will be at 12 months. Further annual follow-up to assess long-term differences between the two group will occur.Ethics and disseminationThis trial has received prospective ethics approval through the Latrobe University Human Research Ethics Committee. Dissemination of outcome data is planned through both national and international conferences and formal publication in a peer-reviewed journal.Trial registration numberAustralia and New Zealand Clinical Trials Register (ANZCTR Trial ID: ACTRN12614000812695).
Support for infants and young people with sight loss: a qualitative study of sight impairment certification and referral to education and social care services
Authors: Boyce Tammy , Dahlmann-Noor Annegret , Bowman Richard , Keil Sue 
Published: December 2015

ObjectivesTo examine the experience of infants, children and their parents, the role of ophthalmologists and other health, social care and education professionals in the certification and registration processes and examine the relationship between certification and referrals and pathways to support.DesignQualitative study.SettingTelephone interviews with health and, social care professionals, qualified teachers of children and young people with vision impairment (QTVIs) and parents of infants/children in England.Participants52 health, social care and education professionals who are part of the certification or registration process. 26 parents of infants and children with vision impairment.ResultsReferrals to education do not require a Certificate of Vision Impairment (CVI); however, the majority of parents received support from education and social services only after an offer of the CVI, which was often dependent on having a formal diagnosis. Parents stated they wanted support sooner, particularly parents of children with additional complex needs who experienced longer delays. Areas with multidisciplinary teams and support roles such as eye clinic liaison officers (ECLOs) appeared to have more reliable referral pathways.ConclusionsFor infants and children with vision impairment, there should be a consistent mechanism for triggering education and social care support even with uncertainty about diagnosis and/or prognosis. All professionals involved in the certification and registration processes (ophthalmologists, optometrists, ECLOs, orthoptists, social workers, QTVIs) can better communicate the value and benefits of certification and registration.