bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early enteral levetiracetam in diazepam‐resistant convulsive status epilepticus
Authors: Shibata Naoaki , Yonemitsu Takafumi , Ueda Kentaro , Tanaka Masaoh , Nakashima Tsuyoshi , Kawazoe Yu , Yamazoe Shinji , Iwasaki Yasuhiro , Kato Seiya 
Published: June 2016

AbstractBackgroundLevetiracetam is used intravenously as an emergent initial and urgent control therapy for acute convulsive status epilepticus. However, the efficacy of early enteral levetiracetam has not been confirmed in cases of benzodiazepine‐resistant convulsive status epilepticus.AimWe evaluated the efficacy and safety of levetiracetam administration through a nasogastric tube in acute convulsive status epilepticus resistant to intravenous diazepam.MethodsIn a single‐center prospective study, we assigned convulsive status epilepticus patients previously treated with intravenous diazepam (20 mg maximum) to either the terminated seizure group or continued seizures group. In both groups, the patient received 1500 or 3000 mg of levetiracetam enterally within 30 min after diazepam according to primary seizure cessation, and the daily enteral levetiracetam maintenance dose after admission was set to the same amount as the initial levetiracetam dose. The primary end‐point was the efficacy of enteral levetiracetam within 30 min after diazepam in the diazepam‐resistant group.ResultsIn eight of nine diazepam‐resistant patients (88.9%) and 11 of 12 (91.7%) diazepam‐responders, the seizures were controlled within 30 min after diazepam (P = 1.00), and the 3‐day seizure freedom rate was equivalent in the two groups (88.9 vs 83.3%, P = 1.00). Less than 10% of the overall patients had levetiracetam‐related mild side‐effects (no differences between the two groups).ConclusionsThroughout the 3‐day acute stage, early enteral levetiracetam just after intravenous diazepam is effective for both primary control of ongoing seizures and preventing seizure recurrence, even in diazepam‐resistant convulsive status epilepticus, without serious side‐effects.
Successful early treatment with intravenous immunoglobulin for seronegative myasthenia gravis with onset during pregnancy: A case report
Authors: Horiuchi Kazuhiro , Sato Chika , Odo Takashi , Houzen Hideki 
Published: June 2016

AbstractMyasthenia gravis is an autoimmune disorder predominantly affecting women of reproductive age; its course during pregnancy is unpredictable. Here we report a case of a 34‐year‐old woman who developed myasthenia gravis during pregnancy. At 18 weeks of pregnancy, she started experiencing general fatigue and weakness when working. After examination, we diagnosed her with seronegative myasthenia gravis. Treatment included pyridostigmine (60 mg/day), oral prednisolone (5 mg, alternate day), intravenous immunoglobulin (0.4 mg/kg/day, 5 days) and methylprednisolone pulse therapy (500 mg/day, 3 days); her clinical response was good.An uneventful vaginal delivery took place and the infant showed no signs of muscular weakness. Myasthenia gravis is a high‐risk disease, particularly when associated with pregnancy. We suggest that early treatment with intravenous immunoglobulin is safe and effective for myasthenia gravis with pregnancy.
Impact of informing donors of low ferritin results
Authors: Goldman Mindy , Uzicanin Samra , Scalia Jenna , Scalia Vito , O'Brien Sheila F. 
Published: June 2016

BACKGROUNDInforming donors of their ferritin status is one possible mitigating strategy to reduce iron deficiency in donors.STUDY DESIGN AND METHODSWe evaluated the impact of informing donors of their ferritin status on their donation frequency, understanding of iron needs, and actions to improve iron intake 2 years after their inclusion in a prospective observational cohort study.RESULTSInforming donors of low ferritin results decreased return rate in first‐time and repeat donors, and the median number of donations declined from three to two donations/year in returning donors with low ferritin on index donation compared to an increase from 1.5 to 2.5 donations/year in donors with normal ferritin. An electronic questionnaire demonstrated that approximately 60% of low ferritin donors saw their primary medical practitioner, and half of this group started iron. Qualitative interviews revealed suboptimal understanding of iron needs and poor compliance with iron supplementation.CONCLUSIONProviding donors with results of ferritin testing may reduce return rates and donation frequency in the 2 years after testing. Simply providing donors with ferritin results and an information sheet is often inadequate to improve donors' understanding of iron needs and may not lead to a substantive increase in iron intake over time.
Complete mitochondrial genomes throw light on budding speciation in three Biston species (Lepidoptera, Geometridae)
Authors: Cheng Rui , Xue Dayong , Galsworthy Anthony , Han Hongxiang 
Published: June 2016

Biston panterinaria, Biston thibetaria and Biston perclara are very closely related species in the genus Biston, judged on the basis of both morphological and molecular evidence. The distribution area and altitudes, and host plants of these three species also show both consistency and differences. However, the exact relationship between the three species is unclear. In this study, we used the ‘distance‐based method’, the ‘tree‐based method’ and Bayesian phylogenetics and phylogeography to elucidate the relationship between the three species. Phylogenetic trees based on mitogenomes, COI+CYTB+16S and three nuDNA genes were constructed. The results of the phylogenetic trees revealed that B. thibetaria and B. perclara were derived from B. panterinaria and render the latter paraphyletic. The budding process of speciation is therefore presumed to be the main factor causing a phylogenetic relationship of this pattern. A host shift from broad‐leaved plants living at low altitudes to gymnosperms living at relatively high altitudes provides evidence of budding speciation in these three species. The divergence time suggests that the budding speciation occurred at approximately 1.38 Ma, which is consistent with the Kunlun‐Yellow River Movement. Tectonic movements occurring around the Qinghai–Tibet Plateau may be the driver of the budding speciation.
SIS epidemiological model for adaptive RT: Forecasting the parotid glands shrinkage during tomotherapy treatment
Authors: Maffei Nicola , Guidi Gabriele , Vecchi Claudio , Ciarmatori Alberto , Gottardi Giovanni , Meduri Bruno , D'Angelo Elisa , Bruni Alessio , Mazzeo Ercole , Pratissoli Silvia , Giacobazzi Patrizia , Baldazzi Giuseppe , Lohr Frank , Costi Tiziana 
Published: June 2016

Purpose:A susceptible‐infected‐susceptible (SIS) epidemic model was applied to radiation therapy (RT) treatments to predict morphological variations in head and neck (H&N) anatomy.Methods:360 daily MVCT images of 12 H&N patients treated by tomotherapy were analyzed in this retrospective study. Deformable image registration (DIR) algorithms, mesh grids, and structure recontouring, implemented in the RayStation treatment planning system (TPS), were applied to assess the daily organ warping. The parotid's warping was evaluated using the epidemiological approach considering each vertex as a single subject and its deformed vector field (DVF) as an infection. Dedicated IronPython scripts were developed to export daily coordinates and displacements of the region of interest (ROI) from the TPS. matlab tools were implemented to simulate the SIS modeling. Finally, the fully trained model was applied to a new patient.Results:A QUASAR phantom was used to validate the model. The patients’ validation was obtained setting 0.4 cm of vertex displacement as threshold and splitting susceptible (S) and infectious (I) cases. The correlation between the epidemiological model and the parotids’ trend for further optimization of alpha and beta was carried out by Euclidean and dynamic time warping (DTW) distances. The best fit with experimental conditions across all patients (Euclidean distance of 4.09 ± 1.12 and DTW distance of 2.39 ± 0.66) was obtained setting the contact rate at 7.55 ± 0.69 and the recovery rate at 2.45 ± 0.26; birth rate was disregarded in this constant population.Conclusions:Combining an epidemiological model with adaptive RT (ART), the authors’ novel approach could support image‐guided radiation therapy (IGRT) to validate daily setup and to forecast anatomical variations. The SIS‐ART model developed could support clinical decisions in order to optimize timing of replanning achieving personalized treatments.
Low Utility of Pediatric Isolator Blood Culture System for Detection of Fungemia in Children: a 10-Year Review
Authors: Campigotto Aaron , Richardson Susan E. , Sebert Michael , McElvania TeKippe Erin , Chakravarty Aparna , Doern Christopher D. 
Published: June 2016

ABSTRACTThe use of the Wampole Isolator 1.5-ml pediatric blood culture tube for the detection of fungemia in children was assessed by a 10-year retrospective review at two pediatric hospitals, The Hospital for Sick Children in Toronto, Canada, and the Children's Medical Center of Dallas, Texas. Over this period, a total of 9,442 pediatric Isolator specimens were processed, with yeast or yeast-like organisms recovered in 297 (3.1%) of the specimens (151 [1.6%] unique clinical episodes) and filamentous or dimorphic fungi recovered in 31 (0.3%) of the specimens (25 unique clinical episodes). Only 18 of the 151 clinical episodes of fungemia attributable to yeast were not detected by automated blood culture systems. The majority of isolated yeast wereCandidaspp., which were usually detected by automated systems, whereas the most common non-Candidayeast wasMalassezia furfur, which the automated system failed to detect. Filamentous or dimorphic fungi were detected in 25 episodes, of which only 9 (36%) episodes were deemed clinically significant after chart review, indicating that in the majority of cases (16/25, 64%) fungal isolation represented contamination. In five of the nine clinically significant episodes, the isolated fungus (Histoplasma capsulatum,Coccidioides immitis/posadasii,Fusarium oxysporum,Aspergillusspp., andBipolarisspp.) was also identified in other clinical specimens. Over the 10-year study period, the use of the pediatric Isolator system, at the discretion of the treating physician, only rarely provided useful clinical information for the diagnosis of fungemia in children, with the exception ofM. furfurand possibly endemic mycoses.
Methicillin-Resistant Staphylococcus aureus Control in the 21st Century: Laboratory Involvement Affecting Disease Impact and Economic Benefit from Large Population Studies
Authors: Peterson Lance R. , Schora Donna M. 
Published: June 2016

ABSTRACT

Methicillin-resistant
Staphylococcus aureus
(MRSA) infection is a global health care problem. Large studies (e.g., >25,000 patients) show that active surveillance testing (AST) followed by contact precautions for positive patients is an effective approach for MRSA disease control. With this approach, the clinical laboratory will be asked to select what AST method(s) to use and to provide data monitoring outcomes of the infection prevention interventions. This minireview summarizes evidence for MRSA disease control, reviews the involvement of the laboratory, and provides examples of how to undertake a program cost analysis. Health care organizations with total MRSA clinical infections of >0.3/1,000 patient days or bloodstream infections of >0.03/1,000 patient days should implement a MRSA control plan.
Mitochondrial p53 Contributes to Reovirus-Induced Neuronal Apoptosis and Central Nervous System Injury in a Mouse Model of Viral Encephalitis
Authors: Zhuang Yonghua , Berens-Norman Heather M. , Leser J. Smith , Clarke Penny , Tyler Kenneth L. 
Published: June 2016

ABSTRACT

The tumor suppressor p53 plays a critical part in determining cell fate both as a regulator of the transcription of several proapoptotic genes and through its binding interactions with Bcl-2 family proteins at mitochondria. We now demonstrate that p53 protein levels are increased in infected brains during reovirus encephalitis. This increase occurs in the cytoplasm of reovirus-infected neurons and is associated with the activation of caspase 3. Increased levels of p53 in reovirus-infected brains are not associated with increased expression levels of p53 mRNA, suggesting that p53 regulation occurs at the protein level. Increased levels of p53 are also not associated with the increased expression levels of p53-regulated, proapoptotic genes. In contrast, upregulated p53 accumulates in mitochondria. Previous reports demonstrated that the binding of p53 to Bak at mitochondria causes Bak activation and results in apoptosis. We now show that Bak is activated and that activated Bak is bound to p53 during reovirus encephalitis. In addition, survival is enhanced in reovirus-infected Bak
−/−
mice compared to controls, demonstrating a role for Bak in reovirus pathogenesis. Inhibition of the mitochondrial translocation of p53 with pifithrin μ prevents the formation of p53/Bak complexes following reovirus infection of
ex vivo
brain slice cultures and results in decreased apoptosis and tissue injury. These results suggest that the mitochondrial localization of p53 regulates reovirus-induced pathogenesis in the central nervous system (CNS) through its interactions with Bak.

IMPORTANCE
There are virtually no specific treatments of proven efficacy for virus-induced neuroinvasive diseases. A better understanding of the pathogenesis of virus-induced CNS injury is crucial for the rational development of novel therapies. Our studies demonstrate that p53 is activated in the brain following reovirus infection and may provide a therapeutic target for virus-induced CNS disease.
Rapid variation in upper-mantle rheology across the San Andreas fault system and Salton Trough, southernmost California, USA
Authors: Barak Shahar , Klemperer Simon L. 
Published: June 2016

Abstract
We present new shear-wave splitting data showing systematic lateral variations in upper-mantle anisotropy across the plate boundary in southernmost California (USA). Beneath the Peninsular Ranges batholith, fast polarization directions parallel the direction of former Farallon subduction, suggestive of a slab remnant. Near the eastern edge of the batholith, across the Elsinore fault, fast polarization directions change rapidly to align with the direction of San Andreas fault shear. We infer that the Elsinore fault penetrates the entire lithosphere and may represent a future localization of the plate boundary that is migrating west from the San Andreas fault. Beneath the Salton Trough and the Chocolate Mountains region, large splitting times, despite a very thin lithosphere, imply vertical melt pockets in the uppermost mantle aligned in the shear direction. Largest splitting times, ∼1.2 s, are seen closest to the Sand Hills fault that projects southeast from the San Andreas fault. Further east, in the southern Basin and Range province, fast directions align with North America absolute plate motion.
Seismicity and sedimentation rate effects on submarine slope stability
Authors: ten Brink U.S. , Andrews B.D. , Miller N.C. 
Published: June 2016

Abstract
We explore the effects of earthquake frequency and sedimentation rate on submarine slope stability by extracting correlations between morphological and geological parameters in 10 continental margins. Slope stability increases with increasing frequency of earthquakes and decreasing sedimentation rate. This increase in stability is nonlinear (power law with b &lt; 0.5), accelerating with decreasing interseismic sediment accumulation. The correlation is interpreted as evidence for sediment densification and associated shear strength gain induced by repeated seismic shaking. Outliers to this correlation likely identify margins where tectonic activity leads to relatively rapid oversteepening of the slope.
Identifying and exploring factors influencing career choice, recruitment and retention of anaesthesia trainees in the UK
Authors: Moore J N , McDiarmid A J , Johnston P W , Cleland J A 
Published: June 2016

ABSTRACTBackgroundMany acute hospital specialties are experiencing low recruitment and high attrition of trainees. Understanding what is important to current trainees is critical in terms of identifying and addressing factors which adversely affect recruitment and retention.ObjectivesTo identify and explore factors involved in anaesthetic trainees’ career decision making.MethodsThis was a mixed methods study using a questionnaire survey (assessing how influential 18 different factors were when choosing anaesthetics, using a five-point Likert scale), supplemented by semi-structured interviews, carried out in August–December 2014, in Scotland, UK.Results42/68 (62%) completed responses were received, representing over half of all core (58%) and Acute Care Common Stem (65%) trainees across Scotland. Overall, questionnaire data indicated that the following were most important in career decision making: perceived job satisfaction among those already in the specialty, structured training, the nature of the work (practical, varied, immediate outcomes). Thirteen interviews were carried out. These highlighted that prior positive exposure and experience with anaesthetists encouraged trainees into the specialty. Enthusiastic, supportive colleagues and structured training (including clear milestones, regular teaching and feedback) were considered to enhance the quality of training. Sustainable working conditions, flexibility within programme and out-of-programme opportunities were valued. Respondents reported concerns about the impact of increasing service delivery demands on training quality.ConclusionsMany of the elements important to today’s anaesthetics trainees are related to positive learning and working environments. This fits with research findings from other professional groups. These findings can inform the development of programmes which cultivate trainee commitment to, and enthusiasm for, anaesthetics.
Interactions of established risk factors and a GWAS-based genetic risk score on the risk of venous thromboembolism
Authors: Crous-Bou Marta , Vivo Immaculata De , Camargo Carlos A. , Varraso Raphaëlle , Grodstein Francine , Jensen Majken K. , Kraft Peter , Goldhaber Samuel Z. , Lindström Sara , Kabrhel Christopher 
Published: June 2016

SummaryMultiple genetic and environmental risk factors contribute to venous thromboembolism (VTE) risk. Understanding how genes and environmental risk factors interact may provide key insight into the pathophysiology of VTE and may identify opportunities for targeted prevention and treatment. It was our aim to examine the main effects and the potential effect-modification between single nucleotide polymorphisms (SNPs) at established loci and lifestyle risk factors for VTE. We performed a nested case-control study using data on 1,040 incident VTE cases and 16,936 controls from the Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study cohorts, who gave blood, were selected as participants in a previous genome-wide association study (GWAS), and completed a biennial questionnaire at time of blood draw. We selected SNPs that were associated with VTE risk in previous GWAS studies. A genetic risk score (GRS) was constructed to evaluate the combined effect of the 16 SNPs that have reached genome-wide significance in previous GWAS of VTE. Interactions between SNPs and VTE risk factors (BMI and smoking) were also assessed. We found a significant association between our GRS and VTE risk. The risk of VTE among individuals in the highest GRS tertile was 2.02 times that of individuals in the lowest GRS tertile (p-trend = 9.69x10-19). The OR was 1.52 (p=1.03x10-8) for participants in the highest GRS tertile compared to those in the medium GRS tertile. However, while BMI and smoking were associated with VTE, and their effects were additive to each other we did not observe any significant multiplicative gene-environment interactions.Supplementary Material to this article is available online at www.thrombosis-online.com.
Standardized patient simulation versus didactic teaching alone for improving residents’ communication skills when discussing goals of care and resuscitation: A randomized controlled trial
Authors: Downar James , McNaughton Nancy , Abdelhalim Tarek , Wong Natalie , Lapointe-Shaw Lauren , Seccareccia Dori , Miller Kim , Dev Shelly , Ridley Julia , Lee Christie , Richardson Lisa , McDonald-Blumer Heather , Knickle Kerry 
Published: June 2016

Background: Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care. Objective: To determine whether standardized patient simulation offers benefit over didactic sessions alone for improving skill and comfort discussing goals of care. Design and intervention: Single-blind, randomized, controlled trial of didactic teaching plus standardized patient simulation versus didactic teaching alone. Participants: First-year internal medicine residents. Main measures: Changes in communication comfort and skill between baseline and 2 months post-training assessed using the Consultation and Relational Empathy measure. Key results: We enrolled 94 residents over a 2-year period. Both groups reported a significant improvement in comfort when discussing goals of care with patients. There was no difference in Consultation and Relational Empathy scores following the workshop ( p = 0.79). The intervention group showed a significant increase in Consultation and Relational Empathy scores post-workshop compared with pre-workshop (35.0 vs 31.7, respectively; p = 0.048), whereas there was no improvement in Consultation and Relational Empathy scores in the control group (35.6 vs 36.0; p = 0.4). However, when the results were adjusted for baseline differences in Consultation and Relational Empathy scores in a multivariable regression analysis, group assignment was not associated with an improvement in Consultation and Relational Empathy score. Improvement in comfort scores and perception of benefit were not associated with improvements in Consultation and Relational Empathy scores. Conclusion: Simulation training may improve communication skill and comfort more than didactic training alone, but there were important confounders in this study and further studies are needed to determine whether simulation is better than didactic training for this purpose.