bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of an emergency triage scale for obstetrics and gynaecology: a prospective study
Authors: Veit‐Rubin N , Brossard P , Gayet‐Ageron A , Montandon C‐Y , Simon J , Irion O , Rutschmann OT , Martinez de Tejada B 
Published: March 2017

ObjectiveTo evaluate the reliability of a four‐level triage scale for obstetrics and gynaecology emergencies and to explore the factors associated with an optimal triage.DesignThirty clinical vignettes presenting the most frequent indications for obstetrics and gynaecology emergency consultations were evaluated twice using a computerised simulator.SettingThe study was performed at the emergency unit of obstetrics and gynaecology at the Geneva University Hospitals.SampleThe vignettes were submitted to nurses and midwives.MethodsWe assessed inter‐ and intra‐rater reliability and agreement using a two‐way mixed‐effects intra‐class correlation (ICC). We also performed a generalised linear mixed model to evaluate factors associated triage correctness.Main outcome measuresTriage acuity.ResultsWe obtained a total of 1191 evaluations. Inter‐rater reliability was good (ICC 0.748; 95% CI 0.633–0.858) and intra‐rater reliability was almost perfect (ICC 0.812; 95% CI 0.726–0.889). We observed a wide variability: the mean number of questions varied from 6.9 to 18.9 across individuals and from 8.4 to 16.9 across vignettes. Triage acuity was underestimated in 12.4% of cases and overestimated in 9.3%. Undertriage occurred less frequently for gynaecology compared with obstetric vignettes [odds ratio (OR) 0.45; 95% CI 0.23–0.91; P = 0.035] and decreased with the number of questions asked (OR 0.94; 95% CI 0.88–0.99; P = 0.047). Certification in obstetrics and gynaecology emergencies was an independent factor for the avoidance of undertriage (OR 0.35; 95% CI 0.17–0.70; P = 0.003).ConclusionThe four‐level triage scale is a valid and reliable tool for the integrated emergency management of obstetrics and gynaecology patients.Tweetable abstractThe Swiss Emergency Triage Scale is a valid and reliable tool for obstetrics and gynaecology emergency triage.
The Longitudinal Association between Psychological Factors and Health Care Use
Authors: Bock Jens‐Oliver , Hajek André , König Hans‐Helmut 
Published: March 2017

ObjectiveLittle attention has been given to psychological factors as correlates of health care use, which could be an important key to manage it. We analyzed the association of psychological factors with health care use.Data SourcesPrimary data were obtained from three follow‐ups (2002, 2008, and 2011) of a large population‐based study with participants aged 40+.Study DesignUsing a longitudinal observational study, we analyzed the psychological factors of negative and positive affect (affective well‐being), life satisfaction (cognitive well‐being), self‐efficacy, loneliness, self‐esteem, optimism, and flexible goal adjustment using fixed‐effects regressions.Data CollectionThe participants provided data on health care use (visits to general practitioners [GPs] and specialists as well as hospitalization) and psychological factors via self‐administered questionnaires and personal interviews (7,116 observations). The sample was drawn using national probability sampling.Principal FindingsControlling for self‐rated health, chronic diseases and sociodemographics, increases in affective well‐being, and optimism decreased health care use of GPs, specialists, and hospital treatment. Increases in cognitive well‐being decreased health care use of GPs and specialists. Increases in self‐efficacy decreased hospitalization.ConclusionsThe study underlines the influence of psychological factors on health care use. Thus, whenever possible, future studies of health care use should include psychological factors, and efforts to reduce health care use might focus on such factors.
Variation in adult stress resistance does not explain vulnerability to climate change in copper butterflies
Authors: Klockmann Michael , Wallmeyer Leonard , Fischer Klaus 
Published: March 2017

AbstractOngoing climate change is a major threat to biodiversity. However, although many species clearly suffer from ongoing climate change, others benefit from it, for example, by showing range expansions. However, which specific features determine a species’ vulnerability to climate change? Phenotypic plasticity, which has been described as the first line of defence against environmental change, may be of utmost importance here. Against this background, we here compare plasticity in stress tolerance in 3 copper butterfly species, which differ arguably in their vulnerability to climate change. Specifically, we investigated heat, cold and desiccation resistance after acclimatization to different temperatures in the adult stage. We demonstrate that acclimation at a higher temperature increased heat but decreased cold tolerance and desiccation resistance. Contrary to our predictions, species did not show pronounced variation in stress resistance, though plastic capacities in temperature stress resistance did vary across species. Overall, our results seemed to reflect population—rather than species‐specific patterns. We conclude that the geographical origin of the populations used should be considered even in comparative studies. However, our results suggest that, in the 3 species studied here, vulnerability to climate change is not in the first place determined by stress resistance in the adult stage. As entomological studies focus all too often on adults only, we argue that more research effort should be dedicated to other developmental stages when trying to understand insect responses to environmental change.
Phenotypical analysis of ectoenzymes CD39/CD73 and adenosine receptor 2A in CD4+CD25highFoxp3+ regulatory T‐cells in psoriasis
Authors: Han Ling , Sugiyama Hideaki , Zhang Qi , Yan Kexiang , Fang Xu , McCormick Thomas S , Cooper Kevin D , Huang Qiong 
Published: March 2017

AbstractBackgroundCD39 and CD73 are two novel cell surface markers of CD25highFoxp3+ regulatory T‐cells (Tregs). Concordant expression of these two ectoenzymes not only discriminate Tregs from other cell populations, but also generates pericellular adenosine, which has been reported to suppress proliferation of activated T effector (Teff) cells. Because it is currently unclear whether human ectoenzymes (CD39/CD73) are involved in the impaired suppressive activity of Tregs in psoriasis, we examined the frequencies and phenotypes of CD39/CD73‐expressing Tregs and related receptor adenosine receptor 2A (A2AR) in peripheral blood of patients with different types of psoriasis.MethodsPeripheral blood mononuclear cells (PMBC) were prepared from patients with three different types of psoriasis (psoriasis vulgaris, pustular psoriasis and erythrodermic psoriasis). CD4+ cells were separated from PBMC by negative selection on midiMACS columns, and the frequencies and phenotypes of CD39 and CD73 expressing Tregs, and A2AR expressing Teff were all determined by flow cytometry analysis. Blood from healthy volunteers served as controls.ResultsThe expression of single CD73+ Tregs was markedly reduced (approximately 50%) in psoriasis vulgaris, compared to normal controls. In pustular psoriasis, the mean numbers of CD39+ Tregs and A2AR+ Teff was significantly lower than in normal controls. Among three different types of psoriasis, CD39 expression was strikingly reduced in the blood Treg population of pustular psoriasis patients. Decreased CD73+ Tregs levels were observed in psoriasis vulgaris compared to pustular psoriasis and erythrodermic psoriasis.ConclusionsThe differences in the expression of CD39− and CD73− Tregs may be a factor in the pathogenesis of psoriasis.
Characteristic features of cutaneous melanoma in a dermatology referral centre in Tehran, Iran
Authors: Kamyab Kambiz , Kazemi Sheyda , Azimi Pourya , Azizpour Arghavan , Ghandi Narges , Pirooz Elham , Noormohammadpour Pedram , Mirshams‐Shahshahani Mostafa , Daneshpazhooh Maryam 
Published: March 2017

AbstractBackground/ObjectivesThe characteristics of cutaneous melanoma in the Middle‐Eastern countries is poorly described. Therefore we conducted this study to determine the characteristics of melanoma in Iran.MethodsA retrospective, cross sectional study of melanoma patients seen at a tertiary referral centre, Iran, from May 2004 to October 2014. Clinical data included age and gender of the patients at the time of diagnosis, tumour location and tumour size. Histological characteristics included Breslow thickness, Clark level and subtype of tumour.ResultsA total of 450 cases of melanoma with a male/female ratio of 1.1:1 were reviewed. The mean age of patients was 57.5 years. The most frequent histological subtypes were acral lentiginous melanoma (30%) and lentigo maligna melanoma (29%). In 215 cases (49%) the tumour was located on the extremities. The second most common site was the face. Tumour invasion was mainly at Clark level III and IV. The mean Breslow thickness was 2.8 mm; 143 (38%) melanomas had a Breslow thickness less than 1 mm (T1) and 86 (23%) were more than 4 mm (T4).ConclusionThis study indicates that clinical and histological features of melanoma in Iranians (who are mainly of skin phototypes 3–4) are different from those observed in Western countries. Further cohort studies are required to evaluate the role of ethnic and environmental risk factors for melanoma in different populations.
Short‐term FSH treatment and sperm maturation: a prospective study in idiopathic infertile men
Authors: Casamonti E. , Vinci S. , Serra E. , Fino M. G. , Brilli S. , Lotti F. , Maggi M. , Coccia M. E. , Forti G. , Krausz C. 
Published: March 2017

SummaryThe standard FSH treatment is based on a 3 months period, after which both quantitative/qualitative improvement of sperm parameters and increased pregnancy rate were reported. In this prospective clinical trial, for the first time, we studied (i) Sperm hyaluronic acid binding capacity after highly purified FSH (hpFSH) treatment; (ii) the effect after short‐term and standard treatment on this functional parameter. As secondary objective, we analyzed three SNPs on FSHβ and FSHR genes to define their potential predictive value for responsiveness. From a total of 210 consecutive patients, 40 oligo‐ and/or astheno‐ and/or teratozoospermic patients fulfilled the inclusion criteria. Treatment consisted in hpFSH 75 IU/L every other day for 3 months. To avoid potential biases derived from the lack of placebo, we analyzed each patient after 4–6 months of ‘wash‐out’ period. After FSH treatment, we observed a statistically significant (p < 0.001) improvement of the percentage of hyaluronic acid bound spermatozoa from basal to T1 (after 1 month) and to T3 (after 3 months). Importantly, these values returned to near‐baseline value after the wash‐out. The same results were detected for total motile sperm count after 3 months with return to baseline after wash‐out. Forty‐two percent of patients responded to the therapy with increasing hyaluronic acid binding capacity above the double of the Intraindividual Variation (IV) while 24% of patients reached above the normal Sperm‐Hyaluronan Binding Assay (HBA) value. Further increase in ‘responders’ was observed at T3. The responsiveness to treatment resulted independent from FSHR/FSHβ polymorphisms. The significant positive effect on sperm maturity after 1 month opens novel therapeutic perspectives. In view of both the high cost and the relative invasiveness of treatment, the short protocol (1 month) could represent a viable FSH treatment option prior Assisted Reproductive Techniques since FSH, by acting on sperm maturation, increases the proportion of functionally competent cells.
Lactadherin is a candidate oviduct Lewis X trisaccharide receptor on porcine spermatozoa
Authors: Silva E. , Frost D. , Li L. , Bovin N. , Miller D. J. 
Published: March 2017

SummaryA recent study has demonstrated that porcine spermatozoa recognize with high affinity carbohydrate structures containing Lewis X motifs. Sperm adhesion to Lewis X is proposed to mediate sperm binding to the oviduct epithelium to form a reservoir. The objective of this study was to identify Lewis X‐binding proteins from porcine spermatozoa as candidate receptors for oviduct glycans. To identify low‐abundance proteins typically masked by proteins originating from seminal fluid, Lewis X candidate receptors were enriched from cauda epididymal boar spermatozoa. Plasma membrane preparations from cauda epididymal spermatozoa were subjected to RP‐HPLC and glycan blotting assays to isolate and detect proteins that bind Lewis X. Following bottom‐up LC‐MS/MS analysis, among the two bands that bound sulfated Lewis X, ADAM5, which spermatozoa, was confidently identified. ADAM family members have been established as contributors to sperm entry into the oviduct. A second sulfated Lewis X‐binding protein identified was the peripheral membrane protein lactadherin (also known as P47, SED1 and MFG‐E8 in different species). The interaction between Lewis X and lactadherin was functionally important because competitive inhibition by soluble recombinant lactadherin reduced sperm binding to the oviduct epithelium. Furthermore, far‐western blotting demonstrated that purified lactadherin could bind oviduct cells. In summary, these findings reveal that, in addition to the previously reported glycan affinity of accessory gland proteins that adhere to spermatozoa, multiple proteins intrinsic to spermatozoa have affinity for a specific oviduct glycan. Further, in addition to binding to the zona pellucida, lactadherin is now implicated in binding to oviduct glycans to promote formation of the sperm reservoir.
PRAS40 alleviates neurotoxic prion peptide‐induced apoptosis via mTOR‐AKT signaling
Authors: Yang Wei , Yang Li‐Feng , Song Zhi‐Qi , Shah Syed Zahid Ali , Cui Yong‐Yong , Li Chao‐Si , Zhao Hua‐Fen , Gao Hong‐Li , Zhou Xiang‐Mei , Zhao De‐Ming 
Published: March 2017

SummaryAimsThe proline‐rich Akt substrate of 40‐kDa (PRAS40) protein is a direct inhibitor of mTORC1 and an interactive linker between the Akt and mTOR pathways. The mammalian target of rapamycin (mTOR) is considered to be a central regulator of cell growth and metabolism. Several investigations have demonstrated that abnormal mTOR activity may contribute to the pathogenesis of several neurodegenerative disorders and lead to cognitive deficits.MethodsHere, we used the PrP peptide 106‐126 (PrP106‐126) in a cell model of prion diseases (also known as transmissible spongiform encephalopathies, TSEs) to investigate the mechanisms of mTOR‐mediated cell death in prion diseases.ResultsWe have shown that, upon stress caused by PrP106‐126, the mTOR pathway activates and contributes to cellular apoptosis. Moreover, we demonstrated that PRAS40 down‐regulates mTOR hyperactivity under stress conditions and alleviates neurotoxic prion peptide‐induced apoptosis. The effect of PRAS40 on apoptosis is likely due to an mTOR/Akt signaling.ConclusionPRAS40 inhibits mTORC1 hyperactivation and plays a key role in protecting cells against neurotoxic prion peptide‐induced apoptosis. Thus, PRAS40 is a potential therapeutic target for prion disease.
Association between fractional exhaled nitric oxide and clinical characteristics and outcomes in patients with subacute cough
Authors: Jiang Mingming , Liu Min , Wang Ying , Xu Lili , Bu Xiaoning , An Li , Zhang Hong , Huang Kewu 
Published: March 2017

AbstractObjectivesTo investigate the relationships between fractional exhaled nitric oxide (FENO) and clinical characteristics and outcomes in patients with subacute cough.MethodsPatients with subacute cough (n = 189) after upper respiratory tract infection were enrolled in this single‐center prospective study, and were divided into low‐FENO (<25 ppb) and high‐FENO groups (≥25 ppb). Empirical therapies (without inhaled or systemic corticosteroids) were prescribed based on clinical experience and follow‐up until the disease course reached 8 weeks. FENO values, cough symptom scores (CSS), and Leicester Cough Questionnaire (LCQ) scores were obtained, analyzed, and compared between two groups of patients.ResultsThe low‐FENO and high‐FENO groups comprised 136 and 53 patients, respectively. The multiple regression analysis showed that blood eosinophil count and gender were independent factors for elevated FENO (β = 1.38, 0.25, respectively). LCQ scores, total CSS, and daytime CSS were comparable between the low‐FENO and high‐FENO groups. The nighttime CSS of the high‐FENO group were significantly higher than that of the low‐FENO group (P = .03). The CSS and LCQ score were improved in both groups but were comparable between groups after 10 days treatment.ConclusionsPatients with subacute cough and high‐FENO levels have more severe nocturnal cough than those of patients with low‐FENO levels. However, FENO levels do not appear to correlate with the clinical outcomes or treatment response. The significance of FENO in the management of subacute cough needs to be further evaluated, at least in the current empirical treatment without corticosteroids.
Longitudinal alcohol consumption patterns and health‐related quality of life: Results from the National Epidemiologic Survey on Alcohol and Related Conditions
Authors: Imtiaz Sameer , Loheswaran Genane , Le Foll Bernard , Rehm Jürgen 
Published: March 2017

AbstractIntroduction and AimsGiven the limited nature of the evidence concerning longitudinal alcohol consumption patterns and health‐related quality of life (HrQoL), this study examined these associations.Design and MethodsData were from the National Epidemiologic Survey on Alcohol and Related Conditions (waves 1 and 2). Multiple linear regression was used to assess the associations between longitudinal alcohol consumption patterns (abstainers, no consumption change, decreased consumption, increased consumption, ceased consumption and initiated consumption) and HrQoL (Short‐Form 12‐Item Health Survey).ResultsIncreased consumption over follow up was related to non‐significant reductions in mental HrQoL for moderate and heavy drinkers at wave 1, whereas decreased consumption coincided with improvements in mental HrQoL for heavy drinkers at wave 1 (β for Mental Health Summary Scale and Mental Health Subscale: 0.84 and 0.91; P‐values significant for both scales). Similarly, initiation of consumption among lifetime abstainers at wave 1 was associated with reductions in mental HrQoL (β for Mental Health Summary Scale, Vitality Subscale, Social Functioning Subscale and Mental Health Subscale: −1.50, −1.89, −0.86 and −1.74; P‐values significant for all scales). On the other hand, cessation of consumption was accompanied by reductions in physical HrQoL (β for Physical Health Summary Scale, Physical Functioning Subscale, Role Physical Subscale, Bodily Pain Subscale and General Health Subscale: −1.29, −1.11, −1.35, −0.87 and −0.88; P‐values significant for all scales).Discussion and ConclusionsIncreased or decreased consumption were inversely associated with mental HrQoL, but decreased consumption was also associated with reductions in physical HrQoL. These findings were confirmed by the ceased consumption and initiated consumption patterns. [Imtiaz S, Loheswaran G, Le Foll B, Rehm J. Longitudinal alcohol consumption patterns and health‐related quality of life: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Rev 2018;37:48–55]
Sexual risk behavior, sexually transmitted infections, and HIV transmission risks in HIV‐positive men who have sex with men (MSM) – approaches for medical prevention
Authors: Esser Stefan , Krotzek Judith , Dirks Henrike , Scherbaum Norbert , Schadendorf Dirk 
Published: March 2017

SummaryBackgroundRising incidence rates of HIV and STIs (sexually transmitted infections) among MSM (men who have sex with men) in Germany since 2001 call for new approaches in medical prevention. The present study addresses appropriate parameters to identify those HIV‐positive MSM who are at high risk for transmitting HIV and STIs.Patients and methodsOver a two‐year period, 223 HIV‐positive MSM attending the HIV outpatient clinic at the University Medical Center Essen (Germany) were systematically surveyed with respect to their sexual behavior, substance abuse, and psychological well‐being in the preceding year. Data analyzed included laboratory and clinical data from the time of the initial HIV diagnosis until January 2014.ResultsIn HIV‐positive MSM, a history of substance abuse, promiscuity, younger age, and known STIs was associated with a greater incidence of unprotected sexual intercourse and STIs. Apart from a detectable viral load, additional HIV‐specific parameters associated with an increased HIV transmission risk included untreated HIV infection, adherence problems, changes in antiretroviral treatment over the preceding twelve months, known multiresistant HIV infection, and a higher CD 4 nadir. Despite routine quarterly monitoring of viral loads – the result thereof was communicated to patients – only 60 % of individuals assessed their HIV transmission risk correctly.ConclusionsIn HIV‐positive MSM, patient history and routine laboratory tests allow for the establishment of patient profiles that suggest sexual behavior associated with a high risk of HIV and STI transmission, thus offering new approaches for medical prevention.
An expert system model for mapping tropical wetlands and peatlands reveals South America as the largest contributor
Authors: Gumbricht Thomas , Roman‐Cuesta Rosa Maria , Verchot Louis , Herold Martin , Wittmann Florian , Householder Ethan , Herold Nadine , Murdiyarso Daniel 
Published: March 2017

AbstractWetlands are important providers of ecosystem services and key regulators of climate change. They positively contribute to global warming through their greenhouse gas emissions, and negatively through the accumulation of organic material in histosols, particularly in peatlands. Our understanding of wetlands’ services is currently constrained by limited knowledge on their distribution, extent, volume, interannual flood variability and disturbance levels. We present an expert system approach to estimate wetland and peatland areas, depths and volumes, which relies on three biophysical indices related to wetland and peat formation: (1) long‐term water supply exceeding atmospheric water demand; (2) annually or seasonally water‐logged soils; and (3) a geomorphological position where water is supplied and retained. Tropical and subtropical wetlands estimates reach 4.7 million km2 (Mkm2). In line with current understanding, the American continent is the major contributor (45%), and Brazil, with its Amazonian interfluvial region, contains the largest tropical wetland area (800,720 km2). Our model suggests, however, unprecedented extents and volumes of peatland in the tropics (1.7 Mkm2 and 7,268 (6,076–7,368) km3), which more than threefold current estimates. Unlike current understanding, our estimates suggest that South America and not Asia contributes the most to tropical peatland area and volume (ca. 44% for both) partly related to some yet unaccounted extended deep deposits but mainly to extended but shallow peat in the Amazon Basin. Brazil leads the peatland area and volume contribution. Asia hosts 38% of both tropical peat area and volume with Indonesia as the main regional contributor and still the holder of the deepest and most extended peat areas in the tropics. Africa hosts more peat than previously reported but climatic and topographic contexts leave it as the least peat‐forming continent. Our results suggest large biases in our current understanding of the distribution, area and volumes of tropical peat and their continental contributions.