bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does your pig go ‘knor’? Medical students’ skills in using animal sounds as a cross‐cultural paediatric engagement tool
Authors: Cornwall Jon , Roy Melyssa 
Published: November 2016

AbstractThe development of verbal communication skills is an important aspect of medical education as accurate assessment in part relies on effectively obtaining information from patients. When assessing children of different cultural or ethnic backgrounds, young medics may find effective verbal communication difficult because they lack understanding about what children are really like. Animal noises are a likely tool with which to successfully engage with young children. However, these differ by culture and it is unclear whether young New Zealand medical students will be adept at effectively engaging and communicating with foreign children via this mode of communication. We therefore assessed whether medical students in our country were able to accurately reproduce animal noises from different cultures. Six current medical students from New Zealand (with English as their first language) were assessed on their ability to reproduce animal noises from three different foreign languages: Dutch, Arabic and Danish. The animals selected were duck, cow, dog, frog, pig and sheep. Students were played recordings of the foreign‐language animal noises, and were then rated on a scale of 1–5 (1 = poor, 5 = outstanding) on their ability to reproduce the noise. Arabic animal noises were reproduced more convincingly than those in the other languages (mean score: 3.8), of which animal noises in Danish were worst (mean score: 3.1). Perhaps unsurprisingly, sheep noises were reproduced best (mean score: 4.7), whereas pig noises were the least convincing (mean score: 2.2). Findings indicate that New Zealand medical students are likely to be better than average at reproducing animal noises in the languages examined, and are perhaps socially and genetically predisposed to replicating sheep noises successfully. They are therefore likely to make good paediatric registrars and fabulous au pairs. The study highlights the more serious issues of multicultural understanding and tolerance of other cultures, and provides a novel paediatric engagement tool for those young medics who do not really ‘get’ children.
Is the long case dead? ‘Uh, I don't think so’: the Uh/Um Index
Authors: Duvivier Robbert , Veysey Martin 
Published: November 2016

AbstractCurrent tools for clinical assessment are tedious and time‐consuming, particularly the dreadful long case. There is a need for novel instruments that incorporate other aspects of competence. We propose such a method, namely the Uh/Um Index. Our innovation paper describes the rationale for using speech dysfluency and occurrences of filler words such as ‘uh’ and ‘um’ as a proxy for competence. This appears to have won initial support from senior clinicians in our institution. Additional research is needed (non‐restricted grants are welcomed) to establish rigorous standard setting and to fund our attendance at overseas conferences to make the Uh/Um Index the new buzzword in medical education.
The Cross‐Canada Quintet presents variations on music: movements in the keys of H, P and E
Authors: Schrewe Brett , Bates Joanna , Watling Christopher , Ellaway Rachel H , Pratt Dan 
Published: November 2016

AbstractWhether it is rock playing in the background during a surgery, cool jazz that wafts from our office computer speakers as we write up our clinical notes, or the soaring of a symphony on the radio that inspires that perfect flourish to an article, music is woven throughout much of our clinical and academic lives. For the five of us, however, music alternates between the background and foreground in our lives as health professions educators. Music balances the working day, illuminates our research, and reconciles the utility of our training with the originality of our practice. We invite you to discover the interplays, dissonances and harmonies inspired by and reflected in this leitmotif. Pull up a chair, sit back, put on one of your own favourite pieces and explore these ideas as we riff and rhapsodise on variations on this theme.
Learning the hard way: 10 lessons for developing undergraduate curricula
Authors: Jacob Hannah , Fertleman Caroline R 
Published: November 2016

AbstractThe present study outlines key learning points derived from 2 years spent developing a national undergraduate curriculum for child health. Findings are sourced from analyses of a series of semi‐structured musings by beleaguered educationalists and may serve to reassure others engaged in developing undergraduate curricula that it is possible to survive the process and even to produce something quite good. The authors’ best advice is to do it, but don't say we didn't warn you.
And you try and tell the medical students of today that… and they won't believe ya
Authors: Harris Benjamin H L , Wilson David J 
Published: November 2016

AbstractOlder clinicians typically engage in reflections on their own early careers and indeed whichever generation of clinician you talk to, their medical school and early career experiences were more challenging than the last. We draw on inspiration from Monty Python and specifically the Four Yorkshiremen to illustrate this point. However, as we strive to lay the foundations of learning that avoids the adage ‘whatever doesn't kill you, makes you stronger’, we must remember that medics are competitive… even at complaining.
What's in a name? Word inflation, punctuation, abbreviation and cloud formation
Authors: Schofield Susie J , Schofield Pieta G 
Published: November 2016

AbstractThe title of a journal paper offers a crucial portal into any scientific field. It determines whether interested readers locate the paper and whether others have enough interest sparked to lead them to read the abstract. This article looks at authored journal paper titles in Medical Education over its first 50 years (n = 6357) of publication and Medical Teacher over its first 35 years of publication, revealing both trends in areas of interest and how those interests are worded. Word clouds per decade showed a shift from teaching to learning and from examination to assessment, and new foci on learning, patients, research and feedback in both journals. The average length of title in Medical Education peeked in the 2000s, dropping to 70 characters in the 2010s, with no titles being longer than 140 characters (the length of a tweet) in this last decade. Abbreviations were used sparingly. The use of humorous titles, although not common, has increased in recent years. The use of the colon showed a marked increase in the 1980s, dropping a little in the 2000s but resurging in the 2010s. Titles posed as a question increased steadily, appearing to plateau in the 2000s at 11%. The use of humour and questions suggests that the authors of these articles are submitting papers to be selected by the human rather than just the virtual eye. We also hypothesise that the use of humour may indicate a maturation of medical education as a subject.
Validation of a screening questionnaire for X‐linked dystonia parkinsonism: The first phase of the population‐based prevalence study of X‐linked dystonia parkinsonism in Panay
Authors: Diestro Jose Danilo B , Pasco Paul Matthew D , Lee Lillian V ,   the XDP Study Group of the Philippine Children's Medical Center
Published: November 2016

AbstractBackgroundThe current prevalence of X‐linked dystonia parkinsonism is not known. No screening tool for the condition exists. By developing a screening questionnaire, the present study is intended to be the first step in identifying the prevalence of the disease.AimTo develop and validate a simple, easy to use, community‐based, screening questionnaire for the diagnosis of X‐linked dystonia parkinsonism.MethodsCommunity health workers administered an 11‐item yes/no questionnaire in the native Panay island language to 54 genetically‐confirmed X‐linked dystonia parkinsonism patients and 54 healthy controls from the island of Panay. The questionnaire is made up of elements from existing questionnaires on Parkinson's disease and dystonia, and known clinical features of the disease. The participants were partitioned into training (n = 88) and test (n = 20) datasets. To select which items were predictive of X‐linked dystonia parkinsonism, the Clinical Utility Index of each item was determined. Afterwards, multivariable binary logistic regression was done to build a predictive model that was run on the test dataset.ResultsFour items on “sustained twisting,” “jaw opening and closing,” “slowness in movement” and “shuffling steps” were found to be the most predictive of X‐linked dystonia parkinsonism. All had at least a “good” Clinical Utility Index. The questions showed 100% sensitivity and 90% specificity (95% CI 65.6–100%) in identifying cases.ConclusionsThe resulting four‐item questionnaire was found to be predictive of X‐linked dystonia parkinsonism. The screening instrument can be used to screen for X‐linked dystonia parkinsonism in a prevalence study.
Generation of targeted mutant rice using a CRISPR‐Cpf1 system
Authors: Xu Rongfang , Qin Ruiying , Li Hao , Li Dongdong , Li Li , Wei Pengcheng , Yang Jianbo 
Published: November 2016

SummaryCRISPR‐Cpf1 is a newly identified CRISPR‐Cas system, and Cpf1 was recently engineered as a molecular tool for targeted genome editing in mammalian cells. To test whether the engineered CRISPR‐Cpf1 system could induce the production of rice mutants, we selected two genome targets in the OsPDS and OsBEL genes. Our results show that both targets could be efficiently mutated in transgenic rice plants using CRISPR‐Cpf1. We found that pre‐crRNAs with a full‐length direct repeat sequence exhibited considerably increased efficiencies compared with mature crRNAs. In addition, the specificity and transmission of the mutation were investigated, and the behaviours of crRNA‐Cpf1‐induced plant targeted genome mutagenesis were assessed. Taken together, our results indicate that CRISPR‐Cpf1 expression via stable transformation can efficiently generate specific and heritable targeted mutations in rice and thereby constitutes a novel and important approach to specific and precise plant genome editing.
Questioning the Clinical Utility of Exome Sequencing in Developing Countries
Authors: Fong Kenneth , Bailey Celeste V. , Tuttle Peggy , Cunningham Bari , McGrath John A. , Cho Raymond J. 
Published: November 2016

AbstractThe availability of whole‐exome sequencing has revolutionized the study of genetic disease in recent years, particularly in dermatology, where clinical phenotypes are readily recognized. As this technology becomes increasingly affordable and accessible, questions are emerging regarding the clinical and ethical responsibilities of physicians who determine variants underlying disease, especially with regard to children, for whom treatment may be warranted and clinical course improved based on a known genotype. These responsibilities are accentuated in the developing countries, which harbor most consanguineous populations and thus bear the brunt of monogenic genodermatoses. Although many genetic disorders are identified in these populations, limited educational and clinical infrastructure rarely offers opportunities to improve the course of disease. Here we report a genetic study that illustrates these challenges.
The Endless Appeal to Rethink Public Administration
Authors: Robbins Donijo 
Published: November 2016

Related Content: Balfour and Newbold (PAR January/February 2017)Related Content: Roberts (PAR January/February 2017)Related Content: Eckerd (PAR January/February 2017)Related Content: Vidal‐Aparicio (PAR January/February 2017)Related Content: Gerrits and Verweij (PAR January/February 2017)
Red blood cell alloimmunization in patients with sickle cell disease: correlation with HLA and cytokine gene polymorphisms
Authors: Sippert Emilia Ângela , Visentainer Jeane Eliete Laguila , Alves Hugo Vicentin , Rodrigues Camila , Gilli Simone Cristina Olenscki , Addas‐Carvalho Marcelo , Saad Sara Teresinha Ollala , Costa Fernando Ferreira , Castilho Lilian 
Published: November 2016

BACKGROUNDThe reason for the difference in susceptibility to red blood cell (RBC) alloimmunization among patients with sickle cell disease (SCD) is not clearly understood and is probably the result of multiple factors. Our hypothesis is that genetic polymorphisms are associated with RBC alloimmunization.STUDY DESIGN AND METHODSWe investigated the possible association of susceptibility to RBC alloimmunization with polymorphisms of HLA and cytokines genes in 161 SCD patients prior exposed to RBC transfusion. Cytokine gene polymorphisms were analyzed by polymerase chain reaction (PCR) and TaqMan assays. HLA Class I genotyping was performed using PCR‐specific sequence of oligonucleotides. Polymorphism frequencies were compared using the Fisher's exact test.RESULTSOur results revealed increased percentage of the A allele and the GA genotype of the TNFA −308G/A cytokine among alloimmunized patients when compared to nonalloimmunized patients (A allele, 16.4% vs. 6.8%, p = 0.004; GA genotype, 32.8% vs. 11.7%, p = 0.0021). In addition, the IL1B −511T allele and the IL1B −511TT and CT genotype frequencies were overrepresented among alloimmunized patients (T allele, 53.0% vs. 37.5%, p = 0.0085; CT + TT genotypes, 81.82% vs. 60.87%, p = 0.0071). In relation to HLA Class I, we found a higher frequency of HLA‐DRB1*15 among patients alloimmunized to Rh antigens when compared to nonalloimmunized patients (15.63% vs. 6.98%, p = 0.044).CONCLUSIONBrazilian SCD patients with the TNFA, IL1B, and HLA‐DRB1 gene polymorphisms were at increased risk of becoming alloimmunized by RBC transfusions. These findings may contribute to the development of future therapeutic strategies for patients with SCD with higher susceptibility of alloimmunization.
In Vitro
Susceptibility Testing of Bedaquiline against Mycobacterium avium Complex
Authors: Brown-Elliott Barbara A. , Philley Julie V. , Griffith David E. , Thakkar Foram , Wallace Richard J. 
Published: November 2016

ABSTRACT

We performed bedaquiline broth microdilution susceptibility testing using Clinical and Laboratory Standards Institute (CLSI) guidelines on 103 respiratory isolates of
Mycobacterium avium
complex (MAC), including multidrug-resistant isolates. Approximately 90% of isolates had bedaquiline MICs of ≤0.008 μg/ml, and 102/103 isolates had MICs of ≤0.015 μg/ml. Bedaquiline has excellent potential for use in patients with MAC infections, although for reasons of its metabolism by the cytochrome P450 system, it should not be given with rifampin.
Glycoside Hydrolases Degrade Polymicrobial Bacterial Biofilms in Wounds
Authors: Fleming Derek , Chahin Laura , Rumbaugh Kendra 
Published: November 2016

ABSTRACT

The persistent nature of chronic wounds leaves them highly susceptible to invasion by a variety of pathogens that have the ability to construct an extracellular polymeric substance (EPS). This EPS makes the bacterial population, or biofilm, up to 1,000-fold more antibiotic tolerant than planktonic cells and makes wound healing extremely difficult. Thus, compounds which have the ability to degrade biofilms, but not host tissue components, are highly sought after for clinical applications. In this study, we examined the efficacy of two glycoside hydrolases, α-amylase and cellulase, which break down complex polysaccharides, to effectively disrupt
Staphylococcus aureus
and
Pseudomonas aeruginosa
monoculture and coculture biofilms. We hypothesized that glycoside hydrolase therapy would significantly reduce EPS biomass and convert bacteria to their planktonic state, leaving them more susceptible to conventional antimicrobials. Treatment of
S. aureus
and
P. aeruginosa
biofilms, grown
in vitro
and
in vivo
, with solutions of α-amylase and cellulase resulted in significant reductions in biomass, dissolution of the biofilm, and an increase in the effectiveness of subsequent antibiotic treatments. These data suggest that glycoside hydrolase therapy represents a potential safe, effective, and new avenue of treatment for biofilm-related infections.
Phagosomal Neutralization by the Fungal Pathogen Candida albicans Induces Macrophage Pyroptosis
Authors: Vylkova Slavena , Lorenz Michael C. 
Published: November 2016

ABSTRACT

The interaction of
Candida albicans
with the innate immune system is the key determinant of the pathogen/commensal balance and has selected for adaptations that facilitate the utilization of nutrients commonly found within the host, including proteins and amino acids; many of the catabolic pathways needed to assimilate these compounds are required for persistence in the host. We have shown that
C. albicans
co-opts amino acid catabolism to generate and excrete ammonia, which raises the extracellular pH, both
in vitro
and
in vivo
and induces hyphal morphogenesis. Mutants defective in the uptake or utilization of amino acids, such as those lacking
STP2
, a transcription factor that regulates the expression of amino acid permeases, are impaired in multiple aspects of fungus-macrophage interactions resulting from an inability to neutralize the phagosome. Here we identified a novel role in amino acid utilization for Ahr1p, a transcription factor previously implicated in regulation of adherence and hyphal morphogenesis. Mutants lacking
AHR1
were defective in growth, alkalinization, and ammonia release on amino acid-rich media, similar to
stp2
Δ and
ahr1
Δ
stp2
Δ cells, and occupied more acidic phagosomes. Notably,
ahr1
Δ and
stp2
Δ strains did not induce pyroptosis, as measured by caspase-1-dependent interleukin-1β release, though this phenotype could be suppressed by pharmacological neutralization of the phagosome. Altogether, we show that
C. albicans
-driven neutralization of the phagosome promotes hyphal morphogenesis, sufficient for induction of caspase-1-mediated macrophage lysis.
Large-scale implementation of disease control programmes: a cost-effectiveness analysis of long-lasting insecticide-treated bed net distribution channels in a malaria-endemic area of western Kenya—a study protocol
Authors: Gama Elvis , Were Vincent , Ouma Peter , Desai Meghna , Niessen Louis , Buff Ann M , Kariuki Simon 
Published: November 2016

IntroductionHistorically, Kenya has used various distribution models for long-lasting insecticide-treated bed nets (LLINs) with variable results in population coverage. The models presently vary widely in scale, target population and strategy. There is limited information to determine the best combination of distribution models, which will lead to sustained high coverage and are operationally efficient and cost-effective. Standardised cost information is needed in combination with programme effectiveness estimates to judge the efficiency of LLIN distribution models and options for improvement in implementing malaria control programmes. The study aims to address the information gap, estimating distribution cost and the effectiveness of different LLIN distribution models, and comparing them in an economic evaluation.Methods and analysisEvaluation of cost and coverage will be determined for 5 different distribution models in Busia County, an area of perennial malaria transmission in western Kenya. Cost data will be collected retrospectively from health facilities, the Ministry of Health, donors and distributors. Programme-effectiveness data, defined as the number of people with access to an LLIN per 1000 population, will be collected through triangulation of data from a nationally representative, cross-sectional malaria survey, a cross-sectional survey administered to a subsample of beneficiaries in Busia County and LLIN distributors’ records. Descriptive statistics and regression analysis will be used for the evaluation. A cost-effectiveness analysis will be performed from a health-systems perspective, and cost-effectiveness ratios will be calculated using bootstrapping techniques.Ethics and disseminationThe study has been evaluated and approved by Kenya Medical Research Institute, Scientific and Ethical Review Unit (SERU number 2997). All participants will provide written informed consent. The findings of this economic evaluation will be disseminated through peer-reviewed publications.
Functional variants in the sucrase–isomaltase gene associate with increased risk of irritable bowel syndrome
Authors: Henström Maria , Diekmann Lena , Bonfiglio Ferdinando , Hadizadeh Fatemeh , Kuech Eva-Maria , von Köckritz-Blickwede Maren , Thingholm Louise B , Zheng Tenghao , Assadi Ghazaleh , Dierks Claudia , Heine Martin , Philipp Ute , Distl Ottmar , Money Mary E , Belheouane Meriem , Heinsen Femke-Anouska , Rafter Joseph , Nardone Gerardo , Cuomo Rosario , Usai-Satta Paolo , Galeazzi Francesca , Neri Matteo , Walter Susanna , Simrén Magnus , Karling Pontus , Ohlsson Bodil , Schmidt Peter T , Lindberg Greger , Dlugosz Aldona , Agreus Lars , Andreasson Anna , Mayer Emeran , Baines John F , Engstrand Lars , Portincasa Piero , Bellini Massimo , Stanghellini Vincenzo , Barbara Giovanni , Chang Lin , Camilleri Michael , Franke Andre , Naim Hassan Y , D'Amato Mauro 
Published: November 2016

ObjectiveIBS is a common gut disorder of uncertain pathogenesis. Among other factors, genetics and certain foods are proposed to contribute. Congenital sucrase–isomaltase deficiency (CSID) is a rare genetic form of disaccharide malabsorption characterised by diarrhoea, abdominal pain and bloating, which are features common to IBS. We tested sucrase–isomaltase (SI) gene variants for their potential relevance in IBS.DesignWe sequenced SI exons in seven familial cases, and screened four CSID mutations (p.Val557Gly, p.Gly1073Asp, p.Arg1124Ter and p.Phe1745Cys) and a common SI coding polymorphism (p.Val15Phe) in a multicentre cohort of 1887 cases and controls. We studied the effect of the 15Val to 15Phe substitution on SI function in vitro. We analysed p.Val15Phe genotype in relation to IBS status, stool frequency and faecal microbiota composition in 250 individuals from the general population.ResultsCSID mutations were more common in patients than asymptomatic controls (p=0.074; OR=1.84) and Exome Aggregation Consortium reference sequenced individuals (p=0.020; OR=1.57). 15Phe was detected in 6/7 sequenced familial cases, and increased IBS risk in case–control and population-based cohorts, with best evidence for diarrhoea phenotypes (combined p=0.00012; OR=1.36). In the population-based sample, 15Phe allele dosage correlated with stool frequency (p=0.026) and Parabacteroides faecal microbiota abundance (p=0.0024). The SI protein with 15Phe exhibited 35% reduced enzymatic activity in vitro compared with 15Val (p<0.05).ConclusionsSI gene variants coding for disaccharidases with defective or reduced enzymatic activity predispose to IBS. This may help the identification of individuals at risk, and contribute to personalising treatment options in a subset of patients.