bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term outcome of 154 patients receiving balloon‐occluded retrograde transvenous obliteration for gastric fundal varices
Authors: Imai Yukinori , Nakazawa Manabu , Ando Satsuki , Sugawara Kayoko , Mochida Satoshi 
Published: March 2016

AbstractBackground and AimThis study aims to clarify the long‐term outcome of therapeutic strategies including balloon‐occluded retrograde transvenous obliteration (B‐RTO) for patients with gastric fundal varices.MethodsThe subjects were 154 patients with gastric fundal varices fulfilling the criteria for receiving B‐RTO. In patients showing variceal bleeding, endoscopic therapies and/or balloon tamponade was performed to achieve hemostasis. B‐RTO was accomplished with injection of 5% ethanolamine oleate through a standard balloon catheter except for patients with atypical varices, in whom a microballoon catheter was used to occlude drainage vessels other than a gastrorenal shunt. In patients complicated with esophageal varices at baseline, endoscopic therapies were performed following B‐RTO.ResultsBalloon‐occluded retrograde transvenous obliteration was performed successfully in 147 patients (95%), including 15 patients using a microballoon catheter. Complete variceal obliteration was achieved in all patients. Additional endoscopic therapies for esophageal varices were performed in 31 patients. Gastric varices did not recur in any of these patients. The cumulative survival rates at 1, 3, and 5 years after B‐RTO were 91%, 76%, and 72%, respectively. Child‐Pugh scores and hepatocellular carcinoma complication were identified as prognostic factors associated with survival rates. The cumulative exacerbation rates of esophageal varices at 1, 3, and 5 years were 13%, 20%, and 27%, respectively, and rupture developed in six patients, which were successfully treated with endoscopic therapies.ConclusionsTherapeutic strategies including B‐RTO with a microballoon catheter were useful to achieve a favorable outcome in patients with gastric fundal varices especially in those manifesting Child‐Pugh class‐A liver damage and/or those without hepatocellular carcinoma complication.
Diabetes Mellitus as a Risk Factor for Development of Depressive Symptoms in a Population‐Based Cohort of Older Mexican Americans
Authors: Garcia Maria E. , Lee Anne , Neuhaus John , Gonzalez Hector , To Tu My , Haan Mary N. 
Published: March 2016

ObjectivesTo determine whether diabetes mellitus increases depressive symptoms in older Latinos in a population‐based cohort.DesignProspective cohort study.ParticipantsIndividuals from the Sacramento Latino Study on Aging aged 60 and older in 1998–99 and followed annually until 2008 (N = 1,586).MeasurementsDiabetes mellitus was defined according to self‐report, fasting blood glucose of 126 mg/dL or greater, glycosylated hemoglobin of 6.5% or greater, or diabetic medication use. Depressive symptoms were defined as Center for Epidemiologic Studies Depression Scale (CES‐D) score of 16 or greater or use of antidepressant medication. Multistate Markov modeling was used to assess the effects of time‐dependent diabetes mellitus on transitions between three states over time: low CES‐D score (normal), high CES‐D score or treated (depressed), and death. Bivariate analyses identified covariates significantly associated with any transition, including sex and baseline measures of age, education, body mass index, hypertension, and stroke.ResultsIn a fully adjusted model, participants with diabetes mellitus had a 35% higher rate of developing depressive symptoms or starting treatment with an antidepressant (hazard ratio (HR) = 1.35, 95% confidence interval (CI) = 1.13–1.62). Time‐dependent diabetes mellitus was associated with a lower rate of regression from depressed to normal (HR = 0.72, 95% CI = 0.59–0.88) and a 2.3 greater rate pf progression from depressed to death (HR = 2.31, 95% CI = 1.57–3.40).ConclusionDiabetes mellitus increased the risk of developing depressive symptoms in older Mexican Americans. Older Latinos with diabetes mellitus should be screened for depressive symptoms and prioritized for close follow‐up, potentially through greater reliance on team‐based models of care.
Anticholinergic Drug Burden in Persons with Dementia Taking a Cholinesterase Inhibitor: The Effect of Multiple Physicians
Authors: Reppas‐Rindlisbacher Christina E. , Fischer Hadas D. , Fung Kinwah , Gill Sudeep S. , Seitz Dallas , Tannenbaum Cara , Austin Peter C. , Rochon Paula A. 
Published: March 2016

ObjectivesTo explore the association between the number of physicians providing care and anticholinergic drug burden in older persons newly initiated on cholinesterase inhibitor therapy for the management of dementia.DesignPopulation‐based cross‐sectional study.SettingCommunity and long‐term care, Ontario, Canada.ParticipantsCommunity‐dwelling (n = 79,067, mean age 81.0, 60.8% female) and long‐term care residing (n = 12,113, mean age 84.3, 67.2% female) older adults (≥66) newly dispensed cholinesterase inhibitor drug therapy.MeasurementsAnticholinergic drug burden in the prior year measured using the Anticholinergic Risk Scale.ResultsCommunity‐dwelling participants had seen an average of eight different physicians in the prior year. The odds of high anticholinergic drug burden (Anticholinergic Risk Scale score ≥ 2) were 24% higher for every five additional physicians providing care to individuals in the prior year (adjusted odds ratio = 1.24, 95% confidence interval = 1.21–1.26). Female sex, low‐income status, previous hospitalization, and higher comorbidity score were also associated with high anticholinergic drug burden. Long‐term care facility residents had seen an average of 10 different physicians in the prior year. After a sensitivity analysis, the association between high anticholinergic burden and number of physicians was no longer statistically significant in the long‐term care group.ConclusionIn older adults newly started on cholinesterase inhibitor drug therapy, greater number of physicians providing care was associated with higher anticholinergic drug burden scores. Given the potential risks of anticholinergic drug use, improved communication among physicians and an anticholinergic medication review before prescribing a new drug are important strategies to improve prescribing quality.
Factors Associated With Full Implementation of Scope of Practice
Authors: Ganz Freda DeKeyser , Toren Orly , Fadlon Yafit 
Published: March 2016

AbstractPurposeTo describe whether nurses fully implement their scope of practice; nurses’ perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self‐efficacy.DesignA descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post‐basic certification from two Israeli university hospitals, from May 2012 to September 2013.MethodsFive questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self‐Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self‐efficacy were the predictors.FindingsHigh levels of professional autonomy, self‐efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self‐efficacy, and attitudes towards future practice, but not with current implementation.ConclusionsNurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers.Clinical RelevanceEven though staff nurses with post‐basic certification had high levels of professional autonomy and self‐efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses should be aware of these barriers and work towards reducing them.
Registry‐based outcome assessment in haemophilia: a scoping study to explore the available evidence
Authors: Osooli M. , Berntorp E. 
Published: March 2016

AbstractHaemophilia is a congenital disorder with bleeding episodes as its primary symptom. These episodes can result in negative outcomes including joint damage, loss of active days due to hospitalization and reduced quality of life. Effective treatment, however, can improve the outcome. Registries have been used as a valuable source of information regarding the monitoring of treatment and outcome. The two main aims of this exploratory study were to establish which haemophilia registries publish peer‐reviewed outcome assessment research and then to extract, classify and report the treatment outcomes and their extent of use in the retrieved registries. Using relevant keywords, we searched PubMed and Web of Science databases for publications during the period 1990–2015. Retrieved references were screened in a stepwise process. Eligible papers were original full articles on haemophilia outcomes that used data from a computerized patient database. Descriptive results were summarized. Of 2352 references reviewed, 25 full texts were eligible for inclusion in the study. These papers were published by 11 registries ranging from local to international in coverage. It is still relatively rare for registries to produce peer‐reviewed publications about outcomes, and most that currently do produce such papers are located in Europe and North America. More information is available on traditional outcomes such as comorbidities and arthropathy than on health‐related quality of life or the social and developmental impact of haemophilia on patients. Inhibitors, HIV and viral hepatitis are amongst the most commonly reported comorbidities. Research has focused more on factor consumption and less on hospitalization or time lost at school or work due to haemophilia. Haemophilia registries, especially those at the national level, are valuable resources for the delivery of effective health care to patients. Validated outcome measurement instruments are essential for the production of reliable and accurate evidence. Finally, such evidence should be communicated to physicians, patients, the public and health policymakers.
Effect of Disinfection on the Bond Strength between Denture Teeth and Microwave‐Cured Acrylic Resin Denture Base
Authors: Matos Adaias O. , Costa Josiane O. , Beline Thamara , Ogawa Erika S. , Assunção Wirley G. , Mesquita Marcelo F. , Consani Rafael X. , Barão Valentim A. 
Published: March 2016

AbstractPurposeDenture tooth debonding is a common complication for denture wearers; however, the effect of complete denture disinfection on bonding between denture teeth and acrylic resin remains unclear. The aim of this study was to evaluate the effect of disinfection methods on the bond strength between denture teeth and microwave‐cured acrylic resin denture base.Materials and MethodsThree commercial brands of denture teeth (Trilux, Biolux, Vipi Dent Plus) and one microwave‐cured acrylic resin denture base were tested. Each brand of denture teeth was divided into seven groups (n = 6; estimated by partial Eta squared). The specimenss of groups H and Cl were immersed in 1% sodium hypochlorite and 4% chlorhexidine digluconate for 7 days, respectively. In group Br, the specimens were subjected to toothbrush simulation under 200 g of force for 20,000 cycles. In groups Br‐H and Br‐Cl, the specimens were brushed and further disinfected with 1% sodium hypochlorite and 4% chlorhexidine digluconate, respectively. In control groups 1 (Co1) and 2 (Co2), the specimens were stored in distilled water for 50 ± 2 hours and 7 days, respectively. Shear bond strength testing was performed at the resin/tooth interface in a universal testing machine at a 1 mm/min crosshead speed. The failure pattern was quantified and classified into adhesive, cohesive, or mixed. Data were analyzed using two‐way ANOVA and Tukey HSD test (α = 0.05).ResultsDisinfection with 1% sodium hypochlorite (p = 0.031), brushing (p < 0.0001), and association of brushing with either 1% sodium hypochlorite (p < 0.0001) or 4% chlorhexidine digluconate (p = 0.01) reduced the bond strength between denture teeth and microwave‐cured acrylic resin denture base. All commercial brands of denture teeth presented a similar bond strength (p > 0.05). The failure pattern was predominantly adhesive independent of the disinfection method and denture tooth brand.ConclusionsDisinfection with sodium hypochlorite, brushing, and the association of mechanical and chemical methods reduced the bond strength between denture tooth and microwave‐cured acrylic resin denture base.
High circulating oestrone and low testosterone correlate with adverse clinical outcomes in men with advanced liver disease
Authors: Sinclair Marie , Gow Paul J. , Angus Peter W. , Hoermann Rudolf , Handelsman David J. , Wittert Gary , Martin Sean , Grossmann Mathis 
Published: March 2016

AbstractBackground & AimsCirculating testosterone is usually reduced in men with cirrhosis, but there has not been a comprehensive analysis of androgen status or circulating oestrogens. Little is known about associations between circulating sex steroids with aspects of health in this population.MethodsWe report data from men with cirrhosis and low serum testosterone (<12 nmol/L or calculated free testosterone <230 pmol/L). Comprehensive circulating sex steroid profiles were measured by liquid chromatography‐mass spectrometry and compared with age‐matched controls. Relationships between sex hormone levels, severity of liver disease, biochemistry and clinical outcomes were assessed.ResultsSerum oestrone and oestradiol were significantly elevated in men with cirrhosis compared with controls (median, 869.1 pmol/L vs. 133.8 pmol/L and 166.7 pmol/L vs. 84.6 pmol/L respectively). Serum oestrone correlated with MELD score (correlation +0.306, P < 0.001) and inversely correlated with serum sodium (correlation −0.208, P = 0.004) and haemoglobin (correlation −0.177, P = 0.012). No such correlations were observed for oestradiol. Serum testosterone levels inversely correlated with MELD score (correlation −0.294, P < 0.001) and positively with handgrip strength (correlation +0.242, P < 0.001), physical activity (correlation +0.276, P = 0.012), haemoglobin (correlation +0.282, P < 0.001) and serum sodium (+0.344, P < 0.001). Dihydrotestosterone inversely correlated with MELD score (correlation −0.225, P = 0.002) and shared similar significant relationships to testosterone.ConclusionLow serum androgens and elevated serum oestrone (but not oestradiol) are associated with higher MELD and individual adverse health outcomes in cirrhotic cohort of men selected for low testosterone. Serum oestrone may be a novel marker of ill health in this population. Whether low androgens are markers or mediators of ill health requires further investigation.
The role of autonomic dysfunction in cirrhotic patients before and after liver transplantation. Review of the literature
Authors: Di Stefano Cristina , Milazzo Valeria , Milan Alberto , Veglio Franco , Maule Simona 
Published: March 2016

AbstractIn patients affected by hepatic cirrhosis, autonomic dysfunction is a common finding; usually it is asymptomatic but it may correlate with increased mortality and morbidity before, during and after liver transplant, due to hemodynamic instability in the course of stressful events like sepsis, gastrointestinal bleeding and reperfusion after transplantation surgery. Hyperdynamic circulation and hepatic dysfunction seem to play a role in the pathogenesis of autonomic dysfunction, even if pathophysiological mechanisms are not completely known. We present a revision of previous literature about prevalence, pathophysiological mechanisms, clinical features, and mortality and morbidity of autonomic dysfunction secondary to hepatic cirrhosis.
Metal‐specific control of gene expression mediated by Bradyrhizobium japonicumMur and Escherichia coliFur is determined by the cellular context
Authors: Hohle Thomas H. , O'Brian Mark R. 
Published: March 2016

SummaryBradyrhizobium japonicum Mur and Escherichia coli Fur are manganese‐ and iron‐responsive transcriptional regulators, respectively, that belong to the same protein family. Here, we show that neither Mur nor Fur discriminate between Fe2+ and Mn2+in vitro nor is there a metal preference for conferral of DNA‐binding activity on the purified proteins. When expressed in E. coli, B. japonicum Mur responded to iron, but not manganese, as determined by in vivo promoter occupancy and transcriptional repression activity. Moreover, E. coli Fur activity was manganese‐dependent in B. japonicum. Total and chelatable iron levels were higher in E. coli than in B. japonicum under identical growth conditions, and Mur responded to iron in a B. japonicum iron export mutant that accumulated high levels of the metal. However, elevated manganese content in E. coli did not confer activity on Fur or Mur, suggesting a regulatory pool of manganese in B. japonicum that is absent in E. coli. We conclude that the metal selectivity of Mur and Fur depends on the cellular context in which they function, not on intrinsic properties of the proteins. Also, the novel iron sensing mechanism found in the rhizobia may be an evolutionary adaptation to the cellular manganese status.
Two ways to skin a cat: acyldepsipeptides antibiotics can kill bacteria through activation or inhibition of ClpP activity
Authors: Vass Robert H. , Chien Peter 
Published: March 2016

SummaryInfection by Mycobacterium tuberculosis (Mtb) has had a devastating effect on the world population. Acyldepsipeptide antibiotics (ADEPs) are known to kill some bacteria by over activating the bacterial ClpP peptidase. ADEP antibiotics also target Mtb, with the assumption that uncontrolled ADEP‐activated proteolysis by ClpP is the common mode of killing. In this issue of Molecular Microbiology, Famulla, et al. now show that ADEP's effectiveness in mycobacteria is likely due to inhibition of ClpP‐dependent protease activity rather than activation. This finding of how the same antibiotic can kill bacteria by either inhibiting or activating proteases illustrates the utility of targeting these enzymes for sorely needed new antibiotics.
Spitz Nevus: A Rare Lesion of the Oral Cavity
Authors: Vaccaro Mario , Romeo Umberto , Romeo Carmelo , Lentini Maria 
Published: March 2016

AbstractPigmented mucosal lesions represent a group of rare entities with different etiopathogenetic origins, histopathologic features, dermoscopic appearances, and clinical course. Solitary pigmented lesions of melanocytic origin are uncommon in the oral mucosa, and intraoral occurrence of Spitz nevus is very rare. Here we present a case of Spitz nevus occurring on the hard palate of a 26‐month‐old boy.
Effects of a New Emollient‐Based Treatment on Skin Microflora Balance and Barrier Function in Children with Mild Atopic Dermatitis
Authors: Bianchi Pascale , Theunis Jennifer , Casas Christiane , Villeneuve Cecile , Patrizi Annalisa , Phulpin Chloe , Bacquey Adeline , Redoulès Daniel , Mengeaud Valerie , Schmitt Anne‐Marie 
Published: March 2016

AbstractBackground/ObjectivesThe use of emollients is widely recommended for the management of atopic dermatitis (AD), especially between flares. An imbalance of skin microflora is suspected of playing a key role in exacerbations of AD. Our aim was to evaluate the effect of a new emollient balm on clinical parameters (SCORing Atopic Dermatitis [SCORAD], xerosis, pruritus), skin barrier function (transepidermal water loss and loricrin, filaggrin, corneodesmosin, and involucrin expression], skin microflora biodiversity, and Staphylococcus aureus and Staphylococcus epidermidis balance in children with mild AD.MethodsFifty‐four children (1–4 yrs old) were enrolled in this randomized, controlled study. Subjects applied a hygiene product and the emollient balm (emollient group, n = 28) or the hygiene product only (control group, n = 26) twice a day for 28 days.ResultsWe found improvement in favor of the emollient group in SCORAD (p < 0.001), pruritus (p = 0.06), and xerosis (p = 0.06) after 28 days of application. Moreover, transepidermal water loss decreased in the emollient group by 34% (p = 0.06) and involucrin expression by 37% (p = 0.001) at day 28 from baseline in association with improvement in barrier function, whereas other barrier‐specific proteins did not vary. S. aureus increased significantly in the control group only (6.5 times, p = 0.01), whereas S. epidermidis remained stable in both groups. The Shannon index (H′ = 2.3) did not vary with treatment in either group.ConclusionTwice‐daily application of a new emollient balm in children with mild AD protected the skin from S. aureus proliferation and preserved microflora biodiversity.
Port‐Wine Stain–Like Presentation of a Tufted Angioma on the Face
Authors: Tobe Joshua , Shum David , Somers Gino R. , Pope Elena , Mohammed Javed Ayoub 
Published: March 2016

AbstractTufted angioma is an uncommon benign vascular tumor that typically is noted during infancy or childhood, with variable clinical presentation. We report the case of an infant with a tufted angioma initially presenting as a port‐wine stain–like patch of the left cheek.
Germination sensitivity to water stress in four shrubby species across the Mediterranean Basin
Authors: Chamorro D. , Luna B. , Ourcival J.‐M. , Kavgacı A. , Sirca C. , Mouillot F. , Arianoutsou M. , Moreno J. M. 
Published: March 2016

AbstractMediterranean shrublands are generally water‐limited and fire‐driven ecosystems. Seed‐based post‐fire regeneration may be affected by varying rainfall patterns, depending on species sensitivity to germinate under water stress. In our study, we considered the germination response to water stress in four species from several sites across the Mediterranean Basin. Seeds of species with a hard coat (Cistus monspeliensis, C. salviifolius, Cistaceae, Calicotome villosa, Fabaceae) or soft coat (Erica arborea, Ericaceae), which were exposed or not to a heat shock and smoke (fire cues), were made to germinate under water stress. Final germination percentage, germination speed and viability of seeds were recorded. Germination was modelled using hydrotime analysis and correlated to the water balance characteristics of seed provenance. Water stress was found to decrease final germination in the three hard‐seeded species, as well as reduce germination speed. Moreover, an interaction between fire cues and water stress was found, whereby fire cues increased sensitivity to water stress. Seed viability after germination under water stress also declined in two hard‐seeded species. Conversely, E. arborea showed little sensitivity to water stress, independent of fire cues. Germination responses varied among populations of all species, and hydrotime parameters were not correlated to site water balance, except in E. arborea when not exposed to fire cues. In conclusion, the species studied differed in germination sensitivity to water stress; furthermore, fire cues increased this sensitivity in the three hard‐seeded species, but not in E. arborea. Moreover, populations within species consistently differed among themselves, but these differences could only be related to the provenance locality in E. arborea in seeds not exposed to fire cues.