bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case series of verrucae vulgares mimicking hyperkeratosis in individuals with diabetic foot ulcers
Authors: Quast D. R. , Nauck M. A. , Bechara F. G. , Meier J. J. 
Published: May 2017

AbstractBackgroundDiabetic foot ulcers are a common complication in the advanced stages of diabetes mellitus. Certain lesions may be refractory to usual treatments with prolonged healing. In these cases, differential diagnoses to classical ulcers should be considered. Although plantar warts are a common and easy‐to‐diagnose finding in the general population, diagnosis can be challenging in people with diabetic foot ulcers, as they mimic hyperkeratosis in these people.Case reportWe report seven cases of people with diabetic foot ulcers and verrucae vulgares mimicking treatment‐refractory hyperkeratosis, presenting to our centre between 2014 and 2016. Diagnosis was aided by the clinical presentation, followed by dermoscopy and punch biopsy. Treatment included topical application of 5‐fluoruracil and salicylic acid (four people), cryotherapy (three people) and surgical excision (three people), all in combination with local pressure offloading. In five people, the verrucae were completely removed after a mean treatment period of 9.4 months; two individuals were lost to follow‐up.ConclusionVerrucae may be more common in people with diabetic foot lesions and polyneuropathy than generally assumed. Typical findings include small, pinhead‐sized bleedings within and surrounding hyperkeratous lesions. These findings should alert the clinician for the potential presence of a verruca. In such cases, biopsy should be performed to enable specific diagnosis and treatment.
Low genetic diversity but frequent sexual reproduction of the chestnut blight fungus Cryphonectria parasitica in Azerbaijan
Authors: Aghayeva D. N. , Rigling D. , Prospero S. 
Published: May 2017

SummaryChestnut blight was first recorded in Azerbaijan on the native European chestnut (Castanea sativa) in 2004, and since then, the disease is expanding in the country. In this study, chestnut blight was detected in seven of eight forest districts that were inspected. To characterize the local population structure of the chestnut blight fungus, 199 Cryphonectria parasitica isolates were collected and assessed for vc type, mating type and microsatellite genotype. Among these isolates, one dominant vc type was detected comprising 93% of the isolates. Six additional vc types were identified among the other isolates. The microsatellite analysis revealed a very similar pattern with 96.5% of the isolates belonging to the same multilocus genotype. Both mating types of C. parasitica were present in all seven districts with a mating type ratio not different from 1:1 in five districts. In accordance with the occurrence of both mating types, sexual fruiting bodies (perithecia) of C. parasitica were found in all districts with an overall prevalence on 20.6% of the cankers. The dominant vc type and microsatellite genotype in Azerbaijan do not occur in Europe, but have previously been found to be widespread in neighbouring Georgia. Our study reveals that sexual reproduction in the invasive C. parasitica population in Azerbaijan is frequent, although the population shows a low genetic diversity. This could favour the biological control of chestnut blight using hypovirulence, which so far does not seem to be present in Azerbaijan.
Evaluation of a multi‐methods approach to the collection and dissemination of feedback on OSCE performance in dental education
Authors: Wardman M.J. , Yorke V.C. , Hallam J.L. 
Published: May 2017

AbstractIntroductionFeedback is an essential part of the learning process, and students expect their feedback to be personalised, meaningful and timely. Objective Structured Clinical Examination (OSCE) assessments allow examiners to observe students carefully over the course of a number of varied station types, across a number of clinical knowledge and skill domains. They therefore present an ideal opportunity to record detailed feedback which allows students to reflect on and improve their performance.MethodsThis article outlines two methods by which OSCE feedback was collected and then disseminated to undergraduate dental students across 2‐year groups in a UK dental school: (i) Individual written feedback comments made by examiners during the examination, (ii) General audio feedback recorded by groups of examiners immediately following the examination. Evaluation of the feedback was sought from students and staff examiners. A multi‐methods approach utilising Likert questionnaire items (quantitative) and open‐ended feedback questions (qualitative) was used. Data analysis explored student and staff perceptions of the audio and written feedback.ResultsA total of 131 students (response rate 68%) and 52 staff examiners (response rate 83%) completed questionnaires. Quantitative data analysis showed that the written and audio formats were reported as a meaningful source of feedback for learning by both students (93% written, 89% audio) and staff (96% written, 92% audio). Qualitative data revealed the complementary nature of both types of feedback. Written feedback gives specific, individual information whilst audio shares general observations and allows students to learn from others. The advantages, limitations and challenges of the feedback methods are discussed, leading to the development of an informed set of implementation guidelines.ConclusionWritten and audio feedback methods are valued by students and staff. It is proposed that these may be very easily applied to OSCEs running in other dental schools.
Commentary: Important design features to consider in observational research on the long‐term outcomes of ADHD – reflections on Sibley et al. (2017) and Swanson et al. (2017)
Authors: Larsson Henrik 
Published: May 2017

AbstractIn this issue of the Journal, Sibley et al. (2017) presented some important insights into how different assessment approaches influence the apparent persistence of ADHD into adulthood, while Swanson et al. (2017) presented interesting results regarding the long‐term benefits (adult symptom reduction) and costs (adult height suppression) associated with the treatment of ADHD with stimulant medication. This commentary highlights that (a) future studies that attempt to explore the occurrence and predictors of persisting and remitting developmental trajectories of ADHD, as well as late‐onset ADHD, need to be based on thorough assessment of ADHD in adulthood using a combination of self‐ratings and other informants (parents), and that (b) observational studies of the long‐term benefits and risk associated with ADHD medications will play an important role in future research and clinical guidelines.
Clinical signs, diagnostics and successful treatment of a myocarditis in an adult chimpanzee (Pan troglodytes)
Authors: van Zijll Langhout Martine , Wolters Marno , Horvath Katalin M. , Thiesbrummel Harold , Smits Paul , van Bolhuis Hester , van der Hulst Victor , Riezebos Robert 
Published: May 2017

AbstractA chimpanzee (Pan troglodytes) was presented with lethargic behaviour. Echocardiography and abnormal cardiac and inflammatory biomarkers revealed a myocarditis. The animal fully recovered after prolonged treatment with losartan and carvedilol. This is the first report of the diagnosis and successful treatment of myocarditis in this species.
An observational study of patient care outcomes sensitive to handover quality in the Post‐Anaesthetic Care Unit
Authors: Lillibridge Nichole , Botti Mari , Wood Beverley , Redley Bernice 
Published: May 2017

Aims and objectivesTo identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post‐Anaesthetic Care Unit nurse.BackgroundThe relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post‐Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood.DesignNaturalistic, exploratory descriptive design using observation.MethodsObservations of 31 patient journeys through Post‐Anaesthetic Care Units across three public and private hospitals. Characteristics of interprofessional handover on arrival in the Post‐Anaesthetic Care Unit, the trajectory of patient care activities in Post‐Anaesthetic Care Unit and patient outcomes were observed.ResultsOf the 821 care activities observed across 31 “patient journeys” in the Post‐Anaesthetic Care Unit, observations (assessments and vital signs) (52.5 %), communication (15.8 %) and pain management (assessment of pain and analgesic administration) (10.3%) were most common. Examination of patterns in handover communications and subsequent trajectories of patient care activities revealed three patient trajectory typologies and two patient outcome indicators expected to be sensitive to the quality of interprofessional handover communication in the Post‐Anaesthetic Care Unit: pain on discharge from the Post‐Anaesthetic Care Unit and timely response to clinical deterioration. An additional process indicator, seeking missing information, was also identified.ConclusionsPatient's pain on discharge from Post‐Anaesthetic Care Unit, escalation of care in response to early signs of deterioration and the need for nurses to seek out missing information to deliver care are indicators expected to be sensitive to the quality of interprofessional handover communication in the Post‐Anaesthetic Care Unit. Future research should test these indicators.Relevance to clinical practicePatient outcomes sensitive to the quality of interprofessional handover on patient arrival in the Post‐Anaesthetic Care Unit can be used to evaluate handover quality improvement initiatives. Quality handovers can improve management of pain and clinical deterioration in Post‐Anaesthetic Care Unit and reduce time wasted searching for missing information.
Pulmonary arterial hypertension – progress in understanding the disease and prioritizing strategies for drug development
Authors: Ghataorhe P. , Rhodes C. J. , Harbaum L. , Attard M. , Wharton J. , Wilkins M. R. 
Published: May 2017

AbstractPulmonary arterial hypertension (PAH), at one time a largely overlooked disease, is now the subject of intense study in many academic and biotech groups. The availability of new treatments has increased awareness of the condition. This in turn has driven a change in the demographics of PAH, with an increase in the mean age at diagnosis. The diagnosis of PAH in more elderly patients has highlighted the need for careful phenotyping of patients and for further studies to understand how best to manage pulmonary hypertension associated with, for example, left heart disease. The breadth and depth of expertise focused on unravelling the molecular pathology of PAH has yielded novel insights, including the role of growth factors, inflammation and metabolic remodelling. The description of the genetic architecture of PAH is accelerating in parallel, with novel variants, such as those reported in potassium two‐pore domain channel subfamily K member 3 (KCNK3), adding to the list of more established mutations in genes associated with bone morphogenetic protein receptor type 2 (BMPR2) signalling. These insights have supported a paradigm shift in treatment strategies away from simply addressing the imbalance of vasoactive mediators observed in PAH towards tackling more directly the structural remodelling of the pulmonary vasculature. Here, we summarize the changing clinical and molecular landscape of PAH. We highlight novel drug therapies that are in various stages of clinical development, targeting for example cell proliferation, metabolic, inflammatory/immune and BMPR2 dysfunction, and the challenges around developing these treatments. We argue that advances in the treatment of PAH will come through deep molecular phenotyping with the integration of clinical, genomic, transcriptomic, proteomic and metabolomic information in large populations of patients through international collaboration. This approach provides the best opportunity for identifying key signalling pathways, both as potential drug targets and as biomarkers for patient selection. The expectation is that together these will enable the prioritization of potential therapies in development and the evolution of personalized medicine for PAH.
Time Alone or Together? Trends and Trade‐offs Among Dual‐Earner Couples, Sweden 1990–2010
Authors: Neilson Jeffrey , Stanfors Maria 
Published: May 2017

AbstractIn recent decades, the dual‐earner couple has become increasingly normative, potentially reducing the time couples and families spend together. The authors investigated how coupled individuals allocated time together, alone, with children, and as a family, exploring changes between 1990 and 2010 in Sweden using three waves of the Swedish Time Use Survey (N = 9,544). Ordinary least squares and decomposition analyses find a trend toward time together over time alone, with childless couples spending similar time together and parents increasing family time. The shift toward family time evolved differently for men and women, indicating gender convergence in private and public spheres, but at higher costs of time alone for women. Change is behavioral and general, applying quite equally across gender and educational groups. There are educational gradients concerning time with children and certain qualitative aspects of time together, indicating that dual‐earner society may be family friendly, but not equally for all.
Diagnostic Ultrasound of the Vagus Nerve in Patients with Diabetes
Authors: Tawfik Eman A. , Walker Francis O. , Cartwright Michael S. , El‐Hilaly Rana A. 
Published: May 2017

ABSTRACTBACKGROUND AND PURPOSEAutonomic neuropathy is a serious and common complication of diabetes mellitus. The vagus nerve is the longest autonomic nerve, and may be affected in diabetes as a part of generalized neuropathy. Our objective was to assess for possible sonographic changes of the vagus nerve in diabetic patients.METHODSThe vagus nerve was bilaterally scanned in 20 healthy volunteers and 54 patients with diabetes in the axial plane at the lateral neck.RESULTSThe mean cross‐sectional area of the vagus nerve was significantly smaller in patients with diabetes compared with controls. Receiver operating characteristic curve analyses revealed an area under the curve of .96, and an optimum cutoff point of 3 mm2 with a sensitivity of 85.2% and specificity of 100%.CONCLUSIONSThis study demonstrates a degree of vagus nerve atrophy in patients with diabetes. This finding may have relevance in the diagnosis and treatment of diabetic neuropathy if further validated.
Consequences of regulatory fit for leader–follower relationship quality and commitment
Authors: Johnson Russell E. , Lin Szu‐Han (Joanna) , Kark Ronit , Van Dijk Dina , King Danielle D. , Esformes Einat 
Published: May 2017

A central tenet of regulatory focus theory is that people hold more positive appraisals and exhibit greater dedication when their regulatory focus is congruent with the orientation of the immediate context, a phenomenon known as regulatory fit. Unfortunately, scant attention has been paid to regulatory fit in interpersonal contexts and the consequences of relationship partners having congruent promotion and prevention foci. Integrating regulatory fit theory with theories of relational leadership, we predicted that regulatory fit would enhance relationship quality and commitment within leader–follower dyads. These predictions were examined across three samples, using data collected from multiple sources and at multiple times. Our results indicated that promotion fit, prevention fit and the interaction between them predicted relationship quality and commitment to the leader, which in turn predicted leader‐targeted citizenship behaviour and withdrawal cognition. These relationships remained after controlling for demographic fit and followers’ and leader's individual regulatory foci.Practitioner points

Leader–follower regulatory fit predicts high‐quality relationship with one's supervisor.

Leader–follower promotion fit predicts affective commitment to supervisor.

Leader–follower prevention fit predicts normative commitment to supervisor.

Promotion fit and prevention fit interact to have synergistic effects on outcomes.
A Strategy for Sperm Cryopreservation of Atlantic Salmon, Salmo salar, for Remote Commercial‐scale High‐throughput Processing
Authors: Yang Huiping , Hu E , Buchanan John T. , Tiersch Terrence R. 
Published: May 2017

AbstractSperm cryopreservation is an essential tool for long‐term storage of genetic resources for aquaculture fishes. The goal of this study was to develop an efficient and streamlined protocol for high‐throughput processing for sperm cryopreservation in Atlantic salmon, Salmo salar. The objectives were to evaluate: (1) osmolality of blood serum for determining extender osmolality, (2) effects of extenders for fresh sperm dilution and refrigerated storage, (3) effects of methanol and dimethyl sulfoxide (DMSO) on fresh sperm motility, and (4) motility and fertility after thawing. In this study, sperm samples were collected at a hatchery site in Canada and shipped to a freezing site located 2200 miles (3550 km) away in the USA. Evaluation of three extenders indicated that Mounib solution was suitable for diluting dry sperm for sample processing. Ten percent of methanol or DMSO was less toxic to sperm cells than was 15% within 30 min. Further testing with methanol at 5, 10, and 15%, and sperm solution : extender dilutions (v:v) of 1:1, 1:3, and 1:19 (at concentrations of 5 × 107, 3 × 108, and 1 × 109 cells/mL) indicated that methanol at 5 and 10% showed less toxicity to fresh sperm within 1 h at sperm:extender dilutions of 1:1 and 1:3. Post‐thaw motility of sperm cryopreserved with 10% methanol was significantly higher than that with 10% DMSO, and fertility reflected those results (0–1% in DMSO vs. 38–55% in methanol). Further evaluation of sperm cryopreservation with 10 and 15% methanol at sperm dilution ratios of 1:1, 1:3, and 1:19 indicated that post‐thaw motility in 10% methanol was significantly higher than that in 15% methanol, and post‐thaw fertility in 10% methanol at 1:1 and 1:3 dilution ratios had fertilization rates similar to that of fresh sperm controls. Sperm samples from 12 males cryopreserved with 10% methanol showed male‐to‐male variation in post‐thaw motility (0–36%). Overall, a simplified standard protocol was established for cryopreservation of shipped sperm of Atlantic salmon using extender without egg yolk and yielded satisfactory post‐thaw motility and fertilization rates. This procedure can be readily adopted by aquaculture facilities to take advantage of high‐throughput cryopreservation capabilities at remote service centers. Most importantly, this approach lays the groundwork for an alternative commercial model for commercial‐scale production, quality control, and development of industrial standards. Control of male variability and sperm quality remain important considerations for future work.
Upper gastrointestinal complications following ablation therapy for atrial fibrillation
Authors: Park S.‐Y. , Camilleri M. , Packer D. , Monahan K. 
Published: May 2017

AbstractBackgroundFollowing ablation therapy for cardiac arrhythmias, patients may develop upper gastrointestinal (UGI) symptoms. The vagus nerve is close to the atria and may be affected by ablating energy.AimTo identify structural or functional complications in UGI tract following ablation for atrial fibrillation (AF) and clinical outcomes and association with vagal dysfunction.MethodsUsing natural language processing of electronic medical records and an AF ablation database of 5380 patients treated during 17 years, we identified 40 patients with UGI complications. We evaluated vagal dysfunction by electrocardiogram (ECG) showing lack of sinus arrhythmia (variation in R‐R interval by ≥120 milliseconds, in presence of normal sinus P waves and constant P‐R interval).Key ResultsAmong 40 patients: (A) eight had structural GI complications confirmed by diagnostic tests: seven with esophageal ulcer/erosions and no signs of UGI bleeding and one developed esophagopericardial fistula (and survived with treatment); (B) 15 had functional UGI complications confirmed by objective motility tests. Nine had newly developed symptoms and six had aggravated symptoms; and (C) the remaining 17 had GI symptoms without relevant diagnostic results. Most UGI issues resolved spontaneously or with conservative treatment. However, 2 died several weeks after ablation procedure; cause of death was suspected atrioesophageal fistula or esophageal rupture. Vagal dysfunction persisted for 3 months in 13 and was transient in 8.Conclusions/InferencesAlthough most GI issues resolved spontaneously, there should be a high index of clinical suspicion in patients with persistent symptoms. Vagal dysfunction may serve as a marker of more extensive tissue damage.
Segmental colonic dilation is associated with premature termination of high‐amplitude propagating contractions in children with intractable functional constipation
Authors: Koppen I. J. N. , Thompson B. P. , Ambeba E. J. , Lane V. A. , Bates D. G. , Minneci P. C. , Deans K. J. , Levitt M. A. , Wood R. J. , Benninga M. A. , Di Lorenzo C. , Yacob D. 
Published: May 2017

AbstractBackgroundColonic dilation is common in children with intractable functional constipation (FC). Our aim was to describe the association between segmental colonic dilation and colonic dysmotility in children with FC.MethodsWe performed a retrospective study on 30 children with intractable FC (according to the Rome III criteria) who had undergone colonic manometry and contrast enema within a 12‐month time period. Colonic diameter was measured at 5 cm intervals from the anal verge up to the splenic flexure. Moreover, the distance between the lateral margins of the pedicles of vertebra L2 was measured to provide a ratio (colonic diameter or length/distance between the lateral margins; “standardized colon size” [SCS]). All manometry recordings were visually inspected for the presence of high‐amplitude propagating contractions (HAPCs); a parameter for colonic motility integrity. The intracolonic location of the manometry catheter sensors was assessed using an abdominal X‐ray.Key ResultsColonic segments with HAPCs had a significantly smaller median diameter than colonic segments without HAPCs (4.08 cm vs 5.48 cm, P<.001; SCS 1.14 vs 1.66, P=.001). Children with prematurely terminating HAPCs had significantly larger SCS ratios for colonic diameter than children with fully propagating HAPCs (P=.008). SCS ratios for the length of the rectosigmoid and the descending colon and the SCS ratio for sigmoid colon diameter were significantly larger in children with FC compared to a previously described normative population (P<.0001, P<.0001 and P=.0007 respectively).Conclusions & InferencesSegmental colonic dilation was associated with prematurely terminating HAPCs and may be a useful indicator of colonic dysmotility.
Primary Cutaneous Mucormycosis in an Extremely Preterm Infant Successfully Treated with Liposomal Amphotericin B
Authors: Lowe Christopher D. , Sainato Rebecca J. , Stagliano David R. , Morgan Maribel M. , Green Brian P. 
Published: May 2017

AbstractCutaneous mucormycosis is a rare but often fatal invasive fungal infection that occurs most commonly in patients with diabetes, malignancy, and other immunocompromising conditions. We report an extremely preterm (<28 weeks) baby boy who developed polymicrobial sepsis and primary cutaneous mucormycosis within his first 10 days of life. He was successfully treated with medical management alone since he was not a candidate for surgery. Successful treatment of cutaneous mucormycosis without surgical debridement has been reported on only two other occasions. This case highlights the importance of rapid and thorough evaluation of skin lesions when evaluating preterm infants and other immunocompromised patients, even when other sources of infection have been identified.