bluuebunny/crossref_metadata_2025_split huggingface dataset:
RNA and a cell wall component of Enterococcus faecalis IC-1 are required for phagocytosis and interleukin 12 production by the mouse macrophage cell line J774.1
Authors: Nakase Junpei , Ukawa Yuuichi , Takemoto Syoji , Kubo Takayoshi , Sagesaka Yuko M , Aoki-Yoshida Ayako , Totsuka Mamoru 
Published: April 2017

Abstract
Enterococcus faecalis is a resident lactic acid bacterium in the human intestine. Its immunostimulatory action was reported to be enhanced by heat sterilization. To investigate its beneficial actions, we evaluated the ability of 10 E. faecalis strains to induce interleukin-12 (IL-12) production in a mouse macrophage cell line, J774.1 and found that the strain, E. faecalis IC-1, had a potent IL-12-inducing ability. Furthermore, we investigated the underlying mechanism by treating IC-1 cells with RNase or lysozyme. Its activity almost disappeared and an antagonist of Toll-like receptor (TLR) 7 inhibited this activity. Moreover, lysozyme-treated IC-1 bacteria were not phagocytized by J774.1 cells, and did not induce IL-12 production. Based on our results, we propose that macrophages recognize the cell wall components of IC-1, leading to phagocytosis. The IC-1 RNA is then recognized by TLR7, which induces the production of IL-12.
Clonal rolling circle amplification for on-chip DNA cluster generation
Authors: Korfhage Christian , Fricke Evelyn , Meier Andreas , Geipel Andreas , Baltes Mark , Krüger Nadine , Herschel Florian , Erbacher Christoph 
Published: April 2017

AbstractGeneration of monoclonal DNA clusters on a surface is a useful method for digital nucleic acid detection applications (e.g. microarray or next-generation sequencing). To obtain sufficient copies per cluster for digital detection, the single molecule bound to the surface must be amplified. Here we describe ClonalRCA, a rolling-circle amplification (RCA) method for the generation of monoclonal DNA clusters based on forward and reverse primers immobilized on the surface. No primer in the reaction buffer is needed. Clusters formed by ClonalRCA comprise forward and reverse strands in multiple copies tethered to the surface within a cluster of micrometer size. Single stranded circular molecules are used as a target to create a cluster with about 10 000 forward and reverse strands. The DNA strands are available for oligonucleotide hybridization, primer extension and sequencing.
Inhibition of the cardiac myocyte mineralocorticoid receptor ameliorates doxorubicin-induced cardiotoxicity
Authors: Lother Achim , Bergemann Stella , Kowalski Jessica , Huck Michael , Gilsbach Ralf , Bode Christoph , Hein Lutz 
Published: April 2017

Abstract

Aim
Anthracyclines such as doxorubicin are widely used in cancer therapy but their use is limited by cardiotoxicity. Up to date there is no established strategy for the prevention of anthracyclin-induced heart failure. In this study, we evaluated the role of the cardiac myocyte mineralocorticoid receptor (MR) during doxorubicin-induced cardiotoxicity.

Methods and results
A single high-dose or repetitive low-dose doxorubicin administration lead to markedly reduced left ventricular function in mice. Treatment with the MR antagonist eplerenone prevented doxorubicin-induced left ventricular dysfunction. In order to identify the cell types and molecular mechanisms involved in this beneficial effect we used a mouse model with cell type-specific MR deletion in cardiac myocytes. Cardiac myocyte MR deletion largely reproduced the effect of pharmacological MR inhibition on doxorubicin-induced cardiotoxicity. RNAseq from isolated cardiac myocytes revealed a repressive effect of doxorubicin on gene expression which was prevented by MR deletion.

Conclusions
We show here that (i) eplerenone prevents doxorubicin-induced left ventricular dysfunction in mice, and (ii) this beneficial effect is related to inhibition of MR in cardiac myocytes. Together with present clinical trial data our findings suggest that MR antagonism may be appropriate for the prevention of doxorubicin-induced cardiotoxicity.
Impact of the SYNTAX scores I and II in patients with diabetes and multivessel coronary disease: a pooled analysis of patient level data from the SYNTAX, PRECOMBAT, and BEST trials
Authors: Cavalcante Rafael , Sotomi Yohei , Mancone Massimo , Whan Lee Cheol , Ahn Jung-Min , Onuma Yoshinobu , Lemos Pedro A. , van Geuns Robert-Jan , Park Seung-Jung , Serruys Patrick W. 
Published: April 2017

Abstract

Aims
To assess the impact of the SYNTAX scores I and II in outcomes after percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for patients with diabetes and multivessel disease (MVD).

Methods and results
We performed a patient-level pooled analysis of three large randomized trials of patients with MVD. The impact of coronary anatomic complexity as measured by the SYNTAX score in the differences in outcomes following PCI and CABG was assessed at a median follow-up of 5 years. We also assessed the performance of the SYNTAX II score model in patients with and without diabetes. From the 3280 patients enrolled in the three trials, a total of 1068 (32.6%) had diabetes. The rate of the composite of death, myocardial infarction (MI), or stroke was similar in the PCI and CABG arms in patients with low-intermediate (≤32) SYNTAX scores (15.1% vs. 14.9%, respectively; P = 0.93) while it was significantly higher in the PCI arm in patients with high (≥33) SYNTAX scores (24.5% vs. 13.2%, respectively; P = 0.018). The SYNTAX score II showed good calibration and moderate discrimination ability in patients with diabetes (c-index = 0.68) as well as in those without (c-index = 0.67).

Conclusions
Differences in 5 years outcomes following PCI and CABG for patients with MVD and diabetes were influenced by anatomic complexity as measured by the SYNTAX score. The SYNTAX score II mortality prediction model showed similar performance regardless of the diabetes status.
Accuracy of Zero-Heat-Flux Cutaneous Temperature in Intensive Care Adults
Authors: Dahyot-Fizelier Claire , Lamarche Solène , Kerforne Thomas , Bénard Thierry , Giraud Benoit , Bellier Rémy , Carise Elsa , Frasca Denis , Mimoz Olivier 
Published: April 2017

Objectives:
To compare accuracy of a continuous noninvasive cutaneous temperature using zero-heat-flux method to esophageal temperature and arterial temperature.

Design:
Prospective study.

Setting:
ICU and NeuroICU, University Hospital.

Patients:
Fifty-two ICU patients over a 4-month period who required continuous temperature monitoring were included in the study, after informed consent.

Interventions:
All patients had esophageal temperature probe and a noninvasive cutaneous device to monitor their core temperature continuously. In seven patients who required cardiac output monitoring, continuous iliac arterial temperature was collected. Simultaneous core temperatures were recorded from 1 to 5 days. Comparison to the esophageal temperature, considered as the reference in this study, used the Bland and Altman method with adjustment for multiple measurements per patient.

Measurements and Main Results:
The esophageal temperature ranged from 33°C to 39.7°C, 61,298 pairs of temperature using zero-heat-flux and esophageal temperature were collected and 1,850 triple of temperature using zero-heat-flux, esophageal temperature, and arterial temperature. Bias and limits of agreement for temperature using zero-heat-flux were 0.19°C ± 0.53°C compared with esophageal temperature with an absolute difference of temperature pairs equal to or lower than 0.5°C of 92.6% (95% CI, 91.9–93.4%) of cases and equal to or lower than 1°C for 99.9% (95% CI, 99.7–100.0%) of cases. Compared with arterial temperature, bias and limits of agreement were –0.00°C ± 0.36°C with an absolute difference of temperature pairs equal to or lower than 0.5°C of 99.8% (95% CI, 95.3–100%) of cases. All absolute difference of temperature pairs between temperature using zero-heat-flux and arterial temperature and between arterial temperature and esophageal temperature were equal to or lower than 1°C. No local or systemic serious complication was observed.

Conclusions:
These results suggest a comparable reliability of the cutaneous sensor using the zero-heat-flux method compared with esophageal or iliac arterial temperatures measurements.
Cutaneous Rosai–Dorfman Disease With Linear Lesions and Monoclonal Gammopathy
Authors: Bae Edward , White Paul , Brophy Mary , Lichtman Michael , Krathen Michael S. , Mahalingam Meera 
Published: April 2017

Abstract:
Cutaneous Rosai–Dorfman disease (CRDD), a benign histiocytosis of unknown etiology, typically presents as a solitary or clusters of lesions. Although the histopathology is fairly distinctive, the laboratory abnormalities are not; past reports note elevated erythrocyte sedimentation rate, anemia, and polyclonal hyperglobulinemia. We describe a 61-year-old African American diabetic gentleman who presented with nodules in a linear distribution on the flank. Histopathologic examination of a biopsied nodule revealed a pandermal sheet-like infiltrate of plasma cells and histiocytes, some demonstrating elastophagocytosis and emperipolesis. The lesional histiocytes were S100 and CD68 positive and CD1a negative—findings consistent with a diagnosis of CRDD. Additional laboratory work-up performed 12 weeks after the biopsy was taken revealed an elevated serum κ light chain concentration of 37.26 mg/L (reference range: 3.30–19.40 mg/L), which correlated with an M-protein spike identified as IgG κ proteins per serum protein electrophoresis. Given the difficulty in excising a large area and preexisting diabetes, a course of low-dose methotrexate was selected for therapy with a recommendation of close follow-up for the monoclonal gammopathy. To the best of our knowledge, this is the first report of CRDD associated with a linear distribution of lesions and serum protein electrophoresis–confirmed monoclonal gammopathy.
Adverse effects of laxatives: update
Authors: Anton Christopher , Crawford Colin 
Published: April 2017

Summary
Laxatives are generally well tolerated and adverse effects mild or moderate, although rarely adverse effects can be fatal. Several laxatives have recently been licensed for intractable constipation not relieved by simple laxatives, opioid-induced constipation, and irritable bowel syndrome with constipation. Like the older laxatives, the new laxatives usually cause only mild adverse effects, although some serious effects have been reported.
Comorbidities in Patients With Chronic Obstructive Pulmonary Disease and Pulmonary Rehabilitation Outcomes
Authors: Tunsupon Pichapong , Lal Ashima , Abo Khamis Mohammed , Mador M. Jeffery 
Published: April 2017

Purpose:
The objective of this study was to evaluate the impact of comorbidities as potential predictors of the response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD).

Methods:
The study included 165 patients with COPD with exercise limitations. Comorbidity was classified as cardiac, metabolic, orthopedic, behavioral health problems, or other diseases. Number of comorbidities was grouped as 0, 1, or ≥2. Outcomes were defined as improvement in exercise capacity (maximal exercise capacity, 6-minute walk test, and constant workload cycle exercise duration) and quality of life (Chronic Respiratory Questionnaire). We assessed the effect of comorbidities on improvement in outcomes and the impact of the number of comorbidities on the percentage of patients reaching the minimal clinically important difference for each outcome.

Results:
Most patients (n = 160; 96%) were elderly males (mean age 70 years) with COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages II to IV. Sixty-four percent of patients had at least 1 comorbidity. The ≥2 comorbidity group (n = 29) had a higher modified Charlson index and more patients required continuous supplemental oxygen. Absolute differences in dyspnea scores in patients with cardiac disease and orthopedic problems compared with those without these comorbidities were 2.6 ± 0.87; 95% CI 0.89 to 4.32; p = .003, and −3.25 ± 1.23; 95% CI −5.69 to −0.82; p = .009, respectively. Comorbidities had no significant effect on other exercise outcomes or quality of life.

Conclusion:
Patients with cardiac disease experienced greater improvement in the dyspnea score compared with patients with no cardiac disease, whereas patients with orthopedic problems had a smaller but also clinically significant improvement in dyspnea after pulmonary rehabilitation.
Rates of Intraocular Pressure Elevation and Use of Topical Antihypertensive Medication After Descemet Stripping Automated Endothelial Keratoplasty
Authors: Kaleem Mona , Ridha Faisal , Shwani Zryan , Swenor Bonnielin , Goshe Jeffrey , Singh Annapurna 
Published: April 2017

Purpose:
To investigate intraocular pressure (IOP) elevation and medication augmentation after Descemet stripping automated endothelial keratoplasty (DSAEK) in those with and without glaucoma.

Methods:
The records of 379 patients who underwent DSAEK at the Cleveland Clinic Foundation between January 2009 and 2014 were retrospectively reviewed. Postoperative IOP elevations were considered significant if IOP was ≥22 mm Hg on at least 1 follow-up visit or if it increased by ≥10 mm Hg from baseline.

Results:
The incidence rate of IOP elevation was 4% per person-month (confidence interval [CI], 3%–6%) in patients with preexisting glaucoma and 3% (CI, 2%–4%) in those without. Rates of medication augmentation were 4% per person-month (CI, 3%–5%) in patients with glaucoma and 1.8% (CI, 1.4%–2.4%) in those without. Incidence rates for both outcomes peaked at 1 month. Whites had nearly a 47% lower incidence of IOP elevation compared with nonwhites (P = 0.004); patients with pseudophakic bullous keratopathy had a 54% higher incidence of IOP elevation (P = 0.024); and those with Fuchs endothelial corneal dystrophy had a 36% lower incidence (P = 0.024). Patients with glaucoma had over a 2-fold higher incidence of medication augmentation compared with those without (hazard rate ratio = 2.08, P < 0.001).

Conclusions:
The incidence of post-DSAEK IOP elevation did not significantly differ by glaucoma status, although patients with glaucoma were more likely to have escalation of topical antihypertensive therapy. The incidence of IOP elevation was significantly associated with pseudophakic bullous keratopathy and nonwhite race. These patients should be followed closely in the early postoperative period, as elevated IOP can be a serious consequence of DSAEK.
Analyzing Patient Safety Culture From Viewpoints of Physicians and Nurses—A Case of a Regional Teaching Hospital in Taiwan
Authors: Lee Yii-Ching , Shieh Jiunn-I , Huang Chih-Hsuan , Wang Chieh Yu , Wu Hsin-Hung 
Published: April 2017

Abstract:
The Chinese version of safety attitudes questionnaire is used to evaluate patient safety culture from the viewpoints of physicians and nurses of a regional teaching hospital in Taiwan in 2014. This study applies Mann–Whitney U test for two independent samples test and analysis of variance to observe if different demographic variables are perceived differently in patient safety culture in terms of eight dimensions. In addition, linear regression models are applied to take into account the confounding effects of demographic variables in eight dimensions. The results show that none of the eight dimensions is more important. Besides, supervisor/manager and experience in position are the two critical demographic variables to influence the patient safety culture. The results imply that the hospital management needs to pay much attention to the employees who are not supervisors/managers and/or more experienced in position because they are less satisfied in patient safety culture.
Imaging Criteria to Predict Surgical Difficulties During Stapes Surgery
Authors: Parra Claire , Trunet Stéphanie , Granger Benjamin , Nguyen Yann , Lamas Georges , Bernardeschi Daniele , Hervochon Rémi , Tankere Frédéric 
Published: April 2017

Background and Purpose:
Stapes surgery for otosclerosis can be challenging if access to the oval window niche is restricted. The aim of this study was to determine the accuracy of the computed tomographic (CT) scan in the evaluation of anatomical distances, and to analyze its reliability in predicting surgical technical difficulties.

Material and Methods:
A total of 96 patients (101 ears) were enrolled in a prospective study between 2012 and May 2015. During surgery, we evaluated the distance D1 between the stapes and the facial nerve, distance D2 between the promontory and the facial nerve after ablation of the superstructure, and the intraoperative discomfort of the surgeon. On preoperative CT scans, we measured the width and depth of the oval window niche, and the angle formed by two axes starting from the center-point of the footplate, the first tangential to the superior wall of the promontory, and the second tangential to the inferior wall of the fallopian canal.

Results:
Intraoperative distances D1 and D2 were correlated with the width of the oval window and with the facial-promontory angle measured on imaging. CT scan measurements of the facial-promontory angle and width of the oval window were associated with the degree of discomfort of the surgeon. The cut-off threshold for intraoperative subjective discomfort was computed as 1.1 mm for the width of the oval window niche, with a sensibility of 71% and a specificity of 84%.

Conclusion:
Preoperative imaging analysis of the oval window width and the facialpromontory angle can predict operative difficulty in otosclerosis surgery.
Change of Uncertainty in Illness and Unmet Care Needs in Patients With Recurrent Hepatocellular Carcinoma During Active Treatment
Authors: Shun Shiow-Ching , Chou Yun-Jen , Chen Chien-Hung , Yang Jyh-Chin 
Published: April 2017

Background:
Uncertainty about or related to cancer-related treatment and prognosis is commonly experienced by patients with hepatocellular carcinoma and might be associated with unmet care needs. However, their dynamic associations have not been examined in this population.

Objective:
The aim of this study was to explore change in unmet care needs and uncertainty under different levels of uncertainty (low vs high) before discharge and the significant factors related to change of uncertainty in patients with recurrent hepatocellular carcinoma after treatment.

Methods:
A set of questionnaires was used to collect data including symptom distress, supportive care needs, and uncertainty of illness before discharge (T0), 1 month after discharge (T1), and 2 months after discharge (T2). The significant factors related to uncertainty were identified by generalized estimating equations.

Results:
The patients with high uncertainty, who were younger in age, had significantly higher levels of symptom distress and unmet care needs. Before discharge, the patients’ highest levels of unmet needs were psychological in the high-uncertainty group. Patients with jobs, higher unmet care needs, and high uncertainty before discharge had higher levels of uncertainty over time.

Conclusions:
The changes in uncertainty were significantly associated with unmet care needs over time, and the baseline level of uncertainty was a significant factor related to the change of uncertainty.

Implications for Practice:
Healthcare providers should take into account each individual’s age, levels of psychological need, and symptom distress and should offer personalized information related to psychological needs and symptom management to decrease levels of uncertainty before discharge.
Fluid Overload and Kidney Injury Score: A Multidimensional Real-Time Assessment of Renal Disease Burden in the Critically Ill Patient*
Authors: Akcan-Arikan Ayse , Gebhard Daniel J. , Arnold Megan A. , Loftis Laura L. , Kennedy Curtis E. 
Published: April 2017

Objective:
Interruptive acute kidney injury alerts are reported to decrease acute kidney injury–related mortality in adults. Critically ill children have multiple acute kidney injury risk factors; although recognition has improved due to standardized definitions, subtle changes in serum creatinine make acute kidney injury recognition challenging. Age and body habitus variability prevent a uniform maximum threshold of creatinine. Exposure of nephrotoxic medications is common but not accounted for in kidney injury scores. Current severity of illness measures do not include fluid overload, a well-described mortality risk factor. We hypothesized that a multidimensional measure of renal status would better characterize renal severity of illness while maintaining or improving on correlation measures with adverse outcomes, when compared with traditional acute kidney injury staging.

Design:
A novel, real-time, multidimensional, renal status measure, combining acute kidney injury, fluid overload greater than or equal to 15%, and nephrotoxin exposure, was developed (Fluid Overload Kidney Injury Score) and prospectively applied to all patient encounters. Peak Fluid Overload Kidney Injury Score values prior to discharge or death were used to measure correlation with outcomes.

Setting:
Quarternary PICU of a freestanding children’s hospital.

Patients:
All patients admitted over 18 months.

Intervention:
None.

Results:
Peak Fluid Overload Kidney Injury Score ranged between 0 and 14 in 2,830 PICU patients (median age, 5.5 yr; interquartile range, 1.3–12.9; 55% male), 66% of patients had Fluid Overload Kidney Injury Score greater than or equal to 1. Fluid Overload Kidney Injury Score was independently associated with PICU mortality and PICU and hospital length of stay when controlled for age, Pediatric Risk of Mortality-3, ventilator, pressor, and renal replacement therapy use (p = 0.047). Mortality increased from 1.5% in Fluid Overload Kidney Injury Score 0 to 40% in Fluid Overload Kidney Injury Score 8+. When urine output points were excluded, Fluid Overload Kidney Injury Score was more strongly correlated with mortality than fluid overload or acute kidney injury definitions alone.

Conclusion:
A multidimensional score of renal disease burden was significantly associated with adverse PICU outcomes. Further studies will evaluate Fluid Overload Kidney Injury Score as a warning and decision support tool to impact patient-centered outcomes.