bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myocardial cytochrome oxidase activity increases with age and hypoxemia in patients with congenital heart disease
Authors: Onwugbufor Michael , Levy Richard J. , Zurakowski David , Jonas Richard A. , Sinha Pranava 
Published: December 2016

Background: Myocardial tolerance to ischemia is influenced by age and preoperative cyanosis through unknown mechanisms and significantly affects postoperative outcomes. Cytochrome c oxidase (CcOx), the terminal enzyme of the mitochondrial electron transport chain, may play a role in the susceptibility to ischemic-reperfusion (IR) injury. Our study aimed at investigating changes in human myocardial CcOx activity based on age and preoperative oxygen saturation to understand its role in transition from neonatal to mature myocardium and hypoxic conditions. Methods: The right atrial appendage from patients undergoing first time surgical repair/palliation of congenital heart defects was analyzed for steady state CcOx activity by oxidation of ferrocytochrome c via spectrophotometry and steady state CcOx subunit I protein content by protein immunoblotting. Student’s t-test compared CcOx activity and protein levels between patients with preoperative hypoxia and normoxia. Multiple linear regression analysis was used to assess the effects of age and preoperative arterial oxygen saturations (SaO2) on CcOx protein activity and protein content. Results: Thirty-two patients with a median (interquartile range) age of 83 days (8-174) and preoperative oxygen saturation 98% (85-100%) were enrolled. Independent of age, preoperative SaO2 ⩽90% was associated with significantly greater CcOx steady state activity (p=0.004). Additionally, older age itself was associated with increased CcOx steady state activity (p=0.022); the combination of preoperative SaO2 and age account for 33% of the variation in CcOx steady state activity (R2=0.332). There was no increase in the CcOx subunit I protein content with either age or preoperative hypoxia. Conclusions: In patients with congenital heart disease, an increase in CcOx steady state activity is seen with increasing age. Hypoxia leads to upregulation of CcOx steady state activity without an increase in the amount of enzyme protein itself. Higher CcOx activity in older and cyanotic patients may indicate CcOx-dependent reactive oxygen species as the mechanism for IR injury.
Effect of dexmedetomidine on postoperative cognitive dysfunction in elderly patients after general anaesthesia: A meta-analysis
Authors: Zhou Chengmao , Zhu Yu , Liu Zhen , Ruan Lin 
Published: December 2016

Objective We undertook a meta-analysis to investigate the effect of dexmedetomidine on postoperative cognitive dysfunction (POCD). Methods We searched PubMed, EMBASE, the Cochrane Library, CNKI and Google Scholar to find randomized controlled trials (RCTs) of the influence of dexmedetomidine on POCD in elderly adults who had undergone general anaesthesia. Two researchers independently screened the literature, extracted data, and evaluated methodologic quality against inclusion and exclusion criteria. We used RevMan 5.2 to undertake our meta-analysis. Results Thirteen RCTs were included. Compared with controls, dexmedetomidine: 1) significantly reduced the incidence of POCD (relative risk = 0.59, 95% confidence interval [CI] 0.45–2.95) and improved Mini-Mental State Examination (MMSE) score (mean difference, MD = 1.74, 95% CI 0.43–3.05) on the first postoperative day; and 2) reduced the incidence of POCD after the first postoperative day (MD = 2.73, 95% CI 1.33–4.12). Conclusion Dexmedetomidine reduces the incidence of POCD and improves postoperative MMSE score.
A 3-year follow-up of a patient with acute renal failure caused by thrombotic microangiopathy related to antiphospholipid syndrome: case report
Authors: Zhou X-J , Chen M , Wang S-X , Zhou F-D , Zhao M-H 
Published: December 2016

Background Microvascular manifestations of antiphospholipid antibody syndrome in the kidneys include acute renal failure, thrombotic microangiopathy and hypertension. Therapy has been largely empiric. Case report A 49-year-old Chinese man presented with anuric acute renal failure without abundant proteinuria and heavy haematuria, but markedly low levels of urinary sodium, potassium and chlorine upon admission. On day 1 of hospitalization, his thrombocytopenia, anaemia and renal failure showed rapid progression. The presence of lupus anticoagulant and vascular ischaemia of the small vessels in renal arteriography were also observed. Anticoagulants, continuous renal replacement therapy, glucocorticoids and six sessions of plasma exchange were started. After the fourth plasma exchange (on day 20), his urine output increased and began to normalize. On day 25, haemodialysis was stopped and his general condition gradually improved. A renal biopsy was subsequently performed, and the histopathological diagnosis was thrombotic microangiopathy due to antiphospholipid antibody syndrome. A further 3-year follow-up showed that his haemoglobin level, platelet count and serum creatinine were within the normal range, with stable blood pressure. Conclusion Treatment modalities such as anticoagulation, immunosuppression and plasma exchange are likely to be necessary when severe acute renal failure combined with thrombotic microangiopathy present in nephropathy of antiphospholipid antibody syndrome.
Comparison of proliferative and immunomodulatory potential of adipose-derived mesenchymal stem cells from young and geriatric cats
Authors: Zajic Lara B , Webb Tracy L , Webb Polly , Coy Jonathan W , Dow Steve W , Quimby Jessica M 
Published: December 2016

Objectives The objective of this study was to compare the ability of adipose-derived mesenchymal stem cells (aMSCs) generated from young vs geriatric cats to proliferate in culture, suppress lymphocyte proliferation and undergo senescence. Methods Adipose tissues from five young (<5 years) and six geriatric (>10 years) cats were harvested and cryopreserved for subsequent aMSC isolation and culture. aMSC proliferation in culture was compared via determination of time until passage two and by 3-(4,5-demethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The immunomodulatory capacity of aMSCs was assessed using lymphocyte proliferation assays, and senescence was evaluated using senescence-associated B-galactosidase (SABG) expression. All assays were performed on aMSCs between passage two and passage three. Results aMSCs from geriatric cats took significantly longer ( P = 0.008) to reach passage two (median 11 days, range 9–22 days) compared with aMSCs from young healthy cats (median 7 days, range 6–8 days). No significant difference was detected between young and geriatric cats in terms of their ability to suppress lymphocyte proliferation. SABG expression was not significantly different between young and geriatric aMSCs. Conclusions and relevance Compared with young feline aMSCs, geriatric aMSCs are significantly impaired in their ability to rapidly proliferate to passage two following initial culture, presenting a concern for autologous therapy. Nonetheless, once the cells are expanded, young and geriatric cat aMSCs appear to be equivalent in terms of their ability to functionally suppress T-cell activation and proliferation.
Combined use of a pCONus and a Solitaire stent: Report of two cases
Authors: Bhogal Pervinder , Aguilar Pérez Marta , Martinez Moreno Rosa , Miś Marcin , Miś Maciej , Henkes Hans 
Published: December 2016

Objective The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. Methods Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery. Both aneurysms had vessels arising from the neck and dome of the aneurysm. We present the strategy involved to protect all the arterial branches and coil occlude the aneurysm, the angiographic appearances and clinical status of the patients. Results Both cases involved the combined use of a pCONus and Solitaire stent. The parent vessel and efferent branches were all preserved with exclusion of the aneurysm from the circulation. There were no intraoperative complications. One patient developed mild transient symptoms 24 hours post procedure, which had resolved completely on discharge. Conclusion The use of the pCONus in conjunction with the Solitaire stent is a useful combination when dealing with complex wide-necked aneurysms with arteries derived from the fundus of the aneurysm.
Intra- and inter-tester reliability and validity of normal finger size measurement using the Japanese ring gauge system
Authors: Suzuki T. , Sato Y. , Sotome S. , Arai H. , Arai A. , Yoshida H. 
Published: December 2016

This study was designed to investigate the reliability and validity of measurements of finger diameters with a ring gauge. A reliability study enrolled two independent samples (50 participants and seven examiners in Study I; 26 participants and 26 examiners in Study II). The sizes of each participant’s little fingers were measured twice with a ring gauge by each examiner. To investigate the validity of the measurements, five hand therapists compared the finger size and hand volume of 30 participants with the ring gauge and with a figure-of-eight technique (Study III). The intra-class correlation coefficient for intra-observer reliability ranged from 0.97 to 0.99 in Study I, and 0.90 to 0.97 in Study II. The intra-class correlation coefficient for inter-observer reliability was 0.95 in Study I and 0.94 in Study II. The validity study showed a Pearson product moment correlation coefficient of 0.75. The ring gauge showed high reliability and validity for measurement of finger size. Level of evidence: III, diagnostic
Restoration of shoulder abduction in brachial plexus avulsion injuries with double neurotization from the spinal accessory nerve: a report of 13 cases
Authors: Huan K. W. S. J. , Tan J. S. W. , Tan S. H. , Teoh L. C. , Yong F. C. 
Published: December 2016

In upper (C5-C7) and total (C5-T1) root avulsion brachial plexus injury, a method of double neurotization from a single donor spinal accessory nerve to two target nerves (suprascapular nerve and axillary nerve) may be done, leaving donor nerves available for reconstruction procedures to restore other aspects of upper limb function. A mean range of shoulder abduction of 91° (SD 25°) was achieved through this procedure in our study of 13 cases, of which seven cases were C5-C7 root avulsion and six cases were C5-T1 root avulsion brachial plexus injuries. Six of the former group and three of the latter group achieved >90° shoulder abduction. The technique of double neurotization from a single donor nerve provides favourable results in restoring shoulder abduction in avulsion brachial plexus injuries. Level of evidence: IV
Tenascin-C Prevents Articular Cartilage Degeneration in Murine Osteoarthritis Models
Authors: Matsui Yuriyo , Hasegawa Masahiro , Iino Takahiro , Imanaka-Yoshida Kyoko , Yoshida Toshimichi , Sudo Akihiro 
Published: December 2016

Objective The objective of this study was to determine whether intra-articular injections of tenascin-C (TNC) could prevent cartilage damage in murine models of osteoarthritis (OA). Design Fluorescently labeled TNC was injected into knee joints and its distribution was examined at 1 day, 4 days, 1 week, 2 weeks, and 4 weeks postinjection. To investigate the effects of TNC on cartilage degeneration after surgery to knee joints, articular spaces were filled with 100 μg/mL (group I), 10 μg/mL (group II) of TNC solution, or control (group III). TNC solution of 10 μg/mL was additionally injected twice after 3 weeks (group IV) or weekly after 1 week, 2 weeks, and 3 weeks (group V). Joint tissues were histologically assessed using the Mankin score and the modified Chambers system at 2 to 8 weeks after surgery. Results Exogenous TNC was maintained in the cartilage and synovium for 1 week after administration. Histological scores in groups I and II were better than scores in group III at 4 and 6 weeks, but progressive cartilage damage was seen in all groups 8 weeks postoperatively. Sequential TNC injections (groups IV and V) showed significantly better Mankin score than single injection (group II) at 8 weeks. Conclusion TNC administered exogenously remained in the cartilage of knee joints for 1 week, and could decelerate articular cartilage degeneration in murine models of OA. We also showed that sequential administration of TNC was more effective than a single injection. TNC could be an important molecule for prevention of articular cartilage damage.
Heterogeneous leukemia stem cells in myeloid blast phase chronic myeloid leukemia
Authors: Kinstrie Ross , Karamitros Dimitris , Goardon Nicolas , Morrison Heather , Hamblin Mike , Robinson Lisa , Clark Richard E. , Copland Mhairi , Vyas Paresh 
Published: December 2016

Key PointsIn BP-CML multiple, nonhierarchically arranged immunophenotypic stem/progenitor populations have functional LSC activity. BP-associated cytogenetic abnormalities are detected equally in all immunophenotypic stem/progenitor cells.
Baseline susceptibility of different European lepidopteran and coleopteran pests to Bt proteins expressed in Bt maize: a systematic review
Authors: Priesnitz Kai U. , Vaasen Anja , Gathmann Achim 
Published: December 2016

Abstract
Background
Lepidopteran and coleopteran species are the most important pests in maize. They can be controlled using genetically modified (GM) crops expressing insecticidal Bacillus thuringiensis (Bt) proteins. The long-term success of this technology demands a pest resistance management. Important information for the successful management of resistance is the baseline susceptibility of the different target pests to the different Bt proteins. The data on baseline susceptibility should enable risk assessors and managers to assess whether a GM maize produces a Bt protein in a high-dose to specific target organisms and resistance has evolved during the commercial cultivation of this GM maize events.

Methods
Our systematic search followed an a priori protocol including the database platforms Web of Science, Scopus, CAB abstracts, Science Direct and JSTOR. We additionally conducted a Google scholar search. We collated all search results and screened all retrieved articles using predetermined inclusion criteria. We identified 30 studies, which fulfilled the criteria of including a relevant Bt protein, a relevant species, an appropriate endpoint, and field-derived pest generations reared in the laboratory no longer than three generations. We then made a quality assessment to discover if the studies considered the dose response curves with confidence intervals, described the protein source, tested the protein concentration and the protein activity via positive controls, use more than ten larvae per concentration, more than two replications, and more than five protein concentrations. Since no quantitative synthesis was possible the synthesis of the results was done in a narrative form.

Results
Seventy percent of the studies fulfilled five or more criteria and 17% fulfilled four of the seven criteria. Six Bt proteins were tested on one or more of the four species Ostrinia nubilalis, Helicoverpa armigera, Sesamia nonagrioides, and Diabrotica virgifera virgifera. We extracted the baseline susceptibility for the given protein-species-combinations and the test method with the Bt protein applied either on the surface of the diet or incorporated. Although, the data displays a high heterogeneity and are thus hard to compare, they give an overview of the baseline susceptibility of lepidopteran/coleopteran pests to Bt proteins.

Conclusion
Our systematic review illustrates the heterogeneity of the data and indicates the necessity of standard protocols for testing susceptibility of insect pests, which provide comparable data. The cultivation of Bt crops, as with any other plant protection measure, is likely to result in resistance evolution in the target pests. Industry, policy makers, and research should combine knowledge to protect the benefits of this technology.
The effect of supportive-expressive therapy on hope and quality of life in patients with multiple sclerosis (MS)
Authors: abolghasemi abbas , Taherifard Mina , Farhang Sara , Kiamarsi Azar , Saharkhiz Arabani Arash 
Published: December 2016

Aim of the studyThe aim of the present study was to investigate the effectiveness of supportive-expressive therapy on the hope and quality of life in patients with multiple sclerosis (MS).Subject or material and methodsThis was an experimental study with pretest-posttest design together with a control group. In this regard, 32 patients from members of MS society of Tehran were selected as the sample by target sampling, and then they were placed into two groups of 16 people (experimental and control group) through random assignment. The supportive-expressive therapy was received by experimental group during twelve sessions in 75 minutes. The instruments used were Snyder et al.’s Hope Inventory and World Health Organization’s Quality of Life-Brief.ResultsThe results showed that there was a significant difference between hope and quality of life in the experimental and control groups (p<0.01).DiscussionSupportive-expressive therapy is effective in increasing hope and quality of life in patients with MS.ConclusionsThe results showed that supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help increases hope and quality of life in patients with MS.
Use of core biopsy in diagnosing cervical lymphadenopathy: a viable alternative to surgical excisional biopsy of lymph nodes?
Authors: Allin D , David S , Jacob A , Mir N , Giles A , Gibbins N 
Published: December 2016

OBJECTIVES Lymphoma often presents with a neck mass and while fine-needle aspiration cytology may be suggestive, tissue biopsy is required for reliable diagnosis and classification of a lymphoma that is sufficient to deliver the correct treatment for the patient. Traditionally, excisional biopsy of a lymph node has been the standard method of tissue sampling, providing ample tissue for assessment. However, this requires theatre time, and preceding fine-needle aspiration cytology, which may incur a delay. With careful use of tissue, coupled with advances in immunohistochemical and molecular investigative techniques, core biopsy provides a possible alternative to traditional fine-needle aspiration and excisional biopsy. In this study, we aimed to determine the efficacy of diagnosing neck masses. METHOD A retrospective analysis was performed of patients being investigated for a neck mass who were undergoing ultrasound-guided core biopsies of cervical lymph nodes over a 17-month period. The final histology report was scrutinised to assess whether adequate tissue was obtained to allow for full tissue diagnosis. RESULTS Over the 17-month period analysed, 70 patients with cervical lymphadenopathy underwent core biopsy. Of these, 63 (90%) were diagnostic for either lymphoma or other pathology and did not require further tissue sampling. Overall, 19 patients were diagnosed with lymphoma, of which only 1 required further biopsy due to inconclusive initial core biopsy. CONCLUSIONS Current guidelines for investigating lymphomas require that excisional biopsy be performed to obtain ample tissue to allow full nodal architecture assessment and ancillary investigation to reach an accurate histological classification. Within our head and neck multidisciplinary team, however, it is considered that results from core biopsies can be obtained in a more timely fashion and with histological accuracy equal to those of open biopsy. The results obtained demonstrate that core biopsy is an effective tool for investigation. We believe this should be the first-line investigation of choice, as it reduces the need for patients to undergo surgery, is more cost effective and offers a faster diagnosis.
Safety in out-of-hours operating in trauma and orthopaedics at a district general hospital
Authors: Gulamhussein MA , Chaudhry S , Noor S , Chaudhry T , Guha A , Knebel R 
Published: December 2016

INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure. Furthermore, the clinical urgency and safety of cases was assessed based on whether there was any record of life or limb threatening indications at the time of admission. RESULTS Overall, 131 procedures were performed after 9pm, with 102 performed between 9pm and midnight, and 29 after midnight. Consultants performed 16 cases and the remaining 115 cases were operated on by middle grades or specialty trainees. A fifth (20%) of the cases were genuinely life or limb threatening. A total of 123 procedures were classed as having good outcomes. The complication rate was 8%. CONCLUSIONS In our study, 80% of the procedures performed after 9pm could not be categorised as life or limb threatening. Appropriate CEPOD classification would ensure that only life or limb threatening cases were listed for theatre after 9pm. Alternative methods of operating within working hours should be considered.
Prophylactic antibiotics in acute pancreatitis: endless debate
Authors: Mourad MM , Evans RPT , Kalidindi V , Navaratnam R , Dvorkin L , Bramhall SR 
Published: December 2016

INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis. RESULTS Mixed evidence was found to support and refute the role of prophylactic antibiotics in acute pancreatitis. Most studies have failed to demonstrate much benefit from its routine use. Data from our unit suggested little benefit of their routine use, and showed that the mortality of those treated with antibiotics was significantly higher compared with those not treated with antibiotics (9% vs 0%, respectively, P = 0.043). In addition, the antibiotic group had significantly higher morbidity (36% vs 5%, respectively, P = 0.002). CONCLUSIONS Antibiotics should be used in patients who develop sepsis, infected necrosis-related systemic inflammatory response syndrome, multiple organ dysfunction syndrome or pancreatic and extra-pancreatic infection. Despite the many other factors that should be considered, prompt antibiotic therapy is recommended once inflammatory markers are raised, to prevent secondary pancreatic infection. Unfortunately, there remain many unanswered questions regarding the indications for antibiotic administration and the patients who benefit from antibiotic treatment in acute pancreatitis.