bluuebunny/crossref_metadata_2025_split huggingface dataset:
A polymorphism in the CYP17A1 gene influences the therapeutic response to steroidogenesis inhibitors in Cushing's syndrome
Authors: Valassi Elena , Aulinas Anna , Glad Camilla AM , Johannsson Gudmundur , Ragnarsson Oskar , Webb Susan M 
Published: June 2017

SummaryContextSteroidogenesis inhibitors, such as ketoconazole (KTZ) and metyrapone (MTP), are used to lower hypercortisolism in patients with Cushing's syndrome (CS). Cortisol normalization is not reached in all patients taking these medications.ObjectiveTo test the hypothesis that variants in genes affecting steroidogenesis contribute to different responses to KTZ and/or MTP in patients with CS.Patients and methodsFifty‐four CS patients (46 women; mean [±SD] age, 39.7±12.7; 83% with Cushing's disease [CD] and 17% with an adrenal adenoma) preoperatively treated with KTZ (20%), MTP (37%) or a combination of both (43%). Thirty‐nine of these (72%) were described in a previous study investigating the outcome of preoperative treatment with KTZ or MTP in CS patients. Following single‐nucleotide polymorphisms (SNPs) were analysed: rs6410 (CYP11B1 gene), rs1799998 and rs4546 (CYP11B2 gene), and rs6163 (CYP17A1 gene). The associations between SNPs and cortisol levels at the end of medical treatment were evaluated.ResultsNormalization of urinary free cortisol (UFC) was achieved in 50% of patients after 5 months of treatment. Patients carrying the CC genotype of SNP rs6163 were more likely to be controlled than AC/AA (OR 0.25 [95%CI, 0.075‐0.88]; P=.031). When only patients reaching eucortisolism after medical treatment were analysed, median interquartile range (IQR) duration of treatment was shorter in patients carrying the CC genotype of SNP rs6163 as compared to AA/AC carriers (4 [4.57] months vs 5.2 [6.1] months; P=.026).ConclusionsA polymorphism in the CYP17A1 gene was associated with the response to steroidogenesis inhibitors in CS. Genetic differences in the steroidogenic enzymes might account for inter‐individual variations in the responsiveness to adrenal‐blocking agents.
Gaps and opportunities for the World Heritage Convention to contribute to global wilderness conservation
Authors: Allan James R. , Kormos Cyril , Jaeger Tilman , Venter Oscar , Bertzky Bastian , Shi Yichuan , Mackey Brendan , van Merm Remco , Osipova Elena , Watson James E.M. 
Published: June 2017

AbstractWilderness areas are ecologically intact landscapes predominantly free of human uses, especially industrial‐scale activities that result in substantial biophysical disturbance. This definition does not exclude land and resource use by local communities who depend on such areas for subsistence and bio‐cultural connections. Wilderness areas are important for biodiversity conservation and sustain key ecological processes and ecosystem services that underpin planetary life‐support systems. Despite these widely recognized benefits and values of wilderness, they are insufficiently protected and are consequently being rapidly eroded. There are increasing calls for multilateral environmental agreements to make a greater and more systematic contribution to wilderness conservation before it is too late. We created a global map of remaining terrestrial wilderness following the established last‐of‐the‐wild method, which identifies the 10% of areas with the lowest human pressure within each of Earth's 62 biogeographic realms and identifies the 10 largest contiguous areas and all contiguous areas >10,000 km2. We used our map to assess wilderness coverage by the World Heritage Convention and to identify gaps in coverage. We then identified large nationally designated protected areas with good wilderness coverage within these gaps. One‐quarter of natural and mixed (i.e., sites of both natural and cultural value) World Heritage Sites (WHS) contained wilderness (total of 545,307 km2), which is approximately 1.8% of the world's wilderness extent. Many WHS had excellent wilderness coverage, for example, the Okavango Delta in Botswana (11,914 km2) and the Central Suriname Nature Reserve (16,029 km2). However, 22 (35%) of the world's terrestrial biorealms had no wilderness representation within WHS. We identified 840 protected areas of >500 km2 that were predominantly wilderness (>50% of their area) and represented 18 of the 22 missing biorealms. These areas offer a starting point for assessing the potential for the designation of new WHSs that could help increase wilderness representation on the World Heritage list. We urge the World Heritage Convention to ensure that the ecological integrity and outstanding universal value of existing WHS with wilderness values are preserved.
Subclinical atherosclerosis in low Framingham risk HIV patients
Authors: León Rafael , Reus Sergio , López Nicolás , Portilla Irene , Sánchez‐Payá José , Giner Livia , Boix Vicente , Merino Esperanza , Torrús Diego , Moreno‐Pérez Óscar , Portilla Joaquín 
Published: June 2017

AbstractBackgroundPathogenesis of atherosclerosis is complex, and differences between HIV‐infected patients and general population cannot be completely explained by the higher prevalence of traditional cardiovascular risk factors. We aimed to analyse the association between inflammation and subclinical atherosclerosis in HIV patients with low Framingham risk score.Materials and methodsCase–control study. Setting: Outpatient Infectious Diseases clinic in a university hospital. Subjects: HIV‐1‐infected patients aged > 35 years receiving antiretroviral treatment with viral load < 50 copies/mL and Framingham risk score < 10%. Exclusion criteria: inflammatory diseases; dyslipidaemia requiring statins; smoking > 5 cigarettes/day; diabetes; hypertension; vascular diseases. Main outcome: subclinical atherosclerosis determined by ultrasonography: common carotid intima‐media thickness greater than 0·8 mm or carotid plaque presence. Explanatory variables: ribosomal bacterial DNA (rDNA), sCD14, interleukin‐6 (IL‐6) and TNF‐α.ResultsEighty‐four patients were included, 75% male, mean age 42 years and mean CD4+ cells 657 ± 215/mm3. Median Framingham risk score was 1% at 10 years (percentile 25–75: 0·5–4%). Eighteen patients (21%) had subclinical atherosclerosis; the associated factors were older age (P = 0·001), waist–hip ratio (P = 0·01), time from HIV diagnosis (P = 0·02), rDNA (P = 0·04) and IL‐6 (P = 0·01). In multivariate analysis, OR for subclinical atherosclerosis was 7 (95% CI, 1.3–40, P = 0.02) and 9 (95% CI, 1.0–85, P = 0.04) for patients older than 44 years and IL‐6 > 6·6 pg/mL, respectively.ConclusionsWell‐controlled HIV patients with low Framingham risk score have a high prevalence of subclinical carotid atherosclerosis, and the main risk factors are age and inflammation. These patients are not receiving primary prophylaxis for cardiovascular events according to current guidelines.
High‐frequency oscillations: The state of clinical research
Authors: Frauscher Birgit , Bartolomei Fabrice , Kobayashi Katsuhiro , Cimbalnik Jan , van ‘t Klooster Maryse A. , Rampp Stefan , Otsubo Hiroshi , Höller Yvonne , Wu Joyce Y. , Asano Eishi , Engel Jerome , Kahane Philippe , Jacobs Julia , Gotman Jean 
Published: June 2017

SummaryModern electroencephalographic (EEG) technology contributed to the appreciation that the EEG signal outside the classical Berger frequency band contains important information. In epilepsy, research of the past decade focused particularly on interictal high‐frequency oscillations (HFOs) > 80 Hz. The first large application of HFOs was in the context of epilepsy surgery. This is now followed by other applications such as assessment of epilepsy severity and monitoring of antiepileptic therapy. This article reviews the evidence on the clinical use of HFOs in epilepsy with an emphasis on the latest developments. It highlights the growing literature on the association between HFOs and postsurgical seizure outcome. A recent meta‐analysis confirmed a higher resection ratio for HFOs in seizure‐free versus non–seizure‐free patients. Residual HFOs in the postoperative electrocorticogram were shown to predict epilepsy surgery outcome better than preoperative HFO rates. The review further discusses the different attempts to separate physiological from epileptic HFOs, as this might increase the specificity of HFOs. As an example, analysis of sleep microstructure demonstrated a different coupling between HFOs inside and outside the epileptogenic zone. Moreover, there is increasing evidence that HFOs are useful to measure disease activity and assess treatment response using noninvasive EEG and magnetoencephalography. This approach is particularly promising in children, because they show high scalp HFO rates. HFO rates in West syndrome decrease after adrenocorticotropic hormone treatment. Presence of HFOs at the time of rolandic spikes correlates with seizure frequency. The time‐consuming visual assessment of HFOs, which prevented their clinical application in the past, is now overcome by validated computer‐assisted algorithms. HFO research has considerably advanced over the past decade, and use of noninvasive methods will make HFOs accessible to large numbers of patients. Prospective multicenter trials are awaited to gather information over long recording periods in large patient samples.
Assessing the public acceptability of proposed policy interventions to reduce the misuse of antibiotics in Australia: A report on two community juries
Authors: Degeling Chris , Johnson Jane , Iredell Jon , Nguyen Ky‐Anh , Norris Jacqueline M. , Turnidge John D. , Dawson Angus , Carter Stacy M. , Gilbert Gwendolyn L. 
Published: June 2017

AbstractObjectiveTo elicit the views of well‐informed community members on the acceptability of proposed policy interventions designed to improve community use of antibiotics in Australia.DesignTwo community juries held in 2016.Setting and participantsWestern Sydney and Dubbo communities in NSW, Australia. Twenty‐nine participants of diverse social and cultural backgrounds, mixed genders and ages recruited via public advertising: one jury was drawn from a large metropolitan setting; the other from a regional/rural setting.Main outcome measureJury verdict and rationale in response to a prioritization task and structured questions.ResultsBoth juries concluded that potential policy interventions to curb antibiotic misuse in the community should be directed towards: (i) ensuring that the public and prescribers were better educated about the dangers of antibiotic resistance; (ii) making community‐based human and animal health‐care practitioners accountable for their prescribing decisions. Patient‐centred approaches such as delayed prescribing were seen as less acceptable than prescriber‐centred approaches; both juries completely rejected any proposal to decrease consumer demand by increasing antibiotic prices.ConclusionThese informed citizens acknowledged the importance of raising public awareness of the risks, impacts and costs of antibiotic resistance and placed a high priority on increasing social and professional accountability through restrictive measures. Their overarching aim was that policy interventions should be directed towards creating collective actions and broad social support for changing antibiotic use through establishing and explaining the need for mechanisms to control and support better prescribing by practitioners, while not transferring the burdens, costs and risks of interventions to consumers.
Tribological properties of nanoclay reinforced polyimide nanocomposite coatings for alloy steels
Authors: Meng Maozhou , Le Huirong 
Published: June 2017

AbstractA new process was developed to deposit uniform Montmorillonite nanoclay reinforced polyimide nanocomposite coating on alloy steels. The nanoclay particles were successfully dispersed in N, N‐Dimethylacetamide using a combination of magnetic stirring, soaking, and ultrasonic agitation. It was found that the uniform and crack‐free coating can be achieved. The tribological tests indicated that the nanocomposite coating has good adhesion to alloy steels, good load carrying capacity, relatively low friction, and wear. This nanocomposite is a promising material for some offshore, aerospace, and automotive structures that are subjected to sliding contact in corrosive environment.
Artificial human antigen‐presenting cells are superior to dendritic cells at inducing cytotoxic T‐cell responses
Authors: Li Hua , Shao Shengwen , Cai Jianshu , Burner Danielle , Lu Lingeng , Chen Qiuqiang , Minev Boris , Ma Wenxue 
Published: June 2017

SummaryPeptide recognition through the MHC class I molecule by cytotoxic T lymphocytes (CTLs) leads to the killing of cancer cells. A potential challenge for T‐cell immunotherapy is that dendritic cells (DCs) are exposed to the MHC class I–peptide complex for an insufficient amount of time. To improve tumour antigen presentation to T cells and thereby initiate a more effective T‐cell response, we generated artificial antigen‐presenting cells (aAPCs) by incubating human immature DCs (imDCs) with poly(lactic‐co‐glycolic) acid nanoparticles (PLGA‐NPs) encapsulating tumour antigenic peptides, followed by maturation with lipopolysaccharide. Tumour antigen‐specific CTLs were then induced using either peptide‐loaded mature DCs (mDCs) or aAPCs, and their activities were analysed using both ELISpot and cytotoxicity assays. We found that the aAPCs induced significantly stronger tumour antigen‐specific CTL responses than the controls, which included both mDCs and aAPCs loaded with empty nanoparticles. Moreover, frozen CTLs that were generated by exposure to aAPCs retained the capability to eradicate HLA‐A2‐positive tumour antigen‐bearing cancer cells. These results indicated that aAPCs are superior to DCs when inducing the CTL response because the former are capable of continuously presenting tumour antigens to T cells in a sustained manner. The development of aAPCs with PLGA‐NPs encapsulating tumour antigenic peptides is a promising approach for the generation of effective CTL responses in vitro and warrants further assessments in clinical trials.
An integrative review on coping skills in nursing students: implications for policymaking
Authors: Labrague L.J. , McEnroe‐Petitte D.M. , Al Amri M. , Fronda D.C. , Obeidat A.A. 
Published: June 2017

AimThis study critically appraised both quantitative and qualitative studies describing coping strategies utilized by nursing students when faced with stress.BackgroundStress in nursing students during clinical training is well documented in the nursing literature. The need to utilize positive‐coping strategies is necessary to effectively deal with stress and its accompanying stressors.MethodsAn integrative review method was used in this review. PsycINFO, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and Scopus were the databases used in searching for relevant literature using the following search terms; ‘coping’, ‘nursing students’, clinical training’, ‘ways of coping’ and ‘clinical practice’. A total of 27 studies published from 2001 to 2016 were included in this review.FindingsFindings demonstrated that nursing students utilized problem‐focused coping strategies rather than emotion‐focused coping strategies. Specific coping behaviours utilized included problem‐solving behaviours, self‐confident approaches and seeking of support from family and friends.ConclusionThe review contributes to the growing literature on coping strategies in nursing students and may have implications on nursing education and nursing policy. This review also demonstrated a scarcity of studies that links specific coping strategies to nursing school stressors and examines predictors of coping skills in nursing students.Implications for nursing educationInstitutionalization of structured student orientation programme, implementation of well‐planned mentoring programmes and establishment of support unit/centres may be helpful in supporting nursing students during their clinical placement. By developing empirically based interventions, nursing faculty can assist nursing students in strengthening their positive‐coping skills to effectively deal with various stressors encountered.
Refractory venous leg ulcers: observational evaluation of innovative new technology
Authors: Harris Connie , Loney Amanda , Brooke Jillian , Charlebois Amanda , Coppola Lucy , Mehta Sowmil , Flett Norman 
Published: June 2017

AbstractThis observational case series reports the evaluation of a novel neuromuscular electrical stimulation device (geko™) that stimulates the common peroneal nerve at the fibular head as an adjunctive therapy in patients with non‐healing venous leg ulcers. The aim was to evaluate and determine if the geko™ device was effective in this population and should be added to the medical supply formulary. Patients whose wounds had failed to heal within 24 weeks of standard therapy were identified in two community settings in Ontario. A total of 11 patients consented to the evaluation with a combined 107‐year history of recalcitrant leg ulcers. Although the pre‐geko™ healing rate was unknown, all ulcers were considered non‐healing. With geko™, the average weekly percentage reduction in surface area for all patients was 4·5% and for the six adherent to geko™ and best practices 7·0%. By comparison, the average weekly percentage reduction for measurable wounds in the five non‐adherent patients was 1·8%. Requirements for success appear to include an arterial status adequate for healing, effective and prompt management of wound infections and adherence to the treatment schedule. The geko™ device has been added to the medical supply formulary in one centre and is pending in the other.
Enhanced structural, dielectric, ferroelectric, and piezoelectric properties of (1−x)Ba0.9Sr0.1TiO3–(x)Ba0.7Ca0.3TiO3 ceramics derived using mechano‐chemical activation technique
Authors: Jain Aditya , Panwar Amrish K. , Saroha Rakesh , Jha A. K. 
Published: June 2017

AbstractThe effect of Ba0.7Ca0.3TiO3 (BCT) substitution on the structural, dielectric, ferroelectric, and piezoelectric properties of mechano‐chemically synthesized lead‐free (1−x)Ba0.9Sr0.1TiO3‐(x)Ba0.7Ca0.3TiO3 (x=0.0, 0.10, 0.20, 0.35, and 0.50) ceramics have been investigated. XRD patterns confirms the formation of tetragonal phase with P4mm space group. The results indicate a strong influence of BCT substitution on the structural and electrical properties of Ba0.9Sr0.1TiO3 (BST) ceramic. BST–BCT ceramic for x=0.35 have shown high dielectric constant εm~21 800, high remnant polarization Pr~10.16 μC/cm2, large piezoelectric charge constant D33~293 pC/N, large piezoelectric voltage constant g33~5.80 mV·m/N, and highest dielectric breakdown strength Ebd~224 kV/cm among the five synthesized samples. The correlation between structural, dielectric, ferroelectric, and piezoelectric properties of the BST ceramic with increasing BCT content have been systematically described on the basis of domain wall motion and grain size effect.
Heritable variation in circulating glucocorticoids and endocrine flexibility in a free‐living songbird
Authors: Stedman J. M. , Hallinger K. K. , Winkler D. W. , Vitousek M. N. 
Published: June 2017

AbstractPhenotypic flexibility is a central way that organisms cope with challenging and changing environments. As endocrine signals mediate many phenotypic traits, heritable variation in hormone levels, or their context‐dependent flexibility, could present an important target for selection. Several studies have estimated the heritability of circulating glucocorticoid levels under acute stress conditions, but little is known about the potential for either baseline hormone levels or rapid endocrine flexibility to evolve. Here, we assessed the potential for selection to operate on the elevation (circulating hormone levels) and flexibility of glucocorticoid reaction norms to acute restraint stress. Multivariate animal models revealed low but significant heritability in baseline (h2 = 0.13–0.14) and stress‐induced glucocorticoids (h2 = 0.18), and moderate heritability in glucocorticoid flexibility in response to acute stress (h2 = 0.38) in free‐living juvenile tree swallows (Tachycineta bicolor; n = 408). Baseline glucocorticoids were not genetically correlated with either stress‐induced glucocorticoids or glucocorticoid flexibility. These findings indicate that baseline glucocorticoids and the acute stress response are distinct traits that can be independently shaped by selection. Microevolutionary changes that influence the expression or flexibility of these endocrine mediators of phenotype may be an important way that populations adapt to changing environments and novel threats.
Reduced risk of hepatocellular carcinoma by achieving a subcirrhotic liver stiffness through antiviral agents in hepatitis B virus‐related advanced fibrosis or cirrhosis
Authors: Kim Byung Seok , Seo Yeon Seok , Kim Young Seok , Lee Chang Hyeong , Lee Han Ah , Um Soon Ho , Yoo Jeong‐Ju , Kim Sang Gyune , Suh Sang Jun , Jung Young Kul , Ahn Sang Hoon , Han Kwang‐Hyub , Yim Hyung Joon , Kim Seung Up ,   The Korean Transient Elastography Study Group
Published: June 2017

AbstractBackground and AimA subcirrhotic range of liver stiffness (sc‐LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc‐LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB‐related advanced fibrosis or cirrhosis.MethodsIn total, 209 patients with CHB‐related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut‐off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa.ResultsThe median age of the study population was 51 years, with males predominating (n = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc‐LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc‐LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P < 0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc‐LS (log‐rank test, P = 0.020).ConclusionsThe achievement of sc‐LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT.