bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biventricular function on early echocardiograms in neonatal hypoxic–ischaemic encephalopathy
Authors: Aggarwal Sanjeev , Natarajan Girija 
Published: April 2017

AbstractAimTo compare early (<24 hours) echocardiograms (ECHOs) in infants with perinatal hypoxic–ischaemic encephalopathy (HIE) undergoing (i) therapeutic hypothermia (TH), (ii) normothermia and (iii) normal controls.MethodsThis was a single‐centre retrospective review of clinical early ECHOs of term infants with moderate or severe HIE and controls (with a normal ECHO <72 hours of age). Right (RVO) and left ventricular output (LVO), RV and LV myocardial performance index (MPI), systolic to diastolic duration ratio (S/D) and eccentricity indices (EI) in systole and diastole were compared using ANOVA.ResultsAmong infants with HIE (n = 56, 38 in the TH and 18 in normothermia groups), 14 (25%) infants died and 42 survived. Significantly elevated biventricular MPI, lower RVO and LVO and pulmonary hypertension (abnormal EI, higher RV S/D and bidirectional or right‐to‐left ductal shunt) were found in groups with HIE, compared to controls (n = 35). LV MPI was lower in HIE‐TH, compared to the HIE‐normothermia group. Infants with HIE who died (n = 14) had a significantly lower EId [0.77 (0.09) vs. 0.83 (0.08), p = 0.021] compared to survivors (n = 42).ConclusionInfants with perinatal HIE have ventricular dysfunction; those who died had significantly lower EId than survivors; this association needs to be further validated.
Randomised clinical trial: yoga vs written self‐care advice for ulcerative colitis
Authors: Cramer H. , Schäfer M. , Schöls M. , Köcke J. , Elsenbruch S. , Lauche R. , Engler H. , Dobos G. , Langhorst J. 
Published: April 2017

SummaryBackgroundPerceived stress seems to be a risk factor for exacerbation of ulcerative colitis. Yoga has been shown to reduce perceived stress.AimsTo assess the efficacy and safety of yoga for improving quality of life in patients with ulcerative colitis.MethodsA total of 77 patients (75% women; 45.5 ± 11.9 years) with ulcerative colitis in clinical remission but impaired quality of life were randomly assigned to yoga (12 supervised weekly sessions of 90 min; n = 39) or written self‐care advice (n = 38). Primary outcome was disease‐specific quality of life (Inflammatory Bowel Disease Questionnaire). Secondary outcomes included disease activity (Rachmilewitz clinical activity index) and safety. Outcomes were assessed at weeks 12 and 24 by blinded outcome assessors.ResultsThe yoga group had significantly higher disease‐specific quality of life compared to the self‐care group after 12 weeks (Δ = 14.6; 95% confidence interval=2.6–26.7; P = 0.018) and after 24 weeks (Δ = 16.4; 95% confidence interval=2.5–30.3; P = 0.022). Twenty‐one and 12 patients in the yoga group and in the self‐care group, respectively, reached a clinical relevant increase in quality of life at week 12 (P = 0.048); and 27 and 17 patients at week 24 (P = 0.030). Disease activity was lower in the yoga group compared to the self‐care group after 24 weeks (Δ = −1.2; 95% confidence interval=−0.1−[−2.3]; P = 0.029). Three and one patient in the yoga group and in the self‐care group, respectively, experienced serious adverse events (P = 0.317); and seven and eight patients experienced nonserious adverse events (P = 0.731).ConclusionsYoga can be considered as a safe and effective ancillary intervention for patients with ulcerative colitis and impaired quality of life. Trial registration: ClinicalTrials.gov identifier: NCT02043600.
Inhibitory Effects of Urothelium‐related Factors
Authors: Guan Na N. , Gustafsson Lars E. , Svennersten Karl 
Published: April 2017

AbstractThe urothelium of the bladder has long been recognized as a protective barrier between detrusor and urine. In recent years, it has become more evident that the urothelium plays a role as an active source of mediators. The urothelium can release neurotransmitters and modulators such as acetylcholine, ATP, nitric oxide, prostaglandins and neuropeptides. They exert both excitatory and inhibitory effects in modulating urinary tract motility. In addition, several studies have reported the existence of an urothelium‐derived unknown inhibitory factor in the urinary bladder. By the use of a new serial cascade superfusion bioassay on guinea pig ureter, recent studies confirm that the guinea pig bladder urothelium releases a substance with inhibitory bioactivity, which was resistant to treatment with nitric oxide synthase inhibitor and cyclooxygenase inhibitor and to adenosine A1/A2 receptor blockade. Lately, a marked and quickly inactivated novel release of PGD2 from the bladder urothelium was discovered, together with localization of prostaglandin D synthase therein. PGD2 was found to have an inhibitory influence on nerve‐induced contractions in guinea pig urinary bladder and on spontaneous contractions in the out‐flow region. An altered release of excitatory and inhibitory factors is likely to play an important part in bladder motility disturbances, of which the prostanoids are a notable group. Due to the fact that the bladder is relaxed 99% of the time, not only excitatory mechanisms in the bladder are necessary to study, but also inhibitory mechanisms need considerable attention, which will contribute to the discovery of new targets to treat bladder motility disorders.
Wrongness, Responsibility, and Conscientious Refusals in Health Care
Authors: Liberman Alida 
Published: April 2017

AbstractIn this article, I address what kinds of claims are of the right kind to ground conscientious refusals. Specifically, I investigate what conceptions of moral responsibility and moral wrongness can be permissibly presumed by conscientious objectors. I argue that we must permit HCPs to come to their own subjective conclusions about what they take to be morally wrong and what they take themselves to be morally responsible for. However, these subjective assessments of wrongness and responsibility must be constrained in several important ways: they cannot involve empirical falsehoods, objectionably discriminatory attitudes, or unreasonable normative beliefs. I argue that the sources of these constraints are the basic epistemic, relational, and normative competencies needed to function as a minimally decent health‐care professional. Finally, I consider practical implications for my framework, and argue that it shows us that the objection raised by the plaintiffs in Zubik v. Burwell is of the wrong sort.
The unique immunological features of heparin‐induced thrombocytopenia
Authors: Staibano Phillip , Arnold Donald M. , Bowdish Dawn M. E. , Nazy Ishac 
Published: April 2017

SummaryHeparin‐induced thrombocytopenia (HIT) is a serious drug reaction that leads to a decrease in platelet count and a high risk of thrombosis. HIT patients produce pathogenic immunoglobulin G (IgG) antibodies that bind to complexes of platelet factor‐4 (PF4) and heparin. HIT immune complexes crosslink Fc‐receptors resulting in platelet and monocyte activation. These events lead to the release of procoagulant chemokines and tissue factor, which together create an intensely prothrombotic state. HIT represents an atypical immune response because it has features of both T cell‐dependent and T cell‐independent mechanisms. The disorder is characterized by newly formed anti‐PF4/heparin IgG antibodies, which are characteristic of a T cell‐dependent mechanism; however, re‐exposure to heparin, months after HIT, does not lead to a memory response, which is consistent with a T cell‐independent mechanism. In this review, we discuss the immunobiological events that can explain these features, including the role for T cell‐dependent and T cell‐independent mechanisms in HIT antibody generation, the immunogenic characteristics of the PF4/heparin antigen, and the concept of a temporary loss in immune regulation contributing to the onset of HIT. We also present a novel immunobiological model to explain the atypical immune response that is characteristic of HIT.
Tectonic uplift of the Xichang Basin (SETibetan Plateau) revealed by structural geology and thermochronology data
Authors: Deng Bin , Liu Shugen , Jiang Lei , Zhao Gaoping , Huang Rui , Li Zhiwu , Li Jinxi , Jansa Luba 
Published: April 2017

AbstractThe Xichang Basin in southeastern Tibet provides crucial information about formation and tectonic processes affecting the eastern Tibetan Plateau. To determine when and how the uplift developed, we conducted detailed studies of structures and obtained thermochronology data from the Xichang Basin and its periphery. The Xichang Basin is characterized by gentle deformation of the strata, segmented by an E‐vergent boundary thrust fault. Two stages of deformation, strike‐slip followed by an E‐W oriented shortening resulted in oblique shortening between the southeastern Tibetan Plateau and the Sichuan Basin. New apatite fission‐track data interpreted together with (U‐Th)/He data confirm a simple burial/heating and exhumation/cooling history across the Xichang Basin and its periphery. Subsidence and burial of the Xichang Basin peaked between 80–30 Ma, followed by mountain building with a protracted cooling starting at around 40–20 Ma, with rates ofca. 2.0–8.0 °C Myr−1(i.e. 0.1–0.3 mm year−1). Our data indicate that the Xichang Basin has experiencedca. 2.5–5 km of exhumation, much more intensive than theca. 1–2 km of exhumation inferred for the southwestern Sichuan Basin. Restored balanced cross‐sections of post‐Late‐Triassic strata along aca. 250 km traverse indicateca. 10–20% east‐west shortening strain (i.e.ca. 20–30 km) at the southeastern Tibetan Plateau during Cenozoic time. Study of crustal thickening and erosion supports a tectonic shortening mechanism to account for the uplift of the Xichang Basin on the southeastern Tibetan Plateau.
Reproductive senescence: new perspectives in the wild
Authors: Lemaître Jean‐François , Gaillard Jean‐Michel 
Published: April 2017

ABSTRACTAccording to recent empirical studies, reproductive senescence, the decline in reproductive success with increasing age, seems to be nearly ubiquitous in the wild. However, a clear understanding of the evolutionary causes and consequences of reproductive senescence is still lacking and requires new and integrative approaches. After identifying the sequential and complex nature of female reproductive senescence, we show that the relative contributions of physiological decline and alterations in the efficiency of parental care to reproductive senescence remain unknown and need to be assessed in the light of current evolutionary theories of ageing. We demonstrate that, although reproductive senescence is generally studied only from the female viewpoint, age‐specific female reproductive success strongly depends on male–female interactions. Thus, a reduction in male fertilization efficiency with increasing age has detrimental consequences for female fitness. Lastly, we call for investigations of the role of environmental conditions on reproductive senescence, which could provide salient insights into the underlying sex‐specific mechanisms of reproductive success. We suggest that embracing such directions should allow building new bridges between reproductive senescence and the study of sperm competition, parental care, mate choice and environmental conditions.
Diversity of arbuscular mycorrhizal fungi in Brazil's Caatinga and experimental agroecosystems
Authors: Pontes Juliana S. , Oehl Fritz , Marinho Frederico , Coyne Danny , Silva Danielle Karla Alves da , Yano‐Melo Adriana M. , Maia Leonor C. 
Published: April 2017

AbstractCowpea (Vigna unguiculata) is a nutritious legume crop for both its grain and leaves and comprises an important component in both human and animal nutrition. In Brazil, the use of mulch, such as coconut fiber, and organic fertilizers to maximize cowpea production offers an alternative to conventional mineral fertilizer strategies. Farming practices affect the diversity and activity of soil microorganisms, including arbuscular mycorrhizal fungi (AMF), important plant growth promoters for legumes. Our objective was to determine the effect of mulching with coconut fiber and manure on AMF diversity in cowpea. Soil samples were collected from an Experimental Station in Petrolina, NE Brazil: one Caatinga (natural dry‐forest vegetation), one fallow, and one experimental site established in the fallow area and cultivated with cowpea receiving cattle manure and four doses (0, 12, 24, 48 t/ha) of coconut fiber. AMF species richness, abundance, and diversity were evaluated. Sixty‐four AMF species were recorded, with predominance of Glomeraceae and Acaulosporaceae. Highest species richness (47) was recovered from the Caatinga but AMF diversity was also high in the cultivated sites, demonstrating the importance of mycotrophic plants, such as cowpea, in crop production systems for the maintenance of AMF species richness. Although several species, such as Claroideoglomus etunicatum, Acaulospora scrobiculata, Glomus trufemii, and Paraglomus pernambucanum, revealed pronounced sporulation patterns, even high doses of coconut fiber did not affect AMF richness and diversity, compared to fallow. Consequently, cultivation of mycotrophic plants and use of organic manures are able to maintain high AMF species richness in tropical agroecosystems.
Antibacterial and antitubercular evaluation of dihydronaphthalenone‐indole hybrid analogs
Authors: V Praveen Kumar , J Renjitha , C T Fathimath Salfeena , K T Ashitha , S. Keri Rangappa , Varughese Sunil , Balappa Somappa Sasidhar 
Published: April 2017

A new series of indole appended dihydronaphthalenone hybrid analogs (5a–t) have been synthesized through the Lewis acid catalyzed Michael addition of indoles to the arylidene/hetero arylidene ketones. All the synthesized derivatives are well characterized through the 1H‐NMR, 13C‐NMR, HRMS spectroscopic techniques, compound 5r was further confirmed through single crystal X‐ray analysis and screened for antibacterial and antitubercular activities. Among the synthesized compounds, the minimum inhibition concentration of 5l (against Escherichia coli) and 5o & 5p (against E. coli & Staphylococcus aureus) was found to be as low as 3.12 μg/ml as compared to the standard antibacterial drug ciprofloxacin 2.5 μg/ml. In antitubercular activity, compounds 5o and 5p with minimum inhibition concentration 6.25 μg/ml were found to be comparable with that of the drugs Pyrazinamide 5 μg/ml and Streptomycin 5 μg/ml. Compounds 5i, 5j, 5m, 5n, 5q, and 5r also showed promising activity against group of organisms tested.
Safety and efficacy of treatment with asfotase alfa in patients with hypophosphatasia: Results from a Japanese clinical trial
Authors: Kitaoka Taichi , Tajima Toshihiro , Nagasaki Keisuke , Kikuchi Toru , Yamamoto Katsusuke , Michigami Toshimi , Okada Satoshi , Fujiwara Ikuma , Kokaji Masayuki , Mochizuki Hiroshi , Ogata Tsutomu , Tatebayashi Koji , Watanabe Atsushi , Yatsuga Shuichi , Kubota Takuo , Ozono Keiichi 
Published: April 2017

SummaryObjectiveHypophosphatasia (HPP) is a rare skeletal disease characterized by hypomineralization and low alkaline phosphatase activity. Asfotase alfa (AA) has been recently developed to treat HPP complications. This study evaluated its safety and efficacy in Japan.DesignOpen‐label, multicentre, prospective trial. Patients were enrolled in 11 hospitals from June 2014 to July 2015.PatientsThirteen patients (9 females, 4 males) ages 0 days to 34 years at baseline were enrolled and treated with AA (2 mg/kg three times weekly subcutaneously in all but one patient). All had ALPL gene mutations. HPP forms were perinatal (n=6), infantile (n=5), childhood (n=1) and adult (n=1).MeasurementsSafety determined from adverse events (AEs) and laboratory data was the primary outcome measure. Efficacy was assessed as a secondary outcome measure from overall survival, respiratory status, rickets severity and gross motor development.ResultsInjection site reactions were the most frequent AEs. Serious AEs possibly related to treatment were convulsion and hypocalcaemia observed in a patient with the perinatal form. In addition, hypercalcaemia and/or hyperphosphatemia was observed in three patients with the infantile form and a low‐calcium and/or low‐phosphate formula was given to these patients. With respect to efficacy, all patients survived and the radiographic findings, developmental milestones and respiratory function improved.ConclusionAsfotase alfa therapy improved skeletal, respiratory and physical symptoms with a few serious AEs in patients with HPP. Our results add support to the safety and efficacy of AA therapy for HPP patients.
Large gene panel sequencing in clinical diagnostics—results from 501 consecutive cases
Authors: Pajusalu S. , Kahre T. , Roomere H. , Murumets Ü. , Roht L. , Simenson K. , Reimand T. , Õunap K. 
Published: April 2017

BackgroundIn addition to whole exomes, large gene panels of clinically associated genes are used as high‐throughput sequencing tests in many clinical centers, but their clinical utility has been much less investigated.Materials and MethodsHere we report the results of the 501 first unselected cases for whom TruSight One panel (Illumina Inc., San Diego, California) was sequenced as a clinical diagnostic test for a variety of indications in our department. The analysis was restricted to virtual subpanels based on referral forms, where doctors were asked to list candidate genes or select one from predefined larger panels.ResultsA probable or definite pathogenic finding was reported in 26.3% of cases. In 238 samples for whom 1 to 9 genes were requested for analysis, the diagnostic yield was significantly higher compared to other 263 cases for whom larger subpanels were requested (31.5% vs 21.7%, respectively, P = .016). Detected mutations included single nucleotide variants, small insertions and deletions, and larger copy number variants. Out of 157 reported mutations, 67 were previously undescribed.ConclusionThe clinical utility of large gene panel sequencing in the context of other genetic diagnostic tests is discussed in detail.
Guided bone regeneration with particulate vs. block xenogenic bone substitutes: a pilot cone beam computed tomographic investigation
Authors: Benic Goran I. , Thoma Daniel S. , Jung Ronald E. , Sanz-Martin Ignacio , Unger Silvan , Cantalapiedra Antonio , Hämmerle Christoph H.F. 
Published: April 2017

AbstractAimTo test whether an equine bone substitute block used for guided bone regeneration (GBR) of peri‐implant defects differs from bovine block or particulate bone substitutes regarding the hard and soft tissue contours of the augmented ridge.Material & MethodsTwo semi‐saddle bone defects were prepared in each side of the mandible of eight dogs, and one titanium implant was inserted into every defect. The defects were randomly allocated to receive one of the following treatments: bone augmentation by GBR using (1) particulate deproteinized bovine bone mineral (DBBM) + a collagen membrane (CM), (2) block DBBM + CM, (3) equine bone substitute block + CM, and (4) empty controls. After 4 months, the jaws were scanned by means of cone beam computed tomography (CBCT). CBCT analysis was performed in one central and two lateral (mesial and distal) regions of interest (ROI) of each site evaluating the horizontal thickness of the augmented hard tissue (HThard tisue) and the total thickness of hard and soft tissue (HTtotal). The Wilcoxon‐Pratt signed rank test was used for statistical analysis.ResultsIn the majority of ROIs, equine and bovine blocks rendered significantly higher values in HThard tissue and HTtotal than controls (P < 0.05). Generally, equine blocks reached the highest values in HThard tissue and HTtotal followed by DBBM blocks and particulate DBBM. The differences in HThard tissue and HTtotal between GBR groups were not statistically significant (P > 0.05). In the central ROI, HThard tissue at the level of the implant shoulder measured 1.7 ± 1.4 mm for equine blocks, 1.7 ± 1.0 mm for DBBM blocks, 0.9 ± 1.2 mm for particulate DBBM, and 0 ± 0 mm for controls. The corresponding values in the lateral ROI reached 1.9 ± 1.1 mm for equine blocks, 1.2 ± 0.8 mm for DBBM blocks, 1.0 ± 0.9 mm for particulate DBBM, and 0 ± 0 mm for controls.ConclusionsGBR with bone substitute blocks lead to higher ridge dimensions than empty controls. The equine block with CM rendered the most favorable outcomes in hard and soft tissue contours followed by DBBM block and DBBM granulate with CM.
Analyse der Mobilitätsbereitschaft von Patienten unter Berücksichtigung individueller Merkmale und zweier Beispielindikationen
Authors: Augustin Jobst , Schäfer Ines , Augustin Matthias , Zander Nicole 
Published: April 2017

ZusammenfassungHintergrundIn der Versorgungsplanung wird davon ausgegangen, dass Patienten den nächstgelegenen Arzt aufsuchen. Die Praxis zeigt jedoch, dass beim Arztbesuch oftmals ein höherer Aufwand in Kauf genommen wird, als notwendig. Es soll der Frage nachgegangen werden, unter welchen Umständen ein Patient einen Mehraufwand in Kauf nimmt und welchen Einfluss soziodemographische und klinische Merkmale haben.MethodikDie Datenerhebung erfolgte mittels einer multizentrischen Querschnittsstudie am Beispiel niedergelassener und in einer Universitätsklinik tätigen Dermatologen in Hamburg. Es wurden n = 309 Patienten mit Psoriasis und chronischen Wunden u. a. zu ihrem Mobilitätsverhalten und Krankheitsbild befragt. Die Datenauswertung erfolgte anhand deskriptiver und multivariater Verfahren.ErgebnisseEine hohe Bereitschaft, einen Mehraufwand in Kauf zu nehmen, wird vor allem durch die Kompetenz sowie das Leistungsangebot des Arztes bestimmt. Vergleiche beider Diagnosen zeigten, dass Psoriasis‐Patienten prinzipiell weitere Anfahrtswege hatten als die Wundpatienten. Unter den Psoriasis‐Patienten konnte u. a. der Schulabschluss als signifikanter Prädiktor für den Mehraufwand ermittelt werden. Bei den Wundpatienten war beispielsweise die Wundgröße (Schweregrad) ausschlaggebend.SchlussfolgerungenEs zeigte sich ein komplexes Mobilitätsverhalten der Patienten, das von zahlreichen persönlichen, aber auch klinischen Merkmalen beeinflusst wird. Je nach Diagnose und individuellen Präferenzen kann der Mehraufwand u. a. durch den Schweregrad der Erkrankung erklärt werden. Weitere Analysen sind notwendig, um detailliertere Aussagen zu erhalten.
Subklinische Enthesitis bei Nagelpsoriasis‐Patienten: eine Fall‐Kontroll‐Studie
Authors: Klaassen Karlijn M.G. , Ploegmakers Marieke J.M. , van de Kerkhof Peter C.M. , Klein Willemijn M. , Pasch Marcel C. 
Published: April 2017

ZusammenfassungHintergrundBei Patienten mit Nagelpsoriasis ist die Prävalenz der Psoriasis‐Arthritis erhöht. Die pathogenetische Beziehung zwischen diesen beiden Störungen ist jedoch noch unklar. Als Epizentrum der Krankheiten wurden Enthesen vorgeschlagen, die die Pathogenese auf anatomischer Ebene erklären könnten.ZielsetzungAufklärung der Hypothese einer anatomischen Verbindung zwischen Nagelpsoriasis und Psoriasis‐Arthritis mit der Extensor‐Enthese des distalen Interphalangealgelenkes als Epizentrum.VerfahrenWir führten eine Querschnitts‐Kohortenstudie durch, bei der die Enthesen der distalen interphalangealen (DIP)‐Gelenke von Patienten mit Fingernagel‐­Psoriasis (n = 54), von Psoriasis‐Patienten ohne Nagelbeteiligung (n = 32), und von gesunden Kontrollpersonen (n = 32) mit dreidimensionalem Ultraschall visualisiert wurden. ­Patienten mit Nagelpsoriasis unterzogen sich nach einem Jahr erneut bildgebenden Untersuchungen.ErgebnissePersonen mit Nagelpsoriasis hatten signifikant stärkere radiale Enthesien als Psoriasis‐Patienten ohne Nagelbeteiligung. Allerdings gab es keine signifikanten Unterschiede bezüglich der Enthesenstärke zwischen betroffenen und nicht betroffenen benachbarten Nägeln (1,297 mm vs. 1,253 mm, p = 0,13). Die Nachuntersuchung nach einem Jahr zeigte keine signifikanten Unterschiede in der Stärke der Enthesen in Korrelation mit der Nagelpsoriasis‐Aktivität.SchlussfolgerungenDie vorliegende Studie liefert Hinweise auf eine subklinische Enthesitis auf der Ebene des DIP‐Gelenks bei Patienten mit Nagelpsoriasis. Allerdings konnte eine anatomische Korrelation zwischen Nagelpsoriasis und Psoriasis‐Arthritis nicht bestätigt werden.