bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of HLA genotypes with phenobarbital hypersensitivity in children
Authors: Manuyakorn Wiparat , Mahasirimongkol Surakameth , Likkasittipan Plernpit , Kamchaisatian Wasu , Wattanapokayakit Sukanya , Inunchot Wimala , Visudtibhan Anannit , Wichukchinda Nuanjun , Benjaponpitak Suwat 
Published: August 2016

SummaryObjectivePhenobarbital hypersensitivity is one of the common drug hypersensitivity syndromes in children. Clinical symptoms of phenobarbital hypersensitivity vary from maculopapular rashes (MPs) to severe cutaneous adverse drug reactions (SCARs) including drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens‐Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Drug hypersensitivity has been demonstrated to be associated with variations in the HLA genotypes. This study was to investigate the association between the variations of HLA genotypes and phenobarbital hypersensitivity in Thai children.MethodsThe cases were Thai children, between 0 and 18 years of age, who were diagnosed with phenobarbital hypersensitivity, which included SCARs and MPs. The control patients were Thai children of a corresponding age who had taken phenobarbital for at least 12 weeks without any hypersensitivity reaction. Blood samples were collected for HLA genotyping by using a reverse‐sequence‐specific oligonucleotide (SSO) probes method. The carrier rates of HLA alleles were compared between 47 cases (27 SCARs and 20 MPs) and 54 controls.ResultsThe carrier rates of HLA‐A*01:01 and HLA‐B*13:01 were significantly higher in the phenobarbital‐induced SCARs than in the tolerant controls (18.5% vs. 1.85%, p = 0.01, odds ratio [OR] 11.66, 95% confidence interval [CI] 1.21–578.19; 37.04% vs. 11.11%, p = 0.009, OR 4.60, 95%CI 1.29–17.98). There was a trend of a higher carrier rate of HLA‐C*06:02 in the phenobarbital‐induced SCARs when compared with those in the tolerant controls (29.63% vs. 11.11%, p = 0.059, OR 3.31, 95% CI 0.88–13.31). In contrast to the phenobarbital‐induced SCARs, only the HLA‐A*01:01 carrier rate in the phenobarbital‐induced MPs was significantly higher than those in the tolerant controls (20% vs. 1.85%, p = 0.017, OR 12.69, 95% CI 1.15–661.62).SignificanceAn association between phenobarbital hypersensitivity and HLA‐A*01:01 and HLA‐B*13:01 has been demonstrated in Thai children.
Regional and global connectivity disturbances in focal epilepsy, related neurocognitive sequelae, and potential mechanistic underpinnings
Authors: Englot Dario J. , Konrad Peter E. , Morgan Victoria L. 
Published: August 2016

SummaryEpilepsy is among the most common brain network disorders, and it is associated with substantial morbidity and increased mortality. Although focal epilepsy was traditionally considered a regional brain disorder, growing evidence has demonstrated widespread network alterations in this disorder that extend beyond the epileptogenic zone from which seizures originate. The goal of this review is to summarize recent investigations examining functional and structural connectivity alterations in focal epilepsy, including neuroimaging and electrophysiologic studies utilizing model‐based or data‐driven analytic methods. A significant subset of studies in both mesial temporal lobe epilepsy and focal neocortical epilepsy have demonstrated patterns of increased connectivity related to the epileptogenic zone, coupled with decreased connectivity in widespread distal networks. Connectivity patterns appear to be related to the duration and severity of disease, suggesting progressive connectivity reorganization in the setting of recurrent seizures over time. Global resting‐state connectivity disturbances in focal epilepsy have been linked to neurocognitive problems, including memory and language disturbances. Although it is possible that increased connectivity in a particular brain region may enhance the propensity for seizure generation, it is not clear if global reductions in connectivity represent the damaging consequences of recurrent seizures, or an adaptive mechanism to prevent seizure propagation away from the epileptogenic zone. Overall, studying the connectome in focal epilepsy is a critical endeavor that may lead to improved strategies for epileptogenic‐zone localization, surgical outcome prediction, and a better understanding of the neuropsychological implications of recurrent seizures.
Post–epilepsy surgery psychogenic nonepileptic seizures
Authors: Asadi‐Pooya Ali A. , Asadollahi Marjan , Tinker Jennifer , Nei Maromi , Sperling Michael R. 
Published: August 2016

SummaryObjectivesWe investigated the prevalence of post–epilepsy surgery psychogenic nonepileptic seizures (PNES) in patients with drug‐resistant epilepsy and the possible influence of risk factors on these seizures.MethodsIn this retrospective study, we examined data from all patients with a clinical diagnosis of drug‐resistant epilepsy who underwent epilepsy surgery at Graduate Hospital and the Jefferson Comprehensive Epilepsy Center between 1986 and 2016. Postsurgical outcome was identified for up to 15 years after surgery. Diagnosis of PNES was verified in the epilepsy monitoring unit with video–electroencephalography (EEG) ictal recording. Potential associated factors were assessed by comparing patients with or without postoperative PNES.ResultsA total of 1,105 patients were studied; 697 patients had postoperative seizures, and, of these, 27 patients (3.9%) had documented PNES after surgery. A full‐scale intelligence quotient (IQ) <80 was significantly associated with post‐epilepsy surgery PNES (odds ratio [OR] 2.89, p = 0.007, 95% confidence interval [CI] 1.33–6.29). A history of a preoperative psychiatric diagnosis was also significantly associated with post–epilepsy surgery PNES (OR 4.67, p = 0.0001, 95% CI 2.01–10.82). Other factors were not significantly associated with post–epilepsy surgery PNES.SignificancePost–epilepsy surgery PNES should be considered when patients report recurrent seizures after epilepsy surgery. Although these seizures probably occur relatively infrequently, attention to factors such as appearance of new ictal behaviors, a preoperative history of a psychiatric disorder, and a low full‐scale IQ should raise suspicion and lead to appropriate diagnostic measures.
Large pituitary adenoma in an 8‐year‐old Arabian stallion
Authors: Madrigal R. G. , Andrews F. M. , Rademacher N. , McConnico R. S. , Duplantis D. , Eades S. C. 
Published: August 2016

SummaryAn 8‐year‐old Arabian stallion weighing 361 kg presented to Louisiana State University Veterinary Teaching Hospital with a 3‐month history of weight loss, exercise intolerance, long hair coat and recent history of seizures and aimless wandering in the pasture. An initial presumptive diagnosis of pituitary pars intermedia dysfunction (PPID) was made based on clinical signs. The initial examination revealed weight loss and loss of body condition (BCS3/9), hypertrichosis, muscle wasting and reluctance to move when prompted. A neurological examination revealed dull mentation with no evidence of proprioceptive deficits in the limbs. Mild hyperglycaemia and a stress leucogram were noted on initial biochemical panel and haematology, respectively. Plasma adrenocorticotrophic hormone (ACTH) concentrations before and after thyrotropin releasing hormone (TRH) stimulation were markedly increased. Rapid slice computed tomography (CT) scan of the head before and after contrast revealed a large mass in the region of the pituitary gland suggestive of macroadenoma causingPPID. Prior to imaging, treatment consisted of supportive nursing care. Due to size of the pituitary gland (measuring 4.6 × 4.6 × 3.8 cm) and the presence of seizure‐like activity and dull mentation, the stallion was subjected to euthanasia. A necropsy was not performed. Pituitary macroadenomas in horses affected withPPID, who show neurological signs such as seizure‐like activity, dull mentation and aimless wandering, might have a poor prognosis and treatment with pergolide mesylate might not reduce pituitary gland size or relieve clinical signs. ACTscan is indicated in horses with neurological signs suspected ofPPIDto further evaluate pituitary gland size and surrounding structures and rule out other causes to better assess prognosis.
Dihydromyricetin enhances the osteogenic differentiation of human bone marrow mesenchymal stem cells in vitro partially via the activation of Wnt/β‐catenin signaling pathway
Authors: Zhang Wei , Wang Shengdong , Yin Houfa , Chen Erman , Xue Deting , Zheng Qiang , Gao Xiang , Pan Zhijun 
Published: August 2016

AbstractSubstantial evidence has demonstrated that the decreased osteogenic differentiation of bone mesenchymal stem cells (BMSCs) is closely related to bone metabolic diseases. Thus, it is very important to develop several potentially useful therapeutic agents to enhance BMSC osteogenesis. Flavonoids show promise in enhancing bone mass. Dihydromyricetin (DMY), a type of flavonoid, has not yet been investigated regarding its effects on BMSC osteogenesis. To investigate the effects of DMY on osteogenesis, human BMSCs were induced with or without DMY. We found that DMY (0.1–50 μm) exhibited no cytotoxic effect on proliferation, but increased alkaline phosphatase activity, osteoblast‐specific gene expression, and mineral deposition. It also enhanced active β‐catenin expression and reduced dickkopf‐1(DKK1) and sclerostin expression. The Wnt/β‐catenin signaling pathway inhibitor (DKK1 and β‐catenin‐specific siRNA) decreased the enhanced bone mineral formation caused by DMY. Taken together, these findings reveal that DMY enhances osteogenic differentiation of human BMSCs partly through Wnt/β‐catenin in vitro.
Linking microbial C:N:P stoichiometry to microbial community and abiotic factors along a 3500‐km grassland transect on the Tibetan Plateau
Authors: Chen Yong‐Liang , Chen Lei‐Yi , Peng Yun‐Feng , Ding Jin‐Zhi , Li Fei , Yang Gui‐Biao , Kou Dan , Liu Li , Fang Kai , Zhang Bei‐Bei , Wang Jun , Yang Yuan‐He 
Published: August 2016

AbstractAimTo explore large‐scale patterns and the drivers of carbon:nitrogen:phosphorus (C:N:P) stoichiometry in heterotrophic microbes.LocationA 3500‐km grassland transect on the Tibetan Plateau.MethodsWe investigated large‐scale C:N:P stoichiometry patterns in the soil microbial biomass and their relationships with abiotic factors and soil microbial community structures by obtaining soil samples from 173 sites across the Tibetan alpine grasslands.ResultsC:N:P ratios in the soil microbial biomass varied widely among grassland types, with higher microbial C:N, C:P and N:P ratios in the alpine steppe than the alpine meadow. The soil microbial C:N:P ratio (81:6:1) in the alpine steppe was significantly wider than the global average (42:6:1). Combined stepwise regression and generalized additive models revealed that variations in the microbial C:N ratio were primarily related to abiotic variables, with the microbial C:N ratio exhibiting a decreasing trend along the precipitation gradient. In contrast, variations in microbial C:P and N:P ratios were primarily associated with shifts in the community structure of soil microbes. The microbial C:P and N:P ratios were both negatively associated with all components of the soil microbial communities. However, the fungi to bacteria ratio only regulated the microbial C:P ratio.Main conclusionsThese results demonstrate that microbial C:N:P stoichiometry exhibits significant flexibility across various ecosystem types. This flexibility is partly induced by shifts in microbial community structure and variations in environmental conditions.
Screening and risk assessment for coronary artery disease in HIV infection: an unmet need
Authors: Nadel J , Holloway CJ 
Published: August 2016

HIV infection is now considered a chronic, treatable disease, although treatment is associated with increased rates of coronary artery disease (CAD). Increased risk of CAD in HIV‐infected patients has been associated with the inflammatory sequelae of the infection as well as the greater prevalence of cardiac risk factors in HIV‐positive populations and the side effects of life‐prolonging antiretroviral therapies. Patients with HIV infection now have a 1.5 to 2‐fold greater risk of developing CAD compared with noninfected individuals, raising the independent risk of CAD in HIV infection to levels similar to those in diabetes. Despite this increased risk, screening and other adjuvant assessment tools are lacking.In this paper we explore the current climate of CAD in the contemporary HIV‐infected population and look at the tools used in the assessment and management of patients as well as the limitations of these approaches for this at‐risk population group.
Peri‐conceptual and mid‐pregnancy drinking: a cross‐sectional assessment in two Scottish health board areas using a 7‐day Retrospective Diary
Authors: Symon Andrew , Rankin Jean , Sinclair Hazel , Butcher Geraldine , Barclay Kylie , Gordon Rhona , MacDonald Michelle , Smith Lesley 
Published: August 2016

AbstractAimsThe aim of this study was to evaluate the use of a 7‐day Retrospective Diary to assess peri‐conceptual and mid‐pregnancy alcohol consumption.BackgroundAlcohol consumption among women has increased significantly and is of international concern. Heavy episodic (‘binge’) drinking is commonplace and is associated with unintended pregnancy. Pre‐pregnancy drinking is strongly associated with continued drinking in pregnancy. Routine antenatal assessment of alcohol history and current drinking is variable; potentially harmful peri‐conceptual drinking may be missed if a woman reports low or no drinking during pregnancy.DesignCross‐sectional study (n = 510) in two Scottish health board areas.MethodsFace‐to‐face Retrospective Diary administration from February to June 2015 assessing alcohol consumption in peri‐conceptual and mid‐pregnancy periods. Women were recruited at the mid‐pregnancy ultrasound clinic.ResultsOf 510 women, 470 (92·0%) drank alcohol before their pregnancy; 187 (39·9%) drank every week. Retrospective assessment of peri‐conceptual consumption identified heavy episodic drinking (more than six units on one occasion) in 52·2% (n = 266); 19·6% (n = 100) reported drinking more than 14 units per week, mostly at the weekend; ‘mixing’ of drinks was associated with significantly higher consumption. While consumption tailed off following pregnancy recognition, 5·5% (n = 28) still exceeded the recommended daily two‐unit limit in pregnancy. Multivariable logistic regression identified that women who ‘binged’ peri‐conceptually were 3·2 times more likely to do this.ConclusionStatistically significant peri‐conceptual consumption levels suggest a substantial proportion of alcohol‐exposed pregnancies before pregnancy recognition. Not taking a detailed alcohol history, including patterns of consumption, will result in under‐detection of alcohol‐exposed pregnancies. The Retrospective Diary offers practitioners a detailed way of enquiring about alcohol history for this population.
From Social Exclusion to Supported Inclusion: Adults with Intellectual Disability Discuss Their Lived Experiences of a Structured Social Group
Authors: Wilson Nathan J. , Jaques Hayden , Johnson Amanda , Brotherton Michelle L. 
Published: August 2016

BackgroundPeople with intellectual disability often have few friends and experience social exclusion. Recognising this gap, supported social groups with the aim of inclusion and interdependence were created by a supported employment provider.MethodsInterviews were undertaken with 10 adults with intellectual disability exploring their lived experiences of a supported social group. Data were analysed using descriptive phenomenology.ResultsTwo themes emerged (i) supported engagement fosters wellbeing, and (ii) developing social belonging and connectedness. Participants not only acknowledged the support that they needed to participate, but also that the social group had changed their lives in many ways.ConclusionsAdults with intellectual disability want to socialise, have friends and be part of their community. For this to be achieved, they recognise the need to seek some form of support. With appropriate and targeted support, adults with intellectual disability can move from social exclusion towards supported inclusion and experience richer lives.
Innovative Strength‐Based Care in Child and Adolescent Inpatient Psychiatry
Authors: Sams Deanna P. , Garrison David , Bartlett Joanne 
Published: August 2016

PROBLEMChild and adolescent psychiatric units serve the highest risk, most vulnerable populations in the mental health delivery system. This article describes the integration of a strength‐based approach with a traditional, medical model of psychiatric care on an acute inpatient unit. A strength‐based framework allows for increased focus on exploring patients' goals, strengths, relationships, skills, and family communication within the hospital setting.METHODSThe process of integration of strength‐based care is described, followed by discussion of the implementation and evaluation of interventions, including mindfulness, family movie, narrative, and animal‐assisted therapies.FINDINGSInnovative interventions led to improvement in patient symptoms, unit culture, and patient, family, and staff satisfaction.CONCLUSIONA strong emphasis on strength‐based, multidisciplinary treatment has enhanced patient care, as the goals of acute inpatient admission are broadened to include more than diagnosis and medication management.
Suicide Risk Screening Tools and the Youth Population
Authors: Patterson Sharon 
Published: August 2016

TOPICThe use of suicide risk screening tools is a critical component of a comprehensive approach to suicide risk assessment. Since nurses frequently spend more time with patients than any other healthcare professional, they are in key positions to detect and prevent suicidal behavior in youth.PURPOSETo inform nurses about suicide risk screening tools for the youth population. Suicide risk screening tools are research‐based standardized instruments that are used to identify people who may be at risk for suicide.SOURCES USEDA literature search was performed using the Athabasca University Library Resource, the databases of the Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, and Google Scholar.CONCLUSIONSNurses are cautioned to utilize suicide risk screening tools as only part of the suicide risk assessment in youth populations and avoid the danger of relying on tools that may result in a blind application of evidence to the detriment of clinical experience and judgement.
Ukraine between a Constrained EU and Assertive Russia
Authors: Kuzio Taras 
Published: August 2016

AbstractThe article analyzes three factors constraining EU power: its unwillingness to view Ukraine as a candidate for membership, a miscalculation of Ukrainian leaders and the ignoring of growing nationalism and xenophobia in Russia. These three factors constrained the EU in its ability to respond to the Russia–Ukraine crisis by ignoring past Russian support for separatist movements and invasion of Georgia and recognition of the independence of two separatist enclaves. The EU did not appreciate that Russia also viewed the EU (not just NATO) as a hostile actor intervening in what it views as its ‘zone of privileged interests’.
The impact of sentinel node dissection on disease‐free and overall tumour‐specific survival in melanoma patients: a single centre group‐matched analysis of 1192 patients
Authors: Geimer T. , Sattler E.C. , Flaig M.J. , Ruzicka T. , Berking C. , Schmid‐Wendtner M.H. , Kunte C. 
Published: August 2016

AbstractBackgroundSentinel lymph node dissection (SLND) is considered a standard staging procedure providing important prognostic information on melanoma patients. It remains a matter of debate, whether SLND and hence, removal of potential lymph node micrometastasis will alter survival outcome.ObjectiveThe aim of this group‐matched analysis was to compare survival data of a large cohort of melanoma patients who were treated by wide local excision only (WLE) and nodal observation (WLE group) to a group of patients treated with WLE plus SLND group to investigate the potential therapeutic benefit of SLND in the treatment of patients with melanoma.Methods and materialsA total of 596 consecutive patients who had undergone WLE plus SLND between 1996 and 2003 were assessed. As a historical control group 596 patients treated with WLE and nodal observation but without SLND between 1986 and 1995 were selected. The groups were matched according to sex, age, Breslow tumour thickness and localization of primary tumour. The adjuvant treatment and follow‐up examinations were performed according to protocols of the German Dermatologic Cooperative Oncology Group (DeCOG) and applicable study protocols that our clinic participated in; and hence, subject to change over time.ResultsKaplan–Meier testing revealed significant differences in survival in favour of the SLND group. Mean overall tumour‐specific survival (OS) was 102.7 months in the SLND group vs. 97.0 months in the WLE group respectively (P‐value: 0.024). Disease‐free survival (log–rank test: 0.003) and time to lymph node progression (P‐value: <0.01) also differed significantly between the two groups.ConclusionSLND is not only an important diagnostic procedure, but might also be of therapeutic benefit in terms of disease‐free and overall tumour‐specific survival of melanoma patients.
Apoptosis of keratinocytes and serum DNase I activity in patients with cutaneous lupus erythematosus: relationship with clinical and immunoserological parameters
Authors: Skiljevic D. , Bonaci‐Nikolic B. , Brasanac D. , Nikolic M. 
Published: August 2016

AbstractBackgroundDysregulation of apoptosis has an important role in the induction of autoimmunity.ObjectiveTo evaluate the influence of keratinocyte apoptosis and deoxyribonuclease I (DNase I) activity on the clinical and immunoserological parameters of cutaneous lupus erythematosus (CLE).MethodsWe studied 69 CLE patients (39 with discoid LE (DLE), 12 with subacute CLE (SCLE), 12 with acute and 6 with intermittent CLE). Thirty of sixty‐nine patients fulfilled criteria for systemic LE (SLE). Apoptotic index (AI) was evaluated immunohistochemically in lesional and non‐lesional, photoprotected skin. Serum DNase I activity, antichromatin and anti‐ENA antibodies were measured by ELISA. Disease activity was determined by SLEDAI‐2K, SLICC/ACR, CLASI and RCLASI.ResultsAI in lesions was higher than in non‐lesional skin (P < 0.001). There was no difference in AI between CLE and SLE patients. Patients with SCLE had higher lesional AI than patients with DLE (P < 0.05). We found a positive correlation between the lesional AI with CLASI A (P < 0.05) and RCLASI D (P < 0.05). CLE and SLE patients had significantly lower DNase I activity than healthy controls (P < 0.001). Patients with normal DNase I activity and low AI had significantly lower CLASI A than patients with decreased DNase I activity and/or elevated AI (P < 0.05).ConclusionsIncreased keratinocyte apoptosis characterizes lesions of all CLE forms, especially of SCLE. AI correlates with CLE markers of acute and chronic inflammation. Normal level of apoptosis and DNase I activity simultaneously reduce the level of acute inflammation in CLE. Serum DNase I activity and AI might be important biomarkers in the evaluation of CLE patients.