bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Airway–Dyspnoea–Voice–Swallow (ADVS) scale and Patient‐Reported Outcome Measure (PROM) as disease‐specific instruments in paediatric laryngotracheal stenosis
Authors: Nouraei S.A.R. , Makmur E. , Dias A. , Butler C.R. , Nandi R. , Elliott M.J. , Hewitt R. 
Published: August 2016

ObjectiveTo validate the Airway–Dyspnoea–Voice–Swallow (ADVS) instrument as a disease‐specific Patient‐Reported Outcome Measure in paediatric laryngotracheal stenosis.DesignProspective observational study.SettingA quaternary referral centre for complex airway disease.ParticipantsForty‐eight patients (30 males) with a mean age of 49 ± 49 months who underwent laryngotracheal surgery or microlaryngoscopy and bronchoscopy (MLB) following laryngotracheal surgery.Main outcome measuresAirway–Dyspnoea–Voice–Swallow summary scale and Patient‐Reported Outcome Measure (PROM), Paediatric Quality of Life (PedsQL) scale, Paediatric Voice Handicap Index (pVHI) and Lansky performance scale were administered to patients before and 6–8 weeks following airway examination/surgery.ResultsMost patients (73%) had intubation‐related subglottic stenosis, and 60% of patients had prior airway treatments. The majority of patients (77%) had more than one major chronic morbidity, and the commonest procedures were diagnostic MLB (49%), followed by airway dilation (29%). Cronbach‐α value for the ADVS PROM was 0.71 overall and 0.85, 0.86 and 0.64 for the dyspnoea, voice and swallow domains, respectively. Rank correlations between Dyspnoea, Voice and Swallow summary scale and PROM scores were 0.83, 0.71 and 0.81, respectively (P < 0.0001). For those patients undergoing diagnostic MLB, pre‐ and post‐examination scores were highly correlated (intraclass correlations >0.75). There was a significant rank correlation between ADVS PROM score and Lansky performance score (r = −0.68; P < 0.0001). There were significant correlations between PROM score and PedsQL (r = −0.57; P < 0.0001) and between voice domain of the PROM and pVHI (r = 0.78; P < 0.0001). There were strong correlations between Myer–Cotton stenosis severity and dyspnoea scale and PROM score (r = 0.68; P < 0.0001). There were significant differences in voice and swallow ADVS scales and PROM scores between patients with and without concomitant laryngeal/oesophageal pathology. Patient age and presence of high dyspnoea and swallowing PROM scores were independently associated with poorer quality of life and performance status.ConclusionsThese series of observations validate the ADVS instrument as a disease‐specific outcome measure for paediatric laryngotracheal stenosis. Dyspnoea and swallowing dysfunction appear to have the greatest impact on quality of life. More widespread adoption of the ADVS instrument could help create a shared language for outcomes communication and benchmarking for children with this complex condition.
A national analysis of trends, outcomes and volume–outcome relationships in thyroid surgery
Authors: Nouraei S.A.R. , Virk J.S. , Middleton S.E. , Aylin P. , Mace A. , Vaz F. , Kaddour H. , Darzi A. , Tolley N.S. 
Published: August 2016

ObjectivesThyroid conditions are common, and their incidence is increasing. Surgery is the mainstay treatment for many thyroid conditions, and understanding its utilisation trends and morbidity is central to improving patient care.DesignAn N = near‐all analysis of the English administrative dataset to identify trends in thyroid surgery specialisation, volume–outcome relationships, and the incidence and risk factors for short‐ and long‐term morbidity.Main outcome measuresBetween 2004 and 2012, 72 594 patients underwent elective thyroidectomy in England. Information about age, sex, morbidities, nature of thyroid disease and surgery, adjuvant treatments and complications including hypocalcaemia and vocal palsy was recorded.ResultsMean age at surgery was 49 ± 30, and a female predominance (82%) was observed. Most patients underwent hemithyroidectomy (51%) or total thyroidectomy (32%). Patients underwent surgery for benign (52.5%), benign inflammatory (21%) and malignant (17%) thyroid diseases. Thyroid surgery grew by 2.9% a year and increased in specialisation. Increased surgeon volume significantly reduced lengths of stay: the proportion of length of stay outliers fell from 11.8% for patients of occasional thyroidectomists (<5 per year) to 2.8% for patients of high‐volume surgeons (>50 thyroidectomies a year). Post‐discharge vocal palsy and hypocalcaemia occurred in 1.87% and 1.58% of cases, respectively. High‐volume surgeons had a reduced incidence of vocal palsy, and volumes >30 were consistently protective.ConclusionsThyroid surgery is increasingly specialised. High‐volume surgeons, that is patients who perform 50 or more thyroidectomies per year, achieve lower complications and shorter lengths of stay.
Baseline swallowing measures predict recovery at 6 weeks after transoral robotic surgery for head and neck cancer
Authors: Owen S. , Puvanendran M. , Meikle D. , Bowe I. , O'Hara J. , Patterson J. , Paleri V. 
Published: August 2016

ObjectivesTo explore whether pre‐treatment swallowing measures predict swallowing recovery at 6 weeks after transoral robotic surgery (TORS).DesignProspective cohort study.SettingTertiary care cancer centre in the United Kingdom.ParticipantsFifty‐one consecutive patients undergoing TORS for head and neck cancer, between April 2013 and February 2015.Main outcome measuresSwallowing function assessed by Performance Status Scale (PSS) Normalcy of Diet, timed water swallow test capacity scores (WST) and duration of tube feeding.ResultsThe primary site distribution was as follows: 21 oropharynx, 8 larynx, 6 mucosectomy and 6 hypopharynx. T stages included 7 staged Tx, 21 T1–T2 tumours and 1 T3 tumour. Moderate‐to‐severe comorbidity was found in 45/51 patients. Mean PSS score was 83 (sd 27.54); mean WST score was 11.14 (sd 7.97). Most patients (73%) required tube feeding post‐operatively, with mean tube feed duration of 18.08 days (sd 17.91); 76% resumed oral intake by 6 weeks. Pre‐treatment swallow tests showed moderate negative correlation with tube feeding duration: PSS (rho 0–.430, P = .003); WST (rho 0–.503, P = 0.002).ConclusionsThe majority of TORS patients resume oral intake by 6 weeks. This study shows that impaired swallowing prior to surgery correlates with post‐operative duration of tube feeding and strengthens the evidence for the utility of these measures in this clinical setting.
Prediction, prevention, and management of delayed graft function: where are we now?
Authors: Nashan Björn , Abbud‐Filho Mario , Citterio Franco 
Published: August 2016

AbstractDelayed graft function (DGF) remains a major barrier to improved outcomes after kidney transplantation. High‐risk transplant recipients can be identified, but no definitive prediction model exists. Novel biomarkers to predict DGF in the first hours post‐transplant, such as neutrophil gelatinase‐associated lipocalin (NGAL), are under investigation. Donor management to minimize the profound physiological consequences of brain death is highly complex. A hormonal resuscitation package to manage the catecholamine “storm” that follows brain death is recommended. Donor pretreatment with dopamine prior to procurement lowers the rate of DGF. Hypothermic machine perfusion may offer a significant reduction in the rate of DGF vs simple cold storage, but costs need to be evaluated. Surgically, reducing warm ischemia time may be advantageous. Research into recipient preconditioning options has so far not generated clinically helpful interventions. Diagnostic criteria for DGF vary, but requirement for dialysis and/or persistent high serum creatinine is likely to remain key to diagnosis until current work on early biomarkers has progressed further. Management centers on close monitoring of graft (non)function and physiological parameters. With so many unanswered questions, substantial reductions in the toll of DGF in the near future seem unlikely but concentrated research on many levels offers long‐term promise.
Bayley‐III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years
Authors: Burakevych Nataliia , Mckinlay Christopher Joel Dorman , Alsweiler Jane Marie , Wouldes Trecia Ann , Harding Jane Elizabeth ,   the Chyld Study Team
Published: August 2016

AimTo determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley‐III) motor scores and neurological examination at 2 years corrected age predict motor difficulties at 4.5 years corrected age.MethodA prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley‐III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC‐2).ResultsOf 333 children, 8 (2%) had Bayley‐III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC‐2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC‐2 scores. A Bayley‐III motor score below 85 predicted MABC‐2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity).InterpretationBayley‐III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years.
Right ventricular global longitudinal strain in repaired tetralogy of Fallot
Authors: Toro Kamill Del , Soriano Brian D. , Buddhe Sujatha 
Published: August 2016

BackgroundEchocardiogram has limitations in effectively assessing right ventricular (RV) function in children post tetralogy of Fallot (TOF) repair. We evaluated the utility of speckle tracking echocardiography (STE)‐based RV global longitudinal strain (GLS) for the assessment of RV systolic function.MethodsAll patients with repaired TOF who had both echocardiograms and cardiac MRI (CMR) within a 6‐month interval were included. RV volumes and ejection fraction (EF) were obtained by CMRs. Traditional echocardiographic function parameters and RV GLS were compared to CMR‐derived RV EF. Subjects were divided into two groups based on CMR RV EF (group I: RV EF ≥45%; and group II: RV EF <45%).ResultsA total of 57 subjects were included. Mean age was 13.0±3.6 years and 58% were males. Group I had 39 subjects and group II had 18. Only six of the 18 patients (33%) in group II were identified as having at least mild RV dysfunction by echocardiogram. The mean RV GLS was significantly abnormal in group II (−15.3±3.8%) compared to group I (−20.9±3.3%; P<.001). By ROC analysis, an RV GLS cutoff value of −18% had 78% sensitivity and 77% specificity in identifying RV EF <45% (area under curve .87, P<.001). Intra‐ and inter‐observer reproducibility of RV GLS were good.ConclusionRV GLS is a simple and effective tool for the assessment of RV systolic function in patients post TOF repair. This technique would help further refine patient selection for timing of CMR and management.
Doppler echocardiographic myocardial stunning index predicts recovery of left ventricular systolic function after primary percutaneous coronary intervention
Authors: Sharif Dawod , Matanis Wisam , Sharif‐Rasslan Amal , Rosenschein Uri 
Published: August 2016

BackgroundMyocardial stunning is responsible for partially reversible left ventricular (LV) systolic dysfunction after successful primary percutaneous coronary intervention (PPCI) in patients with acute ST‐elevation myocardial infarction (STEMI).AimTo test the hypothesis that early coronary blood flow (CBF) to LV systolic function ratios, as an equivalent to LV stunning index (SI), predict recovery of LV systolic function after PPCI in patients with acute STEMI.MethodsTwenty‐four patients with acute anterior STEMI who had successful PPCI were evaluated and compared to 96 control subjects. Transthoracic echocardiography with measurement of LV ejection fraction (EF), LV, and left anterior descending (LAD) coronary artery area wall‐motion score index (WMSI) as well as Doppler sampling of LAD blood velocities, early after PPCI and 5 days later, were performed. SI was evaluated as the early ratio of CBF parameters in the LAD to LV systolic function parameters.ResultsEarly SI‐LVEF well predicted late LVEF (r=.51, P<.01) and the change in LVEF (r=.48, P<.017). Early SI‐LVMSI predicted well late LVEF (r=.56, P<.006) and the change in LVEF (r=.46, P<.028). Early SI‐LADWMSI predicted late LVEF (r=.44, P<.028). Other SI indices measured as other LAD‐CBF to LV systolic function parameters were not predictive of late LV systolic function.ConclusionsLV stunning indices measured as early LAD flow to LVEF, LVWMSI, and LADWMSI ratios well predicted late LVEF and the change in LVEF. Thus, greater early coronary artery flow to LV systolic function parameter ratios predict a better improvement in late LV systolic function after PPCI.
Trade credit use and competition in the value chain
Authors: Hermes Niels , Lensink Robert , Lutz Clemens , Thu Uyen Nguyen Lam 
Published: August 2016

AbstractTrade credit is a major source of finance in value chains in developed and emerging economies. Despite its ubiquitous use, this is one of the first empirical studies that analyzes why the use of trade credit varies along the value chain. We argue that competition faced by firms at different stages in the value chain and enforcement mechanisms that stimulate repayment jointly determine the use of trade credit. We distinguish two dimensions of competition, that is, rivalry and customer bargaining power. Competition may stimulate firms to provide trade credit to keep customers from switching to other suppliers. Yet, high contract enforcement costs relative to the value of the transactions, reduce the willingness to offer trade credit. We find empirical evidence showing that competition does not (strongly) influence the use of trade credit in the retail market, whereas it does in the markets for wholesalers and millers. We interpret these results as suggestive evidence that the retail, wholesale and milling market segments differ in terms of the enforcement costs involved in the provision of trade credit. Rivalry at the retail market segment makes switching easy for customers, even in case of default. As enforcement of repayment in this market segment is difficult and costly, trade credit appears to be a risky and less attractive marketing instrument for retailers. In contrast, in the wholesale and milling market segment, trade credit is widespread as stakeholders know each other, making informal mechanisms effective in supporting the enforcement of trade credit repayment.
Comparison of graduate‐entry and direct school leaver student performance on an applied dental knowledge test
Authors: Ali K. , Zahra D. , Tredwin C. 
Published: August 2016

AbstractAimsTo compare the academic performance of graduate‐entry and direct school leavers in an undergraduate dental programme.MethodsThis study examined the results of students in applied dental knowledge (ADK) progress tests conducted during two academic years. A mixed model analysis of variance (ANOVA) was conducted to compare the performance of graduate‐entry and direct school leavers. ADK was treated as a repeated measures variable, and the outcome variable of interest was percentage score on the ADK.ResultsThe results show statistically significant main effects for ADK [F (1,113) = 61.58, P < 0.001, η2p = 0.35], Cohort [F (1,113) = 88.57, P < 0.001, η2p = 0.44] and Entry [F (1,113) = 11.31, P = 0.001, η2p = 0.09]. That is, students do better on each subsequent test (main effect of ADK), students in later years of the programme perform better than those in earlier years (main effect of cohort), and graduate‐entry students outperform direct school leavers.ConclusionsThis is the first study to explore the differences in the academic performance of graduate‐entry and direct school leavers in an undergraduate dental programme. The results show that the academic performance of graduate students was better than the direct school leavers in years 2 and 3. Further research is required to compare the performance of students longitudinally across the entire duration of undergraduate dental programmes and evaluate whether this difference persists throughout.
Prenatal testosterone exposure decreases colocalization of insulin receptors in kisspeptin/neurokinin B/dynorphin and agouti‐related peptide neurons of the adult ewe
Authors: Cernea Maria , Phillips Rebecca , Padmanabhan Vasantha , Coolen Lique M. , Lehman Michael N. 
Published: August 2016

AbstractInsulin serves as a link between the metabolic and reproductive systems, communicating energy availability to the hypothalamus and enabling reproductive mechanisms. Adult Suffolk ewes prenatally exposed to testosterone (T) display an array of reproductive and metabolic dysfunctions similar to those seen in women with polycystic ovarian syndrome (PCOS), including insulin resistance. Moreover, prenatal T treatment alters neuropeptide expression in KNDy (co‐expressing kisspeptin, neurokinin B/dynorphin) and agouti‐related peptide (AgRP) neurons in the arcuate nucleus, two populations that play key roles in the control of reproduction and metabolism, respectively. In this study, we determined whether prenatal T treatment also altered insulin receptors in KNDy and AgRP neurons, as well as in preoptic area (POA) kisspeptin, pro‐opiomelanocortin (POMC), and gonadotropin‐releasing hormone (GnRH) neurons of the adult sheep brain. Immunofluorescent detection of the beta subunit of insulin receptor (IRβ) revealed that KNDy, AgRP and POMC neurons, but not GnRH or POA kisspeptin neurons, colocalize IRβ in control females. Moreover, prenatal T treatment decreased the percentage of KNDy and AgRP neurons that colocalized IRβ, consistent with reduced insulin sensitivity. Administration of the anti‐androgen drug, Flutamide, during prenatal T treatment, prevented the reduction in IRβ colocalization in AgRP, but not in KNDy neurons, suggesting that these effects are programmed by androgenic and oestrogenic actions, respectively. These findings provide novel insight into the effects of prenatal T treatment on hypothalamic insulin sensitivity and raise the possibility that decreased insulin receptors, specifically within KNDy and AgRP neurons, may contribute to the PCOS‐like phenotype of this animal model.
Modulation of sensitivity to alcohol by cortical and thalamic brain regions
Authors: Jaramillo Anel A. , Randall Patrick A. , Frisbee Suzanne , Besheer Joyce 
Published: August 2016

AbstractThe nucleus accumbens core (AcbC) is a key brain region known to regulate the discriminative stimulus/interoceptive effects of alcohol. As such, the goal of the present work was to identify AcbC projection regions that may also modulate sensitivity to alcohol. Accordingly, AcbC afferent projections were identified in behaviorally naïve rats using a retrograde tracer which led to the focus on the medial prefrontal cortex (mPFC), insular cortex (IC) and rhomboid thalamic nucleus (Rh). Next, to examine the possible role of these brain regions in modulating sensitivity to alcohol, neuronal response to alcohol in rats trained to discriminate alcohol (1 g/kg, intragastric [IG]) vs. water was examined using a two‐lever drug discrimination task. As such, rats were administered water or alcohol (1 g/kg, IG) and brain tissue was processed for c‐Fos immunoreactivity (IR), a marker of neuronal activity. Alcohol decreased c‐Fos IR in the mPFC, IC, Rh and AcbC. Lastly, site‐specific pharmacological inactivation with muscimol + baclofen (GABAA agonist + GABAB agonist) was used to determine the functional role of the mPFC, IC and Rh in modulating the interoceptive effects of alcohol in rats trained to discriminate alcohol (1 g/kg, IG) vs. water. mPFC inactivation resulted in full substitution for the alcohol training dose, and IC and Rh inactivation produced partial alcohol‐like effects, demonstrating the importance of these regions, with known projections to the AcbC, in modulating sensitivity to alcohol. Together, these data demonstrate a site of action of alcohol and the recruitment of cortical/thalamic regions in modulating sensitivity to the interoceptive effects of alcohol.
Substrate specificity determinants of class III nucleotidyl cyclases
Authors: Bharambe Nikhil G. , Barathy Deivanayaga V. , Syed Wajeed , Visweswariah Sandhya S. , Colaςo Melwin , Misquith Sandra , Suguna Kaza 
Published: August 2016

The two second messengers in signalling, cyclic AMP and cyclic GMP, are produced by adenylyl and guanylyl cyclases respectively. Recognition and discrimination of the substrates ATP and GTP by the nucleotidyl cyclases are vital in these reactions. Various apo‐, substrate‐ or inhibitor‐bound forms of adenylyl cyclase (AC) structures from transmembrane and soluble ACs have revealed the catalytic mechanism of ATP cyclization reaction. Previously reported structures of guanylyl cyclases represent ligand‐free forms and inactive open states of the enzymes and thus do not provide information regarding the exact mode of substrate binding. The structures we present here of the cyclase homology domain of a class III AC from Mycobacterium avium (Ma1120) and its mutant in complex with ATP and GTP in the presence of calcium ion, provide the structural basis for substrate selection by the nucleotidyl cyclases at the atomic level. Precise nature of the enzyme–substrate interactions, novel modes of substrate binding and the ability of the binding pocket to accommodate diverse conformations of the substrates have been revealed by the present crystallographic analysis. This is the first report to provide structures of both the nucleotide substrates bound to a nucleotidyl cyclase.DatabaseCoordinates and structure factors have been deposited in the Protein Data Bank with accession numbers: 5D15 (Ma1120CHD+ATP.Ca2+), 5D0E (Ma1120CHD+GTP.Ca2+), 5D0H (Ma1120CHD(KDA→EGY)+ATP.Ca2+), 5D0G (Ma1120CHD(KDA→EGY)+GTP.Ca2+).EnzymesAdenylyl cyclase (EC number: 4.6.1.1).