bluuebunny/crossref_metadata_2025_split huggingface dataset:
The benefits of respectful interactions: fluid alliancing and inter‐occupational information sharing in primary care
Authors: DiCicco‐Bloom Barbara , DiCicco‐Bloom Benjamin 
Published: March 2016

AbstractThough inter‐occupational interactions in health care have been the focus of increasing attention, we still know little about how such interactions shape information sharing in clinical settings. This is particularly true in primary care where research on teams and collaboration has been based on individual perceptions of work (using surveys and interviews) rather than observing the interactions that directly mediate the inter‐occupational flow of information. To explore how interactions shape information sharing, we conducted a secondary analysis of ethnographic data from 27 primary care practices. Ease of information sharing among nurses and doctors is linked to the degree to which practices feature respectful interactions, with practices in the sample falling into one of three categories (those with low, uneven, and high degrees of respectful interactions). Those practices with the highest degree of respectful interactions demonstrate what we describe as fluid‐alliancing: flexible interactions between individuals from different occupational groups in which bidirectional information sharing occurs for the benefit of patients and the efficacy of the practice community. We conclude by arguing that this process unlocks the strengths of all practice members, and that leadership should encourage respectful interactions to augment organisational efficacy and the ability of individual practice members to provide quality patient care.
Electrocardiographic Parameters Indicating Worse Evolution in Patients with Acquired Long QT Syndrome and Torsades de Pointes
Authors: Kukla Piotr , Jastrzębski Marek , Fijorek Kamil , Stec Sebastian , Bryniarski Leszek , Czarnecka Danuta , Baranchuk Adrian 
Published: March 2016

BackgroundAcquired long QT syndrome (a‐LQTS) is associated with life‐threatening ventricular arrhythmias, mainly torsades de pointes (TdP). ECG parameters predicting evolving into ventricular fibrillation (VF) are ill defined.AimsTo determine ECG parameters preceding and during TdP associated with higher risk of developing VF.MethodsWe analyzed 151 episodes of TdP, recorded in 28 patients with a‐LQTS (mean QTc 638 ms ± 57).ResultsAll 28 patients had prolonged QT interval, (mean QTc 638 ms ± 57) ranging from 502 ms to 858 ms correcting by Bazett's formula. The mean TdP heart rate was 218 bpm ± 38 (mean cycle length of TdP 274 ± 47 ms). We classified TdPs episodes into “slower”‐TdP (s‐TdP) < 220 bpm (range from 145–220 bpm) observed in 81 (53.6%) episodes and “faster”‐TdP (f‐TdP) ≥ 220 bpm (ranged from 221–281 bpm) observed in 70 (46.4%) episodes. Among 151 episodes of TdP, 21 (13.9%) were unstable (converted into VF). Out of 81 episodes of “slower”‐TdP only 2 (2.5%) episodes converted into VF. The mean coupling interval (CI) of the PVC initiating TdP was 510 ms ± 118, the pause‐RR interval was 1147 ms ± 335, the prematurity index (PI) of PVC that initiated TdP was 0.45 ± 0.13. The mean cycle length variability of TdP (VRV‐TdP) was 30.79 ms ± 19.7. U wave was observed in 86 episodes (56.9%), among that in 69 episodes, the U/T wave ratio was > 1. Macro T wave alternans was observed in 4 patients. The QT interval was not different in patients with VF(+) and VF(−) episodes, 633 ± 60 and 639 ± 57, respectively.ConclusionsSome electrocardiographic parameters can be helpful in determining the risk of TdP evolving into VF. The slower ventricular rate (< 220 bpm), the higher rate instability (VRV > 30 ms) and the short episodes < 20 beats could predict benign evolution.
The Role of Transmural Repolarization Gradient in the Inversion of Cardiac Electric Field: Model Study of ECG in Hypothermia
Authors: Arteyeva Natalia V. , Azarov Jan E. 
Published: March 2016

BackgroundThe changes in ventricular repolarization gradients lead to significant alterations of the electrocardiographic body surface T waves up to the T wave inversion. However, the contribution of a specific gradient remains to be elucidated. The objective of the present investigation was to study the role of the transmural repolarization gradient in the inversion of the body surface T wave with a mathematical model of the hypothermia‐induced changes of ventricular repolarization.MethodsBy means of mathematical simulation, we set the hypothermic action potential duration (APD) distribution on the rabbit ventricular epicardium as it was previously experimentally documented. Then the parameters of the body surface potential distribution were tested with the introduction of different scenarios of the endocardial and epicardial APD behavior in hypothermia resulting in the unchanged, reversed or enlarged transmural repolarization gradient.ResultsThe reversal of epicardial repolarization gradients (apicobasal, anterior‐posterior and interventricular) caused the inversion of the T waves regardless of the direction of the transmural repolarization gradient. However, the most realistic body surface potentials were obtained when the endocardial APDs were not changed under hypothermia while the epicardial APDs prolonged. This produced the reversed and increased transmural repolarization gradient in absolute magnitude. The body surface potentials simulated under the unchanged transmural gradient were reduced in comparison to those simulated under the reversed transmural gradient.ConclusionsThe simulations demonstrated that the transmural repolarization gradient did not play a crucial role in the cardiac electric field inversion under hypothermia, but its magnitude and direction contribute to the T wave amplitude.
How we manage thrombotic microangiopathies in pregnancy
Authors: Thomas Mari R. , Robinson Susan , Scully Marie A. 
Published: March 2016

SummaryDifferentiation between the thrombotic microangiopathies (TMAs) that present in pregnancy may be clinically challenging, but is critical to ensure correct management because of the impact on fetal and maternal outcomes. Thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uraemic syndrome (aHUS) are medical/obstetric emergencies that require specialist input, both at the time of acute diagnosis and follow‐up in subsequent pregnancies. Features of preeclampsia and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) may precede or be present in evolving TTP or aHUS. Clinicians need to be mindful of how a presumed diagnosis of a specific TMA in pregnancy may evolve and be prepared to frequently reassess signs and symptoms and revise the diagnosis and management plan accordingly.
Glycosylation pattern of anti‐platelet IgG is stable during pregnancy and predicts clinical outcome in alloimmune thrombocytopenia
Authors: Sonneveld Myrthe E. , Natunen Suvi , Sainio Susanna , Koeleman Carolien A. M. , Holst Stephanie , Dekkers Gillian , Koelewijn Joke , Partanen Jukka , van der Schoot C. Ellen , Wuhrer Manfred , Vidarsson Gestur 
Published: March 2016

Fetal or neonatal alloimmune thrombocytopenia (FNAIT) is a potentially life‐threatening disease where fetal platelets are destroyed by maternal anti‐platelet IgG alloantibodies. The clinical outcome varies from asymptomatic, to petechiae or intracranial haemorrhage, but no marker has shown reliable correlation with severity, making screening for FNAIT impractical and highly inefficient. We recently found IgG Fc‐glycosylation towards platelet and red blood cell antigens to be skewed towards decreased fucosylation, increased galactosylation and sialylation. The lowered core‐fucosylation increases the affinity of the pathogenic antibodies to FcγRIIIa and FcγRIIIb, and hence platelet destruction. Here we analysed the N‐linked glycans of human platelet antigen (HPA)‐1a specific IgG1 with mass spectrometry in large series of FNAIT cases (n = 166) including longitudinal samples (n = 26). Besides a significant decrease in Fc‐fucosylation after the first pregnancy (P = 0·0124), Fc‐glycosylation levels remained stable during and after pregnancy and in subsequent pregnancies. Multiple logistic regression analysis identified anti‐HPA‐1a –fucosylation (P = 0·006) combined with galactosylation (P = 0·021) and antibody level (P = 0·038) correlated with bleeding severity, making these parameters a feasible marker in screening for severe cases of FNAIT.
Toddlers’ Word Learning From Contingent and Noncontingent Video on Touch Screens
Authors: Kirkorian Heather L. , Choi Koeun , Pempek Tiffany A. 
Published: March 2016

Researchers examined whether contingent experience using a touch screen increased toddlers’ ability to learn a word from video. One hundred and sixteen children (24–36 months) watched an on‐screen actress label an object: (a) without interacting, (b) with instructions to touch anywhere on the screen, or (c) with instructions to touch a specific spot (location of labeled object). The youngest children learned from contingent video in the absence of reciprocal interactions with a live social partner, but only when contingent video required specific responses that emphasized important information on the screen. Conversely, this condition appeared to disrupt learning by slightly older children who were otherwise able to learn words by passively viewing noninteractive video. Results are interpreted with respect to selective attention and encoding.
Effect of controlled human exposure to diesel exhaust and allergen on airway surfactant protein D, myeloperoxidase and club (Clara) cell secretory protein 16
Authors: Biagioni B. J. , Tam S. , Chen Y.‐W. R. , Sin D. D. , Carlsten C. 
Published: March 2016

SummaryBackgroundAir pollution is a major cause of global morbidity and mortality. Air pollution and aeroallergens aggravate respiratory illness, but the variable effects of air pollutants and allergens in the lung are poorly understood.ObjectiveTo determine the effects of diesel exhaust (DE) and bronchial allergen challenge as single and dual exposures on aspects of innate immunity in the airway as reflected by surfactant protein D (SPD), myeloperoxidase (MPO) and club (Clara) cell secretory protein 16 (CC16) in 18 atopic individuals.MethodsIn this double‐blind, randomized crossover study, atopic individuals were exposed to DE or filtered air, followed by endobronchial allergen or saline 1 hour after inhalational exposure. Bronchoalveolar lavage, bronchial washings, nasal lavage and blood samples were obtained 48 hours after exposures and assayed for CC16, MPO and SPD by ELISA.ResultsIn bronchial samples, the concentration of SPD increased from 53.3 to 91.8 ng/mL after endobronchial allergen, with no additional contribution from DE. MPO also increased significantly in response to allergen (6.8 to 14.7 ng/mL), and there was a small additional contribution from exposure to DE. The concentration of CC16 decreased from 340.7 to 151.0 ng/mL in response to DE, with minor contribution from allergen. These changes were not reflected in nasal lavage fluid or plasma samples.Conclusions and Clinical RelevanceThese findings suggest that allergen and DE variably influence different aspects of the innate immune response of the lung. SPD and MPO, known markers of allergic inflammation in the lung, are strongly increased by allergen while DE has a minor effect therein. DE induces a loss of CC16, a protective protein, while allergen has a minor effect therein. Results support site‐ and exposure‐specific responses in the human lung upon multiple exposures.
Asthma is associated with enhanced thrombin formation and impaired fibrinolysis
Authors: Bazan‐Socha S. , Mastalerz L. , Cybulska A. , Zareba L. , Kremers R. , Zabczyk M. , Pulka G. , Iwaniec T. , Hemker C. , Undas A. 
Published: March 2016

SummaryBackgroundThere is evidence that altered blood coagulation and fibrinolysis are involved in the pathogenesis of asthma. Increased thromboembolic risk has been reported in asthmatics.ObjectiveTo investigate whether enhanced thrombin generation and impaired fibrinolysis occur in asthmatics.MethodsPlasma thrombin generation profile together with a computational assessment of thrombin dynamics and fibrinolytic capacity expressed as clot lysis time (CLT) were determined in 164 consecutive patients with stable asthma and 72 controls matched for age, gender, weight and smoking.ResultsAsthma patients had 20.2% increased endogenous thrombin potential (ETP), 41.4% higher peak thrombin concentration, 61% higher maximal prothrombin conversion rate, 15.5% faster rate of thrombin formation (all, P < 0.0001) and 10% lower thrombin decay capacity (P = 0.0004) compared with controls. Asthmatics had also 14.4% longer CLT (P = 0.001) associated with 21.3% higher plasminogen activator inhibitor‐1 (PAI‐1) (P < 0.0001), and 13% higher plasma α2‐macroglobulin (P = 0.0002). Using ETP and CLT above 75th percentile of the control values as the cut‐off levels, we found increased risks of enhanced thrombin generation and hypofibrinolysis in asthmatics, also after correction for potential confounders. ETP and CLT were associated inversely with forced expiratory volume in 1 s/vital capacity (FEV1/VC) index, after adjustment for age and body mass index. Non‐allergic asthma (n = 70, 42.6%) was characterized by 17.5% longer CLT (P = 0.02), which positively associated with PAI‐1. Thrombin generation profile was not affected by allergy.Conclusion and Clinical RelevanceAsthma is associated with enhanced thrombin generation and impaired fibrinolysis, which might contribute to thromboembolic events in this disease.
Effect of Wnt3a delivery on early healing events during guided bone regeneration
Authors: Moschouris P , Retzepi M , Petrie A , Donos N 
Published: March 2016

AbstractObjectiveTo evaluate the effect of recombinant Wnt3a delivery on the bone regeneration potential following application of the guided bone regeneration (GBR) principle.Materials and methodsA critical‐size calvarial defect was created on each parietal bone of 14 Wistar strain rats. One defect was used as the test side and was treated with a collagen sponge carrying 2.0 μg of recombinant Wnt3a protein, whereas the contralateral side served as sham‐operated control. Both defects were covered at both the extracranial and intracranial aspects with ePTFE non‐resorbable membranes, according to the GBR principle. Following healing periods of 4 and 7 days, qualitative histological and histomorphometric evaluation of undecalcified sections was performed in subgroups of seven animals. The primary outcome parameter was the mean percentage of defect closure in the test and control defects.ResultsAt 4 days of healing, a network of coagulum and fibrin was observed and initial signs of granulation tissue formation were evident with no apparent differences between the test and control groups. At 7 days of healing, the test group presented newly formed woven bone, originating from the borders of the defect, as opposed to the control group, whereby woven bone formation was not observed in any of the specimens.ConclusionsThe delivery of mouse recombinant Wnt‐3a protein in combination with GBR may promote woven bone formation in critical‐size calvarial defects at 7 days of healing.
Bone loss at implants and teeth in the same segment of the dentition in partially dentate subjects
Authors: Cecchinato Denis , Marino Massimiliano , Lindhe Jan 
Published: March 2016

AbstractBackgroundSome studies have indicated that marginal bone loss at implants and at teeth are similar, while results from other studies showed that implants lost more bone than teeth in the same dentition.AimTo determine the amount of progressive marginal bone loss that had occurred at implants and teeth in the same segment of the dentition following implant placement in partially dentate subjects.Material and MethodsA total of 217 patients with a total of 573 implants and 318 teeth present in the same segments of the dentition were included. Radiographs were available from 1 year (baseline) and ≥3 years after loading.ResultsThe mean bone loss that occurred between the two examinations was at implants 0.42 ± 0.68 mm and at teeth 0.44 ± 0.52 mm. Thirty‐eight subjects (18%) had ≥1 implant exhibiting >1 mm bone loss. Bone loss at the 148 implants in this category of patients was 1.30 ± 1.04 mm with a corresponding loss at the 69 teeth of 0.53 ± 0.62 mm. Eighteen subjects (8%) had ≥1 tooth that exhibited >1 mm bone loss. The mean amount of bone loss in this sample was 1.37 ± 0.87 mm (38 teeth) and 0.29 ± 0.31 mm (56 implants).ConclusionsThis study showed that marginal bone loss at implants and teeth in many partially dentate subjects might be independent phenomena.
Pain in Fabry Disease: Practical Recommendations for Diagnosis and Treatment
Authors: Politei Juan M. , Bouhassira Didier , Germain Dominique P. , Goizet Cyril , Guerrero‐Sola Antonio , Hilz Max J. , Hutton Elspeth J. , Karaa Amel , Liguori Rocco , Üçeyler Nurcan , Zeltzer Lonnie K. , Burlina Alessandro 
Published: March 2016

SummaryAimsPatients with Fabry disease (FD) characteristically develop peripheral neuropathy at an early age, with pain being a crucial symptom of underlying pathology. However, the diagnosis of pain is challenging due to the heterogeneous and nonspecific symptoms. Practical guidance on the diagnosis and management of pain in FD is needed.MethodsIn 2014, experts met to discuss recent advances on this topic and update clinical guidance.ResultsEmerging disease‐specific tools, including FabryScan, Fabry‐specific Pediatric Health and Pain Questionnaire, and Würzburg Fabry Pain Questionnaire, and more general tools like the Total Symptom Score can aid diagnosis, characterization, and monitoring of pain in patients with FD. These tools can be complemented by more objective and quantifiable sensory testing. In male and female patients of any age, pain related to FD can be an early indication to start disease‐specific enzyme replacement therapy before potentially irreversible organ damage to the kidneys, heart, or brain occurs.ConclusionTo improve treatment outcomes, pain should be diagnosed early in unrecognized or newly identified FD patients. Treatment should include: (a) enzyme replacement therapy controlling the progression of underlying pathology; (b) adjunctive, symptomatic pain management with analgesics for chronic neuropathic and acute nociceptive, and inflammatory or mixed pain; and (c) lifestyle modifications.
Significance of a positive Clostridium difficile toxin test after hematopoietic stem cell transplantation
Authors: Akahoshi Yu , Kimura Shun‐ichi , Nakano Hirofumi , Harada Naonori , Kameda Kazuaki , Ugai Tomotaka , Wada Hidenori , Yamasaki Ryoko , Ishihara Yuko , Kawamura Koji , Sakamoto Kana , Ashizawa Masahiro , Sato Miki , Terasako‐Saito Kiriko , Nakasone Hideki , Kikuchi Misato , Yamazaki Rie , Kanda Junya , Kako Shinichi , Nishida Junji , Kanda Yoshinobu 
Published: March 2016

AbstractPatients with hematological malignancies show a high prevalence of asymptomatic colonization with Clostridium difficile (CD colonization). Therefore, it is difficult to distinguish CD colonization with diarrhea induced by a conditioning regimen from true Clostridium difficile infection (CDI) in hematopoietic stem cell transplantation (HSCT) recipients. We retrospectively analyzed 308 consecutive patients who underwent a CD toxin A/B enzyme immunoassay test for diarrhea within 100 d after HSCT from November 2007 to May 2014. Thirty patients (9.7%) had positive CD toxin results, and 11 of these had positive results in subsequent tests after an initial negative result. Allogeneic HSCT, total body irradiation, stem cell source, acute leukemia, and the duration of neutropenia were significantly correlated with positive CD toxin results. In a logistic regression model, allogeneic HSCT was identified as a significant risk factor (odds ratio 18.6, p < 0.01). In an analysis limited to within 30 d after the conditioning regimen, the duration of neutropenia was the sole risk factor (odds ratio 10.4, p < 0.01). There were no distinctive clinical features for CDI, including the onset or duration of diarrhea. In conclusion, although CDI may be overdiagnosed in HSCT recipients, it is difficult to clinically distinguish between CDI and CD colonization.
Rentier Statebuilding in a Post‐Conflict Economy: The Case of Kosovo
Authors: Lemay‐Hébert Nicolas , Murshed Syed Mansoob 
Published: March 2016

ABSTRACTKosovo has been under various forms of international administration since 1999. Although the political dimension of this international experience has been widely studied by scholars — especially those associated with the critical theory of liberal peacebuilding — the economic dimension of international rule has received less attention. This article explores the economic dimension by linking insights from rentier theory with critical approaches to liberal peacebuilding and statebuilding. The postulate informing this article is that the sources of a state's income have an impact on its institutional development. The article discusses liberal peacebuilding through the lens of rentier theory, it analyses the economic management in the early years of the international administration of Kosovo, and describes and explores some of the unintended consequences of this massive international presence in Kosovo for the local economy.
High cumulative JC virus seroconversion rate during long‐term use of natalizumab
Authors: Vennegoor A. , van Rossum J. A. , Leurs C. , Wattjes M. P. , Rispens T. , Murk J. L. A. N. , Uitdehaag B. M. J. , Killestein J. 
Published: March 2016

Background and purposeJohn Cunningham virus (JCV) seropositivity is a risk factor for the development of natalizumab‐associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients. When JCV seronegative patients seroconvert, their risk of developing PML increases. Limited longitudinal data exist about the seroconversion rate amongst natalizumab‐treated relapsing−remitting MS (RRMS) patients. Our objective was to evaluate the seroconversion rate in a large Dutch cohort of natalizumab‐treated RRMS patients. Seroconversion was defined as at least two consecutive seropositive serum samples (or cessation of therapy after a single seropositive sample because of seropositivity) after initial seronegative testing.Methods and resultsIn our study of 179 patients for whom longitudinal blood samples were available over a long period (median 4.2 years), anti‐JCV antibody indices were measured in 933 available samples. Eighty‐six patients (48.0%) tested seronegative initially. Of these 86 seronegative patients, 23 patients (26.7%) seroconverted during follow‐up. The annualized seroconversion rate was 7.1%. Seroconversion occurred between 9 and 90 months (median 43 months) of treatment. The rate of seroconversion was independent of follow‐up duration. No significant increase was seen in the anti‐JCV antibody index in the non‐converting patients during the follow‐up.ConclusionThe annualized seroconversion rate of 7.1% in patients using natalizumab, cumulatively leading to more than 25% of seronegative patients becoming seropositive in 4 years, is of clinical relevance and should be taken into account in the risk assessment when considering the start of natalizumab therapy.