bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phytoplankton communities determine the spatio-temporal heterogeneity of alkaline phosphatase activity: evidence from a tributary of the Three Gorges Reservoir
Authors: Yuan Yijun , Bi Yonghong , Hu Zhengyu 
Published: November 2017

AbstractIn order to reveal the role of phytoplankton in the spatio-temporal distribution of alkaline phosphatase activity (APA), monthly investigations were conducted in the Xiaojiang River, a tributary of the Three Gorges Reservoir in China. Different APA fractions, environmental parameters, and phytoplankton communities were followed. High spatio-temporal variations of APA were observed, with the highest value in summer and the lowest in winter. The annual average APAT (total alkaline phosphatase activity) ranged from 7.78–14.03 nmol∙L−1∙min−1 with the highest in the midstream and the lowest in the estuary. The dominant phytoplankton phyla in summer and winter were Cyanophyta and Bacillariophyta, respectively. The mean cell density in the midstream and in the estuary was 5.2 × 107 cell∙L−1 and 1.4 × 107 cell∙L−1, respectively. That APA>3.0 μm was significantly higher than APA0.45-3 μm indicating phytoplankton was the main contributor to alkaline phosphatase. Correlation analysis indicated the dominant species and cell density could determine the distribution pattern of APA. Turbidity, total phosphorus, chemical oxygen demand, water temperature (WT), pH and chlorophyll a were proved to be positively correlated with APA; soluble reactive phosphorus, conductivity, transparency and water level(WL) were negatively correlated with APA. It was concluded that spatio-temporal heterogeneity of APA determined by phytoplankton communities was related to WT and WL.
Immobilized Cerrena sp. laccase: preparation, thermal inactivation, and operational stability in malachite green decolorization
Authors: Yang Jie , Wang Zhengjuan , Lin Yonghui , Ng Tzi Bun , Ye Xiuyun , Lin Juan 
Published: November 2017

AbstractLaccases are polyphenol oxidases with widespread applications in various industries. In the present study, the laccase from Cerrena sp. HYB07 was immobilized with four methods, namely entrapment in alginate, covalently binding to chitosan as well as formation of cross-linked enzyme aggregates (CLEAs) and magnetic CLEAs (M-CLEAs). The activity recovery rates of the immobilized laccases ranged from 29% to 68%. Immobilization elevated the reaction temperature optimum and reduced substrate specificity, but not necessarily the turnover rate. pH stability of immobilized laccases was improved compared with that of the free laccase, especially at acidic pH values. Thermal inactivation of all laccases followed a simple first-order exponential decay model, and immobilized laccases displayed higher thermostability, as manifested by lower thermal inactivation rate constants and longer enzyme half-life time. Operational stability of the immobilized laccase was demonstrated by decolorization of the triphenylmethane dye malachite green (MG) at 60 °C. MG decolorization with free laccase was accompanied by a shift of the absorption peak and accumulation of a stable, colored intermediate tetradesmethyl MG, probably due to lower thermostability of the free laccase and premature termination of the degradation pathway. In contrast, complete decolorization of MG was achieved with laccase CLEAs at 60 °C.
Hidden molecular outflow in the LIRG Zw 049.057
Authors: Falstad N. , Aalto S. , Mangum J. G. , Costagliola F. , Gallagher J. S. , González-Alfonso E. , Sakamoto K. , König S. , Muller S. , Evans A. S. , Privon G. C. 
Published: November 2017

Context. Feedback in the form of mass outflows driven by star formation or active galactic nuclei is a key component of galaxy evolution. The luminous infrared galaxy Zw 049.057 harbours a compact obscured nucleus with a possible far-infrared signature of outflowing molecular gas. Due to the high optical depths at far-infrared wavelengths, however, the interpretation of the outflow signature is uncertain. At millimeter and radio wavelengths, the radiation is better able to penetrate the large columns of gas and dust responsible for the obscuration.
Aims. We aim to investigate the molecular gas distribution and kinematics in the nucleus of Zw 049.057 in order to confirm and locate the molecular outflow, with the ultimate goal to understand how the nuclear activity affects the host galaxy.
Methods. We used high angular resolution observations from the Submillimeter Array (SMA), the Atacama Large Millimeter/submillimeter Array (ALMA), and the Karl G. Jansky Very Large Array (VLA) to image the CO J = 2–1 and J = 6–5 emission, the 690 GHz continuum, the radio centimeter continuum, and absorptions by rotationally excited OH.
Results. The CO line profiles exhibit wings extending ~ 300 km s-1 beyond the systemic velocity. At centimeter wavelengths, we find a compact (~ 40 pc) continuum component in the nucleus, with weaker emission extending several 100 pc approximately along the major and minor axes of the galaxy. In the OH absorption lines toward the compact continuum, wings extending to a similar velocity as for the CO are only seen on the blue side of the profile. The weak centimeter continuum emission along the minor axis is aligned with a highly collimated, jet-like dust feature previously seen in near-infrared images of the galaxy. Comparison of the apparent optical depths in the OH lines indicate that the excitation conditions in Zw 049.057 differ from those within other OH megamaser galaxies.
Conclusions. We interpret the wings in the spectral lines as signatures of a nuclear molecular outflow. A relation between this outflow and the minor axis radio feature is possible, although further studies are required to investigate this possible association and understand the connection between the outflow and the nuclear activity. Finally, we suggest that the differing OH excitation conditions are further evidence that Zw 049.057 is in a transition phase between megamaser and kilomaser activity.
Gefangen im falschen Körper
Authors: Müller Jessica 
Published: November 2017

Zusammenfassung
Protokoll systemische Fallbesprechung Im dritten Teil unserer Serie geht es um einen Patienten, der sich einer Geschlechtsumwandlung
unterzieht und massives selbstverletzendes Verhalten zeigt. Lesen Sie, wie das Pflegeteam es schafft, mithilfe der systemischen
Fallbesprechung neue Perspektiven für den Umgang mit dem Patienten zu entwickeln. Auch hier möchten wir Sie wieder einladen, sich selbst in
die verschiedenen Rollen hineinzuversetzen. Fallen Ihnen weitere Lösungswege ein? Dann schreiben Sie uns an psych.pflegeheute@thieme.de.
Rot, gelb oder grün?
Authors: Kindling Julia , Schreiner Alexandra 
Published: November 2017

Zusammenfassung
Ampelsystem für die psychiatrische Akutaufnahme Wenn ein Patient in die Notfallambulanz kommt, müssen Pflegende oft schnell
einschätzen, wie dringlich Handlungsbedarf besteht. Doch Priorisierungen sind unter Zeitdruck häufig schwierig, zumal bisher eindeutige
Kriterien für ein standardisiertes Aufnahmemanagement fehlten. Wir stellen Ihnen farbgeleitete Checklisten vor, mit denen Pflegende direkt
erfassen können in welchem Zustand der Patient ist und wie schnell ein Arzt hinzugezogen werden sollte.
Neuroendovascular Fellowship Training: Self-Assessment of a Program Accredited by the Committee on Advanced Subspecialty Training
Authors: Shakir Hakeem J , Shallwani Hussain , Rangel-Castilla Leonardo , Bregy Amade , Davies Jason M , Sonig Ashish , Ogilvy Christopher S , Snyder Kenneth V , Hopkins L Nelson , Siddiqui Adnan H , Levy Elad I 
Published: November 2017

Abstract
The University at Buffalo's neuroendovascular fellowship is one of the longest running fellowship programs in North America. The burgeoning neurointerventional workforce and the rapid growth in the neurointerventional space on the heels of groundbreaking clinical trials prompted us to assess the fellowship's academic impact and its graduates’ perceptions and productivity. An anonymized web-based survey was sent to all former neuroendovascular fellows with specific questions pertaining to current practice, research and funding, and perceptions about the fellowship's impact on their skills, competitiveness, and compensation. Additionally, the h-index was calculated to assess the academic productivity of each graduated fellow. Among 50 former fellows, 42 (84%) completed the survey. The fellows came from various countries, ethnic backgrounds, and specialties including neurosurgery (n = 39, 93%), neurology (n = 2, 5%), and neuroradiology (n = 1, 2%). Twenty (48%) respondents were currently chairs or directors of their practice. Most (n = 30, 71%) spent at least 10% of their time on research activities, with 27 (64%) receiving research funding. The median h-index of all 50 former fellows was 14. The biggest gains from the fellowship were reported to be improvement in endovascular skills (median = 10 on a scale of 0-10 [highest]) and increase in competitiveness for jobs in vascular neurosurgery (median = 10), followed by increase in academic productivity (median = 8), and knowledge of vascular disease (median = 8). In an era with open calls for moratoriums on endovascular fellowships, concerns over market saturation, and pleas to improve training, fellowship programs perhaps merit a more objective assessment. The effectiveness of a fellowship program may best be measured by the academic impact and leadership roles of former fellows.
Enhancing Nursing and Midwifery Student Learning Through the Use of QR Codes
Authors: Downer Terri , Oprescu Florin , Forbes Helen , Phillips Nikki , McTier Lauren , Lord Bill , Barr Nigel , Bright Peter , Simbag Vilma 
Published: November 2017

Abstract
A recent teaching and learning innovation using new technologies involves the use of quick response codes, which are read by smartphones and tablets. Integrating this technology as a teaching and learning strategy in nursing and midwifery education has been embraced by academics and students at a regional university.
MRI Characteristics of Spinal Ependymoma in WHO Grade II
Authors: Kobayashi Kazuyoshi , Ando Kei , Kato Fumihiko , Kanemura Tokumi , Imagama Shiro , Sato Koji , Kamiya Mitsuhiro , Ito Kenyu , Tsushima Mikito , Matsumoto Akiyuki , Morozumi Masayoshi , Tanaka Satoshi , Machino Masaaki , Ishiguro Naoki 
Published: November 2017

Study Design.
Retrospective multicenter study.

Objective.
The goal of this study is to determine the characteristic imaging features of spinal ependymoma in a review of magnetic resonance imaging (MRI) data for a large series of surgically proven cases.

Summary of Background Data.
Common spinal intramedullary neoplasms are mostly ependymomas and comprise 50% to 60% of spinal neuroepithelial tumors in adults. Preoperative prediction of the pathological diagnosis could enhance surgical planning and explanation of the procedure to patients. However, these types of tumors exhibit a variety of MRI findings.

Methods.
Records were examined for 59 patients who underwent surgery for spinal cord ependymoma and had a pathological diagnosis of cellular ependymoma of World Health Organization classification grade II.

Results.
The ependymomas included 28 in the cervical spine, 34 in the thoracic spine, and 3 conus lesions. All cases were isointense or hypointense on T1-weighted MRI, and 55 (93%) were hyperintense on T2-weighted MRI. Tumors were located centrally in all cases; 50 (85%) showed surrounding cord edema; and 52 (88%) had associated cysts, including 36 (61%) rostral or caudal cysts, 10 (17%) intratumoral cysts, and 6 (10%) with syringomyelia. Of the 59 tumors, 17 (29%) showed the “cap sign,” a rim of extreme hypointensity seen around the tumor on T2-weighted images, due to hemosiderin. In gadolinium-enhanced MRI, all cases were enhanced, and 27 (46%), 16 (27%), 11 (19%), and 5 (8%) cases showed homogeneous, heterogeneous, rim, and nodular enhancement, respectively.

Conclusion.
Hypointense changes on T2-weighted MRI and hemosiderin deposition reflect easy bleeding. Tumors are associated with various types of cysts, and gadolinium-enhancement patterns reflect a variety of intratumor cellular components. In cases in which the whole tumor shows gadolinium enhancement on MRI, rostral, or caudal cyst and a cap sign with hemorrhage are characteristics of grade II classical ependymoma.

Level of Evidence: 3
Comparing Injectable DaxibotulinumtoxinA and OnabotulinumtoxinA in Moderate and Severe Glabellar Lines: Additional Analyses From a Phase 2, Randomized, Dose-Ranging, Double-Blind, Multicenter Study
Authors: Bertucci Vince , Humphrey Shannon , Carruthers Jean , Solish Nowell , Muhn Channy , Swift Arthur , Rubio Roman G. , Shears Gill , Rosen Nathan 
Published: November 2017

BACKGROUND
Injectable daxibotulinumtoxinA (RT002) is an investigational botulinum toxin Type A. Published Phase 2 data show that, compared with 20U onabotulinumtoxinA, 40U daxibotulinumtoxinA is associated with a significantly greater response rate and significantly longer duration of response (median 24 weeks), and appears generally safe and well tolerated (www.clinicaltrials.gov NCT02303002).

OBJECTIVE
To evaluate whether these efficacy and safety findings are influenced by baseline glabellar line severity.

MATERIALS AND METHODS
In the Phase 2, randomized, dose-ranging, parallel-group, double-blind, multicenter study, subjects with moderate or severe glabellar lines at maximum frown were randomly assigned to 20U, 40U, or 60U daxibotulinumtoxinA, 20U onabotulinumtoxinA, or placebo. Efficacy was evaluated by investigators for ≥24 weeks.

RESULTS
Data from the per protocol population (n = 191) stratified by baseline glabellar line severity (125 moderate, 66 severe) suggest that the clinical advantage of 40U daxibotulinumtoxinA over 20U onabotulinumtoxinA is maintained for a range of efficacy outcomes regardless of whether glabellar lines are moderate or severe at baseline. Statistical evaluations were not completed due to the limited size of each subgroup.

CONCLUSION
40U daxibotulinumtoxinA appears to offer a clinical efficacy advantage over 20U onabotulinumtoxinA in both moderate and severe glabellar lines—with a greater advantage observed in severe glabellar lines.
Minimally Invasive Genioplasty Procedure
Authors: Nadjmi Nasser , Van Roy Sien , Van de Casteele Elke 
Published: November 2017

Summary:
In this technical note, we present a new surgical approach for genioplasty in which a minimally invasive procedure is used to perform the chin osteotomy. The main goal was to reduce postoperative functional recovery time and possible complications, especially reduction of lip incompetence, chin ptosis, and muscle dysfunction, by retaining the intactness of the mentalis muscles.
Discharge Criteria for Bronchiolitis
Authors: Garcia-Mauriño Cristina , Moore-Clingenpeel Melissa , Wallihan Rebecca , Koranyi Katalin , Rajah Bavani , Shirk Tiffany , Vegh Maria , Ramilo Octavio , Mejias Asuncion 
Published: November 2017

Background:
Admission criteria and standardized management strategies for bronchiolitis are addressed in several guidelines and have shown to be beneficial; however, guidance regarding discharge criteria is limited and widely variable. We assessed the impact on clinical outcomes of a discharge protocol for children <2 years of age hospitalized with bronchiolitis in a tertiary care pediatric hospital.

Methods:
In October 2013, a protocol to standardize the discharge of children with bronchiolitis was implemented in the infectious diseases (ID) ward but not in other pediatric units caring for these children (non-ID). The protocol included objective clinical criteria and a standardized oxygen weaning pathway. Patients were identified via International Classification of Diseases-9 codes and data manually reviewed. We compared length of stay (LOS) and readmission rates within 2 weeks of discharge according to protocol implementation (ID versus non-ID), adjusted for demographic factors, comorbidities, viral etiology and stratified by pediatric intensive care unit admission.

Results:
From October 2013 to May 2015, 1118 children were hospitalized in ID and 695 in non-ID units. Median age was 4.5 months, 55% were males and 28% had comorbidities. LOS was 36% longer in non-ID units (risk ratio: 1.36 [1.27–1.45]; P < 0.001) adjusted for age, gender, comorbidities and viral etiology. Difference in LOS remained significant after excluding children with comorbidities and stratifying by pediatric intensive care unit admission. Readmission rates were comparable between units (ID, 2.9% versus non-ID, 2.6%).

Conclusions:
A standardized discharge protocol for bronchiolitis reduced LOS without increasing readmission rates. Unifying bronchiolitis discharge criteria and oxygen weaning pathways could positively impact hospital-based patient care for this condition.
Muscle Damage Due to Fusidic Acid–Statin Interaction: Review of 75 Cases From the French Pharmacovigilance Database and Literature Reports
Authors: Bataillard Maxime , Beyens Marie-Noëlle , Mounier Geneviève , Vergnon-Miszczycha Delphine , Bagheri Haleh , Cathebras Pascal 
Published: November 2017

Background/Area of Uncertainty:
Statins, which reduce cardiovascular risk in both primary and secondary prevention, are one of the most widely prescribed therapeutic classes in the world. Usually well-tolerated, statin-associated muscle symptoms are a well-known adverse effect. Fusidic acid (FA) is a bacteriostatic antibiotic of interest in the treatment of methicillin-resistant Staphylococcus aureus infections. Cases of rhabdomyolysis, sometimes fatal, have been reported after coprescription of FA and a statin.

Data Sources/Area of Uncertainty:
We studied 75 cases of muscle damage related to interaction between FA and a statin reported in the French national pharmacovigilance database (43 cases) and from a literature review (32 cases).

Results:
Cases were mostly men (72.5%), often overweight (mean body mass index: 29.4). The most commonly reported statins were atorvastatin (60%), simvastatin (22.7%), and rosuvastatin (8.0%). Muscle disorders appeared on average 30 days after initiation of FA. Symptoms were muscle weakness (82%), dark urine (71%), and myalgia (61%). Mean creatine kinase level at diagnosis was 43,890 UI/mL, and acute renal injury occurred more than half of the cases. Outcome was fatal in 22% of cases and 28% kept sequelae at the end of the follow-up (54 days).

Conclusions:
Muscle damage induced by interaction between FA and statin is a potentially life-threatening complication, leading to contraindication of this association in France. This is to be reminded especially because FA is about to get FDA approval and should soon be available in the United States.
Enteric Pathologic Manifestations of Alpha-Synucleinopathies
Authors: Punsoni Michael , Friedman Joseph H. , Resnick Murray , Donahue John E. , Yang Dong Fang , Stopa Edward G. 
Published: November 2017

Background:
Gastrointestinal (GI) symptoms are common in Parkinson disease (PD), often preceding neurological manifestations; however, early diagnostic utility of GI biopsies remains controversial. Studies suggest aberrant deposition of alpha-synuclein (α-syn) follows step-wise progression in central nervous system though histologic interpretation of normal and aberrant staining patterns have shown variable results. This study examines whether GI α-syn mRNA expression combined with standard α-syn immunohistochemical staining enhance the role of GI biopsy in PD.

Materials and Methods:
Four groups were examined, including pediatric (21) and adult control patients (18), PD clinic patients (17), and pathologically confirmed PD cases from hospital archives (16). Enteric nervous system α-syn staining was evaluated by immunohistochemistry in 33 PD and 39 controls. α-Syn mRNA levels were compared between patient groups using quantitative polymerase chain reaction and stomach and colon levels in PD.

Results:
PD patients had Lewy bodies (LB) and diffuse neuronal α-syn staining. GI tissues from elderly controls, children, and young adults exhibited diffuse positivity. LB were limited to PD. Myenteric plexus immunoreactivity varied in different regions. Widespread staining was noted within stomach and colon. Immunoreactivity was present within esophagus, appendix, and small bowel. α-Syn mRNA expression was highest in PD; however, levels varied between proximal and distal GI tract.

Conclusions:
α-Syn is normally present within young and elderly enteric nervous system; furthermore, while α-syn mRNA is always detectable, levels are highest and most variable in PD. This suggests that enteric α-syn may be altered in neurodegenerative disease. The presence of LB in the GI tract, not solely α-syn expression, may prove useful, distinguishing neurodegenerative disease patients from normal controls.
Psychological and Psychiatric Outcomes Following PICU Admission: A Systematic Review of Cohort Studies
Authors: Lopes-Júnior Luís Carlos , Rosa Maria Antonia dos Reis de Paula , Lima Regina Aparecida Garcia de 
Published: November 2017

Objective:
Admissions to PICU places pediatric patients at increased risk of persistent psychological and psychiatric morbidity. This systematic review aimed to summarize and critically examine literature regarding psychological and psychiatric outcomes of pediatric patients following PICU admission.

Data Sources:
MEDLINE, Web of Science, Cochrane Library, Science Direct, PsycInfo, CINAHL, LILACS, and SciELO were searched up to May 2016.

Study Selection:
Cohort studies about psychological and psychiatric outcomes of pediatric patients following PICU admission; full-text records published in English, Spanish, or Portuguese in peer-reviewed journals from 2000 to 2015 were included. Neonatal patient population (age, <1 mo), follow-up after PICU discharge (<3 mo), and nonprimary literature were excluded. Two reviewers independently screened studies based on the predetermined exclusion criteria.

Data Extraction:
Data were extracted using an adapted tool. The internal validity and risk of bias were assessed using Newcastle-Ottawa Scale.

Data Synthesis:
The search yielded 1,825 studies after the removal of duplications, of which eight met the inclusion criteria. Methodologic quality of the studies ranged from low to high, with an average score of five of nine. Of all the studies, half had a control group. Regarding the length of follow-up, most of the studies ranged from 3 to 12 months.

Conclusions:
Psychological and psychiatric outcomes after pediatric critical illness appear to be substantial issues that need to be further studied. Our review highlights the need for psychological screening of pediatric patients and their parents following PICU admission since these patients are a vulnerable population at risk for developing psychiatric responses.
Unusual Case of Penile Ecchymosis
Authors: Peterson Thomas , Supenia Emily , Hashikawa Andrew 
Published: November 2017

Abstract
Hirudin is a potent anticoagulant found in the salivary glands of several species of leeches. We report a case of direct hirudin exposure after suspected leech bite causing significant penile ecchymosis. Diagnosis was not apparent on initial evaluation but made after a thorough history was obtained and the leech was found in the lining of his swim trunks, which he left at home. Although this presentation mimics several other potentially serious conditions, treatment is largely observational with anticipated rapid improvement over the course of hours without intervention.