bluuebunny/crossref_metadata_2025_split huggingface dataset:
SubclinicalPropionibacterium acnesinfection estimation in the intervertebral disc (SPInE-ID): protocol for a prospective cohort
Authors: Astur Nelson , Martins Delio E , Wajchenberg Marcelo , Ferretti Mario , Menezes Fernando G , Doi Andre M , Rosemberg Laercio A , Santos Durval C B , Iutaka Alexandre S , Rodrigues Luciano M R , Martino Marines D V , Pagura Jorge R , Kihara Filho Eduardo N , Lenza Mario 
Published: November 2017

IntroductionLow back pain and vertebral endplate abnormalities are common conditions within the population. Subclinical infection caused by indolent pathogens can potentially lead to these findings, with differentiation between them notably challenging from a clinical perspective. Progressive infection of the intervertebral disc has been extensively associated with increasing low back pain, withPropionibacterium acnesspecifically implicated with in relation to sciatica. The main purpose of this study is to identify if the presence of an infective pathogen within the intervertebral disc is primary or is a result of intraoperative contamination, and whether this correlates to low back pain.Methods and analysisAn open prospective cohort study will be performed. Subjects included within the study will be between the ages of 18 and 65 years and have a diagnosis of lumbar disc herniation requiring open decompression surgery. Excised herniated disc fragments, muscle and ligamentum flavum samples will be collected during surgery and sent to microbiology for tissue culture and pathogen identification. Score questionnaires for pain, functionality and quality of life will be given preoperatively and at 1, 3, 6 and 12 months postoperatively. A MRI will be performed 12 months after surgery for analysis of Modic changes and baseline comparison. The primary endpoint is the rate of disc infection in patients with symptomatic degenerative disc disease. The secondary endpoints will be performance scores, Modic incidence and volume.Ethics and disseminationThis study was approved by our Institutional Review Board and was only initiated after it (CAAE 65102617.2.0000.0071). Patients agreeing to participate will sign an informed consent form before entering the study. Results will be published in a peer reviewed medical journal irrespective of study findings. If shown to be the case, this would have profound effects on the way physicians treat chronic low back pain, even impacting health costs.Trials registration numberNCT0315876; Pre-results.
Protocol of the sepsivit study: a prospective observational study to determine whether continuous heart rate variability measurement during the first 48 hours of hospitalisation provides an early warning for deterioration in patients presenting with infection or sepsis to the emergency department of a Dutch academic teaching hospital
Authors: Quinten Vincent M , van Meurs Matijs , Renes Maurits H , Ligtenberg Jack J M , ter Maaten Jan C 
Published: November 2017

IntroductionOne in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED).Methods and analysisThe protocol of a prospective observational study in the ED. We will include 171 adult medical patients presenting with suspected infection or sepsis and at least two systemic inflammatory response syndrome criteria. Patients with known pregnancy, cardiac transplantation or not admitted to our hospital are excluded.High sample frequency ECG signals (500 Hz), respiratory rate, blood pressure and peripheral oxygen saturation will be recorded continuously during the first 48 hours of hospitalisation using a bedside patient monitor (Philips IntelliVue MP70). Primary endpoint is patient deterioration, defined as the development of organ dysfunction, unplanned intensive care unit admission or in-hospital mortality. The ECG data will be used for offline HRV analysis. We will compare the HRV between two groups (deterioration/no deterioration) and analyse whether HRV provides an early warning for deterioration. Furthermore, we will create a multivariate predictive model for deterioration based on heart rate, respiratory rate and HRV. As planned secondary analyses, we (1) perform a subgroup analysis for patients with pneumosepsis and urosepsis and (2) determine whether HRV using lower sample frequencies (1 Hz or less) suffices to predict deterioration.Ethics and disseminationThe Institutional Review Board of the University Medical Center Groningen granted a waiver for the study (METc 2015/164). Results will be disseminated through international peer-reviewed publications and conference presentations. A lay summary of the results will be provided to the study participants.Trial registration numberNTR6168; Pre-results.
Effect of ephedrine and phenylephrine on brain oxygenation and microcirculation in anaesthetised patients with cerebral tumours: study protocol for a randomised controlled trial
Authors: Koch Klaus Ulrik , Tietze Anna , Aanerud Joel , Öettingen Gorm von , Juul Niels , Sørensen Jens Christian Hedemann , Nikolajsen Lone , Østergaard Leif , Rasmussen Mads 
Published: November 2017

IntroductionDuring brain tumour surgery, vasopressor drugs are commonly administered to increase mean arterial blood pressure with the aim of maintaining sufficient cerebral perfusion pressure. Studies of the commonly used vasopressors show that brain oxygen saturation is reduced after phenylephrine administration, but unaltered by ephedrine administration. These findings may be explained by different effects of phenylephrine and ephedrine on the cerebral microcirculation, in particular the capillary transit-time heterogeneity, which determines oxygen extraction efficacy. We hypothesised that phenylephrine is associated with an increase in capillary transit-time heterogeneity and a reduction in cerebral metabolic rate of oxygen compared with ephedrine. Using MRI and positron emission tomography (PET) as measurements in anaesthetised patients with brain tumours, this study will examine whether phenylephrine administration elevates capillary transit-time heterogeneity more than ephedrine, thereby reducing brain oxygenation.Methods and analysisThis is a double-blind, randomised clinical trial including 48 patients scheduled for surgical brain tumour removal. Prior to imaging and surgery, anaesthetised patients will be randomised to receive either phenylephrine or ephedrine infusion until mean arterial blood pressure increases to above 60 mm Hg or 20% above baseline. Twenty-four patients were allocated to MRI and another 24 patients to PET examination. MRI measurements include cerebral blood flow, capillary transit-time heterogeneity, cerebral blood volume, blood mean transit time, and calculated oxygen extraction fraction and cerebral metabolic rate of oxygen for negligible tissue oxygen extraction. PET measurements include cerebral metabolic rate of oxygen, cerebral blood flow and oxygen extraction fraction. Surgery is initiated after MRI/PET measurements and subdural intracranial pressure is measured.Ethics and disseminationThis study was approved by the Central Denmark Region Committee on Health Research Ethics (12 June 2015; 1-10-72-116-15). Results will be disseminated via peer-reviewed publication and presentation at international conferences.Trial registration numberNCT02713087; Pre-results. 2015-001359-60; Pre-results.
Fixation stability of the upward gaze in patients with myasthenia gravis: an eye-tracker study
Authors: Mihara Miharu , Hayashi Atsushi , Fujita Kazuya , Kakeue Ken , Tamura Ryoi 
Published: November 2017

ObjectiveTo quantify fixation stability of the upward gaze in patients with myasthenia gravis (MG) using an eye tracker.Methods and analysisIn this study, 21 normal subjects, 5 patients with MG with diplopia, 5 patients with MG without diplopia and 6 patients with superior oblique (SO) palsy were included. Subjects fixated on a target in the upward direction for 1 min. The horizontal (X) and vertical (Y) eye positions were recorded using an eye tracker. Fixation stability was first quantified using the bivariate contour ellipse areas (BCEA) of fixation points as an index of whole stability. Then, the SDs of the X and Y eye positions (SDX and SDY, respectively) were quantified as indices of directional stability, with the data divided into three 20 s fractions to detect temporal fixation fluctuation.ResultsBCEAs were larger in patients with MG (both with and without diplopia) than normal subjects and patients with SO palsy, without significant differences among the three 20 s fractions. Compared with normal subjects, SDXs were larger only in patients with MG with diplopia; SDYs were larger in both patients with MG with and without diplopia. In addition, SDYs in patients with MG with diplopia were larger than those in patients with MG without diplopia and patients with SO palsy. Furthermore, a significant difference among the three 20 s fractions was detected for SDYs in patients with MG with diplopia.ConclusionPatients with MG, especially those with diplopia, exhibit fixation instability in the upward gaze. Non-invasive quantification of fixation stability with an eye tracker is useful for precisely identifying MG-specific fatigue characteristics.Trial registration numberUMIN000023468; pre-results.
Neither non-toxigenicStaphylococcus aureusnor commensalS.epidermidiactivates NLRP3 inflammasomes in human conjunctival goblet cells
Authors: Li Dayu , Hodges Robin R , Bispo Paulo , Gilmore Michael S , Gregory-Ksander Meredith , Dartt Darlene A 
Published: November 2017

PurposeThe conjunctiva is a wet mucosal surface surrounding the cornea that is continuously exposed to pathogens. Nevertheless, persistent inflammation is not observed. We examined if the NOD-like receptor pyrin domain 3 (NLRP3) inflammasome functions as a sensor that distinguishes commensal and non-pathogenic bacteria from pathogenic bacteria in human conjunctival goblet cells.MethodsGoblet cells were grown from human conjunctiva and co-cultured with commensalStaphylococcus epidermidis, isogenic non-toxigenicS. aureusACL135 and as a control toxigenicS. aureusRN6390. Activation of the NLRP3 inflammasome was determined by measuring changes in NF-κB activity, expression of pro-interleukin (IL)-1β and NLRP3, activation of caspase-1 and secretion of mature IL-1β. Goblet cell mucin secretion was measured in parallel.ResultsWhile all three strains of bacteria were able to bind to goblet cells, neither commensalS. epidermidisnor isogenic non-toxigenicS. aureusACL135 was able to stimulate an increase in (1) NF-κB activity, (2) pro-IL-1β and NLRP3 expression, (3) caspase-1 activation, (4) mature IL-1β and (5) mucin secretion. ToxigenicS. aureus,the positive control, increased these values: knockdown of NLRP3 with small interfering RNA (siRNA) completely abolished the toxigenicS. aureus-induced expression of pro-IL-1β and secretion of mature IL-1β.ConclusionsWe conclude that NLRP3 serves as a sensor capable of discriminating commensal and non-pathogenic bacteria from pathogenic bacteria in conjunctival goblet cells, and that activation of the NLRP3 inflammasome induced by pathogenic bacteria mediates secretion of both mature IL-1β and large secretory mucins from these cells.
Mortality among referrals to a community-based intermediate care team
Authors: Lakkappa Bharath , Shah Sanjay , Rogers Stephen , Holman Leanne Helen 
Published: November 2017

ObjectivesIntermediate care services have been introduced to help mitigate unnecessary hospital demand and premature placement in long-term residential care. Many patients are elderly and/or with complex comorbidities, but little consideration has been given to the palliative care needs of patients referred to intermediate care services. The objective of this study is to determine the proportion of patients referred to a community-based intermediate care team who died during care and up to 24 months after discharge and so to help inform the development of supportive and palliative care in this setting.MethodsA retrospective cohort study of all 4770 adult patients referred to Northamptonshire Intermediate Care Team (ICT) between 11 April 2010 and 10 April 2011.ResultsOf 4770 patients referred, 60% were 75 years or older and 32% were 85 years of age or older. 4.0% of patients died during their ICT stay and 11% within 30 days of discharge. At the end of 12 months, 25% of the patients had died, increasing to 32% before the end of the second year. About 34% of all deaths occurred during the ICT stay or within 30 days of discharge, and a further 46% by the end of the first year. Male gender and higher age were associated with greater likelihood of death.ConclusionsIt is important for ICT clinicians to consider immediate and longer-term palliative care needs among patients referred to ICTs. Care models involving ICTs and palliative care teams working together could enable more people with end-stage non-cancer illnesses to die at home.
Addressing decisional conflict about fertility preservation: helping young female cancer survivors’ family planning decisions
Authors: Müller Madleina , Urech Corinne , Boivin Jacky , Ehrbar Verena , Moffat Rebecca , Daellenbach Rosanna Zanetti , Rochlitz Christoph , Tschudin Sibil 
Published: November 2017

BackgroundHealth professionals are challenged by a growing number of young long-term cancer survivors with their specific needs with regard to family planning. This study aimed at assessing decisional conflict (DC) in young female cancer patients regarding fertility preservation, identifying demographic, fertility and fertility preservation related factors, which may affect DC, and assessing the helpfulness of various decision-supports.MethodsA retrospective, cross-sectional, web-based survey via an online questionnaire available in three languages with specific items concerning cancer, fertility, fertility preservation and the validated Decisional Conflict Scale targeted at current or former female cancer patients aged 18–45 years, with cancer types or treatment potentially affecting reproductive function.ResultsThe 155 participating women showed considerable DC, especially with regard to missing information and support. DC was significantly lower in patients when the risk of infertility was discussed with a health professional, when they had undergone any procedure to preserve fertility, and when they had a university education. A longer time interval since cancer diagnosis was associated with higher DC. The most helpful decision-support tools were specialised websites and leaflets.ConclusionsYoung female cancer patients’ DC with regard to fertility preservation is very high. Information and support seem to be deficient. More information through standardised information tools might be an effective strategy to lower their DC at the time when treatment decisions need to be taken, and to improve their reproductive health after they have overcome cancer in the future.
Genome-wide association study of telomere length among South Asians identifies a second RTEL1 association signal
Authors: Delgado Dayana A , Zhang Chenan , Chen Lin S , Gao Jianjun , Roy Shantanu , Shinkle Justin , Sabarinathan Mekala , Argos Maria , Tong Lin , Ahmed Alauddin , Islam Tariqul , Rakibuz-Zaman Muhammad , Sarwar Golam , Shahriar Hasan , Rahman Mahfuzar , Yunus Mohammad , Jasmine Farzana , Kibriya Muhammad G , Ahsan Habibul , Pierce Brandon L 
Published: November 2017

BackgroundLeucocyte telomere length (TL) is a potential biomarker of ageing and risk for age-related disease. Leucocyte TL is heritable and shows substantial differences by race/ethnicity. Recent genome-wide association studies (GWAS) report ~10 loci harbouring SNPs associated with leucocyte TL, but these studies focus primarily on populations of European ancestry.ObjectiveThis study aims to enhance our understanding of genetic determinants of TL across populations.MethodsWe performed a GWAS of TL using data on 5075 Bangladeshi adults. We measured TL using one of two technologies (qPCR or a Luminex-based method) and used standardised variables as TL phenotypes.ResultsOur results replicate previously reported associations in the TERC and TERT regions (P=2.2×10−8 and P=6.4×10−6, respectively). We observed a novel association signal in the RTEL1 gene (intronic SNP rs2297439; P=2.82×10−7) that is independent of previously reported TL-associated SNPs in this region. The minor allele for rs2297439 is common in South Asian populations (≥0.25) but at lower frequencies in other populations (eg, 0.07 in Northern Europeans). Among the eight other previously reported association signals, all were directionally consistent with our study, but only rs8105767 (ZNF208) was nominally significant (P=0.003). SNP-based heritability estimates were as high as 44% when analysing close relatives but much lower when analysing distant relatives only.ConclusionsIn this first GWAS of TL in a South Asian population, we replicate some, but not all, of the loci reported in prior GWAS of individuals of European ancestry, and we identify a novel second association signal at the RTEL1 locus.
Assessment of thrombus length in acute ischemic stroke by post-contrast magnetic resonance angiography
Authors: Ganeshan Ramanan , Nave Alexander H , Scheitz Jan F , Schindlbeck Katharina A , Haeusler Karl Georg , Nolte Christian H , Villringer Kersten , Fiebach Jochen B 
Published: November 2017

ObjectivesPost-contrast magnetic resonance angiography (PC-MRA) enables visualization of vessel segments distal to an intra-arterial thrombus in acute ischemic stroke. We hypothesized that PC-MRA also allows clot length measurement in different intracranial vessels.MethodsPatients with MRI-confirmed ischemic stroke and intracranial artery occlusion within 24 hours of symptom onset were prospectively evaluated. PC-MRA was added to a standard stroke MRI protocol. Thrombus length was measured on thick slab maximum intensity projection images. Clinical outcome at hospital discharge was assessed by modified Rankin Scale (mRS).ResultsThirty-four patients (median age 72 years) presenting with a median National Institutes of Health Stroke Scale score of 11 and a median onset to imaging time of 116 min were included. PC-MRA enabled precise depiction of proximal and distal terminus of the thrombus in 31 patients (91%), whereas in three patients (9%) PC-MRA presented a partial occlusion. Median thrombus length in patients with complete occlusion was 9.9 mm. In patients with poor outcome (mRS ≥3) median thrombus length was significantly longer than in those with good outcome (mRS ≤2;P=0.011).ConclusionsPC-MRA demonstrates intra-arterial thrombus length at different vessel occlusion sites. Longer thrombus length is associated with poor clinical outcome.Clinical trial registrationNCT02077582; Results.
Emphysematous gastritis associated with Clostridium perfringens type A in a cat
Authors: Burn Jessica , Rousset Nicolas , Henderson Debra W , Legge Carolyn , Uzal Francisco A 
Published: November 2017

A ten‐year‐old male neutered Maine Coon cat was presented with lethargy, weakness, dehydration and inappetence of 48 hours' duration. Initial ultrasound revealed gastric distension, a normal gastric wall and segmental circumferential thickening of the jejunum wall. The cat initially improved with supportive care, but deteriorated on the second day of hospitalisation. Repeat ultrasound examination and radiography 24 hours after presentation showed marked gastric wall thickening with emphysematous changes. At gastroscopy, severe gastric mucosal discoloration was seen, suggestive of necrosis. Euthanasia was performed post‐gastroscopy due to the deteriorating clinical signs and a suspicion of generalised gastric wall necrosis. Postmortem examination and results of ancillary tests confirmed moderate necrosuppurative and emphysematous gastritis, and focal, mild, necrosuppurative and emphysematous enteritis associated with Clostridium perfringens type A infection. C perfringens infection is rare in small animals; however, it can cause severe and sometimes fatal gastrointestinal disease if the bacteria invade and colonise the gastrointestinal wall.
Repetitive vegetative propagation of first-year sea buckthorn (Hippophae rhamnoides L.) cuttings
Authors: Dale Adam , Galić Dragan 
Published: November 2017

Sea buckthorn (Hippophae rhamnoides L.) is used in beverages, pharmaceuticals, cosmetic products, and animal feeds. Although sea buckthorn has been shown to be easy to propagate vegetatively, currently, there is little information on reliable techniques to vegetatively propagate the plant repetitively within a single year. To address this, three experiments were conducted to study whether season and chilling affected the successful rooting of cuttings. Four cultivars, ‘Chuskaya’, ‘Golden Rain’, ‘Lord’, and ‘Sunny’, were used in the season- and chilling-effect experiments. Hardwood and softwood cuttings from field-grown plants did not root from October to December. The percent of rooted cuttings in January was cultivar-dependent. The number and percent of rooted greenhouse-produced cuttings were significantly affected by length of chilling. Most cuttings were produced and the highest percent rooted when the plants chilled for at least 6 wk. ‘Lord’ had the most and ‘Golden Rain’ the least number of rooted cuttings. This study indicated that greenhouse-grown stock plants were a viable source of sea buckthorn cuttings for vegetative propagation. When combined with field-grown sources, it is possible to produce sea buckthorn planting material year-round.
Red clover varieties show nitrogen fixing advantage during the early stages of seedling development
Authors: Thilakarathna M.S. , Papadopoulos Y.A. , Grimmett M. , Fillmore S.A.E. , Crouse M. , Prithiviraj B. 
Published: November 2017

Plant and environmental factors affect root nitrogen (N) exudation dynamics in legumes. To better understand the genotypic variability and plant factors affecting root N release nodulation, plant growth, tissue N content, and root N exudation, six (three diploid and three tetraploid) red clover (Trifolium pratense L.) varieties were evaluated under controlled environmental conditions during the first 8 wk of plant growth after rhizobia inoculation. Genotypic differences were found for nodulation, plant dry weight (DW), leaf area, root attributes (root length, surface area, volume, and diameter), shoot and root N concentration, and N content. Genotypic differences were also found for root exudate N content in terms of NO3−-N, NH4+-N, and dissolved organic N (DON). In general, root exudate inorganic N content was greater in tetraploid varieties than in the diploids throughout the growth period. Root exudate DON content was greater than the inorganic N content. The NO3−-N content in root exudate was positively correlated with root growth attributes and root N concentration, whereas NH4+-N content was positively correlated with nodule number. Root exudate DON was positively correlated with shoot N concentration and average nodule DW. These results highlight the existence of genotypic differences among red clover varieties for plant morphological factors affecting root N release during the early stages of plant development.