bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary N‐acetyl‐β‐glucosaminidase and estimated Glomerular filtration rate may identify patients to be treated with immuno‐suppression at diagnosis in idiopathic membranous nephropathy
Authors: Bazzi Claudio , Usui Tomoko , Rizza Virginia , Casellato Daniela , Gallieni Maurizio , Nangaku Masaomi 
Published: October 2016

AbstractAimThe clinical course of idiopathic membranous nephropathy (IMN) varies from spontaneous remission of nephrotic syndrome (NS) to end‐stage renal disease (ESRD). The aim of the study was baseline identification of patients with high risk of progression for which immunosuppressive therapy is mandatory.MethodsEighty‐six IMN subjects were followed for a median of 69 months (range 6–253). Receiver operating characteristic curve and Cox proportional hazards model were used to evaluate prognostic factors for progression, defined as ESRD or estimated glomerular filtration rate (eGFR) reduction ≥50% of baseline.ResultsAmong all, 24 subjects had progression. Area under the ROC curve of N‐acetyl‐β‐glucosaminidase/creatinine ratio (NAG/C) were significantly higher than proteinuria/24 h (0.770 and 0.637 respectively, P = 0.018). In Cox proportional hazards regression analysis, NAG/C and eGFR were independent predictors of progression. Compared to lowest tertile of NAG/C (<9.4 UI/gC) or highest tertile of eGFR (≥88 mL/min per 1.73m2), the multivariable‐adjusted hazard ratio of highest tertile of NAG/C (≥19.2) was 18.97 (95%CI, 1.70–211.86) and lowest tertile of eGFR (<59) was 11.58 (95%CI, 2.02–66.29). Subjects with high NAG/C or low eGFR (high‐risk, n = 43) had greater progression rate compared to moderate to low NAG/C and high eGFR (low‐risk, n = 43) with or without NS at baseline (Log‐rank test P = 0.001 and 0.006, respectively). In NS subjects (n = 65), high‐risk group progression rate was significantly higher (91% vs. 29%, P = 0.003) and remission rate significantly lower (0% vs. 42%, p < 0.001) in non‐immunosuppressed compared to steroids and cyclophosphamide treated patients; no significant differences were observed in low‐risk group.ConclusionIdiopathic membranous nephropathy subjects with high NAG/C and low eGFR have greater risk of progression, and immunosuppressive treatment is suggested at diagnosis.
The barriers and enablers of healthy eating among young adults: a missing piece of the obesity puzzle: A scoping review
Authors: Munt A. E. , Partridge S. R. , Allman‐Farinelli M. 
Published: October 2016

SummaryYoung adults in Western countries are gaining weight faster than their parents and are more likely to gain weight than any other age cohort. Despite this, investigation into the complex young adults' food choice motives, which enable and prevent healthy eating, has not been widely investigated. A scoping review was conducted involving an extensive literature search of four major electronic databases: Medline, Embase, PsychInfo and CINAHL. Data were collected from 34 articles: study descriptions numerically analysed and key findings thematically analysed. The key barriers found included: male apathy towards diet; unhealthy diet of friends and family; expected consumption of unhealthy foods in certain situations; relative low cost of unhealthy foods; lack of time to plan, shop, prepare and cook healthy foods; lack of facilities to prepare, cook and store healthy foods; widespread presence of unhealthy foods; lack of knowledge and skills to plan, shop, prepare and cook healthy foods; lack of motivation to eat healthily (including risk‐taking behaviour). The key enablers found included: female interest in a healthy diet; healthy diet of friends and family; support/encouragement of friends and family to eat healthy; desire for improved health; desire for weight management; desire for improved self‐esteem; desire for attractiveness to potential partners and others; possessing autonomous motivation to eat healthy and existence and use of self‐regulatory skills. This research provides evidence that can be used to tailor interventions for healthy eating and overweight and obesity in this population. However, government intervention in addressing food access, affordability, marketing and taxation remains essential to any significant change.
Alternative methods of lung isolation in cases of pediatric bilateral thoracoscopic surgery
Authors: Wigginton Mark , Lehrian Laura 
Published: October 2016

SummaryWe compare airway management and lung isolation methods in two pediatric cases of congenital central hypoventilation syndrome undergoing bilateral throacoscopic phrenic‐nerve‐stimulator surgery. One child received lung isolation using a 7Fr bronchial blocker in conjunction with a 6.0 cuffed endotracheal tube; and the second received a technique of endobronchial intubation using a 3.5 microcuffed tube via the tracheostomy stoma in conjunction with 5.0 cuffed endotracheal intubation; a technique previously undescribed in pediatric patients.
Jejunal varices diagnosed by capsule endoscopy in patients with post‐liver transplant portal hypertension
Authors: Bass Lee M. , Kim Stanley , Superina Riccardo , Mohammad Saeed 
Published: October 2016

AbstractPortal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%‐10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7‐16 years) with a median Hgb of 2.8 g/dL (range 1.8‐6.8 g/dL). Upper endoscopy was negative for significant esophageal varices, gastric varices, and bleeding portal gastropathy in all three children. All three patients had significant jejunal varices noted on CE in mid‐jejunum. Jejunal varices were described as large prominent bluish vessels underneath visualized mucosa, one with evidence of recent bleeding. The results led to venoplasty of the portal vein in two patients and a decompressive shunt in one patient with resolution of GI bleed and anemia. CE is useful to diagnose intestinal varices in children with portal hypertension and GI bleeding following liver transplant.
Resolution of non‐alcoholic steatohepatitis after growth hormone replacement in a pediatric liver transplant patient with panhypopituitarism
Authors: Gilliland Thomas , Dufour Sylvie , Shulman Gerald I. , Petersen Kitt Falk , Emre Sukru H. 
Published: October 2016

AbstractNAFLD is a common condition linked to obesity, type 2 diabetes, and metabolic syndrome. Simple hepatic steatosis is a risk factor for inflammatory reactions in the liver (NASH), which may lead to cirrhosis. While the mechanism is unclear, NAFLD and NASH are associated with panhypopituitarism, which in the pediatric population often results from craniopharyngioma or pituitary adenoma and the sequelae of treatment, causing hypothyroidism, adrenal insufficiency, hypogonadotropic hypogonadism, and GH deficiency. Refractory NAFLD in panhypopituitarism may be amenable to GH replacement. Here, we report a pediatric case of NASH secondary to panhypopituitarism from craniopharyngioma, which recurred by 11 months after LDLT. Despite low‐dose GH replacement, the patient remained GH deficient. Pubertal dosed GH therapy led to rapid and complete resolution of hepatic steatosis, which we tracked using serial 1H MRS. Pediatric patients with NASH cirrhosis secondary to panhypopituitarism can be good candidates for liver transplantation, but hormone deficiencies predispose to recurrence after transplant. High‐dose GH replacement should be considered in pediatric patients with GH deficiency and recurrent disease. A multidisciplinary team approach is essential for successful outcomes.
Transition to adult care for pediatric liver transplant recipients: the Western Australian experience
Authors: Mitchell Tim , Gooding Hannah , Mews Cathy , Adams Leon , MacQuillan Gerry , Garas George , Ravikumara Madhur , Lopez Ainslie , Collins Megan , Jeffrey Gary 
Published: October 2016

AbstractTransition to adult care is a vulnerable period for pediatric transplant recipients and is associated with reduced medication compliance, graft loss, and increased mortality. Psychosocial outcomes in young adults differ between pediatric transplant recipients and their healthy peers. We conducted a single‐center, retrospective cohort study of all pediatric liver transplant recipients who were transitioned through our center. This study aimed to assess the outcomes of transitioned pediatric liver transplant recipients at an Australian center, including mortality, adherence, and psychosocial morbidity. The 1‐ and 5‐year survival rates following transition were 100% and 92%, respectively. There were no episodes of late rejection. In total, 66.7% of patients were compliant with immunosuppression and 61.1% of patients were compliant with clinic attendance. There was a significant relationship between medication compliance and clinic attendance, as well as presence of psychological issues with clinic non‐attendance. Psychosocial outcomes were in keeping with age‐matched data from the general population. All patients were employed or studying following transition. This is the first study of its kind in the Australian population, and outcomes were superior to published international data. Despite the demonstrated good outcomes, transition programs may improve healthcare engagement in this cohort.
Applying an animal‐centric approach to improve ecological restoration
Authors: Jones Menna E. , Davidson Neil 
Published: October 2016

AbstractTraditionally, ecological restoration is based on re‐establishing patterns of vegetation communities with the expectation that wildlife will recolonize, restoring the ecological function. However, in many restoration projects, wildlife fails to recolonize, even when vegetation is restored, in many cases because revegetated habitats lack the critical features required by wildlife. We present a new approach to restoration, based on a detailed understanding of ecological process, the mechanisms by which wildlife respond to landscape patterns. Our animal‐centric approach involves measuring the risk‐sensitive decision‐making of individual animals as they balance searching for food, mates, and breeding sites with avoiding being eaten by predators and relates this to fine‐scale habitat and landscape structure. The outcome of these decisions can be measured in occupancy of habitat, the information on which conventional restoration is based. Incorporating landscape genetics allows retrospective assessment of the outcome of dispersal decisions by individual animals on a deeper time frame and at regional scales. Fine‐scale connectivity models can be parameterized with these multiscale spatial and temporal data to direct restoration efforts. We are translating this novel approach to practice in the large Midlands restoration project (4 years, AUD $6 million) in Tasmania, Australia, in partnership with Greening Australia. More than 200 years of intensive agricultural practice in this National Biodiversity Hotspot has resulted in extensive landscape modification, high densities of feral cats, and decline of many native mammals. Our research–practice partnership will alter the way that restoration is done, leading hopefully to successful restoration of wildlife, gene flow, and ecological function.
Causal Mediation Analysis for the Cox Proportional Hazards Model With A Smooth Baseline Hazard Estimator
Authors: Wang Wei , Albert Jeffrey M. 
Published: October 2016

SummaryAn important problem within the social, behavioural and health sciences is how to partition an exposure effect (e.g. treatment or risk factor) among specific pathway effects and to quantify the importance of each pathway. Mediation analysis based on the potential outcomes framework is an important tool to address this problem and we consider the estimation of mediation effects for the proportional hazards model. We give precise definitions of the total effect, natural indirect effect and natural direct effect in terms of the survival probability, hazard function and restricted mean survival time within the standard two-stage mediation framework. To estimate the mediation effects on different scales, we propose a mediation formula approach in which simple parametric models (fractional polynomials or restricted cubic splines) are utilized to approximate the baseline log-cumulative-hazard function. Simulation study results demonstrate low bias of the mediation effect estimators and close-to-nominal coverage probability of the confidence intervals for a wide range of complex hazard shapes. We apply this method to the Jackson heart study data and conduct a sensitivity analysis to assess the effect on the mediation effects inference when the no unmeasured mediator–outcome confounding assumption is violated.
Factors associated with utilization of dental services in a long‐term care facility: a descriptive cross‐sectional study
Authors: Scannapieco Frank A. , Amin Summar , Salme Marc , Tezal Mine 
Published: October 2016

ABSTRACTPurposeTo describe factors associated with the utilization of dental services in a long‐term care facility (LTCF) in Western New York.Methods and materialsA descriptive cross‐sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts.ResultsA total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p < 0.001), stayed longer (1.6 vs. 3.9 years, p < 0.001), more likely to be female (63.6 vs. 75.6%, p = 0.008), and less likely to be married (37.7 vs. 14.0%, p = < 0.001) compared to those who did not. Patients with endocrine, nutritional, metabolic, and immunity disorders, mental disorders, and circulatory system diseases were more likely to receive dental services.ConclusionsDental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not.
Taxonomy as a hypothesis: testing the status of the Bermuda buckeye butterfly Junonia coenia bergi (Lepidoptera: Nymphalidae)
Authors: PETERS MELISSA J. , MARCUS JEFFREY M. 
Published: October 2016

AbstractSpecies determination and definition in eukaryotes have traditionally been based on morphology, with little focus on genetic differentiation. Molecular methods allow for the independent assessment of morphology‐based taxonomic hypotheses. Three criteria used to define a full species for taxonomic purposes are morphological distinction, formation of a monophyletic lineage, and reproductive isolation. Junonia butterflies (Nymphalidae) are becoming an important experimental model system, but the taxonomy of many New World Junonia species is unclear. One of these species is J. coenia, which contains the subspecies J. coenia coenia, J. coenia grisea and J. coenia bergi. Previous studies suggest that J. coenia grisea may meet the criteria for full species status. Therefore, we evaluated the geographically isolated and rarely studied Bermuda buckeye butterfly J. coenia bergi to determine if it was similarly distinct. Physical examination of specimens and phylogenetic and population genetic analyses of mitochondrial cytochrome c oxidase subunit I, nuclear wingless, and complete mitochondrial genome sequences suggest that while J. coenia bergi is smaller in body size than many Junonia and has distinctive ventral hindwing colouration, it does not form a monophyletic lineage and shows indications of continued gene flow with North American mainland J. coenia coenia populations. Thus, J. coenia bergi does not meet the criteria for full species designation, but geographic isolation, morphological distinctiveness, and cultural importance suggest that it remain recognized as a subspecies of J. coenia. Similar analyses will be useful for addressing further taxonomic questions in Junonia and other taxa, especially where morphology‐based taxonomic determinations are ambiguous.
Changes in cardiovascular responses to chemoreflex activation of rats recovered from protein restriction are not related to AT1 receptors
Authors: Sá Renato Willian Martins , Haibara Andrea Siqueira , Gomes Paula Magalhães , Aguiar Giovana Lopes , Nascimento Rafael Souza Leopoldino , Pedrosa Maria Lucia , Alzamora Andréia Carvalho , de Oliveira Lisandra Brandino , Cardoso Leonardo Máximo 
Published: October 2016

New Findings
What is the central question of this study?
In this study, we sought to investigate whether cardiovascular responses to peripheral chemoreflex activation of rats recovered from protein restriction are related to activation of AT1 receptors.

What is the main finding and its importance?
This study highlights the fact that angiotensinergic mechanisms activated by AT1 receptors do not support increased responses to peripheral chemoreflex activation by KCN in rats recovered from protein restriction. Also, we found that protein restriction led to increased resting ventilation in adult rats, even after recovery.

The effects of a low‐protein diet followed by recovery on cardiorespiratory responses to peripheral chemoreflex activation were tested before and after systemic angiotensin II type 1 (AT1) receptor antagonism. Male Fischer rats were divided into control and recovered (R‐PR) groups after weaning. The R‐PR rats were fed a low‐protein (8%) diet for 35 days and recovered with a normal protein (20%) diet for 70 days. Control rats received a normal protein diet for 105 days (CG105). After cannulation surgery, mean arterial pressure, heart rate, respiratory frequency, tidal volume and minute ventilation were acquired using a digital recording system in freely moving rats. The role of angintensin II was evaluated by systemic antagonism of AT1 receptors with losartan (20 mg kg−1
i.v.). The peripheral chemoreflex was elicited by increasing doses of KCN (20–160 μg kg min−1, i.v.). At baseline, R‐PR rats presented increased heart rate and minute ventilation (372 ± 34 beats min−1 and 1.274 ± 377 ml kg−1 min−1) compared with CG105 animals (332 ± 22 beats min−1 and 856 ± 112 ml kg−1 min−1). Mean arterial pressure was not different between the groups. Pressor and bradycardic responses evoked by KCN (60 μg kg−1) were increased in R‐PR (+45 ± 13 mmHg and −77 ± 47 beats min−1) compared with CG105 rats (+25 ± 17 mmHg and −27 ± 28 beats min−1), but no difference was found in the tachypnoeic response. These differences were preserved after losartan. The data suggest that angiotensin II acting on AT1 receptors may not be associated with the increased heart rate, increased minute ventilation and acute cardiovascular responses to peripheral chemoreflex activation in rats that underwent postweaning protein restriction followed by recovery.
What's in a Name? New Bacterial Species and Changes to Taxonomic Status from 2012 through 2015
Authors: Munson Erik , Carroll Karen C. 
Published: October 2016

ABSTRACTTechnological advancements in fields such as molecular genetics and the human microbiome have resulted in an unprecedented recognition of new bacterial genus/species designations by theInternational Journal of Systematic and Evolutionary Microbiology. Knowledge of designations involving clinically significant bacterial species would benefit clinical microbiologists in the context of emerging pathogens, performance of accurate organism identification, and antimicrobial susceptibility testing. In anticipation of subsequent taxonomic changes being compiled by theJournal of Clinical Microbiologyon a biannual basis, this compendium summarizes novel species and taxonomic revisions specific to bacteria derived from human clinical specimens from the calendar years 2012 through 2015.
Deep-Sequence Identification and Role in Virus Replication of a JC Virus Quasispecies in Patients with Progressive Multifocal Leukoencephalopathy
Authors: Takahashi Kenta , Sekizuka Tsuyoshi , Fukumoto Hitomi , Nakamichi Kazuo , Suzuki Tadaki , Sato Yuko , Hasegawa Hideki , Kuroda Makoto , Katano Harutaka 
Published: October 2016

ABSTRACTJC virus (JCV) is a DNA virus causing progressive multifocal leukoencephalopathy (PML) in immunodeficient patients. In the present study, 22 genetic quasispecies with more than 1.5% variant frequency were detected in JCV genomes from six clinical samples of PML by next-generation sequencing. A mutation from A to C at nucleotide (nt) 3495 in JCV Mad1 resulting in a V-to-G amino acid substitution at amino acid (aa) position 392 of the large T antigen (TAg) was identified in all six cases of PML at 3% to 19% variant frequencies. Transfection of JCV Mad1 DNA possessing the V392G substitution in TAg into IMR-32 and human embryonic kidney 293 (HEK293) cells resulted in dramatically decreased production of JCV-encoded proteins. The virus DNA copy number was also reduced in supernatants of the mutant virus-transfected cells. Transfection of the IMR-32 and HEK293 cells with a virus genome containing a revertant mutation recovered viral production and protein expression. Cotransfection with equal amounts of wild-type genome and mutated JCV genome did not reduce the expression of viral proteins or viral replication, suggesting that the mutation did not have any dominant-negative function. Finally, immunohistochemistry demonstrated that TAg was expressed in all six pathological samples in which the quasispecies were detected. In conclusion, the V392G amino acid substitution in TAg identified frequently in PML lesions has a function in suppressing JCV replication, but the frequency of the mutation was restricted and its role in PML lesions was limited.IMPORTANCEDNA viruses generally have lower mutation frequency than RNA viruses, and the detection of quasispecies in JCV has rarely been reported. In the present study, a next-generation sequencer identified a JCV quasispecies with an amino acid substitution in the T antigen in patients with PML.In vitrostudies showed that the mutation strongly repressed the expression of JC viral proteins and reduced the viral replication. However, because the frequency of the mutation was low in each case, the total expression of virus proteins was sustainedin vivo. Thus, JC virus replicates in PML lesions in the presence of a mutant virus which is able to repress virus replication.