bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbiologic yield of bronchoalveolar lavage specimens from stem cell transplant recipients
Authors: Sakata Kenneth K. , Klassen Christine L. , Bollin Kathryn B. , Grys Thomas E. , Slack James L. , Wesselius Lewis J. , Vikram Holenarasipur R. 
Published: February 2017

AbstractPurposeStem cell transplant (SCT) recipients commonly undergo bronchoalveolar lavage (BAL) collection as an infectious pulmonary work‐up. Previous studies report the utility and overall diagnostic yield of fiberoptic bronchoscopy with BAL in this vulnerable population, though none focused purely on microbiologic yield or made comparisons with less invasive means of pathogen detection. We sought to determine and elaborate on the microbiologic yield of BAL in SCT recipients, assess a correlation between BAL studies and less invasive means of pathogen detection, and assess the utility of repeating a BAL within 30 days.MethodsBetween January 1, 2009, and July 31, 2013, we reviewed medical records of 125 SCT recipients who underwent 179 BALs. In addition to demographic information and details pertaining to their SCT, a comprehensive review of their microbiologic data was performed and recorded.ResultsOur study showed an overall BAL microbiologic yield of 40%, despite 92% of patients receiving broad‐spectrum antimicrobial therapy at the time of the BAL procedure.ConclusionsAlthough an initial BAL sample in this population provides crucial microbiologic information, repeating the procedure within 30 days may have minimal additional microbiologic yield. BAL continues to be an essential diagnostic tool in SCT recipients undergoing an infectious pulmonary work‐up.
Hypertension‐induced remodelling: on the interactions of cardiac risk factors
Authors: Tomek Jakub , Bub Gil 
Published: February 2017

AbstractHypertension induces considerable cardiac remodelling, such as hypertrophy, interstitial fibrosis, and abnormal activity of the cardiac sympathetic nervous system, which are established risk factors in several highly dangerous heart diseases, such as ventricular fibrillation and congestive heart failure. All these risk factors and heart diseases are studied extensively in isolation, but to our knowledge, there is no comprehensive review of their interactions. At the same time, there is growing evidence suggesting that such interactions are numerous and that a successful therapy against a particular condition may have unexpectedly weak effects on mortality, as treated patients may die of a different cause exacerbated by the therapy. In this article, we present a multiscale review of the literature focusing on the relationships between the above‐mentioned risk factors and heart diseases, and introduce a framework that gives insight into their possible interactions. We use this framework to demonstrate that conditions such as fibrosis and elevated activity of the sympathetic nervous system may be compensatory, rather than purely pathological, mechanisms in certain contexts. Finally, we show why the described mechanisms are relevant not only in hypertension, but also in the case of healed myocardial infarction.
image
Geniculohypothalamic GABAergic projections gate suprachiasmatic nucleus responses to retinal input
Authors: Hanna Lydia , Walmsley Lauren , Pienaar Abigail , Howarth Michael , Brown Timothy M. 
Published: February 2017

Key points
Visual input to the suprachiasmatic nucleus circadian clock is critical for animals to adapt their physiology and behaviour in line with the solar day.
In addition to direct retinal projections, the clock receives input from the visual thalamus, although the role of this geniculohypothalamic pathway in circadian photoreception is poorly understood.
In the present study, we develop a novel brain slice preparation that preserves the geniculohypothalamic pathway to show that GABAergic thalamic neurons inhibit retinally‐driven activity in the central clock in a circadian time‐dependent manner.
We also show that in vivo manipulation of thalamic signalling adjusts specific features of the hypothalamic light response, indicating that the geniculohypothalamic pathway is primarily activated by crossed retinal inputs.
Our data provide a mechanism by which geniculohypothalamic signals can adjust the magnitude of circadian and more acute hypothalamic light responses according to time‐of‐day and establish an important new model for future investigations of the circadian visual system.
AbstractSensory input to the master mammalian circadian clock, the suprachiasmatic nucleus (SCN), is vital in allowing animals to optimize physiology and behaviour alongside daily changes in the environment. Retinal inputs encoding changes in external illumination provide the principle source of such information. The SCN also receives input from other retinorecipient brain regions, primarily via the geniculohypothalamic tract (GHT), although the contribution of these indirect projections to circadian photoreception is currently poorly understood. To address this deficit, in the present study, we established an in vitro mouse brain slice preparation that retains connectivity across the extended circadian system. Using multi‐electrode recordings, we first confirm that this preparation retains intact optic projections to the SCN, thalamus and pretectum and a functional GHT. We next show that optogenetic activation of GHT neurons selectively suppresses SCN responses to retinal input, and also that this effect exhibits a pronounced day/night variation and involves a GABAergic mechanism. This inhibitory action was not associated with overt circadian rhythmicity in GHT output, indicating modulation at the SCN level. Finally, we use in vivo electrophysiological recordings alongside pharmacological inactivation or optogenetic excitation to show that GHT signalling actively modulates specific features of the SCN light response, indicating that GHT cells are primarily activated by crossed retinal projections. Taken together, our data establish a new model for studying network communication in the extended circadian system and provide novel insight into the roles of GHT‐signalling, revealing a mechanism by which thalamic activity can help gate retinal input to the SCN according to time of day.
Protocol for the development of a core domain set for hidradenitis suppurativa trial outcomes
Authors: Thorlacius Linnea , Ingram John R , Garg Amit , Villumsen Bente , Esmann Solveig , Kirby Joslyn S , Gottlieb Alice B , Merola Joseph F , Dellavalle Robert , Christensen Robin , Jemec Gregor B E 
Published: February 2017

IntroductionRandomised controlled trials (RCTs) should have well-defined primary and secondary outcomes to answer questions generated by the main hypotheses. However, for the chronic, inflammatory skin disease hidradenitis suppurativa (HS), the reported outcome measures are numerous and diverse. A recent systematic review found a total of 30 outcome measure instruments in 12 RCTs. This use of a broad range of outcome measures can increase difficulties in interpretation and comparison of results and may potentially obstruct appropriate evidence synthesis by causing reporting bias. One strategy for dealing with these problems is to develop a core outcome set (COS). A COS is a list of outcomes that are meant as mandatory and should be measured and reported in all clinical trials. The aim of this study is to develop a COS for the management of HS.Method and analysisAn international steering group of researchers, clinicians and a patient research partner will guide the COS development. 6 stakeholder groups are involved: patients, dermatologists, surgeons, nurses, industry representatives and drug regulatory authorities. A 1:1 ratio of patients:healthcare professionals is aimed for. The initial list of candidate items will be obtained by combining three data sets: (1) a systematic review of the literature, (2) US and Danish qualitative interview studies involving patients with HS and (3) an online healthcare professional (HCP) item generation survey. To reach consensus on the COS, 4 anonymous online Delphi rounds are then planned together with 2 face-to-face consensus meetings (1 in Europe and 1 in the USA) to ensure global representation.Ethics and disseminationThe study will be performed according to the Helsinki declaration. All results from the study, including inconclusive or negative results, will be published in peer-reviewed indexed journals. The study will involve different stakeholder groups to ensure that the developed COS will be suitable and well accepted.
Toxin-positive Clostridium difficile latently infect mouse colonies and protect against highly pathogenic C. difficile
Authors: Etienne-Mesmin Lucie , Chassaing Benoit , Adekunle Oluwaseyi , Mattei Lisa M , Bushman Frederic D , Gewirtz Andrew T 
Published: February 2017

ObjectiveClostridium difficile is a toxin-producing bacterium and a leading cause of antibiotic-associated disease. The ability of C. difficile to form spores and infect antibiotic-treated persons at low multiplicity of infection (MOI) underlies its large disease burden. However, C. difficile-induced disease might also result from long-harboured C. difficile that blooms in individuals administered antibiotics.DesignMice purchased from multiple vendors and repeatedly testing negative for this pathogen by quantitative PCR bloomed C. difficile following antibiotic treatment. This endogenous C. difficile strain, herein termed LEM1, which formed spores and produced toxin, was compared with highly pathogenic C. difficile strain VPI10463.ResultsWhole-genome sequencing revealed that LEM1 and VPI10463 shared 95% of their genes, including all known virulence genes. In contrast to VPI10463, LEM1 did not induce overt disease when administered to antibiotic-treated or germ-free mice, even at high doses. Rather, blooms of LEM1 correlated with survival following VPI10463 inoculation, and exogenous administration of LEM1 before or shortly following VPI10463 inoculation prevented C. difficile-induced death. Accordingly, despite similar growth properties in vitro, LEM1 strongly outcompeted VPI10463 in mice even at 100-fold lower inocula.ConclusionsThese results highlight the difficulty of determining whether individual cases of C. difficile infection resulted from a bloom of endogenous C. difficile or a new exposure to this pathogen. In addition to impacting the design of studies using mouse models of C. difficile-induced disease, this study identified, isolated and characterised an endogenous murine spore-forming C. difficile strain able to decrease colonisation, associated disease and death induced by a pathogenic C. difficile strain.
МІЖДИСЦИПЛІНАРНА ІНТЕГРАЦІЯ ЯК ФАКТОР УДОСКОНАЛЕННЯ ВИКЛАДАННЯ ФАРМАКОЛОГІЇ У МЕДИЧНОМУ ВИШІ
Authors: Voloshchuk N. I. , Pashynska O. S. , Ivanytsia A. O. , Taran I. V. 
Published: February 2017

У статті розглянуті роль та місце міждисциплінарної інтеграції як фактора удосконалення викладання на кафедрі фармакології Вінницького національного медичного університету ім. М. І. Пирогова. Міждисциплінарні зв’язки допомагають доповнити зміст однієї дисципліни знаннями з іншої, об’єднують їх і забезпечують формування професійно важливих вмінь та навичок. Застосування міждисциплінарних технологій підготовки лікаря дозволяє підняти його на якісно новий рівень клінічного мислення, здатного комплексно вирішувати завдання медичної практики на основі широкого інтегрування даних різноманітних дисциплін.
Isosorbide Dinitrate, With or Without Hydralazine, Does Not Reduce Wave Reflections, Left Ventricular Hypertrophy, or Myocardial Fibrosis in Patients With Heart Failure With Preserved Ejection Fraction
Authors: Zamani Payman , Akers Scott , Soto‐Calderon Haideliza , Beraun Melissa , Koppula Maheswara R. , Varakantam Swapna , Rawat Deepa , Shiva‐Kumar Prithvi , Haines Philip G. , Chittams Jesse , Townsend Raymond R. , Witschey Walter R. , Segers Patrick , Chirinos Julio A. 
Published: February 2017

Background
Wave reflections, which are increased in patients with heart failure with preserved ejection fraction, impair diastolic function and promote pathologic myocardial remodeling. Organic nitrates reduce wave reflections acutely, but whether this is sustained chronically or affected by hydralazine coadministration is unknown.

Methods and Results

We randomized 44 patients with heart failure with preserved ejection fraction in a double‐blinded fashion to isosorbide dinitrate (
ISDN
; n=13),
ISDN
+hydralazine (
ISDN
+hydral; n=15), or placebo (n=16) for 6 months. The primary end point was the change in reflection magnitude (
RM
; assessed with arterial tonometry and Doppler echocardiography). Secondary end points included change in left ventricular mass and fibrosis, measured with cardiac magnetic resonance imaging, and the 6‐minute walk distance.
ISDN
reduced aortic characteristic impedance (mean baseline=0.15 [95%
CI
, 0.14–0.17], 3 months=0.11 [95%
CI
, 0.10–0.13], 6 months=0.10 [95%
CI
, 0.08–0.12] mm Hg/mL per second;
P
=0.003) and forward wave amplitude (P
f
, mean baseline=54.8 [95%
CI
, 47.6–62.0], 3 months=42.2 [95%
CI
, 33.2–51.3]; 6 months=37.0 [95%
CI
, 27.2–46.8] mm Hg,
P
=0.04), but had no effect on
RM
(
P
=0.64), left ventricular mass (
P
=0.33), or fibrosis (
P
=0.63).
ISDN
+hydral increased
RM
(mean baseline=0.39 [95%
CI
, 0.35–0.43]; 3 months=0.31 [95%
CI
, 0.25–0.36]; 6 months=0.44 [95%
CI
, 0.37–0.51],
P
=0.03), reduced 6‐minute walk distance (mean baseline=343.3 [95%
CI
, 319.2–367.4]; 6 months=277.0 [95%
CI
, 242.7–311.4] meters,
P
=0.022), and increased native myocardial T1 (mean baseline=1016.2 [95%
CI
, 1002.7–1029.7]; 6 months=1054.5 [95%
CI
, 1036.5–1072.3],
P
=0.021). A high proportion of patients experienced adverse events with active therapy (
ISDN
=61.5%,
ISDN
+hydral=60.0%; placebo=12.5%;
P
=0.007).

Conclusions

ISDN
, with or without hydralazine, does not exert beneficial effects on
RM
, left ventricular remodeling, or submaximal exercise and is poorly tolerated.
ISDN
+hydral appears to have deleterious effects on
RM
, myocardial remodeling, and submaximal exercise. Our findings do not support the routine use of these vasodilators in patients with heart failure with preserved ejection fraction.

Clinical Trial Registration

URL
:
www.clinicaltrials.gov
. Unique identifier:
NCT
01516346.
Time Trends and Educational Inequalities in Out‐of‐Hospital Coronary Deaths in Norway 1995–2009: A Cardiovascular Disease in Norway (CVDNOR) Project
Authors: Sulo Enxhela , Nygård Ottar , Vollset Stein Emil , Igland Jannicke , Ebbing Marta , Østbye Truls , Jørgensen Torben , Sulo Gerhard , Tell Grethe S. 
Published: February 2017

Background

Recent time trends and educational gradients characterizing out‐of‐hospital coronary deaths (
OHCD
) are poorly described.

Methods and Results

We identified all deaths from coronary heart disease occurring outside the hospital in Norway during 1995 to 2009. Time trends were explored using Poisson regression analysis with year as the independent, continuous variable. Information on the highest achieved education was obtained from The National Education Database and classified as primary (up to 10 years of compulsory education), secondary (high school or vocational school), or tertiary (college/university). Educational gradients in
OHCD
were explored using Poisson regression, stratified by sex and age (<70 and ≥70 years), and results were expressed as incidence rate ratios (
IRR
s) and 95%CIs. Of 100 783 coronary heart disease deaths, 58.8% were
OHCD
s. From 1995 to 2009, age‐adjusted
OHCD
rates declined across all education categories (primary, secondary, and tertiary) in younger men (
IRR
=0.35; 95%
CI
0.32‐0.38;
IRR
=0.38; 95%
CI
0.35‐0.42;
IRR
=0.33; 95%
CI
0.28‐0.40), younger women (
IRR
=0.47; 95%
CI
0.40‐0.56;
IRR
=0.55; 95%
CI
0.45‐0.67;
IRR
=0.28; 95%
CI
0.16‐0.47), older men (
IRR
=0.20; 95%
CI
0.19‐0.22;
IRR
=0.20; 95%
CI
0.18‐0.22;
IRR
=0.20; 95%
CI
0.17‐0.23), and older women (
IRR
=0.26; 95%
CI
0.24‐0.28;
IRR
=0.25; 95%
CI
0.23‐0.28;
IRR
=0.28; 95%
CI
0.22‐0.34). Tertiary education was associated with lower risk of
OHCD
compared to primary education (
IRR
=0.37; 95%
CI
0.35‐0.40 in younger men,
IRR
=0.26; 95%
CI
0.22‐0.30 in younger women,
IRR
=0.52; 95%
CI
0.49‐0.55 in older men, and
IRR
=0.61; 95%
CI
0.57‐0.66 in older women). These gradients did not change over time (
P
interaction=0.25).

Conclusions

Although
OHCD
rates declined substantially during 1995 to 2009, they displayed educational gradients that remained constant over time.
Impact of Mountains on Tropical Circulation in Two Earth System Models
Authors: Naiman Zachary , Goodman Paul J. , Krasting John P. , Malyshev Sergey L. , Russell Joellen L. , Stouffer Ronald J. , Wittenberg Andrew T. 
Published: February 2017

Abstract
Two state-of-the-art Earth system models (ESMs) were used in an idealized experiment to explore the role of mountains in shaping Earth’s climate system. Similar to previous studies, removing mountains from both ESMs results in the winds becoming more zonal and weaker Indian and Asian monsoon circulations. However, there are also broad changes to the Walker circulation and El Niño–Southern Oscillation (ENSO). Without orography, convection moves across the entire equatorial Indo-Pacific basin on interannual time scales. ENSO has a stronger amplitude, lower frequency, and increased regularity. A wider equatorial wind zone and changes to equatorial wind stress curl result in a colder cold tongue and a steeper equatorial thermocline across the Pacific basin during La Niña years. Anomalies associated with ENSO warm events are larger without mountains and have greater impact on the mean tropical climate than when mountains are present. Without mountains, the centennial-mean Pacific Walker circulation weakens in both models by approximately 45%, but the strength of the mean Hadley circulation changes by less than 2%. Changes in the Walker circulation in these experiments can be explained by the large spatial excursions of atmospheric deep convection on interannual time scales. These results suggest that mountains are an important control on the large-scale tropical circulation, impacting ENSO dynamics and the Walker circulation, but have little impact on the strength of the Hadley circulation.
Multiscale Upstream and In Situ Precursors to the Elevated Mixed Layer and High-Impact Weather over the Midwest United States
Authors: Cordeira Jason M. , Metz Nicholas D. , Howarth Macy E. , Galarneau Thomas J. 
Published: February 2017

Abstract
Two severe MCSs over the upper Midwest United States resulted in &gt;100 mm of rain in a ~24-h period and &gt;200 severe weather reports, respectively, during 30 June–2 July 2011. This period also featured 100 (104) daily maximum high (low) temperature records across the same region. These high-impact weather events occurred in the presence of an elevated mixed layer (EML) that influenced the development of the severe MCSs and the numerous record high temperatures. The antecedent large-scale flow evolution was influenced by early season Tropical Cyclone Meari over the western North Pacific. The recurvature and subsequent interaction of Meari with the extratropical large-scale flow occurred in conjunction with Rossby wave train amplification over the North Pacific and dispersion across North America during 22 June–2 July 2011. The Rossby wave train dispersion contributed to trough (ridge) development over western (central) North America and the development of an EML and the two MCSs over the upper Midwest United States. A composite analysis of 99 warm-season days with an EML at Minneapolis, Minnesota, suggests that Rossby wave train amplification and dispersion across the North Pacific may frequently occur in the 7 days leading up to EMLs across the upper Midwest. The composite analysis also demonstrates an increased frequency of severe weather and elevated temperatures relative to climatology on days with an EML. These results suggest that EMLs over the upper Midwest may often be preceded by Rossby wave train amplification over the North Pacific and be followed by a period of severe weather and elevated temperatures.
Outcomes of a structured education intervention for Latinas concerning breast cancer and mammography
Authors: Laughman Anna Bawtinhimer , Boselli Danielle , Love Magbis , Steuerwald Nury , Symanowski James , Blackley Kris , Wheeler Mellisa , Arevalo Gustavo , Carrizosa Daniel , Raghavan Derek 
Published: February 2017

Objective: This study examined the utility of living room and church-based small group educational sessions on breast cancer and mammography, for under-served Latinas in North Carolina, USA. Design: Non-randomised, single arm design. Setting: A total of 329 self-selected Latinas participated in 31 small group educational classes in church and home locations in rural and urban settings, and underwent pre- and post-intervention testing of knowledge about breast cancer and mammography. Method: Participants completed educational surveys at baseline before intervention (329), immediately after intervention (329) and 3 months after intervention (223 participants). Results: Misconceptions still exist about breast cancer risk, prevalence and mammography use among Latinas, with the greatest knowledge deficit being in the domain of risk factors. Increases of knowledge were achieved when compared to baseline measures as a result of the interventions described in this paper, which were retained at 3 months re-testing. Many eligible women were not receiving mammograms due to financial barriers. Conclusions: Education sessions of the kind described in this paper are useful in enhancing retained knowledge in breast cancer education for US Latinas.
Mental health in a conflict area: Migration, economic stress and religiosity in the three southernmost provinces of Thailand
Authors: Ford Kathleen , Jampaklay Aree , Chamratrithirong Aphichat 
Published: February 2017

Aim: Three southern provinces of Thailand, Pattani, Yala and Narathiwat, have been involved in a long period of unrest due to differences between the population in the provinces and the Thai government with regard to language, culture and governance. The objectives of this article are to examine the effects of everyday stressors due to the conflict, including economic stress and migration, as well as the effect of religiosity on the reporting of psychiatric symptoms among adults in the three provinces. Methods: Data were drawn from a survey conducted in 2014. The survey included a probability sample of 2,053 Muslim adults aged 18–59 years.Mental health was assessed using World Health Organization’s (WHO) Self-Reporting Questionnaire (SRQ) of 20 questions. Multilevel models were estimated to examine the influence of economic stress due to the conflict, as well as community and individual aspects of migration and religion on mental health. Results: The data showed that migration from the household and the community and the economic effects of the unrest were associated with reporting of more psychiatric symptoms among adults in the southern provinces. Religion was related to reporting of fewer psychiatric symptoms at the individual and the community levels. Conclusion: The study documented increased reporting of psychiatric symptoms among persons reporting perceived household economic stress due to the conflict and the migration of family members.