bluuebunny/crossref_metadata_2025_split huggingface dataset:
De novo HIV infection diagnoses in a Department of Dermatology and Venereology in Lisbon, Portugal
Authors: Mendes-Bastos Pedro , Brasileiro Ana , Matos-Pires Eugénia , Rodrigues Isaura , Marques Cristina , Coelho-Macias Vasco , Fernandes Cândida 
Published: November 2016

Background Portugal has the highest prevalence rate of HIV infection in Western Europe. The proportion of patients with a late diagnosis, carried out in full-blown AIDS stage, remains high. Skin and mucous membrane manifestations are not rare in these patients. Objective A demographic, clinical, and laboratorial characterization of patients with de novo HIV infection diagnosis made in the Department of Dermatology and Venereology of a central hospital in Lisbon, Portugal. Methods Retrospective review of medical records of adult patients newly diagnosed with HIV infection (reactive immunoassay for antibodies to HIV-1/HIV-2 or HIV p24 antigen) in the Dermatology and Venereology Department of a Portuguese central hospital in the period between January 2005 and December 2013. Results During the study period, 97 new cases were diagnosed, 70 men and 27 women. The median age at diagnosis was 36 years. Of the total, 50 cases were diagnosed with a concomitant sexually transmitted infection (STI), more frequently syphilis and ano-genital HPV infection. The remaining 47 patients were diagnosed with other dermatological conditions such as prurigo nodularis, psoriasis, and Kaposi’s sarcoma. The duration of complaints that lead to medical attention ranged from <1 week to 8 years, being significantly lower in patients diagnosed with a concomitant STI ( p < 0.01). Basal viral load was also lower in this group of patients ( p < 0.05). Of all the new diagnosed cases, 80% of patients are currently retained in care. Conclusion This study grants a descriptive overview of de novo HIV infection diagnoses performed by dermatovenereologists in a central hospital in Lisbon, Portugal. As in the past, the importance of Dermato–Venereology for HIV infection diagnosis remains present in daily clinical practice.
Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory
Authors: Rybing Jonas , Prytz Erik , Hornwall Johan , Nilsson Heléne , Jonson Carl-Oscar , Bang Magnus 
Published: November 2016

Background. Training of medical professionals is important to improve care during mass-causality events. Therefore, it is essential to extend knowledge on how to design valid and usable simulation-based training environments. Purpose. This article investigates how distributed cognition and simulation theory concepts can guide design of simulation-based training environments. We present the design and user evaluation of DigEmergo, a simulator for training and assessing emergency medicine management. Design approach. A prior Distributed Cognition in Teamwork (DiCoT) analysis of the Emergo Train System (ETS) guided the design process. The design objective of DigEmergo was to be useful, usable, retain distributed cognition features of ETS, and strengthen validity and output reliability. Evaluation. Eight expert ETS instructors participated in a formative system evaluation. The Technology Assessment Model (TAM) questionnaire was used to measure usefulness and ease of use. Observations and post-test interviews were conducted to contextualize the measures. Results. The results showed that DigEmergo was perceived as somewhat to quite useful and somewhat easy to use. Overall, expert users considered DigEmergo promising and successful in retaining core ETS features. Conclusions. The study indicates that a design methodology based on distributed cognition and simulation theory can be successfully combined to guide simulator (re)design and strengthen simulator validity.
Friction Blisters on the Hands Treated Successfully Using 2-Octyl Cyanoacrylate: A Case Report
Authors: Gearhart Peter A. , Gaspar Michael P. , Jacoby Sidney M. 
Published: November 2016

Background: Friction blisters on the hand are challenging to treat as conventional dressings are prone to saturation, contamination, and loosening with active hand use and other mechanical stresses. Alternative methods and materials for dressing hand blisters warrant exploration. Case Summary: A 48-year-old male surgeon presented with friction blisters over his bilateral thumbs. The patient complained of significant difficulty in keeping his dressings clean and dry, significant pain with hand hygiene, and functional limitations at work. The patient’s blisters were dressed with 2-octyl cyanoacrylate (Dermabond; Ethicon US LLC, Somerville, New Jersey), applied directly onto the wound bed. The patient was able to perform his normal duties immediately, without the need for additional intervention. Six days postapplication, the Dermabond sloughed off, revealing an epithelialized surface. Conclusion: Dermabond is a promising agent for dressing unroofed blisters of the hand, as it provides a barrier to moisture and contamination, while allowing the wound to epithelialize, without functional cost.
Telehealth solutions to enable global collaboration in rheumatic heart disease screening
Authors: Lopes Eduardo LV , Beaton Andrea Z , Nascimento Bruno R , Tompsett Alison , dos Santos Julia PA , Perlman Lindsay , Diamantino Adriana C , Oliveira Kaciane KB , Oliveira Cassio M , Nunes Maria do Carmo P , Bonisson Leonardo , Ribeiro Antônio LP , Sable Craig ,   on behalf of the Programa de RastreamentO da Valvopatia Reumática (PROVAR) investigators
Published: November 2016

Background The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease. Objective We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais. Methods The Programa de Rastreamento da Valvopatia Reumática (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data. Results PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted. Discussion A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle income countries can improve access to echocardiography for rheumatic heart disease.
Removal of Osteoid Osteoma of the Calcaneus Using Subtalar Arthroscopy
Authors: Jurina Andrija , Dimnjaković Damjan , Smoljanović Tomislav , Bojanić Ivan 
Published: November 2016

Intra-articular calcaneal osteoid osteoma is a very rare condition and the diagnosis as well as the treatment is extremely challenging. We report a case of a 19-year-old male with intra-articular osteoid osteoma of the calcaneus, initially treated for peroneal tenosynovitis with unsatisfactory results. Thorough diagnostic procedure revealed the superolateral location of a calcaneal osteoid osteoma, near the sinus tarsi. A cherry-red elevated lesion typical of an osteoid osteoma nidus was completely removed arthroscopically using the anterolateral portal and the middle portal for subtalar arthroscopy. Histopathology confirmed the suspected diagnosis. The postoperative clinical course was uneventful with immediate pain relief and full weightbearing and movement allowed soon. The patient had no recurrent pain and normal joint mobility 8 months postoperatively. Considering the accessibility of the lesion, intra-articular osteoid osteoma of the calcaneus can be successfully treated arthroscopically using lateral approach for subtalar arthroscopy. Levels of Evidence: Therapeutic, Level IV: Retrospective, Case report
Two-Year Evaluation of Osteochondral Repair with a Novel Biphasic Graft Saturated in Bone Marrow in an Equine Model
Authors: McCarrel Taralyn M. , Pownder Sarah L. , Gilbert Susannah , Koff Matthew F. , Castiglione Emme , Saska Ryan A. , Bradica Gino , Fortier Lisa A. 
Published: November 2016

ObjectiveTo evaluate a biphasic cartilage repair device (CRD) for feasibility of arthroscopic implantation, safety, biocompatibility, and efficacy for long-term repair of large osteochondral defects.MethodsThe CRD was press-fit into defects (10 mm diameter, 10 mm deep) created in the femoral trochlea of 12 horses. In the contralateral limb, 10 mm diameter full-thickness chondral defects were treated with microfracture (MFX). Radiographs were obtained pre- and postoperatively, and at 4, 12, and 24 months. Repeat arthroscopy was performed at 4 and 12 months. Gross assessment, histology, mechanical testing, and magnetic resonance imaging (MRI) were performed at 24 months.ResultsThe CRD was easily placed arthroscopically. There was no evidence of joint infection, inflammation, or degeneration. CRD-treated defects had significantly more sclerosis compared to MFX early ( P = 0.0006), but was not different at 24 months. CRD had better arthroscopic scores at 4 months compared to MFX ( P = 0.0069). At 24 months, there was no difference in repair tissue on histology or mechanical testing. Based on MRI, CRD repair tissue had less proteoglycan (deep P = 0.027, superficial P = 0.015) and less organized collagen (deep P = 0.028) compared to MFX. Cartilage surrounding MFX defects had more fissures compared to CRD.ConclusionThe repair tissue formed after CRD treatment of a large osteochondral lesion is fibrocartilage similar to that formed in simple chondral defects treated with MFX. The CRD can be easily placed arthroscopically, is safe, and biocompatible for 24 months. The CRD results in improved early arthroscopic repair scores and may limit fissure formation in adjacent cartilage.
Marginal resection and adjuvant strontium plesiotherapy in the management of feline eyelid malignant peripheral nerve sheath tumours: two cases
Authors: Berlato Davide , Serras Ana Rita , Matas Riera Marian , Rasotto Roberta 
Published: November 2016

Case series summary Two cats with a marginally resected eyelid malignant peripheral nerve sheath tumour were treated with adjuvant strontium plesiotherapy a few weeks after surgery. The dose applied in both cases was 200 Gy to the surface, in five fractions, on a Monday–Wednesday–Friday basis. The treatment aimed to achieve a clinical margin of approximately 1 cm around the surgical scar and multiple application fields were required to cover such an area. Local recurrence was not seen in either case after 1330 and 645 days, respectively. Relevance and novel information The majority of periocular malignant peripheral nerve sheath tumours reported in the literature recur after surgery. In the two cases described in this report the combination of surgery and adjuvant plesiotherapy has been able to provide good local control with minimal toxicity. This multimodal approach could be considered as an alternative to aggressive surgery such as enucleation or exenteration.
Successful treatment of vaginal malakoplakia in a young cat
Authors: Cattin Ryan P , Hardcastle Michael R , Simpson Kenneth W 
Published: November 2016

Case summary A 3-year-old, female, spayed, domestic shorthair cat presented for dysuria and haematuria, unresponsive to antibiotic treatment. A small, fleshy, erythematous mass protruded from the vaginal vault. Ultrasound identified a vaginal mass effect with mixed echogenicity measuring in excess of 3 cm. Vaginoscopy confirmed an extensive, fleshy, irregular mass that was characterised histologically as pyogranulomatous vaginitis, with periodic acid–Schiff-positive macrophages containing gram-negative bacteria. Fluorescence in situ hybridisation analysis demonstrated invasive intracellular Escherichia coli. Vaginal malakoplakia was diagnosed. Tissue culture and antimicrobial susceptibility of E coli was used to guide treatment. A 6 week course of enrofloxacin 5 mg/kg q24h resulted in complete resolution of the mass and clinical signs. Relevance and novel information Malakoplakia is a rare chronic inflammatory condition that has been previously reported in the bladder of two cats. The pathogenesis of malakoplakia is thought to involve ineffective killing of bacteria (eg. E coli), similar to granulomatous colitis in Boxers and French Bulldogs. The literature on malakoplakia in cats is sparse. This is the first reported feline case with vaginal involvement, intracellular E coli and successful treatment with a fluoroquinolone. Malakoplakia is an important, non-neoplastic differential diagnosis when a mass is identified in the urogenital system of a young cat.
Respiratory distress associated with lungworm infection in a kitten
Authors: Hawley Melissa M , Johnson Lynelle R , Traversa Donato , Bucy Dan , Vernau Karen M , Vernau William 
Published: November 2016

Case summary A 5-month-old feral kitten developed worsening respiratory signs, including tachypnea, coughing and wheezing after standard anthelmintic treatment with fenbendazole at a local shelter. The kitten was referred to the University of California, Davis, William R Pritchard Veterinary Medicine Teaching Hospital for further evaluation. Thoracic radiographs revealed a severe diffuse bronchointerstitial pattern with bronchial cuffing, ill-defined nodules and lymphadenomegaly. Differentials included infectious etiologies such as toxoplasmosis, feline infectious peritonitis and cryptococcosis. Parasitic infection was considered less likely, owing to previous anthelmintic treatment. Bronchoalveolar lavage revealed marked neutrophilic and eosinophilic inflammation, and parasitic larvae were observed in a swab of trachea mucus. PCR confirmed the larvae as Aelurostrongylus abstrusus. The kitten recovered with two more rounds of anthelmintic treatment. Relevance and novel information Parasitic pneumonia should be considered as a cause of respiratory distress in kittens and cats. Lungworm infections have been more commonly reported in free-roaming young and adult cats, but cannot be excluded as a differential diagnosis in cats from varied environments and in kittens. Kittens appear to be especially sensitive to lungworm infections, manifested by the development of more severe clinical signs; thus lungworm infection should always be considered when presented with a kitten in respiratory distress. In the absence of cytologic confirmation of infection via bronchoalveolar lavage or oropharyngeal swab, PCR provides a valuable means for identification of lungworms, such as A abstrusus and Troglostrongylus brevior.
Optimal cut-off criteria for duplex ultrasound compared with computed tomography angiography for the diagnosis of restenosis in stented carotid arteries in the international carotid stenting study
Authors: Bosch Floris TM , Hendrikse Jeroen , Davagnanam Indran , Bonati Leo H , van der Lugt Aad , van der Worp HB , de Borst Gert J , Mali Willem , Brown Martin M , Nederkoorn Paul J 
Published: November 2016

Introduction Previous studies that reported duplex-ultrasound cut-off criteria, based on blood velocity parameters, for the degree of stenosis in a stented carotid artery were either retrospective, or the reference test was carried out only when a patient was suspected of having restenosis at duplex ultrasound, which is likely to have resulted in verification bias. We performed a prospective study of diagnostic accuracy to find new blood velocity cut-offs in duplex ultrasound for in-stent restenosis. Patients and methods Stented patients within the international carotid stenting study were eligible. Patients had a carotid computed tomography angiography in addition to routine duplex ultrasound performed at a yearly follow-up. Duplex-ultrasound bloodflow velocity parameters were compared to the degree of stenosis on computed tomography angiography. The results were analysed using receiver-operating-characteristic curves. Results We included 103 patients in this study. On computed tomography angiography, 30 (29.1%) patients had a 30%–49% in-stent restenosis, 21 (20.4%) patients had 50%–69% in-stent restenosis and 5 (4.9%) patients a ≥70% in-stent restenosis. The cut-off value ≥50% stenosis was a peak systolic velocity of 125 cm/s (sensitivity: 63% (95% CI: 41–79), specificity: 83% (95% CI: 72–90)). Discussion This study provides a level 2b evidence for new cut-off values for in-stent restenosis. Unfortunately, we could not say anything about severe stenosis because of the low number of severe stenosis after one year. Conclusions The 125 cm/s cut-off value on duplex ultrasound is lower than found in previous studies and equal to unstented arteries. Duplex-ultrasound measurements made in stented carotid arteries should not be corrected for the presence of a stent when determining the degree of stenosis.
Antiplatelet therapy following ischaemic stroke – Continue or change pre-existing therapy?
Authors: Mazlan-Kepli Wardati , MacIsaac Rachael L , Walters Matthew , Bath Philip MW , Dawson Jesse 
Published: November 2016

Introduction Antiplatelet therapy is routinely prescribed early after ischaemic stroke. Many patients will already be taking antiplatelet therapy and it is unknown whether these patients should continue the same antiplatelet treatment or switch to a different regimen. Methods We selected patients with ischaemic stroke from the Virtual International Stroke Trials Archive database who were prescribed antiplatelets both before and after their stroke and who had detailed records of adverse events after stroke. We compared patients who changed to a new antiplatelet regimen after their stroke to those who continued the same regimen. The primary outcome was recurrent ischaemic stroke within 90 days after their index stroke and the secondary outcome was intracranial haemorrhage (ICH) or extracranial haemorrhage (ECH). We used logistic regression analysis and adjusted for age and baseline NIHSS. Results A total of 1129 participants were included. Of these, 538 subjects changed antiplatelet regimen post stroke and 591 continued the same regimen. A recurrent ischaemic event occurred in 4.1% of subjects who changed regimen and 4.3% who continued unchanged (adjusted OR = 0.93; 95% CI 0.54–1.75, p = 0.929). The incidence of ICH and ECH within the first 90 days was similar in both groups (2.4% vs. 2.6% (adjusted OR = 1.02; 95% CI 0.48–2.18, p = 0.955) and 4.7% vs. 2.9% (adjusted OR = 1.82; 95% CI 0.96–3.43, p = 0.065), respectively). Discussion The analysis was performed using a non-randomised registry data. Conclusion In patients who suffer ischaemic stroke whilst taking antiplatelets, a change in antiplatelet regimen was not associated with an altered risk of early recurrent ischaemic stroke rate or bleeding. However, the results must be interpreted in view of the low event rates.
G-CSF-induced sympathetic tone provokes fever and primes antimobilizing functions of neutrophils via PGE2
Authors: Kawano Yuko , Fukui Chie , Shinohara Masakazu , Wakahashi Kanako , Ishii Shinichi , Suzuki Tomohide , Sato Mari , Asada Noboru , Kawano Hiroki , Minagawa Kentaro , Sada Akiko , Furuyashiki Tomoyuki , Uematsu Satoshi , Akira Shizuo , Uede Toshimitsu , Narumiya Shuh , Matsui Toshimitsu , Katayama Yoshio 
Published: November 2016

Key Points
G-CSF-induced sympathetic tone provokes fever and modulates microenvironment via PGE2 production by bone marrow Gr-1high neutrophils.
Distributed gene expression modelling for exploring variability in epigenetic function
Authors: Budden David M. , Crampin Edmund J. 
Published: November 2016

Abstract
Background
Predictive gene expression modelling is an important tool in computational biology due to the volume of high-throughput sequencing data generated by recent consortia. However, the scope of previous studies has been restricted to a small set of cell-lines or experimental conditions due an inability to leverage distributed processing architectures for large, sharded data-sets.

Results
We present a distributed implementation of gene expression modelling using the MapReduce paradigm and prove that performance improves as a linear function of available processor cores. We then leverage the computational efficiency of this framework to explore the variability of epigenetic function across fifty histone modification data-sets from variety of cancerous and non-cancerous cell-lines.

Conclusions
We demonstrate that the genome-wide relationships between histone modifications and mRNA transcription are lineage, tissue and karyotype-invariant, and that models trained on matched -omics data from non-cancerous cell-lines are able to predict cancerous expression with equivalent genome-wide fidelity.
BMP4 acts as a dorsal telencephalic morphogen in a mouse embryonic stem cell culture system
Authors: Watanabe Momoko , Fung Ernest S. , Chan Felicia B. , Wong Jessica S. , Coutts Margaret , Monuki Edwin S. 
Published: November 2016

ABSTRACTThe concept of a morphogen – a molecule that specifies two or more cell fates in a concentration-dependent manner – is paradigmatic in developmental biology. Much remains unknown, however, about the existence of morphogens in the developing vertebrate central nervous system (CNS), including the mouse dorsal telencephalic midline (DTM). Bone morphogenetic proteins (BMPs) are candidate DTM morphogens, and our previous work demonstrated BMP4 sufficiency to induce one DTM cell fate – that of choroid plexus epithelial cells (CPECs) – in a mouse embryonic stem cell (mESC) culture system. Here we used BMP4 in a modified mESC culture system to derive a second DTM fate, the cortical hem (CH). CH and CPEC markers were induced by BMP4 in a concentration-dependent manner consistent with in vivo development. BMP4 concentrations that led to CH fate also promoted markers for Cajal–Retzius neurons, which are known CH derivatives. Interestingly, single BMP4 administrations also sufficed for appropriate temporal regulation of CH, CPEC, and cortical genes, with initially broad and overlapping dose-response profiles that sharpened over time. BMP4 concentrations that yielded CH- or CPEC-enriched populations also had different steady-state levels of phospho-SMAD1/5/8, suggesting that differences in BMP signaling intensity underlie DTM fate choice. Surprisingly, inactivation of the cortical selector gene Lhx2 did not affect DTM expression levels, dose-response profiles, or timing in response to BMP4, although neural progenitor genes were downregulated. These data indicate that BMP4 can act as a classic morphogen to orchestrate both spatial and temporal aspects of DTM fate acquisition, and can do so in the absence of Lhx2.