bluuebunny/crossref_metadata_2025_split huggingface dataset:
CRYPTOCOCCOSIS (TORULOSIS) : SOME PROBLEMS IN DIAGNOSIS AND MANAGEMENT
Authors: HICKIE JOHN B. , WALKER THOMAS 
Published: September 2017

SummaryTen cases of cryptococcosis (torulosis) are described to illustrate some of the difficulties in the diagnosis and management of this disease. Seven patients had nervous involvement with headache the commonest symptom, and seven had pulmonary involvement. Skin lesions occurred in two cases, and a bone lesion in one case. Demonstration of the organism in the cerebro‐spinal fluid was the most useful diagnostic measure (six cases). Sputum examination provided the diagnoses in one case, and a smear from the skin lesions in two cases. There was a reasonable possibility that the infection had been transmitted from patient to patient in one case. This has not previously been recorded. Seven patients were treated with amphotericin B, with improvement or remission in six. Two patients had remissions after the resection of a pulmonary lesion. The techniques, advantages and disadvantages of intravenous and intrathecal therapy are discussed. The side effects are mainly inflammatory, hæmatological, cerebral and renal. It is concluded that amphotericin B therapy is beneficial and may be curative.
RESIN UPTAKE OF 131I‐LABELLED TRIIODOTHYRONINE AS A TEST OF THYROID FUNCTION
Authors: TAYLOR KATHLEEN , WINIKOFF DORA , DAVIES WANDA 
Published: September 2017

SummaryA simple in‐vitro test of thyroid function based on the uptake of 131I‐labelled‐l‐triiodothyronine (T3) by an anion exchange resin is described.Aliquots of serum equilibrated with T3 are incubated with “Amberlite” resin; 24·7 % to 36 % of the T3 is taken up by the resin in the euthyroid state, in hyperthyroidism the figure is 34·5 % to 55%, and in hypothyroidism it is 16·5 % to 26%. In pregnancy the resin uptake is 15·5 % to 26%.Studies have been made on variations in technique.A protein‐bound iodine (P.B.I.) estimation is performed on all patients investigated, including those receiving treatment for disorders of thyroid function. Results of both tests are compared.
MACROCYTIC, NON‐MEGALOBLASTIC, FOLIC‐ACID‐RESPONSIVE ANÆMIAS OF CHILDHOOD
Authors: LOVRIC V. A. 
Published: September 2017

SummaryThe clinical and hæmatological features of six children who presented with a “refractory” macrocytic type of anæmia are described. The anæmia was not associated with megaloblastosis. Furthermore, in the group as a whole the condition clinically differed from the commonly‐recognized syndrome of nutritional megaloblastic anæmia of childhood. That this anæmia was due to lack of folic acid was proved through a clinical trial in one case, though in the others the evidence of folic‐acid deficiency was circumstantial.It is suggested that marginal intake of folic acid through defective diet contributed to the development of anæmia in all cases.
CHRONIC PNEUMONITIS OF THE CHOLESTEROL TYPE
Authors: ARDLIE N. G. , MATZ L. R. 
Published: September 2017

SummaryA case is recorded of chronic pneumonitis of the cholesterol type, in association with both “ incomplete” and complete pulmonary infarction and pulmonary embolism. The hypothesis is offered that ischæmic changes in the lung parenchyma can produce the characteristic changes of cholesterol pneumonitis. Previous case reports have not shown this association.
Trajectory ofAffordances: Insights from a case of telemedicine in Nepal
Authors: Thapa Devinder , Sein Maung K. 
Published: September 2017

AbstractAlthough Affordance Theory has become increasingly influential in the Information Systems (IS) literature, the exact process through which the affordances of IT are actualised is less studied. In this paper, we build on a realist ontology of affordance and an interpretive epistemology of how affordances are perceived and actualised to trace the process of actualisation. On the basis of insights drawn from a case study of a telemedicine project in a remote mountainous region of Nepal, we develop a concept, which we call the “Trajectory of Affordances.” Trajectory of Affordances captures the complex relations between affordances of IT and the role of goal‐oriented actors who perceive and then play a vital role in actualising them, using capabilities that are enabled by facilitating conditions to take the necessary action. Trajectory of Affordances shows that the affordances of IT can travel from perception to actualisation through multiple paths, sometimes clustering together, and in the process, often lead to the emergence of new affordances.
The experience of palliative care service provision for people with non‐malignant respiratory disease and their family carers: An all‐Ireland qualitative study
Authors: Mc Veigh Clare , Reid Joanne , Larkin Philip , Porter Sam , Hudson Peter 
Published: September 2017

AbstractAimTo explore specialist and generalist palliative care provision for people with non‐malignant respiratory disease, in rural and urban areas in the North and Republic of Ireland.BackgroundGlobally, palliative care is recommended as an appropriate healthcare option for people with advanced non‐malignant lung disease. Yet, there is limited evidence regarding the integration of palliative care for this client group.DesignQualitative study.MethodsConvenience sample of 17 bereaved carers and 18 healthcare professionals recruited from two rural and two urban sites on the Island of Ireland. Data were collected throughout 2012 and 2013 through semi‐structured interviews with carers of patients with Chronic Obstructive Pulmonary Disease (N = 12), interstitial lung disease (N = 4) or bronchiectasis (N = 1) who had died 3–18 months previously; and four focus groups with healthcare professionals. Data were analysed using a thematic analysis framework.ResultsCarers’ interviews yielded three overarching themes: (1) lack of preparedness for death, due to ambiguity regarding disease trajectory; (2) lack of consistency in palliative care delivery, in relation with the receipt of generalist and specialist palliative care; and (3) role ambiguity, related to their caregiving role. Focus groups identified two overarching themes: (1) barriers to appropriate palliative care; and (2) the future direction of palliative care for patient with non‐malignant respiratory disease.ConclusionThe uncertain disease trajectory was not only experienced by carers but also healthcare professionals. Although referral to specialist palliative care services was perceived as increasing, the availability and coordination of generalist and specialist palliative care services were fragmented and varied dependent on geographical location.
Efficacy of hemostatic powder in preventing bleeding after gastric endoscopic submucosal dissection in high‐risk patients
Authors: Hahn Kyu Yeon , Park Jun Chul , Lee Yong Kang , Shin Sung Kwan , Lee Sang Kil , Lee Yong Chan 
Published: September 2017

AbstractBackground and AimThe prevention of post‐endoscopic submucosal dissection (ESD) bleeding in high‐risk patients is an important problem. This study evaluated the efficacy of polysaccharide hemostatic powder in preventing post‐ESD bleeding in high‐risk patients.MethodsPatients at high risk for post‐ESD bleeding were prospectively enrolled between December 2015 and July 2016. A high risk of post‐ESD bleeding was considered if the patients were taking antithrombotic agents or had undergone a large resection (specimen size ≥ 40 mm). The endpoints were Forrest classification of the post‐ESD ulcer on second‐look endoscopy 2 days after the procedure and bleeding rates within 48 h and at 4 weeks.ResultsForty‐four patients underwent gastric ESD and treatment with hemostatic powder. Among them, 33 patients (70.5%) underwent large resection (≥ 40 mm) without antithrombotic therapy, and 13 patients (29.5%) received antithrombotic therapy. The mean resected specimen size was 55.3 ± 13.9 mm. The proportion of high‐risk delayed bleeding lesions (Forrest IIa) at second‐look endoscopy was 4.5% (2/44). The overall bleeding rate was 9.1% (4/44). There was no early bleeding event. The median (interquartile range) timing of bleeding after the procedure was 12.5 (interquartile range 10.3–15.5) days. The bleeding rate in the large resection (≥ 40 mm) group without antithrombotic therapy and the antithrombotic therapy group was 3.2% (1/33) and 23.1% (3/13), respectively.ConclusionsHemostatic powder may be a promising new simple and effective method to prevent early post‐ESD bleeding in high‐risk patients, especially for those with larger resection.(Clinical trial registration number: NCT02625792).
Endogenous neurosteroids influence synaptic GABAA receptors during postnatal development
Authors: Belelli D. , Brown A. R. , Mitchell S. J. , Gunn B. G. , Herd M. B. , Phillips G. D. , Seifi M. , Swinny J. D. , Lambert J. J. 
Published: September 2017

GABA plays a key role in both embryonic and neonatal brain development. For example, during early neonatal nervous system maturation, synaptic transmission, mediated by GABAA receptors (GABAARs), undergoes a temporally specific form of synaptic plasticity to accommodate the changing requirements of maturing neural networks. Specifically, the duration of miniature inhibitory postsynaptic currents (mIPSCs), resulting from vesicular GABA activating synaptic GABAARs, is reduced, permitting neurones to appropriately influence the window for postsynaptic excitation. Conventionally, programmed expression changes to the subtype of synaptic GABAAR are primarily implicated in this plasticity. However, it is now evident that, in developing thalamic and cortical principal‐ and inter‐neurones, an endogenous neurosteroid tone (eg, allopregnanolone) enhances synaptic GABAAR function. Furthermore, a cessation of steroidogenesis, as a result of a lack of substrate, or a co‐factor, appears to be primarily responsible for early neonatal changes to GABAergic synaptic transmission, followed by further refinement, which results from subsequent alterations of the GABAAR subtype. The timing of this cessation of neurosteroid influence is neurone‐specific, occurring by postnatal day (P)10 in the thalamus but approximately 1 week later in the cortex. Neurosteroid levels are not static and change dynamically in a variety of physiological and pathophysiological scenarios. Given that GABA plays an important role in brain development, abnormal perturbations of neonatal GABAAR‐active neurosteroids may have not only a considerable immediate, but also a longer‐term impact upon neural network activity. Here, we review recent evidence indicating that changes in neurosteroidogenesis substantially influence neonatal GABAergic synaptic transmission. We discuss the physiological relevance of these findings and how the interference of neurosteroid‐GABAAR interaction early in life may contribute to psychiatric conditions later in life.
The vertebrate heart: an evolutionary perspective
Authors: Stephenson Andrea , Adams Justin W. , Vaccarezza Mauro 
Published: September 2017

AbstractConvergence is the tendency of independent species to evolve similarly when subjected to the same environmental conditions. The primitive blueprint for the circulatory system emerged around 700–600 Mya and exhibits diverse physiological adaptations across the radiations of vertebrates (Subphylum Vertebrata, Phylum Chordata). It has evolved from the early chordate circulatory system with a single layered tube in the tunicate (Subphylum Urchordata) or an amphioxus (Subphylum Cephalochordata), to a vertebrate circulatory system with a two‐chambered heart made up of one atrium and one ventricle in gnathostome fish (Infraphylum Gnathostomata), to a system with a three‐chambered heart made up of two atria which maybe partially divided or completely separated in amphibian tetrapods (Class Amphibia). Subsequent tetrapods, including crocodiles and alligators (Order Crocodylia, Subclass Crocodylomorpha, Class Reptilia), birds (Subclass Aves, Class Reptilia) and mammals (Class Mammalia) evolved a four‐chambered heart. The structure and function of the circulatory system of each individual holds a vital role which benefits each species specifically. The special characteristics of the four‐chamber mammalian heart are highlighted by the peculiar structure of the myocardial muscle.
Merkel cells and Meissner's corpuscles in human digital skin display Piezo2 immunoreactivity
Authors: García‐Mesa Y. , García‐Piqueras J. , García B. , Feito J. , Cabo R. , Cobo J. , Vega J. A. , García‐Suárez O. 
Published: September 2017

AbstractThe transformation of mechanical energy into electrical signals is the first step in mechanotransduction in the peripheral sensory nervous system and relies on the presence of mechanically gated ion channels within specialized sensory organs called mechanoreceptors. Piezo2 is a vertebrate stretch‐gated ion channel necessary for mechanosensitive channels in mammalian cells. Functionally, it is related to light touch, which has been detected in murine cutaneous Merkel cell–neurite complexes, Meissner‐like corpuscles and lanceolate nerve endings. To the best of our knowledge, the occurrence of Piezo2 in human cutaneous mechanoreceptors has never been investigated. Here, we used simple and double immunohistochemistry to investigate the occurrence of Piezo2 in human digital glabrous skin. Piezo2 immunoreactivity was detected in approximately 80% of morphologically and immunohistochemically characterized (cytokeratin 20+, chromogranin A+ and synaptophisin+) Merkel cells. Most of them were in close contact with Piezo2− nerve fibre profiles. Moreover, the axon, but not the lamellar cells, of Meissner's corpuscles was also Piezo2+, but other mechanoreceptors, i.e. Pacinian or Ruffini's corpuscles, were devoid of immunoreactivity. Piezo2 was also observed in non‐nervous tissue, especially the basal keratinocytes, endothelial cells and sweat glands. The present results demonstrate the occurrence of Piezo2 in cutaneous sensory nerve formations that functionally work as slowly adapting (Merkel cells) and rapidly adapting (Meissner's corpuscles) low‐threshold mechanoreceptors and are related to fine and discriminative touch but not to vibration or hard touch. These data offer additional insight into the molecular basis of mechanosensing in humans.
“It just made me feel so desolate”: Patients’ narratives of weight gain following laparoscopic insertion of a gastric band
Authors: Lloyd Frances Marjorie May , Hewison Alistair , Efstathiou Nikolaos 
Published: September 2017

Aims and objectivesTo describe the experiences of patients who have failed to maintain weight loss following the insertion of a laparoscopic adjustable gastric band (LAGB) for the treatment of morbid obesity.BackgroundObesity is a global health problem resulting in physical, psychological and economic problems and presenting challenges for health services. Surgical intervention is an increasingly common approach to treatment; however, some patients do not sustain their weight loss following bariatric surgery and little is known about people's longer‐term experiences following LAGB insertion.DesignA narrative‐based qualitative interview study.MethodsA purposive sample of ten participants who had undergone LAGB insertion for morbid obesity was recruited. Semistructured interviews were conducted in 2014. Thematic analysis identified codes and emerging themes common to the participants’ experiences.FindingsThree major themes emerged: living with the side effects, regret and lack of support. These reflect the difficulties participants experienced and provide new insights on why weight loss is not sustained after 2 years following surgery.ConclusionParticipants reported that the surgery had a detrimental effect on their lives and some regretted having the band inserted. These findings identify areas of care that need to be addressed if patients undergoing LAGB are to experience its potential benefits and indicate that further research is needed into the long‐term effects of gastric band insertion. Patients need to be better informed about the consequences of bariatric surgery if it is to have a lasting impact on their weight reduction.Relevance to clinical practicePatients require comprehensive information and support before and after LAGB insertion to develop strategies which will help them lose weight and sustain it over the longer term. Clinicians need to be sensitive to patients’ needs when weight loss plateaus or weight is regained and intensify support during these periods.
A systematic review to explore influences on parental attitudes towards antibiotic prescribing in children
Authors: Bosley Helen , Henshall Catherine , Appleton Jane V , Jackson Debra 
Published: September 2017

Aims and objectivesTo understand the factors influencing parental attitudes towards antibiotic prescribing.BackgroundOveruse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance (AMR) and is a significant global threat to patient safety. In primary care settings, substantial numbers of antibiotics are prescribed for young children, despite viral nature of illness for which antibiotics are ineffective. Parents play a vital role in decision‐making regarding accessing healthcare services and requesting treatment for their children.DesignA systematic review was conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) statement (Moher et al., Systematic Reviews, 4, 2015, p. 1).MethodsThe CINAHL, MEDLINE, PsycINFO, The Cochrane Library, BRITISH NURSING INDEX, EMBASE and PUBMED databases were searched for primary research published between 2006–2016. All types of primary research were searched and screened against inclusion criteria. The Critical Appraisal Skills Programme tool was used to appraise identified publications. Quantitative data were summarised descriptively, and qualitative data were thematically analysed.ResultsA total of 515 publications were initially screened, and 55 full‐text articles were eligibility assessed. Twenty papers met inclusion criteria. Four main themes were identified: the quality of relationships with healthcare providers, dealing with conflicting messages, rationalising antibiotic use and parental practices informed by past experience.ConclusionsParents wanted reassurance and advice regarding children's illnesses, had poor antibiotic knowledge and were influenced by personal past experiences. More accessible education, including simple information leaflets, is required. Further research on the influence of culture, ethnicity and socio‐economic factors would be beneficial.Relevance to clinical practiceHealthcare professionals must provide adequate time for reassurance and explanations of decision‐making. Easy‐to‐read information regarding appropriate antibiotic usage should be easily accessible for parents.
Assessment of the quality of neonatal care in the Solomon Islands
Authors: Tosif Shidan , Nasi Titus , Gray Amy , Sadr‐Azodi Nahad , Ogaoga Divi , Duke Trevor 
Published: September 2017

AimTo identify strengths and obstacles for improving the quality of newborn care in the Solomon Islands. Improving the quality of newborn care is a priority in the Sustainable Development Goals and the Action Plan for Healthy Newborns in the Western Pacific. The neonatal mortality rate in the Solomon Islands, a lower‐middle‐income country, has improved slower than overall child mortality. In 2013, neonatal mortality (13.2/1000) constituted 44% of under‐5 deaths (30.1/1000).MethodsA cross‐sectional study of newborn care in five provincial hospitals using a World Health Organization assessment tool for hospital quality of care. Twelve months of neonatal records of the National Referral Hospital (NRH) labour ward and nursery were audited.ResultsEssential medications and basic equipment were generally available. Challenges included workforce shortages and lack of expertise, high costs, organisation and maintenance of equipment, infection control and high rates of stillbirth. Over 12 months at the NRH labour ward, there were 5412 live births, 65 (1.2%) ‘fresh’ stillbirths and 96 (1.8%) ‘macerated’ stillbirths. Over the same period, there were an associated 779 nursery admissions, and the main causes of mortality were complications of prematurity, birth asphyxia, congenital abnormalities and sepsis. Total neonatal mortality at NRH was 16 per 1000 live births, and 77% of deaths occurred in the first 3 days of life.ConclusionsInfrastructure limitations, technical maintenance and equipment organisation were obstacles to newborn care. Greater health‐care worker knowledge and skills for early essential newborn care, infection control and management of newborn complications is needed.
Institutional review boards’ attitudes towards remuneration in paediatric research: Ethical considerations
Authors: Flege Marius M , Thomsen Simon F 
Published: September 2017

AbstractRemuneration in paediatric research poses an ethical dilemma. Too large a sum might cause parents to enrol their children in research projects with no benefit for the child, whereas too modest a sum might hamper recruitment. The institutional review boards have the responsibility to only approve remuneration in paediatric trials with ethically sound research plans. However, little is known about which factors influence institutional review boards’ evaluation of remuneration in paediatric research.