bluuebunny/crossref_metadata_2025_split huggingface dataset:
A dermatological questionnaire for general practitioners in England with a focus on melanoma; misdiagnosis in black patients compared to white patients
Authors: Lyman M. , Mills J.O. , Shipman A.R. 
Published: August 2016

AbstractBackgroundMalignant melanoma presents a significant health burden in the UK in terms of mortality and financial cost. This aggressive and often fatal disease is under‐diagnosed among patients with darker skin tones (type 5 and 6) such as Afro‐Caribbean patients. A lack of both patient and practitioner awareness leads to a later diagnosis in patients with black compared to white skin. There is currently a paucity of literature looking at the diagnosis rates of melanoma between patients of different ethnicities in the UK and the reasons behind these differences.ObjectiveThe primary aim was to obtain data on the diagnosis rate of melanoma in the primary care setting, with particular attention to white vs. black skin types.MethodsAn online questionnaire was sent to 2975 general practitioner (GP) practices in England and 287 responses were received. The questionnaire contained 20 high‐quality picture questions of differing common skin conditions. The participants were asked to choose their diagnosis from 20 potential diagnoses. Only 4/20 questions were melanomas, two on white and two on black skin. No accompanying histories were provided.ResultsThe mean score for the questionnaire was 11.6/20 (58%) with a range from 5% to 100%. Of the two black skin melanoma pictures, 177/287 (62%) and 90/287 (31%) responses were incorrectly identified, compared to 37/287 (13%) and 19/287 (7%) in the white skin melanoma pictures.ConclusionThe questionnaire results show a clear increased misdiagnosis of melanoma in black patients in primary care vs. white. The results suggest that vigilance is needed when diagnosing possible melanoma in black patients and better quality melanoma teaching is required in GP training concentrating on pigmented skin. This pilot study should encourage more research into ethnic skin inequalities in the UK.
Leukocytoclastic vasculitis in children: clinical characteristics, subtypes, causes and direct immunofluorescence findings of 56 biopsy‐confirmed cases
Authors: Johnson E.F. , Wetter D.A. , Lehman J.S. , Hand J.L. , Davis D.M.R. , Tollefson M.M. 
Published: August 2016

AbstractBackgroundLeukocytoclastic vasculitis (LCV) in children is a complex group of conditions.ObjectivesThis study presents the demographics, clinical features, direct immunofluorescence (DIF) results and suspected aetiologies of 56 biopsy‐confirmed cases of leukocytoclastic vasculitis in children.MethodsRetrospective review of 56 children seen at Mayo Clinic in Rochester, Minnesota, from 1993 to 2013 with clinical features and cutaneous biopsy consistent with LCV.ResultsTwenty‐seven (48%) cases were found to be due to IgA vasculitis (Henoch‐Schonlein purpura). The remaining cases were found to be due to cutaneous small‐vessel vasculitis (n = 19, 34%), urticarial vasculitis (n = 5, 9%), ANCA‐associated vasculitis (n = 4, 7%) and acute haemorrhagic oedema of infancy (n = 1, 2%). IgA vasculitis was found to be associated with abdominal pain (P = 0.008), whereas the non‐IgA vasculitis group was associated with headache (P = 0.052). Children with IgA vasculitis had palpable purpura (P = <0.001), petechia (P = 0.057), vesicles (P = 0.009) and involvement of the buttock (P = 0.004) more frequently than the non‐IgA vasculitis group. On DIF, perivascular IgA was positive in IgA vasculitis compared to non‐IgA vasculitis cases (P = <0.001), the other conjugates were similar between the two groups.ConclusionThe most common subtype of biopsy‐confirmed LCV in children is IgA vasculitis. Clinical features, exam characteristics and DIF results can be helpful in determining the subtype of cutaneous vasculitis in children.
Risk assessment of comorbidities on 30‐day avoidable hospital readmissions among internal medicine patients
Authors: Hijazi Heba H. , Alyahya Mohammad S. , Hammouri Hanan M. , Alshraideh Hussam A. 
Published: August 2016

AbstractRationale, aims and objectives:Reducing the rate of hospital readmissions, particularly avoidable ones, has significant implications on patient outcomes, cost containment, and quality of care. Given that the reason of readmission may differ from the patient's main diagnosis in the index admission, this study aims to assess the influence of index comorbidities on the primary readmission diagnoses and explore the risk of deemed avoidable readmission because of prior comorbidities.Methods:A retrospective review of 3962 discharges was conducted at a 527‐bed teaching hospital in Jordan, utilizing data related to 2025 internal medicine patients.Results:Among all discharges, 29% were followed by a 30‐day readmission, of which 13% were identified as potentially avoidable. Of all readmissions, 36% of patients were readmitted because of one of the comorbidities that had been identified at index admission. In addition, 47% of the potentially avoidable readmissions had a main diagnosis that was one of the index comorbidities. The results also showed an association between readmission for one of the index stay's comorbidities and being avoidable, with an adjusted odds ratio of 2.12 (95% confidence interval, 1.65‐2.72). Overall, the presence of certain diseases, being identified as one of the preceding comorbidities, was found to have a substantial influence on the risk of potentially avoidable readmission. These diseases included digestive, circulatory, respiratory, genitourinary systems, and infectious and parasitic diseases (adjusted relative risks = 1.57, 1.49, 1.36, 1.30, and 2.30, respectively).Conclusion:To help reduce the rates of readmission, potential gains seem available if hospitals adopt clinical practices that support the patient's care during the post‐discharge transition. This implies that health care providers need to pay more attention to the comorbidities of high‐risk patients to be closely monitored after discharge.
Lifelong Ambiguous Loss: The Case of Cuban American Exiles
Authors: Perez Rose M. 
Published: August 2016

AbstractUsing Cuban Americans who immigrated to the United States between 1959 and 1971 as an example, this article demonstrates the chronic nature of ambiguous loss in the context of loss of homeland. Ambiguous loss theory provides a framework for understanding the pain experienced by this cohort of Cuban Americans and their families who cope with a traumatic loss that defies closure. While keeping their homeland ever present psychologically, this cohort of Cuban Americans has experienced unique identity and relationship challenges rooted in the tensions between the United States and Cuba. They emigrated because of societal changes that followed the 1959 revolution launched by Fidel Castro against the regime of Fulgencio Batista. Contact with their homeland has been limited while they harbor hope that Cuba's government will change for the better. The utility of the ambiguous loss model is supported and suggestions for future research directions are suggested.
Discursive Approaches to Ambiguous Loss: Theorizing Community‐Based Therapy After Enforced Disappearance
Authors: Robins Simon 
Published: August 2016

AbstractAmbiguous loss is experienced and constructed relationally. As a result, the social and political context plays a role alongside psychological factors as elements that both mediate the impact of ambiguous loss and can aid or retard effective coping. By considering the case of persons disappeared in political violence, an approach to addressing ambiguous loss is theorized that uses community‐based therapeutic approaches. Beginning from poststructuralist ideas of discourse as being constitutive of human subjectivity, the role of discourse is discussed in terms of its capacity to both construct ambiguity and mold social relations that can build resilience. A therapeutic approach is postulated with families of the disappeared that seeks explicitly to have an impact on discourses circulating in communities affected by disappearance in ways that positively influence the well‐being of the families of those missing, as well as on the meanings and identities that affected persons construct from them.
The Context and Process of Theory Development: The Story of Ambiguous Loss
Authors: Boss Pauline 
Published: August 2016

AbstractThis is the story of how the theory of ambiguous loss was born—the context of time and space in which it developed; the misunderstandings, clarifications, and corrections; and now, the theory's cultural updates. From an early interest in family stress theory, I coined the term ambiguous loss to name a previously unidentified stressor common to families everywhere. Discovering this phenomenon and developing the theory has been a lifelong process, but with a new generation of scholars, the theory continues to build and improve. This narrative is my tribute to a new generation of scholars, many of whom are testing the theory and broadening its application across cultures, disciplines, and types of ambiguous loss. May this account also stimulate the building of other useful theories of the middle range that include, without bias, the broad diversity of families today.
Preserving elemental content in adherent mammalian cells for analysis by synchrotron‐based x‐ray fluorescence microscopy
Authors: JIN QIAOLING , PAUNESKU TATJANA , LAI BARRY , GLEBER SOPHIE‐CHARLOTTE , CHEN SI , FINNEY LYDIA , VINE DAVID , VOGT STEFAN , WOLOSCHAK GAYLE , JACOBSEN CHRIS 
Published: August 2016

SummaryTrace metals play important roles in biological function, and x‐ray fluorescence microscopy (XFM) provides a way to quantitatively image their distribution within cells. The faithfulness of these measurements is dependent on proper sample preparation. Using mouse embryonic fibroblast NIH/3T3 cells as an example, we compare various approaches to the preparation of adherent mammalian cells for XFM imaging under ambient temperature. Direct side‐by‐side comparison shows that plunge‐freezing‐based cryoimmobilization provides more faithful preservation than conventional chemical fixation for most biologically important elements including P, S, Cl, K, Fe, Cu, Zn and possibly Ca in adherent mammalian cells. Although cells rinsed with fresh media had a great deal of extracellular background signal for Cl and Ca, this approach maintained cells at the best possible physiological status before rapid freezing and it does not interfere with XFM analysis of other elements. If chemical fixation has to be chosen, the combination of 3% paraformaldehyde and 1.5 % glutaraldehyde preserves S, Fe, Cu and Zn better than either fixative alone. When chemically fixed cells were subjected to a variety of dehydration processes, air drying was proved to be more suitable than other drying methods such as graded ethanol dehydration and freeze drying. This first detailed comparison for x‐ray fluorescence microscopy shows how detailed quantitative conclusions can be affected by the choice of cell preparation method.
Cytogenetic profiling by FISH microscopy and comparison with light microscopy and complete blood count findings in myelodysplastic syndrome
Authors: CHANDRASHEKAR V. , TARIGOPULA A. , GOVINDASAMI P. 
Published: August 2016

SummaryKaryotype, bone marrow blast percentage and cytopenia influence the prognosis of myelodysplastic syndrome. We studied the abnormalities detected by fluorescence in situ hybridization (FISH) in myelodysplastic syndrome and associated haematological profile with abnormalities detected by FISH.Complete blood counts, peripheral blood and bone marrow of patients were evaluated for cytopenia, dysplasia and blasts. FISH probes were used to detect del(5q), gain of chromosome 8, de (7q/‐7) and del(20 q). Multiple regression analysis was used to study the association of FISH abnormalities, age and sex with haematological profile. Mc Nemar's test studied the relationship between FISH abnormalities and dysplastic features in bone marrow.Cytogenetic abnormalities were detected by FISH in 25.7% of patients. Del(20 q) was seen in 14.2% of patients. FISH was able to predict changes in peripheral blood blast count by 80% (p ˂ 0.0001).Cytogenetic abnormalities were not seen in 74.2% of patients. Groups with FISH abnormalities have a different haematological profile, and these abnormalities have a significant effect on blast percentage.
Reference measurement procedure for CSF amyloid beta (Aβ)1–42 and the CSF Aβ1–42/Aβ1–40 ratio – a cross‐validation study against amyloid PET
Authors: Pannee Josef , Portelius Erik , Minthon Lennart , Gobom Johan , Andreasson Ulf , Zetterberg Henrik , Hansson Oskar , Blennow Kaj 
Published: August 2016

AbstractA clinical diagnosis of Alzheimer's disease is currently made on the basis of results from cognitive tests in combination with medical history and general clinical evaluation, but the peptide amyloid‐beta (Aβ) in cerebrospinal fluid (CSF) is increasingly used as a biomarker for amyloid pathology in clinical trials and in recently proposed revised clinical criteria for Alzheimer's disease. Recent analytical developments have resulted in mass spectrometry (MS) reference measurement procedures for absolute quantification of Aβ1–42 in CSF. The CSF Aβ1–42/Aβ1–40 ratio has been suggested to improve the detection of cerebral amyloid deposition, by compensating for inter‐individual variations in total Aβ production. Our aim was to cross‐validate the reference measurement procedure as well as the Aβ1–42/Aβ1–40 and Aβ1–42/Aβ1–38 ratios in CSF, measured by high‐resolution MS, with the cortical level of Aβ fibrils as measured by amyloid (18F‐flutemetamol) positron emission tomography (PET). We included 100 non‐demented patients with cognitive symptoms from the Swedish BioFINDER study, all of whom had undergone both lumbar puncture and 18F‐flutemetamol PET. Comparing CSF Aβ1–42 concentrations with 18F‐flutemetamol PET showed high concordance with an area under the receiver operating characteristic curve of 0.85 and a sensitivity and specificity of 82% and 81%, respectively. The ratio of Aβ1–42/Aβ1–40 or Aβ1–42/Aβ1–38 significantly improved concordance with an area under the receiver operating characteristic curve of 0.95 and a sensitivity and specificity of 96% and 91%, respectively. These results show that the CSF Aβ1–42/Aβ1–40 and Aβ1–42/Aβ1–38 ratios using the described MS method are strongly associated with cortical Aβ fibrils measured by 18F‐flutemetamol PET.
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Providing informal home care for pressure ulcer patients: how it affects carers' quality of life and burden
Authors: Rodrigues Alexandre M. , Ferreira Pedro L. , Ferré‐Grau Carmen 
Published: August 2016

Aims and objectivesTo evaluate the quality of life of informal caregivers of patients with pressure ulcer; to assess their levels of burden; to analyse the variables influencing both their quality of life and burden.BackgroundInformal caregivers of pressure ulcer patients, besides coping with the natural dependency of these patients, deal with the specificity of caring these types of wounds. This situation has an impact on not only the quality of life and burden felt by informal caregivers but also on individual and familiar dynamics.DesignDescriptive and correlational study.MethodsThis study focused on 145 informal caregivers providing home care. Measurement instruments were: SF‐36v2 and the Burden Interview Scale. Descriptive analysis of the quantitative variables was carried out according to measures of central tendency, and the qualitative variables were described using absolute and relative frequencies. The relationships or associations between variables were explored through correlational analysis and, whenever the data allowed, multivariate techniques were used.Results and discussionInformal caregivers showed low levels of quality of life and, most of them, significant burden. Quality of life decreased with overload, with the increasing number of pressure ulcer and with less experience of informal caregivers, with lack of financial remuneration, with unemployment, with patient positioning and with the direct care of the wound. The burden increased with the number of pressure ulcer in each patient and with the lack of financial remuneration.ConclusionThese informal caregivers have low quality of life and are overburdened. Both situations are positively and negatively influenced by factors related to the pressure ulcer and to the patients' sociodemographic data.Relevance to clinical practiceThe results of this study allow more effective monitoring by health professionals of levels of burden and quality of life encountered in pressure ulcer informal caregivers, as well as direct interventions to inhibit the factors inducing burden and enhance those that improve quality of life.
Own‐Choice Marriage and Fertility in Turkey
Authors: Manglos‐Weber Nicolette D. , Weinreb Alexander A. 
Published: August 2016

AbstractGoode's foundational work on the fertility transition identified own‐choice marriage as a factor driving fertility decline, part of a widening repertoire of choice pertaining to marriage and childbearing. Yet research supporting this connection in today's transitional societies is scarce and somewhat contradictory, and it is unclear how other marital traditions, such as consanguineous marriage, shape this relationship. This study evaluates Goode's theorized connection using pooled Demographic and Health Survey data from Turkey, comparing children ever born, use of contraception, and parity progression across four types of marriage: own‐choice and arranged marriage and marriage to a cousin versus an unrelated spouse. Results are largely consistent with the idea that a move toward own‐choice marriage reflects a widening repertoire of choice that also leads to fertility decline. However, they also show that hybrid models like own‐choice marriage to a cousin tempers these effects.
From the “Technician Thing” to the “Mental Game”: Masculinity and U.S. Homebirth
Authors: Driesslein April 
Published: August 2016

AbstractPrevious research on pregnancy and birth from the perspective of men has found that men approach them from the perspective of hegemonic masculinity, though many find that hospital birth is a time of potential failure at masculinity. In this qualitative study of 11 men who had children born at home, I find that, like their hospital‐birth counterparts, they find roles in their partners’ pregnancies and early labors that are congruent with hegemonic masculinity. In ways that converge and diverge with the experience of hospital‐birth fathers, they find their masculinity disrupted as the birth approaches, becoming nurturers and servers rather than technicians and protectors. These acts shift them from the masculinity of a young man to that of a father. This is consonant with Connell's (1995) theory that masculinity is not singular, but shifts situationally and across the life course, and Butler's (2003) theory that gender is constructed through acts.
Propofol inhibits carbachol‐induced chloride secretion by directly targeting the basolateral K+ channel in rat ileum epithelium
Authors: Tang S.‐H. , Wang H.‐Y. , Sun H. , An N. , Xiao L. , Sun Q. , Zhao D.‐B. 
Published: August 2016

AbstractBackgroundPropofol is a widely used intravenous general anesthetic. Acetylcholine (ACh) is critical in controlling epithelial ion transport. This study was to investigate the effects of propofol on ACh‐evoked secretion in rat ileum epithelium.MethodsThe Ussing chamber technique was used to investigate the effects of propofol on carbachol (CCh)‐evoked short‐circuit currents (Isc).Key ResultsPropofol (10−2–10−6 mol/L) attenuated CCh‐evoked Isc of rat ileum mucosa in a dose‐dependent manner. The inhibitory effect of propofol was only evident after application to the serosal side. Pretreatment with tetrodotoxin (TTX, 0.3 μmol/L, n=5) had no effect on propofol‐induced inhibitory effect, whereas serosal application of K+ channel inhibitor, glibenclamide, but not, an ATP‐sensitive K+ channel inhibitor, largely reduced the inhibitory effect of propofol. In addition, pretreatment with either hexamethonium bromide (HB, nicotinic nACh receptor antagonist) or Cl− channel blockers niflumic acid and cystic fibrosis transmembrane conductance regulator (inh)‐172 did not produce any effect on the propofol‐induced inhibitory effect.Conclusions & InferencesPropofol inhibits CCh‐induced intestinal secretion by directly targeting basolateral K+ channels.
Alternative oxidase respiration maintains both mitochondrial and chloroplast function during drought
Authors: Dahal Keshav , Vanlerberghe Greg C. 
Published: August 2016

Summary

The mitochondrial electron transport chain (ETC) terminates at cytochrome (cyt) oxidase or alternative oxidase (AOX).

In Nicotiana tabacum leaves, mitochondrial respiration in the light (RL) declined with increasing drought severity but then increased under extreme drought, despite a steep decline in maximal cyt oxidase activity. This increased RL was absent in AOX knockdown lines, while AOX overexpression lines showed enhanced RL relative to the wild‐type (WT). Cyt oxidase activity under extreme drought was higher in overexpressors and lower in knockdowns, compared with the WT, providing evidence that AOX acted to maintain cyt pathway function.

The rate of RL was a strong determinant of the reduction state of the photosynthetic ETC during drought. As such, the maximal quantum yield of photosystem II was compromised in knockdowns, compared with the WT, during extreme drought. By contrast, overexpressors maintained their instantaneous leaf water‐use efficiency equally as high during extreme drought as when they were well watered.

In both mitochondria and chloroplasts, protein carbonyl accumulation during extreme drought was strongly increased in knockdowns, and decreased in overexpressors, relative to WT. Hence the ability of AOX to maintain critical mitochondrial and chloroplast functions during extreme drought is likely due, at least in part, to its ability to reduce oxidative damage.
Nitrogen fertilization and δ18O of CO2 have no effect on 18O‐enrichment of leaf water and cellulose in Cleistogenes squarrosa (C4) – is VPD the sole control?
Authors: Liu Hai Tao , Gong Xiao Ying , Schäufele Rudi , Yang Fang , Hirl Regina Theresia , Schmidt Anja , Schnyder Hans 
Published: August 2016

AbstractThe oxygen isotope composition of cellulose (δ18OCel) archives hydrological and physiological information. Here, we assess previously unexplored direct and interactive effects of the δ18O of CO2 (δ18OCO2), nitrogen (N) fertilizer supply and vapour pressure deficit (VPD) on δ18OCel, 18O‐enrichment of leaf water (Δ18OLW) and cellulose (Δ18OCel) relative to source water, and pexpx, the proportion of oxygen in cellulose that exchanged with unenriched water at the site of cellulose synthesis, in a C4 grass (Cleistogenes squarrosa). δ18OCO2 and N supply, and their interactions with VPD, had no effect on δ18OCel, Δ18OLW, Δ18OCel and pexpx. Δ18OCel and Δ18OLW increased with VPD, while pexpx decreased. That VPD‐effect on pexpx was supported by sensitivity tests to variation of Δ18OLW and the equilibrium fractionation factor between carbonyl oxygen and water. N supply altered growth and morphological features, but not 18O relations; conversely, VPD had no effect on growth or morphology, but controlled 18O relations. The work implies that reconstructions of VPD from Δ18OCel would overestimate amplitudes of VPD variation, at least in this species, if the VPD‐effect on pexpx is ignored. Progress in understanding the relationship between Δ18OLW and Δ18OCel will require separate investigations of pex and px and of their responses to environmental conditions.