bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delirium the under‐recognised syndrome: survey of healthcare professionals’ awareness and practice in the intensive care units
Authors: Selim Abeer A , Ely E. Wesley 
Published: August 2016

Aims and objectivesTo survey intensive care unit healthcare professionals’ awareness and practice related to delirium.BackgroundDespite the current evidence revealing the risks linked to delirium and advances in practice guidelines promoting delirium assessment, healthcare professionals show little sensitivity towards delirium and evident training needs.DesignThe study had a cross‐sectional survey design.MethodsA sample of 168 intensive care unit healthcare professionals including nurses and physicians completed a semistructured questionnaire to survey their awareness, screening and management of delirium in intensive care units. The survey took place at 11 intensive care units from academic (university) and nonacademic (nonuniversity) governmental hospitals in Mansoura, Egypt.ResultsThe mean score of delirium awareness was 64·4 ± 14·0 among intensive care unit healthcare professionals. Awareness of delirium was significantly lower when definition of delirium was not provided, among diploma nurses compared to bachelor degree nurses and physicians, among those who did not attend any workshop/lecture or read an article related to delirium and lastly, those who work in an intensive care unit when <50% of patients develop delirium. The survey found that only 26·8% of the healthcare professionals screen for delirium on a routine basis, and 14·3% reported attending workshops or lectures or reading an article related to delirium in the last year. In screening delirium, healthcare professionals did not use any tools, nor did they follow adopted protocols or guidelines to manage delirium. To manage delirium, 52·4% of the participants reported using sedatives, 36·9% used no drugs, and 10·7% reported using antipsychotics (primarily haloperidol).ConclusionIntensive care unit healthcare professionals do not have adequate training or routine screening of delirium. There is an evident absence of using standardised tools or adapting protocols to monitor and manage delirium.Relevance to clinical practiceThis study has the potentials to shed some lights on the variables that might explain the problem of underdiagnosing delirium by healthcare professionals at intensive care units in Mansoura.
Newborn hearing screening in Queensland 2009–2011: Comparison of hearing screening and diagnostic audiological assessment between term and preterm infants
Authors: Calcutt Trent L , Dornan Dimity , Beswick Rachael , Tudehope David I 
Published: August 2016

AimThis study compares rates and timing of newborn hearing screening outcomes, audiological assessment and hearing loss diagnosis between infants of different gestational age groups. Early identification and management of sensorineural hearing loss (SNHL), ideally by 3–6 months of age, facilitates speech and language optimisation. Literature stratifying hearing screening and diagnostic audiology assessment by gestational age groups is lacking.MethodsSubjects were infants with recorded gestational ages receiving newborn hearing screening in Queensland between 2009 and 2011. Data were provided through the Queensland Healthy Hearing database. Infants were analysed in <34 weeks, 34–36+6 weeks, 37–38+6 weeks and ≥39 weeks gestational age groups.ResultsInfants (175 911) were eligible for analysis, 7.9% being preterm. Per 1000 infants analysed, bilateral SNHL of >40 dB occurred in 2.4 for <34, 1.4 for 34–36+6, 0.7 for 37–38+6 and 0.7 for ≥39 weeks gestation. Diagnoses attributable to newborn hearing screening direct referral were 93.1% for bilateral >40 dB SNHL and 88.2% for other hearing loss. Relative to term, preterm infants had a higher incidence of direct and targeted surveillance referrals, audiology assessment and hearing loss diagnosis. Preterm infants were screened later after birth.ConclusionsSpecific hearing screening and diagnosis characteristics differed between preterm infants <34 and 34–36+6 weeks gestation, and term infants. Consideration of unique gestational age strata characteristics supports care individualisation. Preterm infants represent a diagnostic challenge, with higher rates of bilateral >40 dB SNHL than term but correspondingly higher false positive results on screening, justifying vigilant monitoring. Focused research into specific risk factors in preterm infants is warranted.
Immune cells in repair of the infarcted myocardium
Authors: Chen Bijun , Frangogiannis Nikolaos G. 
Published: August 2016

AbstractThe immune system plays a critical role in both repair and remodeling of the infarcted myocardium. Danger signals released by dying cardiomyocytes mobilize, recruit, and activate immune cells, triggering an inflammatory reaction. CXC chemokines containing the ELR motif attract neutrophils, while CC chemokines mediate recruitment of mononuclear cell subpopulations, contributing to clearance of the infarct from dead cells and matrix debris. Immune cell subsets also participate in suppression and containment of the postinfarction inflammatory response by secreting anti‐inflammatory mediators, such as IL‐10 and TGF‐β. As proinflammatory signaling is suppressed, macrophage subpopulations, mast cells and lymphocytes, activate fibrogenic and angiogenic responses, contributing to scar formation. In the viable remodeling myocardium, chronic activation of immune cells may promote fibrosis and hypertrophy. This review discusses the role of immune cells in repair and remodeling of the infarcted myocardium. Understanding the role of immune cells in myocardial infarction is critical for the development of therapeutic strategies aimed at protecting the infarcted heart from adverse remodeling. Moreover, modulation of immune cell phenotype may be required in order to achieve the visionary goal of myocardial regeneration.
Successful switching of anticoagulants in a patient with superficial siderosis and atrial fibrillation
Authors: Inatomi Yuichiro , Nakajima Makoto , Yonehara Toshiro , Ando Yukio 
Published: August 2016

AbstractA 78‐year‐old man with atrial fibrillation treated with warfarin experienced acute headache, deafness, cerebellar ataxia and dysuria. Superficial siderosis was diagnosed on brain imaging; however, no bleeding sources were detected. His neurological deficits and bloody cerebrospinal fluid diminished after withdrawal of warfarin. Apixaban was started 2 months after the onset, and his deficits and siderosis had not recurred 18 months after switching these anticoagulants.
Determinants and co‐expression of anti‐predator responses in amphibian tadpoles: a meta‐analysis
Authors: Hossie Thomas , Landolt Kristen , Murray Dennis L. 
Published: August 2016

A wide range of taxa respond to perceived predation risk (PPR) through inducible defenses, and many prey are capable of responding both behaviorally and morphologically to the same risk event. In cases where multiple defenses confer protection by independent means (i.e. they are mechanistically independent) responses will either be co‐expressed, or the expression of one defense will limit the capacity (or need) to respond along another axis. Our ability to generate a broad understanding of these patters has been limited, in part, by difficulties in comparing results across studies that employ distinct experimental protocols. Using the extensive literature on tadpole responses to PPR, we conducted a meta‐analysis to identify the ecological and experimental determinants of inducible defence expression. We then assessed whether the magnitude of response to PPR along behavioural versus morphological response axes was positively, or negatively, correlated. The most commonly quantified responses to perceived risk in tadpoles included reductions in movement and swimming behaviour, and altered tail morphology. Our analyses reveal that tadpole behavioural responses are strongly influenced by prey family, predator taxon, evolutionary history with the predator (native versus non‐native), amount of prey consumed by the predator, and how perceived risk was manipulated (e.g. presence versus absence of alarm cues). Tail morphology was similarly influenced by these factors, but also whether the target prey was palatable to predators. Thus, our results identify ecological and experimental features that critically influence the observed effect size in tadpole responses to PPR. A positive correlation between behavioural and morphological responses in studies where both were measured indicates that trait co‐specialization is the predominant pattern of defense deployment in larval amphibians. This positive relationship suggests that survival tends to be maximized in tadpoles through equivalent co‐activation of multiple independent axes of protection, opposed to maximal expression along any single axis.SynthesisOur understanding of plastic responses to perceived predation risk (PPR) has benefited substantially from the vast amount of experimental work examining inducible defences in anuran tadpoles. Indeed this research has illustrated the wide variety of ways that prey animals can respond to the same risk event. We conducted a metaanalysis to identify the key ecological and experimental determinants of inducible defence expression. We then show that, in most cases, behavioural and morphological responses to PPR tend to be co‐expressed suggesting that responding along one axis (moving behaviour) does not limit their ability to respond along another distinct axis (tail morphology).
Optimal Design of Experiments on Connected Units with Application to Social Networks
Authors: Parker Ben M. , Gilmour Steven G. , Schormans John 
Published: August 2016

SummaryWhen experiments are performed on social networks, it is difficult to justify the usual assumption of treatment–unit additivity, owing to the connections between actors in the network. We investigate how connections between experimental units affect the design of experiments on those experimental units. Specifically, where we have unstructured treatments, whose effects propagate according to a linear network effects model which we introduce, we show that optimal designs are no longer necessarily balanced; we further demonstrate how experiments which do not take a network effect into account can lead to much higher variance than necessary and/or a large bias. We show the use of this methodology in a very wide range of experiments in agricultural trials, and crossover trials, as well as experiments on connected individuals in a social network.
Macro‐scale stability with micro‐scale diversity: modelling changing ethnic minority residential segregation – London 2001–2011
Authors: Johnston Ron , Jones Kelvyn , Manley David , Owen Dewi 
Published: August 2016

Most studies of ethnic residential segregation that address the issue of spatial scale make it implicit – if not explicit – that segregation is greater at smaller than larger scales. Such studies, however, invariably measure segregation separately at those scales, and take no account of the fact that measures at the smaller scale necessarily incorporate that at any larger scales. The present paper rectifies that situation by, for the first time, modelling ethnic segregation in London at the 2001 and 2011 censuses within a Bayesian statistical framework at three scales, which allows for the statistical significance of any changes to be formally assessed – something not possible before. It finds that for many of the groups studied segregation was as great, if not greater, at the macro‐scale as at the micro‐scale, with both measures larger than at the meso‐scale, with significant reductions in segregation across the decade, especially at the micro‐scale.
Hepatitis E virus infection in the Irish blood donor population
Authors: O'Riordan Joan , Boland Fiona , Williams Padraig , Donnellan Joe , Hogema Boris M. , Ijaz Samreen , Murphy William G. 
Published: August 2016

BACKGROUNDHepatitis E virus (HEV) Genotype 3 (G3) infection is a zoonosis that may be transmitted during the acute phase by transfusion. The aim of this study was to determine the incidence of HEV and seroprevalence among Irish blood donors.STUDY DESIGN AND METHODSAnonymized samples from 1076 donations collected in 2012 were tested for HEV immunoglobulin (Ig)G using the Wantai enzyme‐linked immunosorbent assay. A total of 24,985 anonymized donations collected between December 2013 and June 2014 were individually tested for HEV RNA using the Procleix HEV assay; reactive donations were confirmed by an in‐house real‐time polymerase chain reaction (PCR) test.RESULTSSeroprevalence for anti‐IgG was 5.3% (95% confidence interval [CI], 4.0%‐6.8%), ranging from 1.1% in the 18‐ to 29‐years age group to 33.3% in males over 60 years. HEV RNA screening of 24,985 samples yielded five PCR‐confirmed donations (1:4997, 0.02%; 95% CI, 0.0065%‐0.0467%), only one of which was serologically reactive (HEV IgM reactive only). Viral loads ranged from 10 to 44,550 IU/mL. Genotype analysis on three samples identified HEV G3 virus. Four of the five viremic donations were from donors in the 18‐ to 29‐years age group (p = 0.01).CONCLUSIONSeroprevalence for anti‐HEV IgG was low compared to some European countries, but 1 in 5000 donations was viremic. Viremia was predominantly in younger Irish donors. After Department of Health approval the Irish Blood Transfusion Service implemented individual blood donation HEV RNA screening initially for a 3‐year period from January 2016.
Orbital reconstruction in the dog, cat, and horse
Authors: Wallin‐Håkansson Nils , Berggren Karin 
Published: August 2016

AbstractObjectiveTo describe an adaptable method for reconstruction of the orbit following partial orbitectomy.Animals studiedOne horse, one cat, and four dogs.Procedure(s)Following partial orbitectomy for removal of bone and soft tissue affected by pathologic processes, reconstruction was achieved. Cerclage wires were used to reconstitute the orbital rim and other salient facial contours involved in excisions. These wires were then covered with a prolene mesh, first inside the orbit and then outwards over the affected extraorbital areas. Thereafter, a collagen sheet was placed over the mesh. Finally, subcutis and skin were closed over the construct.ResultsAll operated eyes remained visual with normal position, direction, and mobility. Eyelid function, tear production, and nasolacrimal function were preserved. Side effects were mild and temporary, but animals requiring a lateral‐posterior surgical approach experienced concavity to the side of the head posterior to the orbital ligament region. One bone tumor out of three recurred.ConclusionsThe reconstruction method presented offers excellent results tectonically, cosmetically, and functionally, even following extensive orbitectomy. By adapted application of three reconstruction steps using readily available materials, large defects may be surgically repaired. Once orbitectomy is mastered, reconstruction requires no additional specialized techniques or equipment.
Ahmed glaucoma valve implantation with Ologen®Collagen Matrix for the surgical treatment of feline glaucoma
Authors: Park Kang‐hyo , Kim Joon‐Young , Choo Seoung‐woo , Yoon Hun‐young , Jeong Soon‐wuk 
Published: August 2016

AbstractAn Ahmed valve implantation with an Ologen®Collagen Matrix (Ologen®CM, Aeon Astron, Leiden, the Netherlands) was performed for the treatment of uncontrolled glaucoma in a cat. This cat was a 5‐year‐old castrated Russian Blue male with a 12‐week history of conjunctival hyperemia and mydriasis of the left eye. During the ophthalmic examination, the intraocular pressure (IOP) oculus sinister (OS) was 52 mmHg, and a narrow iridocorneal angle (ICA) was detected by gonioscopy. Medical treatment with Cosopt®(2% dorzolamide and 0.5% timolol) failed to decrease theIOP. The left eye still had vision, and an Ahmed valve implantation was performed. During the gonioimplantation, Ologen®CMwas used to inhibit scar formation around the valve. Following the operation, theIOPwas stable at an approximate average of 15 mmHg during the 7‐month follow‐up period, and vision in the left eye was retained without medication. An adequate subconjunctival filtering bleb was formed after 140 days. This is the first case report in which an Ahmed valve gonioimplant with an Ologen®CMhas been used for the surgical treatment of glaucoma in a cat.
White blood cell concentrations during lower body negative pressure and blood loss in humans
Authors: van Helmond Noud , Johnson Blair D. , Curry Timothy B. , Cap Andrew P. , Convertino Victor A. , Joyner Michael J. 
Published: August 2016

New Findings
What is the central question of this study?
Is lower body negative pressure a useful surrogate to study white blood cell responses to haemorrhage in humans?

What is the main finding and its importance?
We found that lower body negative pressure appears to be a useful surrogate to study the early white blood cell mobilization response during blood loss.

Hypovolaemia has been associated with an immune response that might be secondary to sympathoexcitation. We tested the hypothesis that simulated hypovolaemia using lower body negative pressure (LBNP) and real hypovolaemia induced via experimental blood loss (BL) cause similar increases in the white blood cell concentration ([WBC]). We measured [WBC] and catecholamine concentrations in 12 men who underwent an LBNP and a BL protocol in a randomized order. We compared 45 mmHg of LBNP with 1000 ml of BL; therefore, [WBC] and catecholamine concentrations were plotted against central venous pressure to obtain stimulus–response relationships using the linear regression line slopes for both protocols. Mean regression line slopes were similar for total [WBC] (LBNP 183 ± 4 μl−1 mmHg−1 versus BL 155 ± 109 μl−1 mmHg−1, P = 0.15), neutrophils (LBNP 110 ± 2 μl−1 mmHg−1 versus BL 96 ± 72 μl−1 mmHg−1, P = 0.15) and lymphocytes (LBNP 65 ± 21 μl−1 mmHg−1 versus BL 59 ± 38 μl−1 mmHg−1, P = 0.90). Mean regression line slopes for adrenaline were similar (LBNP 15 ± 5 pg ml−1 mmHg−1 versus BL 16 ± 4 pg ml−1 mmHg−1, P = 0.84) and were steeper during LBNP for noradrenaline (LBNP 28 ± 6 pg ml−1 mmHg−1 versus BL 9 ± 6 pg ml−1 mmHg−1, P = 0.01). These data indicate that central hypovolaemia elicits a relative leucocytosis with a predominantly neutrophil‐based response. Additionally, our results indicate that LBNP models the stimulus–response relationship between central venous pressure and [WBC] observed during BL.
Identification of the Main Regulator Responsible for Synthesis of the Typical Yellow Pigment Produced by Trichoderma reesei
Authors: Derntl Christian , Rassinger Alice , Srebotnik Ewald , Mach Robert L. , Mach-Aigner Astrid R. 
Published: August 2016

ABSTRACT

The industrially used ascomycete
Trichoderma reesei
secretes a typical yellow pigment during cultivation, while other
Trichoderma
species do not. A comparative genomic analysis suggested that a putative secondary metabolism cluster, containing two polyketide-synthase encoding genes, is responsible for the yellow pigment synthesis. This cluster is conserved in a set of rather distantly related fungi, including
Acremonium chrysogenum
and
Penicillium chrysogenum
. In an attempt to silence the cluster in
T. reesei
, two genes of the cluster encoding transcription factors were individually deleted. For a complete genetic proof-of-function, the genes were reinserted into the genomes of the respective deletion strains. The deletion of the first transcription factor (termed yellow pigment regulator 1 [Ypr1]) resulted in the full abolishment of the yellow pigment formation and the expression of most genes of this cluster. A comparative high-pressure liquid chromatography (HPLC) analysis of supernatants of the
ypr1
deletion and its parent strain suggested the presence of several yellow compounds in
T. reesei
that are all derived from the same cluster. A subsequent gas chromatography/mass spectrometry analysis strongly indicated the presence of sorbicillin in the major HPLC peak. The presence of the second transcription factor, termed yellow pigment regulator 2 (Ypr2), reduces the yellow pigment formation and the expression of most cluster genes, including the gene encoding the activator Ypr1.

IMPORTANCE
Trichoderma reesei
is used for industry-scale production of carbohydrate-active enzymes. During growth, it secretes a typical yellow pigment. This is not favorable for industrial enzyme production because it makes the downstream process more complicated and thus increases operating costs. In this study, we demonstrate which regulators influence the synthesis of the yellow pigment. Based on these data, we also provide indication as to which genes are under the control of these regulators and are finally responsible for the biosynthesis of the yellow pigment. These genes are organized in a cluster that is also found in other industrially relevant fungi, such as the two antibiotic producers
Penicillium chrysogenum
and
Acremonium chrysogenum
. The targeted manipulation of a secondary metabolism cluster is an important option for any biotechnologically applied microorganism.
Understanding the Streptococcus mutans Cid/Lrg System through CidB Function
Authors: Ahn Sang-Joon , Rice Kelly C. 
Published: August 2016

ABSTRACT

The
Streptococcus mutans
lrgAB
and
cidAB
operons have been previously described as a potential model system to dissect the complexity of biofilm development and virulence of
S. mutans
. Herein, we have attempted to further characterize the Cid/Lrg system by focusing on CidB, which has been shown to be critical for the ability of
S. mutans
to survive and persist in a nonpreferred oxygen-enriched condition. We have found that the expression level of
cidB
is critical to oxidative stress tolerance of
S. mutans
, most likely by impacting
lrg
expression. Intriguingly, the impaired aerobic growth phenotype of the
cidB
mutant could be restored by the additional loss of either CidA or LrgA. Growth-dependent expression of
cid
and
lrg
was demonstrated to be tightly under the control of both CcpA and the VicKR two-component system (TCS), regulators known to play an essential role in controlling major catabolic pathways and cell envelope homeostasis, respectively. RNA sequencing (RNA-Seq) analysis revealed that mutation of
cidB
resulted in global gene expression changes, comprising major domains of central metabolism and virulence processes, particularly in those involved with oxidative stress resistance. Loss of CidB also significantly changed the expression of genes related to genomic islands (GI) TnSmu1 and TnSmu2, the CRISPR (clustered regularly interspaced short palindromic repeats)-Cas system, and toxin-antitoxin (T/A) modules. Taken together, these data show that CidB impinges on the stress response, as well as the fundamental cellular physiology of
S. mutans
, and further suggest a potential link between Cid/Lrg-mediated cellular processes,
S. mutans
pathogenicity, and possible programmed growth arrest and cell death mechanisms.

IMPORTANCE
The ability of
Streptococcus mutans
to survive a variety of harmful or stressful conditions and to emerge as a numerically significant member of stable oral biofilm communities are essential elements for its persistence and cariogenicity. In this study, the homologous
cidAB
and
lrgAB
operons, previously identified as being highly balanced and coordinated during
S. mutans
aerobic growth, were further characterized through the functional and transcriptomic analysis of CidB. Precise control of CidB levels is shown to impact the expression of
lrg
, oxidative stress tolerance, major metabolic domains, and the molecular modules linked to cell death and lysis. This study advances our understanding of the Cid/Lrg system as a key player in the integration of complex environmental signals (such as oxidative stress) into the regulatory networks that modulate
S. mutans
virulence and cell homeostasis.