bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of dexmedetomidine with on‐demand midazolam versus midazolam alone for procedural sedation during endoscopic submucosal dissection of gastric tumor
Authors: Lee Sang Pyo , Sung In‐Kyung , Kim Jeong Hwan , Lee Sun‐Young , Park Hyung Seok , Shim Chan Sup , Hwang Hweung Kon , Kim Tae‐Yop , Shim Sang Goon 
Published: May 2015

ObjectiveEndoscopic submucosal dissection (ESD) is commonly performed as a treatment for gastric neoplasms. However, sedation with midazolam (MDZ) often does not reach satisfactory sedation levels during the procedure and the drug may suppress respiration and blood pressure. This study aimed to investigate the safety and efficacy of dexmedetomidine (DEX) with on‐demand MDZ (the DEX group) in comparison with MDZ alone (the MDZ group) as a sedative during ESD of gastric neoplasms.MethodsEighty patients undergoing ESD for gastric tumor were randomly assigned to one of two treatment regimens (40 patients in each). We investigated the depth of sedation by using a Modified Observers Assessment Alertness/Sedation score, the number of patients' reactions interfering with the procedure, sedation related‐adverse events and the degree of satisfaction of patients and doctors.ResultsThere was no statistically significant difference between the two groups regarding their age, gender, body mass index, American Society of Anesthesiologists physical status classification and the characteristics of the tumor. Appropriate sedation rate and the degree of satisfaction of the doctors were significantly higher in the DEX group than in the MDZ group. Patients' reactions interfering with the procedure were more numerous in the MDZ group than in the DEX group. There was no significant difference in adverse events between the two groups.ConclusionsDEX with on‐demand MDZ for sedation during gastric ESD is as safe as MDZ alone and the sedation effect of DEX with MDZ is superior to that of MDZ alone.
Plasma glucose and hemoglobin A1c for the detection of diabetes in Chinese adults
Authors: Xu Yu , Zhao Wenhua , Wang Weiqing , Bi Yufang , Li Jianhong , Mi Shengquan , Xu Min , Lu Jieli , Wang Tiange , Li Mian , Wang Zhuoqun , Jiang Yong , Wang Limin , Wang Linhong , Dai Meng , Zhang Di , Lai Shenghan , Ning Guang ,   2010 China Noncommunicable Disease Surveillance Group
Published: May 2015

AbstractBackgroundThe aim of the present study was to evaluate the performance of plasma glucose (PG) and HbA1c for the detection of diabetes in the general population in China.MethodsA cross‐sectional analysis was conducted in a nationally representative sample of 98 658 Chinese adults aged ≥18 years. Fasting plasma glucose and HbA1c levels were measured in all participants after at least a 10‐h overnight fast. An oral glucose tolerance test (OGTT) was conducted among participants without a self‐reported history of diagnosed diabetes.ResultsAn HbA1c ≥6.5% could identify 4.57% of Chinese adults as having newly detected diabetes, followed by fasting PG (FPG) and 2‐h PG at 4.52% and 3.50%, respectively. Approximately 1.95% of the total population was detected by HbA1c but not by FPG or 2‐h PG. However, FPG plus HbA1c could identify most (85.2%) diabetic individuals identified by any of the three tests (i.e. FPG, 2‐h PG, and HbA1c). Levels of most cardiovascular risk factors, such as body mass index, waist circumference, and cholesterol, were higher in diabetes detected by HbA1c alone than in diabetes identified by the OGTT.ConclusionsAlthough HbA1c ≥6.5% has been recommended by the American Diabetes Association as one of the diagnostic tests for diabetes, caution should be used to avoid potential overdiagnosis when interpreting diabetes identified by elevated HbA1c alone.
Lung cancer mimicking aortic dissecting aneurysm in a patient with situs inversus totalis
Authors: Lin Feng , Yang Mei , Guo Chenglin , Liu Lunxu 
Published: May 2015

AbstractLung cancer and situs inversus totalis are two completely irrelevant conditions. The likelihood of both conditions occurring simultaneously in one person is very rare. We report here a case of a 50‐year‐old man who presented with intermittent chest pain. Enhanced computed tomography of the chest showed situs inversus totalis and a round mediastinal mass embracing the thoracic aorta. The primary diagnosis was suggested as pseudo aortic dissecting aneurysm. However, a tumor in the right lower lung was discovered during surgery, which enclosed and invaded the thoracic aorta. Finally, the patient successfully underwent right lower lobectomy accompanied by lymph node excision and partial replacement of the thoracic aorta with an artificial vascular graft under cardio‐pulmonary bypass.
Renal function and symptoms/adverse effects in opioid‐treated patients with cancer
Authors: Kurita G. P. , Lundström S. , Sjøgren P. , Ekholm O. , Christrup L. , Davies A. , Kaasa S. , Klepstad P. , Dale O. 
Published: May 2015

BackgroundRenal impairment and the risk of toxicity caused by accumulation of opioids and/or active metabolites is an under‐investigated issue. This study aimed at analysing if symptoms/adverse effects in opioid‐treated patients with cancer were associated with renal function.MethodsCross‐sectional multicentre study (European Pharmacogenetic Opioid Study, 2005–2008), in which 1147 adult patients treated exclusively with only one of the most frequently reported opioids (morphine/oxycodone/fentanyl) for at least 3 days were analysed. Fatigue, nausea/vomiting, pain, loss of appetite, constipation and cognitive dysfunction were assessed (EORTC QLQ‐C30). Glomerular filtration rate (GFR) was estimated using Cockcroft–Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI Creatinine) equations.ResultsMild to severe low GFR was observed among 40–54% of patients. CG equation showed that patients with mild and moderate/severe low GFR on morphine treatment had higher odds of having severe constipation (P < 0.01) than patients with normal GFR. In addition, patients with moderate/severe low GFR on morphine treatment were more likely to have loss of appetite (P = 0.04). No other significant associations were found.ConclusionOnly severe constipation and loss of appetite were associated with low GFR in patients treated with morphine. Oxycodone and fentanyl, in relation to the symptoms studied, seem to be safe as used and titrated in routine cancer pain care.
Conservation research presence protects: a case study of great ape abundance in theDja region,Cameroon
Authors: Tagg N. , Willie J. , Duarte J. , Petre C.‐A. , Fa J. E. 
Published: May 2015

AbstractResearch programmes have been shown to exert a positive impact on faunal communities, but few studies provide empirical evidence. In this study, we surveyed three neighbouring sites, differing in terms of official protection status and level of active management, in theDja Conservation Complex, southeastCameroon. We recorded signs of human activity and anthropogenic pressures and found that they significantly differed by site. We assessed chimpanzee and gorilla relative abundance using nest count surveys. We found that chimpanzee nest abundance was related to the presence of active management, but both active management and availability of suitable habitat affected gorilla nest abundance. Our results suggest that gorillas are more tolerant of human activity. We also provide evidence that the presence and activities of the conservation research projectProjetGrandsSinges served to actively deter poachers and limit hunting of great apes as a result of researcher presence, community sensitization and of valuing living apes and intact forests by local people. Such empirical evidence for the positive effect of research activity on biodiversity preservation should encourage continued investment in such programmes as part of a landscape‐wide, multi‐stakeholder conservation management of great ape habitats.
Use of acid‐suppressive therapy before anti‐reflux surgery in 2922 patients: a nationwide register‐based study in Denmark
Authors: Lødrup A. , Pottegård A. , Hallas J. , Bytzer P. 
Published: May 2015

SummaryBackgroundGuidelines recommend that patients with gastro‐oesophageal reflux disease are adequately treated with acid‐suppressive therapy before undergoing anti‐reflux surgery. Little is known of the use of acid‐suppressive drugs before anti‐reflux surgery.AimTo determine the use of proton pump inhibitors and H2‐receptor antagonists in the year before anti‐reflux surgery.MethodsA nationwide retrospective study of all patients aged ≥18 undergoing first‐time anti‐reflux surgery in Denmark during 2000–2012 using data from three different sources: the Danish National Register of Patients, the Danish National Prescription Register, and the Danish Person Register.ResultsThe study population thus included 2922 patients (median age: 48 years, 55.7% male). The annual proportion of patients redeeming ≥180 DDD of acid‐suppressive therapy increased from 17.0% 5 years before anti‐reflux surgery to 64.9% 1 year before. The probability for inadequate dosing 1 year before surgery (<180 DDD) was significantly increased for younger patients, patients operated in the period 2000–2003, patients who had not undergone pre‐surgical manometry, pH‐ or impedance monitoring, and patients who had not redeemed prescriptions on NSAID or anti‐platelet drugs.ConclusionCompliance with medical therapy should be evaluated thoroughly before planning anti‐reflux surgery, as a high proportion of patients receive inadequate dosing of acid‐suppressive therapy prior to the operation.
Comparison of analgesic and systemic effects of bupivacaine, methadone, or bupivacaine/methadone administered epidurally in conscious sheep
Authors: DeRossi R , Jardim PHA , Hermeto LC , Pagliosa RC 
Published: May 2015

ObjectiveThe aim of this study was to evaluate the combination of bupivacaine and methadone administered epidurally in sheep.MethodsSix healthy female mixed‐breed sheep weighing 35–46 kg and aged 12–18 months were included. Each sheep was assigned to receive three treatments: 0.5 mg/kg 0.25% bupivacaine (BP), 0.3 mg/kg 1% methadone (MT) or 0.25 mg/kg bupivacaine and 0.15 mg/kg methadone (BPMT). All drugs were injected into the lumbosacral space through an epidural catheter. Each animal received each treatment at random. Heart rate, arterial blood pressure (systolic, diastolic and mean), respiratory rate, rectal temperature, analgesia, sedation and motor block were determined before treatment and at predetermined intervals.ResultsThe duration of analgesia was 240, 220, and 180 min for BP, MT and BPMT, respectively (P < 0.05). Motor block for all agents was mild to moderate. None or the treatments significantly altered the heart rate, blood pressure or respiratory rate.ConclusionOur findings suggest that lumbosacral epidural administration of bupivacaine, methadone or a combination of the two drugs can provide perioperative analgesia in sheep as part of their management for surgical procedures in the flank and hindlimbs.
An outbreak of primary photosensitisation in lambs secondary to consumption of Biserrula pelecinus (biserrula)
Authors: Kessell AE , Ladmore GE , Quinn JC 
Published: May 2015

Case reportAn outbreak of photosensitisation affecting approximately 25% of a flock of 120 meat lambs that was grazing a monoculture of the pasture legume Biserrula pelecinus var. Casbah (biserrula) was investigated. Blood samples were taken from sheep with moderate to severe clinical signs, and from apparently normal animals, for a complete blood count and biochemistry; 5 affected animals were subjected to a full necropsy. Histopathological investigation showed lesions consistent with photosensitisation of the exposed unpigmented skin of the face and ears. No histopathological or clinical pathological abnormalities suggestive of a hepatopathy were detected in any of the cases, indicating that the lesions observed in this flock were caused by a primary photosensitising agent present in B. pelecinus.ConclusionThis is the first confirmation that photosensitisation caused by ingestion of biserrula is caused by a primary photosensitising agent.
Robot‐assisted radical cystectomy with intracorporeal urinary diversion: impact on an established enhanced recovery protocol
Authors: Koupparis Anthony , Villeda‐Sandoval Christian , Weale Nicola , El‐Mahdy Motaz , Gillatt David , Rowe Edward 
Published: May 2015

ObjectivesTo assess the impact of the introduction of robot‐assisted radical cystectomy (RARC) on an established enhanced recovery programme (ERP) and to examine the effect on mortality and morbidity rates, transfusion rates, and length of stay (LOS).Patients and MethodsData on 102 consecutive patients undergoing RARC with full intracorporeal reconstruction were obtained from our prospectively updated institutional database. These data were compared to previously published retrospective results from three separate groups of patients undergoing open radical cystectomy (ORC) at our centre. Our primary focus was perioperative outcomes including transfusion rate, complication rates, 30‐ and 90‐day mortality rates, and LOS.ResultsThe demographics of the comparative groups showed no significant difference in age, gender distribution, and American Society of Anesthesiologists grade. A significant reduction in transfusion rate was seen in RARC vs ORC (P < 0.001). The median LOS for the RARC group was 8 vs 13 days for the ORC group (P < 0.001). There was trend to a lower total complication rate (48% vs 31%). The 30‐ and 90‐day mortality rates were equivalent between the groups (2%).ConclusionsIntroduction of RARC and intracorporeal reconstruction represents the single biggest impact on our ERP, with significant reduction in transfusion rates and LOS, and a trend towards a lower complication rate.
Gut microbiome and innate immune response patterns in IgE‐associated eczema
Authors: West C. E. , Rydén P. , Lundin D. , Engstrand L. , Tulic M. K. , Prescott S. L. 
Published: May 2015

SummaryBackgroundGut microbiome patterns have been associated with predisposition to eczema potentially through modulation of innate immune signalling.ObjectiveWe examined gut microbiome development in the first year of life in relation to innate immune responses and onset of IgE‐associated eczema over the first 2.5 years in predisposed children due to maternal atopy [www.anzctr.org.au, trial ID ACTRN12606000280505].MethodsMicrobial composition and diversity were analysed with barcoded 16S rRNA 454 pyrosequencing in stool samples in pregnancy and at ages 1 week, 1 month and 12 months in infants (n = 10) who developed IgE‐associated eczema and infants who remained free of any allergic symptoms at 2.5 years of age (n = 10). Microbiome data at 1 week and 1 month were analysed in relation to previously assessed immune responses to TLR 2 and 4 ligands at 6 months of age.ResultsThe relative abundance of Gram‐positive Ruminococcaceae was lower at 1 week of age in infants developing IgE‐associated eczema, compared with controls (P = 0.0047). At that age, the relative abundance of Ruminococcus was inversely associated with TLR2 induced IL‐6 (−0.567, P = 0.042) and TNF‐α (−0.597, P = 0.032); there was also an inverse association between the abundance of Proteobacteria (comprising Gram‐negative taxa) and TLR4‐induced TNF‐α (rs = −0.629, P = 0.024). This relationship persisted at 1 month, with inverse associations between the relative abundance of Enterobacteriaceae (within the Proteobacteria phylum) and TLR4‐induced TNF‐α (rs = −0.697, P = 0.038) and Enterobacteriaceae and IL‐6 (rs = −0.709, P = 0.035). Mothers whose infants developed IgE‐associated eczema had lower α‐diversity of Bacteroidetes (P = 0.04) although this was not seen later in their infants. At 1 year, α‐diversity of Actinobacteria was lower in infants with IgE‐associated eczema compared with controls (P = 0.002).Conclusion and clinical relevanceOur findings suggest that reduced relative abundance of potentially immunomodulatory gut bacteria is associated with exaggerated inflammatory cytokine responses to TLR‐ligands and subsequent development of IgE‐associated eczema.
Dimensional soft tissue changes following soft tissue grafting in conjunction with implant placement or around present dental implants: a systematic review
Authors: Poskevicius Lukas , Sidlauskas Antanas , Galindo‐Moreno Pablo , Juodzbalys Gintaras 
Published: May 2015

AbstractObjectivesTo systematically review changes in mucosal soft tissue thickness and keratinised mucosa width after soft tissue grafting around dental implants.Materials and MethodsAn electronic literature search was conducted of the MEDLINE database published between 2009 and 2014. Sequential screenings at the title, abstract, and full‐text levels were performed. Clinical human studies in the English language that had reported changes in soft tissue thickness or keratinised mucosa width after soft tissue grafting at implant placement or around a present implant at 6‐month follow‐up or longer were included.ResultsThe search resulted in fourteen articles meeting the inclusion criteria: Six of them reported connective tissue grafting around present dental implants, compared to eight at the time of implant placement. Better long‐term soft tissue thickness outcomes were reported for soft tissue augmentation around dental implants (0.8–1.4 mm), compared with augmentation at implant placement (−0.25–1.43 mm). Both techniques were effective in increasing keratinised tissue width: at implant placement (2.5 mm) or around present dental implants (2.33–2.57 mm).ConclusionsThe present systematic review discovered that connective tissue grafts enhanced keratinised mucosa width and soft tissue thickness for an observation period of up to 48 months. However, some shrinkage may occur, resulting in decreases in soft tissue, mostly for the first three months. Further investigations using accurate evaluation methods need to be done to evaluate the appropriate time for grafting.
Insect‐mediated nitrogen dynamics in decomposing wood
Authors: ULYSHEN MICHAEL D. 
Published: May 2015

1. Wood decomposition is characterised by complex and poorly understood nitrogen (N) dynamics with unclear implications for forest nutrient cycling and productivity. Wood‐dwelling microbes have developed unique strategies for coping with theNlimitations imposed by their substrate, including the translocation ofNinto wood by cord‐forming fungi and the fixation of atmospheric nitrogen (N2) by bacteria andArchaea.2. By accelerating the release of nutrients immobilised in fungal tissues and promotingN2fixation by free‐living and endosymbiotic prokaryotes, saproxylic insects have the potential to influenceNdynamics in forests.3. Prokaryotes capable of fixingN2appear to be commonplace among wood‐feeding insects, with published records from three orders (Blattodea,Coleoptera andHymenoptera), 13 families, 33 genera and at least 60 species. These organisms appear to play a significant role in theNeconomies of their hosts and represent a widespread solution to surviving on a diet of wood.4. While agricultural research has demonstrated the role that termites and other insects can play in enhancing crop yields, the importance of saproxylic insects to forest productivity remains unexplored.
Polymorphisms of IL‐10 affect the severity and prognosis of myelodysplastic syndrome
Authors: Kasamatsu Tetsuhiro , Saitoh Takayuki , Minato Yusuke , Shimizu Hiroaki , Yokohama Akihiko , Tsukamoto Norifumi , Handa Hiroshi , Sakura Toru , Murakami Hirokazu 
Published: May 2015

AbstractPolymorphisms of the interluekin‐10 (IL‐10) gene, which alter the production of IL‐10, have been implicated in many cancers. We investigated the association between gene polymorphisms of the promoter region of IL‐10 (‐1082 G/A, IL‐10‐819 C/T, and ‐592 C/A) and the risk to develop myelodysplastic syndrome (MDS) and clinical features of MDS. Genomic DNA was extracted from 119 patients with MDS or chronic myelomonocytic leukemia and 202 healthy controls. Genotypes were determined by PCR‐restriction fragment length polymorphism. There were no statistically significant differences in the genotype, allele, and haplotype frequencies of IL‐10 ‐1082 G/A, IL‐10‐819 C/T, and ‐592 C/A between the patients with MDS and the control group. However, the IL‐10 ‐592 CC genotype group (IL‐10 high producer type) was associated with lower hemoglobin level (7.85 ± 2.02 g/dL vs. 9.37 ± 2.25 g/dL, P = 0.027) and poorer prognosis as compared to the IL‐10 ‐592 non‐CC genotype group (median survival time 50.2 m vs. not reached, p = 0.026). In addition, the IL‐10 high producer haplotype group (GCC/ACC or ACC/ACC) was also associated with lower hemoglobin level and shorter survival time. Our findings indicate that IL‐10 gene polymorphisms may not contribute to susceptibility to MDS, but they may be associated with the severity and prognosis of MDS.
Modulation of neuronal activity by reward identity in the monkey subthalamic nucleus
Authors: Espinosa‐Parrilla Juan‐Francisco , Baunez Christelle , Apicella Paul 
Published: May 2015

AbstractThe subthalamic nucleus (STN) has been argued to be an important component of reward‐sensitive basal ganglia circuitry. This view is especially supported by the behavioral changes observed after STN inactivation, which could reflect impairments in the motivational control of action. However, it is still unclear how the STN integrates reward information and to what extent such integration correlates with behavior. In this study, the response properties of STN neurons in monkeys performing reaching movements with a cue predicting the identity of an upcoming liquid reward (juice or water) were investigated. Although the timing of movements reliably indicated that monkeys had greater motivation for juice than water, rarely did task‐related changes in neuronal activity depend on the nature of the expected reward. Conversely, when presented with a choice of selecting a response that leads to juice or water delivery, animals showed a clear preference for juice and more than half of the neurons were differentially modulated dependent on the reward obtained, mostly after the monkeys's overt choice of action. Under such circumstances, an increase in activity specifically followed the action outcomes across the population of neurons when monkeys failed to choose the juice reward. These results indicate that STN neurons encode whether or not a preferred reward had been received when a choice between response alternatives is required. This differential neuronal activity might reflect the participation of the STN in evaluating the reward value of chosen actions, thus highlighting its contribution to decision‐making processes.