bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine as an Adjuvant to Analgesic Strategy During Vaso‐Occlusive Episodes in Adolescents with Sickle‐Cell Disease
Authors: Sheehy Kathy A. , Finkel Julia C. , Darbari Deepika S. , Guerrera Michael F. , Quezado Zenaide M. N. 
Published: July 2015

AbstractPatients with sickle‐cell disease (SCD) can experience recurrent vaso‐occlusive episodes (VOEs), which are associated with severe pain. While opioids are the mainstay of analgesic therapy, in some patients with SCD, increasing opioid use is associated with continued and increasing pain. Dexmedetomidine, an α2‐adrenoreceptor agonist with sedative and analgesic properties, has been increasingly used in the perioperative and intensive care settings and has been shown to reduce opioid requirement and to facilitate opioid weaning. Therefore, there might be a role for dexmedetomidine in pain management during VOEs in patients with SCD. Here, we present the hospital course of 3 patients who during the course of VOEs had severe pain unresponsive to opioids and ketamine and were treated with dexmedetomidine. Dexmedetomidine infusions that lasted for 3 to 6 days were associated with marked reduction in daily oral morphine‐equivalent intake and decreases in pain scores (numeric rating scale). There were no hemodynamic changes that required treatment with vasoactive or anticholinergic agents. These preliminary findings of possible beneficial effects of dexmedetomidine in decreasing opioid requirements support the hypothesis that dexmedetomidine may have a role as a possible analgesic adjuvant to mitigate VOE‐associated pain in patients with SCD.
Process analysis of trauma‐focused cognitive behavioural therapy for individuals with schizophrenia
Authors: O'Driscoll Ciarán , Mason Oliver , Brady Francesca , Smith Ben , Steel Craig 
Published: July 2015

ObjectiveTherapeutic alliance, modality, and ability to engage with the process of therapy have been the main focus of research into what makes psychotherapy successful. Individuals with complex trauma histories or schizophrenia are suggested to be more difficult to engage and may be less likely to benefit from therapy. This study aimed to track the in‐session ‘process’ of working alliance and emotional processing of trauma memories for individuals with schizophrenia.DesignThe study utilized session recordings from the treatment arm of an open randomized clinical trial investigating trauma‐focused cognitive behavioural therapy (TF‐CBT) for individuals with schizophrenia (N = 26).MethodObserver measures of working alliance, emotional processing, and affect arousal were rated at early and late phases of therapy. Correlation analysis was undertaken for process measures. Temporal analysis of expressed emotions was also reported.ResultsWorking alliance was established and maintained throughout the therapy; however, agreement on goals reduced at the late phase. The participants appeared to be able to engage in emotional processing, but not to the required level for successful cognitive restructuring.ConclusionThis study undertook novel exploration of process variables not usually explored in CBT. It is also the first study of process for TF‐CBT with individuals with schizophrenia. This complex clinical sample showed no difficulty in engagement; however, they may not be able to fully undertake the cognitive–emotional demands of this type of therapy. Clinical and research implications and potential limitations of these methods are considered.Practitioner points

This sample showed no difficulties engaging with TF‐CBT and forming a working alliance.

However, the participants may not have achieved a level of active involvement required for successful cognitive restructuring of trauma memories.

This discrepancy may relate to the mediating role of both working alliance and cognitive–emotional processing.

The results underscore the importance of therapists understanding the relationship between alliance and other process factors which may be implicit in facilitating change.
Infantile Fistula‐in‐Ano: A Report of Two Patients and Review for Dermatologists
Authors: Finelt Nika , Shen Lisa Y. , Chamlin Sarah L. , Browne Marybeth , Mancini Anthony J. 
Published: July 2015

AbstractInfantile fistula‐in‐ano is a well‐known entity to pediatric surgeons but less recognized by dermatologists. Because these patients may initially present to a dermatologist or pediatric dermatologist, familiarity with the presentation is important. We present two infants with fistula‐in‐ano and review the literature on this condition.
Electrocardiographic Monitoring in Patients with Epidermolysis Bullosa: A New Proposal
Authors: Barcellos Bruno M. , Camelier Pedro da Silva , de Jesus Lisieux Eyer 
Published: July 2015

AbstractEpidermolysis bullosa causes serious blistering of the skin even with minor trauma. The use of standard electrodes, tapes, and adhesives is restricted in these patients because it exposes the skin to stretching and shearing forces that cause traumatic blister formation. We propose herein an alternative electrocardiographic monitoring technique to minimize cutaneous trauma.
Dermoscopic Visualization of Vellus Hair Involvement in Tinea Corporis: A Criterion for Systemic Antifungal Therapy?
Authors: Knöpfel Nicole , del Pozo Luis Javier , Escudero Maria del Mar , Martín‐Santiago Ana 
Published: July 2015

AbstractDermoscopy has been shown to be a valuable tool in the diagnosis and monitoring of several infectious diseases. We report a case of tinea corporis in an infant in whom dermoscopy helped us to determine vellus hair involvement, causing treatment to be switched from topical to systemic antifungal therapy.
The effects of smoke derivatives on in vitro seed germination and development of the leopard orchid Ansellia africana
Authors: Papenfus H. B. , Naidoo D. , Pošta M. , Finnie J. F. , Van Staden J. 
Published: July 2015

AbstractPlant‐derived smoke and smoke‐isolated compounds stimulate germination in seeds from over 80 genera. It has also been reported that smoke affects overall plant vigour and has a stimulatory effect on pollen growth. The effect of smoke on orchid seeds, however, has not been assessed. In South Africa, orchid seeds from several genera may be exposed to smoke when they are released from their seedpods. It is therefore possible that smoke may affect their germination and growth. Therefore, the effects of smoke [applied as smoke‐water (SW)] and two smoke‐derived compounds, karrikinolide (KAR1) and trimethylbutenolide (TMB), were investigated on the germination and growth of orchid seeds in vitro. The effect of SW, KAR1 and TMB were investigated on the endangered epiphytic orchid, Ansellia africana, which is indigenous to tropical areas of Africa. Smoke‐water, KAR1 and TMB were infused in half‐strength MS medium. The number of germinated seeds and number of seeds and protocorm bodies to reach predetermined developmental stages were recorded on a weekly basis using a dissecting microscope for a 13‐week period. Infusing SW 1:250 (v:v) into half‐strength MS medium significantly increased the germination rate index (GRI) and the development rate index (DRI) of the A. africana seeds. All the SW treatments significantly increased the number of large protocorm bodies at the final stage of development. Infusing KAR1 into the growing medium had no significant effect on germination or development of the seeds. The TMB treatment, however, significantly reduced the GRI and DRI of A. africana seeds.
Eroding the Community in Community Supported Agriculture (CSA): Competition's Effects in Alternative Food Networks in California
Authors: Galt Ryan E. , Bradley Katharine , Christensen Libby , Van Soelen Kim Julia , Lobo Ramiro 
Published: July 2015

AbstractThe effects of competition within alternative food networks (AFNs) remain largely unexplored. Using a study of farms that operate Community Supported Agriculture (CSA) programmes in California, the state in the USA with the most CSAs, we empirically examine the effects of competition within alternative food networks. We conducted a statewide survey of CSA farmers in California, which collected data from 111 CSAs. For this analysis we construct a perceived competition index composed of variables that measure farmers' perceptions of competition with numerous market outlets and their being constrained in raising their prices due to competitive pressures. Our analysis shows that perceived competition is negatively correlated with CSA farms' profitability, farmers' satisfaction on a number of fronts, various indicators of the social embeddedness of CSA, and two community food security strategies. We conclude that competition is a real, although differential, phenomenon experienced by many CSA farmers in California, and that this competition impacts CSA in ways that undermine some of its commonly held values, especially fair farmer compensation and strong member‐farmer relationships.
Understanding Corporate Bonds, Interest Rates, and Issuance Prices
Authors: Joyner Donald T , McGowan Carl B 
Published: July 2015

Businesses evolveover time and the degree of risk and the needs for financing evolve, too. In the early stages of a business, thebusiness is small and most of the financing comes from the entrepreneur andfrom retained earnings of the business. After a business achieves a certain size, external financing is neededsuch as venture capital, new stockholders’ equity, and bonds. Over the last one hundred years, individualsproviding external funding to businesses have demanded more and betterinformation. Currently, Sarbanes-Oxley requiresboth information and evidence that the information is correct. Thus, companies are required to have internalcontrols that validate the information provided to stakeholders and to have theauditors confirm the quality of the internal control mechanisms.
Quantitative correlational study of microbubble‐enhanced ultrasound imaging and magnetic resonance imaging of glioma and early response to radiotherapy in a rat model
Authors: Yang Chen , Lee Dong‐Hoon , Mangraviti Antonella , Su Lin , Zhang Kai , Zhang Yin , Zhang Bin , Li Wenxiao , Tyler Betty , Wong John , Wang Ken Kang‐Hsin , Velarde Esteban , Zhou Jinyuan , Ding Kai 
Published: July 2015

Purpose:Radiotherapy remains a major treatment method for malignant tumors. Magnetic resonance imaging (MRI) is the standard modality for assessing glioma treatment response in the clinic. Compared to MRI, ultrasound imaging is low‐cost and portable and can be used during intraoperative procedures. The purpose of this study was to quantitatively compare contrast‐enhanced ultrasound (CEUS) imaging and MRI of irradiated gliomas in rats and to determine which quantitative ultrasound imaging parameters can be used for the assessment of early response to radiation in glioma.Methods:Thirteen nude rats with U87 glioma were used. A small thinned skull window preparation was performed to facilitate ultrasound imaging and mimic intraoperative procedures. Both CEUS and MRI with structural, functional, and molecular imaging parameters were performed at preradiation and at 1 day and 4 days postradiation. Statistical analysis was performed to determine the correlations between MRI and CEUS parameters and the changes between pre‐ and postradiation imaging.Results:Area under the curve (AUC) in CEUS showed significant difference between preradiation and 4 days postradiation, along with four MRI parameters, T2, apparent diffusion coefficient, cerebral blood flow, and amide proton transfer‐weighted (APTw) (all p < 0.05). The APTw signal was correlated with three CEUS parameters, rise time (r = − 0.527, p < 0.05), time to peak (r = − 0.501, p < 0.05), and perfusion index (r = 458, p < 0.05). Cerebral blood flow was correlated with rise time (r = − 0.589, p < 0.01) and time to peak (r = − 0.543, p < 0.05).Conclusions:MRI can be used for the assessment of radiotherapy treatment response and CEUS with AUC as a new technique and can also be one of the assessment methods for early response to radiation in glioma.
Synthetic Long Peptide Derived from Mycobacterium tuberculosis Latency Antigen Rv1733c Protects against Tuberculosis
Authors: Coppola Mariateresa , van den Eeden Susan J. F. , Wilson Louis , Franken Kees L. M. C. , Ottenhoff Tom H. M. , Geluk Annemieke 
Published: July 2015

ABSTRACTResponsible for 9 million new cases of active disease and nearly 2 million deaths each year, tuberculosis (TB) remains a global health threat of overwhelming dimensions.Mycobacterium bovisBCG, the only licensed vaccine available, fails to confer lifelong protection and to prevent reactivation of latent infection. Although 15 new vaccine candidates are now in clinical trials, an effective vaccine against TB remains elusive, and new strategies for vaccination are vital. BCG vaccination fails to induce immunity againstMycobacterium tuberculosislatency antigens. Synthetic long peptides (SLPs) combined with adjuvants have been studied mostly for therapeutic cancer vaccines, yet not for TB, and proved to induce efficient antitumor immunity. This study investigated an SLP derived from Rv1733c, a majorM. tuberculosislatency antigen which is highly expressed by “dormant”M. tuberculosisand well recognized by T cells from latentlyM. tuberculosis-infected individuals. In order to assess itsin vivoimmunogenicity and protective capacity, Rv1733c SLP in CpG was administered to HLA-DR3 transgenic mice. Immunization with Rv1733c SLP elicited gamma interferon-positive/tumor necrosis factor-positive (IFN-γ+/TNF+) and IFN-γ+CD4+T cells and Rv1733c-specific antibodies and led to a significant reduction in the bacterial load in the lungs ofM. tuberculosis-challenged mice. This was observed both in a pre- and in a post-M. tuberculosischallenge setting. Moreover, Rv1733c SLP immunization significantly boosted the protective efficacy of BCG, demonstrating the potential ofM. tuberculosislatency antigens to improve BCG efficacy. These data suggest a promising role forM. tuberculosislatency antigen Rv1733c-derived SLPs as a novel TB vaccine approach, both in a prophylactic and in a postinfection setting.
Characterization of Hepatitis C Virus Recombination in Cameroon by Use of Nonspecific Next-Generation Sequencing
Authors: Iles James C. , Njouom Richard , Foupouapouognigni Yacouba , Bonsall David , Bowden Rory , Trebes Amy , Piazza Paolo , Barnes Ellie , Pépin Jacques , Klenerman Paul , Pybus Oliver G. 
Published: July 2015

ABSTRACT
The importance of recombination in the evolution and genetic diversity of the hepatitis C virus (HCV) is currently uncertain. Only a small number of intergenotypic recombinants have been identified so far, and each has core and envelope genes classified as belonging to genotype 2. Here, we investigated two putative genotype 4/1 recombinants from southern Cameroon using a number of approaches, including standard Sanger sequencing, genotype-specific PCR amplification, and non-HCV-specific Illumina RNA sequencing (RNA-seq). Recombination between genotypes 1 and 4 was confirmed in both samples, and the parental lineages of each recombinant belong to HCV subtypes that are cocirculating at a high prevalence in Cameroon. Using the RNA-seq approach, we obtained a complete genome for one sample, which contained a recombination breakpoint at the E2/P7 gene junction. We developed and applied a new method, called Deep SimPlot, which can be used to visualize and identify viral recombination directly from the short sequence reads created by next-generation sequencing in conjunction with a consensus sequence.
Comparing Etest and Broth Microdilution for Antifungal Susceptibility Testing of the Most-Relevant Pathogenic Molds
Authors: Lamoth Frédéric , Alexander Barbara D. 
Published: July 2015

ABSTRACT

Invasive mold infections are life-threatening diseases for which appropriate antifungal therapy is crucial. Their epidemiology is evolving, with the emergence of triazole-resistant
Aspergillus
spp. and multidrug-resistant non-
Aspergillus
molds. Despite the lack of interpretive criteria, antifungal susceptibility testing of molds may be useful in guiding antifungal therapy. The standard broth microdilution method (BMD) is demanding and requires expertise. We assessed the performance of a commercialized gradient diffusion method (Etest method) as an alternative to BMD. The MICs or minimal effective concentrations (MECs) of amphotericin B, voriconazole, posaconazole, caspofungin, and micafungin were assessed for 290 clinical isolates of the most representative pathogenic molds (154
Aspergillus
and 136 non-
Aspergillus
isolates) with the BMD and Etest methods. Essential agreements (EAs) within ±2 dilutions of ≥90% between the two methods were considered acceptable. EAs for amphotericin B and voriconazole were >90% for most potentially susceptible species. For posaconazole, the correlation was acceptable for
Mucoromycotina
but Etest MIC values were consistently lower for
Aspergillus
spp. (EAs of <90%). Excellent EAs were found for echinocandins with highly susceptible (MECs of <0.015 μg/ml) or intrinsically resistant (MECs of >16 μg/ml) strains. However, MEC determinations lacked consistency between methods for strains exhibiting mid-range MECs for echinocandins. We concluded that the Etest method is an appropriate alternative to BMD for antifungal susceptibility testing of molds under specific circumstances, including testing with amphotericin B or triazoles for non-
Aspergillus
molds (
Mucoromycotina
and
Fusarium
spp.). Additional study of molecularly characterized triazole-resistant
Aspergillus
isolates is required to confirm the ability of the Etest method to detect voriconazole and posaconazole resistance among
Aspergillus
spp.
Human Wound Infection with Mannheimia glucosida following Lamb Bite
Authors: Lau Jillian S. Y. , Omaleki Lida , Turni Conny , Barber Stuart Richard , Browning Glenn Francis , Francis Michelle J. , Graham Maryza , Korman Tony M. 
Published: July 2015

ABSTRACT

Mannheimia
spp. are veterinary pathogens that can cause mastitis and pneumonia in domestic cattle and sheep. While
Mannheimia glucosida
can be found as normal flora in oral and respiratory mucosa in sheep, there have been no reported cases of human infection with this organism.
Asymptomatic Leprosy Infection among Blood Donors May Predict Disease Development and Suggests a Potential Mode of Transmission
Authors: Goulart Isabela Maria Bernardes , Araujo Sergio , Filho Adilson Botelho , de Paiva Paulo Henrique Ribeiro , Goulart Luiz Ricardo 
Published: July 2015

ABSTRACT

Blood donor samples (1,007) were assessed for anti-phenolic glycolipid 1 (PGL-1) IgM antibodies and
Mycobacterium leprae
DNA presence, which had 3.8% and 0.3% positivity, respectively. After a 5-year follow-up period, six individuals with positive markers developed leprosy, raising the hypothesis that asymptomatic infection among blood donors may be an undisclosed mode of leprosy transmission via transfusion.
Development and Validation of Digital Enzyme-Linked Immunosorbent Assays for Ultrasensitive Detection and Quantification of Clostridium difficile Toxins in Stool
Authors: Song Linan , Zhao Mingwei , Duffy David C. , Hansen Joshua , Shields Kelsey , Wungjiranirun Manida , Chen Xinhua , Xu Hua , Leffler Daniel A. , Sambol Susan P. , Gerding Dale N. , Kelly Ciarán P. , Pollock Nira R. 
Published: July 2015

ABSTRACT

The currently available diagnostics for
Clostridium difficile
infection (CDI) have major limitations. Despite mounting evidence that toxin detection is paramount for diagnosis, conventional toxin immunoassays are insufficiently sensitive and cytotoxicity assays too complex; assays that detect toxigenic organisms (toxigenic culture [TC] and nucleic acid amplification testing [NAAT]) are confounded by asymptomatic colonization by toxigenic
C. difficile
. We developed ultrasensitive digital enzyme-linked immunosorbent assays (ELISAs) for toxins A and B using single-molecule array technology and validated the assays using (i) culture filtrates from a panel of clinical
C. difficile
isolates and (ii) 149 adult stool specimens already tested routinely by NAAT. The digital ELISAs detected toxins A and B in stool with limits of detection of 0.45 and 1.5 pg/ml, respectively, quantified toxins across a 4-log range, and detected toxins from all clinical strains studied. Using specimens that were negative by cytotoxicity assay/TC/NAAT, clinical cutoffs were set at 29.4 pg/ml (toxin A) and 23.3 pg/ml (toxin B); the resulting clinical specificities were 96% and 98%, respectively. The toxin B digital ELISA was 100% sensitive versus cytotoxicity assay. Twenty-five percent and 22% of the samples positive by NAAT and TC, respectively, were negative by the toxin B digital ELISA, consistent with the presence of organism but minimal or no toxin. The mean toxin levels by digital ELISA were 1.5- to 1.7-fold higher in five patients with CDI-attributable severe outcomes, versus 68 patients without, but this difference was not statistically significant. Ultrasensitive digital ELISAs for the detection and quantification of toxins A and B in stool can provide a rapid and simple tool for the diagnosis of CDI with both high analytical sensitivity and high clinical specificity.
Whole-Genome Mapping as a Novel High-Resolution Typing Tool for Legionella pneumophila
Authors: Bosch Thijs , Euser Sjoerd M. , Landman Fabian , Bruin Jacob P. , IJzerman Ed P. , den Boer Jeroen W. , Schouls Leo M. 
Published: July 2015

ABSTRACT

Legionella
is the causative agent for Legionnaires' disease (LD) and is responsible for several large outbreaks in the world. More than 90% of LD cases are caused by
Legionella pneumophila
, and studies on the origin and transmission routes of this pathogen rely on adequate molecular characterization of isolates. Current typing of
L. pneumophila
mainly depends on sequence-based typing (SBT). However, studies have shown that in some outbreak situations, SBT does not have sufficient discriminatory power to distinguish between related and nonrelated
L. pneumophila
isolates. In this study, we used a novel high-resolution typing technique, called whole-genome mapping (WGM), to differentiate between epidemiologically related and nonrelated
L. pneumophila
isolates. Assessment of the method by various validation experiments showed highly reproducible results, and WGM was able to confirm two well-documented Dutch
L. pneumophila
outbreaks. Comparison of whole-genome maps of the two outbreaks together with WGMs of epidemiologically nonrelated
L. pneumophila
isolates showed major differences between the maps, and WGM yielded a higher discriminatory power than SBT. In conclusion, WGM can be a valuable alternative to perform outbreak investigations of
L. pneumophila
in real time since the turnaround time from culture to comparison of the
L. pneumophila
maps is less than 24 h.
Superbugs on Duodenoscopes: the Challenge of Cleaning and Disinfection of Reusable Devices
Authors: Humphries Romney M. , McDonnell Gerald 
Published: July 2015

ABSTRACT

Inadequate flexible endoscope reprocessing has been associated with infection outbreaks, most recently caused by carbapenem-resistant
Enterobacteriaceae
. Lapses in essential device reprocessing steps such as cleaning, disinfection/sterilization, and storage have been reported, but some outbreaks have occurred despite claimed adherence to established guidelines. Recommended changes in these guidelines include the use of sterilization instead of high-level disinfection or the use of routine microbial culturing to monitor efficacy of reprocessing. This review describes the current standards for endoscope reprocessing, associated outbreaks, and the complexities associated with both microbiological culture and sterilization approaches to mitigating the risk of infection associated with endoscopy.