bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of bi‐planar tissue expanders to augment abdominal domain in a pediatric intestinal transplant recipient
Authors: Weiner Joshua , Wu June , Martinez Mercedes , Lobritto Steven , Ovchinsky Nadia , Rohde Christine , Griesemer Adam , Kato Tomoaki 
Published: July 2014

AbstractIntestinal transplantation is a well‐accepted treatment for SBS. However, patients with SBS often have decreased abdominal capacity, which makes size‐matching of donor organs more difficult, thus decreasing organ availability. Reported approaches for addressing this problem include surgically reducing the graft size, leaving an open abdomen for a prolonged period, and cotransplanting rectus fascia as a non‐vascularized allograft. Each approach has significant disadvantages. There has been one previous report of tissue expanders used intra‐abdominally and two reports of subcutaneous use to increase intra‐abdominal capacity prior to transplantation. We report the first use of bi‐planar expander placement for this purpose. In our case, a two‐yr‐old male child with SBS due to malrotation was treated with tissue expanders 10 months prior to intestinal transplantation, thus allowing transplantation of a larger graft with the ability to close the abdomen safely. There were no complications, and the patient is now doing well and tolerating diet off PN. The use of tissue expanders prior to intestinal transplantation is a promising approach for such patients and avoids the morbidity associated with other approaches. This approach requires a multidisciplinary effort by gastroenterology, transplant surgery, and plastic surgery teams.
Waiting for transplant: Physical, psychosocial, and nutritional status considerations for pediatric candidates and implications for care
Authors: Anthony Samantha J. , Annunziato Rachel A. , Fairey Elise , Kelly Vicky L. , So Stephanie , Wray Jo 
Published: July 2014

AbstractThe waiting period for an organ transplant has been described as a time of tremendous uncertainty and vulnerability, posing unique challenges and stressors for pediatric transplant candidates and their families. It has been identified as the most stressful stage of the transplant journey, yet little attention has been given to the physical, psychological, or social impact of the waiting period in the literature. In this review, we discuss the physical, nutritional, and psychosocial implications of the waiting period for child and adolescent transplant candidates and the impact on their parents and siblings. We identify areas for future research and provide recommendations for clinical practice to support children, adolescents, and families during the waiting period.
Upregulation of α‐enolase in acute rejection of cardiac transplant in rat model: Implications for the secretion of interleukin‐17
Authors: Shi Jiahai , Li Yangcheng , Yang Xuechao , Yang Dunpeng , Zhang Yinghui , Liu Yonghua 
Published: July 2014

AbstractAcute allograft rejection remains a major problem in solid organ transplantation. The enzyme α‐enolase has been shown to induce an immune response in cardiac transplantation. In this study, we investigated the role of α‐enolase in acute allograft rejection in a rat model of heart transplantation. Hearts from either (WF: RT1u) or (Lew: RT11) rats were transplanted into (Lew: RT11) rats. No rejection occurred in the isograft group, for which the median survival time was >168 days, whereas the median survival time of the allograft group was significantly less at 10 ± 2.1 days (n = 8 per group, p < 0.001). Increased inflammation was observed in allografts, including increased α‐enolase expression and increased numbers of infiltrating CD4+ T cells (p < 0.05). By immunohistochemical staining, we confirmed that α‐enolase was expressed not only in myocardial cells but also in the infiltrating lymphocytes. However, on the fifth day after transplantation, α‐enolase expression was no longer observed in the lymphocytes (n = 3, p < 0.001). In contrast, no lymphocytes were found in isografts after transplantation (n = 3, p < 0.001). α‐enolase expression was increased in lymphocytes, which are implicated in the acute rejection of cardiac transplants. Intragraft α‐enolase inhibition may be useful as an adjuvant therapy to systemic immunosuppression in heart transplantation.
Cellular Changes Associated with the Acclimation of the Intertidal Sea AnemoneActinia tenebrosato Ultraviolet Radiation
Authors: Cubillos Victor M. , Lamare Miles D. , Peake Barrie M. , Burritt David J. 
Published: July 2014

AbstractTo assess the relative importance of long‐ and short‐term cellular defense mechanisms in seasonallyUV‐R‐acclimatedActinia tenebrosa(Anthozoa,Actiniidae), individuals were exposed to summer doses ofPAR,UV‐A,UV‐Band enhancedUV‐B(20%) for a period of 4 days. Mycosporine‐like amino acids (MAAs) and cyclobutane pyrimidine dimer (CPD) concentrations were quantified, while oxidative damage to lipids and proteins, and the activities or levels of the antioxidant enzymesSOD,CAT,GR,GPOXand total glutathione were determined. Our results show that summerUV‐R‐acclimated individuals had a higherUV‐Rtolerance, with no significant increases inCPDs levels, than winter‐acclimated sea anemones possibly due to higherMAAconcentrations. Summer‐acclimated individuals showed increased lipid and protein oxidation andGPOXactivity only when they were exposed toUV‐Bat 20% above ambientUV‐Rlevels. In contrast, winter‐acclimated sea anemones showed elevated levels of oxidative damage,GPOXandSODactivities after exposure toUV‐AorUV‐Bat ambient and elevated levels. Thus, this study indicates that long‐termUV‐Racclimation mechanisms such as the accumulation ofMAAs could be more important than short‐term increases in antioxidant defenses with respect to reducing indirectUV‐Rdamage in intertidal sea anemones.
Occupational Allergy to Flowers: Immunoblot Analysis of Allergens in Freesia, Gerbera and Chrysanthemum Pollen
Authors: van Toorenenbergen A. W. 
Published: July 2014

AbstractHigh exposure to pollen from ornamental flowers can induce an IgE‐mediated occupational allergy in florists and horticulture workers. We investigated IgE‐binding antigens in chrysanthemum, freesia and gerbera pollen by immunoblot analysis and analysed the cross‐reactivity of these pollen with birch, grass and mugwort pollen. In immunoblots with chrysanthemum pollen, major IgE‐binding structures were seen with a molecular weight (MW) of approximately 25, 45 and 65 kD. In the immunoblots with freesia pollen, IgE from freesia pollen was directed against two proteins with an MW of approximately 15 kD. Most sera showed IgE binding to an approximately 15 kD band in gerbera pollen; with some sera additional bands were seen in the range of 30–50 kD. IgE binding to chrysanthemum pollen was inhibited by mugwort pollen only, whereas IgE binding to freesia pollen was suppressed by birch, grass and mugwort pollen. The inhibitory activity of birch and grass pollen extract on IgE binding to gerbera pollen extract was serum dependent and ranged from no inhibition to complete inhibition. Occupational exposure to many different flowers induced IgE against all three types of pollen. Exposure in greenhouses to gerbera flowers elicited mainly IgE against gerbera pollen. Mugwort pollen extract inhibited IgE binding to pollen from all three flowers.
Temperature profiles of different cooling methods in porcine pancreas procurement
Authors: Weegman Bradley P. , Suszynski Thomas M. , Scott William E. , Ferrer Fábrega Joana , Avgoustiniatos Efstathios S. , Anazawa Takayuki , O'Brien Timothy D. , Rizzari Michael D. , Karatzas Theodore , Jie Tun , Sutherland David E. R. , Hering Bernhard J. , Papas Klearchos K. 
Published: July 2014

AbstractPorcine islet xenotransplantation is a promising alternative to human islet allotransplantation. Porcine pancreas cooling needs to be optimized to reduce the warm ischemia time (WIT) following donation after cardiac death, which is associated with poorer islet isolation outcomes. This study examines the effect of four different cooling Methods on core porcine pancreas temperature (n = 24) and histopathology (n = 16). All Methods involved surface cooling with crushed ice and chilled irrigation. Method A, which is the standard for porcine pancreas procurement, used only surface cooling. Method B involved an intravascular flush with cold solution through the pancreas arterial system. Method C involved an intraductal infusion with cold solution through the major pancreatic duct, and Method D combined all three cooling Methods. Surface cooling alone (Method A) gradually decreased core pancreas temperature to <10 °C after 30 min. Using an intravascular flush (Method B) improved cooling during the entire duration of procurement, but incorporating an intraductal infusion (Method C) rapidly reduced core temperature 15–20 °C within the first 2 min of cooling. Combining all methods (Method D) was the most effective at rapidly reducing temperature and providing sustained cooling throughout the duration of procurement, although the recorded WIT was not different between Methods (P = 0.36). Histological scores were different between the cooling Methods (P = 0.02) and the worst with Method A. There were differences in histological scores between Methods A and C (P = 0.02) and Methods A and D (P = 0.02), but not between Methods C and D (P = 0.95), which may highlight the importance of early cooling using an intraductal infusion. In conclusion, surface cooling alone cannot rapidly cool large (porcine or human) pancreata. Additional cooling with an intravascular flush and intraductal infusion results in improved core porcine pancreas temperature profiles during procurement and histopathology scores. These data may also have implications on human pancreas procurement as use of an intraductal infusion is not common practice.
Lung xenotransplantation: recent progress and current status
Authors: Harris Donald G. , Quinn Kevin J. , Dahi Siamak , Burdorf Lars , Azimzadeh Agnes M. , Pierson Richard N. 
Published: July 2014

AbstractXenotransplantation has undergone important progress in controlling initial hyperacute rejection in many preclinical models, with some cell, tissue, and organ xenografts advancing toward clinical trials. However, acute injury, driven primarily by innate immune and inflammatory responses, continues to limit results in lung xenograft models. The purpose of this article is to review the current status of lung xenotransplantation—including the seemingly unique challenges posed by this organ—and summarize proven and emerging means of overcoming acute lung xenograft injury.
The increase in body weight induced by lack of methyl CpG binding protein‐2 is associated with altered leptin signalling in the hypothalamus
Authors: Torres‐Andrade Rodrigo , Moldenhauer Rodrigo , Gutierrez‐Bertín Noemí , Soto‐Covasich Jessica , Mancilla‐Medina Cristian , Ehrenfeld Carolina , Kerr Bredford 
Published: July 2014

New Findings
What is the central question of this study?
Previous evidence shows that some patients and mouse models carrying mutations in the methyl CpG binding protein‐2 (MECP2) gene are overweight. However, the underlying mechanism associated with this phenotype has not been fully elucidated.
What is the main finding and its importance?
Using Mecp2‐null mice, we found that the absence of methyl CpG binding protein‐2 produces a deregulation in leptin signalling and alters the expression of key genes involved in body weight control. These results allow us to gain insight into the cellular mechanisms associated with leptin resistance and obesity.
Methyl CpG binding protein‐2 (MECP2) is a chromatin‐remodelling factor with a dual role in gene expression. Evidence from patients carrying MECP2 mutations and from transgenic mouse models demonstrates that this protein is involved in the control of body weight. However, the mechanism for this has not been fully elucidated. To address this, we used a previously characterized Mecp2‐null mouse model and found that the increase in body weight is associated with an increased amount of adipose tissue and high leptin levels. Appropriate body weight control requires the proper expression of pro‐opiomelanocortin (Pomc) and agouti‐related peptide (Agrp), two neuropeptides essential for satiety and appetite signals, respectively. Our results show that in the absence of Mecp2, Pomc and Agrp mRNA expression are altered, and the mice are leptin resistant. To determine the mechanism underlying the defective leptin sensing, we evaluated the expression of genes and the post‐translational modifications associated with leptin signalling, which are fundamental to Pomc and Agrp transcriptional control and proper leptin response. We found a decrease in the phosphorylation level of Akt and its target protein Foxo1, which indicate an alteration in leptin‐induced signal transduction. Our results demonstrate that the absence of Mecp2 disrupted body weight balance by altering post‐translational modifications in leptin‐signalling components that regulate Pomc and Agrp expression.
The International Rugby Board (IRB) Pitch Side Concussion Assessment trial: a pilot test accuracy study
Authors: Fuller Gordon Ward , Kemp Simon P T , Decq Philippe 
Published: July 2014

Background‘On the field and on the run’ assessments of head impact events in professional rugby have resulted in a high proportion of players subsequently diagnosed with confirmed concussion not leaving the field of play at the time of injury. The International Rugby Board (IRB) consequently developed a process to support team doctors in the recognition and management of players at risk of concussion, including development of a multimodal assessment instrument—the Pitch Side Concussion Assessment (PSCA) tool.MethodsThis was a pilot cohort study designed to determine the feasibility of assessing the accuracy of the IRB PSCA tool in elite male rugby. The study population comprised consecutive players identified with a head impact event with the potential to result in concussion during eight international/national competitions. Players were assessed off field by match-day or team doctors, following a temporary substitution. The accuracy of the PSCA tool was measured against a reference standard of postmatch confirmed concussion, based on clinical judgement aided by an established concussion support instrument.ResultsA total of 165 head injury events with the potential to cause concussion were included in the study. The PSCA tool demonstrated a sensitivity of 84.6% (95% CI 73.5% to 92.4%) and a specificity of 74% (95% CI 64.3% to 82.3%) to identify players subsequently diagnosed with confirmed concussion. The negative predictive value was 88.1% (95% CI 79.2% to 94.1%); the positive predictive value was 67.9% (95% CI 56.6% to 77.8%). There were no major barriers identified that would prevent the evaluation of the PSCA process or tool in a future large-scale study.ConclusionsThis pilot study has provided the first preliminary estimates for the performance of the PSCA tool, suggesting a potentially favourable balance between positive and negative predictive values. The study has also offered a strong basis to conduct a further larger trial, providing information for sample size calculations and highlighting areas for methodological development.
A cross-sectional survey investigating the desensitisation of graphic health warning labels and their impact on smokers, non-smokers and patients with COPD in a London cohort
Authors: Ratneswaran Culadeeban , Chisnall Ben , Drakatos Panagis , Sivakumar Sukhanthan , Sivakumar Bairavie , Barrecheguren Miriam , Douiri Abdel , Steier Joerg 
Published: July 2014

ObjectivesThere is a lack of evidence regarding the effectiveness of graphic health warning labels (GHWL) in different individuals, including patients with chronic obstructive pulmonary disease (COPD). Investigating knowledge and attitudes may allow better implementation of future public health policies. We hypothesised that differences in the impact of GHWL exist between non-smokers, smokers and patients with COPD, with decreased efficacy in those groups who are longer and more frequently exposed to them.Participants and setting163 participants (54% male, aged 21–80) including 60 non-smokers, 53 smokers and 50 patients with COPD (Gold stage II–IV), attending London respiratory outpatient clinics, participated in case-controlled surveys (50 items).Outcome measuresTen different GHWL were shown and demographics, smoking history, plans to quit, smoking-risk awareness, emotional response, processing and impact of GHWL on behaviour were recorded. Patients were further asked to prioritise the hypothetical treatment or prevention of five specific smoking-related diseases.ResultsSmokers, in particular those with COPD, were less susceptible to GHWL than non-smokers; 53.4% of all participants expressed fear when looking at GHWL, non-smokers (71.9%) more so than smokers (39.8%, p<0.001). COPD participants were less aware of the consequences than non-COPD participants (p<0.001), including an awareness of lung cancer (p=0.001). Lung cancer (95%), oral cancer (90.2%), heart disease (84.7%) and stroke (71.2%) were correctly associated with smoking, whereas blindness was least associated (23.9%). However, blindness was prioritised over oral cancer, stroke and in patients with COPD also over heart disease when participants were asked about hypothetical treatment or prevention.ConclusionsGHWL are most effective in non-smokers and a desensitisation effect was observed in smokers and patients with COPD. As a consequence, a tailored and concerted public health approach to use such messages is required and ‘blindness’ deserves to be mentioned in this context because of an unexpectedly high-deterring impact.
Clinical questions raised by providers in the care of older adults: a prospective observational study
Authors: Del Fiol Guilherme , Weber Alice I , Brunker Cherie P , Weir Charlene R 
Published: July 2014

ObjectiveTo characterise clinical questions raised by providers in the care of complex older adults in order to guide the design of interventions that can help providers answer these questions.Materials and methodsTo elicit clinical questions, we observed and audio recorded outpatient visits at three healthcare organisations. At the end of each appointment, providers were asked to identify clinical questions raised in the visit. Providers rated their questions based on their urgency, importance to the patient's care and difficulty in finding a useful answer to. Transcripts of the audio recordings were analysed to identify ageing-specific factors that may have contributed to the nature of the questions.ResultsWe observed 36 patient visits with 10 providers at the three study sites. Providers raised 70 clinical questions (median of 2 clinical questions per patient seen; range 0–12), pursued 50 (71%) and successfully answered 34 (68%) of the questions they pursued. Overall, 36 (51%) of providers’ questions were not answered. Over one-third of the questions were about treatment alternatives and adverse effects. All but two clinical questions were motivated either directly or indirectly by issues related to ageing, such as the normal physiological changes of ageing and diseases with higher prevalence in the elderly.ConclusionsThe frequency of clinical questions was higher than in previous studies conducted in general primary care patient populations. Clinical questions were predominantly influenced by ageing-related issues. We propose a series of recommendations that may be used to guide the design of solutions to help providers answer their clinical questions in the care of older adults.
Shorter or longer anticoagulation to prevent recurrent venous thromboembolism: systematic review and meta-analysis
Authors: Lopes Luciane Cruz , Eikelboom John , Spencer Frederick A , Akl Elie A , Kearon Clive , Neumann Ignacio , Schulman Sam , Bhatnagar Neera , Guyatt Gordon 
Published: July 2014

IntroductionVenous thromboembolism (VTE) is a major disease associated with short-term and long-term morbidity and mortality. Patients with a VTE provoked by surgery or immobilisation are at low risk of recurrence and do not require long-term anticoagulation; those with a VTE and metastatic cancer are at high risk of recurrence and require lifetime thromboprophylaxis. In those at intermediate risk of recurrence, it remains controversial whether prolonging anticoagulation and thus incurring treatment burden and bleeding risk is warranted.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised controlled trials enrolling patients with VTE at intermediate risk of recurrence and evaluating short-term anticoagulation (12 weeks to 9 months initial therapy) versus longer term anticoagulation (at least 6 months additional anticoagulation beyond the course of treatment in the shorter arm). Anticoagulation could consist of vitamin K antagonists or new oral anticoagulants. Outcomes of interest include recurrent non-fatal thrombosis (deep venous thrombosis and pulmonary embolism), major non-fatal bleeding and mortality. We will systematically search CINAHL, EMBASE, MEDLINE and the Cochrane Central Registry of Controlled Trials. Teams of two reviewers will, independently and in duplicate, screen titles and abstracts and complete full text reviews to determine eligibility, and subsequently abstract data and assess risk of bias in eligible trials. We will conduct meta-analyses to establish the effect of short-term versus long-term anticoagulation on the outcomes of interest and evaluate confidence in estimates (quality of evidence) using the GRADE (grading of recommendations, assessment, development and evaluation) approach.Ethics and disseminationOur review will facilitate evidence-based management of patients with unprovoked or recurrent VTE. For purposes of privacy and confidentiality, the systematic review will be limited to studies with deidentified data. The study will be disseminated by peer-review publication and conference presentation.Trial registration numberPROSPERO (CRD42014007620).
NKX3.1 is expressed in ER-positive and AR-positive primary breast carcinomas
Authors: Asch-Kendrick Rebecca J , Samols Mark A , Lilo Mohammed T , Subhawong Andrea P , Sharma Rajni , Illei Peter B , Argani Pedram , Cimino-Mathews Ashley 
Published: July 2014

AimsNKX3.1is an androgen-regulated tumour suppressor gene that is downregulated in prostate carcinoma. Immunohistochemistry for NKX3.1 is primarily specific for prostatic-derived tumours and tissue but is reported in a small number of breast carcinomas. NKX3.1 is also shown to inhibit estrogen receptor (ER) signalling in breast carcinoma models. Here, we investigate labelling of NKX3.1 in invasive ductal (IDC) and lobular (ILC) carcinomas of the breast with full characterisation of ER, progesterone receptor (PR), androgen receptor (AR) and Her2 status.MethodsTissue microarrays of 86 primary IDC and 37 ILC were labelled for NKX3.1. The IDC consisted of 20 luminal A, 7 luminal B, 14 Her2, and 45 triple negative carcinomas. The ILC consisted of 34 luminal A and 3 luminal B cases. NKX3.1 expression was scored as percentage nuclear labelling and labelling intensity.ResultsNuclear NKX3.1 labelling was seen in 2 IDC (2%) and 10 ILCs (27%). labelling intensity was weak in all cases (1–100% nuclear positivity). Positive NKX3.1 labelling was significantly associated with ILC (p<0.0001). NKX3.1 labelling was seen only in ER and AR-positive carcinomas, which showed a significant correlation (p=0.0003 and p=0.0079, respectively). Expression was not correlated with tumour stage, size, Her2 expression, presence of lymph node metastases or age.ConclusionsThis is the first study to evaluate NKX3.1 expression in breast carcinomas with known ER, PR, AR and Her2 status. Further studies are needed to evaluate what potential role NKX3.1 plays in ER and AR signalling and hormonal treatment response in breast carcinomas.