bluuebunny/crossref_metadata_2025_split huggingface dataset:
The kiwi fruit peptide kissper displays anti-inflammatory and anti-oxidant effects inin-vitroandex-vivohuman intestinal models
Authors: Ciacci C , Russo I , Bucci C , Iovino P , Pellegrini L , Giangrieco I , Tamburrini M , Ciardiello M A 
Published: October 2013

SummaryLiterature reports describe kiwi fruit as a food with significant effects on human health, including anti-oxidant and anti-inflammatory activity. Fresh fruit or raw kiwi fruit extracts have been used so far to investigate these effects, but the molecule(s) responsible for these health-promoting activities have not yet been identified. Kissper is a kiwi fruit peptide displaying pore-forming activity in synthetic lipid bilayers, the composition of which is similar to that found in intestinal cells. The objective of this study was to investigate the kissper influence on intestinal inflammation using cultured cells and ex-vivo tissues from healthy subjects and Crohn's disease (CD) patients. The anti-oxidant and anti-inflammatory properties of kissper were tested on Caco-2 cells and on the colonic mucosa from 23 patients with CD, by challenging with the lipopolysaccharide from Escherichia coli (EC-LPS) and monitoring the appropriate markers by Western blot and immunofluorescence. EC-LPS challenge determined an increase in the intracellular concentration of calcium and reactive oxygen species (ROS). The peptide kissper was highly effective in preventing the increase of LPS-induced ROS levels in both the Caco-2 cells and CD colonic mucosa. Moreover, it controls the calcium increase, p65-nuclear factor (NF)-kB induction and transglutaminase 2 (TG2) activation inflammatory response in Caco-2 cells and CD colonic mucosa. Kissper efficiently counteracts the oxidative stress and inflammatory response in valuable model systems consisting of intestinal cells and CD colonic mucosa. This study reports the first evidence supporting a possible correlation between some beneficial effects of kiwi fruit and a specific protein molecule rather than generic nutrients.
Cardiovascular morbidity and mortality in surgically treated hyperthyroidism – a nation‐wide cohort study with a long‐term follow‐up
Authors: Ryödi Essi , Salmi Jorma , Jaatinen Pia , Huhtala Heini , Saaristo Rauni , Välimäki Matti , Auvinen Anssi , Metso Saara 
Published: October 2013

SummaryObjectivePrevious studies suggest that patients with hyperthyroidism remain at an increased risk of cardiovascular morbidity even after restoring euthyroidism. The mechanisms of the increased risk and its dependency on the different treatment modalities of hyperthyroidism remain unclear. The aim of this long‐term follow‐up study was to compare the rate of hospitalizations for cardiovascular causes and the mortality in hyperthyroid patients treated surgically with an age‐ and gender‐matched reference population.Patients and MeasurementsA population‐based cohort study was conducted among 4334 hyperthyroid patients (median age 46 years) treated with thyroidectomy in 1986–2007 in Finland and among 12 991 reference subjects. Firstly, the hospitalizations due to cardiovascular diseases (CVD) were analysed until thyroidectomy. Secondly, the hazard ratios for any new hospitalization due to CVDs after the thyroidectomy were calculated in Cox regression analysis adjusted with the prevalent CVDs at the time of thyroidectomy.ResultsThe risk of hospitalization due to all CVDs started to increase already 5 years before the thyroidectomy, and by the time of the operation, it was 50% higher in the hyperthyroid patients compared to the controls (P < 0·001). After the thyroidectomy, the hospitalizations due to all CVDs (HR 1·15), hypertension (HR 1·23), heart failure (HR 1·17) and valvular diseases or cardiomyopathies (HR 1·55) remained more frequent among the patients than among the controls for 20 years after thyroidectomy. The increased morbidity was not clearly related to the aetiology of hyperthyroidism. Despite the increased CVD morbidity among the patients, there was no difference in cardiovascular mortality.ConclusionsThe present study shows that hyperthyroidism increases the risk of hospitalization due to CVDs and the risk is sustained up to two decades after effective surgical treatment. However, there was no excess CVD mortality in the middle‐aged patient cohort studied.
Definitive surgical closure of enterocutaneous fistula: outcome and factors predictive of increased postoperative morbidity
Authors: Ravindran P. , Ansari N. , Young C. J. , Solomon M. J. 
Published: October 2013

AbstractAimEnterocutaneous fistula (ECF) presents a complex management problem with significant mortality and morbidity. The aim of this study was to assess the outcome of patients undergoing surgical cure for ECF and to predict factors that might relate to increased postoperative morbidity.MethodMedical records of all patients who underwent definitive surgery for cure of an ECF within our colorectal surgery unit between 2000 and 2010 were reviewed.ResultsForty‐one patients (18 male) were identified, in whom 44 definitive procedures were performed. The median age was 54 (17–81) years. The median postoperative length of stay in hospital was 14 (2–213) days. Half (50%) of the ECFs occurred as a postoperative complication followed by spontaneous fistulation in Crohn's disease (36%). The interval to definitive surgery was influenced by the aetiology of the fistula. The median time to surgery after formation of postoperative fistula was 240 days (7.9 months). There was no 30‐day postoperative mortality. There were two (4.5%) recurrences at 3 months. Thirty‐eight (86%) patients suffered postoperative morbidity as defined by the Clavien–Dindo classification. High‐grade morbidity occurred in 32% of patients. On univariate analysis, factors identified as being significantly associated with high‐grade morbidity included a fistula output of > 500 ml/day (P = 0.004) in patients with postoperative ECF, malnutrition at presentation (P = 0.04) and a serum albumin value of < 30 g/l (P = 0.02) in patients with spontaneous ECF due to Crohn's disease.ConclusionThe majority of persistent complex ECFs can be cured surgically with low mortality and recurrence in a multidisciplinary setting. Postoperative morbidity, however, remains a significant burden.
Tolerability of sirolimus: a decade of experience at a single cardiac transplant center
Authors: Thibodeau Jennifer T. , Mishkin Joseph D. , Patel Parag C. , Kaiser Patricia A. , Ayers Colby R. , Mammen Pradeep P. A. , Markham David W. , Ring William Steves , Peltz Matthias , Drazner Mark H. 
Published: October 2013

AbstractSirolimus is used in cardiac transplant recipients to prevent rejection, progression of cardiac allograft vasculopathy, and renal dysfunction. However, sirolimus has many potential side effects and its tolerability when used outside of clinical trials is not well established. We describe a decade of experience with sirolimus in cardiac transplant recipients at our institution. We retrospectively reviewed records of all adult cardiac transplant recipients living between September 1999 and February 2010 (n = 329) and identified 67 patients (20%) who received sirolimus. The indications for sirolimus were cardiac allograft vasculopathy (67%), renal dysfunction (25%), rejection (4%), and intolerability of tacrolimus (3%). One‐third of patients discontinued sirolimus at a median (25th, 75th percentiles) of 0.9 (0.2, 1.6) yr of duration. Over 70% of subjects experienced an adverse event attributed to sirolimus. Adverse events were associated with higher average sirolimus levels (9.1 ng/mL vs. 7.1 ng/mL, p = 0.004). We conclude that sirolimus is frequently used in cardiac transplant recipients (20%) and commonly causes side effects, often necessitating discontinuation. Higher average sirolimus levels were associated with adverse events, suggesting that tolerability may improve if levels are maintained within the lower end of the current therapeutic range; however, the improvement in tolerability would need to be balanced with the potential for decreased efficacy.
Angry Birds Need Not Apply: A Perspective on the Flexible form and Multifunctionality of Avian Vocal Duets
Authors: Dahlin Christine R. , Benedict Lauryn 
Published: October 2013

AbstractResearch into avian vocal duets has revealed much about the social interactions of mated pairs, including how communication signals mediate important components of fitness such as reproductive success and resource‐holding ability. Excellent reviews have been written on avian duets, but none have quantified the prevalence of different duet features and functions, or tested for potential links between structure and function. Here we have compiled a thorough list of studies at the species level and investigated whether there are trends in duet form, trends in duet function and matches between form and function. We have also provided recommendations for reporting of duet structure to help standardize future data collection and facilitate comparative analyses. We found that duet vocalizations are typically tightly coordinated (69% of 33 species), initiated by both partners (80% of 35 species), and have sex‐specific contributions (73% of 48 species). Duets vary substantially in structure both across and within species, and this flexibility in duet form may contribute to their use in multiple contexts. Among the well‐studied species (functions well supported by experimental evidence and studied post‐1983), duets are usually multifunctional, with functions including joint resource defence, signalling commitment, maintaining contact, ensuring reproductive synchrony and mate‐guarding. Levels of support for different hypotheses have changed over time as theory within the field developed, but overall, the best‐supported function of duets across avian species (81% of 26 species) has been joint resource defence. In all but one of these 26 species, duets are sometimes cooperative (meaning that duet participation benefits both duetting partners), and they often produce multiple benefits. We found associations between form and function, in that duets directed to non‐pair individuals have higher amplitude and are more likely to have sex‐specific notes than duets directed within the pair. We see the field moving away from labelling duets as representing ‘cooperation’ or ‘conflict’ and moving towards a general multifunctionality framework within which researchers test multiple hypotheses for duet function under the assumption that both duet form and function can vary moment to moment and that such flexibility can provide multiple benefits.
Surgical treatment of synovial osteochondromatosis in the middle carpal joint of a pony
Authors: Newman J. C. , Lustgarten M. , Berman K. G. , Vivrette S. , Redding W. R. 
Published: October 2013

SummaryA 9‐year‐old Paint pony gelding presented for signs of left carpal swelling of 1–2 weeks' duration. Radiographic, ultrasonographic and arthroscopic evaluation of the left carpus was consistent with synovial osteochondromatosis. This presumptive clinical diagnosis was confirmed histopathologically. Arthroscopic removal of the osteochondral bodies resulted in resolution of the carpal effusion and return to previous athletic activity by 4.5 months post operatively. Arthroscopic removal of osteochondral bodies is the treatment of choice in cases of suspected synovial osteochondromatosis.
Nucleic acid delivery by cell penetrating peptides derived from dengue virus capsid protein: design and mechanism of action
Authors: Freire João M. , Veiga Ana Salomé , Rego de Figueiredo Inês , de la Torre Beatriz G. , Santos Nuno C. , Andreu David , Da Poian Andrea T. , Castanho Miguel A. R. B. 
Published: October 2013

Cell penetrating peptides (CPPs) can be used as drug delivery systems for different therapeutic molecules. In this work two novel CPPs, pepR and pepM, designed from two domains of the dengue virus (DENV) capsid protein, were studied for their ability to deliver nucleic acids into cells as non‐covalently bound cargo. Translocation studies were performed by confocal microscopy in HepG2, BHK and HEK cell lineages, astrocytes and peripheral blood mononuclear cells. Combined studies in HepG2 cells, astrocytes and BHK cells, at 4 and 37 °C or using specific endocytosis inhibitors, revealed that pepR and pepM use distinct internalization routes: pepM translocates lipid membranes directly, while pepR uses an endocytic pathway. To confirm these results, a methodology was developed to monitor the translocation kinetics of both peptides by real‐time flow cytometry. Kinetic constants were determined, and the amount of nucleic acids delivered was estimated. Additional studies were performed in order to understand the molecular bases of the peptide‐mediated translocation. Peptide–nucleic acid and peptide–lipid membrane interactions were studied quantitatively based on the intrinsic fluorescence of the peptides. pepR and pepM bound ssDNA to the same extent. Partition studies revealed that both peptides bind preferentially to anionic lipid membranes, adopting an α‐helical conformation. However, fluorescence quenching studies suggest that pepM is deeply inserted into the lipid bilayer, in contrast with pepR. Moreover, only pepM is able to promote the fusion and aggregation of vesicles composed of zwitterionic lipids. Altogether, the results show that DENV capsid protein derived peptides serve as good templates for novel CPP‐based nucleic acid delivery strategies, defining different routes for cell entry.
Pathological upgrading and upstaging of patients eligible for active surveillance according to currently used protocols
Authors: Kim Tae Heon , Jeon Hwang Gyun , Choo Seol Ho , Jeong Byong Chang , Seo Seong Il , Jeon Seong Soo , Choi Han Yong , Lee Hyun Moo 
Published: October 2013

ObjectivesTo investigate the ability of six contemporary active surveillance protocols to appropriately select active surveillance candidates among Korean men who underwent radical prostatectomy.MethodsBetween January 2001 and December 2011, 1968 patients underwent radical prostatectomy for prostate cancer at Samsung Medical Center, Seoul, Korea. Patients met the criteria for active surveillance according to six currently used criteria, including those from the Johns Hopkins Hospital, the University of Toronto, the University of California at San Francisco, the Prospective Prostate Cancer Research International Active Surveillance, the University of Miami and the Memorial Sloan‐Kettering Cancer Center. The rates of Gleason score upgrading, upstaging and misclassification at final pathology were assessed.ResultsAmong 1006 assessable patients, the percentage of men eligible for active surveillance varied from 13.5% to 38.5%, depending on the criteria used. The rates of upgrading ranged from 41.6% to 50.6%. Extracapsular extension was reported in 4.1% to 8.5% of patients, whereas seminal vesicle invasion was reported in 0.5% to 1.6% of patients. The upstaging rates according to the six active surveillance criteria varied from 4.5% to 9.3%, and the rates of misclassification varied from 44.5% to 54.8%.ConclusionsCurrently available active surveillance criteria might not be suitable in Korean patients with prostate cancer, as they have a high likelihood of underestimating cancer.
Improving the physical health of people with severe mental illness: Boundaries of care provision
Authors: Ehrlich Carolyn , Kendall Elizabeth , Frey Nicolette , Kisely Steve , Crowe Elizabeth , Crompton David 
Published: October 2013

AbstractThere is compelling evidence that the physical health of people with severe mental illness is poor. Health‐promotion guidelines have been recommended as a mechanism for improving the physical health of this population. However, there are significant barriers to the adoption of evidence‐based guidelines in practice. The purpose of this research was to apply existing implementation theories to examine the capability of the health system to integrate physical health promotion into mental health service delivery. Data were collected within a regional city in Queensland, Australia. Fifty participants were interviewed. The core theme that emerged from the data was that of ‘care boundaries’ that influenced the likelihood of guidelines being implemented. Boundaries existed around the illness, care provision processes, sectors, the health‐care system, and society. These multilevel boundaries, combined with participants' ways of responding to them, impacted on capability (i.e. the ability to integrate physical health promotion into existing practices). Participants who were able to identify strategies to mediate these boundaries were better positioned to engage with physical health‐promotion practice. Thus, the implementation of evidence‐based guidelines depended heavily on the capability of the workforce to develop and adopt boundary‐mediating strategies.
A study on glabellar wrinkle patterns in Koreans
Authors: Kim H.S. , Kim C. , Cho H. , Hwang J.Y. , Kim Y.S. 
Published: October 2013

AbstractBackgroundBotulinum toxin is a well‐established treatment for dynamic glabellar lines. The glabella is in fact, the most common site for botulinum toxin injection in Asians. Previous studies have identified five glabellar contraction patterns according to the predominance of eyebrow approximation, depression or elevation. Unfortunately, the authors found the former classification somewhat confusing.ObjectiveTo identify and classify glabellar wrinkle patterns in Koreans for a better treatment approach. We also aimed to provide an Asian consensus recommendation for the individual wrinkle pattern.MethodsA retrospective photographic analysis of 139 Korean patients who received botulinum toxin for the first time to treat glabellar wrinkles was conducted. The wrinkle patterns were identified and classified by a panel of experienced Korean dermatologists, based on the prevalence of perpendicular and transverse glabellar lines, the nasal wrinkles and the forehead wrinkles. The panel also convened to develop a clinical consensus on the individual wrinkle pattern in Asians.ResultsFive patterns were identified: (1) ‘U’, (2) ‘11′, (3) ‘X’, (4) ‘π (Phi)’ and (5) ‘I’. The classification method allowed indentifying the most important muscles in each wrinkle pattern. The consensus recommendation addressed the most heavily used muscles to receive higher doses and to be injected into a larger number of sites. Those less solicited muscles were left untreated or received lower doses, allowing for more effective and natural results.ConclusionInterpersonal differences in facial animation exist among Koreans. We hope our simple glabellar wrinkles classification enables a more accurate, individualized treatment with botulinum toxin in Asians.
Anti‐MDA5 positive clinically amyopathic dermatomyositis presenting with severe cardiomyopathy
Authors: Pau‐Charles I. , Moreno P.J. , Ortiz‐Ibáñez K. , Lucero M.C. , Garcia‐Herrera A. , Espinosa G. , Nicolás J.M. , Castro P. , Grau J.M. , Casciola‐Rosen L. , Mascaró J.M. 
Published: October 2013

AbstractBackgroundAnti‐MDA5 (Melanoma differentiation‐associated gene 5) positive dermatomyositis is a new variant of clinically amyopathic dermatomyositis that presents with characteristic mucocutaneous findings and is associated with a higher risk of developing rapidly progressive interstitial lung disease. Because its presentation differs from that of classical dermatomyositis, this entity can be a diagnostic challenge for the clinician.Methods & ResultsWe present the case of a 55‐year‐old male with a 7‐month history of chill sensation, constitutional symptoms and polyarthralgia. Within 3 months, the patient developed progressive heart failure with dyspnoea and orthopnoea, together with characteristic cutaneous lesions. Skin biopsies demonstrated thrombosis of small and medium‐sized arteries in the reticular dermis, together with an evolved lobular panniculitis and prominent mucin deposits.ConclusionsClinicians should be aware of the characteristic clinical and histopathologic presentation of this variant of dermatomyositis to establish an early diagnosis. Further evidence is needed to clarify the risk of cardiac involvement in this subset of patients.
Variability in Maximal Suggested Door‐in‐Door‐out Time for Hospitals Transferring Patients for Primary Angioplasty in STEMI
Authors: HARJAI KISHORE J. , ORSHAW PAMELA , YAEGER LYNNE , ELLIS GEORGE , KIRTANE AJAY 
Published: October 2013

AbstractObjectivesWe derived a formula for maximal suggested door‐in‐door‐out time (DIDO) for hospitals that do not perform primary percutaneous coronary intervention (PCI) for ST‐elevation myocardial infarction (STEMI).BackgroundEfforts to minimize DIDO at non‐PCI hospitals can improve door‐to‐balloon time (D2B). Targeting a maximal suggested DIDO for a transferring hospital can influence reperfusion strategy.MethodsWe examined time to treatment intervals for 193 STEMI patients who underwent primary PCI at our hospital. D2B in transferred patients (D2BT) was divided into 3 intervals: transferring hospital DIDO, inter‐hospital transport time, and interventional time. We defined maximal suggested DIDO as the maximum DIDO that would allow PCI with D2BT ≤120 minutes.ResultsD2B was higher in transfer compared to on‐site patients (147 ± 52 vs. 75 ± 44 minutes, P < 0.0001). In transfer patients, treatment time intervals were: DIDO 80 ± 42 minutes, transport time 37 ± 18 minutes, interventional time 35 ± 16 minutes. The greatest variability in D2BT was related to DIDO. We estimated that maximal suggested DIDO = [120 − (transport time plus interventional time)]. Using a fixed interventional time of 40 minutes, we simplified this as: maximal DIDO = 80 − transport time. Maximal suggested DIDO for 4 transferring hospitals in our network ranged from 1 to 65 minutes. DIDO under the hospital‐specific threshold was the strongest predictor of achieving D2BT <120 minutes.ConclusionsTransferring hospitals' maximal suggested DIDO is variable, and can be calculated from inter‐hospital transport time. Instead of a universal target DIDO (e.g., <30 minutes), maximal suggested DIDO can be calculated individually for each non‐PCI hospital within a STEMI network.
Working with young people: Evaluation of an education resource for medical trainees
Authors: Sawyer Susan M , Conn Jennifer J , Reid Katharine J , Dodds Agnes E , Hudson Lee , Yeo Michele , Proimos Jenny 
Published: October 2013

AimMany health professionals report interest in consulting more effectively with young people but have unmet training needs. We set out to evaluate a teaching resource in adolescent health and medicine that was designed for Australian trainees in specialist medicine.MethodsThirty‐two paediatric and adult trainees of the Royal Australasian College of Physicians completed a pre‐evaluation questionnaire to assess attitudes and confidence in working with young people. They were then provided with a training resource and, 6 weeks later, completed a post‐evaluation questionnaire. Repeated‐measures anovas were used to assess changes in attitudes, self‐reported knowledge and confidence by trainee type. χ2‐tests were used to compare variation in the use of and opinions about the resource.ResultsTrainees' awareness of the health issues that affect young people, confidence in working with young people and confidence in their knowledge greatly improved after using the resource. Beforehand, adult medicine trainees scored lower than paediatric trainees. A relatively higher rate of improvement resulted in similar scores between trainee types after using the resource, which was rated equally highly by the different groups of trainees.ConclusionsAs a result of significant gains in the confidence of specialist medicine trainees after access to the resource, it will now be made available for Australian trainees in specialist medicine.