bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nasotracheal intubation with three indirect laryngoscopes assisted by standard or modified Magill forceps
Authors: Staar S. , Biesler I. , Müller D. , Pförtner R. , Mohr C. , Groeben H. 
Published: March 2013

SummaryWe assessed the effect of modifying standard Magill forceps on the laryngeal introduction of an Eschmann stylet during nasotracheal intubations with three indirect laryngoscopes (Airtraq™, C‐MAC® or GlideScope®) in patients with predicted difficult intubation. We allocated 50 participants to each laryngoscope. The stylet was advanced by one forceps followed by the other (standard or modified), with each sequence allocated to 25/50 for each laryngoscope. There were no differences in rates of failed tracheal intubation with the allocated laryngoscopes: 6/50, 5/50 and 5/50, respectively. An Eschmann stylet was advanced into the trachea less often with the standard forceps (65% vs 93%, p < 0.0001). Mean (SD) time for stylet advancement was longer with the standard forceps, 38 (30) vs 19 (19) s, p < 0.0001. In conclusion, the modified Magill forceps facilitated nasotracheal intubation, independent of the type of indirect laryngoscope.
Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions
Authors: McGowan Yvonne , Humphries Niamh , Burke Helen , Conry Mary , Morgan Karen 
Published: March 2013

BackgroundHospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations.ObjectiveThis article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times.DesignA qualitative methodology was chosen.MethodsSemi‐structured in‐depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software.ResultsDominant themes included the following: (1) unrealistic workloads: characterized by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep‐deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings.ConclusionRespondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several ‘red flags’, which need to be addressed in order to increase retention and sustain a motivated junior medical workforce.Statement of contribution

What is already known on this subject?

Loss of public funding in Ireland has led to large numbers of Irish trained doctors emigrating.

Research indicates the likelihood of medical graduates returning depends on improvements to working conditions.

Good working conditions are likely to encourage doctor retention yet little research has been conducted in this area.

What does this study add?

Intense workplace demands reduce confidence and productivity among doctors.

Junior doctors were reluctant to reflect on the impact current working conditions had on their own health.

Early warning signs of burnout appear to resonate with many of the issues raised by junior doctors in this study.
Nasal lysine aspirin challenge in the diagnosis of aspirin ‐ exacerbated respiratory disease
Authors: Miller B. , Mirakian R. , Gane S. , Larco J. , Sannah A. A. , Darby Y. , Scadding G. 
Published: March 2013

SummaryBackgroundAspirin‐exacerbated respiratory disease is under‐diagnosed and therefore effective and inexpensive therapy with aspirin desensitization is rarely performed.MethodsWe present an audit of 150 patients with difficult to treat nasal polyposis, 132 of whom also had asthma, 131 of whom underwent challenge with the only soluble form of aspirin, lysine aspirin (LAS), to confirm or exclude the diagnosis of aspirin‐exacerbated respiratory disease (AERD).ResultsOne hundred patients proved positive on nasal challenge, 31 who were negative went onto oral LAS challenge and a further 14 gave positive results, leaving 17 who were negative to a dose equivalent to over 375 mg of aspirin. Nineteen were not challenged because of contraindications.With the exception of one patient who developed facial angioedema and two patients with > 20% drop in FEV1 (following nasal plus oral challenge) no other severe adverse events occurred. No hospitalization was required for these three patients.Nasal inspiratory peak flow monitoring was less sensitive to obstruction caused by aspirin than was acoustic rhinometry – which should be employed when aspirin challenge is an outpatient procedure.ConclusionsProvided patients are carefully chosen and monitored LAS challenge is suitable for ENT day case practice where respiratory physician help with asthma is available and should reduce the under‐diagnosis of this condition.
The Emerging Use of Ketamine for Anesthesia and Sedation in Traumatic Brain Injuries
Authors: Chang Lee C. , Raty Sally R. , Ortiz Jaime , Bailard Neil S. , Mathew Sanjay J. 
Published: March 2013

SummaryTraditionally, the use of ketamine for patients with traumatic brain injuries is contraindicated due to the concern of increasing intracranial pressure (ICP). These concerns, however, originated from early studies and case reports that were inadequately controlled and designed. Recently, the concern of using ketamine in these patients has been challenged by a number of published studies demonstrating that the use of ketamine was safe in these patients. This article reviews the current literature in regards to using ketamine in patients with traumatic brain injuries in different clinical settings associated with anesthesia, as well as reviews the potential mechanisms underlying the neuroprotective effects of ketamine. Studies examining the use of ketamine for induction, maintenance, and sedation in patients with TBI have had promising results. The use of ketamine in a controlled ventilation setting and in combination with other sedative agents has demonstrated no increase in ICP. The role of ketamine as a neuroprotective agent in humans remains inconclusive and adequately powered; randomized controlled trials performed in patients undergoing surgery for traumatic brain injury are necessary.
Homovanillic acid in cerebrospinal fluid of 1388 children with neurological disorders
Authors: Molero‐Luis Marta , Serrano Mercedes , Ormazábal Aida , Pérez‐Dueñas Belén , García‐Cazorla Àngels , Pons Roser , Artuch Rafael ,   The Neurotransmitter Working Group
Published: March 2013

AimTo determine the prevalence of dopaminergic abnormalities in 1388 children with neurological disorders, and to analyse their clinical, neuroradiological, and electrophysiological characteristics.MethodWe studied biogenic amines in 1388 cerebrospinal fluid (CSF) samples from children with neurological disorders (mean age 3y 10mo, SD 4y 5mo; 712 males, 676 females. Correlations among CSF homovanillic acid (HVA) values and other biochemical, clinical, neuroradiological, and electrophysiological parameters were analysed.ResultsTwenty‐one patients with primary dopaminergic deficiencies were identified. Of the whole sample, 20% showed altered HVA. We report neurological diseases with abnormal CSF HVA values such as pontocerebellar hypoplasia, perinatal asphyxia, central nervous system infections, mitochondrial disorders, and other genetic diseases. Overlapping HVA levels between primary and secondary dopamine deficiencies were observed. Prevalence of low CSF HVA levels was significantly higher in neonatal patients (χ2=84.8, p<0.001). Abnormalities in white matter were associated with low CSF HVA (odds ratio 2.3, 95% confidence interval 1.5–3.5).InterpretationHVA abnormalities are observed in various neurological diseases, but some are probably an unspecific finding. No clear limits for CSF HVA values pointing towards primary diseases can be stated. We report several neurological diseases showing HVA alterations. No neuroimaging traits were associated with low HVA values, except for white matter abnormalities.
Nonalcoholic fatty liver in nondiabetic patients with acute coronary syndromes
Authors: Boddi Maria , Tarquini Roberto , Chiostri Marco , Marra Fabio , Valente Serafina , Giglioli Cristina , Gensini Gian F. , Abbate Rosanna 
Published: March 2013

AbstractBackgroundGrowing evidence was collected that non‐alcoholic liver fatty disease (NAFLD) is a risk factor for coronary atherosclerosis in terms of angiographic appearance, but its involvement in acute coronary syndromes is still debated. We investigated the prevalence and severity of NAFLD in non‐diabetic patients admitted for ST‐segment elevation myocardial infarction (STEMI) and its association with multi‐vessel coronary artery disease (CAD).Materials and methodsNinety‐five consecutive non‐diabetic patients admitted to cardiac ICU for STEMI were studied by ultrasound within 72 h from admission. NAFLD was graded according to a semi‐quantitative severity score as mild (score < 3) or moderate‐severe (> 3 score). Prevalence of cardiovascular (CV) risk factors, atherosclerotic burden markers and metabolic syndrome (MS) was investigated.ResultsThe overall prevalence of NAFLD was 87%. Forty‐eight patients showed moderate‐severe NAFLD (SFLD). Thirty‐five patients showed mild NAFLD (MLFD group) and 12 patients had no NAFLD. Patients with SFLD were younger and showed higher prevalence of multi‐vessel CAD (i.e. > 2) than patients with mild MFLD (P < 0·01). Total cholesterol, triglycerides, body mass index and waist circumference were higher and HDL lower in SFLD than MFLD patients. About 50% of all NAFLD patients did not have MS. MS prevalence was higher in SFLD than MLFD patients (P < 0·05) and among MS components, waist circumference and triglyceride levels showed the strongest association with SFLD (P < 0·05). At logistic regression analysis, SFLD was independently associated with a three‐fold risk of multi‐vessel CAD.ConclusionsIn non‐diabetic patients admitted for STEMI NAFLD prevalence was very high. Severe NAFLD independently increased the risk for multi‐vessel CAD associated to CV events.
Autotransplantation or replantation of cryopreserved teeth: a case series and literature review
Authors: Yoshizawa Michiko , Koyama Takahiro , Izumi Naoya , Niimi Kanae , Ono Yukiko , Ajima Hisao , Funayama Akinori , Mikami Toshihiko , Kobayashi Tadaharu , Ono Kazuhiro , Takagi Ritsuo , Saito Chikara 
Published: March 2013

AbstractBackgroundThe aim of this report was to evaluate the outcome of autotransplantation or replantation of cryopreserved teeth clinically and radiographically. Donor teeth were slowly frozen in a controlled‐rate freezer using 5% dimethylsulfoxide (DMSO) and 6% hydroxyethyl starch (HES) as protectants. Seven cryopreserved teeth, with duration of storage ranging from 4 to 36 months, were autotransplanted or replanted at Niigata University Medical and Dental Hospital. Endodontic treatment involving root canal debridement followed by interim root canal filling with calcium hydroxide was started 3 weeks after the operation and continued with replacement of the calcium hydroxide filling at 2‐week to 3‐month intervals. Three transplants showed periodontal regeneration clinically and radiographically, whereas replacement root resorption was observed in the remaining transplants. From the results, it can be concluded that cryopreserved tooth autotransplantation has potential for clinical use; however, the risk of replacement root resorption remains.
Foliar fungal pathogens of European woody plants in Siberia: an early warning of potential threats?
Authors: Tomoshevich M. , Kirichenko N. , Holmes K. , Kenis M. 
Published: March 2013

SummaryIn this article, we report observations made during thirteen years on foliar fungal pathogens attacking European and Eurasian woody broadleaved species in Siberian arboreta and cities and discuss the possibility of using such data for detecting exotic pathogens that may represent a danger for European tree and shrub species, should these pathogens be introduced into Europe. A total of 102 cases of symptomatic infections (fungus‐host plant associations) involving 67 fungal species were recorded on 50 of the 52 European and Eurasian woody plant species. All but four of the fungi found during the surveys were previously reported in Europe. However, 29 fungus–host plant associations are apparently new to science, suggesting that complexes of cryptic species differing in their host range and geographic range may occur. Seventeen percentage of associations were given a high damage score, that is, more than 50% of plant area was attacked, for at least some localities. In nearly half of the cases, fungus–host plant associations were found to be very frequent, that is, occurring every year and at all locations where the plant was inspected. A list of pathogen–host associations in Siberia deserving further investigation is provided, either because the pathogen is not yet recorded in Europe or because the pathogen–host association has not yet been reported, and the damage is high or, finally, because the damage and infestation level is unusually high in known associations. Further studies should involve molecular characterization of these foliar pathogens and their host range testing.
Previously unrecorded low‐temperature Phytophthora species associated with Quercus decline in a Mediterranean forest in eastern Spain
Authors: Pérez‐Sierra A. , López‐García C. , León M. , García‐Jiménez J. , Abad‐Campos P. , Jung T. 
Published: March 2013

SummaryOak decline has been a serious problem in Europe since the beginning of the twentieth century. In south‐west Spain,
Quercus ilex and
Q. suber are the main affected species, and their decline has been associated with
Phytophthora cinnamomi. During the last 10 years, a severe decline of
Q. ilex and
Q. faginea accompanied by a significant decrease in the production of acorns affecting natural regeneration was observed in the eastern part of the Iberian Peninsula. Therefore, the aim of this study was to investigate the possible involvement of Phytophthora spp. in the decline. A forest in the Natural Park ‘Carrascar de la Font Roja’ in Comunidad Valenciana (eastern Spain), which is dominated by
Q. ilex and
Q. faginea, was surveyed during 2010–2011. Symptomatic trees showed thinning and dieback of the crown, withering of leaves and death. An extensive loss of both lateral small woody roots and fine roots and callusing or open cankers on suberized roots were observed. Soil samples containing fine roots were baited using both
Q. robur leaves and apple fruits. Six
Phytophthora species were isolated:
P. cryptogea, P. gonapodyides, P. megasperma, P. quercina, P. psychrophila and
P. syringae. These are the first records of
P. quercina and
P. psychrophila on
Q.
faginea, of
P. quercina in Spain and of
P. psychrophila in mainland Spain. A soil infestation trial was conducted for 6 months under controlled conditions with 1‐year‐old seedlings of
Q. ilex and
Q. faginea.
Phytophthora cinnamomi was included in the pathogenicity test for comparison. The results showed that
Q. ilex seedlings were generally more susceptible to infection than
Q. faginea with
P. cinnamomi being the most aggressive pathogen to both oak species. The two most commonly isolated
Phytophthora species,
P. quercina and
P. psychrophila, also proved their pathogenicity towards both
Q. ilex and
Q. faginea.
A meta‐analysis suggesting that the relationship between biodiversity and risk of zoonotic pathogen transmission is idiosyncratic
Authors: Salkeld Daniel J , Padgett Kerry A , Jones James Holland 
Published: March 2013

AbstractZoonotic pathogens are significant burdens on global public health. Because they are transmitted to humans from non‐human animals, the transmission dynamics of zoonoses are necessarily influenced by the ecology of their animal hosts and vectors. The ‘dilution effect’ proposes that increased species diversity reduces disease risk, suggesting that conservation and public health initiatives can work synergistically to improve human health and wildlife biodiversity. However, the meta‐analysis that we present here indicates a weak and highly heterogeneous relationship between host biodiversity and disease. Our results suggest that disease risk is more likely a local phenomenon that relies on the specific composition of reservoir hosts and vectors, and their ecology, rather than patterns of species biodiversity.
Evolution and spread of glyphosate resistance in Conyza canadensis in California
Authors: Okada Miki , Hanson Bradley D. , Hembree Kurt J. , Peng Yanhui , Shrestha Anil , Stewart Charles Neal , Wright Steven D. , Jasieniuk Marie 
Published: March 2013

AbstractRecent increases in glyphosate use in perennial crops of California, USA, are hypothesized to have led to an increase in selection and evolution of resistance to the herbicide in Conyza canadensis populations. To gain insight into the evolutionary origins and spread of resistance and to inform glyphosate resistance management strategies, we investigated the geographical distribution of glyphosate resistance in C. canadensis across and surrounding the Central Valley, its spatial relationship to groundwater protection areas (GWPA), and the genetic diversity and population structure and history using microsatellite markers. Frequencies of resistant individuals in 42 sampled populations were positively correlated with the size of GWPA within counties. Analyses of population genetic structure also supported spread of resistance in these areas. Bayesian clustering and approximate Bayesian computation (ABC) analyses revealed multiple independent origins of resistance within the Central Valley. Based on parameter estimation in the ABC analyses, resistant genotypes underwent expansion after glyphosate use began in agriculture, but many years before it was detected. Thus, diversity in weed control practices prior to herbicide regulation in GWPA probably kept resistance frequencies low. Regionally coordinated efforts to reduce seed dispersal and selection pressure are needed to manage glyphosate resistance in C. canadensis.
The effect of a unique halide‐stabilizing residue on the catalytic properties of haloalkane dehalogenase DatA from Agrobacterium tumefaciens C58
Authors: Hasan Khomaini , Gora Artur , Brezovsky Jan , Chaloupkova Radka , Moskalikova Hana , Fortova Andrea , Nagata Yuji , Damborsky Jiri , Prokop Zbynek 
Published: March 2013

Haloalkane dehalogenases catalyze the hydrolysis of carbon–halogen bonds in various chlorinated, brominated and iodinated compounds. These enzymes have a conserved pair of halide‐stabilizing residues that are important in substrate binding and stabilization of the transition state and the halide ion product via hydrogen bonding. In all previously known haloalkane dehalogenases, these residues are either a pair of tryptophans or a tryptophan–asparagine pair. The newly‐isolated haloalkane dehalogenase DatA from Agrobacterium tumefaciens C58 (EC 3.8.1.5) possesses a unique halide‐stabilizing tyrosine residue, Y109, in place of the conventional tryptophan. A variant of DatA with the Y109W mutation was created and the effects of this mutation on the structure and catalytic properties of the enzyme were studied using spectroscopy and pre‐steady‐state kinetic experiments. Quantum mechanical and molecular dynamics calculations were used to obtain a detailed analysis of the hydrogen‐bonding patterns within the active sites of the wild‐type and the mutant, as well as of the stabilization of the ligands as the reaction proceeds. Fluorescence quenching experiments suggested that replacing the tyrosine with tryptophan improves halide binding by 3.7‐fold, presumably as a result of the introduction of an additional hydrogen bond. Kinetic analysis revealed that the mutation affected the substrate specificity of the enzyme and reduced its K0.5 for selected halogenated substrates by a factor of 2–4, without impacting the rate‐determining hydrolytic step. We conclude that DatA is the first natural haloalkane dehalogenase that stabilizes its substrate in the active site using only a single hydrogen bond, which is a new paradigm in catalysis by this enzyme family.
Internal–external circumferential crack behaviour in the cement layer of total hip replacement
Authors: Oshkour A. A. , Abu Osman N. A. , Yau Y. H. , Tarlochan F. , Pramanik S. , Wan Abas W. A. B. 
Published: March 2013

ABSTRACTThis study aimed to investigate crack behaviour at the internal and external surfaces of the cement layer in total hip replacement. A three‐dimensional model of the femur with the cemented prosthesis was developed and analysed. Cracks were placed on the internal, external and both internal and external surfaces of the cement layer. Stress intensity factors were measured during gait. Results revealed that the stress intensity factors modes I and III were the most dominant in the crack propagation in the cement layer. The domain of mode I was the medial and lateral sides of the cement layer. Meanwhile, the domain of mode III was the anterior and posterior sides of the cement layer. The stress intensity factor and distance from the distal end indicated an inverse relationship. The internal and external cracks had no significant interaction. Moreover, stress intensity factors at the external surface of the cement layer were higher than those on the internal surface.
Miocamycin‐Containing Triple Therapy for H. pylori Infection
Authors: Dore Maria Pina , Massidda Marco , Yilmaz Ozlem , Demiray‐Gürbüz Ebru , Manca Alessandra , Bassotti Gabrio 
Published: March 2013

AbstractIntroductionIn Northern Sardinia, one‐week triple standard therapies containing a proton‐pump inhibitor and two antibiotics for H. pylori infection have an average cure rate of 57% largely due to a high prevalence of antimicrobial resistance. The efficacy of miocamycin‐containing treatment for 10 days was evaluated.Materials and MethodsPatients referred to the endoscopy service for dyspeptic symptoms were enrolled. H. pylori infection was defined as a positive rapid urease test, presence of the bacteria on gastric biopsies, and a positive 13C‐UBT. Treatment consisted of 10 days with omeprazole 20 mg, miocamycin water‐soluble 900 mg, and tinidazole 500 mg all bid. Success was evaluated 40–50 days after the end of therapy and defined by a negative 13C‐UBT. Compliance was considered good if at least 90% of the total number of the pills were taken. Fluorescent in situ hybridization (FISH) technique was applied on paraffin‐embedded gastric tissue sections to test susceptibility to clarithromycin of the bacteria.Results50 patients were enrolled (mean age; 52, 36% men). Miocamycin‐containing therapy cured 86% (42/49; 95% CI = 72–94%) of infected patients by PP analysis. Susceptibility data (FISH) was available for 38 patients. Cure rates for the 28 with clarithromycin‐susceptible infection was 96% vs 50% for those with resistant or mixed infection, (p = .003). Good compliance was recorded in 48 patients. None of the patients discontinued therapy.ConclusionsMiocamycin appears to be a valid alternative for clarithromycin for H. pylori eradication. Head‐to‐head studies will be needed to ascertain whether it is superior.