bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated Effect of an Integrated Approach to Suspected Deep Venous Thrombosis Using Limited‐compression Ultrasound
Authors: Poley Rachel A. , Newbigging Joseph L. , Sivilotti Marco L.A. 
Published: October 2014

AbstractObjectivesDeep vein thrombosis (DVT) is both common and serious, yet the desire to never miss the diagnosis, coupled with the low specificity of D‐dimer testing, results in high imaging rates, return visits, and empirical anticoagulation. The objective of this study was to evaluate a new approach incorporating bedside limited‐compression ultrasound (LC US) by emergency physicians (EPs) into the workup strategy for DVT.MethodsThis was a cross‐sectional observational study of emergency department (ED) patients with suspected DVT. Patients on anticoagulants; those with chronic DVT, leg cast, or amputation; or when the results of comprehensive imaging were already known were excluded. All patients were treated in the usual fashion based on the protocol in use at the center, including comprehensive imaging based on the modified Wells score and serum D‐dimer testing. Seventeen physicians were trained and performed LC US in all subjects. The authors identified a priori an alternate workup strategy in which DVT would be ruled out in “DVT unlikely” (Wells score < 2) patients if the LC US was negative and in “DVT likely” (Wells score ≥ 2) patients if both the LC US and the D‐dimer were negative. The criterion standard was based on comprehensive imaging interpreted by radiologists blinded to LC US findings and by structured medical record review at 6 months in patients without comprehensive imaging.ResultsA total of 227 patients were enrolled (47% DVT likely), of whom 24 had DVT. The LC US was positive in 27 cases (21 actually DVT positive), indeterminate in 28 (one DVT positive), and negative in 172 (two DVT positive). Of 130 patients deemed DVT negative by the new strategy, one had confirmed DVT (miss rate = 0.8%; 95% confidence interval [CI] = 0.1% to 4.0%), but this patient had been misclassified by the treating physician as low risk by Wells criteria. The stand‐alone sensitivity and specificity of LC US were 91% (95% CI = 70% to 98%) and 97% (95% CI = 92% to 99%), respectively. Incorporating LC US into the diagnostic approach would have reduced the rate of comprehensive imaging from 70% to 43%, D‐dimer testing from 100% to 33%, and the mean time to diagnostic certainty by 5.0 hours and avoided 24 (11%) return visits for imaging and 10 (4.4%) cases of unnecessary anticoagulation. In 19% of cases, the treating and scanning physician disagreed whether the patient was DVT likely or DVT unlikely based on Wells score (κ = 0.62; 95% CI = 0.48 to 0.77).ConclusionsLimited‐compression US holds promise as one component of the diagnostic approach to DVT, but should not be used as a stand‐alone test due to imperfect sensitivity. Tradeoffs in diagnostic efficiency for the sake of perfect sensitivity remain a difficult issue collectively in emergency medicine (EM), but need to be scrutinized carefully in light of the costs of overinvestigation, delays in diagnosis, and risks of empirical anticoagulation.
Placenta Growth Factor Induces Invasion and Activates p70 during Rapamycin Treatment in Trophoblast Cells
Authors: Knuth Allison , Liu Lawrence , Nielsen Halden , Merril Daniel , Torry Donald S. , Arroyo Juan A. 
Published: October 2014

ProblemAberrant trophoblast invasion has been associated with human intrauterine growth restriction (IUGR) and preeclampsia (PE). Our objective was to determine placenta growth factor (PlGF)‐mediated regulation of cell invasion in trophoblast cells with reduced mammalian target of Rapamycin (mTOR) signaling.Method of studyFirst trimester SW 71 trophoblast cells were subjected to invasion assays with the following conditions: 10% FBS, 10% FBS with Rapamycin, and 10% FBS with Rapamycin and PlGF. mTOR siRNA was also done in these cells. Western blots were performed on cell lysates with antibodies against phospho‐ and total mTOR, 70‐kDa ribosomal protein kinase I (p70), 4EBP1, extracellular regulated kinase (ERK), and phosphatidylinositol‐3 kinase (AKT).ResultsCompared to controls, trophoblast cells showed: (i) a 33% decrease in invasion following Rapamycin treatment, (ii) protection from decreased invasion following Rapamycin and PlGF treatment, (iii) a 31% decrease in mTOR phosphorylation with Rapamycin, (iv) increased phosphorylation of p70 (43%) with Rapamycin and PlGF, and (v) a 76% decrease in invasion following mTOR depletion.ConclusionWe conclude that first trimester trophoblast invasion is functionally decreased when phosphorylation of mTOR is prevented and this decrease is recovered with the addition of PlGF. Mechanistically, this recovery involves the phosphorylation of p70 independent of mTOR.
Comparative study of Poincaré plot analysis using short electroencephalogram signals during anaesthesia with spectral edge frequency 95 and bispectral index
Authors: Hayashi K. , Yamada T. , Sawa T. 
Published: October 2014

SummaryThe return or Poincaré plot is a non‐linear analytical approach in a two‐dimensional plane, where a timed signal is plotted against itself after a time delay. Its scatter pattern reflects the randomness and variability in the signals. Quantification of a Poincaré plot of the electroencephalogram has potential to determine anaesthesia depth. We quantified the degree of dispersion (i.e. standard deviation, SD) along the diagonal line of the electroencephalogram‐Poincaré plot (named as SD1/SD2), and compared SD1/SD2 values with spectral edge frequency 95 (SEF95) and bispectral index values. The regression analysis showed a tight linear regression equation with a coefficient of determination (R2) value of 0.904 (p < 0.0001) between the Poincaré index (SD1/SD2) and SEF95, and a moderate linear regression equation between SD1/SD2 and bispectral index (R2 = 0.346, p < 0.0001). Quantification of the Poincaré plot tightly correlates with SEF95, reflecting anaesthesia‐dependent changes in electroencephalogram oscillation.
The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50 in children
Authors: Tokuwaka J. , Satsumae T. , Mizutani T. , Yamada K. , Inomata S. , Tanaka M. 
Published: October 2014

SummaryWe evaluated the minimum alveolar concentration of sevoflurane required to maintain the bispectral index below 50 in children. We studied 55 children, divided into 1‐year‐old, 2‐ to 4‐year‐old and 5‐ to 9‐year‐old groups and used Dixon's up‐and‐down method and probit analysis. In the 1‐year‐old group, the bispectral index values remained above 50, with the end‐tidal sevoflurane concentration reaching 4.0% or higher. The minimum alveolar concentration of sevoflurane for maintaining the bispectral index below 50 was significantly higher in the 2‐ to 4‐year‐old group (2.33%, 95% CI 2.25–2.57) than in the 5‐ to 9‐year‐old group (2.10%, 95% CI 1.94–2.25; p = 0.005). We conclude that assessing the depth of anaesthesia using bispectral index is unreliable in children aged < 2 years anaesthetised with sevoflurane.
Time course and role of luteinizing hormone and follicle‐stimulating hormone in the expansion of the Leydig cell population at the time of puberty in the rhesus monkey (Macaca mulatta)
Authors: Verhagen I. , Ramaswamy S. , Teerds K. J. , Keijer J. , Plant T. M. 
Published: October 2014

SummaryIn higher primates, development of the adult population of Leydig cells has received little attention. Here, the emergence of 3β‐hydroxysteroid dehydrogenase (HSD3B) positive cells in the testis of the rhesus monkey was examined during spontaneous puberty, and correlated with S‐phase labeling in the interstitium at this critical stage of development. In addition, the relative role of luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) in initiating the pubertal expansion of Leydig cells was studied by precociously stimulating the juvenile testis in vivo with pulsatile 11‐day infusions of recombinant LH and FSH, either alone or in combination. At the time of castration, testes were immersion fixed in Bouin's, embedded in paraffin, and sectioned at 5 μm. Leydig cells/testis were enumerated using HSD3B as a Leydig cell marker. Leydig cell number per testis increased progressively during puberty to reach values in the adult approximately 10 fold greater than in early‐pubertal animals. The rise in cell number was associated with an increase in nuclear diameter. That the pubertal expansion of Leydig cell number was driven primarily by the increase in LH secretion at this stage of development was suggested by the finding that precocious stimulation of mid‐juvenile monkeys with LH, either alone or in combination with that of FSH, resulted in a 20–30 fold increase in the number of HSD3B‐positive cells. Interestingly, precocious FSH stimulation, alone, also resulted in appearance of Leydig cells as indicated by the occasional HSD3B‐positive cell in the interstitium. The nuclear diameter of these Leydig cells, however, was less than that of those generated in response to LH.
Surveillance vs. adjuvant therapy of clinical stage I testicular tumors – a review and the SWENOTECA experience
Authors: Cohn‐Cedermark G. , Stahl O. , Tandstad T. ,   SWENOTECA
Published: October 2014

SummaryAlthough clinical stage I (CS I) testicular cancer is highly curable, the optimal management is controversial. The aims of the Swedish and Norwegian Testicular Cancer Group (SWENOTECA) studies for CS I non‐seminoma (NS) and seminoma (S) have been to reduce treatment intensity while maintaining high survival rates, reduce the number of patients needing salvage treatment and implement patient autonomy with regard to adjuvant treatment. During 1998–2010 NS CSI patients with lymphovascular invasion (LVI) of the primary tumor (high risk) were recommended bleomycin, etoposide, cisplatin (BEP) × 1. During 2000–2006 S CS I patients had the option to choose surveillance or adjuvant radiotherapy (AR). In 2004, carboplatin × 1 (AUC7) was added as a third treatment option. In 2007 a new risk‐adapted treatment protocol for S CS I was initiated. Patients with two risk factors (tumor size > 4 cm, tumor growth in the rete testis) were recommended carboplatin × 1 and patients with 0–1 risk factor were recommended surveillance. All patients were provided with oral and written information of possible management options and could choose the other alternative. The relapse rate for NS CS I with BEP × 1 was 3.2% for high risk, and 1.6% for low‐risk patients. Five‐year cause‐specific survival was 100%. For S CS I‐patients treated before 2007, 14.3% on surveillance relapsed, 3.9% after carboplatin, and 0.8% after AR. Five‐year cause‐specific survival was 99.9%. For S CS I‐patients treated from 2007, a relapse rate <3% was confirmed for patients without risk factors. SWENOTECA considers BEP × 1 standard adjuvant treatment in NS CS I high‐risk patients. Low‐risk patients should have the opportunity to receive BEP × 1 following thorough information regarding pros and cons. For S CS I patients without risk factors, adjuvant treatment is not necessary. For patients with risk factors, patient autonomy should be respected.
Effect of omission of population‐based eye screening at age 6–9 months in the Netherlands
Authors: Sloot Frea , Sami Aya , Karaman Hatice , Benjamins Janine , Loudon Sjoukje E. , Raat Hein , Sjoerdsma Trijntje , Simonsz Huibert Jan 
Published: October 2014

AbstractPurposeTo investigate omission of population‐based eye screening at age 6–9 months in the Netherlands.MethodsProspective population‐based consecutive birth cohort study was used. In two consecutive birth cohorts, children were eye screened at 1–2 and 3–4 months, but at general‐health screening at 6–9 months, the second cohort was not eye screened, unless anything conspicuous was noted or in case of positive family history. Data were collected from screening records and anonymous questionnaires. Semi‐structured daylong observations were made of physicians examining children aged 0–4 years, including children from the cohorts, by two orthoptic students.Results58 of 6059 children (0.96%), in the screened, and 48 of 5482 children (0.88%) in the unscreened group were referred to orthoptist or ophthalmologist, mostly for observed strabismus. Amblyopia, all combined with strabismus, was diagnosed in ten screened (0.17%) versus six unscreened children (0.11%). Most physicians found preverbal examinations and decisions to refer difficult. The observations by orthoptic students revealed that cover test, pupillary reflexes, pursuit movements and eye motility were frequently performed inadequately, contrary to the Hirschberg test, at this age.ConclusionThe screened and unscreened group differed little regarding the number of children referred and found to have amblyopia. Referral was mostly based on observed strabismus.
Results of a prospective multicentre myeloablative double‐unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia
Authors: Barker Juliet N. , Fei Mingwei , Karanes Chatchada , Horwitz Mitchell , Devine Steven , Kindwall‐Keller Tamila L. , Holter Jennifer , Adams Alexia , Logan Brent , Navarro Willis H. , Riches Marcie ,   the RCI BMT 05‐DCB Protocol Team
Published: October 2014

SummaryDouble‐unit cord blood (CB) grafts may improve engraftment and relapse risk in adults with haematological malignancies. We performed a prospective high‐dose myeloablative double‐unit CB transplantation (CBT) trial in adults with high‐risk acute leukaemia or myelodysplasia (MDS) between 2007 and 2011. The primary aim was to establish the 1‐year overall survival in a multi‐centre setting. Fifty‐six patients (31 acute myeloid leukaemia, 19 acute lymphoblastic leukaemia, 4 other acute leukaemias, 2 myelodysplastic syndrome [MDS]) were transplanted at 10 centres. The median infused total nucleated cell doses were 2·62 (larger unit) and 2·02 (smaller unit) x 107/kg. The cumulative incidence of day 100 neutrophil engraftment was 89% (95% confidence interval [CI]: 80–96). Day 180 grade II‐IV acute graft‐versus‐host disease (GVHD) incidence was 64% (95%CI: 51–76) and 36% (95%CI: 24–49) of patients had chronic GVHD by 3‐years. At 3‐years post‐transplant, the transplant‐related mortality (TRM) was 39% (95%CI: 26–52), and the 3‐year relapse incidence was 11% (95%CI: 4–21). With a median 37‐month (range 23–71) follow‐up of survivors, the 3‐year disease‐free survival was 50% (95%CI: 37–63). Double‐unit CBT is a viable alternative therapy for high‐risk acute leukaemia/ MDS in patients lacking a matched unrelated donor. This is especially important for minority patients. The relapse incidence was low but strategies to ameliorate TRM are needed.
Reporting the characteristics of the policy context for population‐level alcohol interventions: A proposed ‘Transparent Reporting of Alcohol Intervention ContExts’ (TRAICE) checklist
Authors: Holmes John , Meier Petra S. , Booth Andrew , Brennan Alan 
Published: October 2014

AbstractIssuesEffectiveness of alcohol policy interventions varies across times and places. The circumstances under which effective polices can be successfully transferred between contexts are typically unexplored with little attention given to developing reporting requirements that would facilitate systematic investigation.ApproachUsing purposive sampling and expert elicitation methods, we identified context‐related factors impacting on the effectiveness of population‐level alcohol policies. We then drew on previous characterisations of alcohol policy contexts and methodological‐reporting checklists to design a new checklist for reporting contextual information in evaluation studies.Key FindingsSix context factor domains were identified: (i) baseline alcohol consumption, norms and harm rates; (ii) baseline affordability and availability; (iii) social, microeconomic and demographic contexts; (iv) macroeconomic context; (v) market context; and (vi) wider policy, political and media context. The checklist specifies information, typically available in national or international reports, to be reported in each domain.ImplicationsThe checklist can facilitate evidence synthesis by providing: (i) a mechanism for systematic and more consistent reporting of contextual data for meta‐regression and realist evaluations; (ii) information for policy‐makers on differences between their context and contexts of evaluations; and (iii) an evidence base for adjusting prospective policy simulation models to account for policy context.ConclusionsOur proposed checklist provides a tool for gaining better understanding of the influence of policy context on intervention effectiveness. Further work is required to rationalise and aggregate checklists across interventions types to make such checklists practical for use by journals and to improve reporting of important qualitative contextual data. [Holmes J, Meier PS, Booth A, Brennan A. Reporting the characteristics of the policy context for population‐level alcohol interventions: A proposed ‘Transparent Reporting of Alcohol Intervention ContExts’ (TRAICE) checklist. Drug Alcohol Rev 2014;33:596–603]
Urticaria
Authors: Wedi Bettina , Wieczorek Dorothea , Raap Ulrike , Kapp Alexander 
Published: October 2014

SummaryUrticaria is a very common skin disease which was already described in the ancient world. Questions still remain about its pathogenesis and management remain open. Compared to other common skin diseases, the published evidence is rather low. The clinical symptoms with pruritic transient wheals and/or angioedema are caused by mediators (particularly histamine) released by activated mast cells and basophils. The mechanism of target cell activation has not been clarified in detail for most urticaria subtypes.Different urticaria subtypes should be distinguished. Spontaneous forms are more common than inducible forms. Chronic urticaria and urticaria in certain age groups (children, pregnancy) can be difficult to manage. Therefore, international consensus resulting in the regular update of urticaria guidelines can be very helpful. Currently, these updated guidelines include a three‐step treatment algorithm for chronic spontaneous urticaria. Only the first step of this algorithm, second generation H1‐antihistamine in standard dose, utilized approved drugs. However after omalizumab was established as a third line choice in the guideline algorithm, it has approved in many countries for chronic spontaneous urticaria without response to H1‐antihistamines. The exact mechanism of action of omalizumab in urticaria has not been fully elucidated. Unrevealing this mechanism might result in a deeper understanding of urticaria pathogenesis and the development of further therapeutic strategies.
Down‐regulation of connexin43 and connexin32 in keratocystic odontogenic tumours: potential association with clinical features
Authors: Zhong Wen‐Qun , Chen Gang , Zhang Wei , Xiong Xue‐Peng , Ren Jian‐Gang , Zhao Yi , Liu Bing , Zhao Yi‐Fang 
Published: October 2014

AimsThe objective of this study was to explore the potential involvement of connexin43 (Cx43) and connexin32 (Cx32), two vital members of the connexin families, in the pathogenesis of keratocystic odontogenic tumours (KCOT).Methods and resultsThe expression levels of Cx43 and Cx32 in human KCOT and normal oral mucosa (OM) tissues were measured using immunohistochemistry and real‐time quantitative polymerase chain reaction (qPCR). The relationship between Cx43 and Cx32 expression and markers of proliferation [proliferating cell nuclear antigen (PCNA), cyclin D1], anti‐apoptosis [B cell lymphoma 2 (Bcl‐2)] and autophagy [light chain 3 (LC3), Sequestosome 1 p62 (p62)] was then investigated in the KCOT samples. The results showed that Cx43 and Cx32 expression was down‐regulated significantly in KCOT samples relative to OM samples. Meanwhile, the expression levels of Cx43 and Cx32 were correlated negatively with the expression levels of PCNA, cyclin D1, Bcl‐2, LC3 and p62, as confirmed further by double‐labelling immunofluorescence analyses.ConclusionsThis study reveals for the first time that Cx43 and Cx32 are down‐regulated in KCOT and suggests an association with growth regulation, anti‐apoptosis and autophagy in KCOT.
Ceria (La3+, Sr2+)/Carbonates Nanocomposite Electrolytes with High Electrical Conductivity for Low‐Temperature SOFCs
Authors: Jaiswal Nandini , Kumar Devendra , Parkash Om , Upadhyay Shail 
Published: October 2014

A series of ceria‐based nanocomposites consisting of lanthanum and strontium codoped ceria with composition Ce0.89La0.07Sr0.04O1.925 (CL7S4) and eutectic mixture of carbonates Li2CO3‐Na2CO3 (LNCO) have been prepared by mixing nanosize powders of CL7S4 and LNCO. Samples have been characterized using differential thermal analysis, X‐ray diffraction, scanning electron microscopy combined with energy‐dispersive spectroscopy, thermal expansion, and impedance spectroscopy. A sharp increase in ionic conductivity is observed in all the composite specimens corresponding to superionic transition. Sample containing 35 wt% of carbonate shows the maximum conductivity (2.56 × 10−1 S/cm at 500°C) with activation energy of conduction, Ea 0.23 eV.
The evolution of the reproductive system of Urodasys (Gastrotricha: Macrodasyida)
Authors: Atherton Sarah , Hochberg Rick 
Published: October 2014

AbstractMacrodasyidan gastrotrichs are hermaphrodites with complex reproductive organs that function in sperm transfer and receipt, but homology among the organs of members of different clades remains undetermined, as does a broader understanding of evolutionary trends in the reproductive biology of macrodasyidans. In this study, we investigate the evolution of reproduction in Urodasys, a clade of 15 macrodasyidan species that shows variability in reproductive mode (hermaphroditic and parthenogenetic) and sexual anatomy. We use partial 18S rDNA sequence data from 30 specimens representing five described species, sequence data from one undescribed species in GenBank, and sequence data from a potentially new species found at Capron Shoal, Florida, to gain insight into the phylogeny of the clade and clarify evolutionary trends in reproductive modality. Based on a total of 33 specimens of seven potential species, we found that members of Urodasys can be separated into three clades reflective of different reproductive modalities: Clade I, species with paired male and female gonads but without accessory sexual organs; Clade II, species with a single left testis, paired ova, and accessory organs including a sclerotic stylet; and Clade III, parthenogenetic species without testes or accessory organs. In addition, we find that the potentially new species from Florida can form spermatophores, a condition shared with another species in Clade I. Herein, we describe this novel spermatophore‐bearing species and discuss the significance of spermatophore formation in the genus.