bluuebunny/crossref_metadata_2025_split huggingface dataset:
Description of a new non‐injectable connector to reduce the complications of arterial blood sampling
Authors: Mariyaselvam M. Z. , Heij R. E. , Laba D. , Richardson J. A. , Hodges E. J. , Maduakor C. A. , Carter J. J. , Young P. J. 
Published: October 2014

SummaryArterial cannulation is associated with complications including bacterial contamination, accidental intra‐arterial injection and blood spillage. We performed a series of audits and experiments to gauge the potential for these, as well as assess the possible contribution of a new device, the Needle‐Free Arterial Non‐Injectable Connector (NIC), in reducing these risks. The NIC comprises a needle‐free connector that prevents blood spillage and a one‐way valve allowing aspiration only; once screwed onto the side port of a three‐way tap, the device can only be removed with difficulty. We performed a clinical audit of arterial monitoring systems in our intensive care unit, which showed an incidence of bacterial colonisation of five in 86 (6%) three‐way tap ports. We constructed a manikin simulation experiment of the management of acute bradycardia, in which trainee doctors were required to inject atropine intravenously. Ten of 15 (66%) doctors injected the drug into the three‐way tap of the arterial monitoring system rather than into the intravenous cannula or the central venous catheter. In a laboratory study, we replicated the arterial blood sampling and flushing sequence from a three‐way tap, with the syringes attached either directly to the three‐way tap port or to a NIC attached to the port. The first (discard) syringe attached to the three‐way tap was contaminated with bacteria. Bacterial growth was found in 17 of 20 (85%) downstream flushed samples (corresponding to the patient's circulation) when the three‐way tap was accessed directly, compared to none of 20 accessed via the NIC (p < 0.0001). Growth was found on all of 20 (100%) ports accessed directly compared to none of 20 accessed via the NIC (p < 0.0001). The NIC effectively prevents bacteria from contaminating sampling lines. As its design also prevents accidental intra‐arterial injection, we suggest that it can reduce complications of arterial monitoring.
Is the Measurement of Serum Formate Concentration Useful in the Diagnostics of Acute Methanol Poisoning? A Prospective Study of 38 Patients
Authors: Zakharov Sergey , Kurcova Ivana , Navratil Tomas , Salek Tomas , Komarc Martin , Pelclova Daniela 
Published: October 2014

AbstractThe aim of this article was to study the role of serum formate (S‐formate) in diagnosing methanol poisoning. A prospective study was undertaken of 38 patients from the Czech methanol mass poisoning in 2012 – median age 51 [interquartile range (IQR) 37–62] years with confirmed methanol poisoning. S‐formate was measured enzymatically. The receiver operating characteristics (ROC) curve was used to examine the predictive ability of S‐formate. Asymptomatic patients had median S‐formate of 1.9 (IQR 1.5–2.4) mmol/L. The median S‐formate was 15.2 (IQR 13.9–17.6) mmol/L in symptomatic subjects with visual disturbances, 15.4 (12.1–18.0) mmol/L in subjects with dyspnoea and 15.7 (IQR 12.8–18.5) mmol/L in comatose patients. The differences in serum formate concentrations in symptomatic patients depending on clinical features were not significant (all p > 0.05). Patients with long‐term visual sequelae of poisoning had median S‐formate of 16.1 (IQR 14.3–19.9) mmol/L; with central nervous system (CNS) sequelae, patients had 15.9 (IQR 14.2–19.5) mmol/L. In lethal cases, the median S‐formate was 15.2 (IQR 13.8–15.9) mmol/L. The probability of a poor outcome (death or survival with sequelae) was higher than 90% in patients with S‐formate ≥17.5 mmol/L, S‐lactate ≥7.0 mmol/L and/or pH <6.87. The ROC analysis showed that the corresponding areas under the curve (AUC) were 0.64 (0.44–0.85 CI 95%) for S‐formate, 0.75 (0.56–0.93 CI 95%) for ‘S‐formate+S‐lactate’ and only 0.54 (0.38–0.69 CI 95%) for serum methanol, which is lower than for S‐formate (p < 0.05). The measurement of S‐formate is an important tool in the laboratory diagnostics and clinical management of acute methanol poisoning. S‐formate ≥3.7 mmol/L can lead to the first clinical signs of visual toxicity, indicating haemodialysis. S‐formate ≥11–12 mmol/L is associated with visual/CNS sequelae and a lethal outcome.
Impaired intuition in patients with major depressive disorder
Authors: Remmers Carina , Topolinski Sascha , Dietrich Detlef E. , Michalak Johannes 
Published: October 2014

ObjectivesIn daily life, many decisions of minor and major importance have to be made. Thereby, intuitive judgments serve as useful guides and help us to adapt to our environment. People with major depressive disorder (MDD) often have difficulties to come to decisions. Is their intuition impaired? Since this question has not been addressed until now, the present study explored intuition in MDD.MethodsDepressed patients (n = 29) and healthy control participants (n = 27) completed the Judgment of Semantic Coherence Task, a well‐established paradigm used in basic cognitive research to measure intuition. Furthermore, participants' severity of depressive symptoms (BDI‐II), negative affect (PANAS), and rumination (RSQ) were assessed. All participants were interviewed with the SCID.ResultsDepressed patients showed impaired intuition compared to healthy control participants. In the depressed sample, negative affect accounts for the association between rumination and impaired intuition. Results further reveal that negative affect overall mediates the depression‐intuition relationship. Patients with diminished ability to concentrate or indecisiveness had lower intuition indices compared to patients who did not fulfil this diagnostic criterion of MDD.ConclusionsThe study introduces the phenomenon of intuition into depression research. Additionally, these results extent findings from basic research showing that induced negative mood as well difficulties to down‐regulate negative affect impair intuitive coherence judgments. Current results indicate that the negative affectivity of patients is the crucial mediator in the association between depression and impaired intuition. Limitations of the study as well as the potential etiological role of intuition in MDD are discussed.Practitioner points

The finding that intuition is impaired in depressed patients extends our knowledge as to the cognitive profile of patients with MDD.

Patients who suffer from indecisiveness have lower intuition indices compared to patients who do not fulfill this diagnostic criterion of MDD.

Due to the cross‐sectional design, final conclusions as to the etiological role of intuition in MDD cannot be drawn.

The question remains open whether impaired intuition is specific to MDD.
US not bright but right method of thyroid volume estimation even in large and substernal extended goitres. Comparison of US and three methods of CT thyroid evaluation – prospective study
Authors: Kaniuka‐Jakubowska Sonia , Piskunowicz Maciej , Zapaśnik Adam , Lewczuk Anna , Kaniuka Aneta , Mizan‐Gross Krystyna , Kaszubowski Mariusz , Lass Piotr , Sworczak Krzysztof 
Published: October 2014

SummaryBackgroundUltrasound is nowadays a method of choice for thyroid volume assessment. However, its disadvantage is some inaccuracy, which is said to be higher in huge, especially substernally extended goitres.AimsThe aim of the study was to compare the US and CT thyroid volumetric measurements: multi‐observers (CT MO) and one‐observer (CT OO) to CT planimetry results (CT Pl) in patients with large goitres.Materials & MethodsThe study material comprised 70 thyroid imaging examinations obtained from 35 patients with nontoxic goitres, scanned twice before and after radioiodine treatment. Mean thyroid volume was 88·97 ± 60·21 ml. Thirty‐three thyroid scans revealed the extension below the jugular notch (mean of 2·46 cm). Thyroid volume in US, CT MO and CT OO was estimated using the ellipsoid formula. CT Pl was established a reference method.ResultsThe mean thyroid volume in CT Pl was 88·97 ml (median 80·73, range 11·81 to 315·97). US underestimates thyroid volume by 7·55 ml (7·7%) with a sufficient correlation (R2 = 0·89) and precision (20·37). CT OO is the closest and CT MO the most distant from CT Pl, with US between them in thyroid volume estimation. The percentage US bias is constant through all range of thyroid volume. There is no difference for percentage bias between US and CT Pl for goitres with (8·67%), and without (6·70%) substernal part.ConclusionUS examination is sufficient for epidemiological studies, radioiodine activity calculation and goitre size assessment in everyday medical practice. Neither initial size of the goitre nor its substernal extension affects US assessment precision.
Acute decrease in serum testosterone after a mixed glucose and protein beverage in obese peripubertal boys
Authors: Schwartz Alexander , Patel Barkha P. , Vien Shirley , McCrindle Brian W. , Anderson G. Harvey , Hamilton Jill 
Published: October 2014

SummaryBackground and objectivesDelayed puberty and lower levels of testosterone (T) have been observed in adult obese males and some adolescent males. In adult men, enteral glucose ingestion results in acute lowering of serum testosterone levels; however, this has not been studied in adolescents. We aimed to examine the acute effect of a glucose/protein beverage on serum T concentration changes in obese peripubertal males. A second objective was to determine whether change in T concentration was related to appetite hormone levels.Patients and methodsTwenty‐three overweight and obese males aged 8–17 in pre‐early (Tanner stage 1–2) and mid‐late (Tanner stage 3–5) puberty were included in this cross‐sectional study at the Clinical investigative unit at the Hospital for Sick Children. Participants consumed a beverage containing glucose and protein, and blood samples measuring pubertal hormones, ghrelin and glucagon‐like peptide‐1 (GLP‐1) were taken over 60 min.ResultsAcross pubertal stages, there was a significant decrease in T levels in adolescent boys (−18·6 ± 3·1%, P < 0·01) with no proportional differences between pre‐early and mid‐late puberty (P = 0·09). Decrease in T was associated with a decrease in LH (r = 0·52, P = 0·02), and fasting T was inversely correlated with fasting ghrelin (r = −0·51, P = 0·03) with no correlation with GLP‐1.ConclusionsIntake of a mixed glucose/protein beverage acutely decreases T levels in overweight and obese peripubertal boys. A potential mechanism for this decrease may be secondary to an acute decrease in LH, but this requires further evaluation.
Utilisation and outcomes of Case‐based discussion in otolaryngology training
Authors: Awad Z. , Hayden L. , Muthuswamy K. , Ziprin P. , Darzi A. , Tolley N.S. 
Published: October 2014

ObjectivesTo assess the reliability, validity and outcomes of Case‐based Discussion (CBD) in otolaryngology training.DesignRetrospective database analysis.SettingNational electronic database.ParticipantsNorth London otolaryngology trainees.Main outcome measuresWe tested the tool's reliability along with its capacity to denote trainee progress. A score was calculated (cS) and compared across core (CT) and specialty trainees (ST) at all levels. The number of items rated as “development required” (D) was also examined.ResultsOne thousand four hundred and fifty‐six CBDs were submitted by 46 trainees from 2007 to 2013, averaging 13.6 per trainee per year. Items relating to knowledge, management and judgement were more popular (98% usage), and better predictors of cS compared to other parameters (rs: +0.74, +0.70 and +0.72, respectively). CBD was found to be reliable (Cronbach's α = 0.848) and highly sensitive (99%), yet not specific. cS was significantly higher in ST than CT (95.3% ± 0.6 versus 88.7% ± 1.3). pS showed a similar pattern (3.15 ± 0.4 versus 2.0 ± 0.05) (P < 0.001). cS and pS increased from CT1 to ST8 (rs: +0.60 and +0.34, respectively). The number of D‐rated items decreased with increasing year of training.ConclusionCase‐based discussion is a reliable and valid tool in otolaryngology training. It is highly sensitive but not specific. Trainees should be encouraged to use it at all levels.
Fiducial marker placement via conventional or electromagnetic navigation bronchoscopy (ENB): an interdisciplinary approach to the curative management of lung cancer
Authors: Hagmeyer Lars , Priegnitz Christina , Kocher Martin , Schilcher Burkhart , Budach Wilfried , Treml Marcel , Stieglitz Sven , Randerath Winfried 
Published: October 2014

AbstractBackground and AimsConventional and electromagnetic navigation bronchoscopy (ENB) is generally used as a diagnostic tool in suspicious pulmonary nodules. The use of this technique for the placement of fiducial markers in patients with inoperable but early‐stage lung cancer could present an innovative approach enabling risk‐reduced therapy.MethodsWe present seven clinical cases where conventional bronchoscopy and ENB were used as part of an experimental interdisciplinary approach to clinical management and therapy planning. In each case, we analyzed the clinical indication, endoscopic procedures and post‐interventional outcome.ResultsIn six patients (three females, three males) with peripheral non‐small cell lung cancer (NSCLC), stage cT1cN0cM0, surgery and conventional stereotactic radiation therapy was not possible because of end‐stage chronic obstructive pulmonary disease. ENB was used for fiducial marker placement prior to cyberknife radiotherapy. No procedure‐related complications were observed. Complete remission could be achieved in four cases, partial remission in two cases and no relevant complications induced by radiotherapy were observed. In one male patient, an endoluminal relapse in the right lower lobe was diagnosed following a right upper lobe resection for a NSCLC. The tumor could not be clearly identified by computerized tomography, so that the bronchoscopic placement of a fiducial marker in the tumor was performed in order to allow stereotactic radiochemotherapy, by which complete remission could be achieved.ConclusionFiducial marker placement may be an interesting bronchoscopic technique in the interdisciplinary therapeutic approach to inoperable early‐stage lung cancer. In the described cases, therapy planning was successful and no procedure‐related complications were observed.
A pregnancy lifestyle intervention to prevent gestational diabetes risk factors in overweight Hispanic women: a feasibility randomized controlled trial
Authors: Hawkins M. , Hosker M. , Marcus B. H. , Rosal M. C. , Braun B. , Stanek E. J. , Markenson G. , Chasan‐Taber L. 
Published: October 2014

AbstractAimsTo pilot the feasibility of a prenatal lifestyle intervention to modify physical activity and diet among pregnant overweight and obese Hispanic women, with the aim of reducing risk factors for gestational diabetes mellitus.MethodsWomen were randomized either to a lifestyle intervention (n = 33, 48.5%), consisting of a culturally and linguistically modified, motivationally targeted, individually tailored 6‐month prenatal programme, or to standard care (n = 35, 51.5%). Bilingual and bicultural health educators encouraged women to achieve guidelines for physical activity, decrease saturated fat and increase dietary fibre. Outcomes included gestational weight gain, infant birth weight and biomarkers associated with insulin resistance.ResultsPatient retention up to delivery was 97% in both study groups. The lifestyle intervention attenuated the pregnancy‐associated decline in moderate‐intensity physical activity, but differences between groups were not significant (mean ± se −23.4 ± 16.6 vs −27.0 ± 16.2 metabolic equivalent of task h/week; P = 0.88). Vigorous‐intensity activity increased during the course of pregnancy in the lifestyle intervention group (mean ± se 1.6 ± 0.8 metabolic equivalent of task h/week) and declined in the standard care group (−0.8 ± 0.8 metabolic equivalent of task h/week; P = 0.04). The lifestyle intervention group also had slightly lower gestational weight gain and infant birth weights compared with the standard care group; however, these differences were not statistically significant. There were no statistically significant differences in biomarkers of insulin resistance between groups.ConclusionsFindings suggest that a motivationally matched lifestyle intervention is feasible and may help attenuate pregnancy‐related decreases in vigorous physical activity in a population of overweight and obese Hispanic women. The intervention protocol can readily be translated into clinical practice in underserved and minority populations.
Association between the extent of urinary albumin excretion and glycaemic variability indices measured by continuous glucose monitoring
Authors: Jin S.‐M. , Kim T.‐H. , Oh S. , Baek J. , Joung J. Y. , Park S.‐M. , Cho Y. Y. , Sohn S. Y. , Hur K. Y. , Lee M.‐S. , Lee M.‐K. , Kim J. H. 
Published: October 2014

AbstractAimsThe contribution of glycaemic variability to the microvascular complication of diabetes has not been established. We examined whether there is an independent association between indices of glycaemic variability in continuous glucose monitoring and extent of albuminuria.MethodsA total of 173 patients with Type 2 diabetes (without insulin therapy, n = 96; with insulin therapy, n = 77) who had unexplained large fluctuations in blood glucose values underwent three‐day continuous glucose monitoring. We used a multinomial logistic regression model to determine whether the indices of glycaemic variability independently affected the odds of having a spot urine albumin/creatinine ratio of 30–299 mg/g and ≥ 300 mg/g.ResultsHigher standard deviation (P = 0.002), mean of daily differences (P = 0.023) and mean amplitude of glycaemic excursion (P = 0.043) significantly increased the odds of having a urine albumin/creatinine ratio of ≥ 300 mg/g. In multivariable analysis, only higher standard deviation, but not mean amplitude of glycaemic excursion and mean of daily differences, independently increased the odds of having a urine albumin/creatinine ratio of ≥ 300 mg/g (P = 0.025). Coefficient of variation (sd/mean) was not associated with the odds of having a urine albumin/creatinine ratio of 30–299 or ≥ 300 mg/g.ConclusionsThe independent association between standard deviation and the extent of albuminuria was lost when the measures were normalized by mean glucose level. At least in terms of relative measures of glycaemic variability, we failed to demonstrate an independent association between glycaemic variability and albuminuria extent in patients with inadequately controlled Type 2 diabetes.
Relationship of intratumoural protein expression patterns to age and Epstein‐Barr virus status in classical Hodgkin lymphoma
Authors: Ludvigsen Maja , Kamper Peter , Hamilton‐Dutroit Stephen J. , Bendix Knud , Møller Michael B. , d'Amore Francesco A. , Honoré Bent 
Published: October 2014

AbstractIn Western countries, the age distribution of Hodgkin lymphoma (HL) follows a characteristic bimodal curve showing an early and a late peak at approximately 35 and 70 yr, respectively. Furthermore, the presence of latent Epstein‐Barr virus (EBV) genome in the Hodgkin Reed–Sternberg cells, the tumour cell population of classical HL (cHL), has been found to have adverse prognostic impact in elderly, but not in younger cHL patients. We have characterised the protein expression in tumour tissue samples from younger (≤55 yr) and elderly (>55 yr) cHL patients and correlated the findings with EBV status. Differentially expressed proteins according to patients’ age as well as tumoural EBV status belonged to different biological functional domains, such as apoptosis, cytoskeletal organisation, response to oxygen levels and regulation of catabolic/metabolic processes. The differential expression of selected proteins, cytosolic aminopeptidase, heterogeneous nuclear ribonucleoprotein K, serotransferrin and alpha‐1‐antitrypsin was further validated by Western blot analysis. Discovery‐based proteomics characterising biological features distinctive for subsets of cHL patients may be useful for the identification of novel biomarkers with potential therapeutic relevance. An evaluation of the prognostic impact of protein expression pattern in general and individually expressed proteins in particular is warranted.
Prognostic relevance of the flow cytometric count of medullar blasts in myelodysplastic syndromes
Authors: Molteni Alfredo , Riva Marta , Cesana Clara , Speziale Valentina , Nichelatti Michele , Scarpati Barbara , Greco Rosa , Ravano Emanuele , Cairoli Roberto , Rossini Silvano , Morra Enrica 
Published: October 2014

AbstractObjectiveThe medullar blast count is a milestone in the prognostic assessment in myelodysplastic syndromes (MDS). The optical microscopy (OM) may sometimes be inaccurate in this disease. The aim of this work is to test the flow immunocytometric (FCM) determinations of medullar immature cells (CD45±) and the expression, among them, of CD33, CD34, and CD117 markers, for their prognostic relevance.MethodsIn a retrospective analysis of 98 patients affected by MDS, the IPSS was re‐calculated by means of the FCM determination of blasts. Survival of patients at low or intermediate‐1 IPSS risk was compared with the survival of patients at intermediate‐2 or high IPSS risk. In the 64 cases with OM blast count lower than 5%, the survival of patients with the FCM count of medullar blasts ≤2% was compared with that of patients with FCM count >2%.ResultsEach single marker had a prognostic weight comparable to the optical blast count. The FCM blast count was particularly efficient in distinguishing the risk of having up to 2% or more than 2% of blasts in patients without OM excess of blasts.ConclusionThis method is interesting as prognostic tool, especially in patients without excess of blast.