bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kava dermopathy in Fiji: an acquired ichthyosis?
Authors: Hannam Sarah , Murray Michael , Romani Lucia , Tuicakau Meciusela , J Whitfeld Margot 
Published: July 2014

SummaryKava dermopathy is a common cutaneous effect of regular or heavy use of Kava, a psychoactive beverage consumed widely throughout the Pacific. In Fiji in 2012, over 1000 study participants underwent full skin examination, and kava dermopathy was a common cutaneous finding. The clinical manifestations of kava dermopathy share similarities with the spectrum of autosomal recessive congenital ichthyoses, predominantly lamellar ichthyosis. The pathogenesis of Kava dermopathy may be associated with a functional defect in one or more cytochrome P450 enzymes implicated in epidermal integrity, thus mimicking the genetic defect as seen in lamellar ichthyosis type 3.
Association between an educational intervention and a reduction in inappropriate troponin testing in patients presenting to an adult emergency department
Authors: Scorgie R. , Nicholls G. M. , Jones P. 
Published: July 2014

AbstractBackgroundHigh‐sensitivity troponin replaced the fourth generation assay at our institution in July 2010. Prior experience suggested that the number of positive tests with the new assay may double, and that many troponin requests were inappropriate.AimPrimarily, this study aims to design and measure the effect of an educational intervention to reduce the number of inappropriate troponin tests. Second, other objectives are to compare weekly totals of troponin tests before and after the intervention, to note patients with missed acute coronary syndrome (ACS) during the study period and to survey clinicians regarding their likely troponin ordering practices in certain clinical scenarios.MethodsA staff survey informed the content of the educational intervention. Criteria for inappropriate testing were defined prior to the study. Retrospective notes review of pre‐and post‐intervention cohorts were used to determine the reduction in inappropriate troponin tests.ResultsNinety‐six patients were in each cohort. The proportion of inappropriate tests fell from 43% (95% confidence interval (CI) 33–53) pre‐intervention to 22% (95% CI 14–31) post‐intervention, P = 0.002. Weekly total of troponin tests performed decreased from a mean of 298 (95% CI, 290–307) pre‐intervention to 244 (95% CI 232–255) post‐intervention, P < 0.001. No cases of missed ACS were found; all cause mortality was unchanged following the intervention.ConclusionOur educational intervention was associated with a reduction in inappropriate use of troponin tests and a reduction in the total number of tests requested, with no known missed ACS. Others faced with a change to a high‐sensitivity assay should consider a similar intervention.
Sentinel surveillance of influenza in Burkina Faso: identification of circulating strains during 2010–2012
Authors: Tarnagda Zékiba , Yougbaré Issaka , Ilboudo Abdoul K. , Kagoné Thérèse , Sanou Armel M. , Cissé Assana , Médah Isaïe , Yelbéogo Denis , Talla Nzussouo Ndahwouh 
Published: July 2014

BackgroundAlthough influenza surveillance has recently been improved in some sub‐Saharan African countries, no information is yet available from Burkina Faso.ObjectivesOur study was the first to determine the prevalence of influenza viruses circulating in Burkina Faso through a sentinel surveillance system.MethodsWe conducted sentinel surveillance with oropharyngeal (OP) swabs collected from outpatients (1 month to 83 years) from six sites in Bobo‐Dioulasso and Ouagadougou, among patients meeting the WHO/CDC case definition for influenza‐like illness (ILI; fever ≥38°C, and cough and/or sore throat in the absence of other diagnosis) from July 2010 to May 2012. Influenza viruses were detected by real‐time RT‐PCR using CDC primers, probes, and protocols.ResultsThe first three ILI cases were enrolled each day; of 881 outpatients with ILI enrolled and sampled, 58 (6·6%) tested positive for influenza viruses (29 influenza A and 29 influenza B). Among the influenza A viruses, 55·2% (16/29) were influenza A (H1N1)pdm09 and 44·8% (13/29) were seasonal A (H3N2). No cases of seasonal A/H1N1 were detected. Patients within 0–5 years and 6–14 years were the most affected, comprising 41·4% and 22·4% laboratory‐confirmed influenza cases, respectively. Influenza infections occurred during both the dry, dusty Harmattan months from November to March and the rainy season from June to October with peaks in January and August.ConclusionsThis surveillance was the first confirming the circulation of influenza A (H1N1)pdm09, A/H3N2, and influenza B viruses in humans in Burkina Faso.
A companionship between strangers – learning from fellow people with cancer in oncology wards
Authors: Andersen Lene Søndergård , Larsen Birte Hedegaard , Birkelund Regner 
Published: July 2014

AbstractAimAn identification and discussion of learning from experience among hospitalized people with cancer.BackgroundA good deal of literature focuses on the fact that the needs of patients for information about their disease and treatment should be met by healthcare professionals. Less attention is given to the kind of information that can be provided by personal experience. Patient–patient interaction as a learning situation has not been identified in current research.DesignThe study methodology was qualitative and influenced by ethnography.MethodA qualitative approach with participant observation and qualitative interviews was used. From a total of 85 observed people with cancer, ten men and ten women were interviewed in 2010–2011. Data were analysed using qualitative data analysis inspired by Ian Dey and structured using NVivo9.FindingsThe hospitalized patients learnt about life with cancer from sharing information and personal experiences with fellow patients. Information from fellow patients was complementary to information given by healthcare professionals. Sharing personal experiences led patients to oscillate between four general response stages: the response of fighting, the response of keeping hope, the response of non‐acceptance and the response of capitulation.ConclusionLearning from exchanges of experiences with fellow patients provided a better understanding about the disease and was valued because it was first‐hand knowledge. Patients’ personal experience of disease is an underused resource in nursing.
Relationship dimensions of the ‘Down syndrome advantage’
Authors: Mitchell D. B. , Hauser‐Cram P. , Crossman M. K. 
Published: July 2014

AbstractBackgroundSome researchers have proposed an ‘advantage’ for parents of children with Down syndrome over parents of children with other intellectual disabilities, especially in relation to experiencing less parenting stress. Others have maintained that these differences are an artefact of demographic and related differences. This study extends the investigation of possible differences in dimensions of parenting stress and also examines whether differences exist in maternal and child contingent responsiveness during mother–child interaction in these two groups.MethodMothers of children with Down syndrome (n = 43) and undifferentiated developmental disabilities (n = 54) completed measures of children's adaptive functioning and behaviour problems, parenting stress and maternal social support. Observers rated the contingent interactions between mothers and children using the Nursing Child Assessment Teaching Scale.ResultsOnce mother's age, education and social support as well as child adaptive functioning and behaviour problems were considered, neither parent nor child related parenting stress demonstrated an advantage for parents of children with Down syndrome. However, a ‘Down syndrome advantage’ was apparent for both maternal and child contingent responsiveness after accounting for maternal demographic and contextual variables and child attributes.ConclusionsChildren with Down syndrome and their mothers have more positive interactions than children with other developmental disabilities, both in terms of the responsiveness of mothers and of child responses contingent on maternal behaviour. These findings suggest that both children with Down syndrome themselves and their mothers are contributing to a Down syndrome advantage.
LeuO enhances butyrate‐induced virulence expression through a positive regulatory loop in enterohaemorrhagic Escherichia coli
Authors: Takao Miyuki , Yen Hilo , Tobe Toru 
Published: July 2014

SummaryEnterohaemorrhagic Escherichia coli (EHEC) causes bloody diarrhoea and other severe symptoms such as haemorrhagic uraemic syndrome. The expression of virulence genes on the locus for enterocyte effacement (LEE) and associated genes is regulated by a variety of factors, including transcriptional regulators and environmental signals. Butyrate, one of the major short‐chain fatty acids present in the intestine, enhances expression of LEE genes and flagella biosynthesis genes in EHEC O157:H7, resulting in increased bacterial adherence and motility. Here, we show that expression of the leuO gene, which encodes a LysR‐type transcriptional regulator, is enhanced by butyrate via Lrp, which is also necessary for butyrate‐induced responses of LEE genes. LeuO expression induces prolonged activation of the promoter of LEE1 operon, including the ler gene, as well as virulence mechanisms such as microcolony formation. Activation of the LEE1 promoter by LeuO depends on another regulator, called Pch. The response of the leuO promoter to butyrate requires two virulence regulators, Pch and Ler, in addition to Lrp. Pch, Ler and Lrp bind the upstream region of the leuO promoter. Thus, leuO is involved in butyrate‐enhanced expression of LEE genes through a positive feedback mechanism, but its expression and action on the LEE1 promoter are dependent on the virulence regulators Pch and Ler.
Pascal's Wager Today: Belief and the Gift of Existence
Authors: Hodge Joel 
Published: July 2014

AbstractThe enduring value of the Pascal's Wager is that, bypassing intractable debates over God's existence, it brings the question of God into a practical, existential focus. This essay seeks to re-examine this famous Wager for its possible application to the current context of widespread agnosticism and increasingly assertive atheism. The essay argues that if rightly contextualised the Wager reminds people to seriously address their need for meaningful commitments and to confront their mortality. Rather than focusing on winning and losing in the afterlife, the Wager in our modern context can serve to highlight how human life is structured according to meaning, giftedness and relationality. Revealing the gifted and finite nature of existence provides grounds for a discussion of ultimate meaning and God.
WILDLIFE RESERVES, POPULATIONS, AND HUNTING OUTCOME WITH SMART WILDLIFE
Authors: JENSEN FRANK , JACOBSEN JETTE BREDAHL , STRANGE NIELS , THORSEN BO JELLESMARK 
Published: July 2014

AbstractWe consider a hunting area and a wildlife reserve and answer the question: How does clever migration decision affect the social optimal and the private optimal hunting levels and population stocks? We analyze this in a model allowing for two‐way migration between hunting and reserve areas, where the populations’ migration decisions depend on both hunting pressure and relative population densities. In the social optimum a pure stress effect on the behavior of smart wildlife exists. This implies that the population level in the wildlife reserve tends to increase and the population level in the hunting area and hunting levels tend to decrease. On the other hand, the effect on stock tends to reduce the population in the wildlife reserve and increase the population in the hunting area and thereby also increase hunting. In the case of the private optimum, open‐access is assumed and we find that the same qualitative results arise when comparing a situation with and without stress effects, but of course at a higher level of hunting. We also show that when net social benefits of hunting dominate the net social benefits of populations, wildlife reserves are optimally placed in areas of low carrying capacity and vice versa.
Kidney and liver transplantation in children with fibrocystic liver–kidney disease: Data from the US Scientific Registry of Transplant Recipients: 1990–2010
Authors: Wen Jessica W. , Furth Susan L. , Ruebner Rebecca L. 
Published: July 2014

AbstractThe natural history and survival of children with fibrocystic liver–kidney disease undergoing solid organ transplantation have infrequently been described. We report outcomes in a cohort of US children with fibrocystic liver–kidney disease receiving solid organ transplants over 20 yr. Retrospective cohort study of pediatric transplant recipients with diagnoses of fibrocystic liver–kidney disease from 1/1990 to 3/2010, using data from the SRTR. Subjects were categorized by the first transplanted organ: LT, KT, or SLK. Primary outcomes were death, re‐transplant, transplant of the alternate organ, or initiation of dialysis. Seven hundred and sixteen subjects were transplanted in this period. Median age at first transplant was 9.7 yr. Of the LT, 14 (19%) required a second liver transplant at median of 0.2 yr, and five (7%) required kidney transplant or dialysis at a median of 9.0 yr. Of the KT, 188 (31%) required a second kidney transplant or dialysis at a median of 5.9 yr. Twenty‐nine (5%) subsequently received liver transplant at a median of 6.0 yr. Among patients in this registry, far more children underwent kidney than liver transplants. The risk of subsequently needing transplantation of an alternate organ was low.
Interaction of Interferon Gamma-Induced Reactive Oxygen Species with Ceftazidime Leads to Synergistic Killing of Intracellular Burkholderia pseudomallei
Authors: Mosovsky Kara , Silva Ediane , Troyer Ryan , Propst-Graham Katie , Dow Steven 
Published: July 2014

ABSTRACT

Burkholderia pseudomallei
, a facultative intracellular pathogen, causes severe infections and is inherently refractory to many antibiotics. Previous studies from our group have shown that interferon gamma (IFN-γ) interacts synergistically with the antibiotic ceftazidime to kill bacteria in infected macrophages. The present study aimed to identify the underlying mechanism of that interaction. We first showed that blocking reactive oxygen species (ROS) pathways reversed IFN-γ- and ceftazidime-mediated killing, which led to our hypothesis that IFN-γ-induced ROS interacted with ceftazidime to synergistically kill
Burkholderia
bacteria. Consistent with this hypothesis, we also observed that buthionine sulfoximine (BSO), another inducer of ROS, could substitute for IFN-γ to similarly potentiate the effect of ceftazidime on intracellular killing. Next, we observed that IFN-γ induced ROS-mediated killing of intracellular but not extracellular bacteria. On the other hand, ceftazidime effectively reduced extracellular bacteria but was not capable of intracellular killing when applied at 10 μg/ml. We investigated the exact role of IFN-γ-induced ROS responses on intracellular bacteria and notably observed a lack of actin polymerization associated with
Burkholderia
bacteria in IFN-γ-treated macrophages, which led to our finding that IFN-γ-induced ROS blocks vacuolar escape. Based on these results, we propose a model in which synergistically reduced bacterial burden is achieved primarily through separate and compartmentalized killing: intracellular killing by IFN-γ-induced ROS responses and extracellular killing by ceftazidime. Our findings suggest a means of enhancing antibiotic activity against
Burkholderia
bacteria through combination with drugs that induce ROS pathways or otherwise target intracellular spread and/or replication of bacteria.
Randomized Controlled Trial Comparing 7-Day Triple, 10-Day Sequential, and 7-Day Concomitant Therapies for Helicobacter pylori Infection
Authors: Hsu Ping-I , Wu Deng-Chyang , Chen Wen-Chi , Tseng Hui-Hwa , Yu Hsien-Chung , Wang Huay-Min , Kao Sung-Shuo , Lai Kwok-Hung , Chen Angela , Tsay Feng-Woei 
Published: July 2014

ABSTRACT

With the rising prevalence of antimicrobial resistance, the failure rate of the standard triple therapy for
Helicobacter pylori
infection is increasing. Sequential therapy and concomitant therapy have been recommended to replace standard triple therapy for
H. pylori
eradication in regions with high clarithromycin resistance. The aim of this prospective, randomized, and controlled study was to simultaneously assess the efficacies of 10-day sequential and 7-day concomitant therapies versus a 7-day standard triple therapy for treating
H. pylori
infection. Consecutive
H. pylori
-infected subjects were randomly assigned to a 7-day standard triple therapy (pantoprazole, clarithromycin, and amoxicillin for 7 days), a 10-day sequential therapy (pantoprazole and amoxicillin for 5 days, followed by pantoprazole, clarithromycin, and metronidazole for a further 5 days), or a 7-day quadruple therapy (pantoprazole, clarithromycin, amoxicillin, and metronidazole for 7 days).
H. pylori
status was confirmed 6 weeks after therapy. Three hundred seven
H. pylori
-infected participants were randomized to receive triple (
n
= 103), sequential (
n
= 102), or concomitant (
n
= 102) therapies. The eradication rates by an intention-to-treat analysis in the three treatment groups were 81.6% (95% confidence interval [CI], 74.1% to 89.0%), 89.2% (95% CI, 83.2% to 95.2%), and 94.1% (95% CI, 89.5% to 98.7%). The seven-day concomitant therapy had a higher eradication rate than did the 7-day triple therapy (difference, 12.5%; 95% CI, 3.7% to 21.3%). There were no significant differences in the eradication rates between the sequential and standard triple therapies. All three treatments exhibited similar frequencies of adverse events (8.7%, 8.8%, and 13.7%, respectively) and drug compliance (99.0%, 98.0%, and 100.0%, respectively). In conclusion, the seven-day concomitant therapy is superior to the 7-day standard triple therapy for
H. pylori
eradication. Additionally, it is less complex than the 10-day sequential therapy because the drugs are not changed halfway through the treatment course. (This study has been registered at
ClinicalTrials.gov
under registration no. NCT1769365.)
Whole-Genome Assembly of Klebsiella pneumoniae Coproducing NDM-1 and OXA-232 Carbapenemases Using Single-Molecule, Real-Time Sequencing
Authors: Doi Yohei , Hazen Tracy H. , Boitano Matthew , Tsai Yu-Chih , Clark Tyson A. , Korlach Jonas , Rasko David A. 
Published: July 2014

ABSTRACT

The whole-genome sequence of a carbapenem-resistant
Klebsiella pneumoniae
strain, PittNDM01, which coproduces NDM-1 and OXA-232 carbapenemases, was determined in this study. The use of single-molecule, real-time (SMRT) sequencing provided a closed genome in a single sequencing run.
K. pneumoniae
PittNDM01 has a single chromosome of 5,348,284 bp and four plasmids: pPKPN1 (283,371 bp), pPKPN2 (103,694 bp), pPKPN3 (70,814 bp), and pPKPN4 (6,141 bp). The contents of the chromosome were similar to that of the
K. pneumoniae
reference genome strain MGH 78578, with the exception of a large inversion spanning 23.3% of the chromosome. In contrast, three of the four plasmids are unique. The plasmid pPKPN1, an IncHI1B-like plasmid, carries the
bla
NDM-1
,
armA
, and
qnrB1
genes, along with tellurium and mercury resistance operons.
bla
NDM-1
is carried on a unique structure in which Tn
125
is further bracketed by IS
26
downstream of a class 1 integron. The IncFIA-like plasmid pPKPN3 also carries an array of resistance elements, including
bla
CTX-M-15
and a mercury resistance operon. The ColE-type plasmid pPKPN4 carrying
bla
OXA-232
is identical to a plasmid previously reported from France. SMRT sequencing was useful in resolving the complex bacterial genomic structures in the
de novo
assemblies.
In Vivo
Effect of Quaternized Chitosan-Loaded Polymethylmethacrylate Bone Cement on Methicillin-Resistant Staphylococcus epidermidis Infection of the Tibial Metaphysis in a Rabbit Model
Authors: Tan Hong-lue , Ao Hai-yong , Ma Rui , Lin Wen-tao , Tang Ting-ting 
Published: July 2014

ABSTRACT

Infection of open tibial fractures with contamination remains a challenge for orthopedic surgeons. Local use of antibiotic-impregnated polymethylmethacrylate (PMMA) beads and blocks is a widely used procedure to reduce the risk of infection. However, the development of antibiotic-resistant organisms make the management of infection more difficult. Our
in vitro
study demonstrated that quaternized chitosan (hydroxypropyltrimethyl ammonium chloride chitosan [HACC])-loaded PMMA bone cement exhibits strong antibacterial activity toward antibiotic-resistant bacteria. Therefore, the present study aimed to investigate the
in vivo
antibacterial activity of quaternized chitosan-loaded PMMA. Twenty-four adult female New Zealand White rabbits were used in this study. The right proximal tibial metaphyseal cavity was prepared, 10
7
CFU of methicillin-resistant
Staphylococcus epidermidis
was inoculated, and PMMA-only, gentamicin-loaded PMMA (PMMA-G), chitosan-loaded PMMA (PMMA-C), or HACC-loaded PMMA (PMMA-H) bone cement cylinders were inserted. During the follow-up period, the infections were evaluated using X rays on days 21 and 42 and histopathological and microbiological analyses on day 42 after surgery. Radiographic indications of bone infections, including bone lysis, periosteal reactions, cyst formation, and sequestral bone formation, were evident in the PMMA, PMMA-G, and PMMA-C groups but not in the PMMA-H group. The radiographic scores and gross bone pathological and histopathological scores were significantly lower in the PMMA-H group than in the PMMA, PMMA-G, and PMMA-C groups (
P
< 0.05). Explant cultures also indicated significantly less bacterial growth in the PMMA-H group than in the PMMA, PMMA-G, and PMMA-C groups (
P
< 0.01). We concluded that PMMA-H bone cement can inhibit the development of bone infections in this animal model inoculated with antibiotic-resistant bacteria, thereby demonstrating its potential application for treatment of local infections in open fractures.
BB0238, a Presumed Tetratricopeptide Repeat-Containing Protein, Is Required during Borrelia burgdorferi Mammalian Infection
Authors: Groshong Ashley M. , Fortune Danielle E. , Moore Brendan P. , Spencer Horace J. , Skinner Robert A. , Bellamy William T. , Blevins Jon S. 
Published: July 2014

ABSTRACTThe Lyme disease spirochete,Borrelia burgdorferi, occupies both a tick vector and mammalian host in nature. Considering the unique enzootic life cycle ofB. burgdorferi, it is not surprising that a large proportion of its genome is composed of hypothetical proteins not found in other bacterial pathogens.bb0238encodes a conserved hypothetical protein of unknown function that is predicted to contain a tetratricopeptide repeat (TPR) domain, a structural motif responsible for mediating protein-protein interactions. To evaluate the role ofbb0238during mammalian infection, abb0238-deficient mutant was constructed. Thebb0238mutant was attenuated in mice infected via needle inoculation, and complementation ofbb0238expression restored infectivity to wild-type levels.bb0238expression does not change in response to varying culture conditions, and thus, it appears to be constitutively expressed underin vitroconditions.bb0238is expressed in murine tissues during infection, though there was no significant change in expression levels among different tissue types. Localization studies indicate that BB0238 is associated with the inner membrane of the spirochete and is therefore unlikely to promote interaction with host ligands during infection.B. burgdorfericlones containing point mutations in conserved residues of the putative TPR motif of BB0238 demonstrated attenuation in mice that was comparable to that in thebb0238deletion mutant, suggesting that BB0238 may contain a functional TPR domain.