bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Ventricular Fibroma Presenting as Syncope and Ventricular Tachycardia
Authors: Joly Joanna M. , Fuisz Anthon R. , Weissman Gaby 
Published: April 2013

Cardiac fibromas represent the second most common benign cardiac mass seen in the pediatric population, but they are rarely seen in adults. Given their large size and unpredictable location within the heart, patients may present with varying symptomatology, and in many cases, the initial presentation is sudden death. Both echocardiography and magnetic resonance imaging are critical to the early diagnosis and prompt treatment of these potentially dangerous primary tumors. We report a 29‐year‐old woman presenting with syncope and ventricular tachycardia. She was found to have a 5.0 cm inferoapical left ventricular fibroma, which was successfully resected.
Courtship Display Persists Despite Early Social Deprivation
Authors: Barbosa Miguel , Ojanguren Alfredo F. , Magurran Anne E. 
Published: April 2013

AbstractEarly experience is known to be important in the development of mating behaviour. The behavioural and chemical stimuli obtained by observing adults interacting are thought to operate as template by which young acquire the ability to sexually display when appropriate. But, while the importance of early social interactions for the development of mating behaviour is well accepted, how social deprivation at different onto‐genetic phases contributes for this effect is poorly understood. Here, we address this gap by asking how social deprivation at different ontogenetic phases (before or after 6 wk) mediates male mating behaviour in the Trinidadian guppy. We show that in the absence of early social interaction, the latency of mating behaviour is briefly delayed, but that all individuals were able to sexually display in <30 min. Interestingly, regardless of the timing of social deprivation, mating behaviour starts sooner under female‐biased sex ratios environments that than under a male‐biased sex ratio, suggesting that male sexual behaviour is driven by female cues. The short‐lived effects of social deprivation on mating behaviour reflect the extraordinary innate plasticity of guppies, which is likely to contribute to their success as invasive species.
Biodiversity impacts of bioenergy crop production: a state‐of‐the‐art review
Authors: Immerzeel DESIRÉE J. , Verweij PITA A. , van der Hilst FLOOR , Faaij ANDRÉ P. C. 
Published: April 2013

AbstractThe use of biomass as feedstock for energy is often associated with increased claims on land, competition with food production and impacts on other ecosystem services. Studies on sustainability aspects of bioenergy production often indicate biodiversity as a key concern. This article presents a first comprehensive review of published impacts of bioenergy crop production on biodiversity, evaluates the drivers and pressures of biodiversity change and summarizes current trends and impacts. The review provides insight into the types of biodiversity indicators applied under a range of conditions and the mitigating measures proposed to minimize negative impacts or realize biodiversity benefits. The 53 selected publications give diverse results that are explained by the various spatial scales, production systems and regions, time horizons, methodologies and biodiversity indicators used. Reported impacts depend on initial land use and are mostly negative, especially in tropical regions. The impacts of second generation bioenergy crops tend to be less negative than first generation ones, and are in some cases positive (at the field level), in particular in temperate regions. Land‐use change appears as the key driver of biodiversity change, whereas the associated habitat loss, alterations in species richness and abundance are the main impacts addressed. Such changes are often paired with the (initiation of a) process of biological homogenization. The article confirms that concerns about the expansion of bioenergy crop production not only relate to the direct effects on biodiversity by replacing natural vegetation, but increasingly to indirect effects as well. These effects have, however, shown to be difficult to quantify. At the same time, the land sparing vs. land sharing debate receives growing attention, whereas little evidence exists in bioenergy literature on the impacts of large‐scale application of these strategies on (agro)biodiversity. Following the findings of the review, the article finally provides recommendations for future research.
Models for institutional and professional accreditation of haemophilia centres in Italy
Authors: Calizzani G. , Vaglio S. , Arcieri R. , Menichini I. , Tagliaferri A. , Antoncecchi S. , Carloni M. T. , Breda A. , Santagostino E. , Ghirardini A. , Tamburrini M. R. , Morfini M. , Mannucci P. M. , Grazzini G. 
Published: April 2013

SummaryThe Health Commission of the Conference between the Italian State and Regions recognized the need to establish an institutional accreditation model for Haemophilia Centres (HCs) to be implemented by 21 Regions in order to provide patients with haemophilia and allied inherited coagulations disorders with high and uniform standards of care. The Italian National Blood Centre, on behalf of the Commission, convened a panel of clinicians, patients, experts, representatives from Regions and Ministry of Health. The agreed methodology included: systematic literature review and best practice collection, analysis of provisions and regulations of currently avalable services, priority setting, definition of principles and criteria for the development of recommendations on the optimal requirements for HCs. The result was the formulation of two recommendations sets. Two sets of recommendations were produced. The first concerns regional policy planning, in which the following aspects of comprehensive haemophilia care should be considered for implementation: monitoring and auditing, multidisciplinary approach to clinical care, protocols for emergency management, home treatment and its monitoring, patient registries, drug availability and procurement, recruitment and training of health care professionals. The second set concerns the accreditation process and lists 23 organizational requirements for level 1 HCs and 4 additional requirements for level 2 HCs. These recommendations help to provide Italian Regional Health Authorities with an organizational framework for the provision of comprehensive care to patients with inherited coagulation disorders based on current scientific evidence.
Intracranial haemorrhage in von Willebrand disease: a report on six cases
Authors: Labarque V. , Stain A. M. , Blanchette V. , Kahr W. H. A. , Carcao M. D. 
Published: April 2013

SummaryThe incidence of intracranial haemorrhage (ICH) in von Willebrand disease (VWD) is not well documented. We describe our single centre experience regarding ICH in children with VWD and identify how such children presented and were managed. Thirty‐three head trauma events leading to medical attention occurred in 24 of 153 children with VWD followed in our institution. In only 15 of these were computed tomography (CT) imaging studies performed; seven in children with type 1 VWD, one in a child with type 2N VWD and seven in children with type 3 VWD. In six of these 15 episodes an ICH was identified: two children with type 1 VWD, one child with type 2N VWD and three children with type 3 VWD. In two of the 6 cases an ICH was only confirmed following a second CT scan. Neurological symptoms, including vomiting (noted in all six), headache, irritability, lethargy and/or alteration in the level of consciousness were present in all children with confirmed ICH. In contrast vomiting, irritability and alterations in level of consciousness were never present in those children without confirmed ICH. All three children with type 3 VWD who experienced an ICH were commenced on long‐term prophylaxis. ICH, although rare, does occur in children with VWD and particularly in children with type 3 VWD. A much larger cohort of patients with VWD experiencing an ICH is needed to make recommendations regarding treatment of such events, including the role of prophylaxis in patients with more severe forms of VWD.
Impaired brain activity in cirrhotic patients with minimal hepatic encephalopathy: Evaluation by near‐infrared spectroscopy
Authors: Nakanishi Hiroyuki , Kurosaki Masayuki , Nakanishi Kaoru , Tsuchiya Kaoru , Noda Takamasa , Tamaki Nobuharu , Yasui Yutaka , Hosokawa Takanori , Ueda Ken , Itakura Jun , Anami Kimitaka , Asahina Yasuhiro , Enomoto Nobuyuki , Higuchi Teruhiko , Izumi Namiki 
Published: April 2013

AimNear‐infrared spectroscopy (NIRS) is a tool that could non‐invasively measure the regional cerebral oxygenated hemoglobin (oxy‐Hb) concentration with high time resolution. The aim of the present study is to reveal the time‐dependent regional cerebral oxy‐Hb concentration change coupled with brain activity during task performance in patients with minimal hepatic encephalopathy (MHE).MethodsCerebral oxy‐Hb concentration was measured by using NIRS in 29 cirrhotic patients without overt hepatic encephalopathy (HE). Of those, 16 patients who had abnormal electroencephalography findings were defined as having MHE. Responsive increase in oxy‐Hb during a word‐fluency task was compared between MHE and non‐MHE patients.ResultsThere was no difference in the maximum value of oxy‐Hb increase between patients with and without MHE (0.26 ± 0.12 vs 0.32 ± 0.22 mM·mm, P = 0.37). However, the pattern of the time course changes of oxy‐Hb was different between the two groups. The MHE group was characterized by a gradual increase of oxy‐Hb throughout the task compared to steep and repetitive increase in the non‐MHE group. Increase in oxy‐Hb concentration at 5 s after starting the task was significantly small in the MHE group compared to the non‐MHE (0.03 ± 0.05 vs 0.11 ± 0.09 mM·mm, P = 0.006).ConclusionThe cerebral oxygen concentration is poorly reactive in response to tasks among cirrhotic patients without overt HE but having abnormal electroencephalography findings. These impaired responses in regional cerebral oxy‐Hb concentration may be related to the latent impairment of brain activity seen in MHE.
Impact of a cybertutor in dermatological teaching
Authors: Soirefmann Mariana , Comparin Cristiane , Boza Juliana , Wen Chao Lung , Cestari Tania Ferreira 
Published: April 2013

AbstractBackgroundThe potential value of multimedia programs as an accessory instrument for medical education has already been demonstrated in several areas. However, most of them lack adequate validation. The authors proposed this study in order to develop and evaluate a computer multimedia program, aiming at providing a more attractive and state of the art learning tool in dermatology.MethodsThe cybertutor was developed containing clinical cases, self‐education classes, and short video presentations. In order to evaluate its impact, 50 undergraduate students attending the third year of Medical School at UFRGS were randomized into two groups: group 1 was submitted to a multimedia program on a specific dermatological subject – parasite infestations, and group 2 to standard classes on the same subject. Both classes were taught by an experienced teacher, on the same subject and at the same time. In the end, the level of knowledge acquisition for the two groups was evaluated by a multiple choice test.ResultsThe average of correct answers was 11.16 (SD = 1.625) in group 1 and 11.96 (SD = 1.645) in group 2. There were no statistically significant differences between the two groups (P = 0.09). The majority (80%) of the students who attended the cybertutor group showed interest in taking part in similar activities.ConclusionsAccording to this study, multimedia programs may be used for undergraduate education in Dermatology as a complementary educational tool. Contact with an instructor is still considered to be important and should be offered simultaneously.
Repair of postpneumonectomy bronchopleural fistula using pedicled pericardial flap supported by fibrin glue
Authors: Jabłoński Sławomir , Brocki Marian , Klejszmit Piotr , Kutwin Leszek , Wawrzycki Marcin , Śmigielski Jacek 
Published: April 2013

AbstractEffective closure of the postpneumonectomy bronchopleural fistula (PBF) with the use of different techniques still remains a challenge for thoracic surgeons. The aim of this study was to evaluate the efficacy of modified method of PBF closure using pedicled pericardial flap (PPF) supported by fibrin glue (FG). The efficacy of the late PBF closure with the use of two surgical methods was compared. In 10 patients, the edges of the PBF were covered with FG and PPF. In the second group of nine patients, myoplasty was used to close the bronchial fistula. Postsurgical follow‐up was for 1 year. In the first group, the healing of the fistula was achieved in 100% of the cases, whereas in the second, myoplasty group, healing was achieved in only 66·67% of the cases. The number of complications was similar in both groups. Pericardial flap supported by fibrin glue can be an effective method adjunctive to the treatment of PBF in selected patients.
The Psoriasis Symptom Diary: development and content validity of a novel patient‐reported outcome instrument
Authors: Lebwohl Mark , Swensen Andrine R. , Nyirady Judit , Kim Edward , Gwaltney Chad J. , Strober Bruce E. 
Published: April 2013

SummaryBackgroundChronic plaque psoriasis has a profound impact on a patient's daily life. To understand the effects of psoriasis treatments, it is essential to assess the patient's experience of symptoms and how they impact their daily life. The goal of this study was to develop and establish the content validity of a new patient reported outcome (PRO) psoriasis measure.MethodsThe Psoriasis Symptom Diary was developed by (i) identifying key plaque psoriasis‐related symptoms and impacts through qualitative patient interviews (n = 29); (ii) developing an initial set of items that captured the key patient experiences; and (iii) conducting cognitive interviews to test patient understanding of items selected for inclusion in the new psoriasis symptom measure (n = 16).ResultsPatients noted a variety of symptoms, with plaque‐related pain (including related concepts of burning and stinging), changes in skin appearance, and itching reported by all patients. Patients also expressed notable embarrassment and avoidance of social situations, due to the appearance of plaques, and limited mobility. The Psoriasis Symptom Diary assesses the severity and impact of symptoms using a 24‐hour recall period to reduce recall bias and error.ConclusionsThe Psoriasis Symptom Diary was developed to assess important symptoms and disease‐related impacts in a manner consistent with guidelines for establishing the content validity of new PRO instruments. Following quantitative psychometric testing, the Psoriasis Symptom Diary may support efficacy endpoints in clinical trials.
Comparison of Mathematical Models of Lactic Acid Bacteria Growth in Vacuum‐Packaged Raw Beef Stored at Different Temperatures
Authors: Li M. Y. , Sun X. M. , Zhao G. M. , Huang X. Q. , Zhang J. W. , Tian W. , Zhang Q. H. 
Published: April 2013

AbstractThe lactic acid bacteria grown in vacuum‐packaged raw beef under 7, 10, 15, and 20 °C has been studied in this paper. Four primary models, the modified Gompertz, logistic, Baranyi, and Huang model were used for data fitting. Statistical criteria such as the bias factor and accuracy factor, mean square error, Akaike's information criterion, and the residual distribution were used for comparing the models. The result showed that all of the 4 models can fit the data well and they were not significantly different in the performance. They were equally capable of describing bacterial growth, but the growth rate and lag time estimated from the modified Gompertz model were a little higher than other models. The estimate for the lag time was not accurate as the growth rate.
Fabrication of Highly Textured Fine‐Grained α‐Alumina by Templated Grain Growth of Nanoscale Precursors
Authors: Chang Yunfei , Poterala Stephen , Yener Doruk , Messing Gary L 
Published: April 2013

[0001] textured alumina ceramics with a fine grain size were fabricated between 1400°C and 1600°C via templated grain growth (TGG) using fine alumina platelets (~0.6 and ~3 μm diameter) aligned by tape casting in either a 50 nm α‐Al2O3 matrix powder, or in a seeded boehmite sol. The 3 μm templates could be readily aligned by tape casting in both matrices (orientation parameters r = 0.27 and 0.18, respectively), whereas 0.6 μm diameter templates were well aligned in the seeded boehmite sol only (r = 0.29). Improved alignment in boehmite sols is attributed to inorganic gelation, resulting in a strongly pseudo‐plastic rheology that preserves template alignment against the influence of Brownian motion. The in situ formation of fine α‐Al2O3 matrix after transformation in the seeded boehmite system results in a higher driving force for TGG and improves texture development. The combination of 3 μm templates with a seeded boehmite matrix results in extremely high texture qualities (texture fraction f = 0.97–0.99, r = 0.17) while maintaining a relatively fine grain size (5–10 μm in diameter and 1.5–3 μm in thickness). Although undoped samples can be fully textured at 1600°C, adding as little as ~0.25 wt% CaO/SiO2 dopant improves TGG kinetics and yields full texture at 1400°C.
Identification and antifungal susceptibility of fungi isolated from dermatomycoses
Authors: Silva L.B. , de Oliveira D.B.C. , da Silva B.V. , de Souza R.A. , da Silva P.R. , Ferreira‐Paim K. , Andrade‐Silva L.E. , Silva‐Vergara M.L. , Andrade A.A. 
Published: April 2013

AbstractBackgroundDermatomycoses are superficial fungal infections of the skin, hair and nails that affect more than 20–25% of the people worldwide. These infections can be caused by yeasts, dermatophytes and non‐dermatophyte filamentous fungi (NDFF) and are considered a public health problem. Despite this, few studies have investigated the prevalence and antifungal susceptibility of causative agents of dermatomycoses in the developing world.ObjectivesThe aims of this study were to identify and determine the antifungal susceptibility profile of yeast and filamentous fungi isolated from dermatomycoses in Uberaba, Minas Gerais, Brazil.MethodsSpecimens were obtained from patients with clinically diagnosed and laboratory confirmed dermatomycosis between July 2009 and July 2011. Fungal identification was based on classical methods and antifungal susceptibility testing was performed by broth microdilution method.ResultsOf the 216 fungal isolates, 116 (53.8%) were yeasts, 70 (32.4%) dermatophytes and 30 (13.8%) NDFF. Onychomycosis was the most common clinical condition. Candida parapsilosis (24.1%) and Trichophyton rubrum (17.1%) were the fungi most frequently isolated. Voriconazole, ketoconazole and itraconazole were the most potent antifungal agents against yeast, whereas terbinafine, voriconazole and itraconazole had a high in vitro activity against dermatophytes. Overall, the antifungal agents had little or no activity against NDFF and the highest minimum inhibitory concentrations were those against Fusarium spp.ConclusionYeasts, particularly C. parapsilosis, play an important role as causative agents of dermatomycosis in our region. Our results suggest that the antifungal susceptibility testing coupled with proper identification of the fungi may be useful to assist clinicians in determining the appropriate therapy for dermatomycoses.
Water loss at normal enamel histological points during air drying at room temperature
Authors: DE MEDEIROS R.C.G. , DE LIMA T.A.S. , GOUVEIA C.R. , DE SOUSA F.B. 
Published: April 2013

SummaryThis in vitro study aimed to quantify water loss at histological points in ground sections of normal enamel during air drying at room temperature (25°C) and relative humidity of 50%. From each of 10 ground sections of erupted permanent human normal enamel, three histological points (n = 30) located at 100, 300 and 500 μm from enamel surface and along a transversal following prisms paths were characterized regarding the mineral, organic and water volumes. Water loss during air drying was from 0 to 48 h. Drying occurred with both falling and constant‐drying rates, and drying stabilization times (Teq) ranged from 0.5 to 11 h with a mean 0.26 (±0.12)% weight loss. In some samples (n = 5; 15 points), Teq increased as a function of the distance from the enamel surface, and drying occurred at an apparent diffusion rate of 3.47 × 10−8 cm2 s−1. Our data provide evidence of air drying resulting in air replacing enamel's loosely bound water in prisms sheaths following a unidirectional water diffusion rate of 3.47 × 10−8 cm2 s−1 (from the original enamel surface inward), not necessarily resulting in water evaporating directly into air, with important implications for transport processes and optical and mechanical properties.
Enhancing frontline clinical leadership in an acute hospital trust
Authors: Phillips Natasha , Byrne Geraldine 
Published: April 2013

Aims and objectivesTo report on a leadership programme for ward managers in one National Health Service Trust that aimed to enhance their contribution to the delivery of the organisation's key objectives to support excellent patient experience.BackgroundEffective ward leadership has been recognised as vital to the quality of care, resource management and interprofessional working. However, there is evidence that, at present, front‐line nurse leaders are ill equipped to lead effectively and lack confidence in their ability to do so.DesignThe project aimed to provide a tailored programme for ward managers to develop their portfolio of skills to perform this pivotal role. The course contained two key elements: an integrated teaching programme to enhance leadership knowledge and skills and action learning to facilitate application to individual's own leadership practice. Both were underpinned by a change project where each individual indentified, undertook and evaluated an innovation in practice.MethodsTwenty‐two ward managers completed the leadership programme. Participants completed semi‐structured questionnaires after each taught module. Action learning was evaluated through a combined structured and semi‐structured questionnaire.ResultsAll participants evaluated the programme as increasing their repertoire of leadership skills. Following completion of the programme, ward managers continue to work together as an evolving community of practice.ConclusionWard managers' development is enhanced by a programme integrating theory, action learning and completion of a ward‐based project.Relevance to clinical practiceWard managers cannot be effectively developed in isolation. Leadership development is best supported where the organisation is also committed to developing. A leadership development programme that incorporates knowledge from within the organisation with external expertise can be an effective method to enhance front‐line clinical leadership.