bluuebunny/crossref_metadata_2025_split huggingface dataset:
The significance of hypersensitivity to autologous sweat and serum in cholinergic urticaria: cholinergic urticaria may have different subtypes
Authors: Kim Jung Eun , Jung Kwan Ho , Cho Hyun Hee , Kang Hoon , Park Young Min , Park Hyun Jeong , Lee Jun Young 
Published: July 2014

AbstractBackgroundThe pathogenesis of cholinergic urticaria (ChU) has been unclear except for the involvement of acetylcholine. Attempts to classify ChU according to etiology have rarely been performed.ObjectiveTo evaluate the significance of responsiveness to autologous sweat and serum in ChU in relation to their clinical characteristics.MethodsThis study involved 18 patients diagnosed with ChU between January 2010 and April 2011 in the Catholic Medical Center‐St. Paul's Hospital. History taking included symptom duration, association with atopy, decreased sweat secretions, seasonal variation, and response to treatment. Intradermal autologous serum skin test (ASST) and autologous sweat skin test (ASwST) and basophil histamine release test with sweat were done.ResultsSweat hypersensitivity was proven by a positive ASwST and basophil histamine release test in only 37.5% of patients with ChU, and in none of the healthy controls. The weal size of ASwST correlated with percentage basophil histamine release. A positive response to autologous serum was displayed by 38.9% of patients, whereas 10% of healthy controls showed a positive ASST response. Intriguingly, patients with a positive ASwST had a negative ASST, and vice versa. Despite this, there was no difference in the clinical characteristics between positive ASST and positive ASwST groups.ConclusionsThe frequency of hypersensitivity to autologous sweat and serum was significantly higher in patients with ChU, compared with healthy controls. This suggests that autoimmunity to an unknown serum factor as well as sweat hypersensitivity may be involved in the pathogenesis of ChU.
Sticking to minimum standards: implementing antibiotic stewardship in intensive care
Authors: Chaves N. J. , Ingram R. J. , MacIsaac C. M. , Buising K. L. 
Published: July 2014

AbstractBackgroundIn Australia, antimicrobial stewardship programmes are a compulsory component of hospital accreditation. Good documentation around anti‐microbial prescribing aids communication and can improve prescribing practice in environments with multiple decision makers.AimThis study aims to develop and implement an intervention to improve antimicrobial prescribing practice in a 24‐bed intensive care unit in a tertiary referral adult hospital.MethodsWe conducted a four‐phase (observation, reflection, implementation, evaluation) prospective collaborative before–after quality improvement study. Baseline audits and surveys of antimicrobial prescribing practices identified barriers to and enablers of good prescribing practice. A customised intervention was then implemented over 6 weeks and included a yellow medication record sticker, quarterly education sessions and intensive care unit‐specific empiric antimicrobial prescribing guidelines. Post‐implementation, the effects were monitored by serial antimicrobial prescribing audits for 1 year. The primary outcomes were clear documentation of the start date, the planned stop date or review date and the indication for an antibiotic. These were all considered the ‘minimum standards’ for an antimicrobial prescription on the medication record.ResultsDocumentation of minimum standards specifically addressed by the sticker improved (start date (72% to 90%, P < 0.001), stop date (16% to 63%, P < 0.001), antimicrobial indication documented on medication chart (58% to 83%, P < 0.01)). Overall, adherence to all three minimum standards (start date, stop date and indication) improved from 41/306 (13%) to 306/492 (63%) (P < 0.001). One‐year post‐implementation, the yellow sticker had become embedded into daily practice.ConclusionA systematic approach to quality improvement combined with the implementation of a tailored, multi‐faceted intervention can improve antimicrobial prescribing practices.
A prospective study of acute inpatient gout diagnoses and management in a tertiary hospital: the determinants and outcome of a rheumatology consultation
Authors: Teichtahl A. J. , Clemens L. , Nikpour M. , Romas E. 
Published: July 2014

AbstractBackgroundDespite acute gout frequently complicating hospital admissions, diagnosis and management are variable. Rheumatology input may improve patient outcomes.AimTo examine acute episodes of inpatient gout in a tertiary hospital to determine (i) factors that may lead to rheumatology input being sought and (ii) the differences in outcomes when rheumatology input occurs.MethodsData collection occurred between February and October 2012 for inpatients in a tertiary Australian hospital. Data were prospectively collected for all rheumatology consultations with a diagnosis of gout. Subjects who had an inpatient admission complicated by acute gout and who did not have rheumatology input were identified through health information coding from discharge summaries.ResultsFifty‐eight patients (41% with rheumatology input) were included in the study. Rheumatology input was significantly more likely when the patient was younger (68.9 years vs 78.4 years; P = 0.04) with knee joint involvement (41.7% vs 3.0%; P < 0.001). When rheumatology input occurred, subjects were more likely to have had a serum urate measured (83% vs 50%; P = 0.009), joint aspiration performed (54.2% vs 0%; P < 0.001), been prescribed acute gout medications at discharge (95.8% vs 61.3%; P = 0.001), a documented discharge plan (91.7% vs 23.5%; P < 0.001) and outpatient follow up (41.7% vs 0%; P < 0.001).ConclusionAmong inpatients with acute gout, rheumatology input was more likely to be sought in younger patients with knee joint disease. When rheumatology input occurred, patients were more likely to have a synovial fluid confirmed diagnosis of gout with appropriate acute management and a follow‐up plan.
Metoclopramide for patients with intractable hiccups: a multicentre, randomised, controlled pilot study
Authors: Wang T. , Wang D. 
Published: July 2014

AbstractBackgroundLimited data exist regarding the efficacy of metoclopramide in the treatment of intractable hiccups.AimThis study aimed to assess the feasibility efficacy of metoclopramide in the treatment of patients with intractable hiccups.MethodsA total of 36 patients with intractable hiccups was randomly assigned to arm A (n = 18) or arm B (n = 18) in a multicentre, double‐blind, randomised, controlled pilot study. Participants in arm A received 10‐mg metoclopramide thrice daily for 15 days, whereas those assigned to arm B received 10‐mg placebo thrice daily for 15 days. The primary outcome measure was total efficacy against hiccups (including cessation and improvement of hiccups). Secondary outcome measures included a comparison of overall efficacy and adverse events between the two arms.ResultsOf the 36 patients enrolled, 34 participants completed the study. The total efficacy was higher in arm A than in arm B (relative risk, 2.75; 95% confidence interval: 1.09–6.94, P = 0.03). Furthermore, comparison between the two arms revealed that overall efficacy was higher in arm A than that in arm B (P < 0.05). No serious adverse events related to the treatment were documented in either arm. The most common adverse events occurring in patients in arm A included fatigue, upset mood and dizziness.ConclusionMetoclopramide appears to be a promising candidate for the treatment of patients with intractable hiccups, with mild adverse events. However, further clinical trials are required to confirm these results.
Quantifying Compositional Homogeneity in Pb(Zr,Ti)O3 Using Atom Probe Tomography
Authors: Kirchhofer Rita , Diercks David R. , Gorman Brian P. , Ihlefeld Jon F. , Kotula Paul G. , Shelton Christopher T. , Brennecka Geoff L. 
Published: July 2014

Atom probe tomography (APT) is a powerful materials characterization technique capable of ppm chemical resolution and near atomic scale spatial resolution. However, owing to a number of factors, the technique has not been widely applied to insulating materials and even less to complex oxides. In this study, we outline the methodology necessary to obtain high‐quality results on a technologically relevant complex oxide Pb(Zr,Ti)O3 (or PZT) using laser‐assisted APT on both bulk and thin film specimens. We show how, with optimized and well‐controlled conditions, APT complements conventional techniques such as STEM‐EDS. The correlative information can be used to obtain the nanoscale 3‐D chemical information and investigate the nanoscale distribution of cations. Using nearest‐neighbor cluster analysis routines, 5–10 nm segregation of B‐site cations was detected in bulk sintered PZT 53/47 from chemically prepared powders. No statistically significant segregation of B‐site cations was observed in thin film specimens. This work opens new avenues toward understanding the process‐structure properties in complex materials at length scales heretofore unachievable.
Predicting institutional long‐term care admission in dementia: a mixed‐methods study of informal caregivers’ reports
Authors: Afram Basema , Verbeek Hilde , Bleijlevens Michel H.C. , Challis David , Leino‐Kilpi Helena , Karlsson Staffan , Soto Maria E. , Renom‐Guiteras Anna , Saks Kai , Zabalegui Adelaida , Hamers Jan P.H. ,   the RightTimePlaceCare consortium
Published: July 2014

AbstractAimTo investigate agreement between: (1) expected reasons and actual reasons for admission of people with dementia according to informal caregivers; (2) scores on measurement instruments prior to admission and the actual reasons for admission according to informal caregivers.BackgroundTimely admission of people with dementia is a crucial issue. Information is highly warranted on whether informal caregivers are capable of prior identification of causes of admission and, can thus be considered a reliable prospective source on causes of admission.DesignA cohort study among informal caregivers of people with dementia who made a transition to institutional long‐term care.MethodsQualitative data on the expected and actual reasons for admission were collected via open‐ended questions at baseline and follow‐up. Furthermore, at baseline, data were collected using measurement instruments to measure pre‐admission characteristics. Interviews took place between November 2010–April 2012. After categorizing the answers, the agreement between the expected and actual reasons was calculated. Furthermore, bivariate associations were calculated between the actual reasons for admission and scores on corresponding measurement instruments.Results/FindingsFor most informal caregivers, there was agreement between their statements on the expected reason and the actual reason for admission. A third of the caregivers showed no conformity. Bivariate associations showed that there is also agreement between the actual reasons for admission and scores on corresponding measurement instruments.ConclusionInformal caregivers can be considered reliable sources of information regarding what causes the admission of a person with dementia. Professional care should anticipate informal caregivers’ statements and collaborate with them to strive for timely and appropriate admission.
Relationship‐centred care: antidote, guidepost or blind alley? The epistemology of 21st century health care
Authors: Wyer Peter C. , Alves Silva Suzana , Post Stephen G. , Quinlan Patricia 
Published: July 2014

AbstractContemporary health care is increasing in complexity and lacks a unifying understanding of epistemology, methodology and goals. Lack of conceptual consistency in concepts such as ‘patient‐centred care’ (PCC) typifies system‐wide discordance. We contrast the fragmented descriptions ofPCCand related tools to its own origins in the writings ofBalint and to a subsequent construct, relationship‐centred care (RCC). We identify the explicit and elaborated connection betweenRCCand a defined epistemological foundation as a distinguishing feature of the construct and we demonstrate that this makes possible the recognition of alignments betweenRCCand independently developed constructs. Among these, we emphasizeSchon's reflective practice,Nonaka's theory of organizational knowledge creation and the research methodology of realist synthesis. We highlight the relational principles common to these domains and to their common epistemologies and illustrate unsatisfying consequences of adherence to less adequate epistemological frameworks such as positivism. We offerRCCnot as an ‘antidote’ to the dilemmas identified at the outset but as an example that illuminates the value and importance of explicit identification of the premises and assumptions underlying approaches to improvement of the health care system. We stress the potential value of identifying epistemological affinities across otherwise disparate fields and disciplines.
BCLC stage B hepatocellular carcinoma and transcatheter arterial chemoembolization: a 20‐year survey by the Italian Liver Cancer group
Authors: Farinati Fabio , Vanin Veronica , Giacomin Anna , Pozzan Caterina , Cillo Umberto , Vitale Alessandro , Di Nolfo Anna Maria , Del Poggio Paolo , Benvegnu' Luisa , Rapaccini Gianludovico , Zoli Marco , Borzio Franco , Giannini Edoardo G. , Caturelli Eugenio , Trevisani Franco ,   the Italian Liver Cancer (ITA.LI.CA) group
Published: July 2014

AbstractBackground & AimsSignificant proportion of Hepatocellular Carcinoma (HCC) cases are diagnosed in stage B of Barcelona Clinic Liver Cancer (BCLC) algorithm, in which the standard of care is Transcatheter Arterial ChemoEmbolization (TACE). We aimed to ascertain adherence to current guidelines, survival and prognostic factors in BCLC stage B patients.MethodsFrom 3027 HCC cases recruited from 1986 to 2008 by the Italian Liver Cancer group (2430 with data allowing a correct allocation in the BCLC system), a retrospective analysis was conducted on those diagnosed in BCLC stage B (405 patients, 17%). Statistics were performed with Kaplan–Meier (log rank) method and Cox multivariate analysis.ResultsMedian overall survival in BCLC stage B patients was 25 months (Confidence Interval ‐ C.I. ‐ 22–28 months) with a 5‐year survival of 18%. Child–Pugh class, oesophageal varices and Alpha‐foetoprotein (AFP) were the independent predictors of survival. TACE was applied in 40% of cases and did not offer the longest survival in comparison with surgical or percutaneous treatments (median 27 months vs. 37 and 36 months, respectively) (P < 0.001). BCLC stage B patients undergoing radical treatments were more frequently in Child‐Pugh class A and had a significantly lower number of lesions; patients undergoing best supportive care were frequently in Child‐Pugh class B and had a multifocal disease. Survival after TACE did not significantly increase over time.ConclusionsIn clinical practice, TACE cannot be considered the best approach for BCLC stage B patients who represent a heterogeneous population and are often suitable for more aggressive therapies, which lead to a better survival.
NONCOOPERATIVE MANAGEMENT OF THE NORTHEAST ATLANTIC COD FISHERY: A FIRST MOVER ADVANTAGE
Authors: BJØRNDAL TROND , LINDROOS MARKO 
Published: July 2014

AbstractThe point of departure for this analysis is Bjørndal and Lindroos [2012], who developed an empirical bioeconomic model to analyze cooperative and noncooperative management of Northeast Atlantic cod. In their analysis, only constant strategies were analyzed for noncooperative games. In this paper, nonconstant strategies are considered. Moreover, the fishery in question is characterized by cooperative management. What may happen in the real world is that one nation breaks the cooperative agreement by fishing in excess of its quota. Often, it takes time for the other agent to detect this and respond. In this paper, we allow this kind of delayed response into a two‐agent noncooperative game so that, if country 2 exceeds its quota, there will be a time lag before this is detected by country 1; moreover, there may also be a delay until country 1 is able to respond. Results show that the outcome critically depends on the length of these two lags as well as initial conditions.
Aneurysmal dilatation associated with arteriovenous fistula in a transplanted kidney after renal biopsies
Authors: Kamei Koichi , Ogura Masao , Miyazaki Osamu , Nosaka Shunsuke , Ito Shuichi 
Published: July 2014

AbstractAVF is a known complication of renal biopsy in both native and transplanted kidneys. A 20‐yr‐old woman with bilateral hypoplastic kidneys due to branchio‐oto‐renal syndrome had received living‐donor renal transplantation from her father at the age of 11. She had undergone allograft renal biopsies six times and all puncture sites were at the lower pole of her kidney from the first to the fifth biopsy. AVF with aneurysmal dilation (30 mm) had developed at the puncture site after the fifth biopsy. TAE was successfully performed with 11 platinum coils in the branch of the renal artery feeding the aneurysm. According to a review of the literature, the incidence of AVF is higher in transplanted kidneys than in native kidneys (7.5% vs. 2.1%) because transplanted kidneys, as single kidneys, are likely to be punctured repeatedly at the same site. When renal biopsy of a transplanted kidney is performed, previous biopsy puncture sites should be considered and the biopsy should be performed at a different site, if possible, to prevent the development of AVF.
A strategy for characterization of persistent heteroduplex DNA in higher plants
Authors: Dong Chun‐Bo , Mao Jian‐Feng , Suo Yu‐Jing , Shi Le , Wang Jun , Zhang Ping‐Dong , Kang Xiang‐Yang 
Published: July 2014

SummaryHeteroduplex DNA (hDNA) generated during homologous recombination (HR) is an important component that shapes genetic diversity in sexually reproducing organisms. However, studies of this process in higher plants are limited. This is because hDNAs are difficult to capture in higher plants as their reproductive developmental model only produces normal gametes and does not preserve the mitotic products of the post‐meiotic segregation (PMS) process which is crucial for studying hDNAs. In this study, using the model system for tree and woody perennial plant biology (Populus), we propose a strategy for characterizing hDNAs in higher plants. We captured hDNAs by constructing triploid hybrids originating from a cross between unreduced 2n eggs (containing hDNA information as a result of inhibition chromosome segregation at the PMS stage) with normal male gametes. These triploid hybrids allowed us to detect the frequency and location of persistent hDNAs resulting from HR at the molecular level. We found that the frequency of persistent hDNAs, which ranged from 5.3 to 76.6%, was related to locations of the simple sequence repeat markers at the chromosomes, such as the locus–centromere distance, the surrounding DNA sequence and epigenetic information, and the richness of protein‐coding transcripts at these loci. In summary, this study provides a method for characterizing persistent hDNAs in higher plants. When high‐throughput sequencing techniques can be incorporated, genome‐wide persistent hDNA assays for higher plants can be easily carried out using the strategy presented in this study.
The effectiveness of riboflavin photochemical‐mediated virus inactivation and changes in protein retention in fresh‐frozen plasma treated using a flow‐based treatment device
Authors: Zhu Liguo , Pan Jichun , Wei Chao , Wang Haibao , Xiang Rong , Zhang Jingang , Wang Deqing 
Published: July 2014

BackgroundA flow‐based treatment device using riboflavin and ultraviolet (UV) light was developed to inactivate viruses in fresh‐frozen plasma (FFP). The objective of this study was to evaluate the in vitro effectiveness of virus inactivation and changes in protein quality in FFP treated with this device.Study Design and MethodsFFP‐contaminating viruses were treated with riboflavin and UV light using a one‐pass linear flow device. The infectivity of viruses was measured using established biologic assays. Real‐time polymerase chain reaction (PCR) was performed to detect damage to viral nucleotides after treatment. Treated plasma was analyzed using standard coagulation assays.ResultsFFP treated at the UV dose of 3.6 J/cm2 (J) exhibited a mean reduction of virus titer of more than 4 logs. The effectiveness increased significantly at higher doses. Real‐time PCR showed that the cycle threshold values for both complete inactivation and virus recultivation were higher than that of the untreated sample. At doses of 3.6, 5.4, and 7.2 J, the protein recovery rates were 60.2 ± 8.6, 46.6 ± 9.4, and 28.0 ± 1.0% for fibrinogen; 67.0 ± 3.1, 57.3 ± 8.0, and 49.2 ± 3.8% for Factor VIII; 93.6 ± 2.8, 89.6 ± 6.1, and 86.5 ± 5.3% for antithrombin‐III; and 72.1 ± 5.6, 59.8 ± 14.2, and 49.2 ± 8.4% for Protein C, respectively.ConclusionThe effectiveness of virus inactivation was enhanced, but total activity of plasma factors was reduced, in a UV dose‐dependent manner.
Molecular basis and zygosity determination of D variants including identification of four novel alleles in Chinese individuals
Authors: He Ji , Ying Yanling , Hong Xiaozhen , Xu Xianguo , Zhu Faming , Lv Hangjun 
Published: July 2014

BackgroundThe frequency and molecular basis of the D variants have been reported in the Caucasian and African populations, but relatively little information was known in the Chinese population. Here, a study was investigated in Chinese persons with weak or discrepant D serologic typing.Study Design and MethodsD variant was typed with a serologic method. The full coding regions of RHD of these variants were amplified with polymerase chain reaction and then directly sequenced. RHD zygosity test was performed using the hybrid Rhesus box technique and a multiplex ligation–dependent probe amplification (MLPA) assay was also used to analyze the variant alleles and RHD gene copy number.ResultsTwelve distinct RHD mutation alleles were found in 32 D variant individuals, with eight weak D and four partial D alleles. Weak D Type 15 and DVI Type 3 were the major weak D and partial D alleles in Zhejiang Han persons. Three novel weak D alleles (RHD weak D 95A, 779G, and 670G) and one new partial D allele (RHD130‐132 del TCT) were identified. The results of RHD zygosity in three individuals disagreed between the RHD zygosity test and the MLPA assay. The most known variant alleles can be detected, but four novel alleles were missed using the RH‐MLPA assay.ConclusionThe molecular basis and zygosity of D variants in Zhejiang Han persons were analyzed, and four novel RHD alleles were identified. These data extend the information of D variants and may help to improve the transfusion strategy of the D variants.