bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routine computerised tomography in patients with acute supraglottitis for the diagnosis of epiglottic abscess: is it necessary? – a prospective, multicentre study
Authors: Lee Y.C. , Kim T.H. , Eun Y.G. 
Published: April 2013

ObjectivesTo evaluate the predictive factor of epiglottic abscess and to investigate whether routine computerised tomography (CT) in patients with acute supraglottitis are necessary.DesignA prospective and multicentre study.SettingsTertiary care referral medical centre.ParticipantsA total of 202 patients with suspected acute supraglottitis were enrolled. All patients underwent CT to confirm the presence of abscess.Main outcome measuresThe patients' characteristics, symptoms at presentation, laryngoscopic findings of epiglottic swelling and arytenoid swelling by scope classification and initial laboratory finding were analysed.ResultsOf 202 patients, 158 (78%) had acute supraglottitis and 44 (22%) had epiglottic abscess. There was no significant difference in age between the acute supraglottitis group and the epiglottic abscess group. Men were significantly more frequent in the epiglottic abscess group than females (P = 0.042). When comparing the symptom at presentation, the patients with epiglottic abscess complained of voice change more frequently (P = 0.003). Moderate or severe epiglottic swelling in scope classification was significantly associated with epiglottic abscess (P < 0.001). In logistic regression analysis, voice change [OR = 2.64, 95% CI = 1.29–5.40, P = 0.008] and moderate or severe epiglottic swelling in laryngoscopic findings [OR = 3.94, 95% CI = 1.63–9.53, P = 0.002] were independent predictive factors for epiglottic abscess. The positive predictive values of voice change and moderate or severe epiglottic swelling were 33% and 30%, respectively. The negative predictive values of voice change and moderate or severe epiglottic swelling were 15% and 9%, respectively.ConclusionsRoutine CT might be suggested for diagnosis of epiglottic abscess in the patients with acute supraglottitis, because of the poor predictive values of symptoms and signs.
Acetazolamide improves oxygenation in patients with respiratory failure and metabolic alkalosis
Authors: Gulsvik Ragnhild , Skjørten Ingunn , Undhjem Kenneth , Holø Lars , Frostad Anne , Saure Eirunn Waatevik , Lejlic Vasvija , Humerfelt Sjur , Hansen Gunnar , Bruun Wyller Torgeir 
Published: April 2013

AbstractIntroductionCoexistent respiratory failure and metabolic alkalosis is a common finding. Acidotic diuretics cause a fall in pH that may stimulate respiration.ObjectiveThe purpose of the study was to evaluate the effectiveness of short‐term treatment with acetazolamide for combined respiratory failure and metabolic alkalosis.MethodsA randomised, placebo‐controlled and double‐blind parallel group trial where oral acetazolamide 250 mg three times a day for 5 days were administered to patients hospitalised for respiratory failure because of a pulmonary disease (PaO2 ≤ 8 kPa and/or PaCO2 ≥ 7 kPa) who had concurrent metabolic alkalosis [base excess (BE) ≥8 mmol/L]. PaO2 after 5 days was the primary effect variable. Secondary effect variables were PaCO2, BE and pH on day 5, and the total number of days in hospital.ResultsOf 70 patients enrolled (35 in each group), data from 54 were analysed per protocol, while last observation carried forward was used for the remaining 16. During the 5‐day treatment, PaO2 increased on average 0.81 kPa in the placebo group and 1.41 kPa in the acetazolamide group. After adjustment for baseline skewness, the difference was statistically significant (adjusted mean difference 0.55 kPa, 95% confidence interval 0.03–1.06). PaCO2 decreased in both groups, but the difference was not statistically significant. As expected, pH and BE decreased markedly in the acetazolamide group.ConclusionAcetazolamide may constitute a useful adjuvant treatment mainly to be considered in selected patients with respiratory failure combined with prominent metabolic alkalosis or where non‐invasive ventilation is insufficient or infeasible.
The European Parliament and the Future of Comitology after Lisbon
Authors: Kaeding Michael , Hardacre Alan 
Published: April 2013

AbstractThe history of comitology—the system of implementation committees that control the Commission in the execution of delegated powers—has been characterised by institutional tensions. The crux of these tensions has often been the role of the European Parliament and its quest to be granted powers equal to those of the Council. This process came to a head with the 2006 Comitology reform and the introduction of the regulatory procedure with scrutiny (RPS). After just over three years of experience with the RPS procedure, the Treaty of Lisbon has made it redundant through the creation of Delegated Acts (Article 290 TFEU). This article aims to evaluate the practical implications that Delegated Acts will entail for the Parliament, principally by using the experience with the RPS to better understand the challenges ahead. This analysis will be of interest to those following the study of comitology, formal and informal inter‐institutional relations and also to practitioners who will have to work with Delegated Acts in the future.
Development of a real‐time PCR to detect Streptococcus equi subspecies equi
Authors: North S. E. , Wakeley P. R. , Mayo N. , Mayers J. , Sawyer J. 
Published: April 2013

SummaryReasons for performing studyInfection with Streptococcus equi subspecies equi (S. equi) is endemic in the UK. A proportion of horses serve as long‐term carriers and act as a reservoir of infection. Detection of these persistently infected horses is difficult using standard culture techniques owing to a lack of sensitivity and overgrowth by contaminating bacteria. In addition, differentiation of this causative bacterium from the closely related S. equi zooepidemicus has made the development of reliable and accurate diagnostic tests difficult.ObjectiveTo develop and validate a sensitive and specific real‐time PCR assay to detect S. equi and to compare the results with traditional culture techniques.Study designRetrospective cross‐sectional study.MethodsThe assay was validated using a panel of 92 samples from suspected clinical cases of strangles. These were cultured using microbial techniques and tested using the S. equi real‐time PCR. The results of the 2 methods were compared, and the diagnostic sensitivity and specificity of the real‐time PCR were calculated. The real‐time PCR was tested for cross‐reactivity with horse commensal bacteria, and the efficiencies and limits of detection were established.ResultsThe assay had a diagnostic sensitivity of 95% and specificity of 86%. No cross‐reactivity was observed with any of the bacterial species tested, including S. equi zooepidemicus. The assay detected as few as 3 gene copies.ConclusionThe assay is fast, sensitive and specific and will detect S. equi DNA directly from a crude extract of clinical material on a swab.Potential relevanceThis assay could aid in the rapid detection of subclinical shedders of S. equi, enabling quicker treatment and helping to limit the spread of strangles in equine populations.
Land use change from C3 grassland to C4 Miscanthus: effects on soil carbon content and estimated mitigation benefit after six years
Authors: Zatta Alessandro , Clifton‐Brown John , Robson Paul , Hastings Astley , Monti Andrea 
Published: April 2013

AbstractTo date, most Miscanthus trials and commercial fields have been planted on arable land. Energy crops will need to be grown more on lower grade lands unsuitable for arable crops. Grasslands represent a major land resource for energy crops. In grasslands, where soil organic carbon (SOC) levels can be high, there have been concerns that the carbon mitigation benefits of bioenergy from Miscanthus could be offset by losses in SOC associated with land use change. At a site in Wales (UK), we quantified the relatively short‐term impacts (6 years) of four novel Miscanthus hybrids and Miscanthus × giganteus on SOC in improved grassland. After 6 years, using stable carbon isotope ratios (13C/12C), the amount of Miscanthus derived C (C4) in total SOC was considerable (ca. 12%) and positively correlated to belowground biomass of different hybrids. Nevertheless, significant changes in SOC stocks (0–30 cm) were not detected as C4 Miscanthus carbon replaced the initial C3 grassland carbon; however, initial SOC decreased more in the presence of higher belowground biomass. We ascribed this apparently contradictory result to the rhizosphere priming effect triggered by easily available C sources. Observed changes in SOC partitioning were modelled using the RothC soil carbon turnover model and projected for 20 years showing that there is no significant change in SOC throughout the anticipated life of a Miscanthus crop. We interpret our observations to mean that the new labile C from Miscanthus has replaced the labile C from the grassland and, therefore, planting Miscanthus causes an insignificant change in soil organic carbon. The overall C mitigation benefit is therefore not decreased by depletion of soil C and is due to substitution of fossil fuel by the aboveground biomass, in this instance 73–108 Mg C ha−1 for the lowest and highest yielding hybrids, respectively, after 6 years.
Implications of land class and environmental factors on life cycle GHG emissions of Miscanthus as a bioenergy feedstock
Authors: Sanscartier David , Deen Bill , Dias Goretty , MacLean Heather L. , Dadfar Humaira , McDonald Ian , Kludze Hilla 
Published: April 2013

AbstractReplacement of fossil fuels with sustainably produced biomass crops for energy purposes has the potential to make progress in addressing climate change concerns, nonrenewable resource use, and energy security. The perennial grass Miscanthus is a dedicated energy crop candidate being field tested in Ontario, Canada, and elsewhere. Miscanthus could potentially be grown in areas of the province that differ substantially in terms of agricultural land class, environmental factors and current land use. These differences could significantly affect Miscanthus yields, input requirements, production practices, and the types of crops being displaced by Miscanthus establishment. This study assesses implications on life cycle greenhouse gas (GHG) emissions of these differences through evaluating five Miscanthus production scenarios within the Ontario context. Emissions associated with electricity generation with Miscanthus pellets in a hypothetically retrofitted coal generating station are examined. Indirect land use change impacts are not quantified but are discussed. The net life cycle emissions for Miscanthus production varied greatly among scenarios (−90–170 kg CO2eq per oven dry tonne of Miscanthus bales at the farm gate). In some cases, the carbon stock dynamics of the agricultural system offset the combined emissions of all other life cycle stages (i.e., production, harvest, transport, and processing of biomass). Yield and soil C of the displaced agricultural systems are key parameters affecting emissions. The systems with the highest potential to provide reductions in GHG emissions are those with high yields, or systems established on land with low soil carbon. All scenarios have substantially lower life cycle emissions (−20–190 g CO2eq kWh−1) compared with coal‐generated electricity (1130 g CO2eq kWh−1). Policy development should consider the implication of land class, environmental factors, and current land use on Miscanthus production.
Grassland and globalization – challenges for north‐west European grass and forage research
Authors: Taube F. , Gierus M. , Hermann A. , Loges R. , Schönbach P. 
Published: April 2013

AbstractThe concept of sustainable intensification has recently been developed to raise productivity (as distinct from increasing volume of production) while reducing environmental impacts. This means increasing yields per unit of inputs (including nutrients, water, energy capital and land) as well as per unit of undesirable outputs (such as greenhouse gas emissions, water pollution or loss of biodiversity). It is thus helpful to understand ‘intensification’ as referring to ‘environmental factor productivity’ or ‘eco‐efficiency’. Worldwide, grassland is the most important agroecosystem delivering ecosystem services ranging from feed supply for ruminants and soil carbon storage to habitats of biodiversity. However, worldwide, grassland is under threat due to intensified land use and land‐use changes from grass to arable. In this article, we (i) highlight ecosystem services of selected grassland biomes abroad of Europe, (ii) show evidence of sustainable as well as non‐sustainable intensification options in these grassland biomes linked to European agriculture by exports of agricultural commodities (e.g. soy) and (iii) derive research strategies for north‐west European grassland research and management to match sustainable intensification strategies for the grassland‐based dairy industry.
Presence of C11orf95–MKL2 fusion is a consistent finding in chondroid lipomas: a study of eight cases
Authors: Flucke Uta , Tops Bastiaan B J , de Saint Aubain Somerhausen Nicolas , Bras Johannes , Creytens David H , Küsters Benno , Groenen Patricia J T A , Verdijk Marian A J , Suurmeijer Albert J H , Mentzel Thomas 
Published: April 2013

AimsChondroid lipomas are benign adipose tissue tumours. Their rarity and peculiar morphology can lead to misinterpretation, especially in small biopsies. Based on a recurrent translocation t(11;16)(q13;p13), the C11orf95–MKL2 fusion gene has been found in a few cases. Therefore, it seemed appropriate to look for this fusion gene in a larger cohort.Methods and resultsWe describe eight further cases from four females and four males with an age range of 21–81 years (median 49 years). The tumours were situated in the lower arm (three), lower leg (two), thigh (one), back (one) and head (one); seven lesions were deep‐seated and one was located subcutaneously. Sizes ranged from 3 to 12 cm (median 6.3 cm). All patients were treated by simple excision, and follow‐up, available for six patients (range 2 months–12 years; median 15 months), demonstrated recurrence in one case. Histologically, the circumscribed and lobulated tumours showed a variable composition of adipocytes, lipoblasts, hibernoma‐like cells and chondroblast‐like cells embedded in a chondroid matrix. Immunohistochemistry, performed in four cases, revealed positivity for S‐100 and pancytokeratin in two of three neoplasms stained for each marker. A C11orf95–MKL2 fusion gene was shown by RT‐PCR analysis in seven of the eight cases.ConclusionsMolecular analysis can be used to support the diagnosis of chondroid lipoma, especially in small samples. This may be helpful in planning treatment when the differential diagnosis includes malignant lesions.
Identifying the Fundamentals of Care within Cochrane Systematic reviews: The role of the Cochrane Nursing Care Field Fundamentals of Care Node
Authors: Kitson Alison , Robertson‐Malt Suzi , Conroy Tiffany 
Published: April 2013

The role of the Fundamentals of Care (FoC) Node within the Cochrane Nursing Care Field (CNCF) is to identify universal aspects of patient care as they relate to and potentially affect the application of the results of systematic reviews. The CNCF was established to provide a nursing perspective of Cochrane reviews and to promote their dissemination and uptake. The core functions of the CNCF include identifying topics for nursing care not currently addressed by Cochrane Reviews, raising awareness of the Cochrane Collaboration and the resources it has that supports the delivery of nursing care and the dissemination of relevant reviews to the nursing care community.We outline how volunteers with an interest in the FoC can work to identify care‐related aspects for specific clinical reviews. This article describes the development of a tool designed to guide the review of a Cochrane Systematic Review from the vantage of the FoC. The FoC Node is seeking volunteers to undertake this review work, and we have outlined the steps used to do this. We also show how using the FoC Template can inform the tagging and classifying of existing reviews within the Cochrane library.
Supporting minority nursing students: ‘Opportunity for Success’ for Ethiopian immigrants in Israel
Authors: Arieli D. , Hirschfeld M.J. 
Published: April 2013

AimTo report on an Israeli academic nursing project, aimed at supporting the integration of Ethiopian immigrants into nursing studies.BackgroundThe representation of ethnic minorities within nursing is crucial for the provision of efficient care in diverse societies. Nevertheless, successful integration of minority students in nursing programs is not a simple task and needs developing support systems that will attract and retain students from minorities. Ethiopian Jewish immigrants and their descendants in Israel form a community of 120 000 people. Their participation in the national workforce is low, as well as their average income.MethodsThe paper is based on formative evaluation, using action research, of an academic nursing program in Israel.FindingsFour main strategies identify this project: (1) a policy of institutional commitment, (2) personal relations with staff, (3) personal tutoring, and (4) cultural safety education. The project has reached success in terms of attraction, retention and students' satisfactions. The project's two main challenges, which need further concern, are: (1) giving support without labelling and (2) supporting without creating dependency.Conclusions and International Policy ImplicationsAppropriate strategies can enable success of minority students. Nevertheless, the amount of support needed for such programs raises two major questions: (1) To what extent should individual nursing departments be expected to bear solutions to this widely experienced problem? (2) How does focusing on one minority affect cultural safety of the overall group?
Chronic rhinosinusitis and asthma: novel understanding of the role of IgE ‘above atopy’
Authors: Bachert C. , Zhang N. 
Published: April 2013

Abstract.  Bachert C, Zhang N (Ghent University Hospital, Ghent, Belgium). Chronic rhinosinusitis and asthma: novel understanding of the role of IgE ‘above atopy’ (Review). J Intern Med 2012; 272: 133–143.Chronic rhinosinusitis (CRS) affects more than 10% of the European population and is often associated with asthma. Phenotypes of CRS can be differentiated based on mucosal remodelling and inflammatory patterns. Understanding the role of central mediators, such as interleukin‐5, in these different phenotypes may lead to the development of specific therapeutic approaches. The impact of staphylococcal superantigens has been shown to further modify the immune response, contributing to persistent severe disease via the activation of T and B cells and the formation of local IgE. It is clear that these mechanisms are involved in the systemic spread of upper airway disease with resulting asthma comorbidity, when IgE antibodies to staphylococcal enterotoxins are present at measurable levels in serum. Recent findings point to superantigens as possible causal agents in the intrinsic form of severe asthma, and an anti‐IgE strategy has shown promising therapeutic potential in nonatopic patients with nasal polyps and asthma. These findings should lead to a clinically relevant endotyping of patients with upper and lower airway disease and to a new understanding of the role of IgE ‘above atopy’.
Clinical determinants and mortality predictability of stearoyl‐CoA desaturase‐1 activity indices in dialysis patients
Authors: Huang X. , Stenvinkel P. , Qureshi A. R. , Cederholm T. , Bárány P. , Heimbürger O. , Lindholm B. , Risérus U. , Carrero J. J. 
Published: April 2013

AbstractBackgroundStearoyl‐CoA desaturase‐1 (SCD‐1) converts dietary saturated fatty acids to monounsaturated fatty acids. Elevated SCD‐1 activity thus signifies impaired fatty acid metabolism and excess saturated fat intake. In the general population, increased SCD‐1 activity is associated with cardiovascular disease and mortality. The determinants and implications of SCD‐1 activity in dialysis patients are unknown.SubjectsA total of 222 dialysis patients (39% women) with prospective follow‐up, median age of 57 years and an average of 12 months of dialysis.DesignFatty acid compositions in plasma phospholipids and free fatty acids (FFAs) were assessed by gas–liquid chromatography. SCD‐1 activity indices were calculated as the product‐to‐precursor fatty acid ratio (palmitoleic acid/palmitic acid) in each fraction to reflect SCD‐1 activities in the liver and adipose tissue.ResultsMedian hepatic and adipose tissue SCD‐1 activity indices were 0.016 and 0.150, respectively. In multivariate analyses, SCD‐1 was positively associated with age, female sex and serum interleukin‐6 level. During 18.4 (interquartile range 5.5–37.3) months of follow‐up, there were 61 deaths and 115 kidney transplants. The cut‐off level for high SCD‐1 indices was determined by receiver operating characteristic curve analyses. In fully adjusted competing risk models, patients with high SCD‐1 indices in both phospholipids and FFAs had more than twofold increased mortality risk before kidney transplantation [hazard ratio (HR) 2.29, 95% confidence interval (CI) 1.28–4.11 and HR 2.36, 95% CI 1.38–4.03, respectively], compared with patients with low SCD‐1 indices.ConclusionsBoth hepatic and adipose tissue SCD‐1 activity indices independently predict mortality in dialysis patients. Further studies are warranted to determine whether reducing SCD‐1 activity by dietary intervention (limiting saturated fat) could improve survival in dialysis patients.
Genetically elevated bilirubin and risk of ischaemic heart disease: three Mendelian randomization studies and a meta‐analysis
Authors: Stender S. , Frikke‐Schmidt R. , Nordestgaard B. G. , Grande P. , Tybjærg‐Hansen A. 
Published: April 2013

AbstractBackgroundElevated plasma levels of bilirubin, an endogenous antioxidant, have been associated with reduced risk of ischaemic heart disease (IHD) and myocardial infarction (MI). Whether this is a causal relationship remains unclear.ObjectiveWe tested the hypothesis that elevated plasma bilirubin is causally related to decreased risk of IHD and MI.DesignWe used a Mendelian randomization approach and three independent studies from Copenhagen, Denmark. We measured bilirubin in 43 708 white individuals from the general population, and genotyped rs6742078 G>T in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene in 67 068 individuals, of whom 11 686 had IHD.ResultsThird versus first tertile of baseline bilirubin levels was associated with 134% increased bilirubin levels, with sex‐ and age‐adjusted hazard ratios (HRs) of 0.86 [95% confidence interval (CI), 0.76–0.98; P = 0.02] for IHD and 0.81 (95% CI, 0.66–0.99; P = 0.04) for MI, but with corresponding multifactorially adjusted HRs of 0.93 (95% CI, 0.82–1.06; P = 0.29) and 0.90 (95% CI, 0.73–1.12; P = 0.35). UGT1A1 rs6742078 TT versus GG genotype was associated with 95% increased bilirubin levels (P < 0.001); TT versus GG genotype was associated with odds ratios (ORs) of 1.03 (95% CI, 0.96–1.11; P = 0.73) for IHD and 1.01 (95% CI, 0.92–1.12; P = 0.68) for MI. Finally, in a meta‐analysis of the present three studies and eight previous studies including a total of 14 711 cases and 60 324 controls, the random effects OR for ischaemic cardiovascular disease for genotypes with approximately 100% increased bilirubin levels versus reference genotypes was 1.01 (95% CI, 0.88–1.16).ConclusionThese data suggest that plasma bilirubin is not causally associated with risk of IHD.