bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical feasibility of a new through‐the‐scope fully covered esophageal self‐expandable metallic stent: An in vivo animal study
Authors: Cheon Young Koog , Lee Tae Yoon , Sung In Kyung , Shim Chan Sup 
Published: April 2013

BackgroundMost delivery devices used for esophageal stents for obstructing esophageal cancer have a diameter of 5–8 mm, a size that is too large to pass through the endoscopic working channel. The conventional esophageal stent requires multiple endoscopic procedures for implantation. The purpose of the present study was to evaluate the clinical feasibility of a newly developed fully covered, self‐expanding, through‐the‐scope (TTS) esophageal stent in a porcine model.MethodsEight mini pigs were used. Each animal underwent placement of a fully covered TTS stent (Hanarostent® Esophagus TTS) and the upper part of the stent was fixed by suturing with nylon. Fluoroscopy was carried out every week to assess migration of the stent. Follow‐up endoscopy was done every month for 3 months to evaluate the status of the membrane, stent mesh, grade of tissue hyperplasia, and mucosal changes at both ends of the stent.ResultsAll stents were successfully and easily deployed, and were placed without any distortion in the stent or without rupture of the membrane. In two cases, stent migration was observed after 8 weeks. No case of membrane disruption, stent mesh disruption or tissue hyperplasia at either end of the stent was found at the completion of the study.ConclusionOur findings indicate that the new fully covered self‐expanding TTS esophageal stent is easy and simple to implant, and no significant distortion of mesh or disruption of membrane was observed.
Diffusion‐weighted imaging changes in cerebral watershed distribution following neonatal encephalopathy are not invariably associated with an adverse outcome
Authors: Harteman Johanna C , Groenendaal Floris , Toet Mona C , Benders Manon Jnl , Van Haastert Ingrid C , Nievelstein Rutger Aj , Koopman‐Esseboom Corine , de Vries Linda S 
Published: April 2013

AimPatterns of injury in term‐born infants with neonatal encephalopathy following hypoxia–ischaemia are seen earlier and are more conspicuous on diffusion‐weighted magnetic resonance imaging (DW‐MRI) than on conventional imaging. Although the prognostic value of DW‐MRI in infants with basal ganglia and thalamic damage has been established, data in infants in whom there is extensive injury in a watershed distribution are limited. The aim of this study was to assess cognitive and functional motor outcome in a cohort of infants with changes in a predominantly watershed distribution injury on neonatal cerebral MRI, including DWI.MethodDW‐MRI findings in infants with neonatal encephalopathy following hypoxia–ischaemia were evaluated retrospectively. Twenty‐two infants in whom DWI changes exhibited a predominantly watershed distribution were enrolled in the study (10 males, 12 females; mean birthweight 3337g, 2830–3900g; mean gestational age 40.5wks, 37.9–42.1wks). Follow‐up MRI data at the age of 3 months (n=15) and over the age of 18 months (n=7) were analysed. In survivors, neurodevelopmental outcome was assessed with the Griffiths Mental Development Scales at the age of at least 18 months. Amplitude‐integrated electroencephalography was used to score background patterns and the occurrence of epileptiform activity.ResultsDW‐MRI revealed abnormalities that were bilateral in all infants and symmetrical in 10. The posterior regions were more severely affected in five infants and the anterior regions in three. Watershed injury occurred in isolation in 10 out of 22 infants and was associated with involvement of the basal ganglia and thalami in the other 12, of whom seven died. Cystic evolution, seen on MRI at age 3 months, occurred in three of the 15 surviving infants. Neurodevelopmental assessment of the surviving infants was performed at a median age of 35 months (range 18–48mo). Of the five survivors with basal ganglia and thalamic involvement, two developed cerebral palsy, one had a developmental quotient of less than 85, and two had a normal outcome. Of the 10 infants with isolated watershed injury, nine had an early normal motor and cognitive outcome. In all infants with a favourable outcome, background recovery was seen on amplitude integrated EEG within 48 hours after birth.ConclusionExtensive DWI changes in a watershed distribution in term‐born neonates are not invariably associated with adverse sequelae, even in the presence of cystic evolution. Associated lesions of the basal ganglia and thalami are a better predictor of adverse sequelae than the extent and severity of the watershed abnormalities seen on DW‐MRI.
Left Atrial Volume as Predictor of Valve Replacement and Cardiovascular Events in Patients with Asymptomatic Mild to Moderate Aortic Stenosis
Authors: Dalsgaard Morten , Egstrup Kenneth , Wachtell Kristian , Cramariuc Dana , Kjaergaard Jesper , Gerdts Eva , Hassager Christian 
Published: April 2013

BackgroundLeft atrial (LA) size is known to increase with chronically increased left ventricular (LV) filling pressure. We hypothesized that LA volume was predictive of aortic valve replacement (AVR) and cardiovascular events in a large cohort of patients with asymptomatic mild to moderate aortic valve stenosis.MethodsTransthoracic echocardiography was performed in 1,758 patients in the Simvastatin and Ezetemibe in Aortic Stenosis study. LA volume was measured in the apical four‐chamber view in 1,503 patients (85%). The relation of LA volume to AVR or a combined endpoint of cardiovascular events (AVR, congestive heart failure due to aortic stenosis or death from cardiovascular causes) was evaluated.ResultsAVR was performed in 415 (28%) patients, whereas 505 (34%) reached the combined endpoint. A significant but weak association of increased LA volume and risk of the combined endpoint was found (log‐rank test: P = 0.02), but this relation did not reach any significance in a multivariate model adjusting for age, gender, aortic valve area index, LV ejection fraction, LV hypertrophy, hypertension, and mitral regurgitation. LA volume was not predictive of AVR (log‐rank test: P = 0.3).ConclusionIn asymptomatic patients with mild to moderate Aortic valve stenosis (AS), LA volume was not predictive of the combined endpoint of Aortic valve replacement, development of heart failure or cardiac death. AVA and presence of LV hypertrophy were the only predictors of events in multivariate analysis.
A Sinus Venosus Atrial Septal Defect Is Diagnosed by Echocardiography with an Unusual Bubble Study
Authors: Dorosz Jennifer L. , Fonseca Brian M. , Kay Joseph D. , Graham Brian B. , Salcedo Ernesto E. , Quaife Robert A. 
Published: April 2013

Mini‐AbstractA 68‐year‐old man underwent echocardiogram with agitated saline for a presumed diagnosis of primary pulmonary hypertension. Surprisingly, the bubbles from the agitated saline enter the left heart before filling the right side, leading to a diagnosis of Eisenmeger's syndrome from a sinus venosus atrial septal defect. Because of high right‐sided pressure, the bubbles preferentially travel from the superior vena cava through the defect to the right superior pulmonary vein and left atrium, rather than the right side. This diagnosis was later confirmed on cardiac MRI.
The density dilemma: limitations on juvenile production in threatened salmon populations
Authors: Walters Annika W. , Copeland Timothy , Venditti David A. 
Published: April 2013

AbstractDensity‐dependent processes have repeatedly been shown to have a central role in salmonid population dynamics, but are often assumed to be negligible for populations at low abundances relative to historical records. Density dependence has been observed in overall spring/summer Snake River Chinook salmonOncorhynchus tshawytschaproduction, but it is not clear how patterns observed at the aggregate level relate to individual populations within the basin. We used a Bayesian hierarchical modelling approach to explore the degree of density dependence in juvenile production for nine Idaho populations. Our results indicate that density dependence is ubiquitous, although its strength varies between populations. We also investigated the processes driving the population‐level pattern and found density‐dependent growth and mortality present for both common life‐history strategies, but no evidence of density‐dependent movement. Overwinter mortality, spatial clustering of redds and limited resource availability were identified as potentially important limiting factors contributing to density dependence. The ubiquity of density dependence for these threatened populations is alarming as stability at present low abundance levels suggests recovery may be difficult without major changes. We conclude that density dependence at the population level is common and must be considered in demographic analysis and management.
Phenotypic plasticity in habitat use and growth of the European eel (Anguilla anguilla) in transitional waters in the Mediterranean area
Authors: Capoccioni Fabrizio , Lin Dai‐Yu , Iizuka Yoshiyuki , Tzeng Wann‐Nian , Ciccotti Eleonora 
Published: April 2013

AbstractLagoons and estuaries are transitional waters (TW), saline in character but substantially influenced by freshwater (FW) flows and the most productive habitat after upwelling areas. The European eel, Anguilla anguilla, is a typical inhabitant of these habitats and a target of important lagoon fisheries since ancient times. Notwithstanding this, in the Mediterranean region, where the numerous coastal lagoons are the most eligible habitat for this species, eel habitat use and growth, which display a high inter‐individual variability, are poorly studied. To gain knowledge about the migratory behaviour and the relative growth history of this species in TW in the Mediterranean area, the otolith Sr/Ca ratios of 56 individuals were analysed. The study sampling sites were two typical coastal lagoon environments, Caprolace lagoon and Lesina lagoon, located, respectively on the Tyrrhenian and the Adriatic coast of Italy, and the Tiber River (TR) estuary, in Central Italy. Otolith Sr/Ca profiles revealed that in all the sites, the resident contingent is substantial, while the proportion of nomad eels, or habitat inter‐shifter, was different among sites. Mean annual grow rate of resident eels is higher in productive environments (TR and lagoon of Lesina), while in Caprolace lagoon, an oligotrophic lagoon, resident eels grow slower. The observed patterns of habitat use and growth seem linked to local ecological conditions: facultative movements of eels with a nomadic behaviour seem affected by food availability rather than by the salinity gradient. This consideration supports the hypothesis that the facultative catadromous migration of European eel in Mediterranean TW, and the trophic shifts that this species exhibits, depend primarily on the productivity of the environment rather than on its salinity gradient.
Pseudomonas syringae pv. aesculi: foliar infection of Aesculus species and temperature–growth relationships
Authors: Mullett M. S. , Webber J. F. 
Published: April 2013

SummarySince 2001, the incidence of bleeding canker of horse chestnut (Aesculus hippocastanum) has increased markedly in western Europe. The causal agent, the bacterium Pseudomonas syringae pv. aesculi, originally isolated from foliar lesions on Indian horse chestnut (Aesculus indica) in India, is a bark killing pathogen on A. hippocastanum. In this study, P. syringae pv. aesculi was found as a foliar epiphyte on both A. hippocastanum and A. indica trees growing in the UK. When Aesculus leaves were challenged with cell suspensions (109 CFU ml−1) of Pseudomonas syringae pv. aesculi, a high level of asymptomatic infection occurred in all the species tested. The degree of re‐isolation of the bacterium after surface sterilization of leaves ranged from 33% (A. pavia) to 84 and 97% for A. hippocastanum and A. chinensis, respectively. The studies suggest both epiphytic and intrafoliar populations of P. syringae pv. aesculi could play a role in the incidence and spread of bleeding canker of horse chestnut. Growth–temperature responses of P. syringae pv. aesculi indicated a minimum of approximately −4°C and a maximum of approximately 35°C, with an optimum of approximately 25°C. These findings show that P. syringae pv. aesculi is not restricted to bark lesions but is likely to be widespread in the environment. It is also capable of causing foliar infection of several Aesculus species and could persist under extremes of weather in the UK.
Reflective folios for dental hygiene students: what do they tell us about a residential aged care student placement experience?
Authors: Wallace J. P. , Blinkhorn A. S. , Blinkhorn F. A. 
Published: April 2013

AbstractIntroductionCommunity‐based education programmes provide students with an experiential learning opportunity in a real‐life context. The purpose of this study was to examine reflective journals to identify students' experiences and perceived learning during a 12‐week placement programme in residential aged care facilities (RACF) on the NSW Central Coast, Australia.MethodologyAll final year dental hygiene students from the University of Newcastle, Australia attended an aged care orientation workshop prior to commencing the RACF student placement programme. Throughout the placement, students were asked to record their educational experiences in reflective journals. Student reflections were based on the ‘Gibbs Reflective Cycle’, diarising experiences and feelings. Qualitative data was analysed using the constant comparative method and unitised to identify emergent themes.ResultsSixty‐seven students completed reflective journals during the placement programme; emergent themes indicated students felt ill‐prepared for the placement programme despite attending the orientation workshop. They were apprehensive and nervous prior to commencement of the placement. The general consensus after week 6 was that the placement became a more positive experience where students began to feel comfortable in the RACF environment and residents, and staff started to respond more positively to their presence. Overall, they thought the placement was challenging and confronting, but had improved their skills and knowledge in care of older people and increased their confidence in working with other healthcare professionals.ConclusionThe reflective journals provided students with the opportunity to record and reflect on their experience and perceived learning during the placement programme. Student reflections identified negative experiences at the commencement of the placement, suggesting a need for additional orientation prior to the RACF programme.
Nucleus accumbens GABAergic inhibition generates intense eating and fear that resists environmental retuning and needs no local dopamine
Authors: Richard Jocelyn M. , Plawecki Andrea M. , Berridge Kent C. 
Published: April 2013

AbstractIntense fearful behavior and/or intense appetitive eating behavior can be generated by localized amino acid inhibitions along a rostrocaudal anatomical gradient within medial shell of nucleus accumbens of the rat. This can be produced by microinjections in medial shell of either the γ‐aminobutyric acid (GABA)A agonist muscimol (mimicking intrinsic GABAergic inputs) or the AMPA (α‐amino‐3‐hydroxy‐5‐methylisoxazole‐4‐propionic acid) antagonist DNQX (6,7‐dinitroquinoxaline‐2,3‐dione), disrupting corticolimbic glutamate inputs). At rostral sites in medial shell, each drug robustly stimulates appetitive eating and food intake, whereas at more caudal sites the same drugs instead produce increasingly fearful behaviors such as escape, distress vocalizations and defensive treading (an antipredator behavior rodents emit to snakes and scorpions). Previously we showed that intense motivated behaviors generated by glutamate blockade require local endogenous dopamine and can be modulated in valence by environmental ambience. Here we investigated whether GABAergic generation of intense appetitive and fearful motivations similarly depends on local dopamine signals, and whether the valence of motivations generated by GABAergic inhibition can also be retuned by changes in environmental ambience. We report that the answer to both questions is ‘no’. Eating and fear generated by GABAergic inhibition of accumbens shell does not need endogenous dopamine. Also, the appetitive/fearful valence generated by GABAergic muscimol microinjections resists environmental retuning and is determined almost purely by rostrocaudal anatomical placement. These results suggest that nucleus accumbens GABAergic release of fear and eating are relatively independent of modulatory dopamine signals, and more anatomically pre‐determined in valence balance than release of the same intense behaviors by glutamate disruptions.
Depression‐related behaviours displayed by female C57BL/6J mice during abstinence from chronic ethanol consumption are rescued by wheel‐running
Authors: Pang Terence Y. , Renoir Thibault , Du Xin , Lawrence Andrew J. , Hannan Anthony J. 
Published: April 2013

AbstractWithdrawal from a chronic period of alcohol consumption is commonly associated with the manifestation of depression, potentially exerting a significant influence on treatment prospects and increasing the likelihood of relapse. Better therapeutic strategies need to be developed to assist with rehabilitation. Here, we report the detection of depression‐related behaviours in a mouse model of 6‐week free‐choice ethanol (10%, v/v) consumption followed by 2‐week abstinence. Mice abstinent from alcohol showed increased immobility time on the forced‐swim test, reduced saccharin consumption and increased latency to feed in the novelty‐suppressed feeding test. By comparison, there was no significant effect on anxiety‐related behaviours as determined by testing on the light–dark box and elevated plus maze. We found that the provision of running‐wheels through the duration of abstinence attenuated depressive behaviour in the forced‐swim and novelty‐suppressed feeding tests, and increased saccharin consumption. Given the link between withdrawal from addictive substances and depression, this model will be useful for the study of the pathophysiology underlying alcohol‐related depression. The findings of this study establish an interaction between physical activity and the development of behavioural changes following cessation of alcohol consumption that could have implications for the development of rehabilitative therapies.
What should men living with severe haemophilia need to know? The perspectives of Canadian haemophilia health care providers
Authors: Lane S. , Arnold E. , Webert K. E. , Chan A. , Walker I. , Heddle N. M. 
Published: April 2013

SummaryHaemophilia is a complex disease to manage. Home‐based management of haemophilia has placed greater responsibility for disease management on individuals with haemophilia, heightening the individual's need for knowledge, particularly among individuals with severe haemophilia. The aim of this study was to identify and understand the knowledge needs and gaps of Canadian men with severe haemophilia from the perspectives of health care providers. A qualitative approach was undertaken. Data were collected using semi‐structured focus groups and interviews with health care providers from Haemophilia Treatment Centres (HTCs) across Canada; data were analysed using thematic analysis. Three focus groups and two interviews were conducted; 13 individuals participated in this study. Health care providers identified the following areas of knowledge required by men with severe haemophilia: disease pathology, causes and consequences of bleeds, bleed prevention, recognition, treatment, how and when to access support, activity selection and risk reduction, benefits of exercise, genetic inheritance patterns, impact on career selection, travel and ageing. Knowledge gaps and challenges to knowledge provision were highlighted. In addition, providers emphasized the influences of timing, rapport and context on readiness to receive and assimilate information and recommended tailoring education to the individual and creating a developmental curriculum and knowledge assessment tool. Provision and uptake of disease knowledge is essential to patient self‐management. To effectively receive, retain and assimilate information, individuals with severe haemophilia require the right information, from the right source, at the right time. Education should be tailored to the needs of the individual, provided throughout the lifespan.
Assessment of individual dose utilization vs. physician prescribing recommendations for recombinant activated factor VII (rFVIIa) in paediatric and adult patients with congenital haemophilia and alloantibody inhibitors (CHwI): the Dosing Observational Study in Hemophilia (DOSE)
Authors: Gruppo R. A. , Kessler C. M. , Neufeld E. J. , Cooper D. L. 
Published: April 2013

SummaryRecent data from the Dosing Observational Study in Hemophilia diary study has described home treatment with recombinant activated factor VII (rFVIIa) in congenital haemophilia with inhibitors (CHwI). The current analysis compares prescribed and patient/caregiver‐reported rFVIIa administration in paediatric and adult CHwI patients in this study. Patients with ≥4 bleeding episodes within a 3‐month period prescribed rFVIIa as first‐line therapy for bleeding episodes were eligible. Patients/caregivers completed a diary for ≥90 days or until the patient experienced four bleeds. Initial, total and mean rFVIIa doses reported for each bleeding episode were calculated and compared with the physician‐prescribed doses. Of 52 enrolled patients (25 children; 27 adults), 39 (75%) completed the study. Children and adults had similar mean durations of bleeding episodes. Both patient groups were administered higher initial rFVIIa doses for joint bleeds than prescribed: median (range) 215.2 (74.1–400.0) mcg kg−1 vs. 200.0 (61.0–270.0) mcg kg−1 for children, and 231.3 (59.3–379.7) mcg kg−1 vs. 123.0 (81.0–289.0) mcg kg−1 for adults. The median infused dose for joint bleeds was higher in adults than children (175.2 vs. 148.0 mcg kg−1), but children received significantly more doses per joint bleed than adults (median 6.5 vs. 3.0). The median total dose per joint bleed was higher in children than adults (1248.7 vs. 441.6). For children and adults, both initial and additional doses administered for bleeds were higher than prescribed. Children received higher total doses per bleed due to an increased number of infusions per bleed.