bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil gelatinase-associated lipocalin and albuminuria as predictors of acute kidney injury in patients treated with goal-directed haemodynamic therapy after major abdominal surgery
Authors: Cullen MR , Jhanji S , Pearse RM , Fitzgibbon MC 
Published: October 2013

Background Neutrophil gelatinase-associated lipocalin (NGAL) is emerging as a new biomarker for the early identification of acute kidney injury (AKI). There is also increasing evidence of an association between urinary albumin/creatinine ratio (ACR) and AKI. The primary aim of this study was to evaluate the clinical utility of these biomarkers to predict AKI in a population of perioperative patients treated with goal-directed haemodynamic therapy (GDHT). Secondary aims were to examine NGAL and ACR as sensitive biomarkers to detect the effects of GDHT and to investigate the association of these biomarkers with secondary outcomes. Methods Urine was obtained from 109 patients admitted to a critical care unit following major abdominal surgery. Patients were treated with intravenous fluid, GDHT with intravenous fluid or GDHT with intravenous fluid and dopexamine. Urine was collected preoperatively, and at times 0, 8 and 24 h postoperatively and outcome monitored for 28 days. Results There were no significant differences in NGAL or ACR concentrations between the cohorts treated with GDHT compared to standard care. However, both biomarker concentrations rose significantly in all cohorts over the time points. There were no significant differences in NGAL observed between patients who developed AKI and those who did not. However, there were significantly higher ACR preoperatively in patients who developed AKI. There were higher NGAL concentrations in patients who developed an infection and who died. Conclusions NGAL has a poor predictive role in evaluating AKI in this clinical setting. Preoperative ACR may have a role as an AKI marker.
Missed pulmonary metastasis
Authors: Althagafi Khalid Turki , Alashgar Omniyah Abdullah , Almaghrabi Huda Saddig , Nasralla Awrad , Ahmed Mohamed Hussein , Alshehri Ameen Mohammad , Saleh Waleed Neamatallah , Alkattan Khaled Manae 
Published: October 2013

Objective To assess the rate of detection of pulmonary nodules on preoperative computed tomography, based on intraoperative palpation of non-imaged pulmonary nodules, in patients who underwent thoracotomy for metastasectomy with bimanual lung palpation. Methods A retrospective study carried out on all cases of pulmonary metastasectomy performed in King Faisal Specialist Hospital and Research Center over a 10-year period (2001–2011). The number of nodules detected on preoperative computed tomography by a radiologist was compared with the number of nodules identified on pathology. Resected pulmonary nodules were classified to benign or malignant. Secondary outcomes were operative approach and primary malignancy. Results 215 metastasectomies were performed by thoracotomy. The incidence of nodules that were not imaged preoperatively was 36% (41% of mesenchymal tumors, 28% of epithelial tumors). Conclusion Metastasectomy by an open approach, which affords bimanual palpation of the entire lung, discovered ipsilateral non-imaged malignant pulmonary metastases in 36% of cases (41% of mesenchymal tumors).
Neurogenic thoracic outlet syndrome treatment by the supraclavicular approach
Authors: Yaseen Ziyad , Baram Aram 
Published: October 2013

Background thoracic outlet syndrome refers to compression of one or more of the neurovascular structures traversing the superior aperture of the thoracic cavity. Objective a symptom-based patient-directed questionnaire was used to evaluate the outcome of the supraclavicular approach for treatment of neurogenic thoracic outlet syndrome. Patients and Methods a prospective study was performed between April 2007 and October 2010. During this period, 97 patients in different age groups, with signs and symptoms of thoracic outlet syndrome, were surgically treated by the supraclavicular approach. The patients were aged between 14 and 60 years (mean 32.5 years), and the majority were female (89.69%). Surgery was performed on the left side in 52 patients and on the right side in 48, including 3 who had bilateral operations. The median follow-up was 11.2 months. Results in 78% of the 100 operations, excellent improvement in symptoms was noted, there was partial improvement in 18%, and 4% resulted in no response. Conclusions first rib resection remains an important and essential step in the management of the thoracic outlet syndrome, in the absence of bony abnormalities. The supraclavicular approach can be employed with minimal morbidity and an excellent outcome.
Patterns of habituation and clinical fluctuations in migraine
Authors: Restuccia Domenico , Vollono Catello , Virdis Daniela , Piero Ivana del , Martucci Lucia , Zanini Sergio 
Published: October 2013

Background Habituation deficit, suggesting a deregulation of cortical excitability, represents a typical hallmark of interictal stages of migraine. We previously demonstrated that several neurophysiological markers of altered cortical excitability are significantly correlated to spontaneous clinical fluctuations of migraine. We therefore aimed at verifying whether clinical fluctuations are correlated to specific patterns of somatosensory evoked potential (SEP) habituation. Methods We analyzed habituation after median nerve stimulation of both high-frequency oscillations (HFOs) and N20 SEP in 25 migraine patients and 18 healthy volunteers. Subjects underwent six consecutive series of 500 stimuli. Results Migraine patients as a whole showed a significant habituation deficit of the N20 response. Moreover, spontaneously worsening patients show a clear potentiation of this wave in the last block of stimuli, whereas in spontaneously improving patients the N20 amplitude remained stable. Presynaptic HFOs were smaller in worsening patients and larger in improving ones, but they did not undergo habituation in patients as well as in healthy subjects. Conclusions Potentiation of the N20 response in spontaneously worsening migraineurs confirms that the reduction of the thalamocortical drive plays a major role in migraine pathogenesis. Moreover, the stable pattern we observed in spontaneously improving patients suggests that compensatory mechanisms can also play an important role. The normal response to repeated stimuli of HFOs in migraineurs might indicate that, although its initial amount depends on clinical conditions, high-frequency thalamocortical drive remains stable during the stimulation and probably reflects the activity of a buffer mechanism.
Preferential Loading of the ACL Compared With the MCL During Landing
Authors: Quatman Carmen E. , Kiapour Ata M. , Demetropoulos Constantine K. , Kiapour Ali , Wordeman Samuel C. , Levine Jason W. , Goel Vijay K. , Hewett Timothy E. 
Published: October 2013

Background: Strong biomechanical and epidemiological evidence associates knee valgus collapse with isolated, noncontact anterior cruciate ligament (ACL) injuries. However, a concomitant injury to the medial collateral ligament (MCL) would be expected under valgus collapse, based on the MCL’s anatomic orientation and biomechanical role in knee stability. Purpose/Hypothesis: The purpose of this study was to investigate the relative ACL to MCL strain patterns during physiological simulations of a wide range of high-risk dynamic landing scenarios. We hypothesized that both knee abduction and internal tibial rotation moments would generate a disproportionate increase in the ACL strain relative to the MCL strain. However, the physiological range of knee abduction and internal tibial rotation moments that produce ACL injuries are not of sufficient magnitude to compromise the MCL’s integrity consistently. Study Design: Controlled laboratory study. Methods: A novel in sim approach was used to test our hypothesis. Seventeen cadaveric lower extremities (mean age, 45 ± 7 years; 9 female and 8 male) were tested to simulate a broad range of landings after a jump under anterior tibial shear force, knee abduction, and internal tibial rotation at 25° of knee flexion. The ACL and MCL strains were quantified using differential variable reluctance transducers. An extensively validated, detailed finite element model of the lower extremity was used to help better interpret experimental findings. Results: Anterior cruciate ligament failure occurred in 15 of 17 specimens (88%). Increased anterior tibial shear force and knee abduction and internal tibial rotation moments resulted in significantly higher ACL:MCL strain ratios ( P < .05). Under all modes of single-planar and multiplanar loading, the ACL:MCL strain ratio remained greater than 1.7, while the relative ACL strain was significantly higher than the relative MCL strain ( P < .01). Relative change in the ACL strain was demonstrated to be significantly greater under combined multiplanar loading compared with anterior tibial shear force ( P = .016), knee abduction ( P = .018), and internal tibial rotation ( P < .0005) moments alone. Conclusion: While both the ACL and the MCL resist knee valgus during landing, physiological magnitudes of the applied loads leading to high ACL strain levels and injuries were not sufficient to compromise the MCL’s integrity. Clinical Relevance: A better understanding of injury mechanisms may provide insight that improves current risk screening and injury prevention strategies. Current findings support multiplanar knee valgus collapse as a primary factor contributing to a noncontact ACL injury.
A Novel Radiographic Index for the Diagnosis of Posterior Acromioclavicular Joint Dislocations
Authors: Vaisman Alex , Villalón Montenegro Ignacio Eduardo , Tuca De Diego María Jesús , Valderrama Ronco Juanjose 
Published: October 2013

Background: Posterior acromioclavicular (AC) joint dislocations are frequently misclassified because posterior translation of the clavicle is difficult to evaluate in Zanca radiograph views. A novel radiographic index was used in this study to accurately diagnose posterior dislocations of the AC joint. Hypothesis: This novel index has a high degree of accuracy for the diagnosis of posterior AC joint dislocations. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: This was an analytic, descriptive study of 150 patients with different grades of AC injuries according to the Rockwood classification (30 patients for each grade of injury: I, II, III, IV, and V). The diagnosis of an AC injury was made both clinically and radiographically by using comparative Zanca and axillary views. Two measurements were performed in Zanca views: the coracoclavicular distance and the AC width distance. A width index was calculated for each patient. The Student t test, Bonferroni test, logistic regression, linear regression, and receiver operating characteristic (ROC) curves were used for statistical analysis. Forty cases were impartially selected to obtain a κ concordance value. Results: The average value of the AC width index per group (according to the Rockwood classification) was as follows: type I, 2.1% (range, –12% to 25%); type II, 4.2% (range, –19% to 29%); type III, 19.1% (range, –59% to 91%); type IV, 110.3% (range, 47% to 181%); and type V, –3.8% (range, –71% to 62%). There was a significant difference between the average width index in the patients with type IV injuries and those in the remaining groups ( P < .05). The ROC curve showed that a width index of 60% has a sensitivity of 95.7% and specificity of 97.5%, with a positive predictive value of 96.7% and negative predictive value of 95.6% to predict a type IV injury. Intraobserver reliability was rated as substantial agreement for each of 3 observers; the interobserver reliability of the 3 independent raters was almost perfect. Conclusion: An AC width index of ≥60% is highly accurate for the diagnosis of a posterior AC joint dislocation, with high intraobserver and interobserver concordance.
Nursing organizational climates in public and private hospitals
Authors: García I García , Castillo RF , Santa-Bárbara ES 
Published: October 2013

Background: Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction. Objectives: The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals. Materials and methods: A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals. Results: A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale. Discussion and conclusions: In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate.
Kitesports: A new source of major trauma? Report of four cases and literature review
Authors: Durnford AJ , Harrisson SE , Eynon CA 
Published: October 2013

Background Kitesurfing and kiteboarding are so-called extreme sports, whereby participants are attached to powerful kites, which propel the user over water or land. The sports have grown rapidly over the last decade. The impact, burden and mechanism of major neurological injuries resulting from these sports in the United Kingdom are unknown. Methods We reviewed patients requiring admission following kitesurfing or kiteboarding injuries to a regional Neurological Trauma Centre over a five-year period. Results Four cases were identified – two polytrauma and two spinal injuries, representing ∼0.5% of trauma admissions. All occurred due to impact onto land or objects after being lifted by the kite. Conclusions Participants in kitesurfing and kiteboarding must be aware of the possibility of serious injury. Despite the sports’ rapid, recent expansion, the number of injuries requiring admission to our unit over a five-year period was small but included one fatality. All of the injuries resulted from high-energy impact with land rather than in the water. Future safety guidance should include emphasis on care and measures to prevent injuries occurring at the water’s edge. We recommend that personal injury as well as liability insurance is obtained before participation in such sport.
Capsule endoscopy: High negative predictive value in the long term despite a low diagnostic yield in patients with suspected Crohn's disease
Authors: Hall Barry , Holleran Grainne , Costigan Danielle , McNamara Deirdre 
Published: October 2013

IntroductionThe role of small bowel capsule endoscopy (SBCE) in Crohn's disease (CD) has expanded with greater understanding of the technology. The ability of SBCE to differentiate CD from other causes of inflammation has been questioned. Longitudinal studies are required to assess the long‐term impact and significance of SBCE findings in suspected CD. This study aimed to determine the long‐term clinical accuracy of SBCE in patients referred with suspected CD.MethodsA retrospective review was carried out on SBCE procedures performed for suspected CD since 2010. Only patients with at least 6 months of documented follow up were included. A chart review was undertaken to record SBCE findings/correlate with subsequent diagnosis and outcome.ResultsIn all, 95 patients with sufficient follow up were identified. The mean follow up was 13 months (range 8–24). In total, 72 (76%) SBCEs were negative and 23 (24%) positive for CD. Of the 72 negative tests, two patients (3%) were later diagnosed with CD. The negative predictive value is 96%. There was a strong positive correlation between results of WCE and subsequent clinical diagnosis.ConclusionsSBCE appears capable of safely out‐ruling CD, with only 3% of negative SBCE investigations being diagnosed with CD after 15 months.
Pivotal role of Pten in the balance between proliferation and differentiation of hematopoietic stem cells in zebrafish
Authors: Choorapoikayil Suma , Kers Rianne , Herbomel Philippe , Kissa Karima , den Hertog Jeroen 
Published: October 2013

Key PointsLoss of the tumor suppressor, PTEN, results in enhanced blood stem cell proliferation and arrested differentiation, hallmarks of leukemia. Pten mutant zebrafish embryos display defective hematopoiesis and constitute an excellent tool to assess drug treatment.
Hematopoietic specification from human pluripotent stem cells: current advances and challenges toward de novo generation of hematopoietic stem cells
Authors: Slukvin Igor I. 
Published: October 2013

AbstractSignificant advances in cellular reprogramming technologies and hematopoietic differentiation from human pluripotent stem cells (hPSCs) have already enabled the routine production of multiple lineages of blood cells in vitro and opened novel opportunities to study hematopoietic development, model genetic blood diseases, and manufacture immunologically matched cells for transfusion and cancer immunotherapy. However, the generation of hematopoietic cells with robust and sustained multilineage engraftment has not been achieved. Here, we highlight the recent advances in understanding the molecular and cellular pathways leading to blood development from hPSCs and discuss potential approaches that can be taken to facilitate the development of technologies for de novo production of hematopoietic stem cells.
Transcriptional profile of Paracoccidioides induced by oenothein B, a potential antifungal agent from the Brazilian Cerrado plant Eugenia uniflora
Authors: Zambuzzi-Carvalho Patrícia Fernanda , Tomazett Patrícia Kott , Santos Suzana Costa , Ferri Pedro Henrique , Borges Clayton Luiz , Martins Wellington Santos , de Almeida Soares Célia Maria , Pereira Maristela 
Published: October 2013

AbstractBackgroundThe compound oenothein B (OenB), which is isolated from the leaves ofEugenia uniflora, a Brazilian Cerrado plant, interferes withParacoccidioidesyeast cell morphology and inhibits 1,3-β-D-glucan synthase (PbFKS1) transcript accumulation, which is involved in cell wall synthesis. In this work we examined the gene expression changes inParacoccidioidesyeast cells following OenB treatment in order to investigate the adaptive cellular responses to drug stress.ResultsWe constructed differential gene expression libraries using Representational Difference Analysis (RDA) ofParacoccidioidesyeast cells treated with OenB for 90 and 180 min. Treatment for 90 min resulted in the identification of 463 up-regulated expressed sequences tags (ESTs) and 104 down-regulated ESTs. For the 180 min treatment 301 up-regulated ESTs and 143 down-regulated were identified. Genes involved in the cell wall biosynthesis, such as GLN1, KRE6 and FKS1, were found to be regulated by OenB. Infection experiments in macrophages corroborated thein vitroresults. Fluorescence microscopy showed increased levels of chitin in cells treated with OenB. The carbohydrate polymer content of the cell wall of the fungus was also evaluated, and the results corroborated with the transcriptional data. Several other genes, such as those involved in a variety of important cellular processes (i.e., membrane maintenance, stress and virulence) were found to be up-regulated in response to OenB treatment.ConclusionsThe exposure ofParacoccidioidesto OenB resulted in a complex altered gene expression profile. Some of the changes may represent specific adaptive responses to this compound in this important pathogenic fungus.
The RootScope: a simple high-throughput screening system for quantitating gene expression dynamics in plant roots
Authors: Kast Erin J , Nguyen Minh-Duyen T , Lawrence Rosalie E , Rabeler Christina , Kaplinsky Nicholas J 
Published: October 2013

Abstract

Background
High temperature stress responses are vital for plant survival. The mechanisms that plants use to sense high temperatures are only partially understood and involve multiple sensing and signaling pathways. Here we describe the development of the RootScope, an automated microscopy system for quantitating heat shock responses in plant roots.

Results
The promoter of Hsp17.6 was used to build a Hsp17.6
p:GFP transcriptional reporter that is induced by heat shock in Arabidopsis. An automated fluorescence microscopy system which enables multiple roots to be imaged in rapid succession was used to quantitate Hsp17.6
p:GFP response dynamics. Hsp17.6
p:GFP signal increased with temperature increases from 28°C to 37°C. At 40°C the kinetics and localization of the response are markedly different from those at 37°C. This suggests that different mechanisms mediate heat shock responses above and below 37°C. Finally, we demonstrate that Hsp17.6
p:GFP expression exhibits wave like dynamics in growing roots.

Conclusions
The RootScope system is a simple and powerful platform for investigating the heat shock response in plants.
SOD2gene Val16Ala polymorphism is associated with macroalbuminuria in Mexican Type 2 Diabetes patients: a comparative study and meta-analysis
Authors: Ascencio-Montiel Iván de Jesús , Parra Esteban J , Valladares-Salgado Adán , Gómez-Zamudio Jaime H , Kumate-Rodriguez Jesús , Escobedo-de-la-Peña Jorge , Cruz Miguel 
Published: October 2013

Abstract

Background
Several studies in type 2 diabetes patients have shown significant associations between the SOD2 gene Val16Ala polymorphism and albuminuria, but this association has not been explored in the Mexican population.

Methods
We evaluated the association between the SOD2 gene Val16Ala polymorphism (rs4880) and macroalbuminuria in a sample of 994 unrelated Mexican type 2 diabetes patients. The study included 119 subjects with urinary albumin >300 mg/dL and 875 subjects with urinary albumin ≤ 30 mg/dL. Genotyping of the SOD2 gene Val16Ala SNP was carried out with Real-Time Polymerase Chain Reaction (RT-PCR).

Results
The frequency of the TT genotype was 6.7% higher in participants with macroalbuminuria than in the normoalbuminuria group (16.8% vs. 10.1%). Using a logistic regression analysis, we observed that individuals with the CC genotype had significantly lower risks of macroalbuminuria than those with the TT genotype (OR=0.42, p=0.034). We carried out a meta-analysis combining our data with data from four previous studies and estimated an odds ratio (95% CI) for the C allele (with respect to the reference T allele) of 0.65 (0.52-0.80, p<0.001).

Conclusions
A significant association was found between the SOD2 Val16Ala polymorphism and macroalbuminuria in a sample of Mexican type 2 diabetes patients.