bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Nitrous Oxide Anesthesia, B-Vitamins, andMTHFRGene Polymorphisms on Perioperative Cardiac Events
Authors: Nagele Peter , Brown Frank , Francis Amber , Scott Mitchell G. , Gage Brian F. , Miller J. Philip 
Published: June 2013

AbstractBackground:Nitrous oxide causes an acute increase in plasma homocysteine that is more pronounced in patients with the methylenetetrahydrofolate reductase (MTHFR) C677T or A1298C gene variant. In this randomized controlled trial, the authors sought to determine whether patients carrying the MTHFR C677T or A1298C variant had a higher risk for perioperative cardiac events after nitrous oxide anesthesia and whether this risk could be mitigated by B-vitamins.Methods:The authors randomized adult patients with cardiac risk factors undergoing noncardiac surgery, to receive nitrous oxide plus intravenous B-vitamins before and after surgery, or to nitrous oxide and placebo. Serial cardiac biomarkers and 12-lead electrocardiograms were obtained. The primary study endpoint was the incidence of myocardial injury, as defined by cardiac troponin I increase within the first 72 h after surgery.Results:A total of 500 patients completed the trial. Patients who were homozygous for either MTHFR C677T, or A1298C gene variant (n = 98; 19.6%) had no increased rate of postoperative cardiac troponin I increase compared with wild-type and heterozygous patients (11.2 vs. 14.0%; relative risk 0.96; 95% CI, 0.85–1.07; P = 0.48). B-vitamins blunted the rise in homocysteine, but had no effect on cardiac troponin I increase compared with patients receiving placebo (13.2 vs. 13.6%; relative risk 1.02; 95% CI 0.78 to 1.32; P = 0.91).Conclusions:Neither MTHFR C677T and A1298C gene variant, nor acute homocysteine increase are associated with perioperative cardiac troponin increase after nitrous oxide anesthesia. B-vitamins blunt nitrous oxide-induced homocysteine increase but have no effect on cardiac troponin I increase.
Reduced Mitochondrial DNA Content and Heterozygous Nuclear Gene Mutations in Patients With Acute Liver Failure
Authors: Helbling Daniel , Buchaklian Adam , Wang Jing , Wong Lee‐Jun , Dimmock David 
Published: June 2013

ABSTRACTObjectives:Historically, mitochondrial disorders have been associated with predominantly multisystem or neurological symptoms. If present, hepatic complications were thought to be a late feature. Recently, mutations in at least 4 nuclear genes have been identified in infants presenting with rapidly progressive hepatic failure, which may be precipitated by infection or drugs. We aimed to determine whether hepatic mitochondrial DNA (mtDNA) depletion is associated with apparently isolated hepatic failure in individuals with acute liver failure (ALF) of known or unknown etiologies undergoing liver transplant (LT). In addition, we wished to establish whether there was an excess of mutations in gene known to cause hepatic mtDNA depletion.Methods:Using previously established methods, we demonstrated that end‐stage liver disease from known causes did not lead to hepatic mtDNA depletion.Results:Using thresholds derived from receiver‐operator curve analysis, 66% of cases with ALF had probable or definite mtDNA depletion, including 34% with definite mtDNA depletion. There was a small but significant increase in the proportion of patients undergoing LT for ALF with heterozygous mutations known to lead to mtDNA depletion and hepatic failure compared with controls (P = 0.001).Conclusions:Liver disease severe enough to require LT does not cause secondary mtDNA depletion; however, the majority of patients undergoing LT for ALF had reduced mtDNA content, which fell within the range seen in patients with classic mtDNA depletion. A subset of patients with ALF has mutations in genes known to lead to mtDNA depletion and hepatic failure. Together, these results suggest defective mtDNA maintenance is associated with ALF.
Transglutaminase IgA Antibodies in a Celiac Disease Mass Screening and the Role of HLA‐DQ Genotyping and Endomysial Antibodies in Sequential Testing
Authors: Sandström Olof , Rosén Anna , Lagerqvist Carina , Carlsson Annelie , Hernell Olle , Högberg Lotta , Ivarsson Anneli 
Published: June 2013

ABSTRACTObjectives:The aim of this study was to evaluate hypothetical screening strategies in a Swedish celiac disease (CD) mass screening.Methods:Of 10,041 Swedish sixth graders born in 1993 invited to a population‐based CD mass screening, 7208 participated. Anti‐tissue transglutaminase (tTG) immunoglobulin (Ig) A were analyzed in all children and total serum IgA (s‐IgA) in 7161 children. Additional analyses of tTG‐IgG, endomysial antibodies (EMA) IgA and IgG, and human leukocyte antigen (HLA) alleles were performed according to a standardized protocol. Children with elevated levels of serological markers were recommended to undergo a small intestinal biopsy to verify diagnosis, and 153 children with CD were thus identified. Sensitivity, specificity, positive predictive values (PPVs) and negative predictive values (NPVs) were calculated and receiver operating characteristic curves were plotted.Results:By lowering the cutoff for tTG‐IgA, 17 additional cases of CD were identified at the cost of 32 biopsies. All children with tTG‐IgA >50 U/mL (10 times the recommended upper limit of normal) had gluten enteropathy. Area under the receiver operating characteristic curve for tTG‐IgA was 0.988. All cases carried HLA‐DQ2 or HLA‐DQ8, as did 53% of the controls. For different hypothetical screening strategies, sensitivity, specificity, PPV, and NPV ranged between 87.6% and 100%, 99.5% and 99.9%, 79.7% and 89.7%, and 99.7% and 100%, respectively. Efforts to increase sensitivity by lowering tTG‐IgA cutoff would result in increased number of small intestinal biopsies and lower PPV. Sequential testing for both EMA and HLA‐DQ genotyping would reduce the number of negative small intestinal biopsies.Conclusions:tTG‐IgA is a robust marker when used in CD mass screening and its performance can be enhanced by sequential testing for EMA or HLA‐DQ genotyping.
Nutritional and Psychosocial Outcomes of Gastrostomy Tube–Dependent Children Completing an Intensive Inpatient Behavioral Treatment Program
Authors: Silverman Alan H. , Kirby Midge , Clifford Lisa M. , Fischer Elizabeth , Berlin Kristoffer S. , Rudolph Colin D. , Noel Richard J. 
Published: June 2013

ABSTRACTObjectives:Limited published data describe the long‐term effects of behavioral strategies to wean children from gastrostomy tube (GT) feeding dependence. This study presents data relating to nutritional and psychosocial outcomes observed during a 1‐year period in medically complex GT feeding–dependent patients who completed an inpatient behavioral‐based tube weaning protocol.Methods:This was a retrospective study of prospectively and retrospectively collected data associated with a clinical cohort of 77 children diagnosed as having a feeding disorder, GT feeding dependence (>1 year), and an inability to maintain acceptable growth via oral feeding completing an inpatient tube weaning protocol. Nutritional data (percentage of ideal body weight, and oral energy intake as percent ofenergy goal) and psychosocial data (mealtime behavior problems, quality of caregiver and child interactions, and parenting stress) were assessed pre‐ and post‐hospitalization. Nutritional data were also monitored longitudinally at 1, 3, 6, and 12 months postreatment. Data were grouped for retrospective analysis.Results:Mealtime environment and feeding behaviors significantly improved, and all of the patients demonstrated reductions in tube dependence aside from 1 treatment failure. Fifty‐one percent of patients were fully weaned from tube feeding after 2 weeks and an additional 12% completed weaning in the outpatient follow‐up clinic within 1 year. Patients maintained nutritional stability at the 1‐year posttreatment follow‐up appointment.Conclusions:Inpatient behavioral interventions are highly effective and safe for transitioning long‐term tube feeding children to oral feeding.
Subretinal Abscess Causing Restricted Diffusion on Magnetic Resonance Imaging
Authors: Peeler Crandall , Parmar Hemant , Trobe Jonathan D. 
Published: June 2013

Background:
Restricted diffusion of water molecules on diffusion-weighted magnetic resonance imaging most commonly associated with acute stroke, has also been described in brain abscess. It has been reported in only one case of sub-retinal abscess.

Methods:
Review of two cases.

Results:
Two cases of visual loss from subretinal abscess had restricted diffusion in the region of the abscess. In the first case, DWI revealed restricted diffusion in a white mass visible in the posterior retina. In the second case, restricted diffusion was present in an anterior retinal mass invisible by ophthalmoscopy and ultrasound. In combination of restricted diffusion in the cerebrum consistent with septic emboli, these imaging abnormalities allowed earlier treatment that either preserved vision or prevented enucleation.
Mutational activation of the RocR activator and of a cryptic rocDEF promoter bypass loss of the initial steps of proline biosynthesis in Bacillus subtilis
Authors: Zaprasis Adrienne , Hoffmann Tamara , Wünsche Guido , Flórez Lope A. , Stülke Jörg , Bremer Erhard 
Published: June 2013

SummaryThe gamma‐glutamyl‐phosphate reductase (ProA) interlinks both the anabolic and osmostress adaptive proline biosynthetic routes of Bacillus subtilis. Because no paralogous protein to ProA exists in this microorganism, proA mutants should exhibit a tight proline auxotrophic growth phenotype. Contrary to expectations, proA mutants formed microcolonies on agar plates lacking proline and faster growing Pro+ suppressor mutants arose. These mutants carried alterations in the rocR‐rocDEF region encoding enzymes of the arginine degradation pathway and its transcriptional activator RocR. They were of two types: (i) mutants carrying single amino acid substitutions in RocR resulting in partial inducer‐independent variants and (ii) mutants carrying single base‐pair changes in the vicinity of the SigL/Sig‐54‐dependent −12/−24 class rocDEF promoter that activate a cryptic SigA‐type promoter. Consequently, enhanced rocDEF transcription should lead to increased cellular amounts of the RocD ornithine aminotransferase, an enzyme that synthesizes the same reaction product as ProA, gamma‐glutamic‐semialdehyde/delta‐1‐pyrroline‐5‐carboxylate. This compound can be enzymatically converted into proline. The Pro+ suppressors also exhibited a new regulatory pattern by allowing enhanced rocDEF transcription in response to proline availability when ammonium is present. Our work provides an example how flexibly bacteria can genetically develop routes to bypass constraints imposed on their biosynthetic networks and evolve new regulatory mechanisms.
A morphogenetic survey on ciliate plankton from a mountain lake pinpoints the necessity of lineage‐specific barcode markers in microbial ecology
Authors: Stoeck Thorsten , Breiner Hans‐Werner , Filker Sabine , Ostermaier Veronika , Kammerlander Barbara , Sonntag Bettina 
Published: June 2013

SummaryAnalyses of high‐throughput environmental sequencing data have become the ‘gold‐standard’ to address fundamental questions of microbial diversity, ecology and biogeography. Findings that emerged from sequencing are, e.g. the discovery of the extensive ‘rare microbial biosphere’ and its potential function as a seed‐bank. Even though applied since several years, results from high‐throughput environmental sequencing have hardly been validated. We assessed how well pyrosequenced amplicons [the hypervariable eukaryotic V4 region of the small subunit ribosomal RNA (SSU rRNA) gene] reflected morphotype ciliate plankton. Moreover, we assessed if amplicon sequencing had the potential to detect the annual ciliate plankton stock. In both cases, we identified significant quantitative and qualitative differences. Our study makes evident that taxon abundance distributions inferred from amplicon data are highly biased and do not mirror actual morphotype abundances at all. Potential reasons included cell losses after fixation, cryptic morphotypes, resting stages, insufficient sequence data availability of morphologically described species and the unsatisfying resolution of the V4 SSU rRNA fragment for accurate taxonomic assignments. The latter two underline the necessity of barcoding initiatives for eukaryotic microbes to better and fully exploit environmental amplicon data sets, which then will also allow studying the potential of seed‐bank taxa as a buffer for environmental changes.
Relating a City's History and Geography with Bourdieu: One Hundred Years of Spatial Distinction inTelAviv
Authors: Marom Nathan 
Published: June 2013

AbstractThis article advances a conceptualization of spatial distinction that, followingBourdieu, relates principles of division in ‘social space’ with formations of segregation in urban space. It applies this interpretive framework to concisely narrate the one hundred years' history of spatial distinction inTelAviv. Analyzing five moments in the city's development, it focuses on a dominant principle of distinction in each period and its ensuing segregations: predominantly ethno‐national (Jewish–Arab) distinction that establishedTelAviv in opposition to Jaffa at the turn of the twentieth century; nuanced ethno‐class distinction that shaped the city's rapid growth in the 1920s–30s and created an elaborate socio‐spatial hierarchy of neighborhoods; institutionalized distinction that governed the collective supply of housing in the 1930s–40s, evolving into a complex system of housing classifications; ‘distinction‐by‐distance’ through exclusive suburbanization and the emergence of a metropolitan scale of distinction in the 1950s–70s; and a ‘back‐to‐the‐center’ strategy of distinction by way of gentrification in the 1980s–90s and within gated residential enclaves at the beginning of the twenty‐first century. Through this concise history, various principles, mechanisms and scales of spatial distinction are elaborated upon, as a way to think about the socially constructed, historically contingent and continuously changing divisions and segregations in cities.
Optimisation of a process for shelf‐stable dietetic Chhana kheer and changes in physicochemical properties during storage
Authors: Gautam Anuj Kumar , Jha Alok , Jafri Mahwash , Kumar Arvind 
Published: June 2013

In the production of shelf‐stable dietetic Chhana kheer, optimised levels of Chhana and artificial sweeteners were examined using a stationary retort. The product was characterised by short lag period for heating (jh) (0.78–1.03), small heating rate index (fh) (7.69–17.00 min) and short lag factor for cooling (jc) (0.76–1.06), implying convective heating regime. The total process time B was 19.13–32.98 min for corresponding process lethality values (Fo) of 4.56–25.50 min. Based on optimisation, processing of the dietetic Chhana kheer at 121.40 °C for 20 min was found to be the optimum. Optimised product was stable up to 90 days at 37 °C.
Comparison of survival and tumor recurrence rates in patients undergoing liver transplantation for hepatitis B‐related hepatocellular carcinoma using Milan, Shanghai Fudan and Hangzhou criteria
Authors: Gao Ting , Xia Qiang , Qiu De Kai , Feng Yi Yan , Chi Jia Chang , Wang Si Yue , Xi Zhi Feng , Zhang Jian Jun , Xu Ning , Chen Shi Yao , Qiu Yu Lan , Shen Li Wei , Zhou Ting Ting , Dong Xiao Jun , Li Qi Gen , Li Hai 
Published: June 2013

ObjectivesTo assess the performance of the Milan, Shanghai Fudan and Hangzhou criteria based on a preoperative evaluation in patients undergoing liver transplantation (LT) for hepatitis B‐related hepatocellular carcinoma (HCC).MethodsUsing a prospectively collected database, the data of consecutive patients with hepatitis B‐related HCC undergoing LT at the Department of Liver Surgery of Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University from January 2005 to December 2009 were reviewed. Overall survival and tumor recurrence rates of patients fulfilling the Milan, Shanghai Fudan and Hangzhou criteria were compared using log–rank test.ResultsAltogether 148 patients were enrolled in the study, among whom 88 fulfilled the Milan criteria and 24 and 39 were beyond Milan but within the Shanghai Fudan or Hangzhou criteria, respectively. After a median follow‐up of 44 months, survival rates did not differ among the three groups (P = 0.8780). Recurrence rates were significantly higher for newly eligible patients by the Shanghai Fudan or Hangzhou criteria compared with those within the Milan criteria.ConclusionsThe Milan criteria should be used as the preferred criteria for the selection of hepatitis B‐related HCC for LT. Considering the high tumor recurrence rates and donor scarcity, a moderate expansion of the Milan criteria must be performed cautiously until high‐quality clinical trials are conducted.
Avian frugivore assemblages on Celtis gomphophylla, Baker, in Budongo Forest Reserve, Uganda
Authors: Uwimbabazi Moreen , Eilu Gerald 
Published: June 2013

AbstractThe relationship between selective logging and avian frugivores feeding on Celtis gomphophylla was examined in Budongo Forest Reserve, from June to July 2005, using scan sampling. Abundance and species richness of avian frugivores were compared between two compartments (N3 and W22 last logged in 1952 and 1997 respectively). Two 1‐ha plots were established in each compartment from which two C. gomphophylla trees selected for observation. A total of 203 avian frugivores comprising 17 species, visited the eight C. gomphophylla trees. Avian frugivore abundance and richness were significantly higher in N3 than W22 (χ2 = 5.83, χ2 = 0.03, P < 0.05). Fischer's alpha diversity index also indicated a higher avian frugivore (frugivory?) in N3 than that in W22. The Sorensen's similarity index showed that species composition between the two compartments was moderately similar. The diversity of forest specialists and generalists was not significantly different in the two compartments (F = 0.3451, P = 0.082 and F = 0.368, P = 0.553). Our results stress the significance of logging intensity on avian feeding guilds and confirm that forests which have had enough recovery time are better habitats for avian frugivore assemblages.
Effectiveness of cognitive behavioural coaching in improving the well‐being and retention of rural general practitioners
Authors: Gardiner Maria , Kearns Hugh , Tiggemann Marika 
Published: June 2013

AbstractObjectiveTo determine the relationship between cognitive behavioural coaching, the well‐being of rural general practitioners (GPs), their intentions to leave and actual leaving of rural general practice.DesignQuasi‐experimental study utilising an intervention group of rural GPs and deidentified data for a baseline group and a control group consisting of the remaining population of rural GPs in South Australia.SettingRural general practice.ParticipantsRural GPs in South Australia: intervention group (n = 69), baseline group (n = 205) and control group (n = 312).InterventionsA 9‐hour cognitive behavioural coaching program.Main outcome measure(s)Rural doctor distress, intention to leave rural general practice and actual retention rate of rural GPs.ResultsGPs who underwent cognitive behavioural coaching had lower rural doctor distress scores (mean = 24.50; confidence interval, 21.71–27.29) than the baseline group (mean = 28.63; confidence interval, 27.08–30.17). Before coaching, 81% of rural GPs in the intervention group had considered leaving general practice, which reduced to 40% after coaching (χ2(2) = 16.31, P < .001). Over a 3‐year period, 94% of the coaching group remained in general practice compared with 80% of the control group (χ2(1) = 4.89, P = 0.027).ConclusionsCognitive behavioural coaching reduced the stress levels of rural GPs who self‐identified the need for managing stress and reduced their intention to leave rural general practice. Further, despite initially being more stressed compared with the general population of rural GPs, more GPs from the coaching group remained in rural general practice.
Splenic injury admitted to a rural Level 3 trauma centre: A 10‐year audit
Authors: Hoskins Wayne , Jacob Abraham , Wijeratne Shiran , Campbell Ian , Taylor Peter 
Published: June 2013

AbstractObjectiveThere is paucity of research documenting the management of splenic injury in rural Australia. No data exists for Rural, Remote and Metropolitan Area 4 locations.DesignA retrospective review of prospectively collected data. Records were additionally sought from transfer hospitals. A qualitative assessment of splenic trauma management in the Wimmera Region was also performed.SettingWimmera Health Care Group: Horsham Campus, a Level 3 trauma hospital between January 2000 and July 2011.ParticipantsPatients coded with injury of spleen or excision procedure on spleen.InterventionsNilMain outcome measuressurgical vs. non‐surgical managementResultsNineteen patients were included (mean age 27.8, range 8–54). Only 26% were from Horsham. Most injuries were due to sporting trauma/falls (53%) and motor vehicle accidents (37%). One patient died in theatre from massive trauma. Eleven patients were managed non‐operatively. Seven patients had splenec‐ tomy performed. Four of these had delay in computed tomography scanning, delay to theatre and suffered major postoperative complication. The age (mean 39.9 versus 20.8) and Injury Severity Score (mean 21.9 versus 13.8) of patients requiring splenectomy was higher than those managed non‐operatively. Six of the splenic injury admissions (32%) were transferred from surrounding general practitioner‐run Rural, Remote and Metropolitan Area 5 hospitals. All of these patients had Victorian State Trauma Service‐defined major trauma with an Injury Severity Score >15. There was an approximate 4‐hour delay in transfer of these patients, with transfer occurring when clinical deterioration occurred.ConclusionsAlthough splenic injury is uncommon in the Wimmera region, improved trauma triaging is required, with early transfer of unstable patients and high‐energy trauma mechanisms. A lower threshold for computed tomography scanning is recommended.
The human polyomavirus BK (BKPyV): virological background and clinical implications
Authors: Rinaldo Christine Hanssen , Tylden Garth D. , Sharma Biswa Nath 
Published: June 2013

Polyomavirus BK (BKPyV) infects most people subclinically during childhood and establishes a lifelong infection in the renourinary tract. In most immunocompetent individuals, the infection is completely asymptomatic, despite frequent episodes of viral reactivation with shedding into the urine. In immunocompromised patients, reactivation followed by high‐level viral replication can lead to severe disease: 1–10% of kidney transplant patients develop polyomavirus‐associated nephropathy (PyVAN) and 5–15% of allogenic hematopoietic stem cell transplant patients develop polyomavirus‐associated haemorrhagic cystitis (PyVHC). Other conditions such as ureteric stenosis, encephalitis, meningoencephalitis, pneumonia and vasculopathy have also been associated with BKPyV infection in immunocompromised individuals. Although BKPyV has been associated with cancer development, especially in the bladder, definitive evidence of a role in human malignancy is lacking. Diagnosis of PyVAN and PyVHC is mainly achieved by quantitative PCR of urine and plasma, but also by cytology, immunohistology and electron microscopy. Despite more than 40 years of research on BKPyV, there is still no effective antiviral therapy. The current treatment strategy for PyVAN is to allow reconstitution of immune function by reducing or changing the immunosuppressive medication. For PyVHC, treatment is purely supportive. Here, we present a summary of the accrued knowledge regarding BKPyV.