bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum cytokeratin‐18 in the diagnosis of non‐alcoholic steatohepatitis: A meta‐analysis
Authors: Chen Jing , Zhu Yueyong , Zheng Qi , Jiang Jiaji 
Published: July 2013

AimIdentifying patients with non‐alcoholic steatohepatitis (NASH), a more aggressive form with a worse prognosis than for simple steatosis, is highly important. Liver biopsy still remains the gold standard for diagnosing NASH, but with limitations. The diagnostic value of serum cytokeratin‐18 (CK‐18) in predicting NASH is still indefinite.MethodsWe selected relevant studies by a literature search of the PubMed, Ovid Medline and Cochrane Library databases up to January 2012. A DerSimonian‐Laird random effects model was used to compute the pooled estimates of sensitivity (SEN), specificity (SPE), and diagnostic odds ratio (DOR), and a summary receiver operating characteristic (SROC) curve was constructed. Stratified analysis was performed to explore the heterogeneity in test accuracy. Funnel plot and Egger's regression were performed to assess publication bias.ResultsA total of 10 studies with 838 patients were included (nine CK‐18 fragments and five total CK‐18 studies) in this meta‐analysis. Among nine CK‐18 fragment studies with a significant publication bias, the pooled results on SEN, SPE and DOR were 0.83 (95% CI, 0.80–0.86), 0.71 (95% CI, 0.66–0.76) and 11.90 (95% CI, 6.05–23.40), respectively, and age and body mass index were most strongly associated with the observed heterogeneity. Among five total CK‐18 studies with homogeneity, the pooled results of SEN, SPE and DOR were 0.77% (95% CI, 0.70–0.83), 0.71 (95% CI, 0.65–0.77) and 7.99 (95% CI, 4.09–15.62), respectively. The area under the ROC curve (± SE) of CK‐18 fragments and total CK‐18 were 0.8445 (± 0.0306) and 0.8170 (± 0.0429), respectively.ConclusionBoth CK‐18 fragments and total CK‐18 have a clinically meaningful benefit in noninvasive diagnosing of NASH, though total CK‐18 has a relatively low diagnostic accuracy. CK‐18 fragments may be a useful biomarker for screening rather than identifying NASH.
Living donor liver transplantation for non‐alcoholic steatohepatitis: A single center experience
Authors: Tanaka Tomohiro , Sugawara Yasuhiko , Tamura Sumihito , Kaneko Junichi , Takazawa Yutaka , Aoki Taku , Hasegawa Kiyoshi , Sakamoto Yoshihiro , Yamashiki Noriyo , Kokudo Norihiro 
Published: July 2013

AimThe number of patients referred for liver transplantation (LT) with non‐alcoholic steatohepatitis (NASH) continues to increase, but information about living donor liver transplantation (LDLT) for NASH is scarce. We conducted this study to document the details of LDLT for NASH in a Japanese LT center.MethodsAmong all LDLT recipients in our institution from March 1996 to March 2013 (n = 425), we identified seven patients that underwent LDLT for NASH.ResultsOf all the seven recipients, most of the patients (86%) were obese. The median follow‐up period post‐LDLT was 5.3 years. All were alive at the last follow‐up. Recurrent NASH was detected in one patient (14%), and no recurrent hepatic steatosis was detected among the remaining six recipients on prospectively performed ultrasonography. No significant comorbidities were observed following donor surgery among the respective living donors during the follow‐up period. We also retrospectively reviewed 22 patients with NASH‐related end‐stage liver disease (ESLD) who were evaluated but rejected for LDLT during the same period. The reasons for rejection for LDLT were presumably associated with the nature of NAFLD/NASH in either potential recipients or donors.ConclusionThe post‐transplant outcome of LDLT for NASH‐related ESLD in our institution was feasible, although the sample size was small. Further studies in a larger patient cohort are warranted to investigate the long‐term outcome of LDLT for NASH, both for recipients and living donors.
Factors influencing exercises in Chinese people with type 2 diabetes
Authors: He W. , Zhang Y. , Zhao F. 
Published: July 2013

AimsThe purpose of this article is to explore factors influencing adherence to exercise in Chinese people with type 2 diabetes (T2D). The findings can be used to explain exercise behaviours and develop interventions to improve the level of adherence to exercise.MethodsA qualitative approach was used in this study. Data were collected at Nantong City, China. A purposive sampling scheme was used to recruit people with T2D for in‐depth semi‐structured interviews. Potential patients chosen from the case records in one teaching hospital were screened by telephone for eligibility. Inclusion criteria for recruiting participants were: diagnosis with T2D for at least 6 months; a treatment plan that recommends exercises; and ≥20 years of age. Exclusion criteria included: type 1 diabetes; severe complications of T2D; and cognitive impairment. Each interview was audio‐recorded. Recruitment efforts were suspended when the data reached saturation. Thematic analysis was employed to identify themes influencing factors from collected data.ResultsSeventeen participants were recruited for interviews when data reached saturation. Six themes were identified after thematic analysis: ‘beliefs about disease’, ‘health communication’, ‘feasibility of regimen’, ‘conducting skills’, ‘environmental support’ and ‘perceived benefits’.ConclusionThe influencing factors should be comprehensively considered when explaining behaviour relating to exercises or designing health‐promotional and health‐educational interventions to improve the level of adherence to exercise. This study suggests that health professionals need to pay attention to the patient preferences during health communication to design a feasible exercise regimen in a collaborative way. Non‐adherence to exercise cannot be attributed to patients only. Patients should be supported, not blamed.LimitationThe recruitment of participants from one city might limit the generalizations of the findings to larger areas of China and other ethnic groups. Gender differences related to factors influencing exercises need further consideration.
Involvement of nitric oxide in the wound bed microcirculatory change during negative pressure wound therapy
Authors: Sano Hitomi , Ichioka Shigeru 
Published: July 2013

AbstractThis study investigated the role of nitric oxide (NO) in the mechanism of blood flow increase in the wound bed during negative pressure wound therapy (NPWT). We developed an improved experimental model that allowed visualisation of the wound bed microcirculation under NPWT. Wounds were created on the mouse ear, taking care to preserve the subdermal vascular plexus, because the wound bed microcirculation was visualised using an intravital microscope system. We investigated whether application of a NO synthase inhibitor (NG‐nitro‐l‐arginine methyl ester: L‐NAME) might diminish the effect of the NPWT in increasing the wound blood flow. The experimental animals were divided into a negative pressure group (negative pressure of −125 mmHg applied to the wound for 5 minutes; n = 8), and a negative pressure plus L‐NAME group (administration of L‐NAME prior to application of the negative pressure; n = 8). In the negative pressure group, significant increase of blood flow was observed at 1 minute after the negative pressure application, which was sustained until 5 minutes. On the contrary, in the negative pressure plus L‐NAME group, no significant changes were observed throughout the period of observation. These findings suggest that NO synthesis is involved in the wound bed microcirculatory change induced by NPWT.
The cost of wound debridement: a Canadian perspective
Authors: Woo Kevin Y , Keast David , Parsons Nancy , Sibbald R Gary , Mittmann Nicole 
Published: July 2013

AbstractDebridement is integral to wound bed preparation by removing devitalised tissue, foreign material, senescent cells, phenotypically abnormal/dysfunctional cells (cellular burden) and bacteria sequestrum (biofilm). While the body of evidence to substantiate the benefits of debridement is growing, little is known about the cost‐effectiveness of each debridement method. The purpose of this analysis was to compare cost‐effectiveness of various debridement methods and clinical outcomes to help inform clinicians and policy makers of the cost‐effectiveness associated with the various types of therapies and the impact they can have on the Canadian health care system. Results indicated that sharp debridement was the most cost‐effective followed by enzymatic debridement method.
Habitat variation and wing coloration affect wing shape evolution in dragonflies
Authors: Outomuro D. , Dijkstra K.‐D. B. , Johansson F. 
Published: July 2013

AbstractHabitats are spatially and temporally variable, and organisms must be able to track these changes. One potential mechanism for this is dispersal by flight. Therefore, we would expect flying animals to show adaptations in wing shape related to habitat variation. In this work, we explored variation in wing shape in relation to preferred water body (flowing water or standing water with tolerance for temporary conditions) and landscape (forested to open) using 32 species of dragonflies of the genus Trithemis (80% of the known species). We included a potential source of variation linked to sexual selection: the extent of wing coloration on hindwings. We used geometric morphometric methods for studying wing shape. We also explored the phenotypic correlation of wing shape between the sexes. We found that wing shape showed a phylogenetic structure and therefore also ran phylogenetic independent contrasts. After correcting for the phylogenetic effects, we found (i) no significant effect of water body on wing shape; (ii) male forewings and female hindwings differed with regard to landscape, being progressively broader from forested to open habitats; (iii) hindwings showed a wider base in wings with more coloration, especially in males; and (iv) evidence for phenotypic correlation of wing shape between the sexes across species. Hence, our results suggest that natural and sexual selection are acting partially independently on fore‐ and hindwings and with differences between the sexes, despite evidence for phenotypic correlation of wing shape between males and females.
Metamorphic history of glaucophane‐paragonite‐zoisite eclogites from the Shanderman area, northern Iran
Authors: Omrani H. , Moazzen M. , Oberhänsli R. , Tsujimori T. , Bousquet R. , Moayyed M. 
Published: July 2013

AbstractThe Shanderman eclogites and related metamorphosed oceanic rocks mark the site of closure of the Palaeotethys ocean in northern Iran. The protolith of the eclogites was an oceanic tholeiitic basalt with MORB composition. Eclogite occurs within a serpentinite matrix, accompanied by mafic rocks resembling a dismembered ophiolite. The eclogitic mafic rocks record different stages of metamorphism during subduction and exhumation. Minerals formed during the prograde stages are preserved as inclusions in peak metamorphic garnet and omphacite. The rocks experienced blueschist facies metamorphism on their prograde path and were metamorphosed in eclogite facies at the peak of metamorphism. The peak metamorphic mineral paragenesis of the rocks is omphacite, garnet (pyrope‐rich), glaucophane, paragonite, zoisite and rutile. Based on textural relations, post‐peak stages can be divided into amphibolite and greenschist facies. Pressure and temperature estimates for eclogite facies minerals (peak of metamorphism) indicate 15–20 kbar at ~600 °C. The pre‐peak blueschist facies assemblage yields <11 kbar and 400–460 °C. The average pressure and temperature of the post‐peak amphibolite stage was 5–6 kbar, ~470 °C. The Shanderman eclogites were formed by subduction of Palaeotethys oceanic crust to a depth of no more than 75 km. Subduction was followed by collision between the Central Iran and Turan blocks, and then exhumation of the high pressure rocks in northern Iran.
Doula Care Supports Near‐Universal Breastfeeding Initiation among Diverse, Low‐Income Women
Authors: Kozhimannil Katy B. , Attanasio Laura B. , Hardeman Rachel R. , O'Brien Michelle 
Published: July 2013

IntroductionBreastfeeding initiation rates in the United States have risen in recent years. However, there are notable disparities by socioeconomic status and race/ethnicity. Previous research has suggested that care from a doula (a trained professional who provides nonmedical support during the perinatal period) may increase breastfeeding initiation. The goal of this analysis was to study whether doula support may be associated with breastfeeding initiation among low‐income, diverse women.MethodsWe compared breastfeeding initiation rates (means and 95% confidence intervals) for 1069 women who received doula care from Everyday Miracles, a Minnesota‐based organization that employs a diverse group of certified doulas, to a state‐based sample of women with Medicaid coverage who gave birth in 2009 or 2010 and participated in the Minnesota Pregnancy Risk Assessment Monitoring System survey (weighted n = 51,721).ResultsWomen who had doula‐supported births had near‐universal breastfeeding initiation (97.9%), compared with 80.8% of the general Medicaid population. Among African American women, 92.7% of those with doula support initiated breastfeeding, compared with 70.3% of the general Medicaid population.DiscussionThese results suggest that access to culturally appropriate doula care may facilitate higher rates of breastfeeding initiation. When supported in their nonmedical needs by birth doulas, the diverse, low‐income patients of midwives and other maternity care providers may have a greater likelihood of initiating breastfeeding and experiencing the maternal and infant health benefits associated with breastfeeding.
Induction of immune tolerance to caseins and whey proteins by oral intubation in mouse allergy model
Authors: Shandilya U. K. , Kapila R. , Singh S. , Dahiya D. , Kapila S. , Kansal V. K. 
Published: July 2013

SummaryThis study was designed to evaluate the effect of oral tolerance of caseins (CSN) and whey proteins (WP) in alleviating the allergic response to cow's milk proteins in Swiss albino mice raised on a milk protein–free diet. Oral tolerance was induced by feeding mice with 20 mg of CSN or WP once in a day for 4 days consecutively before immunization with respective protein by intraperitoneal (i.p.) injections (20 μg 200 per μl of PBS) using 2% of alum Al(OH)3 as adjuvant. Three weeks later, oral tolerance induction was analysed in humoral and cellular compartments of CSN‐ and WP‐fed versus saline‐fed control mice groups by measuring seric and intestinal antibody responses, mRNA abundance in splenic tissue and cytokine secretion patterns. The specific serum immunoglobulin‐E (IgE) levels were significantly suppressed (p < 0.05), while sIgA was enhanced in these groups when compared with their respective saline‐fed mice. Moreover, the mRNA levels of interferon‐γ (IFN‐γ) and interleukin‐4 (IL‐4) in both CSN‐ and WP‐tolerized mice were found to be significantly decreased, while the abundance of interleukin‐10 (IL‐10) and transforming growth factor‐β (TGF‐β) was increased significantly, as compared to respective control groups. Finally, cytokine profiles indicated a reciprocal decrease in IL‐4 and IFN‐γ versus an increase in IL‐10 secretions in supernatants of cultured splenocytes of tolerized mice. Taken together, these results clearly showed that oral administration of cows' milk caseins and whey proteins can induce significant hyposensitization in mice, with the participation of suppressor cytokines.
Excessive sleep need following traumatic brain injury: a case–control study of 36 patients
Authors: Sommerauer Michael , Valko Philipp O. , Werth Esther , Baumann Christian R. 
Published: July 2013

SummaryIncreased sleep need following traumatic brain injury, referred to in this study as post‐traumatic pleiosomnia, is common, but so far its clinical impact and therapeutic implications have not been characterized. We present a case–control study of 36 patients with post‐traumatic pleiosomnia, defined by an increased sleep need of at least 2 h per 24 h after traumatic brain injury, compared to 36 controls. We assessed detailed history, sleep‐activity patterns with sleep logs and actigraphy, nocturnal sleep with polysomnography and daytime sleep propensity with multiple sleep latency tests. Actigraphy recordings revealed that traumatic brain injury (TBI) patients had longer estimated sleep durations than controls (10.8 h per 24 h, compared to 7.3 h). When using sleep logs, TBI patients underestimated their sleep need. During nocturnal sleep, patients had higher amounts of slow‐wave sleep than controls (20 versus 13.8%). Multiple sleep latency tests revealed excessive daytime sleepiness in 15 patients (42%), and 10 of them had signs of chronic sleep deprivation. We conclude that post‐traumatic pleiosomnia may be even more frequent than reported previously, because affected patients often underestimate their actual sleep need. Furthermore, these patients exhibit an increase in slow‐wave sleep which may reflect recovery mechanisms, intrinsic consequences of diffuse brain damage or relative sleep deprivation.
First neonatal case of fungaemia due to Pseudozyma aphidis and a global literature review
Authors: Prakash Anupam , Wankhede Sandeep , Singh Pradeep K. , Agarwal Kshitij , Kathuria Shallu , Sengupta Sharmila , Barman Purabi , Meis Jacques F. , Chowdhary Anuradha 
Published: July 2013

SummaryThe Ustilaginomycetous basidiomycete yeast, Pseudozyma aphidis has recently been implicated in potentially fatal disorders ranging from subcutaneous mycoses to disseminated infections. Till date a solitary case of P. aphidis fungaemia in a paediatric patient has been reported. We present a case of fungaemia due to P. aphidis in a rhesus factor‐isoimmunised, low‐birth‐weight neonate. The isolate was identified by sequencing the D1/D2 domain of the LSU region. Antifungal susceptibility of the isolate revealed susceptibility to amphotericin B, voriconazole, itraconazole, isavuconazole and posaconazole. It had high minimum inhibitory concentrations of fluconazole and was resistant to flucytosine and echinocandins. Consequently, the patient was successfully treated with intravenous amphotericin B. Although the source of infection could not be traced, as the neonate developed fungaemia on the first day of life, it could possibly be from the maternal urogenital tract or intrahospital transmission. A review of previously published cases revealed that risk factors for invasive Pseudozyma spp. infections were similar to those previously reported for non‐albicans Candida spp. Pseudozyma species are underreported due to the difficulty of identifying this rare yeast pathogen by commercial identification systems. Considering that Pseudozyma spp. cause invasive fungal infections globally and are resistant to flucytosine, fluconazole and echinocandins, this pathogen assumes a greater clinical significance.
Diagnostic Value of Polymerase Chain Reaction Analysis of Skin Biopsies in Purpura Fulminans
Authors: Beau Caroline , Vlassova Natalia , Sarlangue Jean , Brissaud Olivier , Léauté‐Labrèze Christine , Boralevi Franck 
Published: July 2013

AbstractEven though prompt diagnosis and treatment of purpura fulminans (PF) is essential to reduce mortality, early administration of antibiotics may preclude identification of the causative agent by standard bacterial cultures and thus render definitive diagnosis impossible. Here we present a case of an infant with PF and negative bacterial cultures for whom polymerase chain reaction (PCR) analysis of a cutaneous biopsy specimen obtained 4 days after initiation of antibiotics identified the genomic sequence of Neisseria meningitidis genogroup C. When bacterial cultures fail to provide useful information, PCR of skin biopsy specimens can be a valuable diagnostic tool in PF.
Pitfalls and Pearls in the Diagnosis of Monilethrix
Authors: Leitner Christina , Cheung Seautak , de Berker David 
Published: July 2013

AbstractA 4‐year‐old girl presented with sparse, brittle hair on her entire scalp and keratosis pilaris on the nape of her neck. Subtle microscopic and macroscopic diagnostic features presented a challenge for physicians. Only repeated, optimized light microscopy revealed the diagnosis of monilethrix, a rare genetic hair shaft disorder with a variable phenotypic expression and inheritance pattern. We provide a short overview of methods that maximize the diagnostic yield in a clinical setting and of light microscopy to reach a rapid and accurate diagnosis in difficult cases. We conclude with essential learning points, including a link to assistance with hair microscopy from a tertiary center.
Lower socioeconomic status is associated with worse outcomes after both listing and transplanting children with heart failure
Authors: Davies Ryan R. , Russo Mark J. , Reinhartz Olaf , Maeda Katsuhide , Rosenthal David N. , Chin Clifford , Bernstein Daniel , Mallidi Hari R. 
Published: July 2013

AbstractThe relationship between SES and outcomes surrounding pediatric cardiac transplantation is complex and influenced by recipient race. Broad‐based studies of SES have not been performed. A retrospective review of all 5125 primary pediatric heart transplants performed in the United States between 2000 and 2011. Patients were stratified by SES based on zip code of residence and U.S. census data (low SES: 1637; mid‐SES: 2253; high SES: 1235). Survival following listing and transplantation was compared across strata. Risk‐adjusted long‐term mortality on the waitlist was higher among low SES patients (hazard 1.32, CI 1.07–1.63). The relationship between SES and outcomes varied by race. Early risk‐adjusted post‐transplant outcomes were worst among high SES patients (10.8% vs. low SES: 8.9%, p < 0.05). The incidence of non‐compliance was higher among low SES patients (p < 0.0001). Long‐term risk‐adjusted patient survival was poorer among low (hazard 1.41, CI 1.10–1.80) and mid‐SES (1.29, 1.04–1.59) groups. Low SES is associated with worse outcomes on both the waitlist and late following transplantation. Higher SES patients had more complex transplants with higher early mortality. Further research should be directed at identifying and addressing underlying causal factors for these disparities.
Type I Photosensitization of 2′‐deoxyadenosine 5′‐monophosphate (5′‐dAMP) by Biopterin and its Photoproduct Formylpterin
Authors: Serrano Mariana P. , Borsarelli Claudio D. , Thomas Andrés H. 
Published: July 2013

AbstractBiopterin (Bip) and its photoproducts 6‐formylpterin (Fop) and 6‐carboxypterin (Cap) accumulate in the skin of patients suffering from vitiligo, a chronic depigmentation disorder where the protection against UV radiation fails because of the lack of melanin. These compounds absorb in the UV‐A inducing a potential photosensitizing action that can cause damage to DNA and other biomolecules. In this work, we have investigated the capability of these pterin derivatives (Pt) to act as photosensitizers under UV‐A irradiation for the degradation of 2′‐deoxyadenosine 5′‐monophosphate (5′‐dAMP) in aqueous solutions, as model DNA target. Steady‐state and time‐resolved experiments were performed and the effect of pH was evaluated. The results showed that photosensitized degradation of 5′‐dAMP was only observed under acidic conditions, and a mechanistic analysis revealed the participation of the triplet excited state of the pterin derivatives (3Pt*) by electron transfer yielding the corresponding pair of radical ions (Pt•− and 5′‐dAMP•+), with successive photosensitizer recovery by electron transfer from Pt•− to O2. Finally, 5′‐dAMP•+ participates in subsequent reactions to yield degradation products.