bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemical Offense by Means of Toxicysts in the Freshwater Ciliate, Coleps hirtus
Authors: Buonanno Federico , Anesi Andrea , Guella Graziano , Kumar Santosh , Bharti Daizy , La Terza Antonietta , Quassinti Luana , Bramucci Massimo , Ortenzi Claudio 
Published: February 2014

AbstractColeps hirtus is a small common freshwater ciliate belonging to the protostomatid group, its body covered by calcified plates assembled to form an armor. Coleps feeds on bacteria, algae, flagellates, living and dead ciliates, animal and plant tissues. To assist its carnivorous feeding the ciliate is equipped with offensive extrusomes (toxicysts), clustering mainly in and around its oral aperture. In this study, we isolated the discharge of the toxicysts from living cells, evaluating its cytotoxic effects against various ciliate species, and demonstrating that it is essential for the effectiveness of Coleps’ predatory behavior. The analysis of the toxicyst discharge performed by liquid chromatography‐electrospray‐mass spectrometry and gas chromatography‐mass spectrometry, revealed the presence of a mixture of 19 saturated, monounsaturated and polyunsaturated free fatty acids with the addition of a minor amount of a diterpenoid (phytanic acid).
Skin immune response in the zebrafish, Danio rerio (Hamilton), to Aeromonas hydrophila infection: a transcriptional profiling approach
Authors: Lü A‐J , Hu X‐C , Wang Y , Zhu A‐H , Shen L‐L , Tian J , Feng Z‐Z , Feng Z‐J 
Published: February 2014

AbstractSkin plays an important role in innate immune responses to bacterial infection, but its molecular mechanism remains unclear in fish. The transcriptional profiling of the skin immune response to Aeromonas hydrophila infection of the zebrafish, Danio rerio (Hamilton), was performed by Affymetrix microarray analysis. The results showed that 538 genes were differentially expressed, of which 388 genes were up‐regulated and 150 genes were down‐regulated. The expression patterns for 106 representative genes were observed to be up‐regulated in zebrafish skin at 24 and 36 h post‐infection, and gene expression changes were clearly greater at 36 h. Gene Ontology classification indicated that 222 genes were significantly associated with the skin immunity, including complement activation, acute‐phase response, stress response, chemotaxis and apoptosis. Further Kyoto Encyclopedia of Genes and Genomes analysis showed that the significant pathways included MAPK, p53, Wnt, TGF‐β, Notch, ErbB, JAK‐STAT, VEGF, mTOR and Calcium signalling in skin immune responses, and several genes (e.g. akt2l, frap1, nras, rac1, xiap) were found to be involved in signalling networks. Moreover, expression changes in nine selected genes were verified by real‐time qPCR analysis. This is the first known report on transcriptome analysis in the skin of zebrafish against the pathogen A. hydrophila.
Laparoscopic versus open liver resection for elderly patients with malignant liver tumors: A single‐center experience
Authors: Chan Albert C Y , Poon Ronnie T P , Cheung Tan To , Chok Kenneth S H , Dai Wing Chiu , Chan See Ching , Lo Chung Mau 
Published: February 2014

AbstractBackgroundLaparoscopic liver resection is associated with less perioperative blood loss, shorter hospital stay, and fewer postoperative complications in younger patients. However, it remains unclear if these short‐term benefits could also be applicable to elderly patients with medical comorbidities.AimTo evaluate the perioperative outcomes of laparoscopic liver resection in patients with advanced age.Materials and MethodsPatients aged ≥ 70 years old who received liver resections for malignant liver tumors between January 2002 and December 2012 were included. The perioperative outcomes of 17 patients with laparoscopic approach were matched and compared with 34 patients with conventional open approach in a 1:2 ratio.ResultsThere was no significant difference with regard to age, gender, incidence of comorbid illness, hepatitis B positivity, and Child grading of liver function. The median tumor size was 3 cm for both groups. The types of liver resection were similar between the two groups with no significant difference in the duration of operation (laparoscopic: 195 min vs open: 210 min, P = 0.436). The perioperative blood loss was 150 mL in the laparoscopic group and 330 mL in the open group (P = 0.046) with no significant difference in the number of patients with blood transfusion. The duration of hospital stay was 6 days (3–15 days) for the laparoscopic group and 8 days (5–105 days) for the open group (P = 0.005).ConclusionLaparoscopic liver resection is safe and feasible for elderly patients. The short‐term benefits of laparoscopic approach continued to be evident for geriatric oncological liver surgery.
Clinical outcomes and prognostic factors of patients with advanced hepatocellular carcinoma treated with sorafenib as first‐line therapy: A Korean multicenter study
Authors: Lee Sangheun , Kim Beom Kyung , Kim Seung Up , Park Soo Young , Kim Ja Kyung , Lee Hyun Woong , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Tak Won Young , Kweon Young Oh , Lee Jung Il , Lee Kwan Sik , Kim Hyung Joon , Han Kwang‐Hyub 
Published: February 2014

AbstractBackground and AimSorafenib is recommended as a standard treatment for advanced hepatocellular carcinoma (HCC). The efficacy and safety of sorafenib as a first‐line therapy in Korean patients with advanced HCC were investigated.MethodsFrom 2007 to 2012, 86 patients with advanced HCC (Barcelona Clinic Liver Cancer stage C) treated with sorafenib as a first‐line therapy were enrolled from five tertiary hospitals. Predictors of overall survival (OS) and progression‐free survival (PFS) were analyzed.ResultsThe median age was 59.5 years, and 71 (82.6%) were males; 57 (66.3%) patients were in Child–Pugh class A. The median OS and PFS were 5.0 (range 4.0–5.9) and 3.2 (range 2.6–3.7) months, respectively. Regarding OS, Child–Pugh class A (6.0 vs 2.8 months), tumor diameter < 5 cm (6.0 vs 4.3 months), baseline α‐fetoprotein < 200 ng/mL (5.8 vs 4.1 months), and the advent of hand‐foot‐skin reaction of ≥ grade 2 (5.9 vs 4.0 months) were independent favorable predictors (all P < 0.05). Similarly, regarding PFS, Child–Pugh class A (4.3 vs 2.1 months), tumor diameter < 5 cm (3.9 vs 2.8 months), baseline α‐fetoprotein < 200 ng/mL (5.6 vs 2.8 months), and the advent of hand‐foot‐skin reaction of ≥ grade 2 (4.5 vs 2.6 months) were independent favorable predictors (all P < 0.05). All toxicities during sorafenib treatment were manageable.ConclusionsBecause the efficacy of sorafenib seems marginal in Korean patients with treatment‐naïve HCC, how to select candidates with favorable outcomes should be further investigated.
Regulation of T cell recruitment and inflammation in the human immunodeficiency virus/hepatitis C virus coinfected liver
Authors: Nguyen Nam , Hampartzoumian Taline , Cameron Barbara , Palmer Clovis , O'Toole Sandra , Post Jeffrey , Zekry Amany , Lloyd Andrew 
Published: February 2014

AbstractBackground and AimPatients coinfected with both hepatitis C virus (HCV) and human immunodeficiency virus (HIV) have accelerated liver disease compared with HCV mono‐infected patients. In chronic HCV infection, it is known that chemokines play a key role in T cell recruitment and in determining the extent of hepatic injury.MethodsIn this study, we determined by quantitative real‐time reverse transcriptase polymerase chain reaction and immunohistochemistry the intrahepatic phenotype of the cellular infiltrate and its associated chemokine profile and localization in a cohort of relatively immune competent coinfected HIV/HCV subjects.ResultsIncreased lobular expression of CD8+ cytotoxic T cells was found in the coinfected liver in conjunction with increased expression of the T cell chemoattractant, chemokine (C‐C motif) ligand (CCL)5, compared with the HCV mono‐infected liver. Furthermore, the number of lobular‐infiltrating CD8+ T cells was positively correlated with the expression of CCL5. Immunohistochemical staining of CCL5 showed it to primarily localize to the hepatocytes. Within the inflammatory infiltrate, proliferating (Ki‐67+) and apoptotic terminal deoxynucleotidyl transferase 2′‐deoxyuridine 5′‐triphosphate nick end labeling + (TUNEL)+ cells were sparse.ConclusionsCollectively, the data suggest that even in the setting of relatively immune competent coinfected subjects, a pro‐inflammatory milieu exists ,which can potentially drive the increased T cell recruitment found in the HIV/HCV coinfected liver. This profile is likely to contribute to the accelerated progression of liver disease observed in HIV/HCV coinfection.
A Tale of Two Methods: Chart and Interview Methods for Identifying Delirium
Authors: Saczynski Jane S. , Kosar Cyrus M. , Xu Guoquan , Puelle Margaret R. , Schmitt Eva , Jones Richard N. , Marcantonio Edward R. , Wong Bonnie , Isaza Ilean , Inouye Sharon K. 
Published: February 2014

ObjectivesTo compare chart‐ and interview‐based methods for identification of delirium.DesignProspective cohort study.SettingTwo academic medical centers.ParticipantsIndividuals aged 70 and older undergoing major elective surgery (N = 300) (majority orthopedic surgery).MeasurementsParticipants were interviewed daily during hospitalization for delirium using the Confusion Assessment Method (CAM; interview‐based method), and their medical charts were reviewed for delirium using a validated chart‐review method (chart‐based method). Rate of agreement of the two methods and characteristics of those identified using each approach were examined. Predictive validity for clinical outcomes (length of stay, postoperative complications, discharge disposition) was compared. In the absence of a criterion standard, predictive value could not be calculated.ResultsThe cumulative incidence of delirium was 23% (n = 68) according to the interview‐based method, 12% (n = 35) according to the chart‐based method, and 27% (n = 82) according to the combined approach. Overall agreement was 80%; kappa was 0.30. The methods differed in detection of psychomotor features and time of onset. The chart‐based method missed delirium in individuals that the CAM identified who were lacking features of psychomotor agitation or inappropriate behavior. The CAM‐based method missed chart‐identified cases occurring during the night shift. The combined method had high predictive validity for all clinical outcomes.ConclusionsInterview‐ and chart‐based methods have specific strengths for identification of delirium. A combined approach captures the largest number and broadest range of delirium cases.
Epidemiology of Restricting Fatigue in Older Adults: The Precipitating Events Project
Authors: de Rekeneire Nathalie , Leo‐Summers Linda , Han Ling , Gill Thomas M. 
Published: February 2014

ObjectivesTo estimate the rate of restricting fatigue in community‐living older adults and to determine whether the rates differ according to age, sex, race, physical frailty, and depression.DesignProspective cohort study.SettingGreater New Haven, Connecticut.ParticipantsNondisabled community‐living older men and women aged 70 and older (N = 754).MeasurementsRestricting fatigue was defined as staying in bed for at least half the day and/or cutting down on one's usual activities because of fatigue for 3 consecutive months or longer. Physical frailty was defined on the basis of slow gait speed, and depression was assessed using the Center for Epidemiologic Studies Depression Scale.ResultsDuring a median follow‐up of 111 months, the cumulative incidence of restricting fatigue was 31.1% for men and 42.1% for women. The overall incidence rate of restricting fatigue was 6.7 per 1,000 person‐months (7.8 for women and 4.4 for men, P < .001), which did not differ according to race. Rates were higher in persons who were physically frail than those who were not (P < .001), in those who were depressed than those who were not (P < .001), and in persons aged 75 to 79 and 80 to 84 than those aged 70 to 74 (both P < .01) but not in those aged 85 and older. Of the 459 episodes of restricting fatigue, the median duration was 3 months, which did not differ according to age, sex, race, physical frailty, or depression.ConclusionRestricting fatigue is common in community‐living older adults. Women, individuals aged 75 to 84, and individuals with physical frailty or depression had higher rates of restricting fatigue than their respective counterparts.
Depressive Symptoms and Hospital Readmission in Older Adults
Authors: Albrecht Jennifer S. , Gruber‐Baldini Ann L. , Hirshon Jon M. , Brown Clayton H. , Goldberg Richard , Rosenberg Joseph H. , Comer Angela C. , Furuno Jon P. 
Published: February 2014

ObjectivesTo quantify the risk of 30‐day unplanned hospital readmission in adults aged 65 and older with depressive symptoms.DesignProspective cohort study.SettingUniversity of Maryland Medical Center.ParticipantsIndividuals aged 65 and older admitted between July 1, 2011, and August 9, 2012, to the general medical and surgical units and followed for 31 days after hospital discharge (N = 750).MeasurementsPrimary exposure was depressive symptoms at admission, defined as a score of 6 or more on the 15‐item Geriatric Depression Scale. Primary outcome was unplanned 30‐day hospital readmission, defined as an unscheduled overnight stay at any inpatient facility not occurring in the emergency department.ResultsPrevalence of depressive symptoms was 19% and incidence of 30‐day unplanned hospital readmission was 19%. Depressive symptoms were not significantly associated with hospital readmission (relative risk (RR) = 1.20, 95% confidence interval (CI) = 0.83–1.72). Age, Charlson Comorbidity Index score, and number of hospitalizations within the past 6 months were significant predictors of unplanned 30‐day hospital readmission.ConclusionAlthough not associated with hospital readmission, depressive symptoms were associated with other poor outcomes and may be underdiagnosed in hospitalized older adults. Hospitals interested in reducing readmission should focus on older adults with more comorbid illness and recent hospitalizations.
Delirium Risk Prediction, Healthcare Use and Mortality of Elderly Adults in the Emergency Department
Authors: Kennedy Maura , Enander Richard A. , Tadiri Sarah P. , Wolfe Richard E. , Shapiro Nathan I. , Marcantonio Edward R. 
Published: February 2014

ObjectivesTo create a risk prediction rule for delirium in elderly adults in the emergency department (ED) and to compare mortality and resource use of elderly adults in the ED with and without delirium.DesignProspective observational study.SettingUrban tertiary care ED.ParticipantsIndividuals aged 65 and older presenting for ED care (N = 700).MeasurementsA trained research assistant performed a structured mental status assessment and attention tests, after which delirium was determined using the Confusion Assessment Method. Data were collected on participant demographics, comorbidities, medications, ED course, hospital and intensive care unit (ICU) admission, length of stay, hospital charges, 30‐day rehospitalization, and mortality.ResultsNine percent of elderly study participants had delirium. Using logistic regression, a delirium prediction rule consisting of older age, prior stroke or transient ischemic attack, dementia, suspected infection, and acute intracranial hemorrhage was created had good predictive accuracy (area under the receiver operating characteristic curve = 0.77). Admitted participants with ED delirium had longer median lengths of stay (4 vs 2 days) and were more likely to require ICU admission (13% vs 6%) and to be discharged to a new long‐term care facility (37% vs 9%) than those without. In all participants, ED delirium was associated with higher 30‐day mortality (6% vs 1%) and 30‐day readmission (27% vs 13%).ConclusionThis risk prediction rule may help identify a group of individuals in the ED at high risk of developing delirium who should undergo screening, but it requires external validation. Identification of delirium in the ED may enable physicians to implement strategies to decrease delirium duration and avoid inappropriate discharge of individuals with acute delirium, improving outcomes.
Resource Use in Small Island States
Authors: Krausmann Fridolin , Richter Regina , Eisenmenger Nina 
Published: February 2014

SummaryIceland and Trinidad and Tobago are small open, high‐income island economies with very specific resource‐use patterns. This article presents a material flow analysis (MFA) for the two countries covering a time period of nearly five decades. Both countries have a narrow domestic resource base, their economy being largely based on the exploitation of one or two key resources for export production. In the case of Trinidad and Tobago, the physical economy is dominated by oil and natural gas extraction and petrochemical industries, whereas Iceland's economy for centuries has been based on fisheries. More recently, abundant hydropower and geothermal heat were the basis for the establishment of large export‐oriented metal processing industries, which fully depend on imported raw materials and make use of domestic renewable electricity. Both countries are highly dependent on these natural resources and vulnerable to overexploitation and price developments. We show how the export‐oriented industries lead to high and growing levels of per capita material and energy use and carbon dioxide emissions resulting from large amounts of processing wastes and energy consumption in production processes. The example of small open economies with an industrial production system focused on few, but abundant, key resources and of comparatively low complexity provides interesting insights of how resource endowment paired with availability or absence of infrastructure and specific institutional arrangements drives domestic resource‐use patterns. This also contributes to a better understanding and interpretation of MFA indicators, such as domestic material consumption.
Outcomes of Nulliparous Women With Spontaneous Labor Onset Admitted to Hospitals in Preactive Versus Active Labor
Authors: Neal Jeremy L. , Lamp Jane M. , Buck Jacalyn S. , Lowe Nancy K. , Gillespie Shannon L. , Ryan Sharon L. 
Published: February 2014

IntroductionThe timing of when a woman is admitted to the hospital for labor care following spontaneous contraction onset may be among the most important decisions that labor attendants make because it can influence care patterns and birth outcomes. The aims of this study were to estimate the percentage of low‐risk, nulliparous women at term who are admitted to labor units prior to active labor and to evaluate the effects of the timing of admission (ie, preactive vs active labor) on labor interventions and mode of birth.MethodsData from low‐risk, nulliparous women with spontaneous labor onset at term gestation were merged from 2 prospective studies conducted at 3 large Midwestern hospitals. Baseline characteristics, labor interventions, and outcomes were compared between groups using Fisher's exact and Mann‐Whitney U tests, as appropriate. Likelihoods for oxytocin augmentation, amniotomy, and cesarean birth were assessed by logistic regression.ResultsOf the sample of 216 low‐risk nulliparous women, 114 (52.8%) were admitted in preactive labor and 102 (47.2%) were admitted in active labor. Women who were admitted in preactive labor were more likely to undergo oxytocin augmentation (84.2% and 45.1%, respectively; odds ratio [OR], 6.5; 95% confidence interval [CI], 3.43–12.27) but not amniotomy (55.3% and 61.8%, respectively; OR, 0.8; 95% CI, 0.44–1.32) when compared to women admitted in active labor. The likelihood of cesarean birth was higher for women admitted before active labor onset (15.8% and 6.9%, respectively; OR, 2.6; 95% CI, 1.02–6.37).DiscussionMany low‐risk nulliparous women with regular, spontaneous uterine contractions are admitted to labor units before active labor onset, which increases their likelihood of receiving oxytocin and giving birth via cesarean. An evidence‐based, standardized approach for labor admission decision making is recommended to decrease inadvertent admissions of women in preactive labor. When active labor cannot be diagnosed with relative certainty, observation before admission to the birthing unit is warranted.
Intravascular Ultrasound Analysis to Determine the Relationship between High‐Density Lipoprotein Cholesterol and Lesion Characteristics in Patients with Coronary Artery Disease
Authors: KITABATA HIRONORI , LOH JOSHUA P. , PENDYALA LAKSHMANA K. , OMAR ALFAZIR , MAGALHAES MARCO A. , TORGUSON REBECCA , CHEN FANG , PICHARD AUGUSTO D. , BREWER H. BRYAN , WAKSMAN RON 
Published: February 2014

ObjectivesThis study utilized grayscale intravascular ultrasound (IVUS) to explore the relationship between high‐density lipoprotein cholesterol (HDL‐C) levels and culprit lesion characteristics in patients with coronary artery disease.BackgroundLow HDL‐C is associated with an increased risk of cardiovascular events. Previous IVUS studies have suggested a significant association between lesion characteristics and cardiovascular events.MethodsAccording to HDL‐C levels, 120 patients who underwent IVUS for native, de novo coronary lesions before any intervention were divided into a low HDL‐C group (<40 mg/dL, n = 60) and a high HDL‐C group (≥40 mg/dL, n = 60). Quantitative and qualitative IVUS analyses were performed to compare lesion characteristics.ResultsQuantitative IVUS measurements showed no significant differences between the 2 groups. HDL‐C level was not significantly correlated with remodeling index (r = 0.03, P = 0.78). However, attenuated plaque was more frequent in the low HDL‐C group (48.3% vs. 28.3%, P = 0.02) and a greater percentage of attenuated plaque was found in this group (32.5 ± 21.3% vs. 21.0 ± 11.0%, P = 0.02). Moreover, when categorized into 4 groups according to HDL‐C levels, the proportion of attenuated plaque (64.7% in group with <30 mg/dL, 41.9% in group with 30–39 mg/dL, 36.4% in group with 40–59 mg/dL, and 6.3% in group with ≥60 mg/dL; P = 0.001 for trend) was significantly different among groups. On multivariate analysis, only HDL‐C and male gender were independently associated with the presence of attenuated plaque at the culprit lesions.ConclusionsPatients with low levels of HDL‐C may be at increased risk of having a higher incidence of attenuated plaques. (J Interven Cardiol 2014;27:325–333)