bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acclimation to environmentally relevantMn concentrations rescues a cyanobacterium from the detrimental effects of iron limitation
Authors: Salomon Eitan , Keren Nir 
Published: March 2015

SummaryThe functions of micronutrient transition metals in photosynthetic organisms are interconnected. So are the effects of their limitation. Here we present evidence for the effects ofMn limitation onFe limitation responses in the cyanobacteriumSynechocystis sp.PCC6803. LowMn acclimated cells were able to detect and respond to iron insufficiency by inducing specificFe transporters. However, they did not bleach, lose additional photosystemIactivity and did not induceisiAtranscription. Induction of theisiABoperon is a hallmark of iron limitation, and the isiAprotein is considered to be central to the acclimation of the photosynthetic apparatus. Our results suggest that acclimation to environmentally relevantMn concentrations that much lower than those used in laboratory experiments reduces the detrimental effects of iron limitation and modifies iron stress responses.
Intraventricular CNS lesions: A pictorial essay
Authors: Watts Jane , Yap Kelvin K , Ou Daniel , Tartaglia Con , Trost Nicholas , Sutherland Tom 
Published: March 2015

SummaryIntraventricular lesions of the central nervous system (CNS) can present a diagnostic challenge due to a range of differential diagnoses and radiological appearances. Both CT and MRI imaging findings, in combination with location and patient's age, can help limit the differentials. This pictorial essay presents the salient radiological features, location and demographics of the more common intraventricular lesions of the brain.
Impaired NO‐mediated vasodilatation in rat coronary arteries after asphyxial cardiac arrest
Authors: TROELSEN T. T. , GRANFELDT A. , SECHER N. , TØNNESEN E. K. , SIMONSEN U. 
Published: March 2015

BackgroundCardiovascular dysfunction after cardiac arrest is a common finding. It is unknown whether altered endothelium‐mediated vasoreactivity contributes to this dysfunction. We hypothesised that cardiac arrest and resuscitation results in impaired endothelial function. This was addressed by measurements of inflammatory and endothelial plasma markers and of endothelium‐dependent vasodilatation in coronary and mesenteric arteries in rats after cardiac arrest and resuscitation.MethodsMale Sprague Dawley rats underwent either asphyxia‐induced cardiac arrest for 5 min and subsequent resuscitation (n = 30) or a sham procedure (control animals, n = 39). Animals were euthanised after 30 min or 2 h. Blood was analysed for TNF‐α, IL‐1β, IL‐6, IL‐10, sE‐selectin, sP‐selectin, sVCAM‐1, ICAM‐1, VEGF‐α and vWF. Arterial rings of the left anterior descending coronary artery and mesenteric resistance arteries were mounted in microvascular myographs, and concentration–response curves were constructed.ResultsThe plasma levels of the endothelial markers, sP‐selectin and vWF increased following cardiac arrest at both 30 min and 2 h. Acetylcholine‐induced endothelium‐dependent and mainly nitric oxide (NO)‐mediated vasodilatation was impaired in the coronary arteries at 30 min, but not 2 h after resuscitation. Endothelium‐derived hyperpolarisation (EDH)‐type vasodilatation induced by NS309 and vasodilatation induced by the NO donor sodium nitroprusside was unaltered. In parallel with systemic hypotension, mesenteric arteries exhibited a larger response to NS309 2 h after resuscitation.ConclusionThe present results show marked endothelial alterations after cardiac arrest and resuscitation reflected by increased endothelial plasma markers, impaired NO‐mediated coronary vasodilatation in the early post‐resuscitation phase and enhanced EDH‐type vasodilatation in mesenteric arteries later in the post‐resuscitation phase.
Optimising abdominal space with deep neuromuscular blockade in gynaecologic laparoscopy – a randomised, blinded crossover study
Authors: MADSEN M. V. , GÄTKE M. R. , SPRINGBORG H. H. , ROSENBERG J. , LUND J. , ISTRE O. 
Published: March 2015

BackgroundInsufflation of the abdomen during laparoscopy improves surgical space, but may cause post‐operative shoulder pain. The incidence of shoulder pain is reduced using a lower insufflation pressure, but this may, however, compromise the surgical space. We aimed at investigating whether deep neuromuscular blockade (NMB) would enlarge surgical space, measured as the distance from the sacral promontory to the trocar in patients undergoing gynaecologic laparoscopy.MethodsFourteen patients were randomised in an assessor‐blinded crossover design. The distance from the sacral promontory to the trocar was measured during deep NMB and without NMB at pneumoperitoneum 8 and 12 mmHg both. Additionally, we assessed surgical conditions while suturing the abdominal fascia using a 4‐point subjective rating scale. Deep NMB was established with rocuronium and reversed with sugammadex.ResultsAt 12 mmHg pneumoperitoneum, deep NMB improved surgical space with a mean of 0.33 cm (95% confidence interval 0.07–0.59) (P = 0.01, paired t‐test) compared with no NMB. At 8 mmHg pneumoperitoneum deep NMB improved surgical space with a mean of 0.3 cm (95% confidence interval, 0.06–0.54) (P = 0.005) compared with no NMB. Deep NMB resulted in significantly better ratings of surgical conditions during suturing of the fascia (P = 0.03, Mann–Whitney U‐test).ConclusionDeep NMB enlarged surgical space measured as the distance from the sacral promontory to the trocar. The enlargement, however, was minor and the clinical significance is unknown. Moreover, deep NMB improved surgical conditions when suturing the abdominal fascia.
Time to Antivenom Administration Is Not Associated With Total Antivenom Dose Administered in a Copperhead‐predominant Snakebite Population
Authors: Gerardo Charles J. , Scott Evans C. , Kuchibhatla Maragatha , Mando‐Vandrick Jennifer , Drake May Yen Weiying G. , Kopec Kathryn , Lavonas Eric J. 
Published: March 2015

AbstractObjectivesTo prevent unnecessary antivenom administration in crotaline snakebite, observation for progression is recommended for the patient with minor envenomation whose condition is stable and not progressing. The objective of this study was to determine the association between the time from bite to initial antivenom administration (TimeAV) and the total amount of antivenom administered (TotalAV) and to determine what proportion of patients did not have progression of the envenomation syndrome and did not receive antivenom.MethodsThis was a retrospective chart review of patients presenting with crotaline snakebite within 24 hours from 2009 through 2012. Blinded dual‐chart abstraction and strict data point definitions were used. Spearman correlation was used to determine the association between TimeAV and TotalAV. A general linear model was used to examine this association using TimeAV categorized to early and late administration, adjusted for likely confounders. Confounders included age, extremity involved, initial severity, and year of envenomation.ResultsNinety‐five eligible patients were analyzed with 45 (47%) males and a mean (±SD) age of 36.5 (±21.1) years. Eighty‐five (89%) received antivenom, with a median TimeAV of 3.3 hours (interquartile range [IQR] = 2.5 to 5.2 hours). The median TotalAV was 10 vials (IQR = 6 to 14 vials). The univariate analysis showed a small but statistically significant decrease in TotalAV given to patients treated greater than 6 hours from bite (r = –0.26, p = 0.015). The multivariate analysis resulted in no significant relation between early or late TimeAV and TotalAV (p = 0.10) after adjustment for confounders. Most minimal envenomation syndromes (80%, or 41 of 51) progressed to moderate grade envenomations.ConclusionsTimeAV was not associated with TotalAV when adjusted for likely confounders and supports current recommendations to observe for progression in minor envenomation. The majority of envenomations progressed, resulting in only a small proportion of patients not eventually receiving antivenom. The authors recommend observation in an environment where the patient can be adequately reassessed for progression of the envenomation.
Improving Patient Knowledge and Safe Use of Opioids: A Randomized Controlled Trial
Authors: McCarthy Danielle M. , Wolf Michael S. , McConnell Ryan , Sears Jill , Chevrier Allison , Ahlstrom Eric , Engel Kirsten G. , Cameron Kenzie A. , Adams James G. , Mark Courtney D. 
Published: March 2015

AbstractObjectivesThe use of opioid analgesics in the United States has significantly increased in recent years. However, there is minimal consensus on what discharge counseling should accompany these high‐risk prescriptions and large variations in what is done in practice. The objective of this study was to evaluate the effect of a dual‐modality (written and spoken) literacy‐appropriate educational strategy on patients' knowledge of and safe use of opioid analgesics.MethodsThis was a prospective, randomized controlled trial. Consecutive discharged patients at an urban academic ED (>88,000 visits) with new prescriptions for hydrocodone‐acetaminophen were enrolled. Patients were randomized to receive either usual care or the educational intervention. The educational intervention was a one‐page information sheet about hydrocodone‐acetaminophen, which was both given to the patients and read aloud by the research assistant (nonblinded). Follow‐up phone calls were conducted 4 to 7 days after the visit to assess patient knowledge about the medication and self‐report of activities associated with safety of use (e.g., double‐dipping with acetaminophen, storage, use with alcohol or while driving).ResultsA total of 274 patients were enrolled; 210 completed follow‐up (110 usual care and 100 intervention). No significant differences in baseline characteristics emerged between the study arms; 42% were male, and 51% were white, with a median age of 43 years. Half of patients had non–back pain orthopedic injuries (49.5%). On follow‐up, overall knowledge was poor, with only 28% able to name both active ingredients in the medication. The intervention group had better knowledge of precautions related to taking additional acetaminophen (usual care 18.2%, 95% confidence interval [CI] = 10.9% to 25.5% vs. intervention 38%, 95% CI = 28.3% to 47.7%; difference = 27.6, 95% CI of difference = 21.5 to 33.7) and knowledge of side effects (usual care median = 1, interquartile range [IQR] 0 to 2 vs. intervention median = 2, IQR = 1 to 2; p < 0.0001). Additionally, those who received the intervention were less likely to have reported driving within 6 hours after taking hydrocodone (usual care 13.6%, 95% CI = 7.2% to 20% vs. intervention 3%, 95% CI = –0.3% to 6.3%; difference = 10.6, 95% CI of difference = 3.4 to 17.9). There was no difference between groups related to knowledge about drinking alcohol while taking hydrocodone (overall 18.1%) or knowledge that the opioid could be addictive (overall 72.4%).ConclusionsThis simple strategy improved several, but not all, aspects of patient knowledge and resulted in fewer patients in the intervention arm driving while taking hydrocodone. Integration of a patient education document into conversations about opioids holds promise for improving patient knowledge about these high‐risk medications.
The drinking habits of the Lilian's lovebird and incidents of poisoning at waterholes
Authors: Mzumara Tiwonge I. , Perrin Mike R. , Downs Colleen T. 
Published: March 2015

AbstractUse of poison to kill wildlife is a threat to biodiversity. Lilian's lovebirds Agapornis lilianae are among the fatalities at poisoned waterholes in Liwonde National Park, Malawi. Their population in Liwonde National Park (LNP) represents about 20% of the global population. We investigated the drinking habits of Lilian's lovebird, availability of natural waterholes and occurrence of poisoning incidents in LNP. Results showed Lilian's lovebirds congregate at waterholes in the dry season with flocks ranging from 1 to 100 individuals. Significantly larger flocks were seen in the dry than the wet season. Poisoning incidents/year ranged from 1 to 8 and were highest in the dry season. Lilian's lovebirds were killed at a mean of four poisoning incidents each year between 2000 and 2012. Number of lovebirds found dead at a poisoned pool ranged from 5 to 50 individuals. Currently about 32% of the Lilian's lovebird population is threatened by poisoning. Other species were also noted. There is a need for increased efforts in preventing this lethal activity in LNP.
Chemokine (C‐C motif) ligand 2 and chemokine (C‐C motif) ligand 7 in angle‐closure glaucoma
Authors: Gao Xinbo , Huang Wenbin , Zhang Xiulan , Du Shaolin , Wang Jiawei , Wang Wei , Zhou Minwen , Chen Shida , Li Xingyi , Jonas Jost B. 
Published: March 2015

AbstractPurposeTo compare the concentrations of chemokine (C‐C motif) ligand 2 (CCL2) and chemokine (C‐C motif) ligand 7 (CCL7) in aqueous humour of eyes with acute primary angle‐closure (APAC), primary angle‐closure glaucoma (PACG) or with age‐related cataract.MethodsThe prospective investigation included a study group of 56 patients (24 patients with APAC; 32 patients with PACG) undergoing glaucoma surgery and a control group of 21 patients undergoing routine cataract surgery. The interval between glaucoma attack and trabeculectomy was 19.4 ± 9.8 days.ResultsThe concentrations of CCL2 (3037 ± 501 versus 1127 ± 141 pg/ml; p = 0.003) and CCL7 (10.5 ± 2.4 versus 2.8 ± 0.4 pg/ml; p < 0.001) were significantly higher in the APAC group than in the PACG group, while the concentrations of both cytokines did not differ significantly between the PACG group and the control group (CCL2: 1190 ± 98 pg/ml; p = 0.10; CCL7: 2.0 ± 0.6; p = 0.18). The concentrations of both cytokines were significantly and inversely correlated with the interval between the acute angle‐closure attack and surgery (CCL2: p = 0.02; ρ = −0.48; CCL7: p = 0.04; ρ = −0.42). Higher CCL2 concentrations were associated with higher prevalence of surgical failure (28.6% versus 7.1%; p = 0.036).ConclusionsConcentrations of CCL2 and CCL7 as major inflammatory cytokines with potential influence on the risk of filtering surgery failure were significantly elevated after an acute glaucoma attack and decreased with longer interval to the attack. Trabeculectomy may have a lower risk of failure if performed later than earlier after an acute glaucoma attack, with lower CCL2 concentrations associated with better surgical outcome.
Identifying faecal impaction is important for ensuring the timely diagnosis of childhood functional constipation
Authors: Modin Line , Walsted Anne‐Mette , Jakobsen Marianne Skytte 
Published: March 2015

AbstractAimMost research on functional constipation has been carried out at a tertiary level. We focused this study on a secondary‐level hospital outpatients' department, assessing the distribution of diagnostic criteria for childhood functional constipation and evaluating the consequences of current diagnostic practice based on current guidelines.MethodsWe enrolled 235 children, aged two to 16 years of age, with functional constipation according to the Rome III criteria and assessed them using medical histories and physical examinations, including rectal examinations and ultrasound measurements of rectal diameter. Faecal impaction was a rectal diameter exceeding 3 cm.ResultsThe most frequently reported symptom was painful bowel movements (72.3%) and 39.1% had faecal incontinence. Rectal examination identified faecal impaction in 149 children (66.2%), and ultrasound showed a mean rectal diameter of 3.4 ± 0.6 cm, compared to 2.2 ± 0.6 cm in children without impaction (p < 0.001). Of the 149 children with faecal impaction, 19 (12.8%) only had one additional Rome III criterion. The rectal diameter exceeded 3 cm in 79.9% of cases.ConclusionIdentifying faecal impaction is important for ensuring the timely diagnosis of childhood functional constipation at the secondary care level. Ultrasound examination proved a reliable alternative to rectal examination or abdominal radiography when identifying faecal impaction.
Randomised clinical trial: faecal microbiota transplantation by colonoscopy vs. vancomycin for the treatment of recurrent Clostridium difficile infection
Authors: Cammarota G. , Masucci L. , Ianiro G. , Bibbò S. , Dinoi G. , Costamagna G. , Sanguinetti M. , Gasbarrini A. 
Published: March 2015

SummaryBackgroundFaecal microbiota transplantation (FMT) from healthy donors is considered an effective treatment against recurrent Clostridium difficile infection.AimTo study the effect of FMT via colonoscopy in patients with recurrent C. difficile infection compared to the standard vancomycin regimen.MethodsIn an open‐label, randomised clinical trial, we assigned subjects with recurrent C. difficile infection to receive: FMT, short regimen of vancomycin (125 mg four times a day for 3 days), followed by one or more infusions of faeces via colonoscopy; or vancomycin, vancomycin 125 mg four times daily for 10 days, followed by 125–500 mg/day every 2–3 days for at least 3 weeks. The latter treatment did not include performing colonoscopy. The primary end point was the resolution of diarrhoea related to C. difficile infection 10 weeks after the end of treatments.ResultsThe study was stopped after a 1‐year interim analysis. Eighteen of the 20 patients (90%) treated by FMT exhibited resolution of C. difficile‐associated diarrhoea. In FMT, five of the seven patients with pseudomembranous colitis reported a resolution of diarrhoea. Resolution of C. difficile infection occurred in 5 of the 19 (26%) patients in vancomycin (P < 0.0001). No significant adverse events were observed in either of the study groups.ConclusionsFaecal microbiota transplantation using colonoscopy to infuse faeces was significantly more effective than vancomycin regimen for the treatment of recurrent C. difficile infection. The delivery of donor faeces via colonoscopy has the potential to optimise the treatment strategy in patients with pseudomembranous colitis.
Systematic review with meta‐analysis: pharmacological interventions for eosinophilic oesophagitis
Authors: Sawas T. , Dhalla S. , Sayyar M. , Pasricha P. J. , Hernaez R. 
Published: March 2015

SummaryBackgroundEosinophilic oesophagitis (EoE) is a growing cause of dysphagia. Current therapies include dietary manipulation, steroids and biological drugs.AimTo perform a systematic review and summarise the effect of different medical interventions on EoE.MethodsTwo reviewers searched Pubmed and Embase for studies on treatment for EoE. We included randomised controlled trials (RCT) limited to pharmacological interventions. Two reviewers selected studies. Meta‐analysis was done using random effects model to estimate odds ratio (OR). Heterogeneity was determined by Cochran's Q statistic and I2.ResultsSeventeen references met our inclusion criteria. Eleven RCTs involving 455 participants were included in the meta‐analysis. 325 participants were evaluated for symptomatic improvement and 330 were evaluated for histological remission. Symptomatic improvement with topical steroids (7 studies, 250 participants) compared to the control group (placebo or PPI) was noted (OR: 3.03, 95% confidence interval, CI: 1.57–5.87). Histological remission was also noted in nine studies involving 330 participants (OR: 13.66, 95% CI: 2.65–70.34) comparing topical steroids to a control (placebo or PPI). There was no difference between anti‐IL‐5 drugs and placebo in terms of symptomatic improvement (OR: 0.69, 95% CI: 0.34–1.42).ConclusionsTopical steroids induce significant symptomatic and histological remission, and should be considered as a first line treatment. Anti‐IL‐5 therapy has a minor effect on eosinophilic oesophagitis. Future research in eosinophilic oesophagitis should standardise methodology according to published guidelines to improve quality and allow direct comparison between therapies.
Plant beta‐diversity is enhanced around grassland–forest edges within a traditional agricultural landscape
Authors: Ohara Ryohei G. , Ushimaru Atushi 
Published: March 2015

AbstractQuestionsAre there positive edge effects on beta‐ and alpha‐diversity of plant species across semi‐natural grassland–secondary forest gradients located within a traditional agricultural landscape? Is beta‐diversity (dissimilarity in plant species composition between two given plots) well explained by environmental differences for both grasslands and forests? Do gradients of environmental factors created by forest edges influence spatial variation in alpha‐diversity from edges to grasslands and forests?LocationSemi‐natural grasslands and secondary forests (or conifer plantation) around paddy fields in a traditional agricultural landscape, western Japan.MethodsVegetation survey and environmental (soil water content and sunlight) measurements were conducted on 11 transects passing through grassland–forest ecosystems. Spatial variations in plant beta‐ and alpha‐diversity and environmental variables and their relationships were examined.ResultsWe quantitatively demonstrated common positive edge effects on beta‐diversity in both grasslands and forests. Our results suggest that among‐edge variations in light conditions, which likely depend on edge aspect and forest type, promote high grassland plant beta‐diversity in the vicinity of edges. However, the high beta‐diversity of forest floor communities in the proximity of edges cannot be explained by this mechanism. Alpha‐diversity tended to be lower within grassland plots located around edges than in grassland interiors, while the richness of the forest community increased toward the edge. This alpha‐diversity pattern was suggested to be attributable to resource gradients created by the forest edges.ConclusionsAlthough plant alpha‐diversity may not be consistently high in the vicinity of edges, beta‐diversity in the communities bordering grassland–forest edges will generally be high in the traditional agricultural landscape. Thus, maintenance of environmental heterogeneity among grassland–forest edges in agricultural ecosystems should be prioritized for local biodiversity conservation.
Pevonedistat (MLN4924), a First‐in‐Class NEDD8‐activating enzyme inhibitor, in patients with acute myeloid leukaemia and myelodysplastic syndromes: a phase 1 study
Authors: Swords Ronan T. , Erba Harry P. , DeAngelo Daniel J. , Bixby Dale L. , Altman Jessica K. , Maris Michael , Hua Zhaowei , Blakemore Stephen J. , Faessel Hélène , Sedarati Farhad , Dezube Bruce J. , Giles Francis J. , Medeiros Bruno C. 
Published: March 2015

SummaryThis trial was conducted to determine the dose‐limiting toxicities (DLTs) and maximum tolerated dose (MTD) of the first in class NEDD8‐activating enzyme (NAE) inhibitor, pevonedistat, and to investigate pevonedistat pharmacokinetics and pharmacodynamics in patients with acute myeloid leukaemia (AML) and myelodysplastic syndromes (MDS). Pevonedistat was administered via a 60‐min intravenous infusion on days 1, 3 and 5 (schedule A, n = 27), or days 1, 4, 8 and 11 (schedule B, n = 26) every 21‐days. Dose escalation proceeded using a standard ‘3 + 3’ design. Responses were assessed according to published guidelines. The MTD for schedules A and B were 59 and 83 mg/m2, respectively. On schedule A, hepatotoxicity was dose limiting. Multi‐organ failure (MOF) was dose limiting on schedule B. The overall complete (CR) and partial (PR) response rate in patients treated at or below the MTD was 17% (4/23, 2 CRs, 2 PRs) for schedule A and 10% (2/19, 2 PRs) for schedule B. Pevonedistat plasma concentrations peaked after infusion followed by elimination in a biphasic pattern. Pharmacodynamic studies of biological correlates of NAE inhibition demonstrated target‐specific activity of pevonedistat. In conclusion, administration of the first‐in‐class agent, pevonedistat, was feasible in patients with MDS and AML and modest clinical activity was observed.