bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consultation about urinary and faecal incontinence in the year after childbirth: a cohort study
Authors: Brown S , Gartland D , Perlen S , McDonald E , MacArthur C 
Published: July 2014

ObjectiveTo investigate the extent to which primary‐care practitioners routinely inquire about postpartum urinary and faecal incontinence, and assess the proportion of women who disclose symptoms.DesignProspective pregnancy cohort study of nulliparous women.SettingMelbourne, Australia.SampleA total of 1507 nulliparous women recruited in early pregnancy.MethodWomen were recruited from six public maternity hospitals, with follow up at 3, 6, 9 and 12 months postpartum.Main outcome measuresStandardised measures of urinary and bowel symptoms, and measures of health service use.ResultsIn the first 12 months postpartum, the period prevalence of urinary incontinence was 47%, and of faecal incontinence was 17%. In all, 86% of women visited a primary health‐care practitioner at least once to discuss their own health in the first year after childbirth. However, only around a quarter were asked about urinary incontinence, and fewer than one in five women were asked about faecal incontinence. Discussion of symptoms with health professionals was most likely to occur in the first 3 months postpartum, and happened only rarely during the remainder of the first postnatal year. Over 70% of women reporting severe urinary incontinence and/or faecal incontinence had not discussed symptoms with a health professional.ConclusionThe findings provide robust evidence that many women experiencing postpartum urinary and faecal incontinence—including women with moderate and severe symptoms—do not receive adequate primary‐care follow up in the first 12 months postpartum. Systems of maternal health surveillance need to include routine inquiry about urinary and faecal incontinence to overcome women's reluctance to seek help.
Illness‐course modulates suicidality‐related prefrontal gray matter reduction in women with bipolar disorder
Authors: Lijffijt M. , Rourke E. D. , Swann A. C. , Zunta‐Soares G. B. , Soares J. C. 
Published: July 2014

ObjectiveExplore interrelationships between suicide attempt history (Objective 1) or suicide attempt severity (Objective 2) with prefrontal cortex gray matter (PFCGM) volume and illness‐course in patients with bipolar disorder (BD).MethodNinety‐three women with BD‐I or ‐II diagnosis (51 with and 42 without suicide attempt history) underwent structural MRI and filled out questionnaires. Measured were GM volumes of 11 PFC regions, BD illness‐course, and attempt history and severity. Effects were examined with repeated measures GLM or logit analyses.ResultsObjective 1: Attempt history was associated with increased trait impulsivity and aggression, and higher prevalence of BD‐I, past drug use disorder, and past psychiatric hospitalization. PFCGM volume was lower in patients with than without attempt history in those with past psychiatric hospitalization. PFCGM volume was higher in patients with than without attempt history in those without hospitalization. Higher trait aggression predicted attempt history. Objective 2: Increased frontal pole volume and younger age at first hospitalization predicted many suicide attempts.ConclusionAttempt history in patients with BD related to PFCGM volume reduction or increase. Volume modulation by psychiatric hospitalization could reflect effects of illness‐course or care. Attempt severity was not related to volume reduction. Research on suicidality–brain relationships should include illness‐course and attempt severity measures.
Predictors of Successful Cardioversion with Vernakalant in Patients with Recent‐Onset Atrial Fibrillation
Authors: Mochalina Natalia , Juhlin Tord , Öhlin Bertil , Carlson Jonas , Holmqvist Fredrik , Platonov Pyotr G. 
Published: July 2014

BackgroundVernakalant is a novel atrial‐selective antiarrhythmic drug able to convert recent‐onset atrial fibrillation (AF) with reportedly low proarrhythmic risk. Successful cardioversion predictors are largely unknown. We sought to evaluate clinical and electrocardiographic predictors of cardioversion of recent‐onset AF with vernakalant.MethodsConsecutive patients with AF ≤48 hours admitted for cardioversion with vernakalant (n = 113, median age 62 years, 69 male) were included. Sinus rhythm (SR) within 90 minutes after infusion start was considered to be successful cardioversion. Predictive values of demographics, concomitant therapy, comorbidities, and electrocardiographic parameters were assessed. Atrial fibrillatory rate (AFR), exponential decay, and mean fibrillatory wave amplitude were measured from surface ECG using QRST cancellation and time‐frequency analysis.ResultsCardioversion was achieved in 66% of patients. Conversion rate was higher in women than in men (80% vs 58%, P = 0.02) while none of other clinical characteristics, including index AF episode duration, could predict SR restoration. Female gender was predictive of vernakalant's effect in logistic regression analysis (OR = 2.82 95%CI 1.18–6.76, P = 0.020). There was no difference in AFR (350 ± 60 vs 348 ± 62 fibrillations per minute [fpm], P = 0.893), mean fibrillatory wave amplitude (86 ± 33 vs 88 ± 67 μV, P = 0.852), or exponential decay (1.30 ± 0.42 vs 1.35 ± 0.42, P = 0.376) between responders and nonresponders.ConclusionsFemale gender is associated with a higher rate of SR restoration using intravenous (i.v.) vernakalant for recent‐onset AF. ECG‐derived indices of AF organization, which previous studies associated with effect of rhythm control interventions, did not predict vernakalant's effect.
Robot‐assisted oesophageal and gastric surgery for benign disease: antireflux operations and Heller's myotomy
Authors: Falkenback Dan , Lehane Christopher W. , Lord Reginald V. N. 
Published: July 2014

AbstractBackgroundRobot‐assisted general surgery operations are being performed more frequently. This review investigates whether robotic assistance results in significant advantages or disadvantages for the operative treatment of gastro‐oesophageal reflux disease and achalasia.MethodsThe electronic databases (Medline, Embase, PubMed) were searched for original English language publications for antireflux surgery and Heller's myotomy between January 1990 and December 2013.ResultsThirty‐three publications included antireflux operations and 20 included Heller's myotomy. The publications indicate that the safety and effectiveness of robotic surgery is similar to that of conventional minimally invasive surgery for both operations. The six randomized trials of robot‐assisted versus laparoscopic antireflux surgery showed no significant advantages but significantly higher costs for the robotic method. Gastric perforation during non‐redo robotic fundoplication occurred in four trials.ConclusionsNo consistent advantage for robot‐assisted antireflux surgery has been demonstrated, and there is an increased cost with current robotic technology. A reported advantage for robotic in reducing the perforation rate during Heller's myotomy for achalasia remains unproven. Gastric perforation during robotic fundoplication may be due to the lack of haptic feedback combined with the superhuman strength of the robot.
A Compliant, Banded Outflow Cannula for Decreased Afterload Sensitivity of Rotary Right Ventricular Assist Devices
Authors: Gregory Shaun D. , Schummy Emma , Pearcy Mark , Pauls Jo P. , Tansley Geoff , Fraser John F. , Timms Daniel 
Published: July 2014

AbstractBiventricular support with dual rotary ventricular assist devices (VADs) has been implemented clinically with restriction of the right VAD (RVAD) outflow cannula to artificially increase afterload and, therefore, operate within recommended design speed ranges. However, the low preload and high afterload sensitivity of these devices increase the susceptibility of suction events. Active control systems are prone to sensor drift or inaccurate inferred (sensor‐less) data, therefore an alternative solution may be of benefit. This study presents the in vitro evaluation of a compliant outflow cannula designed to passively decrease the afterload sensitivity of rotary RVADs and minimize left‐sided suction events. A one‐way fluid‐structure interaction model was initially used to produce a design with suitable flow dynamics and radial deformation. The resultant geometry was cast with different initial cross‐sectional restrictions and concentrations of a softening diluent before evaluation in a mock circulation loop. Pulmonary vascular resistance (PVR) was increased from 50 dyne s/cm5 until left‐sided suction events occurred with each compliant cannula and a rigid, 4.5 mm diameter outflow cannula for comparison. Early suction events (PVR ∼ 300 dyne s/cm5) were observed with the rigid outflow cannula. Addition of the compliant section with an initial 3 mm diameter restriction and 10% diluent expanded the outflow restriction as PVR increased, thus increasing RVAD flow rate and preventing left‐sided suction events at PVR levels beyond 1000 dyne s/cm5. Therefore, the compliant, restricted outflow cannula provided a passive control system to assist in the prevention of suction events with rotary biventricular support while maintaining pump speeds within normal ranges of operation.
Randomised clinical study: comparison of acceptability, patient tolerance, cardiac stress and endoscopic views in transnasal and transoral endoscopy under local anaesthetic
Authors: Alexandridis E. , Inglis S. , McAvoy N. C. , Falconer E. , Graham C. , Hayes P. C. , Plevris J. N. 
Published: July 2014

SummaryBackgroundTransnasal endoscopy (TNE) with ultrathin endoscopes has been advocated as an attractive alternative, for diagnostic upper endoscopy.AimTo assess tolerability, acceptability and quality of TNE, in comparison with standard upper endoscopy (SOGD, standard oesophago‐gastro‐duodenoscopy) under local anaesthetic.MethodsWe prospectively recruited 157 patients (83 females/74 males) mean age 57 years. The Fujinon EG530N (5.9 mm) and EG530WR (9.4 mm) endoscopes were used. The endoscopist and all patients completed detailed questionnaires regarding tolerability, acceptance and quality of endoscopy using standard visual analogue scales (VAS). Oxygen saturation (SaO2), heart rate (HR) and systolic blood pressure (SBP) were recorded. Quality of biopsies was evaluated.ResultsAnalysis included 161 procedures (TNE:79, SOGD:82) with duodenal intubation achieved in all patients. VAS scores for patient comfort were significantly better in the TNE group (7.3 vs. 5.3 respectively, P < 0.001). Twenty patients with previous experience of standard endoscopy were randomised to TNE and 19 of them (95.5%) preferred the TNE. Gagging was significantly less in the TNE group (0.12 vs. 3.41 respectively, P < 0.001). Cardiovascular stress was significantly less in the TNE group irrespective of the degree of gagging or comfort. TNE biopsies were smaller, but adequate for definitive diagnosis, similarly to standard endoscopy.ConclusionsTransnasal endoscopy is superior to SOGD in terms of comfort and patient acceptance with significantly less cardiovascular stress. TNE can routinely be used as alternative to SOGD under local anaesthetic, for diagnosis and should be preferentially offered in cardiorespiratory compromised patients.
Mapping continuous forest type variation by means of correlating remotely sensed metrics to canopy N:P ratio in a boreal mixedwood forest
Authors: Gökkaya Kemal , Thomas Valerie , Noland Thomas , McCaughey Harry , Morrison Ian , Treitz Paul 
Published: July 2014

AbstractQuestionsCan the ratio of nitrogen to phosphorus (N:P ratio) be predicted at canopy level using imaging spectroscopy (IS) and light detection and ranging (LiDAR) remote sensing data? How do temporal variation and difference in spatial resolution of these data sources affect prediction accuracy of the canopy N:P ratio?LocationBoreal mixedwood forest, northern Ontario, Canada.MethodsCanopy N:P ratio was estimated using spectral indices calculated from IS data at two spatial resolutions, airborne and space‐borne, across two summers. The relationship between the canopy N:P ratio and forest structure was investigated through analysis of LiDAR data. The impact of temporal variation on canopy N:P ratio and the different spatial resolution of IS data on prediction accuracy for canopy N:P was addressed. Maps of canopy N:P ratio generated from airborne and space‐borne IS data were generated.ResultsAirborne and space‐borne IS data explained 70% and 69% of the variation in canopy N:P, ratio, with predictions errors of 5.0% and 7.2%, respectively, in two consecutive years. Predictions differed significantly with changes in spatial resolution. Predictive models obtained from LiDAR data explained 54% and 67% of the variation in canopy N:P ratio, with prediction errors of 6.1% and 7.5%, respectively, for the 2 yrs.ConclusionsThe results show that canopy N:P ratio can be predicted with remote sensing data based on the relationship between canopy N:P ratio and crown closure at this site. The spatial variation due to the mixed deciduous and coniferous forest type is the underlying mechanism that generates the observed spatial pattern in canopy N:P ratio in this ecosystem, and the canopy N:P ratio map displays this variation.
Pre‐dose plasma concentration monitoring of mycophenolate mofetil in patients with autoimmune diseases
Authors: Streicher Caroline , Djabarouti Sarah , Xuereb Fabien , Lazaro Estibaliz , Legeron Rachel , Bouchet Stéphane , Greib Carine , Breilh Dominique , Pellegrin Jean‐Luc , Viallard Jean‐François 
Published: July 2014

AimTo date, neither the benefit of mycophenolic acid (MPA) therapeutic drug monitoring (TDM), the prodrug of mycophenolate mofetil (MMF), nor the optimal monitoring technique have been established in autoimmune diseases. This study was undertaken to confirm, in a cohort of new patients, the plasma MPA thresholds previously published in patients with systemic lupus erythematosus (SLE) or vasculitis.MethodsMPA areas under the concentration–time curves between 0 and 12 h, 12 h trough concentrations and pre‐dose concentrations (C0) were determined for 23 patients with SLE and 21 with systemic vasculitis. The relationship between patients' pharmacokinetic (PK) variables and their clinical outcomes during follow‐up were analyzed.ResultsIn both autoimmune diseases, at PK assessment, median MPA C0 for patients with uncontrolled disease was significantly lower than that of patients with stable disease or in remission, 1.6 mg l–1 (IQR 0.9–2.1 mg l–1) vs. 2.95 mg l–1 (IQR 1.38–3.73 mg l–1) for SLE (P = 0.048) and 1.55 mg l–1 (IQR 0.98–2.18 mg l–1) vs. 3 mg l–1 (IQR 2.2–4.4 mg l–1) for vasculitis (P = 0.016). According to our receiver operating characteristics curve analysis, a C0 threshold of 2.5–3 mg l–1 was best able to discriminate a flare (SLE: 88% sensitivity, 80% specificity; vasculitis: 100% sensitivity, 90% specificity). Patients with C0 ≥ 2.5–3 mg l–1 at inclusion had better clinical outcomes during the 12 months following PK assessment.ConclusionProvided that the benefit of TDM in patients with autoimmune diseases could be confirmed by randomized, controlled trials, it might be based on the C0 measured approximately 12 h post‐dose.
Early and Sustained Activation of Autophagy in Degenerating Axons after Spinal Cord Injury
Authors: Ribas Vinicius Toledo , Schnepf Bianca , Challagundla Malleswari , Koch Jan Christoph , Bähr Mathias , Lingor Paul 
Published: July 2014

AbstractAxonal degeneration is one of the initial steps in many neurological disorders and has been associated with increased autophagic activity. Although there are increasing data on the regulation of autophagy proteins in the neuronal soma after spinal cord injury (SCI), their characterization in the axon is scarce. Here, we examined the regulation of autophagy during axonal degeneration in a rat model of SCI following a lesion at Th 8. We analyzed the morphological and ultrastructural changes in injured axons by immunohistochemical evaluation of autophagy‐related proteins and electron microscopy at different time points following SCI. The expression of ULK1, Atg7 and Atg5 in damaged axons was rapidly upregulated within hours after SCI. The number of axonal LC3‐positive autophagosomes was also rapidly increased after SCI and remained at an increased level for up to 6 weeks. Ultrastructural analysis showed early signs of axonal degeneration and increased autophagy. In conclusion, we show that autophagy is increased early and for a sustained period in degenerating axons after SCI and that it might be an important executive step involved in axonal degeneration. Therefore, autophagy may represent a promising target for future therapeutic interventions in the treatment of axonal degeneration in traumatic central nervous system disorders.
TRPC6 regulates cell cycle progression by modulating membrane potential in bone marrow stromal cells
Authors: Ichikawa Jun , Inoue Ryuji 
Published: July 2014

Background and PurposeCa2+ influx is important for cell cycle progression, but the mechanisms involved seem to vary. We investigated the potential roles of transient receptor potential (TRP) channels and store‐operated Ca2+ entry (SOCE)‐related molecules STIM (stromal interaction molecule)/Orai in the cell cycle progression of rat bone marrow stromal cells (BMSCs), a reliable therapeutic resource for regenerative medicine.Experimental ApproachPCR and immunoblot analyses were used to examine mRNA and protein levels, fluorescence imaging and patch clamping for Ca2+ influx and membrane potential measurements, and flow cytometry for cell cycle analysis.Key ResultsCell cycle synchronization of BMSCs revealed S phase‐specific enhancement of TRPC1, STIM and Orai mRNA and protein expression. In contrast, TRPC6 expression decreased in the S phase and increased in the G1 phase. Resting membrane potential (RMP) of BMSCs was most negative and positive in the S and G1 phases, respectively, and was accompanied by an enhancement and attenuation of SOCE respectively. Chemically depolarizing/hyperpolarizing the membrane erased these differences in SOCE magnitude during the cell cycle. siRNA knockdown of TRPC6 produced a negative shift in RMP, increased SOCE and caused redistribution of BMSCs with increased populations in the S and G2/M phases and accumulation of cyclins A2 and B1. A low concentration of Gd3+ (1 μM) suppressed BMSC proliferation at its concentration to inhibit SOC channels relatively specifically.Conclusions and ImplicationsTRPC6, by changing the membrane potential, plays a pivotal role in controlling the SOCE magnitude, which is critical for cell cycle progression of BMSCs. This finding provides a new therapeutic strategy for regulating BMSC proliferation.
Nicotinic acetylcholine receptors control acetylcholine and noradrenaline release in the rodent habenulo‐interpeduncular complex
Authors: Beiranvand F , Zlabinger C , Orr‐Urtreger A , Ristl R , Huck S , Scholze P 
Published: July 2014

Background and purposeNicotinic acetylcholine receptors (nACh receptors) play a central role in the habenulo‐interpeduncular system. We studied nicotine‐induced release of NA and ACh in the habenula and interpeduncular nucleus (IPN).Experimental approachThe habenula and IPN were loaded with [3H]‐choline or [3H]‐NA and placed in superfusion chambers. [3H]‐ACh release was also stimulated using nicotinic agonists, electrical pulses and elevated [KCl]o in hippocampal and cortical slices from rats, wild‐type mice and mice lacking α5, α7, β2, or β4 nACh receptor subunits. Finally, we analysed nACh receptor subtypes in the IPN using immunoprecipitation.Key resultsNicotine induced release of [3H]‐ACh in the IPN of rats and mice. This release was calcium‐dependent but not blocked by tetrodotoxin (TTX); moreover, [3H]‐ACh release was abolished in β4‐knockout mice but was unaffected in β2‐ and α5‐knockout mice. In contrast, nicotine‐induced release of [3H]‐NA in the IPN and habenula was blocked by TTX and reduced in both β2‐knockout and β4‐knockout mice, and dose–response curves were right‐shifted in α5‐knockout mice. Although electrical stimuli triggered the release of both transmitters, [3H]‐ACh release required more pulses delivered at a higher frequency.Conclusions and implicationsOur results confirm previous findings that β4‐containing nACh receptors are critical for [3H]‐ACh release in the mouse IPN. Experiments using α5‐knockout mice also revealed that unlike in the hippocampus, nicotine‐induced [3H]‐NA release in the habenulo‐interpeduncular system is altered in this knockout model. As α5‐containing nACh receptors play a key role in nicotine intake, our results add NA to the list of transmitters involved in this mechanism.
Microscopic colitis: a review
Authors: Farrukh A. , Mayberry J. F. 
Published: July 2014

AbstractAimIn recent years, microscopic colitis has been increasingly diagnosed. This review was carried out to evaluate demographic factors for microscopic colitis and to perform a systematic assessment of available treatment options.MethodRelevant publications up to December 2013 were identified following searches of PubMed and Google Scholar using the key words ‘microscopic colitis’, ‘collagenous colitis’ and ‘lymphocytic colitis’. Two‐hundred and forty‐eight articles were identified.ResultsThe term microscopic colitis includes lymphocytic colitis and collagenous colitis. Both have common clinical symptoms but are well defined histopathologically. The clinical course is usually benign, but serious complications, including death, may occur. A peak incidence from 60 to 70 years of age with a female preponderance is observed. Although most cases are idiopathic, associations with autoimmune disorders, such as coeliac disease and hypothyroidism, as well as with exposure to nonsteroidal anti‐inflammatory drugs and proton‐pump inhibitors, have been observed. The incidence and prevalence of microscopic colitis is rising and good‐quality epidemiological research is needed. Treatment is currently largely based on anecdotal evidence and on results from limited clinical trials of budesonide. Long‐term follow‐up of these patients is not well established.ConclusionThe review synthesizes work on the definition of microscopic colitis and the relationship between collagenous and lymphocytic colitis. It reviews the international epidemiology and work on aetiology. In addition, it critically considers the efficacy of a range of treatments.