bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy and cost‐analysis of placental alpha‐microglobulin‐1 test in the diagnosis of premature rupture of fetal membranes in resource‐limited community settings
Authors: Eleje George Uchenna , Ezugwu Euzebus Chinonye , Ogunyemi Dotun , Eleje Lydia Ijeoma , Ikechebelu Joseph Ifeanyichukwu , Igwegbe Anthony Osita , Okonkwo John E. , Ikpeze Okechukwu Christian , Udigwe Gerald Okanandu , Onah Hyacinth Eze , Nwosu Betrand Obi , Ezeama Chukwuemeka Okwudili , Ezenkwele Eziamaka Pauline 
Published: August 2014

AbstractAimTo determine accuracy and costs of placental α‐microglobulin‐1 (PAMG‐1) test compared to standard clinical assessment (SCA) for diagnosing rupture of membranes (ROM).MethodsA multicenter double‐blind study of consecutive women with symptoms and signs of ROM in Nnamdi Azikiwe University Teaching Hospital, Nnewi and University of Nigeria Teaching Hospital, Enugu, both in south‐east Nigeria using SCA for ROM and the PAMG‐1 test was done. ROM was diagnosed if two out of three methods from SCA (pooling, positive nitrazine test or ferning) were present and confirmed post‐delivery based on presence of any two of these clinical criteria: delivery in 48 h to 7 days, evidence of chorioamnionitis, membranes overtly ruptured at delivery and adverse perinatal outcomes strongly correlated with prolonged PROM. A cost‐analysis was also done. The outcome measures included sensitivity, specificity, accuracy and costs for the two tests.ResultsAccuracy, sensitivity and specificity for the PAMG‐1 test were 97.2%, 97.4% and 96.7%, higher than for SCA which were 83.7%, 87.9% and 70.5%, respectively (P < 0.001). Accuracy of SCA was higher at less than 34 weeks than 34 weeks or more (88.3% vs 81.4%) while the PAMG‐1 test performed equally at both gestational age categories (96.1% vs 97.7%). In women without pooling, accuracy of the PAMG‐1 test was 96.7%, while it was 40.0% with SCA. Analysis showed that the overall cost of SCA was 45% higher than the PAMG‐1 test.ConclusionThis study confirms that the PAMG‐1 test has a consistently high diagnostic accuracy at all gestational ages and with equivocal cases of ROM. The PAMG‐1 test appears less costly than SCA.
Hemodynamic effects of nifedipine tocolysis
Authors: Yamasato Kelly , Burlingame Janet , Kaneshiro Bliss 
Published: August 2014

AbstractAimTo describe the effects of nifedipine tocolysis on blood pressure and heart rate in non‐hypertensive women.MethodsThis was a retrospective study from 2001 to 2011 to compare blood pressures and heart rates among non‐hypertensive women on nifedipine tocolysis up to 8 h after nifedipine initiation. Measurements at 20–60 and 61–120 min were compared to assess the differential effects of dosing on hemodynamics and reflected the effects of the initial and complete loading doses, respectively. Charts were reviewed for hypotension‐related emergent delivery.ResultsOne hundred and thirty‐eight patients were included. Over the 8‐h study interval, mean systolic blood pressure (P < 0.001) and mean diastolic blood pressure (P < 0.001) decreased by 5 mmHg and heart rate increased by 4 b.p.m. (P < 0.001). Systolic and diastolic blood pressures were unchanged from baseline up to 120 min at all doses. Heart rate increased at both 20–60 and 61–120 min when all doses were considered (P < 0.001), but differential dosing effects were not observed. Rates of tachycardia increased (P < 0.001), but rates of hypotension were unchanged. No hypotension‐related emergent deliveries occurred.ConclusionNifedipine tocolysis was associated with hemodynamic changes in non‐hypertensive women. Tachycardia was increased but hypotension was unaffected, supporting the general safety of nifedipine in this setting.
Maternal outcomes in pregnancies affected by varicella zoster virus infections: Population‐based study on 7.7 million pregnancy admissions
Authors: Zhang Hui Jue , Patenaude Valerie , Abenhaim Haim A. 
Published: August 2014

AbstractAimPrevious estimates of the incidence of varicella zoster virus (VZV) pneumonia and maternal death associated with VZV infection among the pregnant population have varied considerably and been based predominantly on reports from case series. We sought to measure the incidence of VZV‐related morbidity and mortality to provide more representative population estimates.MethodsWe carried out a large cohort study on all births using the United States Healthcare Cost and Utilization Project‐Nationwide Inpatient Sample database between 2003 and 2010. Descriptive statistics were used to measure baseline characteristics and outcomes of women with VZV infection. Multivariate logistic regression analyses were used to identify risk factors for the development of VZV‐related morbidity and mortality.ResultsWe identified 935 patients admitted for VZV infection among 7.7 million pregnancy admissions, representing an incidence of 1.21 cases/10 000 pregnancies (95% confidence interval [CI], 1.13–1.29). The incidence of VZV pneumonia was 2.5% (95% CI, 1.6–3.7). No maternal deaths were recorded during the 8‐year study period. There were no significant risk factors identified for those who developed VZV pneumonia compared to those who had an uncomplicated VZV infection during pregnancy.ConclusionThe incidence of VZV pneumonia and VZV infection associated with maternal death is significantly lower than previously estimated and may reflect better immunization and earlier interventions.
Novel treatment of chronic perineal pain in a woman by extracorporeal shock wave therapy: A case report and published work review
Authors: Tung Chi Wai , Cheon Willy Cecilia , Tong Anny 
Published: August 2014

AbstractIn published work review, extracorporeal shock wave therapy (ESWT) has been showed to be effective in treating chronic perineal/pelvic pain in men, but there was no published report on its use in women. We report a case of female chronic perineal pain successfully treated by ESWT. A 51‐year‐old woman presented with persistent perineal scar pain after excision of a vulval–vaginal nodule despite oral analgesics and gabapentin. After 11 cycles of ESWT, she reported termination of analgesics consumption and decreased perineal pain score from 8 to 2. The Short Form 36 Questionnaire demonstrated improvement in physical and mental health conditions. There was no complication encountered. We postulate that the effect of ESWT in this patient was based on reduction of muscle tone and alternating the threshold of pain memory, similar to the mechanisms in male patients. Further study is required to determine the use of ESWT in treating female chronic perineal pain.
Case of non‐mosaic trisomy 20 in amniotic fluid cultures without anomalies in the fetus: Cytogenetic discrepancy between amniocytes and fetal blood
Authors: Maeda Kazuhisa , Imoto Issei , Kaji Takashi , Yoshida Yukiko , Nakayama Soichiro , Irahara Minoru 
Published: August 2014

AbstractWe report a case of non‐mosaic trisomy 20 detected prenatally by amniocentesis during the 16th week of pregnancy. Fetal blood sampling showed a normal karyotype and no fetal, neonatal or infant abnormalities were observed. Amniotic fluid cell karyotyping revealed a trisomy 20 (47,XY,+20) with 100% trisomic cells (38/38); however, a subsequent cordocentesis revealed a normal male karyotype. Moreover, a follow‐up ultrasonographic examination did not reveal any major congenital malformations, and a healthy male infant was delivered subsequently at an appropriate gestational age without obvious anomalies. Cytogenetic analysis of blood lymphocytes from the infant revealed a normal karyotype, but cultured cells from the term placenta showed a mosaic karyotype 47,XY,+20/46,XY with 88% trisomic cells (44 of 50). Furthermore, no anomalies or developmental delays were observed in the neonatal period, thus suggesting two possibilities: confined placental mosaicism with the presence of normal and abnormal cell lineages, or generalized mosaicism affecting a limited number of tissues in both the placenta and fetus.
Clinical features of gestational thrombocytopenia difficult to differentiate from immune thrombocytopenia diagnosed during pregnancy
Authors: Kasai Junko , Aoki Shigeru , Kamiya Natsuko , Hasegawa Yoshimi , Kurasawa Kentaro , Takahashi Tsuneo , Hirahara Fumiki 
Published: August 2014

AbstractAimTo investigate the clinical features of gestational thrombocytopenia (GT) difficult to differentiate from immune thrombocytopenia (ITP) during pregnancy.MethodsThe January 2000–December 2012 hospital database was analyzed to identify women with ITP or GT (after excluding other possible causes of thrombocytopenia) among those first noted to have platelet counts of less than 100 000/μL during pregnancy. The maternal characteristics, platelet count fluctuations and pregnancy outcomes were compared between women with ITP and GT.ResultsThere were 23 pregnancies (22 women) with thrombocytopenia (GT, 13; ITP, 10). The GT group included five twin pregnancies (38.5%), whereas all pregnancies of the ITP group were singleton pregnancies, with significantly more twin pregnancies in the GT group (P = 0.046). Thrombocytopenia in the first trimester occurred in 70% (7/10) of ITP cases and 23.1% (3/13) of even GT cases. The nadir platelet count was less than 70 000/μL in 100% (10/10) of ITP cases and 30.8% (4/13) of GT cases (P < 0.001). Maternal treatment was required in 80% (8/10) of ITP cases, but in none of the GT cases. The pregnancy outcomes were favorable in both groups, and no case required fetal treatment.ConclusionGestational thrombocytopenia with platelet counts of less than 10 0000/μL occurred more frequently in twin pregnancies. Although onset of thrombocytopenia in the first trimester and a platelet count of less than 70 000/μL is more common in ITP, these findings were not uncommon in GT. Differentiation between ITP and GT may be feasible only with post‐partum changes in the platelet count.
Identification of molecular mechanisms used by Finegoldia magna to penetrate and colonize human skin
Authors: Murphy Elizabeth C. , Mörgelin Matthias , Reinhardt Dieter P. , Olin Anders I. , Björck Lars , Frick Inga‐Maria 
Published: August 2014

SummaryFinegoldia magna is a Gram‐positive anaerobic commensal of the human skin microbiota, but also known to act as an opportunistic pathogen. Two primary virulence factors of F. magna are the subtilisin‐like extracellular serine protease SufA and the adhesive protein FAF. This study examines the molecular mechanisms F. magna uses when colonizing or establishing an infection in the skin. FAF was found to be essential in the initial adherence of F. magna to human skin biopsies. In the upper layers of the epidermis FAF mediates adhesion through binding to galectin‐7 – a keratinocyte cell marker. Once the bacteria moved deeper into the skin to the basement membrane layer, SufA was found to degrade collagen IV which forms the backbone structure of the basement membrane. It also degraded collagen V, whereby F. magna could reach deeper dermal tissue sites. In the dermis, FAF interacts with collagen V and fibrillin, which presumably helps the bacteria to establish infection in this area. The findings of this study paint a clear picture of how F. magna interacts with human skin and explain how it is such a successful opportunistic pathogen in chronic wounds and ulcers.
Sources of perceived social support associated with reduced psychological distress at 1 year after the Great East Japan Earthquake: Nationwide cross‐sectional survey in 2012
Authors: Sugimoto Takashi , Umeda Maki , Shinozaki Tomohiro , Naruse Takashi , Miyamoto Yuki 
Published: August 2014

AimLack of social support has been associated with a higher level of psychological distress after disasters, but its relative associations with sources of support such as neighbors, friends, family, and others, are underreported. The present study assessed the associations of social support with psychological distress according to support source among the general population 1 year after the Great East Japan Earthquake.MethodsAn online survey was completed by a Japanese national sample of 10 469 participants in 2012, from which 8777 were analyzed. Psychological distress was measured using the Kessler Psychological Distress Scale (K6), and the associations between social support from family, friends, or neighbors and psychological distress score were estimated using a proportional odds model. This model was separately fitted for house‐damage certification from the disaster (573 participants were certified, 8204 were uncertified).ResultsPrevalence of K6 ≥ 13 points was 8.4% for house‐damage certified and 9.0% for uncertified participants. K6 ≥ 5 points was observed among 49.9% of the house‐damaged certified group and in 47.7% of the uncertified group. Lack of support from family, friends, and neighbors was similarly associated with higher K6 score among house‐damage certified and uncertified participants. Similar patterns were observed from participants who received house‐damage certificates and those who did not experience damage to their homes.ConclusionEnhancing perceived sources of social support among the general population, not limited to people with house damage, can be an effective way to reduce psychological distress following a disaster.
Evaluation of radiation dose and image quality of CT scan for whole‐body pediatric PET/CT: A phantom study
Authors: Yang Ching‐Ching , Liu Shu‐Hsin , Mok Greta S. P. , Wu Tung‐Hsin 
Published: August 2014

Purpose:This study aimed to tailor the CT imaging protocols for pediatric patients undergoing whole‐body PET/CT examinations with appropriate attention to radiation exposure while maintaining adequate image quality for anatomic delineation of PET findings and attenuation correction of PET emission data.Methods:The measurements were made by using three anthropomorphic phantoms representative of 1‐, 5‐, and 10‐year‐old children with tube voltages of 80, 100, and 120 kVp, tube currents of 10, 40, 80, and 120 mA, and exposure time of 0.5 s at 1.75:1 pitch. Radiation dose estimates were derived from the dose‐length product and were used to calculate risk estimates for radiation‐induced cancer. The influence of image noise on image contrast and attenuation map for CT scans were evaluated based on Pearsonˈs correlation coefficient and covariance, respectively. Multiple linear regression methods were used to investigate the effects of patient age, tube voltage, and tube current on radiation‐induced cancer risk and image noise for CT scans.Results:The effective dose obtained using three anthropomorphic phantoms and 12 combinations of kVp and mA ranged from 0.09 to 4.08 mSv. Based on our results, CT scans acquired with 80 kVp/60 mA, 80 kVp/80 mA, and 100 kVp/60 mA could be performed on 1‐, 5‐, and 10‐year‐old children, respectively, to minimize cancer risk due to CT scans while maintaining the accuracy of attenuation map and CT image contrast. The effective doses of the proposed protocols for 1‐, 5‐ and 10‐year‐old children were 0.65, 0.86, and 1.065 mSv, respectively.Conclusions:Low‐dose pediatric CT protocols were proposed to balance the tradeoff between radiation‐induced cancer risk and image quality for patients ranging in age from 1 to 10 years old undergoing whole‐body PET/CT examinations.
Use ofS-[2,3-Bispalmitoyiloxy-(2R)-Propyl]-R-Cysteinyl-Amido-Monomethoxy Polyethylene Glycol as an Adjuvant Improved Protective Immunity Associated with a DNA Vaccine Encoding Cu,Zn Superoxide Dismutase of Brucella abortus in Mice
Authors: Retamal-Díaz Angello , Riquelme-Neira Roberto , Sáez Darwin , Rivera Alejandra , Fernández Pablo , Cabrera Alex , Guzmán Carlos A. , Oñate Ángel 
Published: August 2014

ABSTRACTThis study was conducted to evaluate the immunogenicity and protective efficacy of a DNA vaccine encodingBrucella abortusCu,Zn superoxide dismutase (SOD) using the Toll-like receptor 2/6 agonistS-[2,3-bispalmitoyiloxy-(2R)-propyl]-R-cysteinyl-amido-monomethoxy polyethylene glycol (BPPcysMPEG) as an adjuvant. Intranasal coadministration of BPPcysMPEG with a plasmid carrying the SOD-encoding gene (pcDNA-SOD) into BALB/c mice elicited antigen-specific humoral and cellular immune responses. Humoral responses were characterized by the stimulation of IgG2a and IgG1 and by the presence of SOD-specific secretory IgA in nasal and bronchoalveolar lavage fluids. Furthermore, T-cell proliferative responses and increased production of gamma interferon were also observed upon splenocyte restimulation with recombinant SOD. Cytotoxic responses were also stimulated, as demonstrated by the lysis of RB51-SOD-infected J774.A1 macrophages by cells recovered from immunized mice. The pcDNA-SOD/BPPcysMPEG formulation induced improved protection against challenge with the virulent strainB. abortus2308 in BALB/c mice over that provided by pcDNA-SOD, suggesting the potential of this vaccination strategy againstBrucellainfection.
DNA Microarray-Based Typing of Streptococcus agalactiae Isolates
Authors: Nitschke Heike , Slickers Peter , Müller Elke , Ehricht Ralf , Monecke Stefan 
Published: August 2014

ABSTRACT

Streptococcus agalactiae
frequently colonizes the urogenital tract, and it is a major cause of bacterial septicemia, meningitis, and pneumonia in newborns. For typing purposes, a microarray targeting group B streptococcus (GBS) virulence-associated markers and resistance genes was designed and validated with reference strains, as well as clinical and veterinary isolates. Selected isolates were also subjected to multilocus sequence typing. It was observed that putative typing markers, such as alleles of the alpha-like protein or capsule types, vary independently of each other, and they also vary independently from the affiliation to their multilocus sequence typing (MLST)-defined sequence types. Thus, it is not possible to assign isolates to sequence types based on the identification of a single distinct marker, such as a capsule type or
alp
allele. This suggests the occurrence of frequent genomic recombination. For array-based typing, a set of 11 markers (
bac
,
alp
,
pil1
locus,
pepS8
,
fbsB
, capsule locus,
hylB
,
abiG
-I/-II plus
Q8DZ34
,
pil2
locus,
nss
plus
srr
plus
rogB2
, and
rgfC/A/D/B
) was defined that provides a framework for splitting the tested 448
S. agalactiae
isolates into 76 strains that clustered mainly according to MLST-defined clonal complexes. There was evidence for region- and host-specific differences in the population structure of
S. agalactiae
, as well as an overrepresentation of strains related to sequence type 17 among the invasive isolates. The arrays and typing scheme described here proved to be a convenient tool for genotyping large numbers of clinical/veterinary isolates and thus might help obtain insight into the epidemiology of
S. agalactiae
.
Major Histocompatibility Complex Class I Downregulation Induced by Equine Herpesvirus Type 1 pUL56 Is through Dynamin-Dependent Endocytosis
Authors: Huang Teng , Lehmann Maik J. , Said Abdelrahman , Ma Guanggang , Osterrieder Nikolaus 
Published: August 2014

ABSTRACTEquine herpesvirus type 1 (EHV-1) downregulates cell surface expression of major histocompatibility complex class I (MHC-I) in infected cells. We have previously shown that pUL56 encoded by the EHV-1 ORF1 gene regulates the process (G. Ma, S. Feineis, N. Osterrieder, and G. R. Van de Walle, J. Virol. 86:3554–3563, 2012, doi:http://dx.doi.org/10.1128/JVI.06994-11). Here, we report that cell surface MHC-I in EHV-1-infected cells is internalized and degraded in the lysosomal compartment in a pUL56-dependent fashion. pUL56-induced MHC-I endocytosis required dynamin and tyrosine kinase but was independent of clathrin and caveolin-1, the main constituents of the clathrin- and raft/caveola-mediated endocytosis pathways, respectively. Downregulation of cell surface MHC-I was significantly inhibited by the ubiquitin-activating enzyme E1 inhibitor PYR41, indicating that ubiquitination is essential for the process. Finally, we show that downregulation is not specific for MHC-I and that other molecules, including CD46 and CD63, are also removed from the cell surface in a pUL56-dependent fashion.IMPORTANCEWe show that alphaherpesvirus induces MHC-I downregulation through endocytosis, which is mediated by pUL56. The dynamin-dependent endocytic pathway is responsible for MHC-I internalization in infected cells. Furthermore, we discovered that this endocytic process can be disrupted by the inhibiting ubiquitin-activating E1 enzyme, which is indispensable for ubiquitination. Finally, pUL56 action extends to a number of cell surface molecules that are significant for host immunity. Therefore, the protein may exert a more general immunomodulatory effect.
Automated detection of physiologic deterioration in hospitalized patients
Authors: Evans R Scott , Kuttler Kathryn G , Simpson Kathy J , Howe Stephen , Crossno Peter F , Johnson Kyle V , Schreiner Misty N , Lloyd James F , Tettelbach William H , Keddington Roger K , Tanner Alden , Wilde Chelbi , Clemmer Terry P 
Published: August 2014

Abstract
Objective Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration.
Materials and methods A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation.
Results Nurses reported the positive predictive value of alerts was 91–100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B.
Conclusions We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before–after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help.