bluuebunny/crossref_metadata_2025_split huggingface dataset:
What do paediatric trainees require from their clinical supervisors?
Authors: Kutzsche Stefan , Kutzsche Hildegunn , Dornan Tim 
Published: December 2013

AbstractAimClinical supervisors are appointed to ensure that medical trainees receive a satisfactory education, improve their academic orientation and develop professional attitudes. The aim of this study was to find out, from the paediatric trainee's perspective, how their clinical supervisor could best do that.MethodsWe conducted in‐depth interviews with seven paediatric trainees in a university hospital. A template analysis of the transcribed data explored what trainees expect from their clinical supervisors and what they would change if they could.ResultsTrainees wanted the supervision process to begin with negotiating how their supervisory relationship would be structured and how the time could be used to best effect. They wanted their supervisors to provide them with stimulating, multifaceted guidance and encouragement and support a reflective approach that linked theory with practice.ConclusionTrainees wanted their supervisors to support them as they took a reflective approach to their practical work and to help them to bridge theoretical and applied learning.
Estimating acute air pollution health effects from cohort study data
Authors: Szpiro Adam A. , Sheppard Lianne , Adar Sara D. , Kaufman Joel D. 
Published: December 2013

SummaryTraditional studies of short‐term air pollution health effects use time series data, while cohort studies generally focus on long‐term effects. There is increasing interest in exploiting individual level cohort data to assess short‐term health effects in order to understand the mechanisms and time scales of action. We extend semiparametric regression methods used to adjust for unmeasured confounding in time series studies to the cohort setting. Time series methods are not directly applicable since cohort data are typically collected over a prespecified time period and include exposure measurements on days without health observations. Therefore, long‐time asymptotics are not appropriate, and it is possible to improve efficiency by exploiting the additional exposure data. We show that flexibility of the semiparametric adjustment model should match the complexity of the trend in the health outcome, in contrast to the time series setting where it suffices to match temporal structure in the exposure. We also demonstrate that pre‐adjusting exposures concurrent with the health endpoints using trends in the complete exposure time series results in unbiased health effect estimation and can improve efficiency without additional confounding adjustment. A recently published article found evidence of an association between short‐term exposure to ambient fine particulate matter (PM2.5) and retinal arteriolar diameter as measured by retinal photography in the Multi‐Ethnic Study of Atherosclerosis (MESA). We reanalyze the data from this article in order to compare the methods described here, and we evaluate our methods in a simulation study based on the MESA data.
Increased diverticular complications with nonsteriodal anti‐inflammatory drugs and other medications: a systematic review and meta‐analysis
Authors: Kvasnovsky C. L. , Papagrigoriadis S. , Bjarnason I. 
Published: December 2013

AbstractAimComplications of colonic diverticula, perforation and bleeding are a source of morbidity and mortality. A variety of drugs have been implicated in these complications. We present a systemic review and meta‐analysis of the literature to assess the importance of this relationship.MethodA systematic review of articles in PubMed, Cochrane Reviews, Embase and Google Scholar was undertaken in February 2013. An initial literature search yielded 2916 results that were assessed for study design and topicality. Twenty‐three articles were included in the review. A qualitative data synthesis was conducted using forest plots of studies comparing single medication with complications.ResultsIndividual studies demonstrated the odds of perforation and abscess formation with nonsteridal anti‐inflammatory drugs (NSAIDs) (1.46–10.30), aspirin (0.66–2.40), steroids (2.17–31.90) and opioids (1.80–4.51) and the odds of bleeding with NSAIDs (2.01–12.60), paracetamol (0–3.75), aspirin (1.14–3.70) and steroids (0.57–5.40). Pooled data showed significantly increased odds of perforation and abscess formation with NSAIDs (OR = 2.49), steroids (OR = 9.08) and opioids (OR = 2.52). They also showed increased odds of diverticular bleeding from NSAIDs (OR = 2.69), aspirin (OR = 3.24) and calcium‐channel blockers (OR = 2.50). Most studies did not describe the duration or dosage of medication used and did not systematically describe the severity of diverticular complications.ConclusionVarious common medications are implicated in complications of diverticular disease.
The significance of eosinophils in hypertrophic lichen planus
Authors: Alomari Ahmed , McNiff Jennifer M. 
Published: December 2013

BackgroundHypertrophic lichen planus (LP) is a variant of LP favoring the lower extremities and showing prominent epidermal hyperplasia and hyperorthokeratosis. Contrary to dogma that eosinophils are rare in LP and variants, we noticed that some cases of hypertrophic LP have eosinophils in the absence of drug history.MethodsRetrospective review of all cases of hypertrophic LP over 22 consecutive years was conducted. The number of eosinophils in 10 representative ×20‐fields was counted in the area of densest dermal infiltrate. Cases of classic LP were used for comparison. Clinical parameters on all cases were recorded.ResultsThe two groups were clinically similar. The average number of eosinophils per 10 ×20‐fields in 63 cases of hypertrophic LP was 10.5 with a range between 0 and 200. Thirteen of 63 cases (20.6%) had more than 10 eosinophils per 10 ×20‐fields. The average number of eosinophils in 17 cases of classic LP was 1.6 (p = 0.016) with a range between 0 and 9 and no cases with more than 10 eosinophils (p = 0.06).ConclusionHypertrophic LP is a distinct variant of LP that may show variable numbers of eosinophils and should be included in the differential diagnosis of lichenoid dermatitis with eosinophils.
Complex formation between malate dehydrogenase and isocitrate dehydrogenase from Bacillus subtilis is regulated by tricarboxylic acid cycle metabolites
Authors: Bartholomae Maike , Meyer Frederik M. , Commichau Fabian M. , Burkovski Andreas , Hillen Wolfgang , Seidel Gerald 
Published: December 2013

In Bacillus subtilis, recent in vivo studies revealed that particular enzymes of the tricarboxylic acid cycle form complexes that allow an efficient transfer of metabolites. Remarkably, a complex of the malate dehydrogenase (Mdh) (EC 1.1.1.37) with isocitrate dehydrogenase (Icd) (EC 1.1.1.42) was identified, although both enzymes do not catalyze subsequent reactions. In the present study, the interactions between these enzymes were characterized in vitro by surface plasmon resonance in the absence and presence of their substrates and cofactors. These analyses revealed a weak but specific interaction between Mdh and Icd, which was specifically stimulated by a mixture of substrates and cofactors of Icd: isocitrate, NADP+ and Mg2+. Wild‐type Icd converted these substrates too fast, preventing any valid quantitative analysis of the interaction with Mdh. Therefore, binding of the IcdS104P mutant to Mdh was quantified because the mutation reduced the enzymatic activity by 174‐fold but did not affect the stimulatory effect of substrates and cofactors on Icd–Mdh complex formation. The analysis of the unstimulated Mdh–IcdS104P interaction revealed kinetic constants of ka = 2.0 ± 0.2 × 102 m−1·s−1 and kd = 1.0 ± 0.1 × 10−3·s−1 and a KD value of 5.0 ± 0.1 μm. Addition of isocitrate, NADP+ and Mg2+ stimulated the affinity of IcdS104P to Mdh by 33‐fold (KD = 0.15 ± 0.01 μm, ka = 1.7 ± 0.7 × 103 m−1·s−1, kd = 2.6 ± 0.6 × 10−4·s−1). Analyses of the enzymatic activities of wild‐type Icd and Mdh showed that Icd activity doubles in the presence of Mdh, whereas Mdh activity was slightly reduced by Icd. In summary, these data indicate substrate control of complex formation in the tricarboxylic acid cycle metabolon assembly and maintenance of the α‐ketoglutarate supply for amino acid anabolism in vivo.Structured digital abstract

Idh physically interacts with Mdh by cross-linking study (View interaction)

Mdh binds to Idh by surface plasmon resonance (1, 2)
‘Victims’ Versus ‘Offenders’ inBritish Political Discourse: The Construction of a False Dichotomy
Authors: Drake Deborah H. , Henley Andrew J. 
Published: December 2013

AbstractThis article evaluates the contemporary discursive status of victims and people convicted of criminal offences. The rhetoric used byBritish politicians to convey the meaning of ‘rights’ is explored within media output, parliamentary speech‐making and other forms of political discourse. Our analysis details how victims’ rights are sometimes advocated for at the expense of ‘offenders’ ’ rights in public discourse. Examination of parliamentary debates illustrates that differentiating between ‘victims’ and ‘offenders’ elides consideration of more meaningful support for victims, worsens opportunities for the reintegration of ex‐prisoners and constructs a false dichotomy between citizens who do not fall into mutually‐exclusive categories.
Actinic cheilitis: clinicopathologic profile and association with degree of dysplasia
Authors: de Santana Sarmento Dmitry José , da Costa Miguel Márcia Cristina , Queiroz Lélia Maria Guedes , Godoy Gustavo Pina , da Silveira Éricka Janine Dantas 
Published: December 2013

AbstractBackgroundActinic cheilitis (AC) is a potentially malignant disorder of the lip caused by exposure to solar radiation.ObjectivesThis study was conducted to evaluate the clinicopathologic profile of cases of AC and to verify associations with the degree of dysplasia.MethodsThis retrospective study analyzed data for 40 patients with AC. Demographic, clinical, and histopathologic data were evaluated. Sections measuring 5 μm in thickness were cut, deparaffinized, and stained with hematoxylin and eosin for histologic examination. The degree of epithelial dysplasia was graded using the criteria defined by the World Health Organization. Two calibrated oral pathologists analyzed the slides.ResultsAnalysis of the AC patients sampled showed that 75.0% were male (P = 0.002), 80.0% were aged ≥40 years (P < 0.001), 74.3% were Caucasian (P = 0.004), and 68.6% had occupational exposure to sunlight (P = 0.028). The most common clinical manifestation was white lesions (55.0%), and 40.0% of patients had no dysplasia. No significant associations emerged between the histologic grading of AC and gender (P = 1.000), age (P = 1.000), ethnicity (P = 0.416), occupational exposure to sunlight (P = 1.000), and clinical presentation (P = 0.467).ConclusionsThe degree of dysplasia in AC was not statistically associated with gender, age, ethnicity, occupational exposure to sunlight, or clinical appearance. This study provides some support for the hypothesis that clinicopathologic features are not related to the degree of dysplasia in AC.
Enrichment of ω‐3 fatty acids in flax seed oil by alkaline lipase of Aspergillus fumigatus MTCC 9657
Authors: Rajan Akhila , Sobankumar Dasiah R. , Nair Ananthakrishnan J. 
Published: December 2013

SummaryFlax seed oil obtained from the seeds of flax plant (Linum usitatissimum, L.) is an unexploited source which contains ω‐3 and ω‐6 fatty acids. Flax seed oil is hydrolysed with a novel alkaline lipase from Aspergillus fumigatus MTCC 9657 for the removal of unwanted fatty acids and enrichment of ω‐3 fatty acids. An appropriate balance of ω‐3 and ω‐6 polyunsaturated fatty acids and enzymatic enrichment of polyunsaturated fatty acids in diet promote nutrition and health. Fatty acid composition shows that flax seed oil contains about 26.80%, 13.5% and 25.45% of ω‐3 and ω‐6 fatty acids in triglyceride (TG), diglyceride (DG) and monoglyceride (MG), respectively. After 8 h of hydrolysis, ω‐3 content was increased to 39% in TG, showing that unwanted saturated fatty acids are removed. ω‐6 content of triglycerides in flax seed oil also showed 54.76% increase after 8 h of hydrolysis. An enzymatic method of hydrolysis by fungal lipase was developed by this study and achieved to concentrate the essential fatty acids linoleic acid (LA) and α‐linoleic acids (ALA).
Utilisation of beds on the general medical unit by ‘non‐acute medical’ patients: a retrospective study of incidence and cost in two Tasmanian regional medical hospital units
Authors: Buist M. D. , Jaffray L. , Bell E. , Hanna L. , Weinstein P. , Kumar S. , Grimmer K. 
Published: December 2013

AbstractBackgroundDemand for healthcare services threatens to overwhelm the Australian healthcare system. Public hospitals have the largest component of expenditure growth and as such represent the largest opportunity for efficiency gains. Utilisation of inpatient hospital beds and in particular those on general medical units has not been studied in Australia.AimTo undertake a retrospective patient medical record review of 200 sequential admissions to the medical wards in two regional Tasmanian hospitals to determine the incidence of non‐acute medical patient admission to the medical unit, and the subsequent days in hospital that were not required for medical reasons. The cost of these days was estimated.ResultsSixteen patient admissions (8%) could not be justified on medical grounds. Forty‐eight (24%) patient admissions had at least one day hospital day that could not be justified on medical grounds. Of the 1438 total bed days, 475 (33%) were for non‐medical reasons. The estimated cost of those non‐medical bed days for this cohort was $764 800.ConclusionsThe incidence of non‐acute medical admissions and non‐acute medical bed days to the medical unit and associated cost was significant. Further research is needed to design alternative care provision for such patients particularly in regional Australia. The potential savings to the Australian healthcare system could be significant.
Strengthening Mechanisms in MLCCs: Residual Stress Versus Crack Tip Shielding
Authors: Lanning Wade R. , Muhlstein Christopher L. 
Published: December 2013

Failure by fracture is a serious problem with multilayer ceramic capacitors (MLCCs), and the interior electrodes are known to strengthen MLCCs. Historically, it has been assumed that the dominant strengthening mechanism is crack tip shielding via direct crack tip‐electrode interactions. However, we have found that residual stresses arising from differential thermal contraction after device sintering are actually responsible for the observed increase in strength. In addition, the fracture initiation sites in MLCCs are located outside of the electrode array, so the established idea that the electrical and mechanical failure controlling flaw populations are one and the same cannot be true. Weibull distributions were compared from the bending fracture of two populations of MLCCs with barium titanate (X7R) dielectric, nickel electrodes, and the same exterior geometries (but different electrode array configurations). MLCCs had characteristic strengths of 236 MPa versus a strength of 190 MPa for 19‐ and 3‐electrode MLCCs, respectively. Fractography, a critical flaw size computation, an analytical residual stress approximation, and in situ electrical measurements taken during bending were also used to examine the fracture process and demonstrate that residual stress and not crack tip shielding is an important strengthening mechanism in MLCCs.
Rearrangement of Multiferroic BiFeO3 Nanodots Smaller than 15 nm Using Atomic Force Microscopy
Authors: Meang Wan J. , Son Jong Y. 
Published: December 2013

In this study, we demonstrate an atomic force microscopy process for manipulating multiferroic BiFeO3 nanodots smaller than 15 nm to desired positions on a Nb‐doped SrTiO3 substrate. For formation of the BiFeO3 nanodot array, nanocrystal movement was achieved using a +1.2 V biased conducting atomic force microscopy (CAFM) followed by nanocrystal attachment to the tip. Using this method, high‐density BiFeO3 nanodot arrays with a density greater than 0.5 Tb/in.2 can be achieved. Perfectly flipped ferroelectric polarization with an external electric field was observed for each BiFeO3 nanodot, whose ferroelectric properties were confirmed using piezoelectric force microscopy.
Effectiveness of a Mindfulness‐Based Childbirth Education Pilot Study on Maternal Self‐Efficacy and Fear of Childbirth
Authors: Byrne Jean , Hauck Yvonne , Fisher Colleen , Bayes Sara , Schutze Robert 
Published: December 2013

IntroductionThis pilot study tested the feasibility and effectiveness of using Mindfulness‐Based Childbirth Education (MBCE), a novel integration of mindfulness meditation and skills‐based childbirth education, for mental health promotion with pregnant women. The MBCE protocol aimed to reduce fear of birth, anxiety, and stress and improve maternal self‐efficacy. This pilot study also aimed to determine the acceptability and feasibility of the MBCE protocol.MethodsA single‐arm pilot study of the MBCE intervention using a repeated‐measures design was used to analyze data before and after the MBCE intervention to determine change trends with key outcome variables: mindfulness; depression, anxiety, and stress; childbirth self‐efficacy; and fear of childbirth. Pregnant women (18‐28 weeks’ gestation) and their support companions attended weekly MBCE group sessions over 8 weeks in an Australian community setting.ResultsOf the 18 women who began and completed the intervention, missing data allowed for complete data from 12 participants to be analyzed. Statistically significant improvements and large effect sizes were observed for childbirth self‐efficacy and fear of childbirth. Improvements in depression, mindfulness, and birth outcome expectations were underpowered. At postnatal follow‐up significant improvements were found in anxiety, whereas improvements in mindfulness, stress, and fear of birth were significant at a less conservative alpha level.DiscussionThis pilot study demonstrated that a blended mindfulness and skills‐based childbirth education intervention was acceptable to women and was associated with improvements in women's sense of control and confidence in giving birth. Previous findings that low self‐efficacy and high childbirth fear are linked to greater labor pain, stress reactivity, and trauma suggest the observed improvements in these variables have important implications for improving maternal mental health and associated child health outcomes. Ways in which these outcomes can be achieved through improved childbirth education are discussed.
Prognostic factors and status of hormone receptors and angiogenic factors in uterine carcinosarcoma
Authors: Etoh Tomomaro , Nakai Hidekatsu 
Published: December 2013

AbstractAimTo determine novel prognostic factors and treatment modalities for uterine carcinosarcoma (UCS).MethodsWe performed immunohistochemical staining of estrogen receptor (ER)‐α, ER‐β, progesterone receptor, gonadotropin‐releasing hormone receptor, vascular endothelial growth factor (VEGF), platelet‐derived endothelial cell growth factor (PD‐ECGF) and platelet‐derived growth factor receptor (PDGFR)‐β in a clinicopathological study of 15 UCS patients.ResultsNo significant differences were found between the sarcomatous and carcinomatous components with respect to expression of ER‐α, ER‐β and progesterone receptor. However, VEGF was significantly more frequently expressed in the carcinomatous component, while PD‐ECGF and PDGFR‐β were significantly more frequently expressed in the sarcomatous component. Only one patient showed gonadotropin‐releasing hormone receptor expression in the sarcomatous component. Moreover, ER‐β expression in resected specimens, increased serum levels of carbohydrate antigen (CA)‐125 and C‐reactive protein (CRP), and thrombocytosis were determined as significant UCS prognostic factors.ConclusionCombination of anti‐VEGF therapy and anti‐PD‐ECGF or anti‐PDGFR‐β therapy would be expected in advanced or recurrent UCS. Furthermore, careful monitoring for early detection of recurrence should be performed when UCS patients showed preoperative increase in serum CA‐125 levels, CRP and platelet counts, and ER‐β expression in biopsied or surgically resected specimens.
Long‐term oncological and reproductive outcomes of fertility‐sparing cytoreductive surgery in females aged 25 years and younger with malignant ovarian germ cell tumors
Authors: Ertas Ibrahim Egemen , Taskin Salih , Goklu Rifat , Bilgin Muzaffer , Goc Goksu , Yildirim Yusuf , Ortac Firat 
Published: December 2013

AbstractAimTo evaluate the long‐term oncological and reproductive outcomes of patients aged 25 years and younger who were treated by fertility‐sparing cytoreductive surgery (FSCS) plus adjuvant chemotherapy (ACT) or observation alone for malignant ovarian germ cell tumors (MOGCT).MethodsRecords of 42 eligible female patients treated for MOGCT between 1 May 1995 and 31 December 2010 at two centers were analyzed retrospectively. A telephone questionnaire was performed to gather reproductive and menstrual history.ResultsOne patient was treated without FSCS and two patients were lost to follow‐up. The mean age of the remaining 39 patients was 18.4 ± 3.2 years. Eighteen of the tumors were histologically pure dysgerminomas (PD) and 21 were non‐dysgerminomatous tumors (non‐DT). Thirteen patients (33%) presented with stage II–III disease. Optimal cytoreduction was achieved in 34 of the 39 patients (87%). Systematic pelvic and para‐aortic lymphadenectomy was performed in 31 of the 39 patients (79.5%). The frequency of lymph node metastasis was 29% (9/31). Twenty‐seven patients (69.2%) received ACT. Disease recurred in six (15.3%) patients, all in the non‐DT group. Four of six underwent secondary optimal FSCS followed by chemotherapy. Retroperitoneal nodal recurrence was detected in two of these four patients (50%). Four deaths occurred, three due to chemoresistant aggressive disease and one due to secondary acute myelocytic leukemia. The overall survival rates for patients with PD and non‐DT were 100% and 81.4%, respectively. Twenty‐three of 27 patients who received ACT continued their regular menses. Sixteen spontaneous pregnancies and one pregnancy by intrauterine insemination were achieved by 21 patients who attempted conception.ConclusionEither primary or secondary FSCS followed by ACT seems to be a feasible and safe approach to preserving future fertility and hormonal function in young patients with MOGCT.
Value of maternal procalcitonin levels for predicting subclinical intra‐amniotic infection in preterm premature rupture of membranes
Authors: Oludag Tülay , Gode Funda , Caglayan Erkan , Saatli Bahadir , Okyay Recep Emre , Altunyurt Sabahattin 
Published: December 2013

AbstractAimTo determine whether procalcitonin (ProCT) levels can be used to predict subclinical intra‐amniotic infection by comparing maternal plasma levels in preterm premature rupture of membranes (PPROM) and premature rupture of membranes (PROM) at term with the levels in healthy pregnant women.MethodsThe mean plasma ProCT levels of 32 patients with PPROM, 35 patients with PROM at term, 24 healthy women at preterm gestation and 30 healthy women at term were compared. In the PPROM group, the presence or absence of histological chorioamnionitis and neonatal infection were used as a reference to analyze ProCT levels.ResultsThe mean ProCT level of patients in the PPROM group was significantly higher than those in the PROM group and healthy controls. Patients in the PPROM group diagnosed with histological chorioamnionitis had significantly higher ProCT levels than those of the remaining patients. At a cut‐off of 0.054 ng/mL, the sensitivity and specificity of ProCT to predict histological chorioamnionitis were 92.3% and 68.4%, respectively.ConclusionProCT levels were significantly higher in patients with PPROM, and facilitate identification of those who require expectant management.