bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pityriasis rubra pilaris: the clinical context of acantholysis and other histologic features
Authors: Ko Christine J. , Milstone Leonard M. , Choi Jaehyuk , McNiff Jennifer M. 
Published: November 2011

AbstractBackground  Acantholysis has been described in biopsies of pityriasis rubra pilaris (PRP), but this has not been emphasized in the dermatology literature. It is helpful for dermatologists to associate acantholysis with PRP in the correct clinical setting.Objective  This study aims to further elucidate the clinical context and associated histologic features of acantholysis in PRP.Methods  Eight cases of PRP with acantholysis, 16 other cases of PRP, 26 cases of psoriasis, and 17 cases of erythroderma of different causes were studied in an academic setting.Results  The presence of acantholysis initially confounded the diagnosis in two cases of PRP. Acantholysis was focal or extensive and resembled Darier’s disease, Hailey–Hailey disease, or pemphigus vulgaris. Acantholysis was seen in biopsies from early, isolated papulosquamous lesions from the trunk as well as from erythroderma. By comparison, 26 cases of psoriasis and 17 cases of erythroderma showed only focal acantholysis in two cases of erythroderma.Conclusions  Acantholysis is a histologic feature of PRP and can serve as a histologic clue to the diagnosis of PRP before the onset of erythroderma. Eosinophils and/or a lichenoid infiltrate may also be evident.
Central centrifugal cicatricial alopecia – an approach to diagnosis and management
Authors: Summers Pamela , Kyei Angela , Bergfeld Wilma 
Published: November 2011

AbstractCentral centrifugal cicatricial alopecia (CCCA) occurs primarily in African–American women and is the most common cause of scarring hair loss in this population. Since the mid 20th century, hair care practices of African–American women have been associated with CCCA, although there is developing evidence that the etiology of CCCA may be multifactorial. Clinically diagnosing CCCA may be challenging because it can resemble female pattern hair loss, alopecia areata, lichen planopilaris, or telogen effluvium. Therapeutic options are limited, thus the goal of treatment is to prevent progression of disease because once scar formation occurs, it is irreversible.
DFNB49 is an important cause of non‐syndromic deafness in Czech Roma patients but not in the general Czech population
Authors: Šafka Brožková D , Laštůvková J , Štěpánková H , Krůtová M , Trková M , Myška P , Seeman P 
Published: November 2011

Šafka Brožková D, Laštůvková J, Štěpánková H, Krůtová M, Trková M, Myška P, Seeman P. DFNB49 is an important cause of non‐syndromic deafness in Czech Roma patients but not in the general Czech population.Due to endogamy, the Roma have a higher risk for autosomal recessive (AR) disorders. We used homozygosity mapping on single‐nucleotide polymorphism chips in one Czech Roma consanguineous family with non‐syndromic hearing loss (NSHL). The second largest homozygous region in a deaf patient was mapped to the previously reported DFNB49 region. The MARVELD2 gene was recently reported as a causal gene for NSHL DFNB49. Sequencing of the MARVELD2 gene revealed a previously reported homozygous mutation c.1331+2 T>C (IVS4 + 2 T>C) in the deaf child. Subsequently, the same mutation was found in two more Roma families from an additional 19 unrelated Czech Roma patients with deafness tested for the MARVELD2 gene. To explore the importance of MARVELD2 mutations and DFNB49 for the general Czech and Central European population with early hearing loss we also tested 40 unrelated Czech patients with AR NSHL. No pathogenic mutation in the MARVELD2 gene was found in a group of 40 Czech non‐Roma patients. Mutations in the MARVELD2 gene seem to be a significant cause of early NSHL in Czech Roma and this gene should be tested in this group of patients after GJB2.
Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia
Authors: WÆLGAARD L. , DAHL B. M. , KVARSTEIN G. , TØNNESSEN T. I. 
Published: November 2011

BackgroundThe aim of this study was to evaluate how tissue gas tensions and tissue metabolites measured in situ can detect hypoperfusion and differentiate between aerobic and anaerobic conditions during hemorrhagic shock. We hypothesized that tissue PCO2 (PtCO2) would detect hypoperfusion also under aerobic conditions and detect anaerobic metabolism concomitantly with or earlier than other markers.MethodsProspective experimental animal study with eight anesthetized pigs subjected to a continuous blood loss ∼ 8% of total blood volume per hour until death. We measured cardiac index, organ blood flows, and tissue levels of PO2, PCO2, glucose, pyruvate, lactate, and glycerol in intestine, liver, kidney, and skeletal muscle.ResultsWith reduction in blood flow to the organs under aerobic conditions, PtCO2 increased ∼ 1–4 kPa from baseline. With the onset of tissue hypoxia there was a pronounced increase of PtCO2, lactate, lactate‐pyruvate (LP) ratio, and glycerol. Tissue pH and bicarbonate decreased significantly, indicating that metabolic acid was buffered by bicarbonate to generate CO2.ConclusionModerate tissue hypoperfusion under aerobic conditions is associated with increased PtCO2, in contrast to metabolic parameters of ischemia (lactate, LP ratio, and glycerol) which remain low. From the onset of ischemia there is a much more rapid and pronounced increase in PtCO2, lactate, and LP ratio. PtCO2 can be used as a marker of hypoperfusion under both aerobic and anaerobic conditions; it gives an earlier warning of hypoperfusion than metabolic markers and increases concomitantly with or earlier than other markers at the onset of tissue anaerobiosis.
Neutrophil inhibition contributes to cardioprotection by postconditioning
Authors: GRANFELDT A. , JIANG R. , WANG N.‐P. , MYKYTENKO J. , ELDAIF S. , DENEVE J. , ZHAO Z.‐Q. , GUYTON R. A. , TØNNESEN E. , VINTEN‐JOHANSEN J. 
Published: November 2011

BackgroundPostconditioning (postcon) reduces infarct size, myocardial superoxide (•O2) generation, and neutrophil (PMN) accumulation. It is unknown whether inhibition of PMNs influence cardioprotection by postcon. The present study tested the following hypotheses: (1) myocardial salvage by postcon is modified by inhibition of PMNs and (2) postcon directly inhibits PMN •O2 generation.MethodsFor hypothesis 1, a deductive approach was used to determine infarct size in vivo with and without PMNs in rats, and for hypothesis 2, blood sampled from the anterior interventricular vein (AIV) in a canine model was used. Protocol 1: anesthetized rats, subjected to 30 min of coronary artery occlusion and 3 h of reperfusion, were randomized to control (n = 13), postcon (n = 13), PMN‐depletion: (n = 9), and postcon in PMN‐depleted rats (n = 9). Protocol 2: blood was sampled at baseline, 2 h and 24 h from the AIV, draining the area at risk (AAR) in anesthetized dogs with 60 min coronary occlusion ± postcon; whole blood was analyzed for •O2 by luminol‐enhanced chemiluminescence.ResultsPostcon and PMN depletion reduced infarct size (42.6 ± 2.1%, P < 0.05 vs. control, and 43.9 ± 3.0%, P < 0.05 vs. control, respectively) vs. control (58.8 ± 0.9%), with no further decrease with postcon in PMN‐depleted rats (37.2 ± 2.9%, P = 0.34 vs. postcon). PMN accumulation in AAR was less in postcon (21.2 ± 0.3%, P < 0.05 vs. control) and PMN‐depleted (9.4 ± 0.3%, P < 0.05 vs. control) vs. control (30.5 ± 1.2%), with a further decrease in the postcon + PMN depletion group (5.4 ± 0.6%, P < 0.05 vs. control). In dogs, •O2 release by PMNs increased at 2 h and 24 h of R, which was reduced to baseline levels by postcon.ConclusionsThese data imply PMN involvement in cardioprotection by postconditioning.
Isoflurane late preconditioning against myocardial stunning is associated with enhanced antioxidant defenses
Authors: CRYSTAL G. J. , MALIK G. , YOON S.‐H. , KIM S.‐J. 
Published: November 2011

BackgroundWe tested the hypothesis that an upregulation of antioxidant proteins [Cu‐Zn superoxide dismutase (SOD), Mn SOD, catalase, glutathione peroxidase, and glutathione peroxidase] plays a role in the delayed protection against myocardial stunning produced by isoflurane preconditioning (ISOPC). Findings were compared with late ischemic PC (IPC).MethodsFourteen mongrel dogs were chronically instrumented to measure coronary blood flow and myocardial wall thickening (WT) in conscious state. In Group 1, dogs underwent IPC, induced by a 10‐min coronary artery occlusion (CAO); after 24 h of reperfusion, they were subjected to a second 10‐min ischemia CAO‐reperfusion. In Group 2 (ISOPC), dogs inhaled one minimum alveolar concentration (MAC) ISO (1.4% in O2
) for 60 min, allowed to recover for 24 h, and then subjected to CAO ischemia‐reperfusion. Recovery of WT following the initial 10‐min CAO in Group 1 served as control response for both ISOPC and IPC. Expression and activity of antioxidant proteins were measured using Western blotting and spectrophotometric techniques, respectively.ResultsTwo to three hours of reperfusion were required for recovery of WT following either ISOPC or IPC; in contrast, without PC, WT remained markedly reduced (30% below baseline) at this time point and required more than 6 h of reperfusion for recovery. Neither IPC nor ISOPC affected expression of Cu‐Zn SOD, Mn SOD, or catalase. However, ISOPC increased activity of Mn SOD (+40%), catalase (+39%), glutathione peroxidase (+37%), and glutathione reductase (+93%) (P < 0.05); IPC had similar effects.ConclusionISOPC had powerful, delayed anti‐stunning effect that was associated with an enhancement of endogenous antioxidant defenses.
White Flank Spots Signal Feeding Dominance in Female Diamond Firetails, Stagonopleura guttata
Authors: Crowhurst Clare J. , Zanollo Valeria , Griggio Matteo , Robertson Jeremy , Kleindorfer Sonia 
Published: November 2011

AbstractPlumage colour can be used as an honest signal to convey health and status, which has traditionally been examined in the sexual selection context of choosy females and elaborate males. We use a model avian system to study the role of plumage coloration in a social context such as inter‐ and intrasexual competition over food resources. The diamond firetail (Stagonopleura guttata) is an endemic Australian finch: females have more white flank spots than males, and white spot number was correlated with cell‐mediated immune response in females. We use two experimental designs to test the role of white flank spots for feeding dominance and dominance discrimination in a group‐living bird. The results from two‐choice trials and from single‐arena trials showed that female ornamentation was consistently important in social food contests, and males consistently responded to female spot number. Females with higher spot number fed first, in trials with males and/or females. Also, females preferred to feed next to test birds with low spot number, but males showed no preference for feeding next to birds with few or many spots. Finally, latency to feed was predicted by spot number: both males and females had longer latency to feed if test birds had more spots than the focal birds. We conclude that female, but not male, ornamentation was important for inter‐ and intrasexual food competition. This is one of the very few studies to show that the same plumage ornament can have a different function between the sexes as a signal of social status. Moreover, this study shows that white plumage can be a signal of dominance.
Young mothers' lived experiences prior to becoming pregnant in rural Victoria: A phenomenological study
Authors: Roberts Sarah , Graham Melissa , Barter‐Godfrey Sarah 
Published: November 2011

AbstractObjective:  To explore the lived experiences and social context prior to becoming pregnant, of women who became mothers during adolescence in rural Victoria.Design:  Qualitative interpretive phenomenological study using semistructured interviews.Setting:  Rural community in North East Victoria, Australia.Participants:  Four rural women who gave birth to a child between the ages of 15 and 19.Results:  Five themes emerged from the data as being essential to the participants' experiences prior to pregnancy. These included feeling isolated; life change: transition into adulthood; support and understanding in sexual relationships; feeling dissatisfied; and overcoming adversity. Participants' provided practical recommendations to improve life for young people in rural areas through reflecting on their own experiences.Conclusion:  These findings highlight the complex nature of rural young women's experiences leading up to pregnancy and suggest that early motherhood might be largely reflective of the social environment in which one lives prior to pregnancy. Providing somewhere safe to go, organised and appropriate social activities and increasing access to health services were identified as being pertinent to improving experiences for rural young people prior to pregnancy. Health professionals should consider the importance of supporting young women through non‐judgemental, approachable and accessible services.
Asian migrants' lived experience and acculturation to Western health care in rural Tasmania
Authors: Terry Daniel , Ali Mohammed , Lê Quynh 
Published: November 2011

AbstractObjectives:  The study was designed to explore the lived experience of Asian migrants' health care‐seeking behaviour in Tasmania, to discern the acculturation process by which Asian migrants are enabled to use the health system and to identify strategies, which assist migrants to understand and use the health system better.Methods:  Qualitative research was adopted. Semistructured interviews were conducted with 36 Asian migrants residing in North, South and North West Tasmania, which were recruited through purposive sampling.Results:  Six main themes emerged from the interviews: the acculturation process, interactions with the health care system, access issues, culturally appropriate health care, positive health care in Tasmania and suggestions for improving health care.Conclusions:  The findings indicated that Asian migrants' views affected their health care‐seeking behaviours because of the lack of information, poor communication, limited access and choices in Tasmania. Interestingly, those married to local Tasmanians had the shortest trajectory to health system acculturation. The study recommended developing health and well‐being for Asian migrants by increasing access to information regarding navigating the health system and improving access to and awareness of language services. In addition, ensuring adequate, appropriately written, culturally specific and congruent information should be available to assist migrants' transition into a new health care system. Lastly, greater cultural awareness within the health profession to meet the needs of culturally specific individuals and communities is required when they seek care.
Performance pressure: Simulated patients and high‐stakes examinations in a regional clinical school
Authors: Harvey Pam , Radomski Natalie 
Published: November 2011

AbstractObjective:  To investigate the effects and challenges of being a simulated patient (SP) in a high‐stakes clinical examination context in a regional setting.Design:  Mixed methods, using a written survey, focus groups, and a retrospective postal survey.Setting:  A university clinical school in a Victorian regional city.Participants:  Nineteen SP volunteers (from an existing database of 55 people) who had been involved in mid‐year, summative Objective Structured Clinical Examination (OSCE) role‐play performances.Main outcome measures:  Challenges of the OSCE role‐play experience and the reported effects on SPs. The implications of these factors have an impact on the sustainability of SP programs in regional settings.Results:  Physical and emotional effects like exhaustion were reported, as well as empathy and concern for the medical students. The retrospective postal survey indicated that the SPs had no long‐term negative effects from their high‐stakes examination experiences. Participants also reported that a level of decision making and improvisation was needed in the performance of their OSCE role plays.Conclusions:  Our study reveals the complexity and demands on SPs in performing in high‐stakes clinical examinations. The results highlight that SP roles involve more than the transfer of scripted information. SPs should be considered as members of the examination team when preparing and implementing high‐stakes examinations to assist in maintaining standardised performance during and across OSCE role plays. Relationships between SPs and educational institutes need to be nurtured to ensure that the ability to continue high‐stakes OSCEs in a regional setting is maintained.
Travelling all over the countryside: Travel‐related burden and financial difficulties reported by cancer patients in New South Wales and Victoria
Authors: Zucca Alison , Boyes Allison , Newling Graham , Hall Alix , Girgis Afaf 
Published: November 2011

AbstractObjective:  To describe travel burden and travel‐related financial burden experienced by cancer patients over the first year after diagnosis.Design, setting, participants:  Population‐based longitudinal cohort of recent adult cancer patients diagnosed with the eight most incident cancers recruited from New South Wales and Victorian Cancer Registries. Self‐report survey data were collected at 6 and 12 months after diagnosis from 1410 participants (city: n = 890; regional/remote: n = 520).Main outcome measures:  Travel time to cancer treatment, living away from home for treatment, travel‐related treatment decisions, extent of financial issues, unmet need for financial help.Results:  During the first 12 months after diagnosis, outer regional/remote residents had the greatest travel burden; 61% (n = 79) travelled at least 2 hours one way to receive treatment, and 49% (n = 66) lived away from home to receive treatment. Strongest associates of travel burden were living in regional/remote areas (odds ratio (OR) = 18.9–135.7), having received surgery (OR = 6.7) or radiotherapy (OR = 3.6). Between 6 and 12 months after diagnosis, 2% (n = 24) of patients declined cancer treatment because of the time it would take to get to treatment. Patients who travelled more than 2 hours or lived away for treatment reported significantly greater financial difficulties (38%; 40%) than those who did not (12%; 14%), even after adjusting for covariates.Conclusions:  Travel burden is greatest for rural patients, and is associated with greater financial burden. Appropriate and adequate provision of travel and accommodation assistance schemes remains paramount to achieving equitable delivery of cancer services.
Factors influencing the selection of rural practice locations for early career pharmacists in Victoria
Authors: Fleming Cristen A. , Spark M. Joy 
Published: November 2011

AbstractObjective:  To identify factors influencing the choice of practice location for early career pharmacists working and living in Victoria.Design:  Survey.Setting:  Victorian pharmacies.Participants:  Pharmacists living in Victoria in April 2009, who had registered with the Pharmacy Board of Victoria after 1 October 2004, stratified into major city and rural areas.Main outcome measures:  Questionnaire responses analysed via descriptive statistics, chi‐square and direct logistic regression.Results:  Early career pharmacists were more likely to practice in a rural location if they had undertaken a rural internship, had a spouse or partner with a non‐metropolitan background and were not practicing in a hospital pharmacy. Pharmacists who had lived in a rural area during their childhood and had studied pharmacy at a rural university were four times more likely to have undertaken a rural internship than those that studied at a major city university.Conclusions:  The strongest indicator for future practice location was a pharmacist's internship location. Childhood location and pharmacy education location were indicators of internship location. Pharmacists with a rural childhood location, especially those who study at rural universities, are more likely to work in rural areas.
Urban–rural influences on suicidality: Gaps in the existing literature and recommendations for future research
Authors: Handley Tonelle E. , Inder Kerry J. , Kelly Brian J. , Attia John R. , Kay‐Lambkin Frances J. 
Published: November 2011

AbstractSuicide is a major public health issue of particular concern among rural populations, which experience a consistently higher suicide rate than urban areas. Although extensive research efforts have been directed towards understanding suicidality and related factors, there is a continued lack of clinically useful factors to target preventive measures, particularly among some regional and demographic groups. This suggests limitations in the conceptualisation of this important construct. A review of the literature was undertaken, using a snowballing and saturation approach. Literature was considered relevant if it addressed the research question ‘what are the current limitations in research on urban/rural influences on suicidality?’ Findings were used to develop a set of guidelines to inform future research. A number of gaps in existing research relevant to limitations in rural suicide research were identified: inconsistencies in terminology; a focus on high‐end suicidal behaviours; a disproportionate focus on urban populations; a dominance of cross‐sectional research; and a high use of clinical samples. These limitations are discussed in terms of their implications for rural suicidality, and are used to support the development of recommendations for future research, with a focus on encouraging consistency and standardisation. A number of limitations can be identified in existing research on suicide. Targeting these specific areas can be an important step in addressing the current gaps in knowledge relating to rural suicide prevention.
Invariant natural killer T cells in chronic obstructive pulmonary disease
Authors: CHI SU YOUNG , BAN HEE JUNG , KWON YONG SOO , OH IN JAE , KIM KYU SIK , KIM YU IL , KIM YOUNG CHUL , LIM SUNG CHUL 
Published: November 2011

ABSTRACTBackground and objective:  Invariant natural killer T (iNKT) cells may play an important role in regulating the innate and acquired immune systems in chronic obstructive pulmonary disease (COPD). However, there is little information regarding the potential role of iNKT cells in the pathogenesis of COPD. To investigate whether iNKT cells have an important role in COPD, the frequency of iNKT cells in peripheral blood of patients with COPD was analysed.Methods:  This was a comparative study of 28 patients with COPD and 19 age‐matched healthy control subjects. Blood iNKT cells were stained with 6B11 mAb, anti‐T cell receptor Vα24 mAb, anti‐T cell receptor Vβ11 mAb or α‐galactosylceramide‐loaded CD1d‐tetramer, and analysed by flow cytometry.Results:  The frequency of CD4+ 6B11+ iNKT, CD4+ Vα24+ iNKT, CD4+ Vβ11+ iNKT and CD3+ 6B11+ iNKT cells was significantly lower in peripheral blood of patients with COPD than in that of healthy control subjects. The frequency of CD4+ 6B11+ iNKT cells was significantly lower in patients with exacerbations of COPD compared with those with stable COPD.Conclusions:  The frequency of iNKT was decreased in peripheral blood of patients with COPD. These results strongly suggest that iNKT cells may play an important role in the pathogenesis of COPD.