bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new perspective on blame culture: an experimental study
Authors: Gorini Alessandra , Miglioretti Massimo , Pravettoni Gabriella 
Published: March 2012

AbstractObjectives  Recently, a range of different institutions worldwide has identified the ‘culture of blame’ and the fear of being punished as the principal reasons for the lack of medical error reporting and, consequently, of their reiteration and of the poor quality of patient care. Despite much theoretical debate, there currently exist no experimental studies that directly investigate the presence and pervasiveness of the blame and punishment culture in health care contexts. In order to document empirical evidence for this culture in medicine and nursing, we conducted an experimental study asking physicians and nurses to express their fear of blame or punishment in the context of having made an error that would cause: (i) no; (ii) mild; (iii) severe consequences; or (iv) the death of the patient.Methods  Two hundred and forty‐nine health care providers (38 physicians, 11 medical students, 127 nurses and 73 nursing students) were included in the study. Two main data emerged: first, in general, the fear of being blamed is higher than the fear of being punished. Second, while the fear of being blamed is equally distributed among all participants, the fear of being punished varies according to the experience of subjects (it is higher in nursing students than in seniors nurses) and to their professional role (student and senior nurses are more susceptible to it than medical students and senior physicians).Conclusion  Given the relevance of these factors in medical error reporting and the evidence that they are so deep‐seated not only in senior professionals, but also in students, we argue that an educational approach, together with an organization‐based intervention, is desirable to shape cultural attitudes of health care providers in the direction of a ‘safety culture’.
Analysis of subtelomeric virulence gene families in Plasmodium falciparum by comparative transcriptional profiling
Authors: Witmer Kathrin , Schmid Christoph D. , Brancucci Nicolas M. B. , Luah Yen‐Hoon , Preiser Peter R. , Bozdech Zbynek , Voss Till S. 
Published: March 2012

SummaryThe Plasmodium falciparum genome is equipped with several subtelomeric gene families that are implicated in parasite virulence and immune evasion. Members of these families are uniformly positioned within heterochromatic domains and are thus subject to variegated expression. The best‐studied example is that of the var family encoding the major parasite virulence factor P. falciparum erythrocyte membrane protein 1 (PfEMP1). PfEMP1 undergoes antigenic variation through switches in mutually exclusive var gene transcription. var promoters function as crucial regulatory elements in the underlying epigenetic control strategy. Here, we analysed promoters of upsA, upsB and upsC var, rifA1‐type rif, stevor, phist and pfmc‐2tm genes and investigated their role in endogenous gene transcription by comparative genome‐wide expression profiling of transgenic parasite lines. We find that the three major var promoter types are functionally equal and play an essential role in singular gene choice. Unlike var promoters, promoters of non‐var families are not silenced by default, and transcription of non‐var families is not subject to the same mode of mutually exclusive transcription as has been observed for var genes. Our findings identified a differential logic in the regulation of var and other subtelomeric virulence gene families, which will have important implications for our understanding and future analyses of phenotypic variation in malaria parasites.
The toxin/immunity network of Burkholderia pseudomallei contact‐dependent growth inhibition (CDI) systems
Authors: Nikolakakis Kiel , Amber Saba , Wilbur J. Scott , Diner Elie J. , Aoki Stephanie K. , Poole Stephen J. , Tuanyok Apichai , Keim Paul S. , Peacock Sharon , Hayes Christopher S. , Low David A. 
Published: March 2012

SummaryBurkholderia pseudomallei is a category B pathogen and the causative agent of melioidosis – a serious infectious disease that is typically acquired directly from environmental reservoirs. Nearly all B. pseudomallei strains sequenced to date (> 85 isolates) contain gene clusters that are related to the contact‐dependent growth inhibition (CDI) systems of γ‐proteobacteria. CDI systems from Escherichia coli and Dickeya dadantii play significant roles in bacterial competition, suggesting these systems may also contribute to the competitive fitness of B. pseudomallei. Here, we identify 10 distinct CDI systems in B. pseudomallei based on polymorphisms within the cdiA‐CT/cdiI coding regions, which are predicted to encode CdiA‐CT/CdiI toxin/immunity protein pairs. Biochemical analysis of three B. pseudomallei CdiA‐CTs revealed that each protein possesses a distinct tRNase activity capable of inhibiting cell growth. These toxin activities are blocked by cognate CdiI immunity proteins, which specifically bind the CdiA‐CT and protect cells from growth inhibition. Using Burkholderia thailandensis E264 as a model, we show that a CDI system from B. pseudomallei 1026b mediates CDI and is capable of delivering CdiA‐CT toxins derived from other B. pseudomallei strains. These results demonstrate that Burkholderia species contain functional CDI systems, which may confer a competitive advantage to these bacteria.
Loss of FlhE in the flagellar Type III secretion system allows proton influx into Salmonella and Escherichia coli
Authors: Lee Jaemin , Harshey Rasika M. 
Published: March 2012

SummaryflhE belongs to the flhBAE flagellar operon in Enterobacteria, whose first two members function in Type III secretion (T3S). In Salmonella enterica, absence of FlhE affects swarming, but not swimming, motility. Based on a chance observation of a ‘green’ colony phenotype of flhE mutants on pH indicator plates containing glucose, we have established that this phenotype is associated with lysis of flagellated cells in an acidic environment created by glucose metabolism. The flhE mutant phenotype of Escherichia coli is similar overall to that of S. enterica but is seen in the absence of glucose and, unlike in S. enterica, causes a substantial growth defect. flhE mutants have a lowered cytoplasmic pH in both bacteria, indicative of a proton leak. GFP reporter assays indicate that the leak is dependent on the flagellar system, is present before the T3S system switches to secretion of late substrates, and gets worse after the switch and upon filament assembly, leading to cell lysis. We show that FlhE is a periplasmic protein that co‐purifies with flagellar basal bodies. FlhE may act as a plug or a chaperone to regulate proton flow through the flagellar T3S system.
Effects of aging on cholinergic neuromuscular transmission in isolated small intestine of ad libitum fed and calorically‐restricted rats
Authors: Hoyle C. H. V. , Saffrey M. J. 
Published: March 2012

AbstractBackground  Age‐associated losses of enteric neurons have been described. In rat ileum, myenteric neurons lost during aging have been reported to be predominantly cholinergic, and caloric restriction (CR) has been shown to protect against these losses. Cholinergic myenteric neurons include excitatory motor neurons, so the aim of this work was to determine whether neuronal loss in ad libitum (AL)‐fed animals is reflected in dysfunctional cholinergic neuromuscular transmission, and if CR reduces any such dysfunction.Methods  Effects of electrical field stimulation (EFS) and applied acetylcholine (ACh) were examined in the longitudinal muscle of isolated ileal segments from 6‐month‐old rats and from 13‐ and 24‐month‐old rats fed either AL or CR diets.Key Results  Contractile responses to EFS were abolished by atropine and potentiated by the acetylcholinesterase inhibitor, eserine. Frequency‐response relationships were not significantly different amongst the three age‐groups. Sensitivity to applied ACh, however, was three‐fold lower in the oldest animals (P < 0.05). Eserine potentiated responses to ACh; there were no statistically significant differences amongst the sensitivities to ACh in its presence. No significant differences between AL‐ and CR‐fed animals were measured, although variability was less in CR‐fed than in AL‐fed groups.Conclusions & Inferences  The cholinergic system supplying the rat ileum longitudinal muscle did not appear to be impaired in old age. Decreased sensitivity to applied ACh in old tissues may have been due to increased acetylcholinesterase activity. Caloric restriction had no significant effect on responses to EFS or applied ACh. The implications of these results are discussed.
Progressive cribriform and zosteriform hyperpigmentation: a clinicopathologic study
Authors: Cho Eujin , Cho Sang Hyun , Lee Jeong Deuk 
Published: March 2012

AbstractBackground Progressive cribriform and zosteriform hyperpigmentation (PCZH) is a disorder of pigmentation. Although several cases of PCZH have been reported, no clinicopathologic studies of the condition have been published in the English‐language literature.Objectives The purpose of this study was to determine the clinical characteristics and histologic findings of PCZH.Methods Between 1999 and 2009, 30 patients were diagnosed with PCZH in our Department of Dermatology. Medical records, clinical photographs, and pathologic findings for each patient were retrospectively reviewed.Results The patients included 16 men and 14 women. The mean age at onset was 14.27 years. The trunk was the most common site of involvement. Microscopic examination showed an increased level of melanin pigment in the basal cell layer compared with adjacent normal skin, although no significant difference existed in the number of melanocytes. Pigmentary incontinence was observed in 13 of 30 cases.Conclusions There was no significant difference in prevalence, age at onset, and duration of lesions between male and female patients with PCZH. The lesions corresponded to the lines of Blaschko and were localized rather than exhibiting diffuse patterns. A common feature of the histopathologic findings was higher melanin content in the lesions than in normal skin but with no significant difference in the number of melanocytes.
Self‐medication and adherence to treatment in psoriasis
Authors: Kivelevitch Dario Nicolas , Tahhan Paula Valeria , Bourren Paula , Kogan Nora Noemi , Gusis Simon Eduardo , Rodríguez Eduardo Adolfo 
Published: March 2012

AbstractBackground Self‐medication and non‐adherence to treatment are very common practice. This often implies bad results for the patients, as well as for the physicians. Several studies suggest that up to 30–40% of the population is non‐adherent to treatments. This problem generates 5% of all hospitalizations, having caused about 45,000 deaths in 2007 in Argentina.Materials and methods A 21‐question survey was carried out among 176 patients with psoriasis in the Psoriasis Center at the Fernandez Hospital in Buenos Aires, Argentina.Results Seventy‐seven percent of the patients were non‐adherent to treatment, and 33% were self‐medicated. The two groups combined accounted for 82% of the population studied. We found no significant differences among the variables studied in either the non‐adherence or the combined group, although males comprised 67% and females 33% of the self‐medicated group, and that difference was statistically significant (P < 0.025).Conclusions Self‐care is a very complex behavior to be explained by a single cause, which clearly makes it a multifactorial problem. In our view, patient education, the physician–patient relationship, and availability of more effective therapeutic options would be significant factors in modifying a deep‐rooted behavior pattern.
Evaluation of a newly‐developed immunochromatography strip test for diagnosing dermatophytosis
Authors: Higashi Yuko , Miyoshi Hayao , Takeda Koichiro , Saruwatari Hiroshi , Kubo Hidemichi , Sakaguchi Ikuyo , Iwata Masahiro , Uchida Youhei , Tada Koichi , Miyamoto Masahiro , Wakamoto Hiroaki , Takasaki Shinichi , Ishida Hisaya , Noriki Sakon , Kanekura Takuro 
Published: March 2012

AbstractBackground  Traditionally, dermatophytosis, a common disease affecting millions of people world‐wide, has been diagnosed by direct microscopy and fungal culture. The immunochromatography (ICG) strip test was recently developed.Methods  We compared the performance of the ICG strip test for the detection of dermatophytes in samples from human skin and nails with direct microscopy. The 160 samples, consisting of 88 skin and 72 nail specimens, were subjected to direct microscopy study using a 20% KOH solution and to examination with the ICG strip test. Of 160 samples, 18 were examined by fungal culture using Sabouraud dextrose agar medium.Results  We found that the overall sensitivity and specificity of the ICG test were 83.5% and 66.7%; they were 82.1% and 76.2% for the 88 skin and 85.4% and 58.3% for the 72 nail specimens, respectively.Conclusions  Our findings indicate that the efficacy of the ICG test is comparable to direct microscopy for the detection of dermatophytes. Performance of the assay was easy, and results were available quickly. We suggest that it is an effective tool for dermatophytosis screening.
Amelanotic melanomas presenting as red skin lesions: a diagnostic challenge with potentially lethal consequences
Authors: McClain Susannah E. , Mayo Kira B. , Shada Amber L. , Smolkin Mark E. , Patterson James W. , Slingluff Craig L. 
Published: March 2012

AbstractObjective To characterize epidemiologic and clinical features of red primary amelanotic melanomas, an atypical presentation of melanoma that is underemphasized in patient and physician education.Patients and methods Review of a prospectively collected melanoma database identified 46 patients with red amelanotic melanomas, whose clinical features were compared with 329 patients with pigmented melanomas from the same database and same timeframe from January 1964 to September 2005.Results Red amelanotic melanomas represented 3.9% of all melanomas recorded in our database and accounted for nearly 70% of amelanotic melanomas. Melanoma was included in the clinical differential diagnosis in 32% of red amelanotic melanomas vs. 94% of pigmented melanomas (P < 0.001). Red amelanotic melanomas more commonly underwent shave biopsy (55 vs. 12%, P < 0.001) and more likely had positive deep margins (35 vs. 9%, P < 0.001) but had comparable risks of metastasis and mortality.Conclusion Red amelanotic melanomas are often misdiagnosed clinically but carry a mortality risk comparable to pigmented melanomas. Clinicians screening for melanoma should be more vigilant in considering melanoma in the differential diagnosis of red skin lesions.
Characterization of TGM1 c.984+1G>A mutation identified in a homozygous carrier of lamellar ichthyosis
Authors: Fachal Laura , Rodríguez‐Pazos Laura , Ginarte Manuel , Beiras Andrés , Suárez‐Peñaranda José M. , Toribio Jaime , Carracedo Ángel , Vega Ana 
Published: March 2012

AbstractBackground  Autosomal recessive congenital ichthyosis (ARCI) is a rare, nonsyndromic, heterogeneous disorder of cornification. It is divided into three clinical subtypes: lamellar ichthyosis (LI); congenital ichthyosiform erythroderma; and harlequin ichthyosis. In the majority of patients, LI is caused by transglutaminase‐1 (TGase1) deficiency resulting from mutations in both copies of the transglutaminase 1 (TGM1) gene in chromosome 14.Case report  We report a patient with a severe LI phenotype who has a homozygous putative splicing mutation in the TGM1 gene. Our aim is to assess the pathologic effect of the TGM1 c.984+1G>A by splicing assays and bioinformatic tools.Results  c.984+1G>A mutation created two alternative TGM1 mRNA splice variants that included 30 or 32 nucleotides of the 5′ of intron 6. At the protein level, the partial in‐frame aberrant transcript retaining 30 bp of intron 6 led to the insertion of 10 amino acids (p.Met329_Val330ins10) at the catalytic core domain of TGM1 protein (codons 247–572), whereas the transcript with the insertion of 32 nucleotides is predicted to encode a truncated protein (p.Val330MetfsX12).Conclusion  Our splicing assay, together with bioinformatic prediction tools, supports the pathological effect of the recently identified c.984+1G>A mutation in the TGM1 gene and unravels the molecular mechanism by which c.984+1G>A acts.
Use of intense pulse light for acne vulgaris in Indian skin – a case series
Authors: Mohanan Saritha , Parveen Basheerahmed , Annie Malathy Priyavathani , Gomathi Nellainayagam 
Published: March 2012

AbstractBackground  Intense pulse light (IPL) has become extremely popular in Indian cosmetology circles. Yet, literature is silent on its effect in heavily melanized skin.Objective  A descriptive study to gauge the effect of IPL on acne vulgaris in Indian patients done in a tertiary care center in south India.Materials and methods  Patients with moderate to severe acne vulgaris were given a maximum of five sittings of IPL treatment. Lesion counts were performed and photographs compared before and after treatment.Results  IPL was offered to 10 patients with acne vulgaris. Two patients dropped out, seven patients had a good response after a mean of 3.4 sittings; 87.5% patients expressed satisfaction with the procedure. No adverse effects were noted.Conclusion  IPL serves a useful role in the treatment of acne vulgaris and could reduce treatment costs and pill burden. There is no increased risk of side effects with IPL on Indian skin with standard care.
Randomized, double‐blind trial of 220 mg zinc sulfate twice daily in the treatment of rosacea
Authors: Bamford Joel T. M. , Gessert Charles E. , Haller Irina V. , Kruger Kim , Johnson Brian P. 
Published: March 2012

AbstractA 2006 article published in the International Journal of Dermatology reported that oral zinc sulfate 100 mg three times daily was associated with improvement in the severity of facial rosacea (Sharquie et al. 2006; 45: 857–861). The current study was undertaken to further assess the role of zinc in the management of rosacea. This was a randomized, double‐blind trial of 220 mg of zinc sulfate twice daily for 90 days in patients with moderately severe facial rosacea at baseline. Subjects were recruited in the Upper Midwest USA between August 2006 and April 2008, and followed until July 2008. Forty‐four subjects completed the trial (22 in each arm). Rosacea improved in both groups. There were no differences in magnitude of improvement based on rosacea severity scores between subjects receiving zinc sulfate and subjects receiving placebo (P = 0.284). Serum zinc levels were higher in subjects receiving zinc (P < 0.001). Oral zinc sulfate was not associated with greater improvement in rosacea severity compared with placebo in this study. Additional studies are needed to determine what role oral zinc may have in the management of rosacea.
Tryptase and histamine metabolites as diagnostic indicators of indolent systemic mastocytosis without skin lesions
Authors: van Doormaal J. J. , van der Veer E. , van Voorst Vader P. C. , Kluin P. M. , Mulder A. B. , van der Heide S. , Arends S. , Kluin‐Nelemans J. C. , Oude Elberink J. N. G. , de Monchy J. G. R. 
Published: March 2012

AbstractBackgroundRisk indicators of indolent systemic mastocytosis (ISM) in adults with clinical suspicion of ISM without accompanying skin lesions [urticaria pigmentosa (UP)] are lacking. This study aimed at creating a decision tree using clinical characteristics, serum tryptase, and the urinary histamine metabolites methylimidazole acetic acid (MIMA) and methylhistamine (MH) to select patients for bone marrow investigations to diagnose ISM.MethodsRetrospective data analysis of all adults, in whom bone marrow investigations were performed to diagnose ISM, was carried out.ResultsIn total, 142 patients were included. SM was absent in all 44 patients with tryptase <10 μg/l, in 45 of 98 (46%) patients with tryptase ≥10 μg/l and in 18 of 52 patients (35%) with tryptase >20 μg/l. Above 43 μg/l, all patients had ISM (n = 11). Male gender, insect venom anaphylaxis as presenting symptom, tryptase, MIMA, and MH were independent ISM predictors. If tryptase was ≥10 μg/l, the diagnostic accuracy of MIMA and MH was high (areas under the ROC curve 0.92).ConclusionsIn suspected patients without UP, the ISM risk is very low (if present at all) if tryptase is <10 μg/l. If tryptase is ≥10 μg/l, this risk depends on MIMA and MH, being low if these are normal, but high if these are elevated. Male gender and insect venom anaphylaxis are additional risk indicators. We recommend refraining from bone marrow examinations in suspected patients without UP if tryptase is <10 μg/l. Our results question the reliability of the minor diagnostic World Health Organization criterion of tryptase >20 μg/l.
The outcome after severe bronchiolitis is related to gender and virus
Authors: Mikalsen Ingvild B. , Halvorsen Thomas , Øymar Knut 
Published: March 2012

To cite this article: Mikalsen IB, Halvorsen T, Øymar K. The outcome after severe bronchiolitis is related to gender and virus. Pediatric Allergy Immunology 2012: 23: 391–398.AbstractThe association between bronchiolitis in the first year of life and subsequent asthma, atopy, airway obstruction and bronchial hyper‐responsiveness (BHR) is unsettled. Genetic predispositions, pre‐morbid lung function, environmental interactions and altered immunological responses are risk factors that have been studied. The aim of this study was to assess lung function, BHR and the occurrence of asthma and atopy 11 yr after hospitalization for bronchiolitis in the first year of life, particularly focusing on the role of gender and virus involved. The study included 121 of 131 (92%) children hospitalized for bronchiolitis, 90 (74%) respiratory syncytial virus (RSV)–positive children and 141 children in an age‐matched and unselected control group. At follow‐up, current asthma was more common after RSV‐negative bronchiolitis compared to controls (35.5% vs. 9.2%; p < 0.001), but not after RSV bronchiolitis (15.6%; p = 0.144). Higher BHR and an obstructive lung function pattern were observed after bronchiolitis, the latter most prominent after RSV‐negative bronchiolitis. Higher BHR was confined to boys, but present in both the RSV‐positive and RSV‐negative groups (p = 0.007 and 0.003, respectively). Asthma after bronchiolitis was not associated with atopy. Atopy was similarly distributed between the RSV‐positive and RSV‐negative bronchiolitis groups and the control group. This study has shown that gender and type of virus are important factors to consider when addressing later development of asthma, BHR and lung function after hospitalization for bronchiolitis in early life.
Study of compliance with a new, targeted antenatal D immunization prevention programme in Denmark
Authors: Damkjær M. B. , Perslev A. , Clausen F. B. , Dziegiel M. H. , Jørgensen F. S. 
Published: March 2012

Background and Objectives  A targeted routine antenatal anti‐D prophylaxis programme was implemented in Denmark where anti‐D immunoglobulin is given based on the result from noninvasive antenatal screening for fetal RHD. Our objective was to evaluate compliance with this new programme right after its initiation.Materials and Methods  We examined the treatment outcome of 239 D‐negative pregnant women who gave birth at our hospital between June and September 2010.Results  The majority of these women (90%) underwent antenatal RHD screening, 86% of the women who were recommended antenatal prophylaxis received anti‐D, and 99% of the women who delivered RhD‐positive infants received postnatal anti‐D.Conclusion  These compliance results are acceptable as they were obtained only a few months after the initiation of the new prophylaxis regime. However, suggestions to further improve compliance are presented.