bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practicing medicine without borders: tele‐consultations and tele‐mentoring for improving paediatric care in a conflict setting in Somalia?
Authors: Zachariah R. , Bienvenue B. , Ayada L. , Manzi M. , Maalim A. , Engy E. , Jemmy J. P. , Ibrahim Said A. , Hassan A. , Abdulrahaman F. , Abdulrahman O. , Bseiso J. , Amin H. , Michalski D. , Oberreit J. , Draguez B. , Stokes C. , Reid T. , Harries A. D. 
Published: July 2012

AbstractObjectives  In a district hospital in conflict‐torn Somalia, we assessed (i) the impact of introducing telemedicine on the quality of paediatric care, and (ii) the added value as perceived by local clinicians.Methods  A ‘real‐time’ audio‐visual exchange of information on paediatric cases (Audiosoft Technologies, Quebec, Canada) took place between clinicians in Somalia and a paediatrician in Nairobi. The study involved a retrospective analysis of programme data, and a perception study among the local clinicians.Results  Of 3920 paediatric admissions, 346 (9%) were referred for telemedicine. In 222 (64%) children, a significant change was made to initial case management, while in 88 (25%), a life‐threatening condition was detected that had been initially missed. There was a progressive improvement in the capacity of clinicians to manage complicated cases as demonstrated by a significant linear decrease in changes to initial case management for meningitis and convulsions (92–29%, P = 0.001), lower respiratory tract infection (75–45%, P = 0.02) and complicated malnutrition (86–40%, P = 0.002). Adverse outcomes (deaths and lost to follow‐up) fell from 7.6% in 2010 (without telemedicine) to 5.4% in 2011 with telemedicine (30% reduction, odds ratio 0.70, 95% CI: 0.57–0.88, P = −0.001). The number needed to be treated through telemedicine to prevent one adverse outcome was 45. All seven clinicians involved with telemedicine rated it to be of high added value.Conclusion  The introduction of telemedicine significantly improved quality of paediatric care in a remote conflict setting and was of high added value to distant clinicians.
Adoption of new HIV treatment guidelines and drug substitutions within first‐line as a measure of quality of care in rural Lesotho: health centers and hospitals compared
Authors: Labhardt Niklaus D. , Sello Motlalepula , Lejone Thabo , Ehmer Jochen , Mokhantso Mohlaba , Lynen Lutgarde , Pfeiffer Karolin 
Published: July 2012

AbstractObjective  In 2007, Lesotho launched new national antiretroviral treatment (ART) guidelines, prioritising tenofovir and zidovudine over stavudine as a backbone together with lamivudine. We compared the rate of adoption of these new guidelines and substitution of first‐line drugs by health centers (HC) and hospitals in two catchment areas in rural Lesotho.Methods  Retrospective cohort analysis. Patients aged ≥16 years were stratified into a HC‐ and a hospital‐group. Main outcome variables: Type of backbone at ART‐initiation (i), substitutions within first line (ii) and type of backbone among patients retained by December 2010 (iii). A multiple logistic regression model including HC vs. hospital, patient characteristics (sex, age, WHO‐stage, baseline CD4‐count, concurrent pregnancy, concurrent tuberculosis treatment) and year of ART‐start, was used.Results  Of 3936 adult patients initiated on ART between 2007 and 2010, 1971 started at hospitals and 1965 at HCs. Hospitals were more likely to follow the new guidelines as measured by prescription of backbones without stavudine (Odds‐ratio 1.55; 95%CI: 1.32–1.81) and had a higher rate of drug substitutions while on first‐line ART (2.39; 1.83–3.13). By December 2010, patients followed at health centres were more likely to still receive stavudine (2.28; 1.83–2.84).Conclusions  Health centers took longer to adopt the new guidelines and substituted drugs less frequently. Decentralised ART‐programmes need close support, supervision and mentoring to absorb new guidelines and to adhere to them.
Allergy to beer in LTP‐sensitized patients: beers are not all the same
Authors: Quercia O. , Zoccatelli G. , Stefanini G. F. , Mistrello G. , Amato S. , Bolla M. , Emiliani F. , Asero R. 
Published: July 2012

AbstractBackgroundMost cases of beer allergy reported so far have been associated with hypersensitivity to the non‐specific lipid transfer protein (LTP). In view of the marked differences in brewing processes we assessed IgE reactivity as well as tolerance to many different beers in an allergic patient.MethodsA 45 year‐old man hypersensitive to grass pollen, cat dander and Alternaria tenuis with a history of urticaria and dyspnoea after drinking beer and a weak skin reactivity to commercial corn extract was studied. The patient underwent SPT with 36 different brands of beer and an open challenge with those scoring negative was performed. An immunoblot analysis was carried out using 2 SPT‐positive beers, 2 SPT‐negative beers, and barley, wheat, and maize extracts using both patient's serum and a maize LTP‐specific in‐house developed polyclonal antibody from rabbit. Further, the immune reactive LTP of one beer was separated by HPLC and the chromatogram was compared to that of purified maize LTP.ResultsBeer SPT scored positive in 30/36 cases. The immunoblot analysis showed IgE reactivity at about 10 kDa against the two SPT‐positive beers and against maize with both patient's serum and the polyclonal anti‐LTP rabbit serum, whereas the two SPT‐negative beers, and barley extract scored negative. The immunodetected protein co‐migrated with maize LTP.ConclusionIn beer‐allergic patients the diagnostic workup may point to the detection of some tolerated products that can be consumed risk‐free.
Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting
Authors: Schmitt Jochen , Spuls Phyllis , Boers Maarten , Thomas Kim , Chalmers Joanne , Roekevisch Evelien , Schram Mandy , Allsopp Richard , Aoki Valeria , Apfelbacher Christian , Bruijnzeel‐Koomen Carla , Bruin‐Weller Marjolein , Charman Carolyn , Cohen Arnon , Dohil Magdalene , Flohr Carsten , Furue Masutaka , Gieler Uwe , Hooft Lotty , Humphreys Rosemary , Ishii Henrique Akira , Katayama Ichiro , Kouwenhoven Willem , Langan Sinéad , Lewis‐Jones Sue , Merhand Stephanie , Murota Hiroyuki , Murrell Dedee F. , Nankervis Helen , Ohya Yukihiro , Oranje Arnold , Otsuka Hiromi , Paul Carle , Rosenbluth Yael , Saeki Hidehisa , Schuttelaar Marie‐Louise , Stalder Jean‐Francois , Svensson Åke , Takaoka Roberto , Wahlgren Carl‐Fredrik , Weidinger Stephan , Wollenberg Andreas , Williams Hywel 
Published: July 2012

AbstractThe use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence‐based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence‐based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long‐term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research.
Co‐factor‐enhanced food allergy
Authors: Cardona V. , Luengo O. , Garriga T. , Labrador‐Horrillo M. , Sala‐Cunill A. , Izquierdo A. , Soto L. , Guilarte M. 
Published: July 2012

AbstractBackgroundAlcohol, exercise or non‐steroidal anti‐inflamatory drugs (NSAID) are frequently mentioned as amplifiers of food allergic reactions but only individual cases or small series have been previously published.MethodsDescriptive study including 74 cases of suspected co‐factor enhanced food allergy, assessed by skin‐prick tests, specific IgE and oral challenges.ResultsAnaphylaxis accounted for 85.1% of reactions. In 99% of cases culprit food allergens were plant‐derived, mainly vegetables and cereals. NSAID were involved in 58%, exercise in 52.7% and alcohol in 12.2%. Lipid transfer protein was the most frequently involved allergen.ConclusionsCo‐factor enhanced food allergy should be considered when assessing food, alcohol, exercise and NSAID allergic reactions.
The interaction between Lyn and FcεRIβ is indispensable for FcεRI‐mediated human mast cell activation
Authors: Okayama Y. , Kashiwakura J.‐I. , Matsuda A. , Sasaki‐Sakamoto T. , Nunomura S. , Yokoi N. , Ebihara N. , Kuroda K. , Ohmori K. , Saito H. , Ra C. 
Published: July 2012

AbstractBackgroundFcεRIβ reportedly functions as an amplifier of the FcεRIγ‐mediated activation signal using a reconstitution system. However, the amplification mechanisms in human mast cells (MCs) are poorly understood. We previously reported the hyperexpression of FcεRIβ of MCs in giant papillae from vernal keratoconjunctivitis patients, compared with that in conjunctivae from nonallergic conjunctivitis patients. Elucidation of the molecular mechanisms of the amplification induced by FcεRIβ should provide new targets for novel therapeutic interventions. The aim is to understand in greater details the function of FcεRIβ in human MC FcεRI expression and signaling.MethodsFcεRIβ and Lyn expression was reduced using a lentiviral shRNA silencing technique. Localization of Lyn and FcεRIβ in cultured MCs was examined by confocal microscopic analysis. Mediators were measured by ELISAs.ResultsThe diminution of FcεRIβ significantly downregulated cell surface FcεRI expression and FcεRI‐mediated mediator release/production. The downregulation of FcεRI‐mediated degranulation was not only due to the decrease in FcεRI expression. The diminution of FcεRIβ inhibited the redistribution of Lyn within the cell membrane following IgE sensitization. The diminution of Lyn in MCs significantly downregulated FcεRI‐mediated degranulation. The recombinant cell‐penetrating forms of phosphorylated FcεRIβ immunoreceptor tyrosine‐based activation motif (ITAM) for intracellular delivery disturbed the interaction between Lyn and phosphorylated endogenous FcεRIβ ITAM, resulted in inhibiting IgE‐dependent histamine release from MCs in vitro and from giant papillae specimens ex vivo.ConclusionThe interaction between Lyn and FcεRIβ is indispensable for FcεRI‐mediated human MC activation, and specific inhibition of the interaction may represent a new therapeutic strategy for the treatment of human allergic diseases.
Pulse transit time as a quick predictor of a successful axillary brachial plexus block
Authors: KORTEKAAS M. C. , NIEHOF S. P. , VAN VELZEN M. H. N. , GALVIN E. M. , HUYGEN F. J. P. M. , STOLKER R. J. 
Published: July 2012

BackgroundIt can take up to 30 min to determine whether or not axillary block has been successful. Pulse transit time (PTT) is the time between the R‐wave on electrocardiography (ECG) and the arrival of the resulting pressure pulse wave in the fingertip measured with photoplethysmography. It provides information about arterial resistance. Axillary block affects vasomotor tone causing loss of sympathetic vasoconstriction resulting in an increased PTT. Early objective assessment of a block can improve efficacy of operating room time and minimize patient's fear of possible conversion to general anesthesia. This study explores whether PTT can objectively, reliably and quickly predict a successful axillary block.MethodsForty patients undergoing hand surgery under axillary block were included. A three‐lead ECG and photoplethysmographic sensors were placed on both index fingers. Measurements were made from 2 min before until 30 min after induction of the block or less if the patient was transferred for operation. Afterwards, PTT was calculated as the time between the R‐wave on ECG and a reference point on the photoplethysmogram. To assess the change in PTT caused by the block, the PTT difference between the control and blocked arm was calculated. Sensitivity and specificity of PTT difference were calculated using receiver operating characteristic analysis.ResultsIn a successful block, the mean PTT difference significantly increased after 3 min by 12 (standard error of the mean 3.9) ms, sensitivity 87% and specificity 71% (area under the curve 0.87, P = 0.004).ConclusionsPTT is a reliable, quick and objective method to assess whether axillary block is going to be successful or not.
Temperature efficiency for dormancy release in apricot varies when applied at different amounts of chill accumulation
Authors: Campoy J. A. , Ruiz D. , Nortes M. D. , Egea J. 
Published: July 2012

AbstractOur aim was to assess the possible differential effect of increasing temperatures due to global warming on dormancy progression in apricot. The effect of a range of chilling temperatures on vegetative and reproductive bud dormancy progression in excised shoots was examined during two seasons. Temperature treatments were applied in different dormant stages to evaluate the possible interaction of date × temperature for dormancy release in apricot. During sampling, chill accumulated in the field ranged from 0 to 49 chill portions (CPs), corresponding to 0–100% of the chilling requirement (CR) of the apricot selection Z505‐2. Forcing conditions were applied after a 60‐day chill treatment on each sampling date, and rate to budbreak (1/mean time to bud break: MTB−1) was established in vegetative (terminal and lateral) and reproductive buds to determine depth of dormancy. Results showed that the stage of dormancy has a strong influence on the effect of different temperatures on dormancy progression in apricot. For the first time, a non‐linear effect of different chilling temperatures during the dormancy cycle in apricot was obtained, especially in the superior range of temperatures traditionally considered to release dormancy. Thus, introduction of this differential effect could help to improve the models to estimate dormancy release in the context of climate change.
Response pattern of amino compounds in phloem and xylem of trees to soil drought depends on drought intensity and root symbiosis
Authors: Liu X.‐P. , Gong C.‐M. , Fan Y.‐Y. , Eiblmeier M. , Zhao Z. , Han G. , Rennenberg H. 
Published: July 2012

AbstractThis study aimed to identify drought‐mediated differences in amino nitrogen (N) composition and content of xylem and phloem in trees having different symbiotic N2‐fixing bacteria. Under controlled water availability, 1‐year‐old seedlings ofRobinia pseudoacacia(nodules withRhizobium),Hippophae rhamnoides(symbiosis withFrankia) andBuddleja alternifolia(no such root symbiosis) were exposed to control, medium drought and severe drought, corresponding soil water content of 70–75%, 45–50% and 30–35% of field capacity, respectively. Composition and content of amino compounds in xylem sap and phloem exudates were analysed as a measure of N nutrition. Drought strongly reduced biomass accumulation in all species, but amino N content in xylem and phloem remained unaffected only inR. pseudoacacia. InH. rhamnoidesandB. alternifolia, amino N in phloem remained constant, but increased in xylem of both species in response to drought. There were differences in composition of amino compounds in xylem and phloem of the three species in response to drought. Proline concentrations in long‐distance transport pathways of all three species were very low, below the limit of detection in phloem ofH. rhamnoidesand in phloem and xylem ofB. alternifolia. Apparently, drought‐mediated changes in N composition were much more connected with species‐specific changes in C:N ratios. Irrespective of soil water content, the two species with root symbioses did not show similar features for the different types of symbiosis, neither in N composition nor in N content. There was no immediate correlation between symbiotic N fixation and drought‐mediated changes in amino N in the transport pathways.
Medication errors: Perspectives of newly graduated and experienced nurses
Authors: Unver Vesile , Tastan Sevinc , Akbayrak Nalan 
Published: July 2012

This study investigated the perspectives of newly graduated and experienced nurses concerning medication errors. This is a descriptive cross‐sectional study conducted in a military education and research hospital in Turkey, which was performed between July and August 2009. Totally, 169 nurses were involved in this study: 87 were new graduates and 82 were experienced nurses. The Modified Gladstone's Scale of Medication Errors was used to collect data on rates, causes and reporting of medication errors. The two highest perceived causes of medication errors were nurse exhaustion and nurse distraction. Most medication errors were preventable errors. The reasons for error occurrence and failure to inform co‐workers of medical errors were examined.Implications: Training nurses to understand the causes of medication errors and related prevention methods should be provided to newly graduated nurses, and continuous training should be provided.
Maternal ventilation and sedation for H1N1 influenza resulting in fetal bladder rupture and urinary ascites
Authors: Chaudhari Tejasvi , Robertson Meiri , Ellwood David , Simpson Erroll , Kecskes Zsuzsoka , Kent Alison L 
Published: July 2012

AbstractUrinary ascites in a newborn infant is unusual and most commonly results from bladder perforation following umbilical arterial catheterisation or obstructive uropathy. The following report describes a case of fetal bladder rupture with urinary ascites in a mother ventilated and sedated with narcotics and benzodiazepines for H1N1 influenza. This was associated with a unique biochemical profile of hyponatraemia and elevated serum urea and creatinine characteristic of urinary autodialysis in the neonate.
Can an athlete have too much ticker? Hypertrophic cardiomyopathy in young athletes
Authors: Fitzgerald Nicholas M , Sherwood Megan , Fitzgerald Dominic A 
Published: July 2012

AbstractSudden cardiac death (SCD) is an uncommon but devastating potential consequence of participation in competitive sport. It is seen in adolescent and young adult athletes. The most common cause of this, hypertrophic cardiomyopathy (HCM), is a genetic disorder responsible for more than a third of cases and is manageable. Screening is undertaken for HCM, using differing strategies in Europe and North America. Screening and early diagnosis have reduced the mortality rate but has come at a significant economic cost. The evidence and relevant arguments for and against screening are presented together with management strategies as reflected by an illustrative case.
Ecophysiology of embryo development and seed germination of the European woodland herbaceous perennial Corydalis cava (L.) Schweigg. & Körte subsp. cava (Fumariaceae)
Authors: MONDONI ANDREA , ORSENIGO SIMONE , ROSSI GRAZIANO 
Published: July 2012

AbstractIn this study we examined the germination ecology with special reference to the temperature requirements for embryo development and germination of Corydalis cava subsp. cava, under both outdoor and laboratory conditions. Corydalis cava is a spring flowering woodland tuberous geophyte widely distributed across Europe. Germination phenology, including embryo development and radicle and cotyledon emergence, was investigated in a population growing in northern Italy. Immediately after harvest, seeds of C. cava were sown both in the laboratory under simulated seasonal temperatures and naturally. Embryos, undifferentiated at the time of seed dispersal, grew during summer and autumn conditions, culminating in radicle emergence in winter, when temperatures fell to ca 5°C. Cotyledon emergence also occurred at ca 5°C, but first emergence was delayed until late winter and early spring. Laboratory experiments showed that high (summer) followed by medium (autumn) and low temperatures (winter) are needed for physiological dormancy loss, embryo development and germination respectively. Unlike seeds of C. cava that germinated in winter, in other Corydalis species radicle emergence occurred in autumn (C. flavula) or did not depend on a period of high summer temperature to break dormancy (C. solida). Our results suggest that subtle differences in dormancy and germination behavior between Corydalis species could be related to differences in their geographical distribution.
Genetic diversity and conservation ofIpomoea microdactyla(Convolvulaceae): an endemic vine from the Bahamas, Cuba, and southeastern Florida
Authors: Geiger John H. , Meerow Alan W. , Lewis Carl , Oviedo Ramona , Francisco‐Ortega Javier 
Published: July 2012

AbstractIpomoea microdactylaGriseb. (Convolvulaceae) is restricted to the Bahamian archipelago, Cuba, and southeastern Florida. The species is listed as a state endangered species in Florida, where it is mostly restricted to the hyperfragmented pine rockland of Miami‐Dade County. Using seven DNA microsatellite loci, we assessed levels of genetic diversity for 12 populations of this species from Andros Island in the Bahamas (six sites), Cuba (one site), and Florida (five sites). We found significantly greater mean numbers of alleles, and higher mean values for both observed and expected heterozygosity in populations from the continuous forest on Andros than those from the habitat fragments in Florida. It is unknown if these patterns of genetic diversity in the Florida populations are the result of habitat fragmentation or founder effects. The population from Cuba exhibited relatively high levels of genetic variation, suggesting that this island is a major center of diversity and dispersal for this species. It appears that hybrid introgression forI. carolinaalleles withinI. microdactylaindividuals occurred at a single site on Andros Island. Overall, the mean inbreeding coefficient value was 0.089, suggesting low levels of inbreeding. The highest inbreeding coefficient values were mostly recorded in Florida. Two groups were revealed, one containing the populations from Florida, and the second one encompassing those from the Bahamas and Cuba. Our results highlight the negative genetic consequences of habitat fragmentation and support initiatives recently established to establish corridors to connect the remnants of the pine forest of the Miami‐Dade County.