bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postprandial triglyceride profile after a standardized oral fat load is altered in growth hormone (GH)‐deficient adult patients and is not improved after short‐term GH replacement therapy
Authors: Perotti Mario , Caumo Andrea , Brunani Amelia , Cambiaghi Nadia , Casati Marco , Scacchi Massimo , Perra Silvia , Rocco Cristina , Mancia Giuseppe , Grassi Guido , Cavagnini Francesco , Pincelli Angela Ida 
Published: April 2012

SummaryObjectiveAdult growth hormone deficiency (GHD) has detrimental effects on metabolic profile, leading to an increased cardiovascular mortality and morbidity. Above all, disturbance in postprandial triglyceride metabolism is of major concern because of the crucial role of triglyceride‐rich lipoproteins in atherogenesis. The majority of previous studies on GH replacement have shown favourable changes in the fasting lipid profile. Aim of this study is to investigate whether this beneficial effect is exerted also on postprandial triglyceride (TG) metabolism.Patients and methodsWe challenged nine GHD patients with a standardized fat loading meal at baseline and after 6 months of GH replacement therapy. Nine healthy control subjects were similarly tested under baseline conditions. Blood samples were obtained before and up to 8 h after fat loading for serum lipid analysis.ResultsWe found that GHD patients with fasting TG level in the normal range (1·29 ± 0·31 mm) had a delayed postprandial TG clearance compared to healthy controls (triglyceride level at 8 h, 3·82 ± 0·83 vs 1 ± 0·06 mm P < 0·01), and the postprandial hypertriglyceridaemia was not corrected by 6 months of GH therapy.ConclusionsThis study has shown for the first time that GHD adult patients have a higher postprandial triglyceridaemia compared to healthy controls when challenged by a standardized fat load and that this atherogenic feature is not normalized by short‐term GH treatment despite a decrease in visceral fat mass described during the replacement therapy.
Longevity and lifetime reproductive success of barn swallow offspring are predicted by their hatching date and phenotypic quality
Authors: Saino Nicola , Romano Maria , Ambrosini Roberto , Rubolini Diego , Boncoraglio Giuseppe , Caprioli Manuela , Romano Andrea 
Published: April 2012

Summary1. Longevity is a major determinant of individual differences in Darwinian fitness. Several studies have analyzed the stochastic, time‐dependent causes of variation in longevity, but little information exists from free‐ranging animal populations on the effects that environmental conditions and phenotype early in ontogeny have on duration of life.2. In this long‐term (1993–2011) study of a migratory, colonial, passerine bird, the barn swallow (Hirundo rustica), we analyzed longevity and, in a subsample of individuals, lifetime reproductive success (LRS) of the offspring that reached sexual maturity in relation to hatching date, which can affect the rearing environment through a seasonal deterioration in ecological conditions. Moreover, we analyzed the consequences of variation in body size and, for the first time in any species, of a major component of immunity on longevity, both by looking at absolute phenotypic values and at deviations from the brood mean.3. Accelerated failure time models showed that individuals of both sexes that hatched early in any breeding season enjoyed larger longevity and larger LRS, indicating directional selection for early breeding. Both male and female offspring with large T cell‐mediated immune response relative to their siblings and female nestlings that dominated the brood size/age hierarchy had larger longevity than their siblings of inferior phenotypic quality/age. Conversely, absolute phenotypic values did not predict longevity.4.Frailty modelling disclosed marked spatial heterogeneity in longevity among colonies of origin, again stressing the impact of rearing conditions on longevity.5. This study therefore reinforces the notion that perinatal environment and maternal decisions over timing and site of breeding, and position in the brood hierarchy can have marked effects on progeny life history that extend well into adulthood. In addition, it provides the first evidence from any bird population in the wild that immune response when nestlings predicts individuals’ longevity after sexual maturation.
Associations between medical school and career preferences in Year 1 medical students in Scotland
Authors: Cleland Jennifer , Johnston Peter W , French Fiona H , Needham Gillian 
Published: April 2012

Medical Education 2012: 46: 473–484Objectives  Little is known about the relationship between the career preferences of medical students and the medical schools at which they are enrolled. Our aim was to explore this relationship early in students’ medical training.Methods  Year 1 (2009–2010) medical students at the five Scottish medical schools were invited to take part in a career preference questionnaire survey. Questions were asked about demographic factors, career preferences and influencing factors.Results  The response rate was 87.9% (883/1005). No significant differences were found among medical schools with regard to first‐choice specialty. Surgery (22.5%), medicine (19.0%), general practice (17.6%) and paediatrics (16.1%) were the top career choices. Work–life balance, perceived aptitude and skills, intellectual satisfaction, and amount of patient contact were rated as the most important job‐related factors by most respondents. Few differences were found among schools in terms of the impact of job‐related factors on future career preferences. Students for whom the work–life balance was extremely important (odds ratio [OR] = 0.6) were less likely to prefer surgery. Students for whom the work–life balance (OR = 2.2) and continuity of care (OR = 2.1) were extremely important were more likely to prefer general practice.Conclusions  Students’ early career preferences were similar across the five medical schools. These preferences result from the interplay among demographic factors and the perceived characteristics of the various specialties. Maintaining a satisfactory work–life balance is very important to tomorrow’s doctors, and the data hint that this may be breaking down some of the traditional gender differences in specialty choice. Longitudinal work is required to explore whether students’ career preferences change as they progress through medical school and training.
Clinical reasoning processes: unravelling complexity through graphical representation
Authors: Charlin Bernard , Lubarsky Stuart , Millette Bernard , Crevier Françoise , Audétat Marie‐Claude , Charbonneau Anne , Caire Fon Nathalie , Hoff Lea , Bourdy Christian 
Published: April 2012

Medical Education 2012: 46: 454–463Context  Clinical reasoning is a core skill in medical practice, but remains notoriously difficult for students to grasp and teachers to nurture. To date, an accepted model that adequately captures the complexity of clinical reasoning processes does not exist. Knowledge‐modelling software such as mot Plus (Modelling using Typified Objects [MOT]) may be exploited to generate models capable of unravelling some of this complexity.Objectives  This study was designed to create a comprehensive generic model of clinical reasoning processes that is intended for use by teachers and learners, and to provide data on the validity of the model.METHODS Using a participatory action research method and the established modelling software (mot Plus), knowledge was extracted and entered into the model by a cognitician in a series of encounters with a group of experienced clinicians over more than 250 contact hours. The model was then refined through an iterative validation process involving the same group of doctors, after which other groups of clinicians were asked to solve a clinical problem involving simulated patients.Results  A hierarchical model depicting the multifaceted processes of clinical reasoning was produced. Validation rounds suggested generalisability across disciplines and situations.Conclusions  The MOT model of clinical reasoning processes has potentially important applications for use within undergraduate and graduate medical curricula to inform teaching, learning and assessment. Specifically, it could be used to support curricular development because it can help to identify opportune moments for learning specific elements of clinical reasoning. It could also be used to precisely identify and remediate reasoning errors in students, residents and practising doctors with persistent difficulties in clinical reasoning.
Residency selection: do the perceptions of US programme directors and applicants match?
Authors: Go Pauline H , Klaassen Zachary , Chamberlain Ronald S 
Published: April 2012

Medical Education 2012: 46: 491–500Objectives  This study sought to evaluate the practices and perceptions of US residency programme directors (PDs) and residency applicants with reference to the use of social media and Internet resources in the resident doctor selection process.Methods  A survey was distributed via e‐mail (SurveyMonkey®) to 2592 PDs of programmes in 22 specialties accredited by the Accreditation Council for Graduate Medical Education. A separate survey was distributed to all residency candidates applying for postgraduate year 1 (PGY1) positions at the Saint Barnabas Medical Center, Livingston, New Jersey.Results  A total of 1200 (46.3%) PDs completed the survey. Overall, 16.3% (n = 196) of respondents reported visiting Internet resources to gain more information about applicants, 38.1% (74 of 194) of whom had ranked an applicant lower as a result. American medical graduates (AMGs), US international medical graduates (USIMGs) and non‐USIMGs all felt that performance on Step 1 of the US Medical Licensing Examination (USMLE) was a critical aspect of a residency application. More AMGs than USIMGs and non‐USIMGs believed that PDs made use of social media resources when evaluating applicants and that their online profiles might influence their rankings.Conclusions  Residency candidates universally understand the importance of USMLE Step 1 scores in maintaining a competitive application. However, significant differences exist among AMGs, USIMGs and non‐USIMGs in their perceptions of the value of other applicant criteria, which may place some applicants at a disadvantage. A small but growing number of PDs currently use Internet resources to learn more about applicants and base their recruitment decisions in part on the information they encounter. At present, applicants are generally unaware of the implications their online activity may have on their selection for residency. Content guideline programmes that raise awareness of the possible impact of social media on the residency recruitment process are needed and should be delivered early in medical education.
The quorum‐sensing protein TraR of Agrobacterium tumefaciens is susceptible to intrinsic and TraM‐mediated proteolytic instability
Authors: Costa Esther D. , Chai Yunrong , Winans Stephen C. 
Published: April 2012

SummaryTraR of Agrobacterium tumefaciens is a LuxR‐type transcription factor that regulates genes required for replication and conjugation of the tumour‐inducing plasmid. TraR binds the pheromone 3‐oxo‐octanoylhomoserine lactone (OOHL) and requires this molecule for folding into a protease‐resistant, soluble conformation. Even after binding to OOHL, TraR is degraded at readily detectable rates. Here we show that the N‐terminal domain of TraR, which binds OOHL, is more resistant to degradation than the full length protein, suggesting that sites on the C‐terminal DNA binding domain [TraR(170–234)] enhance protein turnover. A fusion between GFP and TraR(170–234) was poorly fluorescent, and truncations of this fusion protein allowed us to identify residues in this domain that contribute to protein degradation. TraR activity was previously shown to be inhibited by the antiactivator TraM. These proteins form 2:2 complexes that fail to bind DNA sequences. Here we show that TraM sharply decreased the accumulation of TraR in whole cells, indicating that TraM facilitates proteolysis of TraR. The TraM component of these complexes is spared from proteolysis, and could therefore act catalytically.
Inactivation of PbTopo IIIβ causes hyper‐excision of the Pathogenicity Island HAI2 resulting in reduced virulence of Pectobacterium atrosepticum
Authors: Vanga Bhanupratap R. , Butler Ruth C. , Toth Ian K. , Ronson Clive W. , Pitman Andrew R. 
Published: April 2012

SummaryTopoisomerase III enzymes are present only in a limited set of bacteria and their physiological role remains unclear. Here, we show that PbTopo IIIβ, a homologue of topoisomerase III encoded on the chromosome of Pectobacterium atrosepticum strain SCRI1043 (Pba SCRI1043), is involved in excision of HAI2, a discrete ∼ 100 kb region, from the Pba SCRI1043 chromosome. HAI2 is a Pathogenicity Island (PAI) that encodes coronafacic acid (Cfa), a major virulence determinant required for infection of potato. PAIs are horizontally acquired genetic elements that in some instances are able to excise from the chromosome of their host cell to form a circular episome prior to transfer to a recipient bacterium. We demonstrate excision of HAI2 from the chromosome, a process that is independent of growth phase and that results in the production of a circular intermediate. Inactivation of PbTopo IIIβ causes a 103‐ to 104‐fold increase in excision, leading to reduced fitness in vitro and a decrease in the virulence of Pba SCRI1043 on potato. These results suggest that PbTopo IIIβ is required for stable maintenance of HAI2 in the chromosome of Pba SCRI1043 and may control as yet unidentified genes involved in viability and virulence of Pba SCRI1043 on potato.
Characterization of the dog lipocalin allergen Can f 6: the role in cross‐reactivity with cat and horse
Authors: Nilsson O. B. , Binnmyr J. , Zoltowska A. , Saarne T. , van Hage M. , Grönlund H. 
Published: April 2012

AbstractBackgroundAllergy to the domestic dog (Canis familiaris) affects 5–10% of the population in affluent countries. Three of four patients are allergic to more than one pet, which can only partially be explained by cross‐reactivity between serum albumins. The lipocalin protein family harbours allergens in mammalian species.MethodsWe set out to clone and characterize a novel dog allergen, and investigate its potential role in cross‐sensitization between dog, cat and horse. The gene encoding Can f 6 was amplified from dog skin and bladder cDNA libraries. The corresponding allergen was produced and purified by recombinant techniques and evaluated by SDS‐PAGE, size exclusion chromatography, circular dichroism spectra, ELISA and basophil activation test.ResultsIgE antibodies to Can f 6 were found in serum from 38% of dog‐sensitized subjects. Sequence similarities between the lipocalin allergens Can f 6, Fel d 4 (cat) and Equ c 1 (horse) suggested a probability for cross‐reactivity, which was demonstrated by competitive ELISA. The biological relevance of Can f 6 was confirmed by basophil activation test in dog‐allergic patients.ConclusionCan f 6 is a new lipocalin dog allergen that cross‐reacts with lipocalins from horse and cat. Can f 6 and homologous allergens may contribute to multisensitization and symptoms in individuals allergic to mammals.
Coloration signals the ability to cope with elevated stress hormones: effects of corticosterone on growth of barn owls are associated with melanism
Authors: ALMASI B. , ROULIN A. , KORNER‐NIEVERGELT F. , JENNI‐EIERMANN S. , JENNI L. 
Published: April 2012

AbstractStressful situations during development can shape the phenotype for life by provoking a trade‐off between development and survival. Stress hormones, mainly glucocorticoids, play an important orchestrating role in this trade‐off. Hence, how stress sensitive an animal is critically determines the phenotype and ultimately fitness. In several species, darker eumelanic individuals are less sensitive to stressful conditions than less eumelanic conspecifics, which may be due to the pleiotropic effects of genes affecting both coloration and physiological traits. We experimentally tested whether the degree of melanin‐based coloration is associated with the sensitivity to an endocrine response to stressful situations in the barn owl. We artificially administered the mediator of a hormonal stress response, corticosterone, to nestlings to examine the prediction that corticosterone‐induced reduction in growth rate is more pronounced in light eumelanic nestlings than in darker nest mates. To examine whether such an effect may be genetically determined, we swapped hatchlings between randomly chosen pairs of nests. We first showed that corticosterone affects growth and, thus, shapes the phenotype. Second, we found that under corticosterone administration, nestlings with large black spots grew better than nestlings with small black spots. As in the barn owl the expression of eumelanin‐based coloration is heritable and not sensitive to environmental conditions, it is therefore a reliable, genetically based sign of the ability to cope with an increase in blood corticosterone level.
Transfusion‐related mortality after primary hip arthroplasty – an analysis of mechanisms and confounders
Authors: Jans Ø. , Kehlet H. , Johansson P. I. 
Published: April 2012

Background and Objectives  Bleeding and postoperative anaemia after total hip arthroplasty (THA) may trigger transfusion of red blood cells (RBC). However, large observational studies have reported associations between RBC transfusion and increased postoperative morbidity and mortality. As major bleeding or severe postoperative anaemia is intrinsically linked with RBC transfusion, direct causality between transfusion and adverse outcomes remains unclear. This study aimed to identify possible relations between RBC transfusion, severe bleeding or anaemia and mortality in all patients who died < 90 days after THA in Denmark in 2008.Materials and Methods  Nationwide review of patient records. Cases of adverse transfusion events, infections following transfusion, severe perioperative bleeding or anaemia and possible causal relations to mortality were identified by two independent reviewers.Results  Of 6932 THA patients, 45 (0·6%) were transfused within 30 days and died < 90 days from surgery. Three patients (7%) died from causes possibly related to either severe anaemia, major bleeding alone or major bleeding with transfusion‐related acute lung injury, while five (11%) died from infections occurring after RBC transfusion. Mortality in the remaining 37 patients (82%) was of unknown cause (nine patients) or related to patient or surgical factors (28 patients).Conclusion  Transfusion‐related mortality after THA included cases of major perioperative bleeding or severe postoperative anaemia with delayed RBC transfusion in addition to possible complications to RBC transfusion per se. Future studies should account for pretransfusion haemoglobin and perioperative blood loss when evaluating RBC transfusion‐associated outcomes after surgery.
Association of 3D Reconstruction and Conventional Radiography for the Description of the Appendicular Skeleton of Chelonoidis carbonaria (Spix, 1824)
Authors: Bortolini Z. , Lehmkuhl R. C. , Ozeki L. M. , Tranquilim M. V. , Sesoko N. F. , Teixeira C. R. , Vulcano L. C. 
Published: April 2012

SummaryIn this study, we associated imaging modalities, such as computed tomography (CT) and standard radiography, with anatomical specimens to describe the anatomy of the appendicular skeleton of red‐footed tortoises (Chelonoidis carbonaria), using animals of different sizes, ages, sexes and weights. Manus and pes bones were described from conventional radiography and osteological specimens, because they have small structures that could not be reconstructed. The main anatomical feature that differentiates C. carbonaria from others Testudines is the ischial‐pubic tuberculum. The pectoral girdle is formed by the union of two bones, the scapula and the coracoid, showing no bone connection with the shell. Carpal and tarsal bones can be fused or not and include: carporadial and central carpus, carpoulnar and V carpal, central tarsal and fibular tarsal, distal tarsal I and II. The phalangeal formula is 2:2:2:2:2 in the forelimb and 2:2:2:2:1 in the hind limb. Imaging examinations are important tools in anatomical description and can be used in living individuals, replacing or aiding the study with anatomical specimens.
Patch testing is an effective method for the diagnosis of carbamazepine‐induced drug reaction, eosinophilia and systemic symptoms (DRESS) syndrome in an 8‐year‐old girl
Authors: Buyuktiryaki Ayse Betul , Bezirganoglu Handan , Sahiner Umit Murat , Yavuz Suleyman Tolga , Tuncer Ayfer , Kara Ates , Sackesen Cansin 
Published: April 2012

ABSTRACTDrug reaction, eosinophilia and systemic symptoms (DRESS) is an acute and life‐threatening disease, characterised by fever, rash and systemic symptoms, including lymphadenopathy, abnormal liver function, interstitial nephritis, pulmonary and cardiac infiltrates and haematological abnormalities with eosinophilia and atypical lymphocytes. The drugs mostly associated with DRESS are anticonvulsants, allopurinol, minocycline and sulfonamides. This syndrome is rarely seen in childhood even though a large number of children have anticonvulsant treatment. An 8‐year‐old girl was admitted with fever, lymphadenopathy and skin eruptions on her trunk. Her medical history was notable for epilepsy and carbamazepine treatment had been started 5 weeks previously. Laboratory studies showed a white cell count of 6200/µL (normal, 4100–11 200/µL) with 22% eosinophils and a γ‐glutamyl transpeptidase level of 296 U/L (normal, 0–23 U/L). Laboratory tests for infections and collagen diseases were in the normal range. Persistence of fever and maculopapular eruption with generalised desquamation and the appearance of cheilitis and facial angioedema suggested a hypersensitivity reaction to carbamazepine. The carbamazepine was replaced with levetiracetam. All clinical symptoms improved within a week with corticosteroids and antihistamine treatment. Six weeks after complete recovery an epicutaneous patch test with carbamazepine was performed and a carbamazepine‐induced positive skin reaction was observed at 48‐h. Carbamazepine‐induced DRESS syndrome is a rare entity in children. An epicutaneous patch test is a useful tool for identifying the inducing agent for the DRESS syndrome and for identifying a safe anticonvulsant drug.