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[PMID]: 29506469
[Au] Autor:Goyal RK; Tulpan D; Chomistek N; González-Peña Fundora D; West C; Ellis BE; Frick M; Laroche A; Foroud NA
[Ad] Address:Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, 5403 - 1st Avenue South, Lethbridge, Alberta, T1J 4B1, Canada.
[Ti] Title:Analysis of MAPK and MAPKK gene families in wheat and related Triticeae species.
[So] Source:BMC Genomics;19(1):178, 2018 Mar 05.
[Is] ISSN:1471-2164
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The mitogen-activated protein kinase (MAPK) family is involved in signal transduction networks that underpin many different biological processes in plants, ranging from development to biotic and abiotic stress responses. To date this class of enzymes has received little attention in Triticeae species, which include important cereal crops (wheat, barley, rye and triticale) that represent over 20% of the total protein food-source worldwide. RESULTS: The work presented here focuses on two subfamilies of Triticeae MAPKs, the MAP kinases (MPKs), and the MAPK kinases (MKKs) whose members phosphorylate the MPKs. In silico analysis of multiple Triticeae sequence databases led to the identification of 152 MAPKs belonging to these two sub-families. Some previously identified MAPKs were renamed to reflect the literature consensus on MAPK nomenclature. Two novel MPKs, MPK24 and MPK25, have been identified, including the first example of a plant MPK carrying the TGY activation loop sequence common to mammalian p38 MPKs. An EF-hand calcium-binding domain was found in members of the Triticeae MPK17 clade, a feature that appears to be specific to Triticeae species. New insights into the novel MEY activation loop identified in MPK11s are offered. When the exon-intron patterns for some MPKs and MKKs of wheat, barley and ancestors of wheat were assembled based on transcript data in GenBank, they showed deviations from the same sequence predicted in Ensembl. The functional relevance of MAPKs as derived from patterns of gene expression, MPK activation and MKK-MPK interaction is discussed. CONCLUSIONS: A comprehensive resource of accurately annotated and curated Triticeae MPK and MKK sequences has been created for wheat, barley, rye, triticale, and two ancestral wheat species, goat grass and red wild einkorn. The work we present here offers a central information resource that will resolve existing confusion in the literature and sustain expansion of MAPK research in the crucial Triticeae grains.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1186/s12864-018-4545-9

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[PMID]: 29523611
[Au] Autor:Triplett KE; Murray R; Anstey M
[Ad] Address:Intensive Care, Sir Charles Gairdner Hospital, Nedlands, Australia.
[Ti] Title:Multifactorial non-cirrhotic hyperammonaemic encephalopathy.
[So] Source:BMJ Case Rep;2018, 2018 Mar 09.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient's history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract infection and bacteraemia with The patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia with , a urease-producing bacteria, and also valproate use, a medication known to interfere with ammonia elimination. The patient's treatment included supportive care, ceasing valproate, empiric then rationalised antibiotics, N-acetylcysteine and L-carnitine. We present a case of non-cirrhotic hyperammonaemic encephalopathy and explain why it is multifactorial in origin.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process

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[PMID]: 29523567
[Au] Autor:Stevenson J; Tong A; Campbell KL; Craig JC; Lee VW
[Ad] Address:Westmead Clinical School, The University of Sydney, Sydney, Australia.
[Ti] Title:Perspectives of healthcare providers on the nutritional management of patients on haemodialysis in Australia: an interview study.
[So] Source:BMJ Open;8(3):e020023, 2018 Mar 08.
[Is] ISSN:2044-6055
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To describe the perspectives of healthcare providers on the nutritional management of patients on haemodialysis, which may inform strategies for improving patient-centred nutritional care. DESIGN: Face-to-face semistructured interviews were conducted until data saturation, and thematic analysis based on principles of grounded theory. SETTING: 21 haemodialysis centres across Australia. PARTICIPANTS: 42 haemodialysis clinicians (nephrologists and nephrology trainees (15), nurses (12) and dietitians (15)) were purposively sampled to obtain a range of demographic characteristics and clinical experiences. RESULTS: Six themes were identified: responding to changing clinical status (individualising strategies to patient needs, prioritising acute events, adapting guidelines), integrating patient circumstances (assimilating life priorities, access and affordability), delineating specialty roles in collaborative structures (shared and cohesive care, pivotal role of dietary expertise, facilitating access to nutritional care, perpetuating conflicting advice and patient confusion, devaluing nutritional specialty), empowerment for behaviour change (enabling comprehension of complexities, building autonomy and ownership, developing self-efficacy through engagement, tailoring self-management strategies), initiating and sustaining motivation (encountering motivational hurdles, empathy for confronting life changes, fostering non-judgemental relationships, emphasising symptomatic and tangible benefits, harnessing support networks), and organisational and staffing barriers (staffing shortfalls, readdressing system inefficiencies). CONCLUSIONS: Organisational support with collaborative multidisciplinary teams and individualised patient care were seen as necessary for developing positive patient-clinician relationships, delivering consistent nutrition advice, and building and sustaining patient motivation to enable change in dietary behaviour. Improving service delivery and developing and delivering targeted, multifaceted self-management interventions may enhance current nutritional management of patients on haemodialysis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Data-Review
[do] DOI:10.1136/bmjopen-2017-020023

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[PMID]: 29523559
[Au] Autor:Émond M; Boucher V; Carmichael PH; Voyer P; Pelletier M; Gouin É; Daoust R; Berthelot S; Lamontagne ME; Morin M; Lemire S; Minh Vu TT; Nadeau A; Rheault M; Juneau L; Le Sage N; Lee J
[Ad] Address:Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.
[Ti] Title:Incidence of delirium in the Canadian emergency department and its consequences on hospital length of stay: a prospective observational multicentre cohort study.
[So] Source:BMJ Open;8(3):e018190, 2018 Mar 08.
[Is] ISSN:2044-6055
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: We aim to determine the incidence of delirium and describe its impacts on hospital length of stay (LOS) among non-delirious community-dwelling older adults with an 8-hour exposure to the emergency department (ED) environment. DESIGN: This is a prospective observational multicentre cohort study (March-July 2015). Patients were assessed two times per day during their entire ED stay and up to 24 hours on hospital ward. SETTING: The study took place in four Canadian EDs. PARTICIPANTS: 338 included patients: (1) aged ≥65 years; (2) who had an ED stay ≥8 hours; (3) were admitted to hospital ward and (4) were independent/semi-independent. MAIN OUTCOMES AND MEASURES: The primary outcomes of this study were incident delirium in the ED or within 24 hours of ward admission and ED and hospital LOS. Functional and cognitive status were assessed using validated Older Americans Resources and Services and the modified Telephone Interview for Cognitive Status tools. The Confusion Assessment Method was used to detect incident delirium. Univariate and multivariate analyses were conducted to evaluate outcomes. RESULTS: Mean age was 76.8 (±8.1), 17.7% were aged >85 years old and 48.8% were men. The mean incidence of delirium was 12.1% (n=41). Median IQR ED LOS was 32.4 (24.5-47.9) hours and hospital LOS was 146.6 (75.2-267.8) hours. Adjusted mean hospital LOS was increased by 105.4 hours (4.4 days) (95% CI 25.1 to 162.0, P<0.001) for patients who developed an episode of delirium compared with non-delirious patient. CONCLUSIONS: An incident delirium was observed in one of eight independent/semi-independent older adults after an 8-hour ED exposure. An episode of delirium increases hospital LOS by 4 days and therefore has important implications for patients and could contribute to ED overcrowding through a deleterious feedback loop.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Data-Review
[do] DOI:10.1136/bmjopen-2017-018190

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[PMID]: 29523001
[Au] Autor:Guérant M; Vaz MA; Peoc'h M; Gaillard Y; Boyer B
[Ad] Address:Service de Médecine Légale, CHU de Clermont-Ferrand, 58 rue Montalembert, 63003 Clermont Ferrand, France. Electronic address: mguerant@chu-clermontferrand.fr.
[Ti] Title:Suicidal shot in the mouth with rubber bullets.
[So] Source:Leg Med (Tokyo);32:52-56, 2018 Mar 02.
[Is] ISSN:1873-4162
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:Rubber bullets weapons can have tragic consequences when used at short range and on vulnerable body areas. A man in his forties was found deceased at his house, covered in blood. A "non-lethal" firearm was found near the bed: the «SAPL GC27¼. This is a single shot handgun with mini Gomm Cogne ammunition: 12 rubber spherical pellets, 7.4 mm in diameter. The findings were consistent with an intra buccal shot, and an ingestion-inhalation of blood and projectiles. Cause of the death was linked to both the hemorrhage due to mouth and aero digestive crossroad trauma, responsible of a mechanical asphyxia, and blood absorption in lungs. This case insists on the deadly potential of this weapon if misused. Fortunately, the term "non-lethal" has been progressively replaced, but sometimes still can be seen, especially in gunsmith and webstores. It should be deleted to avoid confusion among inexperienced people, and at best, this weapon should be restricted to certain professions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

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[PMID]: 29522637
[Au] Autor:Mora M; Saluto V; Balbi P; Spotti M; Fadel D
[Ad] Address:Servicio de Salud Mental Instituto de Investigaciones Médicas "A. Lanari", Facultad de Medicina, UBA.
[Ti] Title:Síndrome de Munchausen mixto con comorbilidad orgánica. [Mixed Munchausen Syndrome with organic comorbidity].
[So] Source:Vertex;XXVIII(132):145-151, 2017 Mar.
[Is] ISSN:0327-6139
[Cp] Country of publication:Argentina
[La] Language:spa
[Ab] Abstract:We present a detailed case report that shows a woman patient who has Factitious Disorder manifested by the coexistence both of: A) typical/direct Munchausen and B) Munchausen by proxy or indirect: being the frst one (A) about the own person and the second one (B) about other people (most cases about their own young children). Furthermore, in the reported case we observed that the patient shown the particularity of having positive biological markers for Myasthenia Gravis (serology markers), and having inconsistent clinical manifestations that are typically observed in the exacerbation phase when she still continued in remission phase. In our own bibliographic research we couldn`t fnd anything about this case of "Mixed Munchausen Syndrome with organic comorbidity". In the same way as we tried to get information about the diagnostic algorithms and the possible therapeutic treatment strategies we found nothing like this reported before. Finally, this clinical presentation constitutes a blind spot for the scientifc community generating a lack of recognition for this diagnostic category and above all of the confusion that this mental disorder can generate in: a) the inadequate use of therapeutic resources, b) the irrational use of drugs, c) the distortion of institutional instances, and d) the medical behaviors that occurred in this case.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review

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[PMID]: 29522634
[Au] Autor:De Ciervo F; Willimburgh V; Finvarb G
[Ad] Address:Hospital de Niños "Dr. Ricardo Gutiérrez", Ciudad de Buenos Aires. facundo.dc@hotmail.com.
[Ti] Title:Encefalitis por anticuerpos contra el receptor N-metil-D-aspartato: presentación clínica en un adolescente y revisión de la literatura. ¿Cómo manejar los síntomas neuropsiquiátricos? [N-Methyl-D-Aspartate receptor encephalitis: An adolescent case report and literature review. How to manage neuropsychiatric symptoms].
[So] Source:Vertex;XXVIII(132):128-135, 2017 Mar.
[Is] ISSN:0327-6139
[Cp] Country of publication:Argentina
[La] Language:spa
[Ab] Abstract:Anti-N-methyl-D-aspartate receptor encephalitis was described as a clinical entity in 2007. The present case report aims to describe the signs and symptoms, differential diagnosis, treatment and course of a sixteen-year-old boy with this disorder who was hospitalized for almost two months. In addition, we will expose the therapeutic management and the diffculties presented in the handling of neuropsychiatric symptoms, considering the complex context of heterogeneous clinical manifestations caused by this disorder. The authors conducted a PubMed, LILACS and Cochrane search and added supplementary methods to compile the major quantity of evidence to support the clinical decisions. To date no systematic reviews or clinical guidelines about the management of psychiatric symptoms in adolescents with this condition were found. Only case reports and series of cases are available. The quality of evidence is poor as long as there are not analytic studies available. The adolescent presented to the emergency department with confusion, speech disturbances and right brachio-crural hemiparesis. During the course of hospitalization he developed a catatonic syndrome, several episodes of psychomotor agitation, sleep disorders and psychotic symptoms. He received successive immunomodulatory therapy for autoimmune encephalitis and psychiatric medication. He was discharged with recovery almost ad integrum. In conclusion, the diagnosis of anti-rNMDA encephalitis should be suspected in previously healthy adolescents with no psychopathological antecedents who suddenly present psychiatric and neurological symptoms. The evolution and prognosis depend on the early initiation of immunomodulating therapy. Psychiatrists should be aware and suspect this entity rapidly and play an important role as consultants for the management of psychiatric and behavioral disturbances.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review

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[PMID]: 29522407
[Au] Autor:Li W; Zhaopeng Q; Yijun F; Haijun N
[Ti] Title:Design and Preliminary Evaluation of Electrolarynx With F0 Control Based on Capacitive Touch Technology.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;26(3):629-636, 2018 Mar.
[Is] ISSN:1558-0210
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:An electrolarynx (EL) is one of the most popular voice rehabilitation technologies used after laryngectomy. However, most ELs generate monotonic EL speech, which has been shown to create a particular deficit in speech intelligibility, especially for Chinese Mandarin (Mandarin). Mandarin is a tonal language that makes lexical distinctions using variations in tone. Our purpose is to design an EL that can produce the four Mandarin tones, and to evaluate its performance. We designed a fundamental frequency (F0) control method for Mandarin EL speech and manufactured a touch-controlled electrolarynx (T-EL) prototype. Using monosyllables, disyllabic words, and frequently used phrases, we evaluated speech produced with a T-EL, as well as with monotone (M-EL) and variable-frequency modes (P-EL) of a commercially available TruTone EL. A male native Mandarin speaker with laryngectomy volunteered to be the speaker. Results show that the normal speech pitch contours of the four Mandarin tones were most closely matched by the characteristics produced with T-EL. The statistical accuracy of the T-EL's tone and word perception was significantly higher than that of the other EL types. Moreover, the confusion matrix indicates that the listeners could correctly identify the tones of monosyllables and disyllabic words in T-EL speech. Accurate tone judgment can improve the intelligibility of EL speech in Mandarin. The mean opinion score was used to evaluate the listeners' acceptability of EL speech. The scores of the T-EL and M-EL were very close, and the score of the P-EL was significantly lower than that of the other two ELs. However, the results from a single speaker cannot provide sufficient data to conclude which EL has a higher acceptability. The evaluation of multiple EL speakers with different EL types at difference levels of proficiency should be studied in future research.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1109/TNSRE.2018.2805338

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[PMID]: 29373587
[Au] Autor:Palmer KS; Brown AD; Evans JM; Marani H; Russell KK; Martin D; Ivers NM
[Ad] Address:Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
[Ti] Title:Qualitative analysis of the dynamics of policy design and implementation in hospital funding reform.
[So] Source:PLoS One;13(1):e0191996, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: As in many health care systems, some Canadian jurisdictions have begun shifting away from global hospital budgets. Payment for episodes of care has begun to be implemented. Starting in 2012, the Province of Ontario implemented hospital funding reforms comprising three elements: Global Budgets; Health Based Allocation Method (HBAM); and Quality-Based Procedures (QBP). This evaluation focuses on implementation of QBPs, a procedure/diagnosis-specific funding approach involving a pre-set price per episode of care coupled with best practice clinical pathways. We examined whether or not there was consensus in understanding of the program theory underpinning QBPs and how this may have influenced full and effective implementation of this innovative funding model. METHODS: We undertook a formative evaluation of QBP implementation. We used an embedded case study method and in-depth, one-on-one, semi-structured, telephone interviews with key informants at three levels of the health care system: Designers (those who designed the QBP policy); Adoption Supporters (organizations and individuals supporting adoption of QBPs); and Hospital Implementers (those responsible for QBP implementation in hospitals). Thematic analysis involved an inductive approach, incorporating Framework analysis to generate descriptive and explanatory themes that emerged from the data. RESULTS: Five main findings emerged from our research: (1) Unbeknownst to most key informants, there was neither consistency nor clarity over time among QBP designers in their understanding of the original goal(s) for hospital funding reform; (2) Prior to implementation, the intended hospital funding mechanism transitioned from ABF to QBPs, but most key informants were either unaware of the transition or believe it was intentional; (3) Perception of the primary goal(s) of the policy reform continues to vary within and across all levels of key informants; (4) Four years into implementation, the QBP funding mechanism remains misunderstood; and (5) Ongoing differences in understanding of QBP goals and funding mechanism have created challenges with implementation and difficulties in measuring success. CONCLUSIONS: Policy drift and policy layering affected both the goal and the mechanism of action of hospital funding reform. Lack of early specification in both policy goals and hospital funding mechanism exposed the reform to reactive changes that did not reflect initial intentions. Several challenges further exacerbated implementation of complex hospital funding reforms, including a prolonged implementation schedule, turnover of key staff, and inconsistent messaging over time. These factors altered the trajectory of the hospital funding reforms and created confusion amongst those responsible for implementation. Enacting changes to hospital funding policy through a process that is transparent, collaborative, and intentional may increase the likelihood of achieving intended effects.
[Mh] MeSH terms primary: Financial Management, Hospital/organization & administration
Organizational Innovation
Organizational Policy
[Mh] MeSH terms secundary: Ontario
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180127
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191996

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[PMID]: 29346418
[Au] Autor:Collaco JM; Appel LJ; McGready J; Cutting GR
[Ad] Address:Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
[Ti] Title:The relationship of lung function with ambient temperature.
[So] Source:PLoS One;13(1):e0191409, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Lung function is complex trait with both genetic and environmental factors contributing to variation. It is unknown how geographic factors such as climate affect population respiratory health. OBJECTIVE: To determine whether ambient air temperature is associated with lung function (FEV1) in the general population. DESIGN/SETTING: Associations between spirometry data from two National Health and Nutrition Examination Survey (NHANES) periods representative of the U.S. non-institutionalized population and mean annual ambient temperature were assessed using survey-weighted multivariate regression. PARTICIPANTS/MEASUREMENTS: The NHANES III (1988-94) cohort included 14,088 individuals (55.6% female) and the NHANES 2007-12 cohort included 14,036 individuals (52.3% female), with mean ages of 37.4±23.4 and 34.4±21.8 years old and FEV1 percent predicted values of 99.8±15.8% and 99.2±14.5%, respectively. RESULTS: After adjustment for confounders, warmer ambient temperatures were associated with lower lung function in both cohorts (NHANES III p = 0.020; NHANES 2007-2012 p = 0.014). The effect was similar in both cohorts with a 0.71% and 0.59% predicted FEV1 decrease for every 10°F increase in mean temperature in the NHANES III and NHANES 2007-2012 cohorts, respectively. This corresponds to ~2 percent predicted difference in FEV1 between the warmest and coldest regions in the continental United States. CONCLUSIONS: In the general U.S. population, residing in regions with warmer ambient air temperatures was associated with lower lung function with an effect size similar to that of traffic pollution. Rising temperatures associated with climate change could have effects on pulmonary function in the general population.
[Mh] MeSH terms primary: Air
Forced Expiratory Volume
Temperature
[Mh] MeSH terms secundary: Adult
Cohort Studies
Confounding Factors (Epidemiology)
Female
Humans
Male
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180119
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191409


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