bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebellar physiology: links between microcircuitry properties and sensorimotor functions
Authors: Jörntell Henrik
Published: July 2016

Existing knowledge of the cerebellar microcircuitry structure and physiology allows a rather detailed description of what it in itself can and cannot do. Combined with a known mapping of different cerebellar regions to afferent systems and motor output target structures, there are several constraints that can be used to describe how specific components of the cerebellar microcircuitry may work during sensorimotor control. In fact, as described in this review, the major factor that hampers further progress in understanding cerebellar function is the limited insights into the circuitry‐level function of the targeted motor output systems and the nature of the information in the mossy fiber afferents. The cerebellar circuitry in itself is here summarized as a gigantic associative memory element, primarily consisting of the parallel fiber synapses, whereas most other circuitry components, including the climbing fiber system, primarily has the role of maintaining activity balance in the intracerebellar and extracerebellar circuitry. The review explores the consistency of this novel interpretational framework with multiple diverse observations at the synaptic and microcircuitry level within the cerebellum.

image
Rapid auditory learning of temporal gap detection
Authors: Mishra Srikanta K. , Panda Manasa R.
Published: July 2016

The rapid initial phase of training-induced improvement has been shown to reflect a genuine sensory change in perception. Several features of early and rapid learning, such as generalization and stability, remain to be characterized. The present study demonstrated that learning effects from brief training on a temporal gap detection task using spectrally similar narrowband noise markers defining the gap (within-channel task), transfer across ears, however, not across spectrally dissimilar markers (between-channel task). The learning effects associated with brief training on a gap detection task were found to be stable for at least a day. These initial findings have significant implications for characterizing early and rapid learning effects.
On the use of geometric and harmonic means with the generalized cross-correlation in the time domain to improve noise source maps
Authors: Padois Thomas , Doutres Olivier , Sgard Franck , Berry Alain
Published: July 2016

Microphone array techniques are an efficient tool to detect acoustic source positions. The delay and sum beamforming is the standard method. In the time domain, the generalized cross-correlation can be used to compute the noise source map. This technique is based on the arithmetic mean of the spatial likelihood functions. In this study, the classical arithmetic mean is replaced by the more standard generalized mean. The noise source maps provide by the arithmetic, geometric and harmonic means are compared in the case of numerical and experimental data obtained in a reverberant room. The geometric and harmonic means provide the best noise source maps with no side lobes and a better source level estimation.
Interactions between amplitude modulation and frequency modulation processing: Effects of age and hearing loss
Authors: Paraouty Nihaad , Ewert Stephan D. , Wallaert Nicolas , Lorenzi Christian
Published: July 2016

Frequency modulation (FM) and amplitude modulation (AM) detection thresholds were measured for a 500-Hz carrier frequency and a 5-Hz modulation rate. For AM detection, FM at the same rate as the AM was superimposed with varying FM depth. For FM detection, AM at the same rate was superimposed with varying AM depth. The target stimuli always contained both amplitude and frequency modulations, while the standard stimuli only contained the interfering modulation. Young and older normal-hearing listeners, as well as older listeners with mild-to-moderate sensorineural hearing loss were tested. For all groups, AM and FM detection thresholds were degraded in the presence of the interfering modulation. AM detection with and without interfering FM was hardly affected by either age or hearing loss. While aging had an overall detrimental effect on FM detection with and without interfering AM, there was a trend that hearing loss further impaired FM detection in the presence of AM. Several models using optimal combination of temporal-envelope cues at the outputs of off-frequency filters were tested. The interfering effects could only be predicted for hearing-impaired listeners. This indirectly supports the idea that, in addition to envelope cues resulting from FM-to-AM conversion, normal-hearing listeners use temporal fine-structure cues for FM detection.
The Energy Cost of Household Chores, Rollerblading, and Riding Scooters in 9- to 14-Year-Old Children
Authors: Ridley Kate , Olds Timothy
Published: July 2016

Background:

To improve the scope of the Youth Compendium of Energy Expenditures, a range of everyday activities of varying intensity should be measured. This study measures the energy cost of children undertaking common household chores, rollerblading and riding a foot-propelled scooter.

Methods:

Participants were 9- to 14-year-old children. A metabolic cart was used to measure oxygen cost (VO2) of a variety of household chores. A Cosmed K4b2 portable oxygen analyzer was used to measure VO2 during rollerblading and riding a scooter at self-selected speeds. Energy costs for each participant were calculated as child METs.

Results:

Mean child MET costs for the household chores ranged from 1.3 to 3.6 METs. Rollerblading and riding a scooter yielded mean child MET costs of 6.5 and 6.3 METs respectively.

Conclusions:

Household chores were found to be of light to moderate intensity, while rollerblading and riding a scooter were vigorous activities.
Energy Cost of Free-Play Activities in 10- to 11-Year-Old Children
Authors: Mackintosh Kelly A. , Ridley Kate , Stratton Gareth , Ridgers Nicola D.
Published: July 2016

Objective:

This study sought to ascertain the energy expenditure (EE) associated with different sedentary and physically active free-play activities in primary school-aged children.

Methods:

Twenty-eight children (13 boys; 11.4 ± 0.3 years; 1.45 ± 0.09 m; 20.0 ± 4.7 kg·m-2) from 1 primary school in Northwest England engaged in 6 activities representative of children’s play for 10 minutes (drawing, watching a DVD, playground games and free-choice) and 5 minutes (self-paced walking and jogging), with 5 minutes rest between each activity. Gas exchange variables were measured throughout. Resting energy expenditure was measured during 15 minutes of supine rest.

Results:

Child (Schofield-predicted) MET values for watching a DVD, self-paced jogging and playing reaction ball were significantly higher for girls (P < .05).

Conclusions:

Utilizing a field-based protocol to examine children’s free-living behaviors, these data contribute to the scarcity of information concerning children’s EE during play to update the Compendium of Energy Expenditures for Youth.
Energy Expenditure and Intensity of Classroom Physical Activity in Elementary School Children
Authors: Honas Jeffery J. , Willis Erik A. , Herrmann Stephen D. , Greene Jerry L. , Washburn Richard A. , Donnelly Joseph E.
Published: July 2016

Background:

There is limited data regarding objectively measured energy cost and intensity of classroom instruction. Therefore, the purpose of current study was to objectively measure energy cost and subsequently calculate MET values using a portable indirect calorimeter (IC) for both normal classroom instruction (NCI) and active classroom instruction (ACI).

Methods:

We assessed energy expenditure (EE) and intensity levels (METs) in elementary school children (17 boys and 15 girls) using an IC (COSMED K4b2). Independent t-tests were used to evaluate potential sex and grade level differences for age, BMI, VO2, EE, and METs.

Results:

The average EE for NCI and ACI were 1.8 ± 0.4 and 3.9 ± 1.0, respectively. The average intensity level for NCI and ACI were 1.9 ± 0.4 and 4.2 ± 0.9 METs, respectively.

Conclusions:

PA delivered through ACI can elicit EE at a moderate intensity level. These results provide evidence for ACI as a convenient/feasible avenue for increasing PA in youth without decreasing instruction time.
Developmental Trends in the Energy Cost of Physical Activities Performed by Youth
Authors: Trost Stewart G. , Drovandi Christopher C. , Pfeiffer Karin
Published: July 2016

Background:

Published energy cost data for children and adolescents are lacking. The purpose of this study was to measure and describe developmental trends in the energy cost of 12 physical activities commonly performed by youth.

Methods:

A mixed age cohort of 209 participants completed 12 standardized activity trials on 4 occasions over a 3-year period (baseline, 12-months, 24-months, and 36-months) while wearing a portable indirect calorimeter. Bayesian hierarchical regression was used to link growth curves from each age cohort into a single curve describing developmental trends in energy cost from age 6 to 18 years.

Results:

For sedentary and light-intensity household chores, YOUTH METs (METy) remained stable or declined with age. In contrast, METy values associated with brisk walking, running, basketball, and dance increased with age.

Conclusions:

The reported energy costs for specific activities will contribute to efforts to update and expand the youth compendium.
Activity Energy Expenditure in Youth: Sex, Age, and Body Size Patterns
Authors: Lee Jung-Min , Saint-Maurice Pedro F. , Kim Youngwon , Gaesser Glenn A. , Welk Gregory
Published: July 2016

Background:

The assessment of physical activity (PA) and energy expenditure (EE) in youth is complicated by inherent variability in growth and maturation during childhood and adolescence. This study provides descriptive summaries of the EE of a diverse range of activities in children ages 7 to 13.

Methods:

A sample of 105 7- to 13-year-old children (boys: 57%, girls: 43%, and Age: 9.9 ± 1.9) performed a series of 12 activities from a pool of 24 activities while being monitored with an indirect calorimetry system.

Results:

Across physical activities, averages of VO2 ml·kg·min-1, VO2 L·min-1, EE, and METs ranged from 3.3 to 53.7 ml·kg·min-1, from 0.15 to 3.2 L·min-1, from 0.7 to 15.9 kcal·min-1, 1.5 MET to 7.8 MET, respectively.

Conclusions:

The energy costs of the activities varied by age, sex, and BMI status reinforcing the need to consider adjustments when examining the relative intensity of PA in youth.
Examining Energy Expenditure in Youth Using XBOX Kinect: Differences by Player Mode
Authors: Barkman Jourdin , Pfeiffer Karin , Diltz Allie , Peng Wei
Published: July 2016

Background:

Replacing sedentary time with physical activity through new generation exergames (eg, XBOX Kinect) is a potential intervention strategy. The study’s purpose was to compare youth energy expenditure while playing different exergames in single- vs. multiplayer mode.

Methods:

Participants (26 male, 14 female) were 10 to 13 years old. They wore a portable metabolic analyzer while playing 4 XBOX Kinect games for 15 minutes each (2 single-, 2 multiplayer). Repeated-measures ANOVA (with Bonferroni correction) was used to examine player mode differences, controlling for age group, sex, weight status, and game.

Results:

There was a significant difference in energy expenditure between single player (mean = 15.4 ml/kg/min, SD = 4.5) and multiplayer mode (mean = 16.8 ml/kg/min, SD = 4.7). Overweight and obese participants (mean = 13.7 ml/kg/min, SD = 4.2) expended less energy than normal weight (mean = 17.8 ml/kg/min, SD = 4.5) during multiplayer mode (d = 0.93).

Conclusion:

Player mode, along with personal factors such as weight status, may be important to consider in energy expenditure during exergames.
Early-life nutrition modulates the epigenetic state of specific rDNA genetic variants in mice
Authors: Holland Michelle L. , Lowe Robert , Caton Paul W. , Gemma Carolina , Carbajosa Guillermo , Danson Amy F. , Carpenter Asha A. M. , Loche Elena , Ozanne Susan E. , Rakyan Vardhman K.
Published: July 2016

Mom's diet affects growth

Nutrition is important during development. This appears to be true even in utero, with potential long-lasting effects on adult phenotype and disease. Epigenetic factors are prime suspects in identifying the corresponding molecular mechanism because they can be maintained throughout cell division. Holland
et al.
show in mice that in utero nutritional deficits influence offspring growth through epigenetic states at multicopy ribosomal DNA elements. This effect is influenced by the genetic variation that naturally exists within the ribosomal RNA.

Science
, this issue p.
495
Light-dependent chlorophyll f synthase is a highly divergent paralog of PsbA of photosystem II
Authors: Ho Ming-Yang , Shen Gaozhong , Canniffe Daniel P. , Zhao Chi , Bryant Donald A.
Published: July 2016

Sometimes, red light means grow

Some cyanobacteria are able to use the far-red end of the light spectrum by synthesizing chlorophyll f pigments. Introducing the protein responsible for chlorophyll f synthesis into crop plants could potentially expand the range of wavelengths that such plants use during photosynthesis and thereby increase their growth efficiency. Ho
et al.
identified chlorophyll f synthase (ChlF) in two cyanobacteria that are acclimatized to grow using far-red light. Introducing the ChlF-encoding gene into a model cyanobacterium allowed the organism to synthesize chlorophyll f. Similarities between ChlF and a core protein of photosystem II suggest that they have a close evolutionary relationship, and ChlF may even represent a more primitive photochemical reaction center.

Science
, this issue p.
886
Draft Genome Sequence of the Deep-Sea Ascomycetous Filamentous Fungus
Cadophora malorum
Mo12 from the Mid-Atlantic Ridge Reveals Its Biotechnological Potential
Authors: Rédou Vanessa , Kumar Abhishek , Hainaut Matthieu , Henrissat Bernard , Record Eric , Barbier Georges , Burgaud Gaëtan
Published: July 2016

Cadophora malorum
Mo12 was isolated from the Rainbow hydrothermal site on the Mid-Atlantic Ridge. We present the draft genome sequence of this filamentous fungal strain, which has high biotechnological potentials as revealed by the presence of genes encoding biotechnologically important enzymes and genes involved in the synthesis of secondary metabolites.
Draft Genome Sequence of a Hypermucoviscous Extended-Spectrum-β-Lactamase-Producing
Klebsiella quasipneumoniae
subsp.
similipneumoniae
Clinical Isolate
Authors: Garza-Ramos U. , Silva-Sánchez J. , Catalán-Nájera J. , Barrios H. , Rodríguez-Medina N. , Garza-González E. , Cevallos M. A. , Lozano L.
Published: July 2016

A clinical isolate of extended-spectrum-β-lactamase-producing
Klebsiella quasipneumoniae
subsp.
similipneumoniae
06-219 with hypermucoviscosity phenotypes obtained from a urine culture of an adult patient was used for whole-genome sequencing. Here, we report the draft genome sequences of this strain, consisting of 53 contigs with an ~5.6-Mb genome size and an average G+C content of 57.36%. The annotation revealed 6,622 coding DNA sequences and 77 tRNA genes.
Genome Sequence of
Gordonia
Phage Yvonnetastic
Authors: Pope Welkin H. , Bandyopadhyay Anshika , Carlton Meghan L. , Kane Meghan T. , Panchal Niyati J. , Pham Yvonne C. , Reynolds Zachary J. , Sapienza Michael S. , German Brian A. , McDonnell Jill E. , Schafer Claire E. , Yu Victor J. , Furbee Emily C. , Grubb Sarah R. , Warner Marcie H. , Montgomery Matthew T. , Garlena Rebecca A. , Russell Daniel A. , Jacobs-Sera Deborah , Hatfull Graham F.
Published: July 2016

Gordonia
bacteriophage Yvonnetastic was isolated from soil in Pittsburgh, PA, using
Gordonia terrae
3612 as a host. Yvonnetastic has siphoviral morphology and a genome of 98,136 bp, with 198 predicted protein-coding genes and five tRNA genes. Yvonnetastic does not share substantial sequence similarity with other sequenced bacteriophage genomes.
Draft Genome Sequence of the Endophytic Strain
Rhodococcus kyotonensis
KB10, a Potential Biodegrading and Antibacterial Bacterium Isolated from
Arabidopsis thaliana
Authors: Hong Chi Eun , Jo Sung Hee , Jeong Haeyoung , Park Jeong Mee
Published: July 2016

Rhodococcus kyotonensis
KB10 is an endophytic bacterium isolated from
Arabidopsis thaliana
. The organism showed mild antibacterial activity against the phytopathogen
Pseudomonas syringae
pv. tomato DC3000. This study reports the genome sequence of
R. kyotonensis
KB10. This bacterium contains an ectoine biosynthesis gene cluster and has the potential to degrade nitroaromatic compounds. The identified bacterium may be a suitable biocontrol agent and degrader of environmental pollutants.
Draft Genome Sequence of the Causative Antigen of Summer-Type Hypersensitivity Pneumonitis,
Trichosporon domesticum
JCM 9580
Authors: Cho Otomi , Ichikawa Tomoe , Kurakado Sanae , Takashima Masako , Manabe Ri-ichiroh , Ohkuma Moriya , Sugita Takashi
Published: July 2016

Here, we report the draft genome sequence of
Trichosporon domesticum
JCM 9580, isolated from the house of a patient with summer-type hypersensitivity pneumonitis (SHP) in Japan. This genomic information will help elucidate the mechanisms of the development of SHP.
Draft Genome Sequence of “
Candidatus
Mycoplasma haemobos,” a Hemotropic Mycoplasma Identified in Cattle in Mexico
Authors: Martínez-Ocampo Fernando , Rodríguez-Camarillo Sergio D. , Amaro-Estrada Itzel , Quiroz-Castañeda Rosa Estela
Published: July 2016

We present here the draft genome sequence of the first “
Candidatus
Mycoplasma haemobos” strain found in cattle in Mexico. This hemotropic mycoplasma causes acute and chronic disease in animals. This genome is a starting point for studying the role of this mycoplasma in coinfections and synergistic mechanisms associated with the disease.
Whole-Genome Sequencing of Two
Bartonella bacilliformis
Strains
Authors: Guillen Yolanda , Casadellà Maria , García-de-la-Guarda Ruth , Espinoza-Culupú Abraham , Paredes Roger , Ruiz Joaquim , Noguera-Julian Marc
Published: July 2016

Bartonella bacilliformis
is the causative agent of Carrion's disease, a highly endemic human bartonellosis in Peru. We performed a whole-genome assembly of two
B. bacilliformis
strains isolated from the blood of infected patients in the acute phase of Carrion's disease from the Cusco and Piura regions in Peru.
Acupuncture for Chronic Central Serous Chorioretinopathy: A Prospective Case Series
Authors: Liang Zhu , Tian Chenbin
Published: July 2016

Objective

The aim of this prospective observational study was to evaluate the effects of acupuncture at Erjian on chronic central serous chorioretinopathy (CSC).

Study Design

Prospective case series.

Methods

Nine patients with chronic CSC were recruited and each patient received 12 sessions of acupuncture treatment. Subjective symptom measures included complications, best-corrected visual acuity (BCVA), fluorescein leakage (via fluorescein fundus angiography), and central subfield foveal subretinal fluid (on optical coherence tomography (OCT)) at 3 months. Successful treatment was defined as the complete resolution of subretinal fluid observed by the OCT following completion of treatment.

Results

After 2 months of treatment, two patients showed improvements in visual acuity, a significant reduction in subretinal fluid and an improvement in BCVA to 0.5±0.10 (mean±SD). By contrast, four patients experienced no significant changes. After 3 months of treatment, four patients showed improvements in visual acuity and complete resolution of the subretinal fluid (mean BCVA=0.6), while parameters in two patients remained unchanged. Compared to baseline (before treatment), the proportions of patients experiencing visual improvement at 2 and 3 months were 33% (n=2) and 67% (n=4), respectively. No major complications were observed during the treatment course.

Conclusions

Acupuncture might be a promising supplementary therapy for patients with CSC. However, this is ultimately only an exploratory study with a small sample size and no untreated comparator group to control for the natural history of the condition. Randomised controlled trials will be needed to demonstrate the efficacy and effectiveness of this approach.
Unusual association between cardiac, skeletal, urogenital and renal abnormalities
Authors: Goryaeva Maria , Sykes Mark Christopher , Lau Benjamin , West Simon
Published: July 2016

We present a 33-year-old woman with an array of congenital abnormalities. She has been diagnosed with polycystic kidney disease (PCKD) with no detectable mutations in PKD1 or PKD2, spina bifida occulta, thoracic skeletal abnormalities, a uterus didelphys and a patent foramen ovale (PFO). There are several associations reported in the literature that include abnormalities similar to the patient's, but none describe her presentation in its entirety. The MURCS association is characterised by (MU)llerian duct aplasia, (R)enal dysplasia and (C)ervical (S)omite anomalies and goes some way in explaining these condition. Patients with both MURCS and PCKD have not been described in current literature. Through this report, we hope to bring a potential diagnosis to light and provide the patient with an improved understanding of her health.
Retroperitoneoscopic pyeloplasty for the management of pelvic-ureteric junction obstruction in horseshoe kidney: our initial experience
Authors: Sinha Rahul Janak , Jhanwar Ankur , Singh Vishwajeet , Prakash Gaurav
Published: July 2016

Horseshoe kidney (HSK) is the most common congenital renal fusion anomaly with approximate incidence of 1:400 to 1:1000 births. Pelvic-ureteric junction obstruction (PUJO) occurs in 15–33% of patients in this population. Herein, we report our experience of management of PUJO in HSK by retroperitoneoscopic pyeloplasty.
Peripheral sensory neuropathy is associated with altered postocclusive reactive hyperemia in the diabetic foot
Authors: Barwick Alex L , Tessier John W , Janse de Jonge Xanne , Ivers James R , Chuter Vivienne H
Published: July 2016

Objective

This study examined whether the presence of peripheral sensory neuropathy or cardiac autonomic deficits is associated with postocclusive reactive hyperemia (reflective of microvascular function) in the diabetic foot.

Research design and methods

99 participants with type 2 diabetes were recruited into this cross-sectional study. The presence of peripheral sensory neuropathy was determined with standard clinical tests and cardiac autonomic function was assessed with heart rate variation testing. Postocclusive reactive hyperemia was measured with laser Doppler in the hallux. Multiple hierarchical regression was performed to examine relationships between neuropathy and the peak perfusion following occlusion and the time to reach this peak.

Results

Peripheral sensory neuropathy predicted 22% of the variance in time to peak following occlusion (p<0.05), being associated with a slower time to peak but was not associated with the magnitude of the peak. Heart rate variation was not associated with the postocclusive reactive hyperemia response.

Conclusions

This study found an association between the presence of peripheral sensory neuropathy in people with diabetes and altered microvascular reactivity in the lower limb.
Up-skilling associate clinicians in Malawi in emergency obstetric, neonatal care and clinical leadership: the ETATMBA cluster randomised controlled trial
Authors: Ellard David R , Chimwaza Wanangwa , Davies David , Simkiss Doug , Kamwendo Francis , Mhango Chisale , Quenby Siobhan , Kandala Ngianga-bakwin , O'Hare Joseph Paul
Published: July 2016

Background

The ETATMBA (Enhancing Training And Technology for Mothers and Babies in Africa) project-trained associate clinicians (ACs/clinical officers) as advanced clinical leaders in emergency obstetric and neonatal care. This trial aimed to evaluate the impact of training on obstetric health outcomes in Malawi.

Method

A cluster randomised controlled trial with 14 districts of Malawi (8 intervention, 6 control) as units of randomisation. Intervention districts housed the 46 ACs who received the training programme. The primary outcome was district (health facility-based) perinatal mortality rates. Secondary outcomes included maternal mortality ratios, neonatal mortality rate, obstetric and birth variables. The study period was 2011–2013. Mortality rates/ratios were examined using an interrupted time series (ITS) to identify trends over time.

Results

The ITS reveals an improving trend in perinatal mortality across both groups, but better in the control group (intervention, effect −3.58, SE 2.65, CI (−9.85 to 2.69), p=0.20; control, effect −17.79, SE 6.83, CI (−33.95 to −1.64), p=0.03). Maternal mortality ratios are seen to have improved in intervention districts while worsening in the control districts (intervention, effect −38.11, SE 50.30, CI (−157.06 to 80.84), p=0.47; control, effect 11.55, SE 87.72, CI (−195.87 to 218.98), p=0.90). There was a 31% drop in neonatal mortality rate in intervention districts while in control districts, the rate rises by 2%. There are no significant differences in the other secondary outcomes.

Conclusions

This is one of the first randomised studies looking at the effect of structured training on health outcomes in this setting. Notwithstanding a number of limitations, this study suggests that up-skilling this cadre is possible, and could impact positively on health outcomes.

Trial registration number

ISRCTN63294155; Results.
Use of extensively hydrolysed formula for refeeding neonates postnecrotising enterocolitis: a nationwide survey-based, cross-sectional study
Authors: Lapillonne Alexandre , Matar Maroun , Adleff Ariane , Chbihi Marwa , Kermorvant-Duchemin Elsa , Campeotto Florence
Published: July 2016

Objective

To evaluate the prevalence of and reasons for using extensively hydrolysed formulas (EHFs) of cow's milk proteins in the French neonatal units as well as the modality of their prescription for refeeding infants recovering from necrotising enterocolitis (NEC).

Methods

A multicentre nationwide cross-sectional study using a questionnaire to address the prevalence of use and the reasons for prescribing EHF in hospitalised neonates and to examine the protocols and the actual reasons for their use for refeeding infants in recovery from NEC. The questionnaire was sent to only 1 senior neonatologist in each neonatal unit included in the study.

Results

More than half of the French neonatal units participated in the survey. 91% of the surveyed units used EHF. Of 1969 infants hospitalised on the day the survey was run, 12% were fed on an EHF. 11% of the EHF prescriptions were due to previous NEC. The main reasons for using an EHF to feed infants post-NEC were the absence of human milk (75%) and surgical management of NEC (17%). When given, EHF was mainly prescribed for a period varying between 15 days and 3 months. None of the involved units continued using the EHF after 6 months of age. More than half of the surveyed units acknowledged hospitalising infants for the initiation of weaning EHF but only 21% of them tested these infants for cow's milk allergy.

Conclusions

The prevalence of EHF use in the French neonatal units is high. Refeeding infants post-NEC is one of the main reasons for such a high prevalence. The main incentive for using an EHF is the absence of human breast milk, either maternal or donor.
Multicountry survey of emergency and critical care medicine physicians’ fluid resuscitation practices for adult patients with early septic shock
Authors: McIntyre Lauralyn , Rowe Brian H , Walsh Timothy S , Gray Alasdair , Arabi Yaseen , Perner Anders , Gordon Anthony , Marshall John , Cook Deborah , Fox-Robichaud Alison , Bagshaw Sean M , Green Robert , Schweitzer Irwin , Turgeon Alexis , Zarychanski Ryan , English Shane , Chassé Michaël , Stiell Ian , Fergusson Dean
Published: July 2016

Objectives

Evidence to guide fluid resuscitation evidence in sepsis continues to evolve. We conducted a multicountry survey of emergency and critical care physicians to describe current stated practice and practice variation related to the quantity, rapidity and type of resuscitation fluid administered in early septic shock to inform the design of future septic shock fluid resuscitation trials.

Methods

Using a web-based survey tool, we invited critical care and emergency physicians in Canada, the UK, Scandinavia and Saudi Arabia to complete a self-administered electronic survey.

Results

A total of 1097 physicians’ responses were included. 1 L was the most frequent quantity of resuscitation fluid physicians indicated they would administer at a time (46.9%, n=499). Most (63.0%, n=671) stated that they would administer the fluid challenges as quickly as possible. Overall, normal saline and Ringer's solutions were the preferred crystalloid fluids used ‘often’ or ‘always’ in 53.1% (n=556) and 60.5% (n=632) of instances, respectively. However, emergency physicians indicated that they would use normal saline ‘often’ or ‘always’ in 83.9% (n=376) of instances, while critical care physicians said that they would use saline ‘often’ or ‘always’ in 27.9% (n=150) of instances. Only 1.0% (n=10) of respondents indicated that they would use hydroxyethyl starch ‘often’ or ‘always’; use of 5% (5.6% (n=59)) or 20–25% albumin (1.3% (n=14)) was also infrequent. The majority (88.4%, n=896) of respondents indicated that a large randomised controlled trial comparing 5% albumin to a crystalloid fluid in early septic shock was important to conduct.

Conclusions

Critical care and emergency physicians stated that they rapidly infuse volumes of 500–1000 mL of resuscitation fluid in early septic shock. Colloid use, specifically the use of albumin, was infrequently reported. Our survey identifies the need to conduct a trial on the efficacy of albumin and crystalloids on 90-day mortality in patients with early septic shock.
Bacteraemia predictive factors among general medical inpatients: a retrospective cross-sectional survey in a Japanese university hospital
Authors: Fukui Sayato , Uehara Yuki , Fujibayashi Kazutoshi , Takahashi Osamu , Hisaoka Teruhiko , Naito Toshio
Published: July 2016

Objectives

The precise criteria for obtaining blood cultures have not been established; they depend on the physician's judgement. We examined clinical parameters to determine predictive factors of bacteraemia and the need for blood cultures among general medical inpatients.

Design

A retrospective cross-sectional survey.

Setting

A Japanese university hospital.

Participants

All general inpatients who had blood cultures taken from 1 January 2011 to 31 December 2012.

Main Measures

Clinical information at or just before blood culture sampling was extracted from medical charts. Factors potentially predictive of bacteraemia were analysed using Fisher's exact test, followed by multivariable logistic regression model analysis.

Main Results

A total of 200 patients (male: female=119:81, 64.3±19.1 years old) comprised this study; 57 (28.5%) had positive blood culture results. Multivariable logistic regression analysis revealed that age >60 years (OR=2.75, 95% CI 1.23 to 6.48, p=0.015), female sex (OR=2.21, 95% CI 1.07 to 4.67, p=0.038), pulse rate >90 bpm (OR=5.18, 95% CI 2.25 to 12.48, p<0.001) and neutrophil percentage >80% (OR=3.61, 95% CI 1.71 to 8.00, p=0.001) were independent risk factors for positive blood culture results. The area under the receiver operating characteristic curve analysis of this model was 0.796.

Conclusions

Our results emphasise the importance of taking blood cultures if the pulse rate is >90 bpm, in elderly patients and in women, and for ordering a differential white cell count.
Impact of maternal BMI and sampling strategy on the concentration of leptin, insulin, ghrelin and resistin in breast milk across a single feed: a longitudinal cohort study
Authors: Andreas Nicholas J , Hyde Matthew J , Herbert Bronwen R , Jeffries Suzan , Santhakumaran Shalini , Mandalia Sundhiya , Holmes Elaine , Modi Neena
Published: July 2016

Objectives

We tested the hypothesis that there is a positive association between maternal body mass index (BMI) and the concentration of appetite-regulating hormones leptin, insulin, ghrelin and resistin in breast milk. We also aimed to describe the change in breast milk hormone concentration within each feed, and over time.

Setting

Mothers were recruited from the postpartum ward at a university hospital in London. Breast milk samples were collected at the participants’ homes.

Participants

We recruited 120 healthy, primiparous, breastfeeding mothers, aged over 18 years. Mothers who smoked, had multiple births or had diabetes were excluded. Foremilk and hindmilk samples were collected from 105 women at 1 week postpartum and 92 women at 3 months postpartum.

Primary and secondary outcome measures

We recorded maternal and infant anthropometric measurements at each sample collection and measured hormone concentrations using a multiplex assay.

Results

The concentration of leptin in foremilk correlated with maternal BMI at the time of sample collection, at 7 days (r=0.31, p=0.02) and 3 months postpartum (r=0.30, p=<0.00). Foremilk insulin correlated with maternal BMI at 3 months postpartum (r=0.22, p=0.04). Breast milk ghrelin and resistin were not correlated with maternal BMI. Ghrelin concentrations at 3 months postpartum were increased in foremilk compared with hindmilk (p=0.01). Concentrations of ghrelin were increased in hindmilk collected at 1  week postpartum compared with samples collected at 3 months postpartum (p=0.03). A trend towards decreased insulin concentrations in hindmilk was noted. Concentrations of leptin and resistin were not seen to alter over a feed.

Conclusions

A positive correlation between maternal BMI and foremilk leptin concentration at both time points studied, and foremilk insulin at 3 months postpartum was observed. This may have implications for infant appetite regulation and obesity risk.
Migration and head penetration of Vitamin-E diffused cemented polyethylene cup compared to standard cemented cup in total hip arthroplasty: study protocol for a randomised, double-blind, controlled trial (E1 HIP)
Authors: Sköldenberg Olof , Rysinska Agata , Chammout Ghazi , Salemyr Mats , Muren Olle , Bodén Henrik , Eisler Thomas
Published: July 2016

Introduction

In vitro, Vitamin-E-diffused, highly cross-linked polyethylene (PE) has been shown to have superior wear resistance and improved mechanical properties when compared to those of standard highly cross-linked PE liners used in total hip arthroplasty (THA). The aim of the study is to evaluate the safety of a new cemented acetabular cup with Vitamin-E-doped PE regarding migration, head penetration and clinical results.

Methods and analysis

In this single-centre, double-blinded, randomised controlled trial, we will include 50 patients with primary hip osteoarthritis scheduled for THA and randomise them in a 1:1 ratio to a cemented cup with either argon gas-sterilised PE (control group) or Vitamin-E-diffused PE (vitamin-e group). All patients and the assessor of the primary outcome will be blinded and the same uncemented stem will be used for all participants. The primary end point will be proximal migration of the cup at 2 years after surgery measured with radiostereometry. Secondary end points include proximal migration at other follow-ups, total migration, femoral head penetration, clinical outcome scores and hip-related complications. Patients will be followed up at 3 months and at 1, 2, 5 and 10 years postoperatively.

Results

Results will be analysed using 95% CIs for the effect size. A regression model will also be used to adjust for stratification factors.

Ethics and dissemination

The ethical committee at Karolinska Institutet has approved the study. The first results from the study will be disseminated to the medical community via presentations and publications in relevant medical journals when the last patient included has been followed up for 2 years.

Trial registration number

NCT02254980.
Understanding recruitment and retention in the NHS community pharmacy stop smoking service: perceptions of smoking cessation advisers
Authors: Sohanpal Ratna , Rivas Carol , Steed Liz , MacNeill Virginia , Kuan Valerie , Edwards Elizabeth , Griffiths Chris , Eldridge Sandra , Taylor Stephanie , Walton Robert
Published: July 2016

Objectives

To understand views of pharmacy advisers about smoker recruitment and retention in the National Health Service community pharmacy stop smoking programme.

Design

Thematic framework analysis of semistructured, in-depth interviews applying the Theoretical Domains Framework and COM-B behaviour change model. We aimed to identify aspects of adviser behaviour that might be modified to increase numbers joining and completing the programme.

Participants

25 stop smoking advisers (13 pharmacists and 12 support staff).

Setting

29 community pharmacies in 3 inner east London boroughs.

Results

Advisers had preconceived ideas about smokers likely to join or drop out and made judgements about smokers' readiness to quit. Actively recruiting smokers was accorded low priority due in part to perceived insufficient remuneration to the pharmacy and anticipated challenging interactions with smokers. Suggestions to improve smoker recruitment and retention included developing a more holistic and supportive approach using patient-centred communication. Training counter assistants were seen to be important as was flexibility to extend the programme duration to fit better with smokers’ needs.

Conclusions

Cessation advisers feel they lack the interpersonal skills necessary to engage well with smokers and help them to quit. Addressing advisers' behaviours about active engagement and follow-up of clients, together with regular skills training including staff not formally trained as cessation advisers, could potentially boost numbers recruited and retained in the stop smoking programme. Adjustments to the pharmacy remuneration structure to incentivise recruitment and to allow personalisation of the programme for individual smokers should also be considered.
Rationale and design of Diabetes Prevention with active Vitamin D (DPVD): a randomised, double-blind, placebo-controlled study
Authors: Kawahara Tetsuya , Suzuki Gen , Inazu Tetsuya , Mizuno Shoichi , Kasagi Fumiyoshi , Okada Yosuke , Tanaka Yoshiya
Published: July 2016

Introduction

Recent research suggests that vitamin D deficiency may cause both bone diseases and a range of non-skeletal diseases. However, most of these data come from observational studies, and clinical trial data on the effects of vitamin D supplementation on individuals with pre-diabetes are scarce and inconsistent. The aim of the Diabetes Prevention with active Vitamin D (DPVD) study is to assess the effect of eldecalcitol, active vitamin D analogue, on the incidence of type 2 diabetes among individuals with pre-diabetes.

Methods and analysis

DPVD is an ongoing, prospective, multicentre, randomised, double-blind and placebo-controlled outcome study in individuals with impaired glucose tolerance. Participants, men and women aged ≥30 years, will be randomised to receive eldecalcitol or placebo. They will also be given a brief (5–10 min long) talk about appropriate calorie intake from diet and exercise at each 12-week visit. The primary end point is the cumulative incidence of type 2 diabetes. Secondary endpoint is the number of participants who achieve normoglycaemia at 48, 96 and 144 weeks. Follow-up is estimated to span 144 weeks.

Ethics and dissemination

All protocols and an informed consent form comply with the Ethics Guideline for Clinical Research (Japan Ministry of Health, Labour and Welfare). The study protocol has been approved by the Institutional Review Board at Kokura Medical Association and University of Occupational and Environmental Health. The study will be implemented in line with the CONSORT statement.

Trial registration number

UMIN000010758; Pre-results.
Sociodemographic patterning of long-term diabetes mellitus control following Japan's 3.11 triple disaster: a retrospective cohort study
Authors: Leppold Claire , Tsubokura Masaharu , Ozaki Akihiko , Nomura Shuhei , Shimada Yuki , Morita Tomohiro , Ochi Sae , Tanimoto Tetsuya , Kami Masahiro , Kanazawa Yukio , Oikawa Tomoyoshi , Hill Sarah
Published: July 2016

Objective

To assess the sociodemographic patterning of changes in glycaemic control of patients with diabetes affected by the 2011 triple disaster in Japan (earthquake, tsunami and nuclear accident).

Methods

A retrospective cohort study was undertaken with 404 patients with diabetes at a public hospital in Minamisoma City, Fukushima Prefecture. Glycated haemoglobin (HbA1c) levels were measured in 2010, 2011 and 2012 to capture changes in glycaemic control postdisaster. Age, sex, urban/rural residency, evacuation status and medication use were also assessed.

Results

There was an overall deterioration in glycaemic control after the disaster, with the mean HbA1c rising from 6.77% in 2010 to 6.90% in 2012 (National Glycohemoglobin Standardization Program, NGSP). Rural residency was associated with a lower likelihood of deteriorating control (OR 0.34, 95% CI 0.13 to 0.84), compared with urban residency. Older age (OR 0.95, 95% CI 0.91 to 0.98) was also slightly protective against increased HbA1c. Evacuation and sex were not significant predictors.

Conclusions

Patients with diabetes who were affected by Japan's triple disaster experienced a deterioration in their glycaemic control following the disasters. The extent of this deterioration was mediated by sociodemographic factors, with rural residence and older age protective against the effects of the disaster on glycaemic control. These results may be indicative of underlying social determinants of health in rural Japan.
Protocol for a randomised controlled trial comparing aqueous with alcoholic chlorhexidine antisepsis for the prevention of superficial surgical site infection after minor surgery in general practice: the AVALANCHE trial
Authors: Heal C F , Charles D , Hardy A , Delpachitra M , Banks J , Wohlfahrt M , Saednia Sabine , Buettner P
Published: July 2016

Introduction

Surgical site infection (SSI) after minor skin excisions has a significant impact on patient morbidity and healthcare resources. Skin antisepsis prior to surgical incision is used to prevent SSI, and is performed routinely worldwide. However, in spite of the routine use of skin antisepsis, there is no consensus regarding which antiseptic agents are most effective. The AVALANCHE trial will compare Aqueous Versus Alcoholic Antisepsis with Chlorhexidine for Skin Excisions.

Methods and analysis

The study design is a prospective, randomised controlled trial (RCT) with the aim of investigating the impact of two different antiseptic preparations on the incidence of superficial SSI in patients undergoing minor skin excisions. The intervention of 0.5% chlorhexidine gluconate (CHG) in 70% alcohol will be compared with that of 0.5% CHG in aqueous solution. The trial will be conducted in four Australian general practices over a 9-month period, with 920 participants to be recruited. Consecutive patients presenting for minor skin excisions will be eligible to participate. Randomisation will be on the level of the patient. The primary outcome is superficial SSI in the first 30 days following the excision. Secondary outcomes will be adverse effects, including anaphylaxis, skin irritation, contact dermatitis and rash and patterns of antibiotic resistance.

Ethics and dissemination

The study has been approved by the James Cook University Human Research Ethics Committee (HREC). Findings will be disseminated in conference presentations and journals and through online electronic media.

Discussion

RCTs conducted in general practice differ from hospital-based projects in terms of feasibility, pragmatism and funding. The success of this trial will be cemented in the fact that the research question was established by a group of general practitioners who identified an interesting question which is relevant to their clinical practice and not answered by current evidence.

Trial registration number

ACTRN12615001045505; Pre-results.
Mood disturbance and depression in Arab women following hospitalisation from acute cardiac conditions: a cross-sectional study from Qatar
Authors: Donnelly Tam Truong , Al Suwaidi Jassim Mohd , Al-Qahtani Awad , Asaad Nidal , Fung Tak , Singh Rajvir , Qader Najlaa Abdul
Published: July 2016

Objectives

Depression is associated with increased morbidity and mortality rates among cardiovascular patients. Depressed patients have three times higher risk of death than those who are not. We sought to determine the presence of depressive symptoms, and whether gender and age are associated with depression among Arab patients hospitalised with cardiac conditions in a Middle Eastern country.

Setting

Using a non-probability convenient sampling technique, a cross-sectional survey was conducted with 1000 Arab patients ≥20 years who were admitted to cardiology units between 2013 and 2014 at the Heart Hospital in Qatar. Patients were interviewed 3 days after admission following the cardiac event. Surveys included demographic and clinical characteristics, and the Arabic version of the Beck Depression Inventory Second Edition (BDI-II). Depression was assessed by BDI-II clinical classification scale.

Results

15% of the patients had mild mood disturbance and 5% had symptoms of clinical depression. Twice as many females than males suffered from mild mood disturbance and clinical depression symptoms, the majority of females were in the age group 50 years and above, whereas males were in the age group 40–49 years. χ2Tests and multivariate logistic regression analyses indicated that gender and age were statistically significantly related to depression (p<0.001 for all).

Conclusions

Older Arab women are more likely to develop mood disturbance and depression after being hospitalised with acute cardiac condition. Gender and age differences approach, and routine screening for depression should be conducted with all cardiovascular patients, especially for females in the older age groups. Mental health counselling should be available for all cardiovascular patients who exhibit depressive symptoms.
Epidemiological impact of achieving UNAIDS 90-90-90 targets for HIV care in India: a modelling study
Authors: Maddali Manoj V , Gupta Amita , Shah Maunank
Published: July 2016

Objective

Recent UNAIDS ‘90-90-90’ targets propose that to end the HIV epidemic by 2030, 90% of persons living with HIV (PLWH) worldwide should know their diagnosis, 90% of diagnosed PLWH should be on antiretroviral therapy (ART) and 90% of PLWH on ART should be virally suppressed by 2020. We sought to quantify the epidemiological impact of achieving these targets in India.

Methods

We constructed a dynamic-transmission model of the Indian HIV epidemic to project HIV infections and AIDS-related deaths that would occur in India over 15 years. We considered several scenarios: continuation of current care engagement (with early ART initiation), achieving 90-90-90 targets on time and delaying achievement by 5 or 10 years.

Results

In the base case, assuming continuation of current care engagement, we project 794 000 (95% uncertainty range (UR) 571 000–1 104 000) HIV infections and 689 000 (95% UR 468 000–976 000) AIDS-related deaths in India over 15 years. In this scenario, nearly half of PLWH diagnosed would fail to achieve viral suppression by 2030. With achievement of 90-90-90 targets, India could avert 392 000 (95% UR 248 000–559 000) transmissions (48% reduction) and 414 000 (95% UR 260 000–598 000) AIDS-related deaths (59% reduction) compared to the base-case scenario. Furthermore, fewer than 20 000 (95% UR 12 000–30 000) HIV infections would occur in 2030. Delaying achievement of targets resulted in a similar reduction in HIV incidence by 2030 but at the cost of excess overall infections and mortality.

Conclusions

India can halve the epidemiological burden of HIV over 15 years with achievement of the UNAIDS 90-90-90 targets. Reaching the targets on time will require comprehensive healthcare strengthening, especially in early diagnosis and treatment, expanded access to second-line and third-line ART and long-term retention in care.