bluuebunny/crossref_metadata_2025_split huggingface dataset:
67 Reducing Delays to Operative Management of Anti-Coagulated Patients With Hip Fractures
Authors: Ensanullah J , Shah B , Fertleman M 
Published: February 2020

Abstract

Introduction
In the UK, the gold-standard treatment of a hip fracture is surgical fixation within 36 hours. Reduced delay to surgery has been shown to minimise the risk of complications. Locally, frequent delays to surgery were observed in patients taking long-term anticoagulation. There are no national guidelines regarding anticoagulation reversal and surgery timing in patients with hip fractures, and doctors are often unfamiliar with increasingly prevalent Direct Oral Anti-coagulants (DOACs). This quality improvement project aimed to reduce delays to surgery in anti-coagulated patients with hip fractures.

Methods
A guideline was formulated following literature review and consultation with a Consultant Ortho-geriatrician, Orthopaedic Surgeon and Haematologist. Retrospective casenote audit was conducted including 3-month period before and after implementation. The new guideline was disseminated in poster form. Due to the observation that delays in receiving INR results resulted in reversal delay, patient’s on warfarin were recommended to receive 5 mg IV Vitamin K prior to receiving INR results. The INR was rechecked after 6 hours, and if less than 1.6, surgery could proceed. Those on DOACs could undergo surgery 24 hours after the last dose providing eGFR &gt;30, and after 48 hours if eGFR &lt;30. Exclusions were those anti-coagulated for metallic heart valves or recent venous thromboembolism.

Results
In the 3 months prior to guideline implementation, 71 patients had a hip fracture; 15 were anti-coagulated. Of these, 8 patients were delayed due to their anticoagulation. Repeat audit after implementation, included 46 patients with a hip fracture over the 3-month period; 7 were anti-coagulated. None were delayed due to anticoagulation (p &lt; 0.05).

Conclusions
This improvement project describes formulation of a simple protocol with evidence from the literature and local expert opinion in order to reduce unnecessary delays in anti-coagulated patients with hip fractures.
Contrasting multilevel relationships between behavior and body mass in blue tit nestlings
Authors: Class Barbara , Brommer Jon 
Published: February 2020

Abstract
Repeatable behaviors (i.e., animal personality) are pervasive in the animal kingdom and various mechanisms have been proposed to explain their existence. Genetic and nongenetic mechanisms, which can be equally important, predict correlations between behavior and body mass on different levels (e.g., genetic and environmental) of variation. We investigated multilevel relationships between body mass measured on weeks 1, 2, and 3 and three behavioral responses to handling, measured on week 3, which form a behavioral syndrome in wild blue tit nestlings. Using 7 years of data and quantitative genetic models, we find that all behaviors and body mass on week 3 are heritable (h2 = 0.18–0.23) and genetically correlated, whereas earlier body masses are not heritable. We also find evidence for environmental correlations between body masses and behaviors. Interestingly, these environmental correlations have different signs for early and late body masses. Altogether, these findings indicate genetic integration between body mass and behavior and illustrate the impacts of early environmental factors and environmentally mediated growth trajectory on behaviors expressed later in life. This study, therefore, suggests that the relationship between personality and body mass in developing individuals is due to various underlying mechanisms, which can have opposing effects. Future research on the link between behavior and body mass would benefit from considering these multiple mechanisms simultaneously.
Application of CRISPR/Cas9 technology in sepsis research
Authors: Wu Miao , Hu Niandan , Du Xianjin , Wei Jie 
Published: February 2020

AbstractCRISPR/Cas9, as a new genome-editing tool, offers new approaches to understand and treat diseases, which is being rapidly applied in various areas of biomedical research including sepsis field. The type II prokaryotic CRISPR/Cas system uses a single-guide RNA (sgRNA) to target the Cas9 nuclease to a specific genomic sequence, which is introduced into disease models for functional characterization and for testing of therapeutic strategies. This incredibly precise technology can be used for therapeutic research of gene-related diseases and to program any sequence in a target cell. Most importantly, the multifunctional capacity of this technology allows simultaneous editing of several genes. In this review, we focus on the basic principles, advantages and limitations of CRISPR/Cas9 and the use of the CRISPR/Cas9 system as a powerful tool in sepsis research and as a new strategy for the treatment of sepsis.
Sowing Uncertainty: What We Do and Don’t Know about the Planting of Pesticide-Treated Seed
Authors: Hitaj Claudia , Smith David J , Code Aimee , Wechsler Seth , Esker Paul D , Douglas Margaret R 
Published: February 2020

ABSTRACT
Farmers, regulators, and researchers rely on pesticide use data to assess the effects of pesticides on crop yield, farm economics, off-target organisms, and human health. The publicly available pesticide use data in the United States do not currently account for pesticides applied as seed treatments. We find that seed treatment use has increased in major field crops over the last several decades but that there is a high degree of uncertainty about the extent of acreage planted with treated seeds, the amount of regional variability, and the use of certain active ingredients. One reason for this uncertainty is that farmers are less likely to know what pesticides are on their seed than they are about what pesticides are applied conventionally to their crops. This lack of information affects the quality and availability of seed treatment data and also farmers’ ability to tailor pesticide use to production and environmental goals.
Polygenic Architecture of Human Neuroanatomical Diversity
Authors: Biton Anne , Traut Nicolas , Poline Jean-Baptiste , Aribisala Benjamin S , Bastin Mark E , Bülow Robin , Cox Simon R , Deary Ian J , Fukunaga Masaki , Grabe Hans J , Hagenaars Saskia , Hashimoto Ryota , Kikuchi Masataka , Muñoz Maniega Susana , Nauck Matthias , Royle Natalie A , Teumer Alexander , Valdés Hernández Maria , Völker Uwe , Wardlaw Joanna M , Wittfeld Katharina , Yamamori Hidenaga ,   Alzheimer’s Disease Neuroimaging Initiative, Bourgeron Thomas , Toro Roberto 
Published: February 2020

Abstract
We analyzed the genomic architecture of neuroanatomical diversity using magnetic resonance imaging and single nucleotide polymorphism (SNP) data from &gt;26 000 individuals from the UK Biobank project and 5 other projects that had previously participated in the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) consortium. Our results confirm the polygenic architecture of neuroanatomical diversity, with SNPs capturing from 40% to 54% of regional brain volume variance. Chromosomal length correlated with the amount of phenotypic variance captured, r ~ 0.64 on average, suggesting that at a global scale causal variants are homogeneously distributed across the genome. At a local scale, SNPs within genes (~51%) captured ~1.5 times more genetic variance than the rest, and SNPs with low minor allele frequency (MAF) captured less variance than the rest: the 40% of SNPs with MAF &lt;5% captured &lt;one fourth of the genetic variance. We also observed extensive pleiotropy across regions, with an average genetic correlation of rG ~ 0.45. Genetic correlations were similar to phenotypic and environmental correlations; however, genetic correlations were often larger than phenotypic correlations for the left/right volumes of the same region. The heritability of differences in left/right volumes was generally not statistically significant, suggesting an important influence of environmental causes in the variability of brain asymmetry. Our code is available athttps://github.com/neuroanatomy/genomic-architecture.
Continued Evidence of the Impact of Rotavirus Vaccine in Children Less Than 3 Years of Age From the United States New Vaccine Surveillance Network: A Multisite Active Surveillance Program, 2006–2016
Authors: Staat Mary Allen , Payne Daniel C , Halasa Natasha , Weinberg Geoffrey A , Donauer Stephanie , Wikswo Mary , McNeal Monica , Edwards Kathryn M , Szilagyi Peter G , Bernstein David I , Curns Aaron T , Sulemana Iddrisu , Esona Mathew D , Bowen Michael D , Parashar Umesh D ,   New Vaccine Surveillance Network (NVSN)
Published: February 2020

Abstract

Background
Since 2006, the New Vaccine Surveillance Network has conducted active, population-based surveillance for acute gastroenteritis (AGE) hospitalizations and emergency department (ED) visits in 3 United States counties. Trends in the epidemiology and disease burden of rotavirus hospitalizations and ED visits were examined from 2006 to 2016.

Methods
Children &lt; 3 years of age hospitalized or visiting the ED with AGE were enrolled from January 2006 through June 2016. Bulk stool specimens were collected and tested for rotavirus. Rotavirus-associated hospitalization and ED visit rates were calculated annually with 2006–2007 defined as the prevaccine period and 2008–2016 as the postvaccine period. Rotavirus genotype trends were compared over time.

Results
Over 11 seasons, 6954 children with AGE were enrolled and submitted a stool specimen (2187 hospitalized and 4767 in the ED). Comparing pre- and postvaccine periods, the proportion of children with rotavirus dramatically declined for hospitalization (49% vs 10%) and ED visits (49% vs 8%). In the postvaccine era, a biennial pattern of rotavirus rates was observed, with a trend toward an older median age. G1P[8] (63%) was the predominant genotype in the prevaccine period with a significantly lower proportion (7%) in the postvaccine period (P &lt; .001). G2P[4] remained stable (8% to 14%) in both periods, whereas G3P[8] and G12P[8] increased in proportion from pre- to postvaccine periods (1% to 25% and 17% to 40%), respectively.

Conclusions
The epidemiology and disease burden of rotavirus has been altered by rotavirus vaccination with a biennial disease pattern, sustained low rates of rotavirus in children &lt; 3 years of age, and a shift in the residual genotypes from G1P[8] to other genotypes.
Multistate, Population-Based Distributions of Candidate Vaccine Targets, Clonal Complexes, and Resistance Features of Invasive Group B Streptococci Within the United States, 2015–2017
Authors: McGee Lesley , Chochua Sopio , Li Zhongya , Mathis Saundra , Rivers Joy , Metcalf Benjamin , Ryan Alison , Alden Nisha , Farley Monica M , Harrison Lee H , Snippes Vagnone Paula , Lynfield Ruth , Smelser Chad , Muse Alison , Thomas Ann R , Schrag Stephanie , Beall Bernard W 
Published: February 2020

AbstractBackgroundGroup B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis and an important cause of invasive infections in pregnant and nonpregnant adults. Vaccines targeting capsule polysaccharides and common proteins are under development.MethodsUsing whole genome sequencing, a validated bioinformatics pipeline, and targeted antimicrobial susceptibility testing, we characterized 6340 invasive GBS isolates recovered during 2015–2017 through population-based Active Bacterial Core surveillance (ABCs) in 8 states.ResultsSix serotypes accounted for 98.4% of isolates (21.8% Ia, 17.6% V, 17.1% II, 15.6% III, 14.5% Ib, 11.8% IV). Most (94.2%) isolates were in 11 clonal complexes (CCs) comprised of multilocus sequence types identical or closely related to sequence types 1, 8, 12, 17, 19, 22, 23, 28, 88, 452, and 459. Fifty-four isolates (0.87%) had point mutations within pbp2x associated with nonsusceptibility to 1 or more β-lactam antibiotics. Genes conferring resistance to macrolides and/or lincosamides were found in 56% of isolates; 85.2% of isolates had tetracycline resistance genes. Two isolates carrying vanG were vancomycin nonsusceptible (minimum inhibitory concentration = 2 µg/mL). Nearly all isolates possessed capsule genes, 1–2 of the 3 main pilus gene clusters, and 1 of 4 homologous alpha/Rib family determinants. Presence of the hvgA virulence gene was primarily restricted to serotype III/CC17 isolates (465 isolates), but 8 exceptions (7 IV/CC452 and 1 IV/CC17) were observed.ConclusionsThis first comprehensive, population-based quantitation of strain features in the United States suggests that current vaccine candidates should have good coverage. The β-lactams remain appropriate for first-line treatment and prophylaxis, but emergence of nonsusceptibility warrants ongoing monitoring.
The Impact of Clinical Decision Support Alerts onClostridioides difficileTesting: A Systematic Review
Authors: Dunn Aaron N , Radakovich Nathan , Ancker Jessica S , Donskey Curtis J , Deshpande Abhishek 
Published: February 2020

AbstractBackgroundSeveral studies have investigated the utility of electronic decision support alerts in diagnostic stewardship for Clostridioides difficile infection (CDI). However, it is unclear if alerts are effective in reducing inappropriate CDI testing and/or CDI rates. The aim of this systematic review was to determine if alerts related to CDI diagnostic stewardship are effective at reducing inappropriate CDI testing volume and CDI rates among hospitalized adult patients.MethodsWe searched Ovid Medline and 5 other databases for original studies evaluating the association between alerts for CDI diagnosis and CDI testing volume and/or CDI rate. Two investigators independently extracted data on study characteristics, study design, alert triggers, cointerventions, and study outcomes.ResultsEleven studies met criteria for inclusion. Studies varied significantly in alert triggers and in study outcomes. Six of 11 studies demonstrated a statistically significant decrease in CDI testing volume, 6 of 6 studies evaluating appropriateness of CDI testing found a significant reduction in the proportion of inappropriate testing, and 4 of 7 studies measuring CDI rate demonstrated a significant decrease in the CDI rate in the postintervention vs preintervention period. The magnitude of the increase in appropriate CDI testing varied, with some studies reporting an increase with minimal clinical significance.ConclusionsThe use of electronic alerts for diagnostic stewardship for C. difficile was associated with reductions in CDI testing, the proportion of inappropriate CDI testing, and rates of CDI in most studies. However, broader concerns related to alerts remain understudied, including unintended adverse consequences and alert fatigue.
Relative and Absolute Effectiveness of High-Dose and Standard-Dose Influenza Vaccine Against Influenza-Related Hospitalization Among Older Adults—United States, 2015–2017
Authors: Doyle Joshua D , Beacham Lauren , Martin Emily T , Talbot H Keipp , Monto Arnold , Gaglani Manjusha , Middleton Donald B , Silveira Fernanda P , Zimmerman Richard K , Alyanak Elif , Smith Emily R , Flannery Brendan L , Rolfes Melissa , Ferdinands Jill M 
Published: February 2020

Abstract

Background
Seasonal influenza causes substantial morbidity and mortality in older adults. High-dose inactivated influenza vaccine (HD-IIV), with increased antigen content compared to standard-dose influenza vaccines (SD-IIV), is licensed for use in people aged ≥65 years. We sought to evaluate the effectiveness of HD-IIV and SD-IIV for prevention of influenza-associated hospitalizations.

Methods
Hospitalized patients with acute respiratory illness were enrolled in an observational vaccine effectiveness study at 8 hospitals in the United States Hospitalized Adult Influenza Vaccine Effectiveness Network during the 2015–2016 and 2016–2017 influenza seasons. Enrolled patients were tested for influenza, and receipt of influenza vaccine by type was recorded. Effectiveness of SD-IIV and HD-IIV was estimated using a test-negative design (comparing odds of influenza among vaccinated and unvaccinated patients). Relative effectiveness of SD-IIV and HD-IIV was estimated using logistic regression.

Results
Among 1487 enrolled patients aged ≥65 years, 1107 (74%) were vaccinated; 622 (56%) received HD-IIV, and 485 (44%) received SD-IIV. Overall, 277 (19%) tested positive for influenza, including 98 (16%) who received HD-IIV, 87 (18%) who received SD-IIV, and 92 (24%) who were unvaccinated. After adjusting for confounding variables, effectiveness of SD-IIV was 6% (95% confidence interval [CI] −42%, 38%) and that of HD-IIV was 32% (95% CI −3%, 54%), for a relative effectiveness of HD-IIV versus SD-IIV of 27% (95% CI −1%, 48%).

Conclusions
During 2 US influenza seasons, vaccine effectiveness was low to moderate for prevention of influenza hospitalization among adults aged ≥65 years. High-dose vaccine offered greater effectiveness. None of these findings were statistically significant.
Waning Vaccine Immunity and Vaccination Responses in Children Treated for Acute Lymphoblastic Leukemia: A Canadian Immunization Research Network Study
Authors: Top Karina A , Vaudry Wendy , Morris Shaun K , Pham-Huy Anne , Pernica Jeffrey M , Tapiéro Bruce , Gantt Soren , Price Victoria E , Rassekh S Rod , Sung Lillian , McConnell Athena , Rubin Earl , Chawla Rupesh , Halperin Scott A 
Published: February 2020

Abstract

Background
There is no uniform guideline for postchemotherapy vaccination of children with acute lymphoblastic leukemia (ALL). We evaluated waning immunity to 14 pneumococcal serotypes, pertussis toxin (PT), tetanus toxoid (TT) and varicella, and immunogenicity of postchemotherapy diphtheria, tetanus, pertussis, hepatitis B, polio, and Haemophilus influenzae type b (DTaP-IPV-Hib) and pneumococcal vaccination among previously vaccinated children treated for ALL.

Methods
This was a multicenter trial of children with ALL enrolled 4–12 months postchemotherapy completion. Exclusion criteria included: infant ALL, relapsed ALL, and stem cell transplant recipients. Immunocompetent children were recruited as controls. Postchemotherapy participants received DTaP-IPV-Hib and 13-valent pneumococcal conjugate vaccine (PCV13) concurrently, followed by 23-valent pneumococcal polysaccharide vaccine (PPV23) 2 months later. Serology was measured at baseline, 2 and 12 months postvaccination. Adverse events were captured via surveys.

Results
At enrollment, postchemotherapy participants (n = 74) were less likely than controls (n = 78) to be age-appropriately immunized with DTaP (41% vs 89%, P &lt; .001) and PCV (59% vs 79%, P = .008). Geometric mean concentrations (GMCs) to TT, PT, PCV serotypes, and varicella were lower in postchemotherapy participants than controls after adjusting for previous vaccine doses (P &lt; .001). Two months postvaccination, GMCs to TT, PT, and PCV serotypes increased from baseline (P &lt; .001 for all antigens) and remained elevated at 12 months postvaccination. Antibody levels to PPV23 serotypes also increased postvaccination (P &lt; .001). No serious adverse events were reported.

Conclusions
Children treated for ALL had lower antibody levels than controls against pneumococcal serotypes, tetanus, pertussis, and varicella despite previous vaccination. Postchemotherapy vaccination with DTaP-IPV-Hib, PCV13, and PPV23 was immunogenic and well tolerated. Children with ALL would benefit from systematic revaccination postchemotherapy.

Clinical Trials Registration
NCT02447718.
The Protein Binding of Acetylsalicylic Acid and Salicylic Acid
Authors: Ali M Amir , Routh Joseph I 
Published: February 2020

Abstract
Quantitative experiments to study the binding of acetylsalicylic acid (ASA) and salicylic acid (SA) by human serum albumin (HSA) were carried out using 14C-labeled ASA or SA and gel filtration to separate the free from the bound forms. Two binding procedures were employed: the ASA or SA was incubated with the HSA, or the mixture was placed in an equilibrium dialysis cell. By withdrawing samples at intervals, the extent of binding or the attainment of equilibrium could be assessed. Evidence that filtration by the gel caused unbinding of the bound SA was obtained, with resultant lower percentage binding of SA by HSA than that obtained by equilibrium dialysis without gel filtration. In either case, binding equilibrium was reached in 4-8 hr. The binding of ASA by HSA was markedly different from that of SA. The experiments both with or without gel filtration demonstrated a progressive increase in binding of ASA in the 20- to 53-hr periods studied. In addition, ASA apparently displaces SA from its binding sites on albumin, an observation that may have therapeutic implications.
A Procedure for the Measurement of Urinary 17-Hydroxycorticosteroids, Aldosterone Acid-labile Conjugate, and Free Plasma Cortisol in Patients with Chronic Illness
Authors: Walker Jacqueline Claus 
Published: February 2020

Abstract
The usual steps for steroid isolation are: (1) hydrolysis, acid for the urinary acid-labile aldosterone conjugate, and enzymatic for the urinary 17-hydroxycorticosteroids (17-OHCS); (2) organic solvent extraction of the corticosteroids; and (3) alkaline, acid, and aqueous washing of the organic extracts of steroids.
In the method described the crude extracts are purified by 3 or 4 sequential partitions using solvent systems of increasing polarity. After three chromatographic separations the 17-OHCS are still near the origin, and the fourth solvent system will separate these from each other. For the measurement of 17-OHCS, the mixed steroids are eluted after the third separation. Half of each eluate is analyzed by the Porter-Silber reaction; the other half is used as a blank to obtain the absorbance of the phenylhydrazones by spectrophotometry. For the measurement of aldosterone or cortisol, aldosterone (mixed with cortisone) or cortisol (mixed with tetrahydrocortisone) is eluted after the fourth paper chromatographic separation and acetylated with 100 µg (2 µc) of 14C-acetic anhydride (specific activity, 2 mc/mmol). The labeled acetates are extracted by liquid partition and isolated by paper chromatography after addition of stable carriers. The beta emissions of the isotopic derivatives are counted by liquid scintillation. Concentrations are calculated from data obtained by acetylation and chromatographic separation of pure steroid standards and suitable blanks.
Solid-phase radioimmunoassay with protein-A-bearing Staphylococcus aureus cells used to assay a protein (ferritin) and a hapten (digoxin).
Authors: Gauldie J , Tang H K , Corsini A , Walker W H 
Published: February 2020

Abstract
We compared use of protein-A-containing Staphylococcus aureus bacteria with conventional ammonium sulfate precipitation and second-antibody methods of separating bound and free antigen in the radioimmunoassay of a hapten (digoxin) and protein (ferritin) in human sera. In each case, values obtained with the heat-killed, formalin-fixed bacteria correlated well with those found by established methods. No matrix effects were detected in either hapten or protein measurements. Because of the affinity of S. aureus for rabbit IgG, rabbit antisera could be used with a small number of bacteria to detect antigen in the presence of 50-fold excess human IgG. The availability of S. aureus and ease of handling make this reagent a rapid, economical alternative of general applicability in radioimmunoassay.
Amniotic fluid phosphatidylglycerol and phosphatidylinositol separated by stepwise-development thin-layer chromatography.
Authors: Mitnick M , DeMarco B , Gibbons J M 
Published: February 2020

Abstract
We describe a stepwise-development thin-layer-chromatographic technique for separating phosphatidylglycerol and phosphatidylinositol in samples of amniotic fluid. Plates are prepared from silica gel G slurried in a 50 g/L ammonium sulfate solution. Phospholipid phosphorus determination is not needed. Phospholipid phosphorus determination is not needed. Phosphatidylglycerol and phosphatidylinositol, measured densitometrically, are expressed as ratios to the sphingomyelin present. These ratios are correlated with the lecithin/sphingomyelin ratio and age of gestation in normal and abnormal pregnancies.