bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric Escherichia coli bacteraemia presentations and high‐risk factors in the emergency department
Authors: Elgoibar Borja , Gangoiti Iker , Garcia‐Garcia Juan José , Hernandez‐Bou Susanna , Gomez Borja , Martinez Indart Lorea , Mintegi Santiago ,   Bacteremia Study Working Group from the Infectious Diseases Working Group, Spanish Society of Pediatric Emergencies (SEUP)
Published: August 2020

AbstractAimEscherichia coli (E coli) is a known cause of paediatric bacteraemia. The main objective was to characterise the emergency department (ED) presentations of paediatric E coli bacteraemia and secondarily to identify those related to greater severity.MethodsThis was a sub‐study of a multicentre cross‐sectional prospective registry including all with E coli bacteraemia episodes between 2011 and 2016. We used multiple correspondence and cluster analysis to identify different patterns.ResultsWe included 291 patients and 43 met criteria for severe disease (14.3%, 95% confidence interval 11.2‐19.3). We identified four types of paediatric E coli bacteraemia presentations. Two (178 patients, 61.2%) were related to well‐appearing previously healthy infants with associated urinary tract infection (UTI). Well‐appearing children older than 12 months old with underlying disease (n = 60, 20.6%) and non‐well‐appearing children of different ages (n = 53, 18.2%) corresponded to the other two types; these had associated UTI infrequently and higher severity rate (15% and 50.9%, respectively, higher when compared with the two previous types, P < .01), including the two patients who died.ConclusionThere were four different types of ED paediatric E coli bacteraemia presentations with different severity. Febrile young children with associated UTI showed the best outcome.
Perceptions of Not Equally Tolerable Discriminations: Is Personal Experience so Decisive?
Authors: Cea D'Ancona Mª Ángeles 
Published: August 2020

AbstractDiscrimination is nowadays more frequently perceived, whilst not always readily identifiable. This study extends previous research on perceived discrimination by examining, simultaneously, the effects of both direct and indirect personal experiences of discrimination, together with sociodemographic variables (conservatism and social status), on the perception of group‐based discriminations; in addition to the mediating role of discriminatory outgroup attitudes. All of this comparing discriminations that are not understood as equally tolerable (race–nationality vs. age–disability discriminations), in two different nationwide surveys (2013 and 2016), and applying multigroup structural equation modelling. The final models showed different patterns, depending on the type of perceived discrimination. Whilst the effects of experiences were similar in both models, those as a result of sociodemographic variables differed, coupled with the interrelation between outgroup attitudes and perceived group‐based discrimination. Discriminatory attitudes showed to be what most affected both types of perceived discrimination, although in opposite directions.
Prescriber compliance to direct oral anticoagulant labels and impact on outcomes in Thailand
Authors: Wattanaruengchai Phannita , Nathisuwan Surakit , Rattanavipanon Wipharak , Chulavatnatol Suvatna , Kongwatcharapong Junporn , Mitsuntisuk Phatcharin , Chaiyasothi Thanaputt , Kritsanapipat Duangkamon , Phrommintikul Arintaya , Chaiyakunapruk Nathorn , Likittanasombat Khanchit , Lip Gregory Y.H. 
Published: August 2020

AimsThis study aimed to evaluate the prescriber compliance to the approved labels of direct oral anticoagulants (DOACs) and impact of appropriateness of dosing on clinical outcomes.MethodsA retrospective study was conducted using simple‐stratified random sampling of adult patients receiving ≥6 months of DOACs for various indications during 2013–2017 in 10 tertiary care hospitals. Patients were classified into 3 dosing groups including approved dose, underdosing and overdosing based on the Thai Food and Drug Administration‐approved labels. Cox proportional hazard models were used to evaluate the impact of different dosings on thromboembolic and bleeding events.ResultsFrom 1200 patients included in the data analysis, prescribing of DOACs was consistent with the approved indications in 1130 cases (94.2%) while 70 patients (5.8%) received DOACs despite having contraindications or with off‐label usage. Among 1026 cases of dosing evaluation cohort, 688 patients (67.1%) received approved doses. There were 227 (21.9%) and 110 (10.7%) cases of underdosing and overdosing, respectively. Multivariate analysis showed that underdosing was associated with an increased risk of thromboembolism 3.023 (95% confidence interval [CI]: 1.291–7.080; P = .011) while overdosing was associated with an increased risk of bleeding requiring hospitalization (adjusted hazard ratio, 3.045; 95% CI, 1.501–6.178; P = .002) and Bleeding Academic Research Consortium type 2 or more (adjusted hazard ratio, 2.196; 95% CI, 1.083–4.452; P = .029).ConclusionPrescribers’ compliance to approved indications were high. However, 1/3 of DOAC prescriptions were inconsistent with approved dosing. Dosing deviation was associated with an increase in adverse clinical outcomes.
Loss of cell–cell and cell–substrate contacts in single pancreatic β‐cells divert insulin release to intracellular vesicular compartments
Authors: Ljubicic Sanda , Cottet‐Dumoulin David , Bosco Domenico 
Published: August 2020

Background informationCell–cell or cell–substrate interactions are lost when cells are dissociated in culture, or during pathophysiological breakdowns, therefore impairing their structure and polarity, and affecting their function. We show that single rat β‐cells, cultured under non‐adhesive conditions, form intracytoplasmic vacuoles increasing in number and size over time. We characterized these structures and their implication in β‐cell function.ResultsUltrastructurally, the vacuoles resemble vesicular apical compartments and are delimited by a membrane, containing microvilli and expressing markers of the plasma membrane, including glucose transporter 2 and actin. When insulin secretion is stimulated, insulin accumulates in the lumen of the vacuoles. By contrast, when the cells are incubated under low calcium levels, the hormone is undetectable in vesicular compartments. Insulin release studies from single cells revealed that vacuole‐containing cells release less insulin as compared to control cells. When added to the medium, a non‐permeant fluid phase marker becomes trapped within vacuoles. Inhibition of vesicular trafficking and exocytosis as well as dynamin‐dependent endocytosis changed the percentage of vacuole‐containing cells, suggesting that both endocytic and exocytic track contribute to their formation.ConclusionsThese results suggest that loss of cell–cell and cell–substrate contacts in isolated β‐cells affect normal vesicular trafficking and redirects insulin secretion to intracellular vesicular compartments.SignificanceOur study reveals for the first time that single β‐cells develop vacuolar compartments when cultured in suspension and redirect their insulin secretion to these vacuoles. This may underlie a compensatory process for cultured cells who lost their interactions with adhesive substrates or neighbouring cells.
Epidemiology of nonmelanoma skin cancer in Japan: Occupational type, lifestyle, and family history of cancer
Authors: Cai Honglin , Sobue Tomotaka , Kitamura Tetsuhisa , Sawada Norie , Iwasaki Motoki , Shimazu Taichi , Tsugane Shoichiro 
Published: August 2020

AbstractSkin cancer is the most frequently diagnosed cancer in the fair‐skinned population. In recent years, the incidence of nonmelanoma skin cancer (NMSC) has been increasing worldwide. However, there is no epidemiological study on skin cancer in the Asian population. A prospective cohort study including 140 420 participants was initiated in 1990 for cohort Ⅰ and 1993 for cohort Ⅱ at baseline survey from 11 public health center (PHC) areas. Of these participants, 284 NMSC cases were diagnosed during the follow‐up period (through 2012 in the Osaka PHC area and 2013 in the other PHC areas). The Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals (CI) for NMSC incidence according to occupational type, lifestyle factors (alcohol consumption, coffee consumption, smoking status, physical activity, and body mass index), and family history of cancer. Among men, compared with indoor workers, outdoor workers were associated with 2.18 (95% CI, 1.17‐4.04) higher risk of squamous cell carcinoma (SCC) but not of basal cell carcinoma (BCC). Furthermore, men who have a family history of cancer had 1.99 (95% CI, 1.10‐3.62) higher SCC risk. In women, we did not observe any association between occupational type and the risk of SCC (1.26; 95% CI, 0.68‐2.32) or BCC (0.74; 95% CI, 0.42‐1.28). In conclusion, men who are outdoor workers or have a family history of cancer had an increased risk of SCC.
Structural insight into the effect of polymorphic variation on the functional dynamics of methionine synthase reductase: Implications in neural tube defects
Authors: Sadhukhan Susanta , Maity Subhajit , Chakraborty Sandipan , Paul Silpita , Munian Dinesh , Kumar Pattanayak Arup , Jana Biman , Das Madhusudan 
Published: August 2020

AbstractNeural tube defects (NTDs), one of the most common birth defects, are strongly associated with the variations of several single nucleotide polymorphisms (SNPs) in the MTRR gene. The gene codes a key enzyme that is involved in the rejuvenation of methionine synthase activity. An allelic variant of the protein leads to missense mutation at 49th position from isoleucine to methionine (I49M) is associated with higher disease prevalence in different populations. Here, extensive molecular dynamics simulations and interaction network analysis reveal that the 49th isoleucine is a crucial residue that allosterically regulates the dynamics between the flavin mononucleotide (FMN) and NADP(H) binding domains. I49M variation alters the functional dynamics in a way that might impede the electron transport chain along the NADP(H) → flavin adenine dinucleotide → FMN pathway. The present study provides functional insights into the effect of the genetic variations of the MTRR gene on the NTDs disease pathogenesis.
State‐Dependent Memory in Infants
Authors: Seehagen Sabine , Schneider Silvia , Sommer Katharina , La Rocca Laura , Konrad Carolin 
Published: August 2020

Why do infants remember some things and not others? Human infants frequently cycle through different states such as calm attentiveness, wakeful activity, and crying. Given that cognitive processes do not occur in isolation, such fluctuations in internal state might influence memory processing. In the present experiment, declarative memory in 9‐month‐old infants (N = 96) was heavily state dependent. Infants exhibited excellent retention of a deferred imitation task after a 15‐min delay if their state at encoding was identical to their state at retrieval (e.g., calm). Infants failed to exhibit retention if their state at encoding was different from their state at retrieval (e.g., calm vs. animated). Infant memory processing depends on internal cues.
Too Much Familiarity! The Developmental Path of the Fluency Heuristic in Children
Authors: Geurten Marie , Willems Sylvie , Lloyd Marianne 
Published: August 2020

We tested whether changes in attribution processes could account for the developmental differences observed in how children’s use fluency to guide their memory decisions. Children ranging in age from 4 to 9 years studied a list of familiar or unfamiliar cartoon characters. In Experiment 1 (n = 84), participants completed a recognition test during which the perceptual fluency of some items was enhanced using a prime. In Experiment 2 (n = 96), participants completed a source recollection judgment on their recognition decisions. Primed items were recognized at a higher rate than unprimed items. However, while young children rely on fluency for all items, older children use fluency only for unfamiliar items. This pattern came together with a reduction in familiarity‐based—but not recollection‐based—memory responses.
Can the school environment influence oral health–related behaviours? A multilevel analysis of the Brazilian National Adolescent School‐Based Health Survey 2015
Authors: Nery Newillames Gonçalves , Antunes José Leopoldo Ferreira , Jordão Lidia Moraes Ribeiro , Freire Maria do Carmo Matias 
Published: August 2020

AbstractObjectiveTo investigate the association between the potential support of schools for oral health promotion and a set of oral health–related behaviours among adolescent students in Brazilian state capitals.MethodsA cross‐sectional study using individual and school environment data from the 2015 Brazilian National Adolescent School‐Based Health Survey (PeNSE) was conducted. The sample consisted of 51 192 students from 1339 public and private schools in the 27 Brazilian State Capitals, aged 11‐19 years old. The outcomes were six oral health‐related behaviours: dental visits; toothbrushing frequency; soft drink and sweets consumption; smoking and alcohol consumption. The explanatory variable was the Oral Health Promotion School Environment index (OHPSE). Covariates were the adolescents' sociodemographic characteristics and organizational aspects of the schools. A two‐level multilevel mixed‐effects Poisson regression analysis with fixed slopes and random intercepts was performed, considering the complex sample design.ResultsThe prevalence of risk behaviours was 28.0% for ‘low frequency of annual dental visits’, 6.9% for ‘low daily toothbrushing frequency’, 28.8% for ‘high weekly soft drink consumption’, 41.7% for ‘high weekly sweet consumption’, 18.9% for ‘cigarette experimentation’ and 52.6% for ‘alcoholic beverage experimentation’. The schools were classified as low (36.3%), intermediate (30.4%) and high (33.3%) OHPSE. In the adjusted model, schools with ‘high OHPSE’ had lower prevalence of ‘low frequency of annual dental visits’ (PR = 0.94 [95% CI 0.90; 0.99]), ‘high weekly frequency of soft drink consumption’ (PR = 0.94 [95% CI 0.89; 0.99]) and ‘sweet consumption’ (PR = 0.96 [95% CI 0.93; 1.00]) than those with ‘low OHPSE’. In addition, schools with ‘intermediate OHPSE’ had higher prevalence's of ‘low daily toothbrushing frequency’ (PR = 1.12 [95% CI 1.03; 1.23]) and ‘cigarette experimentation’ (PR = 1.08 [95% CI 1.01; 1.16]) than those with ‘low OHPSE’. ‘Alcoholic beverage experimentation’ was not associated with OHPSE.ConclusionsThe potential support of schools for oral health promotion was associated with most of the oral health–related behaviours among adolescent students. Those attending schools with higher OHPSE scores reported a higher annual frequency of dental visits and a lower weekly frequency of soft drink and sweet consumption, while those in schools with intermediate OHPSE had a lower daily toothbrushing frequency and a higher rate of cigarette experimentation.
The airway fungal microbiome in asthma
Authors: Rick Eva‐Maria , Woolnough Kerry F. , Seear Paul J. , Fairs Abbie , Satchwell Jack , Richardson Matthew , Monteiro William R. , Craner Michelle , Bourne Michelle , Wardlaw Andrew J. , Pashley Catherine H. 
Published: August 2020

AbstractBackgroundFungal involvement in asthma is associated with severe disease. The full spectrum of fungal species in asthma is not well described and is derived largely from insensitive culture techniques.ObjectivesTo use high‐throughput sequencing to describe the airway mycobiota in asthmatics with and without fungal sensitization and healthy controls; to compare samples representing different airway compartments; to determine whether the mycobiota was influenced by the fungal composition of outdoor air; and to compare findings with clinically relevant outcomes.MethodsWe amplified the internal transcribed spacer region 2 of the nuclear ribosomal operon to identify the fungal species present. Ninety‐seven subjects were recruited and provided sputum (83 asthmatics; 14 healthy subjects), with 29 also undergoing a bronchoscopy. A subset of airway samples were compared with matched outdoor air and mouthwash samples.ResultsTwo hundred and six taxa at the species level were identified in sputum, most at low relative abundance. Aspergillus fumigatus, Candida albicans and Mycosphaerella tassiana had the highest relative abundances and were the most prevalent species across all subjects. The airway mycobiota consisted of a complex community with high diversity between individuals. Notable shifts in the balance of fungi detected in the lung were associated with asthma status, asthma duration and biomarkers of inflammation. Aspergillus tubingensis, a member of the Aspergillus niger species complex, was most prevalent from bronchoscopic protected brush samples and significantly associated with a low sputum neutrophilia. Cryptococcus pseudolongus, from the Cryptococcus humicola species complex, was more abundant from bronchoscopy samples than sputum, and differentially more abundant in asthma than health.Conclusions and Clinical RelevanceThe airway mycobiota was dominated by a relatively small number of species, but was distinct from the oropharyngeal mycobiota and air samples. Members of the A. niger and C. humicola species complexes may play unexpected roles in the pathogenesis of asthma.
Health‐related quality of life and treatment strategies in myasthenia gravis
Authors: Utsugisawa Kimiaki , Nagane Yuriko , Uzawa Akiyuki , Murai Hiroyuki , Imai Tomihiro , Suzuki Shigeaki 
Published: August 2020

AbstractOur multicenter studies have repeatedly shown that disease severity and oral steroid dose are major independent factors negatively impacting health‐related quality of life (QOL) in patients with myasthenia gravis (MG). Even if pharmacological remission is achieved, QOL is low in patients taking oral prednisolone >10 mg/day. Disease severity tends to affect QOL by decreasing personal activities, whereas insufficiently reduced steroids affects QOL by decreasing social activities. MG patients often experience unemployment and decreased income, and many patients report reduced social positivity. More effort is required to reduce both the severity and dose of oral steroids. QOL in patients with minimal manifestations (MM) or better status who are treated with prednisolone at ≤5 mg/day (MM‐or‐better‐5 mg) is almost identical to that in patients achieving complete stable remission. Early achievement of MM‐or‐better‐5 mg is now recommended as a target for MG treatment in Japan. However, our studies suggested that the percentage of patients achieving MM‐or‐better‐5 mg was not high in 2010 and 2012 (<40% of generalized MG patients), and was not considered to be increased by physician skill in steroid dosing. In Japan, treatment strategies are now being reconsidered to further increase treatment success, placing a focus on helping MG patients resume a normal lifestyle by achieving the target as soon as possible. An initial attempt to achieve early MM‐or‐better‐5 mg for some period through aggressive use of non‐oral fast‐acting therapies can be more important for patient QOL, even if long‐term stability cannot be provided.
Sustainable inspiratory pressure and incremental threshold loading for respiratory muscle endurance in chronic obstructive pulmonary disease: A pilot study
Authors: Gokcen Selda , Inal‐Ince Deniz , Saglam Melda , Vardar‐Yagli Naciye , Calik‐Kutukcu Ebru , Arikan Hulya , Coplu Lutfi 
Published: August 2020

AbstractIntroductionA prolonged mismatch between the demand for respiratory muscle work and the capacity to meet that demand in chronic obstructive pulmonary disease (COPD) can result in symptoms of dyspnea and the development of muscle fatigue.ObjectivesThe purpose of this study was to compare two different respiratory muscle endurance assessment methods of sustainable inspiratory pressure (SIP) and incremental threshold loading (ITL) in COPD.MethodsThirty‐four patients diagnosed with COPD were included in the study. Physical and demographic characteristics of the subjects were recorded. Pulmonary function testing (PFT), modified Medical Research Council (MMRC) dyspnea scale, COPD assessment test, inspiratory and expiratory muscle strength (MIP and MEP, respectively) measurement and six‐minute walk test (6MWT) were used to assess subjects. Two different respiratory muscle endurance tests (SIP and ITL) were performed within 48 hours apart, and each test was repeated two times on the same day.ResultsThere was no correlation between the SIP and ITL tests (r = 0.069, P = .699). According to the test‐retest reliability analysis, both tests were reproducible (ICC = 0.843; P < .001 for SIP, ICC = 0.905; P < .001 for ITL). Finding no differences between repeated tests showed that tests are not affected by learning effect.ConclusionThe SIP and ITL tests are used for the same purpose but have different characteristics. Regarding the relationship between the other parameters and tests, the ITL is well tolerated and reflects the differences in respiratory muscle endurance better.
Predictors of mediastinal staging and usefulness of pet in patients with stage IIIA (N2) or IIIB (N3) lung cancer
Authors: Gullón José Antonio , Villanueva Manuel A. , Sánchez‐Antuña Andrés A. , Rodríguez Manuel R. , Álvarez‐Navascues Fernando , Allende Jesús , Martínez‐Muñiz Manuel A. , García‐García José M. 
Published: August 2020

AbstractObjectiveTo analyze which factors predict mediastinal N2/N3 lymph node staging and diagnostic accuracy of PET and CT to determine it.Patients and MethodsWe analyzed data collected prospectively in a database that included patients with non‐small cell lung cancer (NSCLC) who underwent EBUS‐TBNA. Prior to EBUS‐TBNA, CT and PET were used to define the radiographic N stage and lymph nodes with short axis ≥ 1 cm by CT or with ratio between maximum standardized uptake value (maxSUV), by PET, of lymph node and primary tumor greater than 0.56, were considered pathological. Definitive lymph node staging was established through EBUS‐TBNA, mediastinoscopy or surgical lymph node dissection.ResultsOne hundred and thirty four patients were included, in 88 of whom (65.6%), definitive lymph node staging was N2 or N3. Primary tumor of central location, lymph node size, maxSUV of lymph node and radiographic N stage by CT or PET were associated with N2/N3 in univariate analysis, but in logistic regression model it was only independently related with N stage by CT or PET. Negative predictive value and positive predictive value of CT were 0.81 and 0.74, respectively, and for PET 0.78 and 0.68.ConclusionIn NSCLC, in locoregional disease radiographic staging by CT or PET predict the existence of N2/N3 mediastinal disease, but negative and positive predictive values of both imaging techniques are not adequate, so EBUS‐TBNA samples should be taken in all lymph nodes with a diameter greater than 5 mm, regardless of PET findings.