bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efects of whey protein and resistant starch on body weight
Authors: Malekian Fatemah , Sebhatu Gebrelul Sebhatu , Henson James F , Cyrus Kasundra D. , Goita Mfamara , Kennedy Betty M. 
Published: December 2019

Background: Obesity is widely recognized as one of the most critical health threats to families and children across the country. Obesity is a very serious health problem for people in Louisiana and especially in African Americans Children with 40.5% in the State classified as either overweight or obese as compared to 41.2% nationally. African American women have the highest rates of being overweight or obese (79.8%) compared to non-Hispanic whites (57.9%). In 2007, African Americans were 1.4 times as likely to be obese as whites. Therefore this study was designed to test the impact of dietary whey protein (WP) and resistant starch (RS) shakes/smoothies on reduction of body fat via increased satiety and increased energy expenditure in African Americans. Methods: Twenty eight African American males and females, age 21-43 years old were randomly divided into two groups. For a period of 24-weeks, the treatment group consumed WP and RS shakes/smoothies for breakfast and received nutrition education. For the same period, the control group consumed the same shake/smoothies but with starch powder and received nutrition education. The data was analyzed using SAS version 9.3. Results: At the end of the 24 week study, the treatment group lost a mean body weight of approximately 7 kg (P ≤ 0.008) that was significantly different from the control group (P ≤ 0.209). In addition, the treatment group exhibited a significant decrease of ~6 cm in waist circumference (P ≤ 0.023). There was no significant effect on mean blood pressure in treatment and control group.Conclusion: The findings from this study suggest that a combination of WP and RS in the form of shake/smoothie consumed for breakfast along with a nutrition education component may be an effective method in decreasing body weight, improving waist circumferences and cumulative food intake in African American males and females. Key Words: Whey Protein, Resistant Starch, Obesity, Breakfast shakes, Nutrition education
Impact of nutritional stress on early embryonic survival
Authors: Mondal Sukanta , Reddy I. J. , Mor A. 
Published: December 2019

AbstractBackground: Low reproductive efficiency is the most critical problem faced by the livestock industry across the globe. Early embryonic loss is one the major cause of poor reproductive efficiency resulting in delayed pregnancy, fewer calves born, reduced milk production, slower genetic progress and substantial financial loss to the beef or dairy industry. The establishment of pregnancy results from the interaction between the embryo and the dam and is the culmination of a series of events initiated with development of the follicle and gametes. Among numerous internal and external factors nutrition has the potency to alter the micro-environment of the oocyte and the embryo, making it more hostile to optimal fertilization and pre-implantation embryonic growth. Understanding the impact of nutritional stress on oocyte function, embryo development and reciprocal signaling networks between the embryo and uterus will lead to alleviation of the problems of early embryonic mortality. Keywords: Early embryonic loss, establishment of pregnancy, maternal recognition of pregnancy, interferon-tau, progesterone, nutritional stress, oocyte function, embryo development
Amplitude integrated EEG in very low birth weight infants exposed	to preterm infant massage
Authors: Massaro An N. , El-Dib Mohamed 
Published: December 2019

Objective: To describe our experience with the use of aEEG as a measure of brain maturity in preterm neonates involved in a randomized controlled trial of infant massage. Study design: This is a prospective observational study from a subset of patients who were recruited in a randomized controlled trial evaluating the effects of massage in very low birthweight (VLBW) infants. Infants included in this report had an aEEG recording at 34 weeks post-menstrual age (PMA). aEEG recordings were evaluated by an investigator who was blinded to subjects' clinical history and study group. Each infant was assigned scores for continuity, sleep wake cycling, amplitude of lower border, bandwidth span, and overall aEEG maturation. Differences in scores between intervention and control groups are described. Results: Twenty-six VLBW infants had aEEG recordings at 34 weeks PMA; 13 who received massage and 13 in the control group. Twenty three percent of patients in the control group had a somewhat discontinuous aEEG, whereas all patients in the intervention group had a continuous aEEG. Overall maturation scores were delayed in 15% of massage group vs. 38% in control group. Both groups had similar sleep-wake cycle patterns. Conclusion: aEEG may be a useful tool to evaluate interventions hypothesized to have neurobehavioral effects on preterm infants such as massage therapy. Further studies that evaluate aEEG maturation and other neurodevelopmental outcomes in neonates exposed to preterm infant massage are needed.
Deviation of naso-gastric tube on frontal chest radiograph: A	marker of left atria enlargement in babies with ductus arteriosus
Authors: Sehgal Arvind , Kumbla Surekha , Jolley Damien , Ramsden Andrew 
Published: December 2019

Background: Presence of a hemodynamically significant ductus arteriosus is common in preterm infants and left atria enlargement is used as a surrogate marker. Cardiothoracic ratio may not be a reliable indicator of left atria enlargement given its posterior location. Aims: To assess the ability of angle of naso-gastric tube deviation to discriminate between babies with and without a hemodynamically significant ductus arteriosus. Methodology and data analysis: Retrospective chart review and radiographic measurements of frontal chest radiographs for babies with hemodynamically significant ductus arteriosus that was proven by echocardiography (ECHO) (Group I) compared with individually matched babies with no hemodynamically significant ductus arteriosus matching on corrected gestation age. Unrotated frontal chest radiographs done within 72 hours of echo and gestational age matched frontal chest radiographs for Control (Group II) were assessed for measurements of angle of naso-gastric tube deviation and carinal angle by digital imaging technique. Results: A total of 32 babies were enrolled in each group. Mean naso-gastric tube angle was significantly greater in babies from group I, with average difference 4.5° (95% CI 3° to 6°. Angle greater than 9° increased the odds of being a Group I baby (Odds ratio 25.9, 95% CI 3.4–198). Conclusions: Measurement of naso-gastric tube angle deviation may be helpful in babies with hemodynamically significant ductus arteriosus and left heart volume overload.
Infant resuscitation outside the delivery room in	neonatal-perinatal and pediatric critical care fellowship programs: NRP or	PALS? Results of a national survey
Authors: Sawyer Taylor , Clark Aaron , Ridout Robert 
Published: December 2019

Introduction: Infant cardiopulmonary resuscitation outside the delivery room can follow one of two national guidelines: Neonatal Resuscitation Program (NRP), or Pediatric Advanced Life Support (PALS). Important differences exist between NRP and PALS guidelines. There are no published recommendations concerning the chronologic age at which to change from NRP to PALS guidelines. This study was designed to investigate current resuscitative practices outside the delivery room for infants cared for in Neonatal-Perinatal (N-P) and Pediatric Critical Care (PCC) medicine fellowship programs with regard to the use of NRP or PALS guidelines. Methods: Surveys were mailed to the program director of all one hundred fifty-eight ACGME accredited N-P and PCC medicine fellowship programs in the US. The survey included questions regarding the existence of written resuscitative policies for infants regarding the use of PALS versus NRP, provider certification requirements in NRP and PALS, resuscitation leadership, and the age after birth at which infants are resuscitated using PALS rather than NRP guidelines. Results: Of the 158 programs surveyed, 98 responded (62%). Of those responding only one center (1%) reported having a written policy concerning the use of NRP versus PALS. Significant differences were seen in provider certification requirements in NRP and PALS. There were significant differences in the time to change from NRP to PALS guidelines between responding N-P programs and PCC fellowship programs. None of the responding PCC programs reported using NRP guidelines past two months of age, while 35% of N-P programs continued to resuscitate infants using NRP guidelines up to 1 year of life. Twenty seven percent of responding N-P programs reported using "NRP only" for infant resuscitation. Conclusions: We found no consensus regarding the age at which infants are resuscitated with PALS rather than NRP in responding N-P and PCC fellowship programs. Our findings suggest that compared to infants cared for under the supervision of physicians in PCC medicine fellowship programs, infants cared for under the supervision of physicians in N-P medicine fellowship programs are much more likely to be resuscitated using NRP guidelines. While it is unclear if this variation in clinical practice has a significant effect on outcomes, this variation in practice makes it difficult to define the current standard of care for infant resuscitation in N-P and PCC fellowship programs and requires further investigation.
Clinical availability of neonatal blood culture results at 48	hours
Authors: d'Haens E.J. , Roell-Schorer E.A.M. , van Elzakker E.P.M. , de Beaufort A.J. , Sprij A.J. 
Published: December 2019

Background/aim: To minimize the use of antibiotics in the neonatal unit, it is crucial to know the time needed for a blood culture to become positive. With the development of newer automated blood culture systems, the time needed to detect a positive culture is said to be reduced to 48 hours. The aim of this study was to determine the time at which neonatal blood culture results become clinically available to the attending neonatologist. Design and methods: In an eighteen-months-period prospective study we collected 361 blood cultures from neonates admitted to our neonatal unit. Time to positivity (TTP) (the time between culture sampling and the moment the neonatologist received the results) was determined. Incubation time (time actually spent in the Bactec machine) was automatically registered. Results: 72 out of 361 blood cultures were positive (20%). 93% (67/72) of the positive cultures had a TTP of less than 48 hours. One sample had a TTP of 50 and one of 53 hours. Three samples had an incubation time of more than 94 hours. A total of 99% (68/69) of the remaining cultures were positive within 30 hours of incubation. Conclusion: This study demonstrated that 93% of blood cultures results are determined by 48 hours. Incubation time in the Bactec is consistent with reliable detection of pathogen microbes by 30 hours. If effort is made to improve logistics TTP can further be reduced to 30 hours resulting in further reduction of antibiotic usage in neonatal intensive care units.
The interindividual variability in metabolism of the analgesic	tramadol in neonates is independent of their disease state	characteristics
Authors: Allegaert Karel , van den Anker John N. , Verbesselt Rene , Rayyan Maissa , Debeer Anne , de Hoon Jan 
Published: December 2019

Objective: To investigate the impact of disease characteristics on the interindividual variability of O- and N-demethylation of tramadol in neonates. Methods: Tramadol (M), O-demethyl tramadol (M1), $N$-demethyl tramadol (M2), log M/M1 and log M/M2 were assessed in 24 hours urine collections during intravenous tramadol. Correlations with postnatal (PNA) and postmenstrual age (PMA), disease state characteristics [cardiopathy, (cardiac) surgery, small-for gestational age (SGA)] and CYP2D6 activity score were investigated. Results: Collections were available in 67 neonates. The mean log M/M1 was 1.01 (SD 0.63). Inverse relationships between log M/M1 and PMA, PNA and CYP2D6 activity score were observed. Median log M/M1 in early life (< day 8) was higher compared to late neonatal life (day 8–28) (p < 0.01). In a multiple forward regression model, PMA and CYP2D6 activity score remained independent variables. The mean log M/M2 was 1.71 (SD 0.46). Inverse relationships between log M/M2 and PMA and PNA were observed. Median log M/M2 in early life was higher compared to late neonatal life (p < 0.01). In a multiple forward regression model, PMA and PNA remained independent variables. Conclusions: Extensive interindividual variability in demethylation metabolic activity was observed. O-demethylation was in part explain by PMA and CYP2D6 activity score, N-demethylation by PMA and PNA while disease characteristics had no impact of demethylation activity.
Effects of nasal continuous positive airway pressure on pulmonary	and systemic output in preterm infants
Authors: Di Bernardo Stefano , Sekarski Nicole , Tolsa Jean-François 
Published: December 2019

Objective: Respiratory assistance with nasal continuous positive airway pressure (n-CPAP) is an effective treatment in premature newborns presenting respiratory distress. The aim of the study was to depict cardiac function, systemic (Qs) and pulmonary output (Qp) by echocardiography in stable premature infants requiring prolonged n-CPAP. Our hypothesis was that n-CPAP could reduce pulmonary blood flow. Patients and methods: All premature infants < 32 weeks gestation, > 7 days-old, requiring n-CPAP without severe respiratory compromise nor need for additional oxygen were prospectively included. Every patient had a first echocardiography while on n-CPAP. N-CPAP was then discontinued for two hours and a second echocardiography was performed. Results: 17 premature infants were included. Mean gestational age was 28 ± 2 weeks and mean weight 1.1 ± 0.3 kg. Following retrieval of n-CPAP we observed an increase in Qp of 53 ml/kg/min (95% CI 19–87 ml/kg/min), but no significant change in Qs. Consecutively a significant increase in Qp/Qs ratio of 16% was found (95% CI 7–29%). Conclusions: Nasal continuous positive airway pressure has hemodynamic effects in preterm infants in stable pulmonary and cardiac conditions. It reduces pulmonary output without interference with systemic output.
Whole body hypothermia using a portable cooling unit in a neonatal	pig model: Implications for transport
Authors: Rabenstein Eric , Tyree Melissa , Dirnberger Daniel , DiGeronimo Robert 
Published: December 2019

Background: Recent studies demonstrate a neuroprotective effect of therapeutic hypothermia following newborn hypoxic-ischemic encephalopathy; however, initiation of cooling must begin within 6 hours of birth. Evidence from animal models suggests that the earlier treatment is begun, the more efficacious hypothermia is in preventing brain injury. Unfortunately, timely initiation of therapy is often practically difficult to achieve for outborn neonates. Currently, there is no standardized methodology to safely initiate and regulate hypothermia during neonatal transport. Methods: This study evaluated the effectiveness of the Electri-Cool II Cold Therapy Unit (Cincinnati Sub-Zero®) to induce and regulate mild whole body hypothermia (33.5°C) in a neonatal porcine model. Seven healthy neonatal piglets (2–3.5 kg) were initially allowed to passively cool from baseline in an open air isolette over 1 hour. Following this, animals were rewarmed to baseline (if necessary) and then actively cooled to 33.5°C using the Electri-Cool II. Once the target temperature was achieved, temperature was closely monitored using rectal and skin temperature probes over the next 1 hour. Results: None of the study animals significantly lowered their temperature from baseline during the passive cooling period. By comparison, piglets actively cooled with the Electri-Cool II reached 33.5°C in a mean of 38 ± 19.7 minutes. Once at target temperature, hypothermia was maintained in the piglets with minimal average variation (0.3 ± 0.1°C) for the duration of the active study cooling period. Conclusion: The Electri-Cool II is superior to passive cooling for inducing and maintaining mild whole body hypothermia in a neonatal piglet model. Further evaluation of this device to include its potential utility during transport of newborn infants is warranted.
Peripherally inserted central catheter inserted from the lower	extremity veins: Catheter tip placement
Authors: Hoang Viet , Sills Jack , Clifton-Koeppel Robin , Modanlou Houchang D. 
Published: December 2019

The lower extremity veins are less utilized for the insertion of central catheter for prolonged venous access and the provision of total parenteral nutrition. We compared the complication rates for catheters inserted from the lower extremity veins in relation to their tip placement. During a 48-month period, 90 catheters inserted from the lower extremity veins were identified and their tip placement was documented. Catheter tips were placed in the upper portion of the inferior vena cava below the right atrium in 65, and just above or below the renal veins in 25. Data was analyzed for gestational age, birth weight, duration of catheters in place, duration of total parenteral nutrition, complications, necrotizing enterocolitis, serum direct bilirubin, liver enzyme, serum creatinine, length of hospitalization, and survival rate. The median birth weight and gestational age, duration of catheter in place, duration of total parenteral nutrition infusion were similar between the two groups. Catheter related infections, occlusions, phlebitis, and leakage; necrotizing enterocolitis, intraventricular hemorrhage, serum direct bilirubin, liver enzyme and serum creatinine were also similar between the two groups. We suggest that the lower extremity veins inserted catheters, with their tips at a lower position of the inferior vena cava may be as safe as those with their tips at the upper part of the inferior vena cava below the right atrium.
Multicenter investigation of prophylactic phenobarbital on	intraventricular hemorrhage in premature infants in China
Authors: Chen Hui-Jin , Wei Ke-Lun , Yao Yu-Jia , Yang Yu-Jia , Zhou Cong-Le , Fan Xiu-Fang , Gao Xi-Rong , Jiang Lian , Liu Xiao-Hong , Qian Ji-Hong , Wang Li , Wu Ben-Qing , Wu Gao-Qiang , Zhang Qing-Mei , Zhang Xiao-Lan , Zhou Xiao-Yu 
Published: December 2019

Objective: The prophylactic use of phenobarbital for the prevention of intraventricular hemorrhage (IVH) in premature infants remains controversial. In order to objectively assess the effect of phenobarbital on IVH, nine large-scale hospitals participated in a nearly two year investigation of brain injuries in premature Infants in China. Study Design: All premature infants with gestational age less than 34 weeks in three hospitals and less than 37 weeks in two other hospitals received intravenous phenobarbital (loading dose of 20 mg/kg) as early as possible before 6 hours of age. A maintenance dose of 5 mg/kg daily was given 24 hours after the loading dose and continued for 5 days. Premature infants in 4 other hospitals did not receive phenobarbital. All infants in nine hospitals were subjected to routine cranial ultrasound scanning within seven days after birth, and then repeated every 3∼7 days until discharge. The study period lasted from Jan. 2005 to Aug. 2006.
High altitude and microtia in Ecuadorian patients
Authors: González-Andrade Fabricio , López-Pulles Ramiro , Espín Víctor H. , Paz-y-Miño César 
Published: December 2019

Objective: To examine the relationship between high altitude and microtia in Ecuador. Methods: We evaluated the epidemiological issues of 1298 cases of microtia reported in Ecuador from 2001 to 2007. It used data arising from the Vital Statistics National Reports: Annual Survey of Admissions and Discharges in this 7 year period. The register is national and population based, run and funded by the government. Results: It reported a total of 1298 cases of microtia out of 34654 cases of congenital malformations described in the registries. The overall prevalence was 2.38/10000 admissions/discharges calculated out of 5462263 admissions. An overall percentage (of 90.22%) were admitted before 19 years of age with the most prevalent group between 5 to 9 years of age (31.90%). There was progressive increase of cases every year; from 132 cases in 2001 to 304 in 2007. Total male cases in this study were 723 (55.70%) and female cases were 575 (44.30%). Tungurahua reported the highest prevalence of 18.31/10000 births, followed by Chimborazo, Azuay, Pichincha and Cotopaxi; all of them located over 2500 meters above sea level. It found that highest prevalence was 10.21 over 2700 meters above sea level followed by 8.28 over 2800 meters above sea level; with both having a cumulative prevalence of 8.81. Conclusion: There is a higher prevalence of microtia in patients living above 2500 meters above sea level. This study was not able to establish a clear relationship between microtia and different ethnic groups.
Time limits for a failed response to inhaled nitric oxide in	newborn infants with persistent pulmonary hypertension: A retrospective	observational study
Authors: Salama Husam , Adlburaki Wissam , Ibrahim Amani Saeed , Lutfi Samawal , Magzoob Nawal 
Published: December 2019

Background: The onset of response to inhaled nitric oxide (INO) vary in the literature. It is important to identify non responders from those who respond to the INO in order to formulate management plans. Objective: To define a time limit for the acute effects of inhaled nitric oxide (INO) on systemic oxygenation beyond which the response to the inhaled therapy is unlikely to take place in sick newborn infants suffering from persistent pulmonary hypertension. Methods: This study was a hospital-based retrospective chart review. All infants who received INO for the treatment of pulmonary hypertension with acute sever hypoxemic respiratory failure over a period of four years were analyzed using the oxygenation index (OI) as an indicator for starting the therapy and following the response for total period of gas exposure. The OI was measured before and every one to six hours after initiating the therapy. The starting time of the gas, timing of first response, course of responses, blood gases, calculated OI before, during, and after initiation of the gas were also recorded until INO was discontinued. Results: Seventy-six infants were studied: 35 infants were born at 24 to 32 weeks gestation age, and 41 at 33 weeks gestation to full term. Mean duration time of exposure to INO was 53 hours in the preterm group and 84 hours in the near and full term group. The mean age at starting the therapy was 59 hours in the preterm group and 23 hours in the near and full term group. The degree of response to INO was as follows: 52.2% full response, 27.5% partial response, and 20.3% no response. The first two (2) hours contained the highest number of responders, 64%; while the response was 15% in the second two hours. No responders were recorded after eight hours of exposure. Conclusion: Exposure to INO for eight (8) hours could be carefully considered as a time limit to determine the type of response to such gas and to help in making a decision of ``wean to discontinue'' in non-responders.