bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing of tracheostomy placement among children with severe traumatic brain injury: A propensity-matched analysis
Authors: McLaughlin Cory , Darcy David , Park Caron , Lane Christianne J. , Mack Wendy J. , Bliss David W. , Bhalla Anoopindar , Upperman Jeffrey S. , Nathens Avery B. , Burd Randall S. , Jensen Aaron R. 
Published: March 2019

BACKGROUND
Early tracheostomy has been associated with shorter hospital stay and fewer complications in adult trauma patients. Guidelines for tracheostomy have not been established for children with severe traumatic brain injury (TBI). The purpose of this study was to (1) define nationwide trends in time to extubation and time to tracheostomy and (2) determine if early tracheostomy is associated with decreased length of stay and fewer complications in children with severe TBI.

METHODS
Records of children (<15 years) with severe TBI (head Abbreviated Injury Severity [AIS] score ≥3) who were mechanically ventilated (>48 hours) were obtained from the National Trauma Data Bank (2007–2015). Outcomes after early (≤14 days) and late (≥15 days) tracheostomy placement were compared using 1:1 propensity score matching to control for potential confounding by indication. Propensity scores were calculated based on age, race, pulse, blood pressure, Glasgow Coma Scale motor score, injury mechanism, associated injury Abbreviated Injury Severity scores, TBI subtype, craniotomy, and intracranial pressure monitor placement.

RESULTS
Among 6,101 children with severe TBI, 5,740 (94%) were extubated or died without tracheostomy, 95% of the time within 18 days. Tracheostomy was performed in 361 children (6%) at a median [interquartile range] of 15 [10, 22] days. Using propensity score matching, we compared 121 matched pairs with early or late tracheostomy. Early tracheostomy was associated with fewer ventilator days (14 [9, 19] vs. 25 [19, 35]), intensive care unit days (19 [14, 25] vs. 31 [24, 43]), and hospital days (26 [19, 41] vs. 39 [31, 54], all p < 0.05). Pneumonia (24% vs. 41%), venous thromboembolism (3% vs. 13%), and decubitus ulcer (4% vs. 13%) occurred less frequently with early tracheostomy (p < 0.05).

CONCLUSIONS
Early tracheostomy is associated with shorter hospital stay and fewer complications among children with severe TBI. Extubation without tracheostomy is rare beyond 18 days after injury.

LEVEL OF EVIDENCE
Prognostic and epidemiological, retrospective comparative study, level III.
Young lives cut short: The relationship between firearms and pediatric suicide
Authors: McLoughlin Robert J. , Hazeltine Max , Dacier Brittany M. , Hirsh Michael P. , Cleary Muriel A. , Aidlen Jeremy T. 
Published: March 2019

BACKGROUND
To describe the demographic characteristics and burden of pediatric suicides by firearm in the United States using a large all-payer pediatric inpatient care database.

METHODS
Children and young adults (<21 years old) were identified with an International Classification of Diseases, Ninth Revision diagnosis of suicide and self-inflicted injury with a firearm (SIF) in the Kids' Inpatient Database for the study years of 2006, 2009, and 2012. National estimates were obtained using case weighting. Multivariable logistic regression was performed to examine the association between SIF and risk factors while adjusting for various sociodemographic characteristics using separate models incorporating mental health diagnoses.

RESULTS
There were a total of 613 hospitalizations for SIF during the years under study. Almost four hospitalizations per week occurred, and in-hospital mortality was 39.1%. The mean age of the study population was 17.3 years, and this population was predominantly male (87.5%), white (62.4%), resided in an urban area (43.8%), lived in the south (51.3%), and within the lowest income quartile (33.8%). Mental health (38.3%) and mood disorders (28.3%) were common. Males had a markedly increased likelihood of hospitalization for SIF (adjusted odds ratio [aOR], 7.56; 95% confidence interval [CI], 5.54–10.30). Children and adolescents from rural environments and those in the south were more likely to have a hospitalization for SIF than respective comparison groups. Using separate regression models, a diagnosis of any mental health disorder increased the likelihood of hospitalization for a SIF (aOR, 11.9: 95% CI, 9.51–14.9), mood disorders (aOR, 17.2; 95% CI, 13.3–22.3), and depression (aOR, 21.3; 95% CI, 16.1–28.3).

CONCLUSION
Pediatric hospitalizations for SIF are a common occurrence with high associated mortality. The prevalence of mental health disorders and their impact on this population highlight the need for early identification and intervention for individuals at risk.

LEVEL OF EVIDENCE
Epidemiological, level III.
Differences in Gene Expression in Older Compared With Younger Kidney Transplant Recipients
Authors: Schaenman Joanna M. , Rossetti Maura , Lum Erik , Abdalla Basmah , Bunnapradist Suphamai , Pham Thu-Phuong , Danovitch Gabriel , Reed Elaine F. , Cole Steve 
Published: March 2019

Background
For the growing numbers of older transplant patients, increased incidence of infection and death compared with younger patients may limit the many benefits provided by transplantation. However, little is known about age-associated immune dysfunction in the older transplant recipient.

Methods
A cohort of 60 kidney transplant recipients, 23 older (≥ 60y) and 37 younger (30-59y), matched on antithymocyte induction and donor type (living vs deceased) was evaluated. Gene expression in peripheral blood mononuclear cells 3 months after kidney transplantation was analyzed to compare differences between older and younger patients.

Results
Proinflammatory genes were upregulated in older kidney transplant patients, including cytokines IL1-β and IL-6. Downregulated genes were associated with B-cell and T-cell function, including CCR7 and CD27. Analysis of predicted transcription factor binding suggested an increase in proinflammatory transcription factor CCAAT/enhancer binding protein β-binding sites in older patients, whereas interferon regulatory factor 2 transcription factor binding sites were less prevalent.

Conclusions
Older kidney transplant recipients exhibited multiple differences in gene expression compared with younger patients, with upregulation of proinflammatory genes and downregulation of adaptive immune response genes. These findings may explain the mechanism of increased vulnerability to infection and malignancy observed in older transplant patients.
Impact of Different Clinical Perfusates During Normothermic Ex Situ Liver Perfusion on Pig Liver Transplant Outcomes in a DCD Model
Authors: Linares-Cervantes Ivan , Kollmann Dagmar , Goto Toru , Echeverri Juan , Kaths Johan Moritz , Hamar Matyas , Urbanellis Peter , Mazilescu Laura , Rosales Roizar , Bruguera Claudia , Oquendo Fabiola , Ganesh Sujani , Adeyi Oyedele A. , Yip Paul , Selzner Nazia , Selzner Markus 
Published: March 2019

Background
Human albumin/dextran (HA-D), bovine-gelatin (BG), and packed red blood cells plus plasma have been used in European and North-American clinical trials of normothermic ex situ liver perfusion (NEsLP). We compared the effects of these perfusates in a porcine model during NEsLP and after transplantation.

Methods
Porcine livers were retrieved 30 minutes after circulatory death. After 5 hours of NEsLP, grafts were transplanted. Three groups (n = 6) were assessed (HA-D vs BG vs whole blood [WB]). One group of static cold storage (SCS) was evaluated for comparison with the perfusion groups. Hemodynamic variables, liver and endothelial injury, and function were assessed during NEsLP and posttransplantation.

Results
Hepatic artery flow was higher since the beginning of NEsLP in the HA-D group (HA-D, 238 ± 90 mL/min vs BG, 97 ± 33 mL/min vs WB, 148 ± 49 mL/min; P = 0.01). Hyaluronic acid was lower in the HA-D at the end of perfusion (HA-D, 16.28 ± 7.59 ng/μL vs BG, 76.05 ± 15.30 ng/μL vs WB, 114 ± 46 ng/μL; P < 0.001). After transplant, aspartate aminotransferase was decreased in the HA-D group when compared with the rest of the groups (HA-D, 444 ± 226 IU/L vs BG, 1033 ± 694 IU/L vs WB, 616 ± 444 IU/L vs SCS, 2235 ± 1878 IU/L). At 5 hours after transplant, lactate was lower in the HA-D group (HA-D, 3.88 ± 1.49 mmol/L vs BG, 7.79 ± 2.68 mmol/L vs WB, 8.16 ± 3.86 mmol/L vs SCS, 9.06 ± 3.54 mmol/L; P = 0.04). International Normalized Ratio was improved in HA-D group compared to the rest of the groups (HA-D, 1.23 ± 0.30 vs BG, 1.63 ± 0.20 vs WB, 1.50 ± 0.31 vs SCS, 1.97 ± 1.55; P = 0.03) after transplantation. In contrast, BG displayed lower aspartate aminotransferase levels during NEsLP (HA-D, 183 ± 53 IU/L vs BG, 142 ± 52 IU/L vs WB, 285 ± 74 IU/L; P = 0.01) and less cleaved-caspase-3 staining (HA-D, 2.05 ± 0.73% vs BG, 0.95 ± 1.14% vs WB, 1.74 ± 0.54% vs SCS, 7.95 ± 2.38%) compared with the other groups. On the other hand, the bile from the WB showed higher pH (HA-D, 7.54 ± 0.11 vs BG, 7.34 ± 0.37 vs WB, 7.59 ± 0.18) and lower glucose levels (HA-D, 0.38 ± 0.75 mmol/L vs BG, 1.42 ± 1.75 mmol/L vs WB, 0 ± 0 mmol/L) by the end of perfusion.

Conclusions
Overall HA-D displayed more physiologic conditions during NEsLP that were reflected in less graft injury and improved liver function and survival after transplantation. Optimization of the perfusates based on the beneficial effects found with these different solutions would potentially improve further the outcomes through the use of NEsLP in marginal grafts.
Development of a deep amplicon sequencing method to determine the proportional species composition of piroplasm haemoprotozoa as an aid in their control
Authors: Chaudhry Umer , Ali Qasim , Rashid Imran , Shabbir Muhammad Zubair , Abbas Muhammad , Numan Muhammad , Evans Mike , Ashraf Kamran , Morrison Ivan , Morrison Liam , Sargison Neil D. 
Published: March 2019

AbstractPiroplasmosis is caused by tick-borne haemoprotozoa of the generaTheileriaandBabesia. These parasitic infections can cause serious impact on the health of livestock and production. Multiple piroplasm species can infect a single host, but reliable molecular diagnostic tools are needed with which to understand the composition of these complex parasite communities.TheileriaandBabesiavary in their epidemiology, drug sensitivity, pathogenicity and interaction of co-infecting species, but are similar in the animals, become persistent carriers after recovery from primary infection, acting as reservoir hosts. Here, we describe for the first time the use of a deep amplicon sequencing platform to identify proportions of piroplasm species in co-infecting communities and develop the concept of a “haemoprotobiome”. First, four phenotypically-verified species ofTheileriaandBabesiawere used to prepare mock pools with random amounts of the parasites and amplified with four different numbers of PCR cycles to assess sequence representation of each species. Second, we evaluated the detection threshold of the deep amplicon sequencing assay for each of the four species and to assess the accuracy of proportional quantification of all four species. Finally, we applied the assay to the field samples to afford insight of the species composition of piroplasm communities in small and large ruminants in the Punjab province of Pakistan. The “haemoprotobiome” concept has several potential applications in veterinary and human research, including understanding of responses to drug treatment; parasite epidemiology and ecology; species interactions during mixed infections; and parasite control strategies.
Presynaptic boutons that contain mitochondria are more stable
Authors: Lees Robert M. , Johnson James D. , Ashby Michael C. 
Published: March 2019

AbstractAddition and removal of presynaptic terminals reconfigures neuronal circuits of the mammalian neocortex, but little is known about how this presynaptic structural plasticity is controlled. Since mitochondria can regulate presynaptic function, we investigated whether the presence of axonal mitochondria relates to structural plasticity of presynaptic boutons in mouse neocortex. We found that the overall density of axonal mitochondria did not appear to influence loss and gain of boutons. However, positioning of mitochondria at individual presynaptic sites did relate to increased stability of those boutons. In line with this, synaptic localisation of mitochondria increased as boutons aged and showed differing patterns of localisation aten passantandterminauxboutons. These results suggest that mitochondria accumulate locally at boutons over time to increase bouton stability.
Molecular mechanisms for intestinal HCO3-secretion and its regulation by guanylin in seawater-acclimated eels
Authors: Takei Yoshio , Wong Marty K.S. , Ando Masaaki 
Published: March 2019

AbstractThe intestine of marine teleosts secretes HCO3-into the lumen and precipitates Ca2+and Mg2+in the imbibed seawater as carbonates to decrease luminal fluid osmolality and facilitate water absorption. However, reports on studies on the hormonal regulation of HCO3-secretion are just emerging. Here, we showed that guanylin (GN) applied to the mucosal side of intestinal epithelia increased HCO3-secretion in seawater-acclimated eels. The effect of GN on HCO3-secretion was slower than that on the short-circuit current, and the time-course of the GN effect was similar to that of bumetanide. Mucosal bumetanide and serosal 4,4’-dinitrostilbene-2,2’-disulfonic acid (DNDS) inhibited the GN effect, suggesting an involvement of apical Na+-K+-2Cl-cotransporter (NKCC2) and basolateral Cl-/HCO3-exchanger (AE)/Na+-HCO3-cotransporter (NBC) in the GN effect. However, mucosal DNDS and diphenylamine-2-carboxylic acid (DPC) failed to inhibit the GN effect, showing that apical AE and Cl-channel are not involved. To identify molecular species of possible transporters involved in the GN effect, we performed RNA-seq analyses followed by quantitative real-time PCR after transfer of eels to seawater. Among the genes upregulated after seawater transfer, those of Slc26a3a, b (DRAa, b) and Slc26a6a, c (Pat-1a, c) on the apical membrane of the intestinal epithelial cells, and those of Sls4a4a (NBCe1a), Slc4a7 (NBCn1), Slc4a10a (NBCn2a) and Slc26a1 (Sat-1) on the basolateral membrane were candidate transporters involved in HCO3-secretion. Judging from the slow effect of GN, we suggest that GN inhibits NKCC2b on the apical membrane and decreases cytosolic Cl-and Na+, which then activates apical DNDS-insensitive DRAa, b and basolateral DNDS-sensitive NBCela, n1, n2a to enhance transcellular HCO3-flux across the intestinal epithelia of seawater-acclimated eels.
Ultra-compliant carbon nanotube stretchable direct bladder interface
Authors: Yan Dongxiao , Bruns Tim M. , Wu Yuting , Zimmerman Lauren L. , Stephan Chris , Cameron Anne P. , Yoon Euisik , Seymour John P. 
Published: March 2019

AbstractThe bladder, stomach, intestines, heart, and lungs all move dynamically to achieve their purpose. A long-term implantable device that can attach onto an organ, sense its movement, and deliver current to modify the organ function would be useful in many therapeutic applications. The bladder, for example, is a smooth muscle organ that can suffer from incomplete contractions that result in urinary retention with patients requiring using catheterization. Those affected may benefit from a combination of strain sensor and electrical stimulator to better control bladder emptying. We describe the materials and design of such a device made from thin layer carbon nanotube (CNT) and Ecoflex 00-50 and demonstrate its function with in vivo feline bladders. During bench-top characterization, the resistive and capacitive sensors exhibited reliable output throughout 5,000 stretching cycles under physiology condition. In vivo measurement with piezoresistive device showed a high correlation between sensor resistance and volume. Stimulation driven from Pt-PDMS composite electrodes successfully induced bladder contraction. We present method for reliable connection and packaging of medical grade wire to the CNT device. This work is an important step toward the translation of low-durometer elastomers, stretchable CNT percolation and Pt-PDMS composite, which are ideal for large strain bioelectric applications to sense or modulate dynamic organ states.
Increased hippocampal excitability and altered learning dynamics mediate cognitive mapping deficits in human aging
Authors: Diersch Nadine , Valdes-Herrera Jose P , Tempelmann Claus , Wolbers Thomas 
Published: March 2019

ABSTRACTLearning the spatial layout of a novel environment is associated with dynamic activity changes in the hippocampus and in medial parietal areas. With advancing age, the ability to learn spatial environments deteriorates substantially but the underlying neural mechanisms are unknown. Here, we report findings from a behavioral and a fMRI experiment where older and younger adults performed a spatial learning task in a photorealistic virtual environment. We modeled individual learning states using a Bayesian state-space model and found that activity in retrosplenial cortex/parieto-occipital sulcus and anterior hippocampus did not change systematically as a function learning in older compared to younger adults across repeated episodes in the environment. Moreover, effective connectivity analyses revealed that the age-related learning deficits are linked to an increase in hippocampal excitability. Together, these results provide important insights into how human aging affects computations in the brain’s navigation system, highlighting the critical role of the hippocampus.
The distinct phenotypic signatures of dispersal and stress in an arthropod model: from physiology to life history
Authors: Dahirel Maxime , Masier Stefano , Renault David , Bonte Dries 
Published: March 2019

AbstractDispersing individuals are expected to encounter costs during transfer and in the novel environment, and may also have experienced stress in their natal patch. Given this, a non-random subset of the population should engage in dispersal and eventually show divergent stress-related responses towards new conditions. Dispersal allows escape from stress, but is equally subjecting individuals to it.Physiological shifts expressed in the metabolome form a major part of responses to stress exposure and are expected to be associated with the dispersal phenotype, thereby shaping physiological dispersal syndromes. We analyzed how metabolic profiles and life-history traits varied between dispersers and residents of the model two-spotted spider miteTetranychus urticae, and whether and how these syndromes varied with exposure to a stressful new host plant (tomato). Regardless of the effect of host plant, we found a physiological dispersal syndrome where, relative to philopatric individuals, dispersers were characterized by lower leaf consumption rates and a lower concentration of several amino acids, indicating a potential dispersal-foraging trade-off. As a possible consequence of this lower food intake, dispersers also showed a lower reproductive performance. Responses to tomato exposure were consistent with this plant being a stressor forTetranychus urticae, including reduced fecundity and reduced feeding by mites. Tomato-exposed mites laid larger eggs, which can be interpreted as a plastic response to food stress, increasing the likelihood of survival to maturity. Contrary to what could be expected from the costs of dispersal and stress resistance and from previous meta-population level studies, there was no interaction between dispersal status and host plant for any of the examined traits, indicating that the impacts of a new stressful host plant are equally incurred by residents and dispersers.We thus provide novel insights in the processes that shape dispersal and the putative feedbacks on ecological dynamics in spatially structured populations.
Tissue mechanics controls T-cell activation and metabolism
Authors: Meng Kevin P. , Majedi Fatemeh S. , Thauland Timothy J. , Butte Manish J. 
Published: March 2019

SUMMARYUpon immunogenic challenge, lymph nodes become mechanically stiff as immune cells proliferate within their encapsulated environments, and with resolution, they reestablish a soft, baseline state. We found that these mechanical changes in the microenvironment promote and then restrict T-cell activation and metabolic reprogramming. Sensing of tissue mechanics by T cells requires the mechanosensor YAP. Unlike in other cells where YAP promotes proliferation, YAP in T cells suppresses proliferation in a stiffness-dependent manner by directly restricting the translocation of NFAT into the nucleus. YAP regulates T-cell responses against viral infections and in autoimmune diabetes. Our work reveals a new paradigm whereby tissue mechanics fine-tunes adaptive immune responses in health and disease.One Sentence SummaryTissue mechanics regulates T cells.
Differences in proteome response to cold acclimation inZoysia japonicacultivars with different levels of freeze tolerance
Authors: Brown J.M. , Holloway H. McCamy P. , DaCosta Michelle , Bernstein Rachael P. , Lu Jefferson , Tuong Tan D. , Patton Aaron J. , Dunne Jeffrey C. , Arellano Consuelo , Livingston David P. , Milla-Lewis Susana R. 
Published: March 2019

ABSTRACTZoysiagrasses (Zoysiaspp.) are warm season turfgrasses primarily grown in the southern and transition zones of the United States. An understanding of the physiological changes that zoysiagrasses undergo during cold acclimation may shed light on physiological phenotypic traits useful in selection of freeze tolerant genotypes. We investigated the relationship between cold acclimation, protein expression, and freeze tolerance in cold-acclimated (CA) and non-acclimated (NCA) plants ofZoysia japonicaSteud. cultivars ‘Meyer’ (freeze-tolerant) and ‘Victoria’ (freeze-susceptible). Freeze tolerance was assessed using chambers reaching −6, −8, −10, and −12°C. Additionally, meristematic tissues from the grass crowns of ‘Meyer’ and ‘Victoria’ were harvested for proteomic analysis after a four week cold acclimation period. Freeze testing indicated that cold acclimation accounted for a 1.9-fold increase in plant survival compared to the non-acclimation treatment. Overall, proteomic analysis identified 62 protein spots having at least a twofold change in abundance under cold acclimation. Nine and 22 unique protein spots were identified for Meyer and Victoria, respectively, with increased abundance (up-regulated) or decreased abundance (down-regulated). In addition, 23 shared protein spots were found among the two cultivars having differential expression in response to cold acclimation. In Meyer, protein response to cold acclimation was primarily upregulated, while in Victoria, protein response was primarily downregulated. These cold acclimation responsive proteins were found to be involved primarily in transcription, metabolism, protein destination and storage, and energy production. As identified through MALDI-TOF/TOF mass spectrometry followed matching of protein homologues against the NCBI Arabidopsis database, major proteins of interest for their association with cold acclimation were LEA 3, MAPK, SOD, GAST1, Phytochrome A, ATP synthase, AGP, PLD, and PSII. Further investigation of these proteins and their functional categories may contribute to increase our understanding of the differences in freezing tolerance among zoysiagrass germplasm.