bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher Sun Exposure is Associated With Lower Risk of Pediatric Inflammatory Bowel Disease
Authors: Holmes Elizabeth Ann , Ponsonby Anne‐Louise , Pezic Angela , Ellis Justine A. , Kirkwood Carl D. ,   PAID consortium, Lucas Robyn M. 
Published: May 2019

ABSTRACTObjectives:The incidence of pediatric inflammatory bowel disease (IBD) is increasing worldwide. Ecological studies show higher incidence in regions at higher latitude or lower ambient ultraviolet radiation; individual‐level associations with sun exposure have not been assessed.Methods:We recruited children (0–17 years) with IBD from 2 large hospitals in Melbourne, Australia. Control participants were recruited from the day surgery unit of one of the same hospitals. Questionnaires provided data on demographics, past sun exposure, the likelihood of sunburn (skin sensitivity) or tanning following sun exposure, use of sun protection, physical activity, and parental smoking and education. Grandparent ancestry was used to determine participant ethnicity. Cases and controls were matched on age and sex. We used conditional logistic regression to test the association between being an IBD case and past sun exposure at different ages, adjusted for a range of other factors.Results:After matching, n = 99 cases and n = 396 controls were included in the analysis. In multivariable analysis, for each 10 min increment in leisure‐time sun exposure in summer or winter there was a linear 6% reduction in the odds of having IBD (P = 0.002). Results were similar in sensitivity analyses including only the most recently diagnosed cases, only Caucasian cases and controls, only those with symptom onset within the year before study entry, or additionally adjusted for age or physical activity.Conclusions:Higher sun exposure in the previous summer or winter was associated with a reduced risk of having IBD. There are plausible pathways that could mediate this effect.
Feeding the Late and Moderately Preterm Infant
Authors:   ESPGHAN Committee on Nutrition, Lapillonne Alexandre , Bronsky Jiri , Campoy Cristina , Embleton Nicholas , Fewtrell Mary , Fidler Mis Nataša , Gerasimidis Konstantinos , Hojsak Iva , Hulst Jessie , Indrio Flavia , Molgaard Christian , Moltu Sissel Jennifer , Verduci Elvira , Domellöf Magnus 
Published: May 2019

ABSTRACTNutritional guidelines and requirements for late or moderately preterm (LMPT) infants are notably absent, although they represent the largest population of preterm infants. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition (CoN) performed a review of the literature with the aim to provide guidance on how to feed infants born LMPT, and identify gaps in the literature and research priorities.Only limited data from controlled trials are available. Late preterm infants have unique, often unrecognized, vulnerabilities that predispose them to high rates of nutritionally related morbidity and hospital readmissions. They frequently have feeding difficulties that delay hospital discharge, and poorer rates of breastfeeding initiation and duration compared with term infants. This review also identified that moderately preterm infants frequently exhibit postnatal growth restriction.The ESPGHAN CoN strongly endorses breast milk as the preferred method of feeding LMPT infants and also emphasizes that mothers of LMPT infants should receive qualified, extended lactation support, and frequent follow‐up. Individualized feeding plans should be promoted. Hospital discharge should be delayed until LMPT infants have a safe discharge plan that takes into account local situation and resources.In the LMPT population, the need for active nutritional support increases with lower gestational ages. There may be a role for enhanced nutritional support including the use of human milk fortifier, enriched formula, parenteral nutrition, and/or additional supplements, depending on factors, such as gestational age, birth weight, and significant comorbidities. Further research is needed to assess the benefits (improved nutrient intakes) versus risks (interruption of breast‐feeding) of providing nutrient‐enrichment to the LMPT infant.
Elevation of Postmortem Cerebrospinal Fluid Sodium and Chloride Levels Is a Potential Adjunct Test in the Diagnosis of Salt Water Drowning
Authors: Garland Jack , McCarthy Sinead , Hensby-Bennett Sarah , Philcox Winston , O'Regan Toni , Rousseau Guillaume , Palmiere Cristian , Elstub Hannah , Cala Allan , Clifton Leah , Lam Leo , Barker Claire , Ondruschka Benjamin , Woydt Lina , Spark Amy , Kesha Kilak , Morrow Paul , Glenn Charley , Stables Simon , Tse Rexson 
Published: May 2019

Abstract
Postmortem vitreous humor biochemistry is a useful test in the diagnosis of salt water drowning (SWD). A significant limitation of vitreous humor is the potential effect of prolonged immersion. A recent animal study and case report suggested that cerebrospinal fluid biochemistry may be an alternative to vitreous because it is more resistant to the effects of immersion, given its protected anatomical location. This study compared postmortem cerebrospinal fluid sodium and chloride (PMCSC) levels collected via ventricular aspiration (PMCSC_V) and via lumbar puncture (PMCSC_L) in 13 SWD and 31 nonimmersion deaths. It showed a significant elevation in PMCSC levels in SWD deaths for both PMCSC_V and PMCSC_L (P < 0.05). The areas under the curve on the receiver operating characteristic curves for PMCSC_V and PMCSC_L were 0.73 and 0.83, respectively. The optimal cutoff for PMCSC_V was 216 mmol/L (sensitivity, 0.60; specificity, 0.72; likelihood ratio, 1.80; positive predictive value, 0.45) and for PMCSC_L was 241 mmol/L (sensitivity, 0.78; specificity, 0.73; likelihood ratio, 2.89; positive predictive value, 0.46). This study supports PMCSC levels as another biochemical test that can potentially aid in the diagnosis of SWD, particularly in cases where vitreous humor samples are unavailable or uninterpretable.
Perinephric Fat Stranding on Postmortem Computed Tomography Scan in Acute Pyelonephritis
Authors: Garland Jack , Olds Kelly , Tse Rexson 
Published: May 2019

Abstract
Infection/inflammation of solid organ can be difficult to appreciate at postmortem computed tomography (CT) scan (PMCT). Perinephric fat stranding is a clinical CT finding to suggest pyelonephritis; however, PMCT scan showing perinephric fat stranding in acute pyelonephritis has not been documented in the forensic literature. We present a death from acute pyelonephritis in a setting of hypertensive heart disease, in which the unenhanced PMCT performed before postmortem examination was able to show florid bilateral perinephric fat stranding. This PMCT finding subsequently guided the pathologist to pay special attention to the kidney and take appropriate microbiology specimens to confirm the diagnosis. Perinephric fat stranding on PMCT may be a useful sign to alert the pathologist to consider acute pyelonephritis during the postmortem examination.
International Study of the Epidemiology of Platelet Transfusions in Critically Ill Children With an Underlying Oncologic Diagnosis
Authors: Nellis Marianne E. , Goel Ruchika , Karam Oliver , Cushing Melissa M. , Davis Peter J. , Steiner Marie E. , Tucci Marisa , Stanworth Simon J. , Spinella Philip C. 
Published: May 2019

Objectives:
To describe the epidemiology of platelet transfusions in critically ill children with an underlying oncologic diagnosis and to examine effects of prophylactic versus therapeutic transfusions.

Design:
Subgroup analysis of a prospective, observational study.

Setting:
Eighty-two PICUs in 16 countries.

Patients:
All children (3 d to 16 yr old) who received a platelet transfusion during one of the six predefined screening weeks and had received chemotherapy in the previous 6 months or had undergone hematopoietic stem cell transplantation in the last year.

Interventions:
None.

Measurements and Main Results:
Of the 548 patients enrolled in the parent study, 237 (43%) had an underlying oncologic diagnosis. In this population, 71% (168/237) of transfusions were given prophylactically, and 59% (139/237) of transfusions were given at a total platelet count greater than 20 × 109/L, higher than the current recommendations. Those with an underlying oncologic diagnosis were significantly older, and received less support including less mechanical ventilation, fewer medications that affect platelet function, and less use of extracorporeal life support than those without an underlying oncologic diagnosis. In this subpopulation, there were no statistically significant differences in median (interquartile range) platelet transfusion thresholds when comparing bleeding or nonbleeding patients (50 × 109/L [10–50 × 109/L] and 30 × 109/L [10–50 × 109/L], respectively [p = 0.166]). The median (interquartile range) interval transfusion increment in children with an underlying oncologic diagnosis was 17 × 109/L (6–52 × 109/L). The presence of an underlying oncologic diagnosis was associated with a poor platelet increment response to platelet transfusion in this cohort (adjusted odds ratio, 0.46; 95% CI, 0.22–0.95; p = 0.035).

Conclusions:
Children with an underlying oncologic diagnosis receive nearly half of platelet transfusions prescribed by pediatric intensivists. Over half of these transfusions are prescribed at total platelet count greater than current recommendations. Studies must be done to clarify appropriate indications for platelet transfusions in this vulnerable population.
Antibiotic Prophylaxis for Open Chest Management After Pediatric Cardiac Surgery
Authors: Hatachi Takeshi , Sofue Toshiki , Ito Yukie , Inata Yu , Shimizu Yoshiyuki , Hasegawa Moyu , Kugo Yosuke , Yamauchi Sanae , Iwai Shigemitsu , Takeuchi Muneyuki 
Published: May 2019

Objectives:
Although open chest management optimizes hemodynamics after cardiac surgery, it increases postoperative infections and leads to increased mortality. Despite the importance of antibiotic prophylaxis during open chest management, no specific recommendations exist. We aimed to compare the occurrence rates of bloodstream infection and surgical site infection between the different prophylactic antibiotic regimens for open chest management after pediatric cardiac surgery.

Design:
Retrospective, single-center, observational study.

Setting:
PICU at a tertiary children’s hospital.

Patients:
Consecutive patients younger than or equal to 18 years old with open chest management after cardiac surgery followed by delayed sternal closure, between January 2012 and June 2018.

Interventions:
None.

Measurements and Main Results:
We compared the composite occurrence rate of postoperative bloodstream infection and surgical site infection within 30 days after cardiac surgery between three prophylactic antibiotic regimens: 1) cefazolin, 2) cefazolin + vancomycin, and 3) vancomycin + meropenem. In 63 pediatric cardiac surgeries with open chest management, 17 bloodstream infections, and 12 surgical site infections were identified postoperatively. The composite occurrence rates of bloodstream infection and surgical site infection were 10 of 15 (67%), 10 of 19 (53%), and nine of 29 (31%) in the cefazolin, cefazolin + vancomycin, and vancomycin + meropenem regimens, respectively (p = 0.07). After adjusting for age, open chest management duration, extracorporeal membrane oxygenation use, and nasal methicillin-resistant Staphylococcus aureus colonization in multivariable analysis, there was no significant difference between the cefazolin and the cefazolin + vancomycin regimens (p = 0.19), while the vancomycin + meropenem regimen had a lower occurrence rate of bloodstream infection and surgical site infection than the cefazolin regimen (odds ratio, 0.0885; 95% CI, 0.0176–0.446; p = 0.003).

Conclusions:
In this study, a lower occurrence rate of postoperative bloodstream infection and surgical site infection was observed among patients with broad-spectrum antibiotic regimen after pediatric cardiac surgery with open chest management. Further studies, ideally randomized controlled studies investigating the efficacy of broad-spectrum antibiotics and their complications, are warranted before routine implementation of broad-spectrum prophylactic antibiotic regimen.
Advanced Glycation End Products Are Associated With Inflammation and Endothelial Dysfunction in HIV
Authors: El Kamari Vanessa , Thomas Alicia , Shan Lingpeng , Sattar Abdus , Monnier Vincent , Howell Scott K. , Beisswenger Paul J. , McComsey Grace A. 
Published: May 2019

Objective:
To compare levels of advanced glycation end products (AGEs) between HIV-infected patients and uninfected controls and assess the relationship between AGEs, HIV, inflammation, and endothelial dysfunction.

Design:
Cross-sectional study involving 90 individuals (68 HIV+ and 22 healthy controls matched by age and sex).

Methods:
AGE levels were assessed using 3 different modalities: free AGEs were measured in the serum, skin autofluorescence (AF) was determined with a noninvasive reader, and dietary AGEs were estimated using 24-hour dietary recalls. Markers of inflammation, immune activation, and endothelial dysfunction were also measured. Wilcoxon rank-sum and χ2 tests were used to compare AGEs between groups. Spearman correlations were used to explore relationships between variables while adjusting for different covariates.

Results:
Overall, 71% were men and 68% were African American, with a median age of 53 years. Among HIV-infected individuals, all participants were on antiretroviral therapy by design, and most participants (78%) had an undetectable HIV-1 RNA level (≤20 copies/mL). Skin AF and serum AGEs were significantly higher in HIV-infected participants compared with uninfected controls (P < 0.01), whereas no differences in dietary AGEs were found between groups (P = 0.2). In the HIV-infected group, but not in controls, skin AF and circulating AGEs were significantly associated with inflammatory and oxidative markers, and with markers of endothelial dysfunction.

Conclusions:
These results suggest intrinsic production of AGE in HIV-infected individuals. The relationship between serum/skin AGE and inflammatory, oxidative, and cardiovascular markers highlights the potential implications of AGEs in chronic inflammation and endothelial dysfunction in HIV, suggesting a new potential target for HIV-associated heightened inflammation and cardiovascular risk.
TNF-Related Apoptosis-Inducing Ligand Receptor 1 in Patients With Ankylosing Spondylitis
Authors: Karadag Duygu Temiz , Tekeoglu Senem , Yazici Ayten , Isik Ozlem Ozdemir , Eraldemir Fatma Ceyla , Cefle Ayse 
Published: May 2019

Objectives
Tumor necrosis factor–related apoptosis-inducing ligand (TRAIL) belongs to the tumor necrosis factor (TNF) superfamily and is reported to play a role in autoimmune diseases. In this study, we aimed to measure serum TRAIL receptor 1 (TRAIL-R1) concentration and assess any phenotypic relationship in patients with ankylosing spondylitis (AS).

Methods
Fifty-three patients with AS were recruited from August 2014 to December 2014 cross-sectionally. Fifty-three sex- and age-matched healthy controls were also recruited. Serum TRAIL-R1 concentrations were measured using an enzyme-linked immunosorbent assay. The association between serum TRAIL-R1, TNF-α, disease activity indices, markers of systemic inflammation, and clinical features were evaluated.

Results
Serum TRAIL-R1 and TNF-α levels were increased in patients with AS compared with healthy controls (4.5 ± 2.3 vs 3.5 ± 2.3 pg/mL, p = 0.036; 3.8 [1.6–7.7] vs 2.0 [0.21–5.7] pg/mL, p = 0.048, respectively). Serum TRAIL-R1 displayed a medium positive correlation with serum TNF-α concentrations (r = 0.412; p = 0.002). Serum TRAIL-R1 concentration was higher in human leucocyte antigen (HLA)-B27–positive patients compared with non–HLA-B27 patients (5.5 ± 2.2 vs 3.1 ± 1.6 pg/mL, p < 0.001). No relationship was found between serum TRAIL-R1 concentration and disease activity scores.

Conclusions
This study confirms that serum TRAIL-R1 levels are higher in AS patients than healthy controls. The persistence of significantly elevated serum TRAIL-R1 levels, even in patients with low disease activity or after excluding biologic treatment, and the association with HLA-B27 positivity, warrants further investigation due to the unclear role of TRAIL-R1 in the pathophysiology of AS.
Systematic reviews of scores and predictors to trigger activation of massive transfusion protocols
Authors: Shih Andrew W. , Al Khan Shadhiya , Wang Alan Ying-Hsu , Dawe Philip , Young Pang Y. , Greene Adam , Hudoba Monika , Vu Erik 
Published: May 2019

BACKGROUND
The use of massive transfusion protocols (MTPs) in the resuscitation of hemorrhaging trauma patients ensures rapid delivery of blood products to improve outcomes, where the decision to trigger MTPs early is important. Scores and tools to predict the need for MTP activation have been developed for use to aid with clinical judgment. We performed a systematic review to assess (1) the scores and tools available to predict MTP in trauma patients, (2) their clinical value and diagnostic accuracies, and (3) additional predictors of MTP.

METHODS
MEDLINE, EMBASE, and CENTRAL were searched from inception to June 2017. All studies that utilized scores or predictors of MTP activation in adult (age, ≥18 years) trauma patients were included. Data collection for scores and tools included reported sensitivities and specificities and accuracy as defined by the area under the curve of the receiver operating characteristic.

RESULTS
Forty-five articles were eligible for analysis, with 11 validated and four unvalidated scores and tools assessed. Of four scores using clinical assessment, laboratory values, and ultrasound assessment the modified Traumatic Bleeding Severity Score had the best performance. Of those scores, the Trauma Associated Severe Hemorrhage score is most well validated and has higher area under the curve of the receiver operating characteristic than the Assessment of Blood Consumption and Prince of Wales scores. Without laboratory results, the Assessment of Blood Consumption score balances accuracy with ease of use. Without ultrasound use, the Vandromme and Schreiber scores have the highest accuracy and sensitivity respectively. The Shock Index uses clinical assessment only with fair performance. Other clinical variables, laboratory values, and use of point-of-care testing results were identified predictors of MTP activation.

CONCLUSION
The use of scores or tools to predict MTP need to be individualized to hospital resources and skill set to aid clinical judgment. Future studies for triggering nontrauma MTP activations are needed.

LEVEL OF EVIDENCE
Systematic review, level III.
Alzheimer Disease-associated Cortical Atrophy Does not Differ Between Chinese and Whites
Authors: Fan Jia , Tse Marian , Carr Jessie S. , Miller Bruce L. , Kramer Joel H. , Rosen Howard J. , Bonham Luke W. , Yokoyama Jennifer S. 
Published: May 2019

Purpose:
To assess whether there are differences in Alzheimer disease (AD)-associated atrophy regions in Chinese and white patients with AD versus cognitively normal older adults, and to test whether associations between clinical severity and gray matter volume are similar or different across these ethnic groups in a cross-sectional analysis.

Materials and Methods:
Chinese and white patients with AD, individuals with mild cognitive impairment, and cognitively normal controls (46 white and 48 Chinese) were clinically evaluated at an academic center within 1 year of magnetic resonance imaging acquisition. Clinical severity was assessed using the Clinical Dementia Rating Sum of Boxes and cortical atrophy was measured using voxel-based morphometry as well as Freesurfer. Chinese and white cohorts were demographically matched for age, sex, and education.

Results:
Clinical severity by diagnosis was similar across ethnicities. Chinese and white patient groups showed similar amounts of atrophy in the regions most affected in AD after accounting for demographic variables and head size. There was no significant difference between ethnic groups when compared by atrophy and clinical severity.

Conclusions:
Our study suggests that Chinese and white patients with AD, when matched demographically, are clinically and neuroanatomically similar on normalized measures of cortical atrophy and clinical severity.
Estimating probabilistic dark diversity based on the hypergeometric distribution
Authors: Carmona Carlos P. , Szava-Kovats Robert , Pärtel Meelis 
Published: May 2019

AbstractThe biodiversity of a site includes the absent species from the region that are theoretically able to live in the site’s particular ecological conditions. These species constitute the dark diversity of the site. Unlike present species, dark diversity is unobservable and can only be estimated. Most existing methods to designate dark diversity act in a binary fashion. However, dark diversity is more suitably defined as a fuzzy set—in which the degree of certainty about species membership is expressed as a probability.We present a new method to estimate probabilistic dark diversity based on the hypergeometric distribution. The method relies on co-occurrences to infer the strength of the association between pairs of species and assign probabilistic adscription to dark diversity to absent species. We compare it with two established methods to estimate dark diversity (Beals index and favorability correction). To test the methods, we created simulations based on individual agents in which the suitability of each species in each site is known. We compared the ability of the methods to accurately predict suitability and the size of dark diversity, and compared their sensitivity to data availability. Further, we assessed the methods in two real datasets with nested sampling designs.Our simulations revealed that predictions of the Beals method were extremely sensitive to species frequency, and predicted suitability poorly. The Favorability transformation corrected this relationship, but did still predicted extremely low probabilities for species with very little information. The Hypergeometric method outperformed the Beals and Favorability methods in all considered aspects in the simulations and displayed better characteristics in the real datasets.Probabilistic consideratiosn of biodiversity will help to acknowledge the uncertainty associated with ecological information. Although the Beals method has been described as the best estimator of dark diversity, it should be preferred only when the goal is to predict future apperances of species. However, studies on dark diversity should focus on the ecological affinities of species. The Hypergeometric method is the most promising method to estimate probabilistic dark diversity and species pool composition based on co-occurrences.
Fruit and vegetable expenditure disparities: evidence from Chile
Authors: Carreño Pia , Silva Andres 
Published: May 2019

Purpose
The purpose of this paper is to explore fruit and vegetable (FV) procurement disparity across income groups.

Design/methodology/approach
This study uses mean comparison and quintile regression to explain FVs variations.

Findings
Households from the highest income quantile spend more than two times on FVs than households from the lowest quantile; however, this expenditure disparity is largely mitigated in terms of purchase quantity. This paper presents evidence that, rather than quantity discounts or income neighborhood, the type of store (traditional markets vs supermarkets) plays a relevant role in explaining the smaller gap in terms of purchase quantity.

Research limitations/implications
Traditional markets help low-income households access low-cost FVs.

Social implications
The authors generate evidence to show that traditional markets play a relevant role to supply affordable FV to low-income households.

Originality/value
The paper used a high-quality and uncommon data set. It is a topic of high social impact.