bluuebunny/crossref_metadata_2025_split huggingface dataset:
A RANDOMIZED CONTROLLED TRIAL: SUPRAPUBIC ASPIRATION VERSUS URINARY CATHETERIZATION IN THE NEONATAL INTENSIVE CARE UNIT
Authors: Moore Gregory , Momoli Franco , Agarwal Amisha , Agarushi Rula , Brophy Jason , Bariciak Erika 
Published: May 2018

Abstract

BACKGROUND
Urinary tract infection (UTI) is common in infants (10%). Urinary catheterization (UC) and supra-pubic aspiration (SPA) allow for sterile collection of urine. Some studies suggest SPA has a lower contamination rate than UC, however the optimal method of urine collection for culture remains unclear.

OBJECTIVES
To determine if there is: 1) a lower contamination rate in urine obtained by SPA assisted by bladder ultrasound versus UC in infants admitted to a neonatal intensive care unit (NICU); 2) a difference between procedures in: success rates for obtaining urine, short-term complication rates, and number of attempts required.

DESIGN/METHODS
A multicentre, unblinded, randomized controlled trial from 04/2013 to 05/2016. All gestational age (GA) infants greater than 72 hours of age investigated for UTI were eligible for randomization. Crossover to the other procedure could occur after 2 hours or 2 failed attempts. Target sample size was 165. Contamination was defined as growth of ≥2 microorganisms (SPA, UC) or growth <104 CFU/ml (UC). Primary analysis was by intention-to-treat.

RESULTS
Enrolment was stopped for futility. 906 families were approached with 151 providing consent. 50 infants were eligible for randomization with 47 randomized (SPA n=23, UC n=24). Table 1 shows participant demographics. UTI incidence was 13% for SPA, 8% for UC (p=0.67). Crossover rates were high: 56% for SPA; 21% for UC. No urine sample was obtained in 2 participants per group despite attempts. There was no statistically significant difference between the 2 groups in contamination rates (14% SPA, 18% UC, p=1.00). No short-term complications were reported in either group. Prior to crossover, there was no difference in the number of attempts (i.e. up to 2 attempts pre-crossover or to successfully obtain urine) per procedure (p=0.08); however, there was a difference in the success rates per procedure (44% SPA, 75% UC, p=0.04).

CONCLUSION
This trial found no difference in contamination rates between SPA and UC, while noting the low enrolment and high crossover rate. More procedural training (particularly for SPA) may ensure greater procedural confidence and success. Post-procedural consent could improve enrolment given that equipoise on the optimal urine collection method still exists.
EVALUATION OF THE USE OF SHARED DECISION MAKING DURING ANTENATAL COUNSELLING FOR ANTICIPATED EXTREMELY PRETERM BIRTH
Authors: Ding Sharon , Bijelic Vid , Daboval Thierry , Lemyre Brigitte , Dunn Sandra , Moore Gregory 
Published: May 2018

Abstract

BACKGROUND
Paediatric organizations advocate the use of shared decision making (SDM) during counselling with families facing the birth of an extremely preterm infant. A local guideline was implemented in 2015 to promote SDM.

OBJECTIVES
To determine the percentage of consultations where SDM was used.

DESIGN/METHODS
Single-center prospective cohort study from September 2015 to June 2017 with data collected on all women presenting to obstetrical triage at 22 + 0 to 25 + 6 wks GA. Decision coaching (determined from the written consultation) during consultations served as a surrogate marker for use of SDM. Fisher’s exact test was used to compare proportions; logistic regression was used to examine trend over time.

RESULTS
130 women presented. A neonatology consultation occurred in 92 cases. SDM was used at initial consultation in 85% (78/92) of cases: 84% (16/19) at 22 wks; 88% (22/25) at 23 wks; 96% (27/28) at 24 wks; 65% (13/20) at 25 wks. Secondary analyses indicate use of SDM declined over time (p=0.03) and parental ability to come to a decision was not significantly different between SDM and ‘non-SDM’ consults (89% in SDM vs 92% in non-SDM; p=0.7). At 22 wks, 89% (17/19) made a decision; at 23 wks, 80% (20/25); at 24 wks, 86% (24/28); at 25 wks, 85% (17/20) (p=0.84). Infant survival to NICU discharge, using denominator ‘infants who received resuscitation’, was 67% (2/3) at 22 wks; 33% (3/9) at 23 wks; 87% (13/15) at 24 wks; 89% (17/19) at 25 wks.

CONCLUSION
Implementation of an SDM framework is feasible with a resulting high percentage of consultations appearing to use SDM. The possible waning use of SDM and lower use at 25 wks GA requires further investigation. Recordings of consultations and parental perspectives to directly assess the use of SDM would provide greater insight into the applicability of SDM in this clinical setting.
Effect of Monitor Placement on Situational Awareness and Visual Attention in Simulated Neonatal Resuscitations
Authors: Yan Law Brenda Hiu , Cheung Po-Yin , van Os Sylvia , Fray Caroline , Schmölzer Georg 
Published: May 2018

Abstract

BACKGROUND
Decision-making in neonatal resuscitation depends on clinical evaluation, oxygen saturation and heart-rate. However, the position of vital signs monitors varies between institutions and might lead to obstructed or difficult to see displays, which might affect Health Care Provider (HCP) performance.

OBJECTIVES
To compare Situation Awareness (SA), Neonatal Resuscitation (NRP) checklist score, Visual Attention (VA) and participant satisfaction during simulated neonatal resuscitations using two vital signs monitors locations.

DESIGN/METHODS
NRP-trained HCPs were recruited from a tertiary Neonatal Intensive Care Unit and randomized to either central (eye-level on the radiant warmer) or peripheral (left of the warmer) monitor placement. Following an orientation scenario, each HCP lead a resuscitation requiring intubation and chest compressions with a high-fidelity manikin (Newborn HAL, Gaumard Scientific, Miami, FL) and a standardized assistant. Each scenario was paused at 3 predetermined points and the HCP was asked 5 SA questions at each pause, per the Situation Awareness Global Assessment Tool (SAGAT) format. Simulations were video-recorded to analyze SAGAT responses and performance rating using a modified NRP checklist. VA was recorded using eye-tracking glasses (Tobii Pro, Tobii Technology Inc., Falls Church, VA) worn by participants. Statistical analysis was performed using Mann-Whitney U test. A post-simulation survey examined user preference.

RESULTS
We randomized 30 HCPs; all were analyzed for SA and NRP checklist scores. Twenty-two eye-tracking recordings were of sufficient quality and analyzed. SAGAT scores (median 11/15 vs. 12/15, p=0.52) and NRP Checklist Scores (median 46/50, p=0.75) were similar between groups. Distribution of VA was also similar in both groups. In the post-simulation survey, all HCPs found central monitor placement convenient, compared with only 8/15 in peripheral placement.

CONCLUSION
During simulated neonatal resuscitation, HCPs found central monitor placement more convenient. However, no differences in accuracy of situation awareness responses, NRP checklist scores, or visual attention were found. Hi-fidelity simulation, SAGAT, and eye-tracking can be used to evaluate physical ergonomics of neonatal resuscitation.
DOES PRESENCE OF DOWN SYNDROME INCREASE RESPIRATORY SYNCYTIAL VIRUS (RSV) RELATED HOSPITALIZATION IN CHILDREN LESS THAN 2 YEARS OF AGE? A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Mitra Souvik , McCord Helen , El Azrak Mohamed , Paes Bosco 
Published: May 2018

Abstract

BACKGROUND
Down syndrome (DS) is associated with a number of immunologic abnormalities and congenital heart disease (CHD) which increase susceptibility to respiratory syncytial virus (RSV). However current position statements from the American Academy of Pediatrics and the Canadian Paediatric Society do not recommend routine RSV prophylaxis with Palivizumab to all infants with DS,

OBJECTIVES
To conduct a systematic reviewand meta-analysis of observational studies to compare RSV-related hospitalization (RSVH) rates, length of hospital stay(LOS), need for intensive care and assisted ventilation in DS children <2 years of age compared with children without DS.

DESIGN/METHODS
Data Sources:
The authors searched MEDLINE, Embase, CINAHL, reference lists of relevant articles, abstracts and conference proceedings, results of unpublished trials, and contacted the primary authors of relevant studies. Studies were included if data was provided on RSV-related hospitalization in children <2yr of age with and without DS.
Data extraction & Synthesis:
Two reviewers independently screened the search results, applied inclusion criteria and assessed methodological quality using the Newcastle-Ottawa Scale. Data was extracted and checked in duplicate.
Main outcomes & measures:
The primary outcome was RSV-related hospitalization. Secondary outcomes included length of hospital stay, need for intensive care and assisted ventilation. Sensitivity analysis was conducted for the primary outcome comparing DS infants without congenital heart disease (CHD) with non-DS infants.

RESULTS
19 cohort studies met the inclusion criteria. Ten studies involving 1,390,380 children were analyzed. DS-children had significantly higher RSVH compared to non-DS children (Relative Risk, 6.97; 95% CI, 6.01 to 8.08; I2=0%; Figure 1a). Among children hospitalized with RSV, need for assisted ventilation (RR, 5.82; 95% CI, 1.81 to 18.69; I2=84%; Figure 1b) and LOS (Mean difference, 2.28 days; 95% CI, 1.61 to 2.96 days; I2=0%; Figure 1c) were significantly higher in DS-children. The sensitivity analysis also confirmed that DS children without CHD had a significantly higher RSVH rate compared to non-DS children (RR, 6.31; 95% CI, 4.83 to 8.23;I2=0%; Figure 1d).

CONCLUSION
Compared to children without DS, RSV-related hospitalization, need for assisted ventilation and length of RSV-related hospital stay is significantly higher in children with DS in the first 2 years of life. The results of this systematic review should prompt a favorable recommendation for routine RSV prophylaxis in both healthy and medically compromised DS children aged <2years.
Exploiting metamerism to regulate the impact of a visual display on alertness and melatonin suppression independent of visual appearance
Authors: Allen Annette E , Hazelhoff Esther M , Martial Franck P , Cajochen Christian , Lucas Robert J 
Published: May 2018

Abstract

Objectives
Artificial light sources such as visual display units (VDUs) elicit a range of subconscious and reflex light responses, including increases in alertness and suppression of pineal melatonin. Such responses employ dedicated retinal circuits encompassing melanopsin photoreceptors. Here, we aimed to determine whether this arrangement can be exploited to modulate the impact of VDUs on melatonin onset and alertness without altering visual appearance.

Methods
We generated a five-primary VDU capable of presenting metameric movies (matched for color and luminance) but varying in melanopic-irradiance. Healthy human participants (n = 11) were exposed to the VDU from 18:00 to 23:00 hours at high- or low-melanopic setting in a randomized cross-over design and measured salivary melatonin and self-reported sleepiness at 30-minute intervals.

Results
Our VDU presented a 3× adjustment in melanopic-irradiance for images matched photometrically for color and luminance. Participants reported no significant difference in visual appearance (color and glare) between conditions. During the time in which the VDU was viewed, self-reported sleepiness and salivary melatonin levels increased significantly, as would be expected in this phase of the diurnal cycle. The magnitude of the increase in both parameters was significantly enhanced when melanopic-irradiance was reduced.

Conclusions
Our data demonstrate that melatonin onset and self-reported sleepiness can be modulated independent of photometric parameters (color and luminance) under a commonly encountered light exposure scenario (evening use of a VDU). They provide the first demonstration that the impact of light on alertness and melatonin production can be controlled independently of visual experience, and establish a VDU capable of achieving this objective.
The Political Incorporation of Undocumented Youth
Authors: Wong Tom K , García Angela S , Valdivia Carolina 
Published: May 2018

AbstractThis article develops and empirically tests a model of political incorporation for undocumented youth in the United States, focusing on nonvoting forms of political engagement. Using one of the ﬁrst nationwide surveys of undocumented millennials between the ages of 18 and 35 (n = 1,472), we show that (1) undocumented youth express much higher levels of political efficacy and participation than the literature on immigrant political incorporation leads us to expect, (2) membership in organizations that work on immigration-related issues is a main determinant of this sense of political efficacy, and (3) through mediation analysis, that organizational membership (the mediator) inﬂuences how political efficacy affects political participation, and not the other way around. The literature on immigrant political incorporation is vast, but precedent studies too often focus on formal acts of political participation, such as naturalization and voting, by those with lawful immigration status. With an analytical focus on youth without lawful immigration status, this article contributes to theoretical and empirical knowledge about how and to what extent undocumented youth become politically active and engaged despite the many obstacles that exist to their formal participation in politics.
What Is the Frequency of Early Dissociation of Bipolar Cups and What Factors Are Associated With Dissociation?
Authors: Lee Young-Kyun , Park Chan Ho , Ha Yong-Chan , Koo Kyung-Hoi 
Published: May 2018

Abstract

Background
Dissociation between a prosthetic cup and femoral head is a rare complication of bipolar hemiarthroplasty that usually occurs during closed reduction of a dislocated bipolar cup. The dissociation usually results in reoperation because closed reduction is challenging. To our knowledge, no study has reported on the frequency of bipolar cup-femoral head dissociation, and risk factors for dissociation are unknown.

Questions/purposes
The purposes of this study were (1) to evaluate the frequency of dissociation of prosthetic femoral heads from bipolar cups during manual reduction of a dislocated bipolar hemiarthroplasty; and (2) to explore in a preliminary fashion any prosthesis or patient factors that may be associated with dissociation.

Methods
From May 2003 to August 2016, 60 bipolar hemiarthroplasties were treated at three institutions as a result of early (within 3 years) dislocation after arthroplasty; of these, 55 could be identified and categorized in terms of the type of locking mechanism used, and these were the patients evaluated in this retrospective study. Because the index hemiarthroplasties were not performed exclusively at the three participating centers, we cannot comment on the indications for prosthesis selection in these patients (such as why some patients may have received components with single rather than double locking mechanisms). Manual reduction was attempted in all patients. Although 34 dislocations were manually reduced, 21 hips underwent surgical intervention because they could not be closed reduced (14 hips) or because of bipolar cup-femoral head dissociation (seven hips). We compared patients’ demographics and prosthetic factors between the dissociation group (n = 7) and the nondissociation group (n = 48).

Results
Bipolar cup-femoral head dissociation occurred in seven of 55 patients with dislocations (13%). Among the seven dissociated cups, six had a single polyethylene locking ring, whereas 20 of 48 nondissociation cups (42%) had the single locking ring (p = 0.044). We found no other patient or prosthesis factors associated with dissociation.

Conclusions
Bipolar cups with a single locking mechanism (rather than a double locking mechanism) may be associated with an increased risk of bipolar cup-femoral head dissociation. However, because we could not evaluate prosthesis indications in this study, and because our sample size was too small to control for potential confounding variables, future studies are needed to confirm this finding. All the same, because good alternatives are available, we do not recommend the use of this type of locking mechanism in bipolar hemiarthroplasty.

Level of Evidence
Level III, therapeutic study.
Involvement of Parents in the Care of Preterm Infants: A Pilot Study Evaluating a Family-Centered Care Intervention in a Chinese Neonatal ICU
Authors: Zhang Rong , Huang Rui-wena , Gao Xi-ronga , Peng Xiao-minga , Zhu Li-hui , Rangasamy Ramanathan , Latour Jos M. 
Published: May 2018

Objectives:
To evaluate the effectiveness and safety of a family-centered care intervention in a Chinese neonatal ICU.

Design:
Pilot study using a randomized controlled trial design to inform a main randomized controlled trial study.

Setting:
Stand-alone tertiary children’s hospital in China with a 60-bed neonatal ICU serving as a regional neonatal ICU center.

Patients:
Premature infants (n = 61) and their parents (n = 110).

Interventions:
Parent education program followed by parents’ participation in care as primary caregiver until discharge for a minimum of 4 hours per day.

Measurements and Main Results:
Primary outcomes were infants’ weight gain at discharge, length of stay, and readmission. Parental outcomes were stress, anxiety, satisfaction, and clinical knowledge. Infants in family-centered care group (n = 31) had higher weight gain (886g vs 542g; p = 0.013), less neonatal ICU length of stay in days (43 vs 46; p = 0.937), and decreased readmission rate at 1 week (41.9 vs 70.0; p = 0.045) and at 1 month (6.5% vs 50%; p < 0.001) compared with the control group (n = 30). Total Mean Parental Stress and Anxiety scores were lower in the family-centered care group (42 vs 59; p ≤ 0.007), mean satisfaction rates in family-centered care group were higher compared with control group (96 vs 90; p < 0.001), and parents in the family-centered care group had better educational outcomes related to neonatal specialized care skills (p < 0.05).

Conclusions:
Involving parents in the care of their infant improved clinical outcomes of infants. Family-centered care also contributed to a better understanding of parent’s clinical education, decrease stress levels, and increased parental satisfaction. Our study suggests that involving parents in the daily care of their infants is feasible and should be promoted by neonatal ICU clinicians.
Structure and consistency of self-reported social contact networks in British secondary schools
Authors: Kucharski Adam J. , Wenham Clare , Brownlee Polly , Racon Lucie , Widmer Natasha , Eames Ken T. D. , Conlan Andrew J. K. 
Published: May 2018

AbstractSelf-reported social mixing patterns are commonly used in mathematical models of infectious diseases. It is particularly important to quantify patterns for school-age children given their disproportionate role in transmission, but it remains unclear how the structure of such social interactions changes over time. By integrating data collection into a public engagement programme, we examined self-reported contact networks in year 7 groups in four UK secondary schools. We collected data from 460 unique participants across four rounds of data collection conducted between January and June 2015, with 7,315 identifiable contacts reported in total. Although individual-level contacts varied over the study period, we were able to obtain out-of-sample accuracies of more than 90% and F-scores of 0.49-0.84 when predicting the presence or absence of social contacts between specific individuals across rounds of data collection. Network properties such as clustering and number of communities were broadly consistent within schools between survey rounds, but varied significantly between schools. Networks were assortative according to gender, and to a lesser extent school class, with the estimated clustering coefficient larger among males in all surveyed co-educational schools. Our results demonstrate that it is feasible to collect longitudinal self-reported social contact data from school children and that key properties of these data are consistent between rounds of data collection.
A dynamic power-law sexual network model of gonorrhoea outbreaks
Authors: Whittles Lilith K , White Peter J , Didelot Xavier 
Published: May 2018

AbstractHuman networks of sexual contacts are dynamic by nature, with partnerships forming and breaking continuously over time. Sexual behaviours are also highly heterogeneous, so that the number of partners reported by individuals over a given period of time is typically distributed as a power-law. Both the dynamism and heterogeneity of sexual partnerships are likely to have an effect in the patterns of spread of sexually transmitted diseases. To represent these two fundamental properties of sexual networks, we developed a stochastic process of dynamic partnership formation and dissolution, which results in power-law numbers of partners over time. Model parameters can be set to produce realistic conditions in terms of the exponent of the power-law distribution, of the number of individuals without relationships and of the average duration of relationships. Using an outbreak of antibiotic resistant gonorrhoea amongst men have sex with men as a case study, we show that our realistic dynamic network exhibits different properties compared to the frequently used static networks or homogeneous mixing models. We also consider an approximation to our dynamic network model in terms of a much simpler branching process. We estimate the parameters of the generation time distribution and offspring distribution which can be used for example in the context of outbreak reconstruction based on genomic data. Finally, we investigate the impact of a range of interventions against gonorrhoea, including increased condom use, more frequent screening and immunisation, concluding that the latter shows great promise to reduce the burden of gonorrhoea, even if the vaccine was only partially effective or applied to only a random subset of the population.
Detection of protein markers for autophagy, autolysis and apoptosis processes in aSaccharomyces cerevisiaewine flor yeast strain when forming biofilm
Authors: Moreno-García Jaime , Mauricio Juan Carlos , Moreno Juan , García-Martínez Teresa 
Published: May 2018

AbstractYeast autophagy, autolysis and apoptosis are biological processes triggered by nutrient starvation conditions that usually take place in winemaking. Biological aging of Sherry wines constitutes an enological environment suitable for the induction of these mechanisms due to the scarcity of nutrients and formation of yeast social communities, i.e.; biofilm; however, few studies have been carried out in this regard. Here, we perform a proteomic analysis to detect any autolysis/autophagy/apoptosis protein markers and/or proteins potentially related to these processes under flor forming and fermentative conditions. The scarce presence of autophagy proteins in flor biofilm forming conditions, the existence of autophagy inhibitors (e.g. Pph21p), and high quantity of crucial proteins for autolysis and apoptosis, Pep4p and Mca1p, respectively; indicate that autophagy may be silenced while autolysis and apoptosis are activated when the yeasts are forming flor. This is the first time that autophagy, autolysis and apoptosis proteomes have been studied as a whole in flor yeast under film forming conditions to our knowledge.