bluuebunny/crossref_metadata_2025_split huggingface dataset:
DOZ047.83: Coordination of care through implementation of a multidisciplinary clinic for patients with esophageal atresia and tracheoesophageal fistula
Authors: Platt J , Mitchell I , Bjornson C , Bailey J A M 
Published: June 2019

Abstract

Introduction
Esophageal atresia/tracheoesophageal atresia (EA/TEF) is a multisystem congenital anomaly. Initial treatment is complex and ongoing complications are numerous. Coordination of care has been shown to reduce costs and hospitalizations in complex populations. A previous study at our center demonstrated that children with EA/TEF lacked coordinated care. A multidisciplinary clinic was established to provide coordinated care, screen for complications, provide anticipatory guidance, and improve outpatient access.

Methods
This single-center retrospective cohort study included children with EA/TEF born between March 2005 and March 2011 and enrolled in the clinic. Patients with EA alone were excluded. A chart review was completed to identify demographics, hospitalizations, emergency visits, clinic visits, coordination of outpatient care, and adherence to the intended clinic schedule.

Results
Twenty-five patients were included; 84% had a C-type EA/TEF. Multidisciplinary clinics had an average of 4.3 health care providers (1.75 physicians) per visit. Adherence to the visit schedule was 91.4%. The average length of stay (46.2 + 37.9 days) for the initial hospital admission was similar to the previous study cohort. Subsequent hospital admissions were reduced in number and length of stay, most notably in the first two years of life (0–1 year: 1.28 + 1.2 admissions/patient; 10.7 + 19.1 days/admission; 1–2 years: 0.6 + 0.76 admissions/patient; 3.7 + 3.2 days/admission).

Conclusions
Multidisciplinary care clinics for medically complex children such as those with EA/TEF can improve care through coordination of visits with multiple health care providers and may contribute to reduced use of acute care services.
DOZ047.98: The role of laryngeal electromyography in differential diagnosis of vocal cord immobility: a case report
Authors: Salvati A , Trozzi M , Meucci D , Tropiano M L , Bottero S 
Published: June 2019

Abstract

Object
The term ‘vocal cord immobility’ (VCI) encompasses both vocal cord paralysis and crico-arytenoid joint ankylosis (CAJA). Bilateral VCI represents an emergency condition characterized by stridor and respiratory distress sometimes requiring tracheostomy to ensure an adequate and safe airway. The aim of this study is to describe the diagnostic and therapeutic management of a rare case of congenital bilateral CAJA in a patient without pregnancy complications, perinatal traumas, or other comorbidities.

Materials and Methods
The patient was born full term by C-section after a healthy pregnancy (BW 3270 g, APGAR 9 at 5'). After birth she presented severe stridor with respiratory distress. She was admitted to our hospital when she was 3 months old. The diagnostic assessment was performed with airway endoscopy, pulmonary function tests (PFT), sleep study, echocardiogram, neurological evaluation, chest computed tomography (CT) scan, and brain magnetic resonance imaging (MRI). Laryngeal electromyography (LEMG) with endoscopic placement of Hookwire electrodes was carried out for the differential diagnosis between paralysis and ankylosis and the subsequent choice of the treatment. PFT and sleep study were repeated after each endoscopic procedure.

Results
The first airway endoscopy showed bilateral VCI in paramedian position and palpatory evidence of bilateral crico-arytenoid joint fixation. PFT highlighted inspiratory obstruction at the flow/volume and flow/time curves and tidal volume reduction. Sleep study was indicative of mild–moderate obstructive apnea. Echocardiogram, neurological evaluation, brain MRI, and chest CT scan did not detect anomalies. LEMG showed continuous low-amplitude basal activity in all analyzed muscles, in the absence of spontaneous neurotonic activations. Motor evoked potentials (MEP) denoted normal left response and minimum right delay. Two glottic dilations were performed with 7 and 8 mm balloons determining the decrease of stridor and good respiratory balance confirmed by PFT. Endoscopy showed a slight recovery of laryngeal motility.

Conclusion
The management of this rare clinical case points out the crucial role of a careful and complete endoscopic examination including the palpation of the crico-arytenoid joints. Moreover LEMG represents an important instrument for the correct differential diagnosis in VCI. In the future the use of LEMG could be mandatory in pediatric patients in order to avoid tracheotomy in favor of more conservative procedures.
Imaging residual inflammatory cardiovascular risk
Authors: Antoniades Charalambos , Antonopoulos Alexios S , Deanfield John 
Published: June 2019

Abstract
Targeting residual cardiovascular risk in primary and secondary prevention, would allow deployment of novel therapeutic agents, facilitating precision medicine. For example, lowering vascular inflammation is a promising strategy to reduce the residual inflammatory cardiovascular risk in patients already receiving optimal medical therapy, but prescribing novel anti-inflammatory treatments will be problematic due to the lack of specific companion diagnostic tests, to guide their targeted use in clinical practice. Currently available tests for the detection of coronary inflammation are either non-specific for the cardiovascular system (e.g. plasma biomarkers) or expensive and not readily available (e.g. hybrid positron emission tomography imaging). Recent technological advancements in coronary computed tomography angiography (CCTA) allow non-invasive detection of high-risk plaque features (positive remodelling, spotty calcification, low attenuation plaque, and napkin-ring sign) and help identify the vulnerable patient, but they provide only indirectly information about coronary inflammation. Perivascular fat attenuation index (FAI), a novel method for assessing coronary inflammation by analysing routine CCTA, captures changes in the perivascular adipose tissue composition driven by inflammatory signals coming from the inflamed coronary artery, by analysing the three-dimensional gradients of perivascular attenuation, followed by adjustments for technical, anatomical, and biological factors. By detecting vascular inflammation, perivascular FAI enhances cardiovascular risk discrimination which could aid more cost-effective deployment of novel therapeutic agents. In this article, we present the existing non-invasive modalities for the detection of coronary inflammation and provide a practical guide for their use in clinical practice.
Transgenerational Obesity and Healthy Aging in Drosophila
Authors: Camilleri-Carter Tara-Lyn , Dowling Damian K , L. Robker Rebecca , Piper Matthew D W 
Published: June 2019

Abstract
Substantial evidence suggests that individuals born to overweight and obese parents suffer detrimental health consequences that dramatically decrease healthy aging. The number of obese individuals worldwide now exceeds the number of under- and malnourished individuals. This obesity epidemic is responsible for approximately 4 million deaths worldwide each year, and predisposes sufferers to a range of age-related diseases such as cardiovascular diseases, and metabolic syndrome. Additionally, obesity is associated with an accelerated onset of age-related ailments, such as cancers and inflammation. The importance of dietary interventions to reduce the incidence of obesity is magnified by emerging evidence that parental physiology can predispose future generations to poor health outcomes. Characterizing and understanding these effects, and how they are mediated, is important if we are to continue to drive improvements to population health. In this article, we synthesize evidence for the intergenerational and transgenerational phenotypic effects of parental obesity. We concentrate on how the fruit fly Drosophila melanogaster can be used as a model to study these effects. Fruit flies are highly tractable, and their conserved nutrient signaling and metabolic pathways make them an ideal model for studying nutritional effects on metabolic, reproductive, and aging phenotypes.
Pyridox (am) ine 5'-phosphate oxidase deficiency induces seizures in Drosophila melanogaster
Authors: Chi Wanhao , Iyengar Atulya S R , Albersen Monique , Bosma Marjolein , Verhoeven-Duif Nanda M , Wu Chun-Fang , Zhuang Xiaoxi 
Published: June 2019

Abstract
Pyridox (am) ine 5'-phosphate oxidase (PNPO) is a rate-limiting enzyme in converting dietary vitamin B6 (VB6) to pyridoxal 5'-phosphate (PLP), the biologically active form of VB6 and involved in the synthesis of neurotransmitters including γ-aminobutyric acid (GABA), dopamine, and serotonin. In humans, PNPO mutations have been increasingly identified in neonatal epileptic encephalopathy and more recently also in early-onset epilepsy. Till now, little is known about the neurobiological mechanisms underlying PNPO-deficiency-induced seizures due to the lack of animal models. Previously, we identified a c.95 C&gt;A missense mutation in sugarlethal (sgll)—the Drosophila homolog of human PNPO (hPNPO)—and found mutant (sgll95) flies exhibiting a lethal phenotype on a diet devoid of VB6. Here, we report the establishment of both sgll95 and ubiquitous sgll knockdown (KD) flies as valid animal models of PNPO-deficiency-induced epilepsy. Both sgll95 and sgll KD flies exhibit spontaneous seizures before they die. Electrophysiological recordings reveal that seizures caused by PNPO deficiency have characteristics similar to that in flies treated with the GABA antagonist picrotoxin. Both seizures and lethality are associated with low PLP levels and can be rescued by ubiquitous expression of wild-type sgll or hPNPO, suggesting the functional conservation of the PNPO enzyme between humans and flies. Results from cell type-specific sgll KD further demonstrate that PNPO in the brain is necessary for seizure prevention and survival. Our establishment of the first animal model of PNPO deficiency will lead to better understanding of VB6 biology, the PNPO gene and its mutations discovered in patients, and can be a cost-effective system to test therapeutic strategies.
Toward a Global Genomic Epidemiology of Meningococcal Disease
Authors: Retchless Adam C , Fox LeAnne M , Maiden Martin C J , Smith Vincent , Harrison Lee H , Glennie Linda , Harrison Odile B , Wang Xin 
Published: June 2019

Abstract
Whole-genome sequencing (WGS) is invaluable for studying the epidemiology of meningococcal disease. Here we provide a perspective on the use of WGS for meningococcal molecular surveillance and outbreak investigation, where it helps to characterize pathogens, predict pathogen traits, identify emerging pathogens, and investigate pathogen transmission during outbreaks. Standardization of WGS workflows has facilitated their implementation by clinical and public health laboratories (PHLs), but further development is required for metagenomic shotgun sequencing and targeted sequencing to be widely available for culture-free characterization of bacterial meningitis pathogens. Internet-accessible servers are being established to support bioinformatics analysis, data management, and data sharing among PHLs. However, establishing WGS capacity requires investments in laboratory infrastructure and technical knowledge, which is particularly challenging in resource-limited regions, including the African meningitis belt. Strategic WGS implementation is necessary to monitor the molecular epidemiology of meningococcal disease in these regions and construct a global view of meningococcal disease epidemiology.
Immunoglobulin-Like Transcript 5 Inhibits Macrophage-Mediated Bacterial Killing and Antigen Presentation During Sepsis
Authors: Ming Siqi , Li Musheng , Wu Minhao , Zhang Jianhui , Zhong Haibo , Chen Junyang , Huang Yaopan , Bai Jun , Huang Li , Chen Juan , Lin Quanshi , Liu Jiao , Tao Jianping , He Duanman , Huang Xi 
Published: June 2019

AbstractBackgroundImmunosuppression contributes to the mortality of sepsis. However, the underlying mechanism remains unclear.MethodsIn the present study, we investigated the role of inhibitory receptor immunoglobulin-like transcript 5 (ILT5) in sepsis. We first screened the expression of ILT family members, and we found that ILT5 was dramatically up-regulated in the peripheral blood mononuclear cells from sepsis patients versus healthy donors.ResultsKnockdown of ILT5 by small interfering ribonucleic acid increased bacterial killing and reactive oxygen species production in THP-1 and RAW264.7 cells. Moreover, ILT5-expressing monocytes/macrophages exhibited lower expression of antigen-presenting molecules including major histocompatibility complex-II and CD80. In the in vitro coculture system with monocytes/macrophages, blockage of ILT5 facilitated Th1 proliferation and differentiation of CD4+ T cells. Furthermore, in vivo experiments demonstrated that pretreatment with ILT5 blocking peptide improved the survival and pulmonary pathology of septic mice.ConclusionsTogether, our study identified ILT5 as an immunosuppressive regulator during sepsis, which may provide potential therapeutic strategy for sepsis.
Live-Attenuated Influenza Vaccine Induces Tonsillar Follicular T Helper Cell Responses That Correlate With Antibody Induction
Authors: Lartey Sarah , Zhou Fan , Brokstad Karl A , Mohn Kristin G-I , Slettevoll Steffen A , Pathirana Rishi D , Cox Rebecca J 
Published: June 2019

Abstract

Background
Influenza remains a major threat to public health. Live-attenuated influenza vaccines (LAIV) have been shown to be effective, particularly in children. Follicular T helper (TFH) cells provide B-cell help and are crucial for generating long-term humoral immunity. However the role of TFH cells in LAIV-induced immune responses is unknown.

Methods
We collected tonsils, plasma, and saliva samples from children and adults receiving LAIV prior to tonsillectomy. We measured influenza-specific TFH-cell responses after LAIV by flow cytometry and immunohistochemistry. Systemic and local antibody responses were analysed by hemagglutination inhibition assay and enzyme-linked immunosorbent assay.

Results
We report that LAIV induced early (3–7 days post-vaccination) activation of tonsillar follicles and influenza-specific TFH-cell (CXCR5+CD57+CD4+ T cell) responses in children, and to a lesser extent in adults. Serological analyses showed that LAIV elicited rapid (day 14) and long-term (up to 1 year post-vaccination) antibody responses (hemagglutination inhibition, influenza-specific IgG) in children, but not adults. There was an inverse correlation between pre-existing influenza-specific salivary IgA concentrations and tonsillar TFH-cell responses, and a positive correlation between tonsillar TFH-cell and systemic IgG induction after LAIV.

Conclusions
Our data, taken together, demonstrate an important role of tonsillar TFH cells in LAIV-induced immunity in humans.
Algorithms at War: The Promise, Peril, and Limits of Artificial Intelligence
Authors: Jensen Benjamin M , Whyte Christopher , Cuomo Scott 
Published: June 2019

AbstractHow might rapid advances in artificial intelligence (AI) technologies affect the construction and application of military power? Despite the emerging importance of AI systems in defense modernization initiatives, there has been little empirical or theoretical study from the perspective of the international relations (IR) and security studies fields. This article addresses this shortcoming by describing AI developments and assessing the manner in which AI is likely to affect military organizations. We focus specifically on military power, as new methods and modes thereof will alter the constitution of security relationships around the world and affect the ability of states to bargain, signal, and influence in the twenty-first century. We argue that, though rapid adoption of AI technologies stands to transform states’ ways of war on a number of fronts, an AI revolution brings with it new forms of risk that must be reconciled with the widespread integration of algorithmic systems across military functions. Where new technology promises a transformation of the character of military power in some veins, it also complicates the cognitive aspects of decision-making and bureaucratic interactions in security institutions. The speed with which complex integrated AI systems enable entirely new modes of war also stands to detach human agency in a potentially destabilizing fashion from the conduct of warfare on several fronts. Preventing the negative externalities of these “ghosts in the machine” will involve significant efforts to educate decision makers, promote accountability, and restrain irresponsible employment of AI.
Dramatic rise in the proportion of ESBL-producing Escherichia coli and Klebsiella pneumoniae among clinical isolates identified in Canadian hospital laboratories from 2007 to 2016
Authors: Denisuik Andrew J , Karlowsky James A , Adam Heather J , Baxter Melanie R , Lagacé-Wiens Philippe R S , Mulvey Michael R , Hoban Daryl J , Zhanel George G ,   Canadian Antimicrobial Resistance Alliance (CARA) and CANWARD, Zhanel George G , Hoban Daryl J , Adam Heather J , Baxter Melanie R , Nichol Kimberly A , Lagacé-Wiens Philippe R S , Walkty Andrew , Karlowsky James A , Blondeau J , Slinger R , Davidson R , Zhanel G , Hoban D , Delport J , Ellis C , Laverdière M , Loo V , Poutanen S , Fuller J , Roscoe D , Desjardins M , Matukas L , Goyette M , Lee C , Carignan A , Bergevin M , Pelletier R 
Published: June 2019

Abstract

Objectives
To assess the prevalence, antimicrobial susceptibilities and molecular characteristics of ESBL-producing Escherichia coli and Klebsiella pneumoniae infecting patients receiving care in Canadian hospitals from January 2007 to December 2016.

Methods
Clinical isolates of E. coli (n = 8387) and K. pneumoniae (n = 2623) submitted to CANWARD, an ongoing Canadian national surveillance study, were tested using the CLSI reference broth microdilution method to determine their susceptibility to 15 antimicrobial agents. ESBL-producing E. coli and K. pneumoniae confirmed by the CLSI phenotypic method and putative AmpC-producing E. coli underwent PCR testing and DNA sequencing to identify resistance genes. Annual proportions of isolates harbouring ESBL and AmpC genes were assessed by the Cochran–Armitage test of trend.

Results
The annual proportion of isolates of E. coli that were ESBL producing increased from 3.4% in 2007 to 11.1% in 2016 (P < 0.0001); >95% of ESBL-producing E. coli were susceptible to amikacin, colistin, ertapenem, meropenem and tigecycline. The proportion of isolates of K. pneumoniae that were ESBL producing increased from 1.3% in 2007 to 9.7% in 2016 (P < 0.0001); >95% of ESBL-producing K. pneumoniae were susceptible to amikacin and meropenem. CTX-M-15 was the predominant genotype in both ESBL-producing E. coli (64.2% of isolates) and ESBL-producing K. pneumoniae (51.0%). The annual proportion of isolates of E. coli that were AmpC producing [annual proportion mean 1.9% (range 0.3%–3.1%)] was unchanged from 2007 to 2016 (P > 0.5).

Conclusions
The prevalence of both ESBL-producing E. coli and K. pneumoniae increased significantly in Canada during the study period while the prevalence of AmpC-producing E. coli remained low and stable.
An investigation of the effects of procalcitonin testing on antimicrobial prescribing in respiratory tract infections in an Irish university hospital setting: a feasibility study
Authors: O’Riordan F , Shiely F , Byrne S , O’Brien D , Palmer B , Dahly D , O’Connor T M , Curran D , Fleming A 
Published: June 2019

Abstract

Background
Diagnostic uncertainty and a high prevalence of viral infections present unique challenges for antimicrobial prescribing for respiratory tract infections (RTIs). Procalcitonin (PCT) has been shown to support prescribing decisions and reduce antimicrobial use safely in patients with RTIs, but recent study results have been variable.

Methods
We conducted a feasibility study of the introduction of PCT testing in patients admitted to hospital with a lower RTI to determine if PCT testing is an effective and worthwhile intervention to introduce to support the existing antimicrobial stewardship (AMS) programme and safely decrease antimicrobial prescribing in patients admitted with RTIs.

Results
A total of 79 patients were randomized to the intervention PCT-guided treatment group and 40 patients to the standard care respiratory control group. The addition of PCT testing led to a significant decrease in duration of antimicrobial prescriptions (mean 6.8 versus 8.9 days, P = 0.012) and decreased length of hospital stay (median 7 versus 8 days, P = 0.009) between the PCT and respiratory control group. PCT did not demonstrate a significant reduction in antimicrobial consumption when measured as DDDs and days of therapy.

Conclusions
PCT testing had a positive effect on antimicrobial prescribing during this feasibility study. The successful implementation of PCT testing in a randomized controlled trial requires an ongoing comprehensive education programme, greater integration into the AMS programme and delivery of PCT results in a timely manner. This feasibility study has shown that a larger randomized controlled trial would be beneficial to further explore the positive aspects of these findings.
Signal amplification in flow cytometry for cell surface antigen analysis
Authors: Mori Takeshi , Katayama Yoshiki 
Published: June 2019

AbstractSignal enhancing systems have been introduced to enable detection of cell surface antigens by flow cytometry. Cell surface antigens are important targets that describe the function and lineage of cells. Although flow cytometry is an effective tool for analysing cell surface antigens, this technique has poor sensitivity, which prohibits the detection of many important antigens on cell membranes. Thus, signal amplification is essential for developing practical tools for evaluating cell surface antigens by flow cytometry. Using a bright fluorophore or fluorescent polymer incorporated into antibodies is a straightforward strategy to improve flow cytometry sensitivity but may affect the functional characteristics of the labelled antibody. In contrast, enzymatic signal amplification is a more practical and efficient strategy to improve sensitivity that should not affect antibody activity. Although enzymatic signal amplification still has a number of drawbacks, this approach is a promising strategy to analyse cell surface antigens.
Abundance matching with the mean star formation rate: there is no missing satellites problem in the Milky Way above M200 ∼ 109 M⊙
Authors: Read J I , Erkal D 
Published: June 2019

ABSTRACT
We introduce a novel abundance matching technique that produces a more accurate estimate of the pre-infall halo mass, M200, for satellite galaxies. To achieve this, we abundance match with the mean star formation rate, averaged over the time when a galaxy was forming stars, 〈SFR〉, instead of the stellar mass, M∗. Using data from the Sloan Digital Sky Survey, the GAMA survey and the Bolshoi simulation, we obtain a statistical 〈SFR〉−M200 relation in Λ cold dark matter. We then compare the pre-infall halo mass, $M^{\rm abund}_{200}$, derived from this relation with the pre-infall dynamical mass, $M^{\rm dyn}_{200}$, for 21 nearby dSph and dIrr galaxies, finding a good agreement between the two. As a first application, we use our new 〈SFR〉−M200 relation to empirically measure the cumulative mass function of a volume-complete sample of bright Milky Way satellites within 280 kpc of the Galactic centre. Comparing this with a suite of cosmological ‘zoom’ simulations of Milky Way-mass haloes that account for subhalo depletion by the Milky Way disc, we find no missing satellites problem above M200 ∼ 109 M⊙ in the Milky Way. We discuss how this empirical method can be applied to a larger sample of nearby spiral galaxies.