bluuebunny/crossref_metadata_2025_split huggingface dataset:
HLA-DR Expression on Monocyte Subsets in Critically Ill Children
Authors: Boeddha Navin P. , Kerklaan Dorian , Dunbar Albert , van Puffelen Esther , Nagtzaam Nicole M. A. , Vanhorebeek Ilse , Van den Berghe Greet , Hazelzet Jan A. , Joosten Koen F. , Verbruggen Sascha C. , Dik Willem A. , Driessen Gertjan J. 
Published: March 2018

Background:
To longitudinally study blood monocyte subset distribution and human leukocyte antigen-DR (HLA-DR) expression on monocyte subsets in children with sepsis, post-surgery and trauma in relation to nosocomial infections and mortality.

Methods:
In 37 healthy children and 37 critically ill children (12 sepsis, 11 post-surgery, 10 trauma and 4 admitted for other reasons)—participating in a randomized controlled trial on early versus late initiation of parenteral nutrition—monocyte subset distribution and HLA-DR expression on monocyte subsets were measured by flow cytometry upon admission and on days 2, 3 and 4 of pediatric intensive care unit (PICU) stay.

Results:
Upon PICU admission, critically ill children had a higher proportion of classical monocytes (CD14++CD16−) than healthy children [PICU 95% (interquartile range [IQR] 88%–98%); controls, 87% (IQR 85%–90%), P < 0.001]. HLA-DR expression was significantly decreased within all monocyte subsets and at all time points, being most manifest on classical monocytes and in patients with sepsis. Percentage of HLA-DR expressing classical monocytes [upon PICU admission 67% (IQR 44%–88%); controls 95% (IQR 92%–98%), P < 0.001], as well as the HLA-DR mean fluorescence intensity [upon PICU admission 3219 (IQR 2650–4211); controls 6545 (IQR 5558–7647), P < 0.001], decreased during PICU stay. Patients who developed nosocomial infections (n = 13) or who died (n = 6) had lower HLA-DR expression on classical monocytes at day 2 (P = 0.002) and day 3 (P = 0.04), respectively.

Conclusions:
Monocytic HLA-DR expression decreased during PICU stay and was lower compared with controls on all examined time points, especially on classical monocytes and in children admitted for sepsis. Low HLA-DR expression on classical monocytes was associated with nosocomial infections and death.
Single Balloon–assisted Colonoscopy for Placement of Colonic Manometry Catheters
Authors: Sanghavi Rinarani M. , Centeno Ricardo Medina‐ , Barth Bradley 
Published: March 2018

ABSTRACTObjectives:Colonic manometry is used frequently in children with long standing and difficult to manage constipation to aid in management decisions. Accurate analysis requires placement of the colonic manometry catheter in the colon without looping. This is technically difficult due to the long‐standing nature of the constipation in most patients leading to sigmoid and other colonic redundancy. Single balloon colonoscopy has been successfully used in adult in cases of difficult colonoscopy. We report the first series of single balloon–assisted colonoscopy for performing difficult colonoscopy in children and placing colonic manometry catheters.Methods:Retrospective chart review was performed to identify patients undergoing the procedure. All patients had prior preparation with nasogastric golytely.Results:Using the single balloon technique, 36 patients underwent placement of the colonic manometry catheter (ages ranging from 3 to 16 years, weights 12 to 95 kg). Catheter placement was successful in all cases with procedure times of 20 to 105 minutes. No major complications were noted.Conclusions:This is the first reported series of using single balloon–assisted colonoscopy to perform difficult colonoscopy in children and place colonic manometry catheters. It may have other therapeutic implications in children such as removal of polyps or placement of similar catheters.
The Health Care Transition of Youth With Liver Disease Into the Adult Health System
Authors: Vajro Pietro , Fischler Björn , Burra Patrizia , Debray Dominique , Dezsofi Antal , Guercio Nuzio Salvatore , Hadzic Nedim , Hierro Loreto , Jahnel Joerg , Lamireau Thierry , McKiernan Patrick , McLin Valerie , Nobili Valerio , Socha Piotr , Smets Francoise , Baumann Ulli , Verkade Henkjan J. 
Published: March 2018

ABSTRACTBackground:Medical advances have dramatically improved the long‐term prognosis of children and adolescents with once‐fatal hepatobiliary diseases. However, there is no generally accepted optimal pathway of care for the transition from paediatric care to the adult health system.Aim:The purpose of this position paper is to propose a transition process for young people with paediatric onset hepatobiliary diseases from child‐centred to adult‐centred healthcare services.Methods:Seventeen ESPGHAN/EASL physicians from 13 countries (Austria, Belgium, France, Germany, Hungary, Italy, the Netherlands, Norway, Poland, Spain, Sweden, Switzerland, and United Kingdom) formulated and answered questions after examining the currently published literature on transition from childhood to adulthood. PubMed and Google Scholar were systematically searched between 1980 and January 2018. Quality of evidence was assessed by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) system. Expert opinions were used to support recommendations whenever the evidence was graded weak. All authors voted on each recommendation, using the nominal voting technique.Results:We reviewed the literature regarding the optimal timing for the initiation of the transition process and the transfer of the patient to adult services, principal documents, transition multi‐professional team components, main barriers, and goals of the general transition process. A transition plan based on available evidence was agreed focusing on the individual young people's readiness and on coordinated teamwork, with transition monitoring continuing until the first year of adult services.We further agreed on selected features of transitioning processes inherent to the most frequent paediatric‐onset hepatobiliary diseases. The discussion highlights specific clinical issues that will probably present to adult gastrointestinal specialists and that should be considered, according to published evidence, in the long‐term tracking of patients.Conclusions:Transfer of medical care of individuals with paediatric onset hepatobiliary chronic diseases to adult facilities is a complex task requiring multiple involvements of patients and both paediatric and adult care providers.
The Use and Safety of a Novel Haemostatic Spray in the Endoscopic Management of Acute Nonvariceal Upper Gastrointestinal Bleeding in Children
Authors: Thomson Mike , Urs Arun , Narula Priya , Rao Prithviraj , Belsha Dalia 
Published: March 2018

ABSTRACTAims and Background:Advanced endohaemostatic technique performance and experience is extremely variable in distribution amongst paediatric endoscopists. Haemostatic spray (Hemospray), a novel endohaemostatic topically applied powder has the advantage of extreme ease of use and; hence may lower the threshold of competency required by the endoscopist thereby potentially reducing mortality. The aim of the study is to prospectively evaluate the efficacy and the safety of haemostatic spray in paediatric patients with acute upper gastrointestinal bleeding (AUGIB).Methods:Prospective enrolment of children with AUGIB (Group 1) occurred, either as primary therapy or as an adjunct to standard endohaemostatic therapeutic techniques. Patients were assessed for likely need for endohaemostatic intervention of >8 of 24 of the paediatric Sheffield AUGIB score.A follow‐up endoscopy occurred in those deemed to have clinical need pre‐discharge. For comparison, another group (Group 2) of patients, who received conventional endohaemostatic treatment in the preceding 36 months, were reviewed.Results:A total of 20 applications of Hemospray occurred in 17 patients (8 boys, median (range) age: 6.5 years (2 days to 17.75 years) and a total of 29 patients were enrolled in Group 2 (16 boys, median [range] age: 5.1 [0.25–17.0]). All patients tolerated haemostatic spray applications with no adverse events. The haemostatic spray group achieved 100% initial haemostasis with 18% rebleeding rate, although only a 6% failure rate after re‐application. In the conventional group, similar 100% initial haemostasis was achieved with 24% rebleeding rate and 7% failure rate necessitating surgical interventions.Conclusions:This paediatric series suggests that monotherapy with haemostatic spray is as effective as conventional approaches in the management of AUGIB.
The Treatment of Post-hysterectomy Vaginal Vault Prolapse: A Systematic Review and Meta-analysis
Authors: Coolen Anne-Lotte W. M. , Bui Bich Ngoc , Dietz Viviane , Wang Rui , van Montfoort Aafke P. A. , Mol Ben Willem J. , Roovers Jan-Paul W. R. , Bongers Marlies Y. 
Published: March 2018

(Abstracted from Int Urogynecol J 2017;28:1767–1783)
Although treatment of posthysterectomy vaginal vault prolapse (VVP) has been investigated in several randomized clinical trials, the best treatment remains controversial. There has been no prior systematic overview comparing VVP treatments.
Pain Management for First-Trimester Uterine Aspiration
Authors: Moayedi Ghazaleh , Tschann Mary 
Published: March 2018

Importance
First-trimester uterine aspiration can easily be performed in the office setting if adequate pain management for the patient is achieved. It is important for clinicians to understand evidence-based approaches for pain control to ensure a safe and efficient procedure.

Objective
This article reviews the literature regarding pharmacologic and nonpharmacologic pain control options for first-trimester abortion performed in the clinical setting. Preoperative, procedural, and postoperative pain control are all reviewed.

Evidence Acquisition
Authors searched the online database PubMed for relevant published literature through January 2018. To identify possible publications for review, the key word “abortion” was paired with the following key words: “pain,” “pain-control,” “pain management,” “aspiration,” “paracervical block,” “sedation, “non-pharmacologic,” and “post-operative.”

Results
Optimizing pain control for first-trimester uterine aspiration may involve interventions before, during, and after the surgery. Evidence shows patients benefit from premedication with nonsteroidal anti-inflammatory drugs, a defined paracervical block technique, and an option to use one of several nonpharmacologic interventions.

Conclusions and Relevance
Pain management for first-trimester uterine aspiration should be individualized for optimal patient satisfaction. Evidence supports multiple approaches to support this individualization. Targeted interventions before, during, and after the procedure should be offered to improve procedure experience and satisfaction.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to identify at least 3 evidence-based pharmacologic pain interventions for first-trimester uterine aspiration, interpret evidence for nonpharmacologic pain management interventions for first-trimester uterine aspiration, analyze the gaps in knowledge for current pain management options, and compare predictors of pain for uterine aspiration.
A Forensic Approach to Sotos Syndrome
Authors: Byard Roger W. 
Published: March 2018

Abstract
Sotos syndrome is a childhood overgrowth condition that is caused by deletions or mutations in the NSD1 gene located on chromosome 5q35. The syndrome is associated with a wide variety of features that may result in sudden death. The aim of this report was to investigate the spectrum of potential findings in cases presenting to autopsy. A 4-month-old girl with Sotos syndrome was found dead after being put down to sleep. Her death was due to complex cardiac disease that included surgically repaired atrial and ventricular septal defects and valve abnormalities, with cardiomegaly. If the features of Sotos syndrome are identified de novo at autopsy, genetic investigations are warranted, although the recurrence risk is low. The involvement of a clinical geneticist may assist in evaluating cases, and postmortem imaging studies may provide useful information.
Sudden and Unexpected Death During Sexual Activity, Due to a Glial Cyst of the Pineal Gland
Authors: Barranco Rosario , Lo Pinto Sara , Cuccì Maria , Caputo Fiorella , Fossati Francesca , Fraternali Orcioni Giulio , Ventura Francesco 
Published: March 2018

Abstract
Cysts of the pineal gland are benign lesions. Often asymptomatic, in the majority of cases they are discovered incidentally during brain magnetic resonance imaging or autopsy. Sporadically, however, they may cause such symptoms as chronic headache, loss of consciousness, corticospinal and sensory impairment, and, in some cases, even sudden death. A 45-year-old woman, in apparently good health, collapsed and died suddenly, after reaching orgasm while engaged in sexual intercourse. According to the circumstantial account of her relatives, the woman suffered from severe headaches, which were exacerbated by certain types of physical strain, such as sexual activity. Postmortem examination revealed no external injuries or internal diseases except for a cystic lesion of the pineal gland. Microscopically, the wall of the cyst consisted of a layer of glial tissue surrounded by an area of pineal elements. A complete forensic approach concluded that the cause of death was fatal cardiorespiratory failure resulting from midbrain compression due to a nonneoplastic pineal gland cyst, exacerbated by sexual activity. In this case, the intracranial pressure increase, secondary to Valsalva maneuver during climax, may further aggravate compression on the brainstem, thus concurring to determine the death.
The impact of paediatric antimicrobial stewardship programmes on patient outcomes
Authors: Patel Sanjay V. , Vergnano Stefania 
Published: March 2018

Purpose of review
Although there has been an unprecedented global effort to reduce the spread of antimicrobial resistance, little emphasis has been placed on children. This review aims to evaluate the impact of paediatric antimicrobial stewardship programmes as well as providing a practical approach for effectively implementing them in community-based settings and in hospitals.

Recent findings
Although rates of serious bacterial infection are low in children, the rates of antimicrobial use and resistance are comparable with adults. Different strategies are required to implement antimicrobial stewardship in community-based settings compared to in hospitals. Nationally coordinated, whole-system approaches have achieved long-term, sustainable reductions in antimicrobial prescribing, as well as reductions in resistance rates at population level, with no evidence of an increase in rate of serious infection or bacterial complications.

Summary
Antimicrobial stewardship programmes in neonates and children have unique characteristics and issues. There is currently no consensus on how to measure consumption of antimicrobials in neonates and children. This is a research priority. Benchmarking and clinical networks in neonates and paediatrics are important to share practice and drive best use of antimicrobials.
Simultaneous Implant Placement in a Mandibular Defect Reconstructed With a Free Fibula Graft and Fabrication of a Fixed Metal Porcelain Prosthesis
Authors: Kökat Ali M. , Erçöçen Ali R. , Karayazgan-Saraçoğlu Banu 
Published: March 2018

Abstract
This clinical report presents the multidisciplinary treatment approach for a 23-year-old male patient who underwent a total mandibular reconstruction due to trauma in the past and experienced postoperative complications. For his retreatment, exposed fixation plate was removed and infected bone was debrided and then a free fibula graft augmentation with simultaneous implant placement procedure was performed. After an osseointegration period of 6 months, a screw-retained porcelain fused to metal fixed prosthesis was fabricated and delivered.
An Unusual Case of Headache: Isolated Fungus Ball in Concha Bullosa
Authors: Bulut Fuat , Kazikdas Kadir Cagdas 
Published: March 2018

Abstract
A concha bullosa forms when the middle turbinate becomes pneumatized, which is a common anatomic variation; however, fungus ball in concha bullosa is rather rare. An otherwise healthy 52-year-old man presented to our ear, nose and throat clinic with the complaints of midfacial pressure headache and malodorous postnasal drip. Computed tomography of the paranasal sinuses demonstrated a polypoid hyperdense lesion with slight microcalcifications in the right nasal cavity, accompanied with a complicated fluid collection in the right frontoethmoideal recess seen as hypodensity in contrast to this hyperdensity. The histopathological examination reported a fungal infection. We present an extremely rare case of isolated fungal mass in the right middle concha detected in an early stage without any evidence of fungal infection of the other paranasal sinuses and discuss the importance of reevaluation of the computed tomography scans in suspicion of a fungal sinusitis.
Endoscopic Transsphenoidal Surgery for an Adult Patient With Giant Exophytic Chiasmatic/Hypothalamic Glioma
Authors: Wang Jing , Jia Jianwu , Hou Zhaoyuan , Yuan Xunhui , Sun Gaoling , Niu Jianyi , Li Zhiping 
Published: March 2018

Abstract
Optic pathway hypothalamic gliomas are intrinsic low-grade gliomas involving the optic nerve, chiasm, optic tract, and hypothalamus. The rarity of these tumors and their unpredictable course make assessment and standardization of treatment modalities difficult. Tumor debulking via various transcranial approaches was considered to be effective at controlling tumor growth, but with high rates of severe surgery-related complications. In the present case, endoscopic transsphenoidal surgery was initiated to debulk the exophytic chiasmatic/hypothalamic glioma with good preservation of hypothalamic and endocrine functions. The authors suggest transsphenoidal surgery with tumor debulking could be an effective and safe treatment for patients with chiasmatic/hypothalamic gliomas.
RAD51 paralogs regulate double strand break repair pathway choice by limiting Ku complex retention
Authors: Mejías-Navarro Fernando , Gómez-Cabello Daniel , Huertas Pablo 
Published: March 2018

AbstractRAD51 paralogs are a group of conserved proteins in eukaryotes that are involved in the repair of DNA breaks at several levels. On one hand, they help the strand invasion step catalyzed by RAD51. Also, they play late roles in Holliday Junction metabolism. Here we uncover a new role of the RAD51 paralogs at an earlier event in the repair of broken chromosomes. All five RAD51 paralogs affect the balance between double strand break repair pathways. Specifically, they favor homology-mediated repair over non-homologous end-joining. Such role is independent of RAD51 or the checkpoint activity of these proteins. Moreover, it defines a novel control point of double strand break repair independent and subsequent to DNA-end resection initiation.Mechanistically, RAD51 paralogs limit the retention of Ku80 at the sites of DNA breaks. Thus, our data extend the role of this family of proteins to the earliest event of double strand break repair.
A novel mouse model ofCampylobacter jejunienteropathy and diarrhea
Authors: Giallourou N , Medlock GL , Bolick DT , Medeiros PHQS , Ledwaba SE , Kolling GL , Tung K , Guerry P , Swann JR , Guerrant RL 
Published: March 2018

AbstractCampylobacterinfections are among the leading bacterial causes of diarrhea and of ‘environmental enteropathy’ (EE) and growth failure worldwide. However, the lack of an inexpensive small animal model of enteric disease withCampylobacterhas been a major limitation for understanding its pathogenesis, interventions or vaccine development. We describe a robust standard mouse model that can exhibit reproducible bloody diarrhea or growth failure, depending on the zinc or protein deficient diet and on antibiotic alteration of normal microbiota prior to infection. Zinc deficiency and the use of antibiotics create a niche forCampylobacterinfection to establish by narrowing the metabolic flexibility of these mice for pathogen clearance and by promoting intestinal and systemic inflammation. Several biomarkers and intestinal pathology in this model also mimic those seen in human disease. This model provides a novel tool to testing specific hypotheses regarding disease pathogenesis as well as vaccine development that is currently in progress.Author SummaryCampylobacter jejunihas been identified as one of the leading causes of enteropathy and diarrhea. In developing countries, these repeated enteric infections often result in growth deficits and cognitive impairment. There is a lack of small animal models ofCampylobacterinfection. This is a major hurdle in understanding the pathogenesis ofCampylobacterinfection in order to lead to therapeutic treatments and vaccines. We have developed a highly reproducible mouse model ofCampylobacterinfection that has clinical outcomes that match those of malnourished children. We hope that these insights intoCampylobactersusceptibility will lead to the development of treatments against this major cause of diarrheal illness.
Recombinant expression of Proteorhodopsin and biofilm regulators in Escherichia coli for nanoparticle binding and removal in a wastewater treatment model
Authors: Yang Justin , Wei Yvonne , Yeh Catherine , Liou Florence , Chen William , Lu Dylan , Chen Christine , Pei Justin , Lee Candice , Chen Emily , Lin Ashley , Imbrogulio Paul , Chang Katie , Hu Andrew , Kao Jesse , Chen Kelly , Tei Audrey , Yang Chansie , Hsu Katherine , Hsia Laurent , Wallace Oscar , Hau Abby , Liu Allen , Huang William , Chang Stephanie , Chang Catherine , Tsai Leona , Wang Avery , Lee Chang Sun , Wang Alvin , Shah Moksha , Yim Leon , Tsao Sean , Chiang Teresa , Clapper Jude C. 
Published: March 2018

AbstractThe small size of nanoparticles is both an advantage and a problem. Their high surface-area-to-volume ratio enables novel medical, industrial, and commercial applications. However, their small size also allows them to evade conventional filtration during water treatment, posing health risks to humans, plants, and aquatic life. This project aims to remove nanoparticles during wastewater treatment using genetically modified Escherichia coli in two ways: 1) binding citrate-capped nanoparticles with the membrane protein Proteorhodopsin, and 2) trapping nanoparticles using Escherichia coli biofilm produced by overexpressing two regulators: OmpR234 and CsgD. We demonstrate experimentally that Escherichia coli expressing Proteorhodopsin binds to 60 nm citrate-capped silver nanoparticles. We also successfully upregulate biofilm production and show that Escherichia coli biofilms are able to trap 30 nm gold particles. Finally, both Proteorhodopsin and biofilm approaches are able to bind and remove nanoparticles in simulated wastewater treatment tanks. We envision integrating our trapping system in both rural and urban wastewater treatment plants to efficiently capture all nanoparticles before treated water is released into the environment.Financial DisclosureThis work was funded by the Taipei American School. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Competing InterestsThe authors have declared that no competing interests exist.Ethics StatementN/AData AvailabilityYes – all data are fully available without restriction. Sequences for the plasmids used in this study are available through the Registry of Standard Biological Parts. Links to raw data are included in Supplementary Information.