bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment efficacy for idiopathic recurrent pregnancy loss – a systematic review and meta‐analyses
Authors: Rasmark Roepke Emma , Hellgren Margareta , Hjertberg Ragnhild , Blomqvist Lennart , Matthiesen Leif , Henic Emir , Lalitkumar Sujata , Strandell Annika 
Published: March 2018

AbstractIntroductionMedical treatment of women with idiopathic recurrent pregnancy loss is controversial. The objective was to assess the effects of different treatments on live birth rates and complications in women with unexplained recurrent pregnancy loss.Material and methodsWe searched MEDLINE, Embase and the Cochrane Library, and identified 1415 publications. This systematic review included 21 randomized controlled trials regarding acetylsalicylic acid, low‐molecular‐weight heparin, progesterone, intravenous immunoglobulin or leukocyte immune therapy in women with three or more consecutive miscarriages of unknown cause. The study quality was assessed and data was extracted independently by at least two authors.ResultsNo significant difference in live birth rate was found when acetylsalicylic acid was compared with low‐molecular‐weight heparin or with placebo. Meta‐analyses of low‐molecular‐weight heparin vs. control found no significant differences in live birth rate [risk ratio (RR) 1.47, 95% CI 0.83–2.61]. Treatment with progesterone starting in the luteal phase seemed effective in increasing live birth rate (RR 1.18, 95% CI 1.09–1.27) but not when started after conception. Intravenous immunoglobulin showed no effect on live birth rate compared with placebo (RR 1.07, 95% CI 0.91–1.26). Paternal immunization compared with autologous immunization showed a significant difference in outcome (RR 1.8, 95% CI 1.34–2.41), although the studies were small and at high risk of bias.ConclusionThe literature does not allow advice on any specific treatment for idiopathic recurrent pregnancy loss, with the exception of progesterone starting from ovulation. We suggest that any treatment for recurrent pregnancy loss should be used within the context of a randomized controlled trial.
Antimicrobial stewardship in the neonatal unit reduces antibiotic exposure
Authors: McCarthy KN , Hawke A , Dempsey EM 
Published: March 2018

AbstractAimAntimicrobial stewardship plays an important role in ensuring that the appropriate drug, dose, route and duration are employed to provide adequate treatment while minimising the risks of unnecessary antibiotic use. Surveillance of antibiotic use with prescriber feedback is recommended as a high‐impact stewardship intervention. The aim of this study was to reduce unnecessary antimicrobial use in a neonatal unit.MethodsA prospective audit was performed to assess compliance with antimicrobial guidelines. Following this, educational interventions were applied, electronic prescribing was introduced to the neonatal unit, and re‐audit was performed. The primary outcome was a reduction in days of therapy (DOT).ResultsThere were 312 neonatal admissions. There was a significant overall reduction in the primary outcome of DOT/1000 patient days from 572 to 417 DOT. This represents a 27% reduction in total antibiotic use. Prolonged antibiotic treatment courses >36 hours in negative sepsis evaluations were reduced from 82 DOT to 7.5 DOT. Similarly, treatment courses greater than five days for culture‐negative sepsis were reduced from 46.5 DOT to 7 DOT.ConclusionMonitoring antibiotic prescribing data can provide useful insights into the trends of antibiotic use and also inform clinicians of potential areas where antibiotic use may be safely reduced.
Combined multichannel intraluminal impedance‐pH monitoring should be used to diagnose reflux‐related otitis media with effusion in children
Authors: Pavić Ivan , Babić Irena , Matijašić Nuša , Hojsak Iva 
Published: March 2018

AbstractAimThis study investigated the diagnostic usefulness of combined multichannel intraluminal impedance‐pH monitoring (MII‐pH) in children with suspected reflux‐related otitis media with effusion (OME) as existing data were scarce.MethodsThis was a prospective study that included children up to seven years of age who underwent MII‐pH due to OME lasting more than three months. The study was conducted in the Children's Hospital Zagreb, Croatia, from January 2014 to August 2016.ResultsThe study comprised 63 children (63% male) with a mean age of 4.7 years. Gastroesophageal reflux (GER) disease was detected by impedance in 22 (35%) of the children and by pH‐metry in nine (14%). In children with OME, MII‐pH found a median number of 24 proximal GER episodes, of which a median of nine was acidic and a median of 11 was weakly acidic. There was a significant positive correlation between the number of GER episodes and the presence of eosinophils in nasal swabs.ConclusionBoth acidic and weakly acidic refluxes seemed to play a significant role in the pathogenesis of OME. Localised nasal eosinophilia may serve as a marker of extraoesophageal reflux in children with suspected reflux‐related OME.
Head‐up tilt test provokes dynamic alterations in total peripheral resistance and cardiac output in children with vasovagal syncope
Authors: Li Hongxia , Liao Ying , Han Zhenhui , Wang Yuli , Liu Ping , Zhang Chunyu , Tang Chaoshu , Du Junbao , Jin Hongfang 
Published: March 2018

AbstractAimThis study examined the total peripheral vascular resistance (TPVR) and cardiac output changes due to the head‐up tilt test (HUTT) in children with vasovagal syncope (VVS).MethodsFrom December 2013 to January 2016, we recruited 77 children diagnosed with VVS group at Peking University First Hospital, China, and 28 children without VVS provided the control group. Heart rate, blood pressure, TPVR, cardiac output and baroreflex sensitivity were monitored during the HUTT.ResultsIn the supine position, TPVR and baroreflex sensitivity were higher in the patients with VVS than the controls, but cardiac output did not differ between the two groups. There were obvious increases in the VVS patients from TPVR in the supine position to the prepositive response period (p < 0.05), then the positive response period (p < 0.01). However, we noted the opposite trend in cardiac output, from the supine position to the prepositive response period (p < 0.01) then the positive response period (p < 0.01).ConclusionDuring HUTT, children with VVS demonstrated increases in TPVR but decreases in cardiac output, during the transition from the supine position to the positive response. This response might be involved in the pathogenesis of VVS.
Paediatric antiepileptic polytherapy: systematic review of efficacy and neurobehavioural effects and a tertiary centre experience
Authors: Plevin D , Jureidini J , Howell S , Smith N 
Published: March 2018

AbstractAimThis paper presents the prevalence of antiepileptic polytherapy at a single tertiary institution and systematically reviews the evidence base for its efficacy and neurobehavioural safety in children.MethodPrevalence of antiepileptic polypharmacy was determined from pharmacy dispensing records at a paediatric tertiary hospital and neurobehavioural comorbidities quantified through casenote review; comparison is made with studies evaluating the neurobehavioural safety of antiepileptic polytherapy, identified via systematic literature review.ResultsAmongst 262 patients at the hospital, 117 (44.7%) were prescribed polytherapy; with patients having an intellectual disability statistically more likely to be prescribed polytherapy than those without (70.5% vs 40.6%; p < 0.0001). Systematic review identified no trials addressing the efficacy or neurobehavioural outcomes of polytherapy as a primary outcome. Several observational studies identified associations between polytherapy and neurobehavioural adverse outcomes such as anxiety and behavioural disturbance. Observational studies also suggest that a reduction in polytherapy load is generally not associated with worsening seizure control.ConclusionWhilst antiepileptic polytherapy is common practice within paediatric epilepsy cohorts attending tertiary care institutions, evidence is lacking to support its efficacy. There are significant practical difficulties to undertaking randomised controlled trials within this population. Nonetheless, clinicians must consider that adverse neurobehavioural consequences of polytherapy might outweigh benefits to seizure control.
Observation study showed that the continuity of skin‐to‐skin contact with low‐birthweight infants in Uganda was suboptimal
Authors: Watkins Heather C. , Morgan Melissa C. , Nambuya Harriet , Waiswa Peter , Lawn Joy E. 
Published: March 2018

AbstractAimKangaroo mother care (KMC) is a safe and effective method of reducing neonatal mortality in resource‐limited settings, but there has been a lack of data on the duration of skin‐to‐skin contact (SSC) in busy, low‐resource newborn units. Previous studies of intermittent KMC suggest the duration of SSC ranged from 10 minutes to 17 hours per day.MethodsThis was an observational study of newborn infants born weighing less than 2000 g, which collected quantitative data on SSC over the first week after birth. The study took place in July 2016 in the newborn unit of a low‐resource facility in Uganda.ResultsThe mean daily duration of SSC over the first week after birth was three hours. This differed significantly from the World Health Organization recommendation of at least 20 hours of SSC per day. SSC was provided by mothers most of the time (73.5%), but other family members also took part, especially on the day of birth.ConclusionOur study found a disappointingly low daily duration of SSC in this Ugandan newborn unit. However, advocacy and community education of SSC may help to decrease the stigma of KMC, improve overall acceptance and reduce the age at SSC initiation.
Reductions in otitis and other respiratory tract infections following childhood pneumococcal vaccination
Authors: Johansson Kostenniemi Urban , Palm Jessica , Silfverdal Sven‐Arne 
Published: March 2018

AbstractAimStreptococcus pneumoniae commonly causes respiratory tract infections including acute otitis media and pneumonia. In this study, we evaluated the impact of general infant pneumococcal vaccination, introduced in Sweden in 2009, on respiratory tract infections.MethodsWe studied the incidence of respiratory tract infections and antibiotic consumption in Västerbotten County, Sweden, during 2005–2014 using the County Council's diagnosis register.ResultsComparing the prevaccination period of 2005–2008 to 2014, the incidences of all‐cause acute otitis media decreased significantly in children aged 0–4 and five years to 17 years, by 41.5% and 20.9%, respectively. In addition, we also noted significant reductions in sinusitis and other upper respiratory tract infections, and some reductions in adults. Antibiotic consumption for upper respiratory tract infections decreased by 37.1%, with the largest decrease occurring in children aged 0–4 years. For pneumonia, the incidence significantly decreased by 28.6% for children aged 0–4 years, with no significant changes in older children or adults.ConclusionPneumococcal vaccination was followed by reduced incidence of upper respiratory tract infections and antibiotic consumption in vaccinated children, with some indications of possible herd immunity. For pneumonia, a major reduction was noted limited to the youngest children.
Multiple functional gastrointestinal disorders are frequent in formula‐fed infants and decrease their quality of life
Authors: Bellaiche Marc , Oozeer Raish , Gerardi‐Temporel Geraldine , Faure Christophe , Vandenplas Yvan 
Published: March 2018

AbstractAimThis prospective study evaluated the incidence of functional gastrointestinal disorders (FGIDs) during infancy, on their own or combined with other symptoms.MethodsWe asked 273 French paediatricians with a specific interest in FGIDs to provide feedback on 2757 infants aged zero to six months from March 2013 to January 2014. Gastrointestinal health status was assessed by two questionnaires at inclusion and at a four‐week follow‐up visit. FGIDs were assessed according to the Rome III criteria and quality of life (QoL) was monitored.ResultsCombined FGIDs were diagnosed in 2145 (78%) infants: 63% with two disorders and 15% with three or more disorders. The most frequently combined FGIDs were gas/bloating and colic (28%), colic and regurgitation (17.0%) and gas/bloating and regurgitation (8%). Compared to infants with a single FGID, combined FGID were associated with lower body weight (4.63 vs 4.79 kg, p = 0.009), shorter breastfeeding duration (33 vs 43 days, p < 0.001), a decreased QoL score (5.9 vs 6.5, p < 0.001), more frequent drug prescriptions (25% vs 13%, p < 0.001) and significantly greater improvements in QoL scores after four weeks (p = 0.003).ConclusionCombined FGIDs were extremely common in infants up to six months of age and had a negative impact on breastfeeding, weight gain and QoL.
Lower Apgar scores and Caesarean sections are related to attention‐deficit/hyperactivity disorder
Authors: Sucksdorff Minna , Lehtonen Liisa , Chudal Roshan , Suominen Auli , Gissler Mika , Sourander Andre 
Published: March 2018

AbstractAimWe examined the associations between prenatal, birth‐related and newborn risk factors and attention‐deficit/hyperactivity disorder (ADHD).MethodsIn this population‐based study, 10 409 subjects diagnosed with ADHD by 31 December 2011 and 39 124 controls, born between 1 January 1991 and 31 December 2005, were identified from Finnish nationwide registers. Perinatal data were obtained from the Birth Register. Conditional logistic regression was used to examine the associations after controlling for confounders.ResultsLower Apgar scores were associated with a higher risk of ADHD, with odds ratios of 1.12 (95% confidence intervals 1.06–1.19) for one‐minute Apgar scores of 7–8, 1.17 (95% CI 1.02–1.35) for scores of 5–6 and 1.41 (95% CI 1.18–1.68) for scores of 0–4, compared to Apgar scores of 9–10. Elective Caesarean sections were associated with an increased risk of ADHD with an adjusted odds ratio of 1.15 (95% CI 1.05–1.26). Other identified risk factors were breech presentation, induced labour and admission to a neonatal intensive care unit. Low umbilical artery pH did not increase the risk of ADHD.ConclusionElective Caesareans and perinatal adversities leading to lower Apgar scores increased the risk of ADHD. Future research to identify the mechanisms behind these findings is warranted.
WHY WAGES TEND TO BE LOWER IN WORKER‐OWNED FIRMS THAN IN INVESTOR‐OWNED FIRMS
Authors: BONATTI Luigi , LORENZETTI Lorenza A. 
Published: March 2018

ABSTRACTConsistently with the empirical evidence and in contrast with Shapiro and Stiglitz (1984), we demonstrate that worker‐owned firms exhibit not only more wage flexibility and less employment volatility than investor‐owned firms, but also lower expected wages than the latter. This is due to the informational advantage enjoyed by the firm's owners relatively to the workers concerning some circumstances that affect the performance of the firm. We show this both in the case in which each investor owned firm offers labor contracts to single workers who act atomistically and in the case in which each investor owned firm negotiates labor conditions with its workers who act as a group (a ‘union’). Finally, we show that differences in attitudes towards risk between investor owned firms and their workers are not necessary to explain the typical combination of state‐independent wages and cyclical layoffs that characterizes most industries.
Effects of the butyric acid‐producing strain Clostridium butyricum MIYAIRI 588 on broiler and piglet zootechnical performance and prevention of necrotic enteritis
Authors: Takahashi Motomichi , McCartney Elinor , Knox Anne , Francesch Maria , Oka Kentaro , Wada Kaoruko , Ideno Marie , Uno Koji , Kozłowski Krzysztof , Jankowski Jan , Gracia Marta I. , Morales Joaquin , Kritas Spyridon K. , Esteve‐Garcia Enric , Kamiya Shigeru 
Published: March 2018

AbstractThe objective of this study was to assess the effects of a probiotic strain Clostridium butyricumMIYAIRI 588 (CBM588) on broiler and weaned piglet health and zootechnical performance. Five field studies were carried out in broilers and five in weaned piglets under European feed additive guidelines. Each study followed a randomized blocked design with two treatments: Control (basal diet) and CBM588 supplemented groups. The zootechnical performance parameters selected were body weight, daily gain, feed intake and feed efficiency (feed:gain). Broilers fed diets with CBM588 gained significantly more weight (+2%, p < .001) and exhibited significantly better feed efficiency (−1.6%, p < .001) in comparison with Controls. Similarly, analysis of pooled data of weaned piglet trials showed that CBM588‐fed piglets were significantly heavier than Controls (+2.6%, p = .014), exhibited significantly higher mean daily gain (+4.7%; p = .004), and significantly improved feed efficiency (−4.2%, p = .001). In addition to the zootechnical efficacy studies, the preventive effect of CBM588 on necrotic enteritis (NE) was assessed in a natural challenge model in broilers where CBM588 reduced the incidence and severity of NE lesions. These data indicate the potential of CBM588 to improve broiler and weaned piglet zootechnical performance, and to make a positive contribution to animal health.
CYP3A5*3 and ABCB1 61A>G Significantly Influence Dose‐adjusted Trough Blood Tacrolimus Concentrations in the First Three Months Post‐Kidney Transplantation
Authors: Hu Rong , Barratt Daniel T. , Coller Janet K. , Sallustio Benedetta C. , Somogyi Andrew A. 
Published: March 2018

AbstractTacrolimus (TAC) is a first‐line immunosuppressant used to prevent organ rejection after kidney transplantation. There is large inter‐individual variability in its pharmacokinetics. Single nucleotide polymorphisms (SNPs) in genes encoding TAC metabolizing enzymes cytochromes P450 3A4/5 (CYP3A4/5), P‐glycoprotein efflux transporter (ABCB1), their expression regulator pregnane X receptor (NR1I2) and CYP3A co‐factor cytochrome P450 reductase (POR) have been studied for their effects on tacrolimus disposition. However, except for CYP3A5*3, controversies remain about their roles in predicting dose‐adjusted trough blood TAC concentrations (C0/D). This study aimed to investigate the effects of ABCB1 (61A>G, 1199G>A, 1236C>T, 2677G>T and 3435C>T), CYP3A4*22, CYP3A5*3, NR1I2 (8055C>T, 63396C>T and ‐25385C>T) and POR*28 SNPs on TAC C0/D. In total, 165 kidney transplant recipients were included in this study. SNPs were genotyped by probe‐based real‐time polymerase chain reaction. Associations between log‐transformed whole blood TAC C0/D (measured at 1 and 3 months post‐transplant) and genotypes/haplotypes were assessed by linear mixed effects analysis, controlling for age, sex and haematocrit. It was observed that CYP3A5 expressors (*1/*1 + *1/*3) (p = 5.5 × 10−16) and ABCB1 61G allele carriers (p = 0.001) had lower log‐transformed TAC C0/D (56% and 26% lower geometric mean TAC C0/D, respectively) and accounted for approximately 30% and 4%, respectively, of log‐transformed TAC C0/D variability in the first 3 months post‐transplant. In conclusion, CYP3A5*3 is a major, and ABCB1 61A>G is a novel, although minor, genetic factor affecting TAC C0/D in kidney transplant recipients.
Prostaglandin F2α Receptor Modulation Affects Eye Development in Guinea Pigs
Authors: Yang Jinglei , Pan Miaozhen , Reinach Peter S. , Chen Rongfang , Yu Lan , Zhou Feng , Zhang Sen , Qu Jia , Zhou Xiangtian 
Published: March 2018

AbstractRetinal arachidonic acid (ARA) levels in form‐deprived eyes decline in guinea pigs. As prostaglandin F2α (PGF2α) is an ARA metabolite and endogenous agonist of prostaglandin F receptor (FP), we have been suggested that down‐regulation of PGF2α‐FP receptor signalling pathway contributes to myopia onset. To test this hypothesis, this study determines whether: (i) retinal PGF2α levels decline during the development of form deprivation myopia (FDM) in guinea pigs; (ii) FP receptor agonism and antagonism alter emmetropization and myopia development. Pigmented guinea pigs were randomly assigned to normal vision and form‐deprived groups. Ultraperformance liquid chromatography coupled with a mass spectrometer (UPLC‐MS) measured retinal PGF2α levels 2 weeks after form deprivation (FD). The selective FP agonist, latanoprost acid (LAT) and its corresponding antagonist, AL8810, were peribulbarly injected into each group. An eccentric infrared photorefractor (EIR) monitored refraction. A‐scan ultrasonography measured axial elongation (AL) and vitreous chamber depth (VCD). Tonometry measured the intraocular pressure (IOP). Retinal PGF2α levels declined in form‐deprived eyes compared to those in normal eyes. Neither LAT nor AL8810 affected IOP with or without FD. On the other hand, after 4 weeks of daily 0.5 μg AL8810 treatment, a myopia of −1.99 ± 0.34 dioptre (D) developed, but LAT had no effect on emmetropization in a normal visual environment. Nevertheless, daily 30 μg LAT treatment for 4 weeks inhibited FDM development by 41% (vehicle control: −8.39 ± 0.45 D; LAT: −4.95 ± 0.39 D; two‐way anova with repeated measures, p < 0.05). Down‐regulation of PGF2α‐FP receptor signalling pathway may contribute to myopia onset as retinal PGF2α declined in myopic eyes and antagonism of FP receptor by AL8810 induced a myopic shift in normal vision environment. Meanwhile, up‐regulation of this pathway by LAT inhibited FDM development. However, the mechanism underlying LAT‐induced FDM inhibition needs further clarification. This uncertainty exists because its inhibition of FDM suggests that LAT strengthens the scleral framework which reduces axial elongation. On the other hand, its IOP‐lowering effect is attributed to thinning and weakening the scleral framework in glaucoma treatment.
Integrated Approaches to Testing and Assessment
Authors: Casati Silvia 
Published: March 2018

AbstractThe concept of Integrated Approaches to Testing and Assessment (IATA) has been advanced by the Organisation for Economic Cooperation and Development (OECD) member countries to enable a progressive shift from traditional chemical assessments largely based on the observation of the adverse effect in animal models, using individual methods or predefined batteries of standard toxicity tests, to assessment strategies integrating diverse lines of evidence. The flexible nature of IATA allows the inclusion of mechanistic data generated with non‐animal methods and with new technologies (e.g. high‐throughput and high content methods). The assessment process within IATA is typically conducted through weight‐of‐evidence which inevitably includes the elements of subjective expert judgement. For these reasons, IATA cannot be fully harmonized across sectors and countries. Nevertheless, some of the IATA components, such as defined approaches, which consist of a fixed data interpretation procedure (DIP) applied to data generated with a defined set of information sources, can be harmonized. The focus of this MiniReview is to provide an illustration of the differences between the IATA developed so far in the areas of regulatory toxicology, and ongoing activities related to the international harmonization of defined approaches that rely on multiple non‐animal information sources.