bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bleeding Assessment Scale in Critically Ill Children (BASIC): Physician-Driven Diagnostic Criteria for Bleeding Severity
Authors: Nellis Marianne E. , Tucci Marisa , Lacroix Jacques , Spinella Philip C. , Haque Kelly D. , Stock Arabela , Steiner Marie E. , Faustino E. Vincent S. , Zantek Nicole D. , Davis Peter J. , Stanworth Simon J. , Cholette Jill M. , Parker Robert I. , Demaret Pierre , Kneyber Martin C. J. , Russell Robert T. , Stricker Paul A. , Vogel Adam M. , Willems Ariane , Josephson Cassandra D. , Luban Naomi L. C. , Loftis Laura L. , Leteurtre Stéphane , Stocker Christian F. , Goobie Susan M. , Karam Oliver 
Published: September 2019

Objective:
Although bleeding frequently occurs in critical illness, no published definition to date describes the severity of bleeding accurately in critically ill children. We sought to develop diagnostic criteria for bleeding severity in critically ill children.

Design:
Delphi consensus process of multidisciplinary experts in bleeding/hemostasis in critically ill children, followed by prospective cohort study to test internal validity.

Setting:
PICU.

Patients:
Children at risk of bleeding in PICUs.

Interventions:
None.

Measurements and Main Results:
Twenty-four physicians worldwide (10 on a steering committee and 14 on an expert committee) from disciplines related to bleeding participated in development of a definition for clinically relevant bleeding. A provisional definition was created from 35 descriptors of bleeding. Using a modified online Delphi process and conference calls, the final definition resulted after seven rounds of voting. The Bleeding Assessment Scale in Critically Ill Children definition categorizes bleeding into severe, moderate, and minimal, using organ dysfunction, proportional changes in vital signs, anemia, and quantifiable bleeding. The criteria do not include treatments such as red cell transfusion or surgical interventions performed in response to the bleed. The definition was prospectively applied to 40 critically ill children with 46 distinct bleeding episodes. The kappa statistic between the two observers was 0.74 (95% CI, 0.57–0.91) representing substantial inter-rater reliability.

Conclusions:
The Bleeding Assessment Scale in Critically Ill Children definition of clinically relevant bleeding severity is the first physician-driven definition applicable for bleeding in critically ill children derived via international expert consensus. The Bleeding Assessment Scale in Critically Ill Children definition includes clear criteria for bleeding severity in critically ill children. We anticipate that it will facilitate clinical communication among pediatric intensivists pertaining to bleeding and serve in the design of future epidemiologic studies if it is validated with patient outcomes.
Maternal Anxiety, Parenting Stress, and Preschoolers' Behavior Problems: The Role of Child Self-Regulation
Authors: Tsotsi Stella , Broekman Birit F.P. , Sim Lit Wee , Shek Lynette P. , Tan Kok Hian , Chong Yap Seng , Qiu Anqi , Chen Helen Y. , Meaney Michael J. , Rifkin-Graboi Anne 
Published: September 2019

ABSTRACT:

Objective:
Maternal anxiety is a well-known risk factor for early childhood behavior problems. In this study, we explore (1) whether parenting stress mediates this relation and also (2) whether child factors, namely self-regulation, modify the influence of maternal well-being on child externalizing and internalizing problems at 4 years of age.

Method:
Mothers taking part in the Growing Up in Singapore Towards Healthy Outcomes cohort completed the Spielberger State-Trait Anxiety Inventory when their children were 24 months of age. At 42 months of age, children performed a self-regulation task (n = 391), and mothers completed the Parenting Stress Index. When children were 48 months old, both parents completed the Child Behavior Checklist.

Results:
As predicted, parenting stress mediated the relation between maternal trait anxiety and child externalizing and internalizing problems. This mediating effect was further moderated by child self-regulation. The indirect effect of maternal trait anxiety through parenting stress on child externalizing problems was stronger among children with low self-regulation.

Conclusion:
Parenting stress is an additional pathway connecting maternal trait anxiety and children's externalizing and internalizing behavior problems. The risk for child externalizing problems conveyed by elevated maternal trait anxiety and parenting stress may be buffered by better self-regulation in 4-year-olds. These results suggest that interventions that include decreasing parenting stress and enhancing child self-regulation may be important to limiting the transgenerational impact of maternal trait anxiety.
Meeting FNP students' and faculty clinical needs: Two perspectives
Authors: Nicoteri Jo Ann L. 
Published: September 2019

ABSTRACTAppropriate clinical practice sites with skilled preceptors are the backbone of family nurse practitioner (FNP) students' education. Faculty are also in need of practice sites to stay abreast of current clinical practice and maintain clinical hours for certification. The purpose of this article is to relate the process of developing a practice model to meet the needs of the FNP student and faculty. Academia and student life professionals collaborated to use an existing student health center on campus as an education site with an FNP nursing faculty member as a preceptor. This qualitative descriptive study presents reflections of the experience from the student perspective. Three main themes were identified: independence, confidence, and trust. Lessons learned from the faculty perspective are also reviewed. Benefits of the project ultimately outweighed barriers. The interdepartmental precepted practice experience completed its fourth successful year and maintains support through the university's student life division. The model may provide strategies, particularly for FNP programs and faculty in smaller universities, to increase and diversify clinical experiences and provide a faculty practice site.
Epidemiology of carbapenem-resistant Gram-negative infections globally
Authors: Brink Adrian J. 
Published: September 2019

Purpose of review
The spread of carbapenem-resistant Gram-negative bacteria (GNB) with changes in institutional epidemiology continues to evolve worldwide. The purpose of this review is to evaluate new data with regard to the epidemiology, mechanisms of resistance and the impact of carbapenem resistance on mortality.

Recent findings
The rapid expansion of acquired carbapenem resistance is increasingly propagated by mobile genetic elements such as epidemic plasmids that transfer carbapenemase genes within and between GNB. The risk of acquisition of carbapenem-resistant Acinetobacter baumannii increases four-fold with carbapenem exposure and new meta-analyses have confirmed excess mortality associated with carbapenem-resistant Pseudomonas aeruginosa. Carbapenemase-producing Klebsiella pneumoniae, the most commonly encountered carbapenemase-producing Enterobacterales (CPE) and a major cause of high-mortality hospital-related infections, represents the most rapidly growing global threat. Carbapenem use in patients colonized with such genotypes, leads to an increase in CPE abundance in the gastrointestinal tract, which in turn increases the risk of blood-stream infections four-fold.

Summary
High-resistance rates in carbapenem-resistant GNB in many countries will inevitably complicate treatment of serious infections in vulnerable patient groups and should accelerate global attempts to overcome the impediments we face with regard to effective antimicrobial stewardship and infection prevention and control programs.
Death rattle: reassuring harbinger of imminent death or a perfect example of inadequacies in evidence-based practice
Authors: Watts Tessa , Willis Derek , Noble Simon , Johnston Bridget 
Published: September 2019

Purpose of review
Death is the inevitable consequence of life. Although clinicians are unlikely to accurately pinpoint when death is likely to occur in the people they care for, the death in a person with a diagnosis of malignant and nonmalignant tends to involve a period of predictable progressive clinical and functional deterioration. During this time, it is common for death rattle to occur. Due to its presentation, death rattle can cause stress and distress to caregivers. This often prompts clinicians to consider medical interventions that are not only ineffective in treating the problem but may also do harm.

Recent findings
There is a dearth of research related to the management of death rattle.

Summary
The article discusses the existing evidence in the management of death rattle, considerations for clinicians in the absence of reliable evidence and suggests areas for future research.
Autonomic dysfunction following mild traumatic brain injury
Authors: Callaway Cali C.M. , Kosofsky Barry E. 
Published: September 2019

Purpose of reviewBetween 1.6 and 3.6 million concussions, or mild traumatic brain injuries (mTBI), occur each year, nearly half of which go unreported and untreated. Despite the high incidence, practitioners currently lack both objective gold-standard diagnostic tools and evidence-based treatments to enable optimal care of concussed individuals.Recent findingsThis article aims to review recent research on the topic, emphasizing the role of the autonomic nervous system (ANS) in concussion. Current data suggests that ANS dysfunction is often evident following mTBI and accounts for many of the symptoms commonly seen in concussed patients. This link suggests several objective biomarkers that could be used to diagnose and monitor recovery following mTBI. Contrary to conventional wisdom, symptoms and biomarkers of ANS function improve when individuals are exposed to a program of graded exercise as treatment within the first week following concussion.SummaryANS dysfunction contributes to concussion symptomatology, an effect likely mediated through diffuse axonal injury, including brainstem structures and pathways mediating normal cerebrovascular autoregulation. Exercise, which enhances ANS function, is a well tolerated and effective method of treatment for both acute concussion patients and those suffering from postconcussion syndrome (PCS). The relationship between the ANS, exercise, and concussion creates an opportunity for the identification of objective biomarkers that can facilitate the diagnosis and treatment of mTBI.
Estimates of the global burden of Japanese Encephalitis and the impact of vaccination from 2000-2015
Authors: Quan Tran Minh , Thao Tran Thi Nhu , Duy Nguyen Manh , Nhat Tran Minh , Clapham Hannah E. 
Published: September 2019

AbstractJapanese encephalitis (JE) is a mosquito-borne disease, known for its high death and disability rate among symptomatic cases. Many effective vaccines are available for JE, and the use of a recently developed and inexpensive vaccine has been increasing over the recent years particularly with Gavi support. Estimates of the local burden and the past impact of vaccination are therefore increasingly needed, but difficult due to the limitations of JE surveillance. In this study, we implemented a mathematical modelling method combined with age-stratifed case data which can overcome some of these limitations. We estimate in 2015 JE infections caused 100,308 cases (95%CI: 61,720 - 157,522) and 25,125 deaths (95%CI: 14,550 - 46,031), and that between 2000 and 2015 307,774 JE cases (95%CI: 167,442- 509,583) were averted due to vaccination. Our results highlight areas that could have the greatest benefit from starting vaccination or from scaling up existing programs and will be of use to support local and international policymakers in making vaccine allocation decisions.
Anticipatory Control of Momentum for Bipedal Walking on Uneven Terrain
Authors: Darici Osman , Temeltas Hakan , Kuo Arthur D. 
Published: September 2019

AbstractHumans and other walking bipeds often encounter and compensate for uneven terrain. They might, for example, regulate the body’s momentum when stepping on stones to cross a stream. We examined what to do and how far to look, as a simple optimal control problem, where forward momentum is controlled to compensate for a step change in terrain height, and steady gait regained with no loss of time relative to nominal walking. We modeled planar, human-like walking with pendulum-like legs, and found the most economical control to be quite stereotypical. It starts by gaining momentum several footfalls ahead of an upward step, in anticipation of the momentum lost atop that step, and then ends with another speed-up to regain momentum thereafter. A similar pattern can be scaled to a variety of conditions, including both upward or downward steps, yet allow for considerably reduced overall energy and peak power demands, compared to compensation without anticipation. We define a “persistence time” metric from the transient decay response after a disturbance, to describe how momentum is retained between steps, and how far ahead a disturbance should be planned for. Anticipatory control of momentum can help to economically negotiate uneven terrain.
Mutation ofCFAP57causes primary ciliary dyskinesia by disrupting the asymmetric targeting of a subset of ciliary inner dynein arms
Authors: Bustamante-Marin Ximena M. , Horani Amjad , Stoyanova Mihaela , Charng Wu-Lin , Bottier Mathieu , Sears Patrick R. , Daniels Leigh Anne , Bowen Hailey , Conrad Donald F. , Knowles Michael R. , Ostrowski Lawrence E. , Zariwala Maimoona A. , Dutcher Susan K. 
Published: September 2019

AbstractPrimary ciliary dyskinesia (PCD) is characterized by chronic airway disease, male infertility, and randomization of the left/right body axis, and is caused by defects of motile cilia and sperm flagella. We screened a cohort of affected individuals that lack an obvious TEM structural phenotype for pathogenic variants using whole exome capture and next generation sequencing. The population sampling probability (PSAP) algorithm identified one subject with a homozygous nonsense variant [(c.1762C>T) p.(Arg588*) exon 11] in the uncharacterizedCFAP57gene. In normal human nasal epithelial cells, CFAP57 localizes throughout the ciliary axoneme. Analysis of cells from the PCD patient shows a loss of CFAP57, reduced beat frequency, and an alteration in the ciliary waveform. Knockdown ofCFAP57in human tracheobronchial epithelial cells (hTECs) recapitulates these findings. Phylogenetic analysis showed that CFAP57 is conserved in organisms that assemble motile cilia, andCFAP57is allelic with theBOP2gene identified previously inChlamydomonas. Two independent, insertionalfap57 Chlamydomonasmutant strains show reduced swimming velocity and altered waveforms. Tandem mass spectroscopy showed that CFAP57 is missing, and the “g” inner dyneins (DHC7 and DHC3) and the “d” inner dynein (DHC2) are reduced. Our data demonstrate that the FAP57 protein is required for the asymmetric assembly of inner dyneins on only a subset of the microtubule doublets, and this asymmetry is essential for the generation of an effective axonemal waveform. Together, our data identifies mutations inCFAP57as a cause of PCD with a specific defect in the inner dynein arm assembly process.SignificanceMotile cilia are found throughout eukaryotic organisms and performs essential functions. Primary ciliary dyskinesia (PCD) is a rare disease that affects the function of motile cilia. By applying a novel population sampling probability algorithm (PSAP) that uses large population sequencing databases and pathogenicity prediction algorithms, we identified a variant in an uncharacterized gene,CFAP57. This is the first reported example of PCD caused by a mutation that affects only a subset of the inner dynein arms, which are needed to generate the waveform. CFAP57 identifies an address for specific dynein arms. These findings demonstrate the effectiveness of the PSAP algorithm, expand our understanding of the positioning of dynein arms, and identify mutations inCFAP57as a cause of PCD.
Non-invasive stimulation of vagal afferents reduces gastric frequency
Authors: Teckentrup Vanessa , Neubert Sandra , Santiago João C. P. , Hallschmid Manfred , Walter Martin , Kroemer Nils B. 
Published: September 2019

AbstractMetabolic feedback between the gut and the brain relayed via the vagus nerve contributes to energy homeostasis. We investigated in healthy adults whether non-invasive stimulation of vagal afferents impacts energy homeostasis via efferent effects on metabolism or digestion. In a randomized crossover design, we applied transcutaneous auricular vagus nerve stimulation (taVNS) while recording efferent metabolic effects using simultaneous electrogastrography (EGG) and indirect calorimetry. We found that taVNS reduced gastric myoelectric frequency (p =.008), but did not alter resting energy expenditure. We conclude that stimulating vagal afferents induces gastric slowing via vagal efferents without acutely affecting net energy expenditure at rest. Collectively, this highlights the potential of taVNS to modulate digestion by activating the dorsal vagal complex. Thus, taVNS-induced changes in gastric frequency are an important peripheral marker of brain stimulation effects.
Neuroinflammation and EIF2 signaling persist in an HiPSC tri-culture model of HIV infection despite antiretroviral treatment
Authors: Ryan Sean K. , Gonzalez Michael V. , Garifallou James P. , Bennett Frederick C. , Williams Kimberly S. , Hakonarson Hakon , Anderson Stewart A. , Jordan-Sciutto Kelly L. 
Published: September 2019

AbstractHIV-Associated Neurocognitive Disorders (HAND) affect over half of HIV-infected individuals worldwide, despite antiretroviral therapy (ART). Therapeutically targetable mechanisms underlying HAND remain elusive. We developed a human-induced pluripotent stem cell (HiPSC) based model; whereby, we independently differentiate HiPSCs into neurons, astrocytes, and microglia and systematically combine to generate a tri-culture with or without HIV-infection and ART. scRNAseq analysis on tri-cultures including HIV-infected microglia revealed inflammatory signatures in the microglia and EIF2 signaling in all three cell types. Remarkably, EFZ alone induced a similar response to infection. Treatment with the antiretroviral compound Efavirenz (EFZ) mostly resolved these signatures; However, EFZ increased RhoGDI and CD40 signaling in the HIV-infected microglia. This activation was associated with a persistent increase in TNFa expression. This work establishes a tri-culture that recapitulates key features of HIV infection in the CNS and provides a new model to examine the effects of HIV infection and its treatment with antiretrovirals.
Revealing the Temporal Dynamics in Non-invasive Electrophysiological recordings with Topography-based Analyses
Authors: Wang Xuefei , Zhu Hao , Tian Xing 
Published: September 2019

AbstractThe fine temporal resolution of electroencephalography (EEG) makes it one of the most widely used non-invasive electrophysiological recording methods in cognitive neuroscience research. One of the common ways to explore the neural dynamics is to create event-related potentials (ERPs) by averaging trials, followed by the examination of the response magnitude at peak latencies. However, a complete profile of neural dynamics, including temporal indices of onset time, offset time, duration, and processing speed, is needed to investigate cognitive neural mechanisms. Based on the multivariate topographic analysis, we developed an analytical framework that included two methods to explore neural dynamics in ERPs. The first method separates continuous ERP waveforms into distinct components based on their topographic patterns. Crucial temporal indices such as the peak latency, onset and offset times can be automatically identified and indices about processing speed such as duration, rise, and fall speed can be derived. The second method scrutinizes the temporal dynamics of identified components by reducing the temporal variance among trials. The response peaks of signal trials are identified based on a target topographic template, and temporal-variance-free ERPs are obtained after aligning individual trials. This method quantifies the temporal variance as a new measure of cognitive noise, as well as increases both the accuracy of temporal dynamics estimation and the signal-to-noise ratio (SNR) of the ERP responses. The validity and reliability of these methods were tested with simulation as well as empirical datasets from an attention study and a semantic priming (N400) study. Together, we offer an analytical framework in a data-driven, bias-free manner to investigate neural dynamics in non-invasive scalp recordings. These methods are implemented in the Python-based open-source package TTT (Topography-based Temporal-analysis Toolbox).
Habitual foot strike pattern does not affect simulated Triceps Surae muscle metabolic energy consumption during running
Authors: Swinnen Wannes , Hoogkamer Wouter , De Groote Friedl , Vanwanseele Benedicte 
Published: September 2019

AbstractFoot strike pattern affects ankle joint work and Triceps Surae muscle-tendon dynamics during running. Whether these changes in muscle-tendon dynamics also affect Triceps Surae muscle energy consumption is still unknown. In addition, as the Triceps Surae muscle accounts for a substantial amount of the whole body metabolic energy consumption, changes in Triceps Surae energy consumption may affect whole body metabolic energy consumption. However, direct measurements of muscle metabolic energy consumption during dynamic movements is hard. Model-based approaches can be used to estimate individual muscle and whole body metabolic energy consumption based on Hill type muscle models. In this study, we use an integrated experimental and dynamic optimization approach to compute muscle states (muscle forces, lengths, velocities, excitations and activations) of 10 habitual mid-/forefoot striking and 9 habitual rearfoot striking runners while running at 10 and 14 km/h. The Achilles tendon stiffness of the musculoskeletal model was adapted to fit experimental ultrasound data of the Gastrocnemius medialis muscle during ground contact. Next, we calculated Triceps Surae muscle and whole body metabolic energy consumption using four different metabolic energy models provided in literature. Neither Triceps Surae metabolic energy consumption (p > 0.35), nor whole body metabolic energy consumption (p > 0.14) was different between foot strike patterns, regardless of the energy model used or running speed tested. Our results provide new evidence that mid-/forefoot and rearfoot strike pattern are metabolically equivalent.