bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of hospitalizations for pneumonia among Finnish drug users
Authors: Olubamwo Olubunmi O , Onyeka Ifeoma N , Aregbesola Alex , Ronkainen Kimmo , Tiihonen Jari , Föhr Jaana , Kauhanen Jussi 
Published: June 2018

Objective: The study examined the determinants of being hospitalized for pneumonia in a large cohort of drug users. Methods: Information of 4817 clients seeking treatment for illicit drug use was linked with the Finnish hospital discharge register to identify those who were hospitalized with main/primary diagnoses of pneumonia during 1997–2013. Cox regression models were used to examine the association between age, gender, homelessness, and route of drug administration of the primary drug at initial clinical consultation and pneumonia hospitalization. Findings were presented as adjusted hazard ratios and 95% confidence intervals. Results: There were 354 persons diagnosed with pneumonia, with a total of 522 hospitalizations at the end of 2013. The univariate Cox models revealed that being over 44 years of age, male gender, homelessness, and intravenous drug use at initial clinical consultation increased the risk of being hospitalized for pneumonia. In the fully adjusted multivariate model, being over 44 years was the strongest factor independently associated with pneumonia hospitalization (adjusted hazard ratio: 2.67, 95% confidence interval: 1.56–4.57, p < 0.001), followed by homelessness (adjusted hazard ratio: 1.75, 95% confidence interval: 1.38–2.22, p < 0.001) and intravenous drug use (adjusted hazard ratio: 1.27, 95% confidence interval: 1.01–1.59, p = 0.041). Of the 354 clients hospitalized for pneumonia, 31.9% ( n = 113) were rehospitalized within 30 days of being discharged. One-third of the reasons for the 30-day rehospitalization were pneumonia-related. Conclusion: Vaccination, measures addressing housing instability, safe injecting and good hygienic practices, and treating underlying drug use problems could help to reduce morbidity for pneumonia in this cohort.
Onset of secondary progressive multiple sclerosis is not influenced by current relapsing multiple sclerosis therapies
Authors: Coret Francisco , Pérez-Miralles Francisco C , Gascón Francisco , Alcalá Carmen , Navarré Arantxa , Bernad Ana , Boscá Isabel , Escutia Matilde , Gil-Perotin Sara , Casanova Bonaventura 
Published: June 2018

Background Disease-modifying therapies are thought to reduce the conversion rate to secondary progressive multiple sclerosis. Objective To explore the rate, chronology, and contributing factors of conversion to the progressive phase in treated relapsing–remitting multiple sclerosis patients. Methods Our study included 204 patients treated for relapsing–remitting multiple sclerosis between 1995 and 2002, prospectively followed to date. Kaplan–Meier analysis was applied to estimate the time until secondary progressive multiple sclerosis conversion, and multivariate survival analysis with a Cox regression model was used to analyse prognostic factors. Results Relapsing–remitting multiple sclerosis patients were continuously treated for 13 years (SD 4.5); 36.3% converted to secondary progressive multiple sclerosis at a mean age of 42.6 years (SD 10.6), a mean time of 8.2 years (SD 5.2) and an estimated mean time of 17.2 years (range 17.1–18.1). A multifocal relapse, age older than 34 years at disease onset and treatment failure independently predicted conversion to secondary progressive multiple sclerosis but did not influence the time to reach an Expanded Disability Status Scale of 6.0. Conclusions The favourable influence of disease-modifying therapies on long-term disability in relapsing–remitting multiple sclerosis is well established. However, the time to progression onset and the subsequent clinical course in treated patients seem similar to those previously reported in natural history studies. More studies are needed to clarify the effect of disease-modifying therapies once the progressive phase has been reached.
Cladribine: Off-label disease modification for people with multiple sclerosis in resource-poor settings?
Authors: Mao Zhifeng , Álvarez-Gonzalez César , De Trane Stefania , Yildiz Ozlem , Albor Christo , Doctor Gabriel , Soon Derek , Pepper George , Turner Benjamin P , Marta Monica , Mathews Joela , Giovannoni Gavin , Baker David , Schmierer Klaus 
Published: June 2018

Background A considerable number of people with multiple sclerosis (pwMS) live in low- and middle-income countries (LMIC), where lack of resource adversely affects access to effective disease-modifying treatment. Objective The objective of this commentary is to propose a useful cost-effective disease-modifying treatment option for pwMS in LMIC with potential high efficacy and high convenience to the pwMS and treating physician. Viewpoint: We propose using generic 2-chloro-2’-deoxyadenosine (cladribine), a small molecule licensed for treatment of people with hairy cell leukaemia, as a solution of this significant equity imbalance. Cladribine has been shown in phase II and III trials to be a highly effective disease-modifying treatment for pwMS, and its adverse effect profile is comparable with any DMT currently licensed in high-income economies where an oral preparation has recently been licensed by the European Medicines Agency. Conclusion Our viewpoint takes into account experience we have gathered over the past three years in the use of generic cladribine to treat pwMS. Whilst here we focus on MS, there is significant potential for use of cladribine in other conditions that could benefit from its mechanism of action.
Ubiquitin C-Terminal Hydrolase 1 and Phosphorylated Axonal Neurofilament Heavy Chain in Infants Undergoing Cardiac Surgery: Preliminary Assessment as Potential Biomarkers of Brain Injury
Authors: Lee Timothy , Chikkabyrappa Sathish M. , Reformina Diane , Mastrippolito Amanda , Chakravarti Sujata B. , Mosca Ralph S. , Shaw Gerry , Malhotra Sunil P. 
Published: June 2018

Background: There are no reliable markers to assess brain injury in neonates following cardiac surgery. We examine ubiquitin C-terminal hydrolase 1 (UCHL1) and phosphorylated axonal neurofilament heavy chain (pNF-H), neuronal-specific biomarkers released following axonal and cortical injury, in neonates undergoing cardiac surgery involving cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). Methods: Twenty-six patients younger than three months were prospectively enrolled (CPB only, n = 12 and DHCA, n = 14). Healthy newborns (n = 22) served as the control. Blood samples were collected preoperatively and postoperatively upon intensive care unit admission (hour 0) and subsequently at 12, 24, 36, and 48 hours. Serum was tested for UCHL1 and pNF-H using enzyme-linked immunosorbent assay. Concomitant arterial blood gas, lactate, and cerebral near-infrared spectroscopy (NIRS) monitoring were performed. Results: Ubiquitin C-terminal hydrolase 1 showed a significant rise at 0 hours in the DHCA group compared to baseline (74.9 ± 13.7 pg/mL vs 33.9 ± 37.3 pg/mL, P < .0001). Levels returned to baseline at 12 hours. There was an early rise in UCHL1 at 0 hours in the CPB group, P = .09. Phosphorylated axonal neurofilament heavy chain was decreased at 0 hours in both the CPB and DHCA groups compared to baseline, P = .06. There was no difference between control and baseline levels of UCHL1 ( P = .9) or pNF-H ( P = .77). Decreased NIRS was observed in the DHCA group at 0 hours (57.3 ± 10.5) versus baseline (64.2 ± 12.3), but not significant ( P = .21). There was no correlation between biomarkers and NIRS at 0 hours. Conclusion: A rapid rise in UCHL1 levels was observed in the DHCA group, suggesting that it may be a marker for acute brain injury. Follow-up with neurodevelopmental studies is ongoing.
Rotational Thromboelastometry Rapidly Predicts Thrombocytopenia and Hypofibrinogenemia During Neonatal Cardiopulmonary Bypass
Authors: Scott John P. , Niebler Robert A. , Stuth Eckehard A. E. , Newman Debra K. , Tweddell James S. , Bercovitz Rachel S. , Benson D. Woodrow , Cole Regina , Simpson Pippa M. , Yan Ke , Woods Ronald K. 
Published: June 2018

Background: Thrombocytopenia and hypofibrinogenemia during neonatal cardiopulmonary bypass (CPB) contribute to bleeding and morbidity. Rotational thromboelastometry (ROTEM) is a viscoelastic assay with a rapid turnaround time. Data validating ROTEM during neonatal cardiac surgery remain limited. This study examined perioperative hemostatic trends in neonates treated with standardized platelet and cryoprecipitate transfusion during CPB. We hypothesized that ROTEM would predict thrombocytopenia, hypofibrinogenemia, and the correction thereof. Methods: Forty-four neonates undergoing CPB were included in this prospective observational study. Blood samples were obtained at Baseline, On CPB, Post-CPB, and Postoperative. The ROTEM analysis included extrinsically activated (Extem) and fibrinogen-specific (Fibtem) assays. Platelet-specific thromboelastometry (Pltem) values were calculated. Platelet and cryoprecipitate transfusion was initiated prior to termination of CPB. Results: Platelet count and Extem amplitude decreased significantly On CPB ( P < .0001), increased significantly Post-CPB ( P < .0001), and Postoperative values were not significantly different from Baseline. Extem amplitude at 10 minutes (A10) > 46.5 mm (AUC = 0.941) and Pltem A10 > 37.5 mm [area under curve (AUC) = 0.960] predicted platelet count > 100 × 103/μL, and they highly correlated with platelet count ( R = 0.89 and R = 0.90, respectively). Fibrinogen concentration and Fibtem amplitude decreased significantly On CPB ( P ≤ .0001) and normalized after cryoprecipitate transfusion. Fibtem A10 > 9.5 mm predicted fibrinogen >200 mg/dL (AUC = 0.817), but it correlated less well with fibrinogen concentration ( R = 0.65). Conclusions: ROTEM analysis during neonatal cardiac surgery is sensitive and specific for thrombocytopenia and hypofibrinogenemia, identifying deficits within 10 minutes. Platelet and cryoprecipitate transfusion during neonatal CPB normalizes platelet count, fibrinogen level, and ROTEM amplitudes.
Role of Negative Pressure Wound Care and Hyperbaric Oxygen Therapy for Sternal Wound Infections After Pediatric Cardiac Surgery
Authors: Copeland Hannah , Newcombe Jennifer , Yamin Feras , Bhajri Khaled , Mille Vanessa Ayer , Hasaniya Nahidh , Bailey Leonard , Razzouk Anees J. 
Published: June 2018

Background: Sternal wound infections after pediatric cardiac surgery are uncommon but can be morbid. Methods: We describe an institutional protocol for complicated sternal wounds utilizing hyperbaric oxygen therapy (HBO) and negative pressure wound therapy (NPWT). Participants: A retrospective chart review (2001-2013) of 4,028 pediatric cardiac operations in 3,264 patients less than 18 years of age. Results: Fifty-three patients (1.62%; 53/3,264) were diagnosed with clinical sternal wound infections. There were 27 (50.9%) males and 26 (49.1%) females. Thirty-seven (69.8%) patients received antibiotics and/or debridement; sixteen (30.2%) patients had more complicated infections requiring NPWT and/or HBO therapy. The time to heal for wounds treated with HBO and HBO + NPWT was a mean of 43.75 (±24.27) days (range: 21-98 days; median: 35 days). Among all infected patients, the time from diagnosis of the infection to resolution of the infection for all survivors was 7 to 98 days (mean: 26.41 days; median: 21 days). Forty-eight (90.6%) patients completely healed their wounds, and 45 (84.9%) patients are currently alive. Thirty-eight patients had a cyanotic cardiac diagnosis and 15 had an acyanotic cardiac diagnosis. The most common bacteria isolated from the blood or wound cultures was Staphylococcus aureus. Six of 53 patients died. Causes of death are as follows: three from respiratory failure, one from sepsis, one from hypoxic ischemic encephalopathy, and one from exsanguination leading to cardiac arrest Conclusions: Complicated sternal wound infections after pediatric cardiac surgery refractory to antibiotic therapy and/or debridement can be successfully treated with NPWT and/or HBO therapy.
Acetabular revision using a Kerboull-type reinforcement device through direct anterior approach
Authors: Tamaki Tatsuya , Ninomiya Taishi , Jonishi Kurato , Miura Yoko , Oinuma Kazuhiro , Shiratsuchi Hideaki 
Published: June 2018

Background: The direct anterior approach has gained popularity in total hip arthroplasty (THA) over the past decade. However, there are few reports that describe the use of this approach for cases of complex revision. The purpose of this study was to report the surgical procedure and early clinical results of acetabular revision in the presence of bone defects using a Kerboull-type reinforcement device through the direct anterior approach. Methods: Eleven patients who had undergone acetabular reconstruction using a Kerboull-type reinforcement device for aseptic or septic loosening bone defects were enrolled. All procedures were performed using the direct anterior approach on a standard operating table. The mean age was 71.8 years, the mean period from initial surgery to revision THA was 14.5 years, and the mean follow-up period was 19.8 months. Results: The Kerboull-type acetabular reinforcement device with cemented cup combined with allogenic femoral head bone grafts was used in all hips. The mean operative time and intraoperative blood loss were 148 min and 743 g, respectively. None of the patients required allogeneic blood transfusion. One patient required revision surgery 11 months postoperatively because of device displacement. No other major or minor orthopedic complications were observed. Conclusion: The direct anterior approach allows for less invasive acetabular reconstruction using a Kerboull-type reinforcement device.
ADAP deficiency impairs megakaryocyte polarization with ectopic proplatelet release and causes microthrombocytopenia
Authors: Spindler Markus , van Eeuwijk Judith M. M. , Schurr Yvonne , Nurden Paquita , Nieswandt Bernhard , Stegner David , Reinhold Annegret , Bender Markus 
Published: June 2018

Key Points
ADAP deficiency in mice leads to microthrombocytopenia caused by a reduced platelet life span and ectopic (pro)platelet release. Lack of ADAP in MKs impairs demarcation membrane system polarization and podosome formation.
Evolution of a chemosensitive core-binding factor AML into an aggressive leukemia with eosinophilic differentiation
Authors: Xiao Wenbin , Yabe Mariko , Offin Michael , Khattar Pallavi , Baik Jeeyeon , Daley Ryan J. , Pappacena Jeremy J. , Roshal Mikhail , Zhang Yanming , Tallman Martin S. , Cai Sheng F. 
Published: June 2018

Key Points
Core-binding factor AML can evolve from good-risk disease into aggressive disease through the gain of additional genomic aberrations. In this unique case, an AML patient died of hypereosinophilic syndrome with solid organ infiltration of differentiated eosinophils.
ClC-2 knockdown prevents cerebrovascular remodeling via inhibition of the Wnt/β-catenin signaling pathway
Authors: Lu Jingjing , Xu Feng , Zhang Yingna , Lu Hong , Zhang Jiewen 
Published: June 2018

Abstract
Background
Mishandling of intracellular chloride (Cl−) concentration ([Cl−]i) in cerebrovascular smooth muscle cells is implicated in several pathological processes, including hyperplasia and remodeling. We investigated the effects of ClC-2-mediated Cl− efflux on the proliferation of human brain vascular smooth muscle cells (HBVSMCs) induced by angiotensin II (AngII).

Methods
Cell proliferation and motility were determined using the CCK-8, bromodeoxyuridine staining, wound healing and invasion assays. ClC-2, PCNA, Ki67, survivin and cyclin D1 expression, and β-catenin and GSK-3β phosphorylation were examined using western blotting. Histological analyses were performed using hematoxylin and eosin staining and α-SMA staining.

Results
Our results showed that AngII-induced HBVSMC proliferation was accompanied by a decrease in [Cl−]i and an increase in ClC-2 expression. Inhibition of ClC-2 by siRNA prevented AngII from inducing the efflux of Cl−. AngII-induced HBVSMC proliferation, migration and invasion were significantly attenuated by ClC-2 downregulation. The inhibitory effects of ClC-2 knockout on HBVSMC proliferation and motility were associated with inactivation of the Wnt/β-catenin signaling pathway, as evidenced by inhibition of β-catenin phosphorylation and nuclear translocation, and decrease of GSK-3β phosphorylation and survivin and cyclin D1 expression. Recombinant Wnt3a treatment markedly reversed the effect of ClC-2 knockdown on HBVSMC viability. An in vivo study revealed that knockdown of ClC-2 with shRNA adenovirus ameliorated basilar artery remodeling by inhibiting Wnt/β-catenin signaling in AngII-treated mice.

Conclusion
This study demonstrates that blocking ClC-2-mediated Cl− efflux inhibits AngII-induced cerebrovascular smooth muscle cell proliferation and migration by inhibiting the Wnt/β-catenin pathway. Our data indicate that downregulation of ClC-2 may be a viable strategy in the prevention of hyperplasia and remodeling of cerebrovascular smooth muscle cells.
Undeclared animal species in dry and wet novel and hydrolyzed protein diets for dogs and cats detected by microarray analysis
Authors: Ricci Rebecca , Conficoni Daniele , Morelli Giada , Losasso Carmen , Alberghini Leonardo , Giaccone Valerio , Ricci Antonia , Andrighetto Igino 
Published: June 2018

Abstract
Background
Although the European Pet Food Industry Federation (FEDIAF) stated that labels must be accurate and provide detailed information on the ingredients, mislabeling of pet food has been documented by several authors. This phenomenon is of particular concern when related to products used as elimination diets for the diagnosis of adverse food reaction (AFR) in dogs and cats because the presence of undeclared ingredients may negatively interfere with the trial and prevent the veterinarian from making an appropriate diagnosis. The aim of this study was to shed light upon the problem of contamination and mislabeling in both dry and wet novel protein diets (NPDs) and hydrolyzed protein diets (HPDs) using a microarray-based commercial kit which tests for the presence of 19 animal species.

Results
Of the 40 analyzed products (9 dry NPDs, 22 wet NPDs, 6 dry HPDs and 3 wet HPDs), ten presented a content that correctly matched the label, while five did not contain the declared animal species, twenty-three revealed the presence of undeclared animal species, and two had a vague label that did not allow the evaluation of its accuracy. The most frequently contaminants identified in both dry and wet pet foods were pork, chicken and turkey. The presence of undeclared animal species was higher in dry than wet pet foods; furthermore, a lower number of contaminating animal species was identified in HPDs than NPDs (4 vs 10), and a lower number of contaminated HPDs (6 out of 9, 67%) than contaminated NPDs was detected (24 out of 31, 77%). Thirteen out of 14 brands tested presented at least one mislabeled product.

Conclusions
Mislabeling seems to be a widespread issue in pet foods used as elimination diets. Contamination can occur in all types of products used for the purpose, although dry NPDs are the main issue. Due to the high risk of contamination, particular attention should be given to both the selection of raw material suppliers and the production process.
Maternal daily work hours affect nutritional status of children in Northern Ghana
Authors: Garti Humphrey , Ali Zakari , Garti Helene Akpene 
Published: June 2018

Abstract
Background
Data on the effect of maternal daily work hours on child nutritional status is scarce in Ghana. Such data may be important in defining maternal employment policies for improved child nutrition. This study therefore sought to determine the effect of maternal daily work hours on the nutritional status of farmer and public service mothers in the northern region of Ghana.

Methods
An analytical cross-sectional survey was conducted among 320 mothers with children 6–59 months. Maternal daily work hours and dietary intake of children were assessed with a structured questionnaire. Anthropometric measurements of children were also taken to classify child nutritional status. The association between maternal daily work hours and child nutritional status was determined using both bivariate analysis and multivariate regression modelling.

Results
Majority of the children (45.1%) were aged between their second and third birthdays. The prevalence of stunting, wasting, and underweight were 17.8, 8.1, and 10.3% respectively. Only stunting (p = 0.031) associated significantly with maternal employment and was higher among children of farmers (22.1%) compared to public servants (12.8%). Even though maternal age (p = 0.035), minimum dietary diversity (p = 0.040), non-consumption of legumes (p = 0.031) and other vegetables (p = 0.006) associated with stunting at bivariate level, multivariate logistic regression analysis revealed that only maternal daily work hours had significant effect on stunting. Compared to mothers who worked above 6 h a day, those who worked only a maximum of 4 h were 5.4 times more likely to have stunted children [AOR = 5.375; 95% CI (1.751–16.502); p = 0.003].

Conclusion
Present study results show that maternal daily work hours could be an important determinant of child stunting in northern region of Ghana.
Insulin signaling modulates border cell movement in Drosophila oogenesis
Authors: Sharma Aditi , Halder Sudipta , Felix Martina , Nisaa Khairun , Deshpande Girish , Prasad Mohit 
Published: June 2018

ABSTRACT
As collective cell migration is intimately involved in different aspects of metazoan development, molecular mechanisms underlying this process are being explored in a variety of developmental contexts. Border cell (BC) migration during Drosophila oogenesis has emerged as an excellent genetic model for studying collective cell migration. BCs are of epithelial origin but acquire partial mesenchymal characteristics before migrating as a group towards the oocyte. Here, we report that insulin signaling modulates collective BC movement during Drosophila oogenesis. Supporting the involvement of Insulin pathway, we demonstrate that compromising Insulin-like Receptor (InR) levels in BCs, inhibits their migration. Furthermore, we show that canonical Insulin signaling pathway components participate in this process. Interestingly, visualization of InR-depleted BC clusters, using time-lapse imaging, revealed a delay in detachment of BC clusters from the surrounding anterior follicle cells and altered protrusion dynamics. Lastly, based on genetic interactions between InR, the polarity determinant, par-1 and a regulatory subunit of Drosophila Myosin (spaghetti squash), we propose that Insulin signaling likely influences par-1 activity to engineer border cell detachment and subsequent movement via Drosophila Myosin.