bluuebunny/crossref_metadata_2025_split huggingface dataset:
COLLABORATIVE RESEARCH, CAPACITY BUILDING AND KNOWLEDGE TRANSLATION DEVELOPMENT FOR RESEARCH ON ADVERSE BIRTH OUTCOMES AND THE ENVIRONMENT
Authors: Wine Osnat , Spiers Jude , van Manen Michael , Burns Katharina Kovacs , Vargas Alvaro Osornio ,   DoMiNO Project
Published: May 2018

Abstract

BACKGROUND
The DoMiNO (Data mining & Neonatal outcomes) project explores the relationship between the environment and adverse birth outcomes. The project applies Integrated Knowledge Translation; a collaborative approach that builds on the participation, expertise and perspectives of interdisciplinary researchers, clinicians and knowledge-users, to ground and enhance the depth and breadth of research and to facilitate knowledge translation. Understanding the components that impact team building processes can contribute to supporting collaborative efforts.

OBJECTIVES
Based on the DoMiNO project we present major components that contributed to building team capacity for knowledge creation and the development of a knowledge translation plan.

DESIGN/METHODS
We use this project’s Integrated Knowledge Translation process as a case study in a qualitative evaluation of the ongoing research collaboration (experience and learnings) following team engagement in the research process (e.g., meetings, informal interactions). Participants included all 24 DoMiNO team members. Data were collected through interviews, focus groups, surveys and participant observations, all adding to the cumulative understanding of the collaborative research process and the knowledge translation plan evolution. All data were coded and analyzed using thematic analysis procedures.

RESULTS
Findings highlight the interrelated components of building capacity to support the research progress, co-production and knowledge translation plan development. These components include commitment, work etiquette, balancing perspectives, power and ownership, as well as communication, transparency, learning/ sharing knowledge and alignment. These contribute to building relationships, trust and capacity. Once those were established and research deliverables were clearer, the main messages and attainable knowledge translation goals were identified. The knowledge translation Several components contribute to capacity building and the development of the KT plan. In this complex context, it is an ongoing iterative process that evolves through time, as the team works and builds capacity. Identifying and supporting the essential components of team development could optimize capacity building.
plan was then articulated to identify potential users, audiences, and strategies.

CONCLUSION
Several components contribute to capacity building and the development of the KT plan. In this complex context, it is an ongoing iterative process that evolves through time, as the team works and builds capacity. Identifying and supporting the essential components of team development could optimize capacity building.
EXPERIENCE WITH USING RAPID MOLECULAR TESTING IN DIAGNOSING PULMONARY AND EXTRA-PULMONARY PEDIATRIC TUBERCULOSIS IN A NON-ENDEMIC SETTING - A RETROSPECTIVE CASE SERIES
Authors: Mijovic Hana , Al-Nasser Yossef , Al-Rawahi Ghada , Roberts Ashley 
Published: May 2018

Abstract

BACKGROUND
Tuberculosis (TB) is a rare but potentially devastating infection among Canadian children. Accurate diagnosis and initiation of treatment are limited in part by the fact that it takes 2–6 weeks for culture results to be confirmed. Xpert MTB/RIF (Xpert) is a rapid, automated molecular assay that has been validated for diagnosing pulmonary but not extra-pulmonary TB in children.

OBJECTIVES
This was a retrospective study of children investigated for active TB at our facility in order to:
1.Outline demographic characteristics and describe clinical presentations of children diagnosed with active TB.
2.Compare performance of molecular testing (Xpert) to stain and Mycobacterium tuberculosis culture on pulmonary and extra-pulmonary specimens.

DESIGN/METHODS
We conducted a retrospective chart review of all paediatric patients investigated for active TB at our facility with stain, culture and molecular (Xpert) testing between January 2015 and August 2017. Due to a small number of patients, our data analysis was limited to narrative summary and descriptive statistics.

RESULTS
A total of 10 children were diagnosed with active TB, including 3 cases of pulmonary, 4 extra-pulmonary and 3 disseminated disease. Age range at diagnosis was 2 months to 16 years, with 3 children younger than 1 year. Most children contracted TB while travelling to and/or being exposed to an index case from endemic areas, including East Asia/Western Pacific (5), South Asia (2) and Africa (1). All children were HIV negative.
Time from symptom onset to TB diagnosis and treatment ranged from approximately 4 days to 5 months. Multi-drug resistant TB was confirmed in 1 child. Sadly, 1 child passed away from TB related complications.
AFB stain was positive on at least one specimen in 4/10 cases, cultures were positive in 8/10 and molecular testing (Xpert) in 7/10 cases. Time to positive cultures ranged from 10 to 35 days, with an average of 19 days. All cases positive on Xpert were also culture positive. Xpert test diagnosed TB in 5/6 of extra-pulmonary specimens submitted, including pericardial fluid, lymph node tissues and cerebrospinal fluid.

CONCLUSION
Many paediatric TB patients at our facility are children who have traveled to/have contacts from TB endemic regions, emphasizing the need for obtaining thorough exposure and travel history. Culture and molecular testing demonstrated similar TB detection rates, albeit based on a small patient population. While cultures remain the most reliable diagnostic method, molecular testing may facilitate rapid diagnosis and treatment of pulmonary and extra-pulmonary paediatric TB in a non-endemic setting.
DO MODIFIABLE HOUSEHOLD BEHAVIORS AND EARLY INFANT FEEDING PRACTICES CONTRIBUTE TO VARIATIONS IN INFANT LINEAR GROWTH? EVIDENCE FROM A BIRTH COHORT IN DHAKA, BANGLADESH
Authors: Silverberg Sarah , Shi Joy , Al Mahmud Abdullah , Roth Daniel 
Published: May 2018

Abstract

BACKGROUND
Numerous postnatal risk factors have been associated with child length/height in cross-sectional studies in low- and middle-income countries. However, there have been few longitudinal studies of the effects of modifiable risk factors on postnatal linear growth during discrete developmental windows of infancy.

OBJECTIVES
We aimed to assess associations between modifiable household behaviours and conditional growth from birth to 1 year of life.

DESIGN/METHODS
We conducted a longitudinal cohort study using data from women and their infants (n=1162 pairs) in the Maternal Vitamin D and Infant Growth trial in Dhaka, Bangladesh. Infant length was measured tri-monthly from birth to 12 months, and infant feeding patterns were ascertained at weekly visits from 0 to 6 months of age. Confounder-adjusted associations of selected modifiable household factors (i.e., household air quality, sanitation/hygiene) or early infant feeding with change in length-for-age z-score (LAZ) were estimated in five intervals: birth to 3 months, 3 to 6 months, birth to 6 months, 6 to 12 months and birth to 12 months. In primary analyses, the outcome was conditional growth in LAZ (cLAZ) in each interval, derived as model residuals from regression of end-interval LAZ on initial LAZ. Effect estimates were expressed as mean difference in cLAZ (95% confidence interval) between the exposed versus referent group.

RESULTS
LAZ was symmetrically distributed, with mean (± standard deviation) LAZ of -0.95 (± 1.02) at birth and -1.00 (± 1.04) at 12 months. In multivariable-adjusted linear regression models, indicators of household air quality and sanitation/hygiene were not significantly associated with cLAZ in any interval. No breastfeeding and partial breastfeeding (versus exclusive breastfeeding), and any infant formula use (versus no formula use) were associated with slower growth in the 0–3 month interval: -0.11 (95% CI: -0.20, -0.02), -0.30 (95% CI: -0.52, -0.08), and -0.13 (95% CI: -0.22, -0.05), respectively, but not in later intervals. Several non-modifiable factors (maternal height, paternal education, and household wealth) were associated with cLAZ and LAZ in multivariable models.

CONCLUSION
Compared to international standards, the length distribution of infants in Dhaka, Bangladesh was harmonically shifted down at birth and throughout the first year of life, suggesting that observed infant length deficits relative to international norms were primarily caused by ubiquitous factors. Infant feeding practices explained some between-child variation in linear growth in the early postnatal period (0–3 months). Behaviors related to cooking or sanitation/hygiene were not related to infant linear growth trajectories.
CHARACTERIZATION AND RISK FACTOR IDENTIFICATION IN CHILDREN WITH SEVERE CROUP
Authors: Bensoussan Natan , Nguyen Lily , Oosenbrug Marcus , He Haitian , Duval Melanie 
Published: May 2018

Abstract

BACKGROUND
Croup is a self-limiting illness predominantly affecting young children, the most common etiology being Parainfluenza virus types 1 and 2. While the majority of croup remains self-limiting, 1.6–3% of cases are severe requiring acute airway management such as intubation and ventilatory support. While much is known about the diagnosis, management, and clinical course of self-limiting croup, factors contributing to severe cases remain unexplored.

OBJECTIVES
To characterize the clinical features and risk factors associated with severe croup in children admitted to a tertiary care centre.

DESIGN/METHODS
A retrospective chart review study of paediatric patients with severe croup presenting at a single tertiary care paediatric institution between 2011 and 2015 was performed. Severe croup was defined as those requiring major airway intervention (i.e. intubation), emergent management in the operating room (i.e. rigid bronchoscopy) or admission to the paediatric intensive care unit. Our findings were compared to previous reported characteristics of children with viral croup and recurrent croup. Multiple univariate regression models were constructed to isolate predictor variables of longer hospital stay and isolate confounders such as known comorbidities and risk factors.

RESULTS
Sixty-seven croup patients were analyzed, aged 4–170 months (median, 15) of which 76.8% were male. Several presented with risk factors, namely previous croup history (23.2%), intubation history (13%), airway abnormalities (8.7%) and nonspecific reactive airway disease (8.7%), while others exhibited comorbid conditions such as asthma (7.3%), GERD (14.5%) and known drug allergy (5.8%). In our cohort, Parainfluenza virus type 3 (PIV3) was shown to be a predictor for increased length of stay with a univariate regression coefficient of 3.2 (95% CI 0.72–5.7). Known croup risk factors did not contribute to the effect observed with PIV3 (coefficient 3.0, 95% CI 0.4–5.7). Further analysis accounting for comorbidity confounders predicted a coefficient of 2.6 for PIV3 (95% CI 0.01–5.12). Mean length of stay for PIV3 infected children was 7.4 nights.

CONCLUSION
To our knowledge, this is the first study linking PIV3 with severe croup and predicting longer hospitalizations in this cohort. Further investigation is required to determine optimal management of PIV3-infected croup patients to shorten clinical course and improve patient outcomes.
Assessing effect of catheter type and position on central line-associated bloodstream infections in the NICU
Authors: Leveillee Ariane , Lapointe Anie , Lachance Christian , Descarries Myriam , Autmizguine Julie , Dubois Josée , Moussa Ahmed 
Published: May 2018

Abstract

BACKGROUND
Central venous catheter usage in NICU remains associated with serious complications such as bloodstream infection. Also, low position (underdiaphragmatic) of umbilical venous catheter (UVC) is tolerated despite not recommended. To our knowledge, no previous study assessed the effect of such a position on central line associated bloodstream infections (CLABSI) rates in the NICU.

OBJECTIVES
The primary objectives of this study were to assess global CLABSI rates for each central catheter subtype and position, and specific rates according to birth weight and gestational age. Dwell time before infection and microorganisms involved were also evaluated.

DESIGN/METHODS
For this retrospective cohort study, all neonates hospitalized in Level 3 NICU, from April 1st 2011 to March 31st 2016, in whom a central line was inserted, were included. Data about catheter insertion, demographic characteristics and bloodstream infections was extracted from local CVC database, local CLABSI database, patient medical record, post catheter insertion X-rays and Canadian Neonatal Network database. Difference in CLABSI rates and type of microorganisms involved were analyzed using Cox regression and Chi2. Difference in dwell time was analyzed using a one-way ANOVA and evolution in time of the proportion of each type of catheter presented as observational data.

RESULTS
A total of 1577 neonates were included and 2440 CVC were studied. Median gestational age (GA) was 30 2/7 [26 6/, 37] weeks and birth weight (BW) was 1310 [680, 2796] g. Of the 2440 neonates, 1308 were boys (53.6%). There was a total of 197 CLABSI. Total number of catheter days over the study period was 23 479 days. CLABSI rate for high UVC was 11.49 per 1000 catheter days compared to 6.92 for PICC line (p < 0.001) and 5.14 for femoral CVC (p = 0.008). CLABSI rate for low UVC was 17.31 per 1000 catheter days (p = 0.002 when compared to high UVC). Median dwell time before infection is 7 days for high UVC, 5 days for low UVC and 11 days for PICC (p < 0.001). Microorganism involved in CLABSI was a majority of Coagulase-negative Staphylococcus in 57.1–71.9% without a statistically significant difference between groups (p= 0.33).

CONCLUSION
Evolution of CVC usage over years remained stable. CLABSI rates are significantly higher with all UVC compared with PICC line and femoral CVC, particularly for newborn < 1500g and < 32 weeks of GA. Low UVC are associated to higher CLABSI rates than high UVC. Health professionals should be cautious with indwelling UVC, especially when in low position. They might conisder replacing low lines by a PICC as soon as possible.
Childhood Trauma, DNA Methylation of Stress-Related Genes, and Depression: Findings From Two Monozygotic Twin Studies
Authors: Peng Hao , Zhu Yun , Strachan Eric , Fowler Emily , Bacus Tamara , Roy-Byrne Peter , Goldberg Jack , Vaccarino Viola , Zhao Jinying 
Published: May 2018

ABSTRACT

Objective
DNA methylation has been associated with both early life stress and depression. This study examined the combined association of DNA methylation at multiple CpG probes in five stress-related genes with depressive symptoms and tested whether these genes methylation mediated the association between childhood trauma and depression in two monozygotic (MZ) twin studies.

Methods
The current analysis comprised 119 MZ twin pairs (84 male pairs [mean = 55 years] and 35 female pairs [mean = 36 years]). Peripheral blood DNA methylation of five stress-related genes (BDNF, NR3C1, SLC6A4, MAOA, and MAOB) was quantified by bisulfite pyrosequencing or 450K BeadChip. We applied generalized Poisson linear-mixed models to examine the association between each single CpG methylation and depressive symptoms. The joint associations of multiple CpGs in a single gene or all five stress-related genes as a pathway were tested by weighted truncated product method. Mediation analysis was conducted to test the potential mediating effect of stress gene methylation on the relationship between childhood trauma and depressive symptoms.

Results
Multiple CpG probes showed nominal individual associations, but very few survived multiple testing. Gene-based or gene-set approach, however, revealed significant joint associations of DNA methylation in all five stress-related genes with depressive symptoms in both studies. Moreover, two CpG probes in the BDNF and NR3C1 mediated approximately 20% of the association between childhood trauma and depressive symptoms.

Conclusions
DNA methylation at multiple CpG sites are jointly associated with depressive symptoms and partly mediates the association between childhood trauma and depression. Our results highlight the importance of testing the combined effects of multiple CpG loci on complex traits and may unravel a molecular mechanism through which adverse early life experiences are biologically embedded.
Anatomical Resections Improve Survival Following Lung Metastasectomy of Colorectal Cancer Harboring KRAS Mutations
Authors: Renaud Stéphane , Seitlinger Joseph , Lawati Yaseen Al , Guerrera Francesco , Falcoz Pierre-Emmanuel , Massard Gilbert , Ferri Lorenzo , Spicer Jonathan 
Published: May 2018

Objective:
The aim of this study was to evaluate the benefit of anatomical resection (AR) in lung metastasectomy (LM) of colorectal cancer (CRC) harboring KRAS mutations

Summary Background Data:

KRAS mutations are related to high aggressiveness in the lung metastasis of CRC. It is unknown whether AR can lead to better outcomes than can non-AR (NAR) in KRAS patients.

Methods:
We retrospectively reviewed the data from 574 consecutive patients who underwent a LM for CRC. We focused on patients exhibiting 1 lung metastasis who underwent an AR (segmentectomy) or an NAR (wedge) and for whom the KRAS mutational status was known. Overall survival (OS) and time to pulmonary recurrence (TTPR) were analyzed.

Results:
We included 168 patients, of whom 95 (56.5%) harbored KRAS mutations. An AR was performed in 74 patients (44%). The type of resection did not impact the median OS in wild-type (WT) patients (P = 0.67) but was significantly better following AR in KRAS patients (101 vs 45 months, P = 0.02) according to the multivariate analysis [hazard ratio (HR): 6.524; 95% confidence interval (CI), 2.312–18.405; P < 0.0001). TTPR was not affected by the type of resection in WT patients (P = 0.32) but was significantly better for AR in KRAS patients (50 vs 15 months, P = 0.01) in the multivariate analysis (HR: 5.273; 95% CI, 1.731–16.064; P = 0.003). The resection-margin recurrence rate was significantly higher for NAR in KRAS patients (4.8% vs 54.2%, P = 0.001) but not in WT patients (P = 0.97).

Conclusion:
AR seems to improve both the OS and TTPR in LM of CRC harboring KRAS mutations.
Projecting the end of the Zika virus epidemic in Latin America: a modelling analysis
Authors: O’Reilly Kathleen M , Lowe Rachel , Edmunds W John , Mayaud Philippe , Kucharski Adam , Eggo Rosalind M , Funk Sebastian , Bhatia Deepit , Khan Kamran , Kraemar Moritz U , Wilder-Smith Annelies , Rodrigues Laura C , Brasil Patricia , Massad Eduardo , Jaenisch Thomas , Cauchemez Simon , Brady Oliver J , Yakob Laith 
Published: May 2018

AbstractBackground Zika virus (ZIKV) emerged in Latin America & the Caribbean (LAC) region in 2013, and has had serious implications for population health in the region. In 2016, the World Health Organization declared the ZIKV outbreak a Public Health Emergency of International Concern following a cluster of associated neurological disorders and neonatal malformations. In 2017, Zika cases declined, but future incidence in LAC remains uncertain due to gaps in our understanding, considerable variation in surveillance and a lack of a comprehensive collation of data from affected countries.Methods Our analysis combines information on confirmed and suspected Zika cases across LAC countries and a spatio-temporal dynamic transmission model for ZIKV infection to determine key transmission parameters and projected incidence in 91 major cities within 35 countries. Seasonality was determined by spatio-temporal estimates of Aedes aegypti vector capacity. We used country and state-level data from 2015 to mid-2017 to infer key model parameters, country-specific disease reporting rates, and the 2018 projected incidence. A 10-fold cross-validation approach was used to validate parameter estimates to out-of-sample epidemic trajectories.Results There was limited transmission in 2015, but in 2016 and 2017 there was sufficient opportunity for wide-spread ZIKV transmission in most cities, resulting in the depletion of susceptible individuals. We predict that the highest number of cases in 2018 within some Brazilian States (Sao Paulo and Rio de Janeiro), Colombia and French Guiana, but the estimated number of cases were no more than a few hundred. Model estimates of the timing of the peak in incidence were correlated (p<0.05) with the reported peak in incidence. The reporting rate varied across countries, with lower reporting rates for those with only confirmed cases compared to those who reported both confirmed and suspected cases.Conclusions The findings suggest that the ZIKV epidemic is by and large over, with incidence projected to be low in most cities in LAC in 2018. Local low levels of transmission are probable but the estimated rate of infection suggests that most cities have a population with high levels of herd immunity.
Identification of cereulide producingBacillus cereusby MALDI-TOF MS
Authors: Ulrich Sebastian , Gottschalk Christoph , Dietrich Richard , Märtlbauer Erwin , Gareis Manfred 
Published: May 2018

AbstractTheBacillus(B.)cereusgroup is genetically highly homogenous and consists of nine recognized species which are present worldwide.B. cereussensu stricto play an important role in food-borne diseases by producing different toxins. Yet, only a small percentage ofB. cereusstrains are able to produce the heat stable depsipeptide cereulide, the causative agent of emetic food poisonings. To minimize the entry of emeticB. cereusinto the food chain, food business operators are dependent on efficient and reliable methods enabling the differentiation between emetic and non-emetic strains. Currently, only time-consuming cell bioassays, molecular methods and tandem mass spectrometry are available for this purpose. Thus, the aim of the present study was to establish a fast and reliable method for the differentiation between emetic and non-emetic strains by MALDI-TOF MS. Selected isolates/strains of theB. cereusgroup (total n=110, i.e. emetic n=45, non-emetic n=65) were cultured on sheep blood agar for 48h.Subsequently, the cultures were directly analyzed by MALDI-TOF MS without prior extraction steps (direct smear method). The samples were measured in linear positive ionization mode in the mass range ofm/z800 - 1,800 Da. Using ClinProTools 3.0 statistical software and flex analyst, a differentiation between emetic and non-emetic isolates was possible with a rate of correct identification of 99.1 % by means of the evaluation of two specific biomarkers (m/z1171 and 1187 Da).ImportanceBacillus(B.)cereusplays an important role in food-borne diseases due to the production of different toxins, e.g. the heat stable depsipeptide cereulide. Only a small number ofB. cereusstrains are able to produce this toxin, the causative agent of emetic food poisonings. To minimize the entry of emeticB. cereusinto the food chain, food business operators require efficient and reliable methods enabling the differentiation between emetic and non-emetic strains. The aim of the present study was to develop a fast and reliable method for the differentiation between emetic and non-emetic strains by MALDI-TOF MS. A differentiation between emetic and non-emetic isolates was possible with a rate of correct identification of 99.1 % by means of the evaluation of two specific biomarkers (m/z1171 and 1187 Da).