bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With First Medication Time for Children Treated in the Emergency Department for Asthma
Authors: Jang Hoon , Ozkaynak Mustafa , Ayer Turgay , Sills Marion R. 
Published: October 2018

Objectives
Acute asthma exacerbations are among the most common reasons for childhood emergency department (ED) visits and hospitalizations. Although early ED administration of asthma medication has been shown to decrease hospitalizations, studies of factors associated with early ED asthma medication delivery have been limited. The objective of our study was to identify patient- and ED-related factors associated with early medication delivery among children treated in the ED for asthma exacerbations.

Methods
This retrospective study used electronic health record data from all encounters for a primary diagnosis of asthma in an academic children's hospital ED during the study period 2009 to 2013. Using multivariate logistic regression, we identified the association between patient- and ED-related factors and the time to first medication defined as a binary outcome using a threshold of 1 hour from ED arrival. We then stratified our analysis by triage level (Emergency Severity Index [ESI]).

Results
Of the 4846 encounters during the study period, 62% were male, mean age was 7.30 years, 76% had public insurance, and 57% had an ESI level of 3. Medication was administered within 1 hour of arrival in 2236 encounters (46%). After adjusting for covariates, multivariate logistic regression revealed that patients were less likely to have medications within 1 hour when they had less severe ESI (ESI 2 vs ESI 4: odds ratio [OR], 0.139; confidence interval [CI], 0.114–0.170), arrived via non–emergency medical services (OR, 0.525; CI, 0.413–0.665), or arrived to a crowded ED (OR, 0.574; CI, 0.505–0.652). Age, sex, and insurance type were not associated with timeliness of initial medication administration. Stratified analyses demonstrated that the crowding effect was larger for less severely ill patients.

Conclusions
Our study found that patient severity (acuity level, arrival mode) and level of ED crowing—but not demographic factors—are associated with the administration of medication in the first hour to pediatric patients with asthma. Our findings may be helpful in redesigning asthma care management strategies.
Biased Competition Favoring Physical Over Emotional Pain: A Possible Explanation for the Link Between Early Adversity and Chronic Pain
Authors: Lane Richard D. , Anderson Frances Sommer , Smith Ryan 
Published: October 2018

ABSTRACTBackgroundEarly adversity predisposes to chronic pain, but a mechanistic explanation is lacking. Survivors of early adversity with chronic pain often seem impaired in their ability to be aware of, understand, and express distressing emotions such as anger and fear in social contexts. In this context, it has been proposed that pain may at times serve as a “psychic regulator” by preventing awareness of more intolerable emotions.MethodThis narrative review builds on the premise that physical pain and emotional pain are conscious experiences that can compete for selective attention. We highlight mechanisms whereby the consequences of early adversity may put emotional pain at a competitive disadvantage. A case history, supportive research findings, and an evidence-based neurobiological model are presented.ResultsArising from abuse or neglect in childhood, impairments in the adult capacity to attend to and/or conceptualize the emotional meaning of felt distress may be associated with impaired engagement of the default network and impaired top-down modulation of affective response generation processes. Persistent and poorly conceptualized affective distress may be associated with reduced emotion regulation ability, reduced vagal tone, increased inflammation, and amplified nociceptive signals. Attention to physical pain may be reinforced by the temporary reduction in negative emotions that it causes.ConclusionsThese processes jointly promote biased competition favoring attention to physical pain and away from one's own emotions. They may constitute an unintentional analog of the phenomenon of self-injury in patients with borderline personality disorder in whom the intentional infliction of physical pain serves to downregulate intense emotional distress. Attending to, expressing, and understanding previously unacknowledged psychological distress unrelated to pain may facilitate recovery from chronic pain after early adversity. Mechanistic studies that can validate this clinically derived neurobiological hypothesis are urgently needed.
Resilience From a Stakeholder Perspective: The Role of Next of Kin in Cancer Care
Authors: Bergerød Inger Johanne , Braut Geir S. , Wiig Siri 
Published: October 2018

Objective
The aim of this article was to provide new knowledge on how next of kin are co-creators of resilient performance, as seen from the viewpoint of the healthcare personnel and managers. The following research question guided the study: How are next of kin involved in shaping resilience within cancer care in hospitals?

Methods
The design of the study is a case study of cancer departments in two Norwegian hospitals. Data collection included a total of 32 qualitative semistructured interviews at two organizational levels (managers and staff). The data were analyzed by ways of a directed content analysis according to Hollnagel's Resilience in Health Care framework of resilience potentials (anticipate, monitor, respond, learn).

Results
Next of kin are involved in creating and maintaining resilience in cancer care by different kind of activities and in-depth insight into the patient's condition, which strengthen all resilience potentials of responding, anticipation, monitoring, and learning. We have identified nine areas in which next of kin are co-creators in shaping resilience. Next of kin are important stakeholders, both as safety experts and as safety resources, helping healthcare professionals provide quality and safety in the patient care process under difficult conditions. Next of kin's knowledge of the patient's history, their observation of the patient over time within the hospital, at home, and across care transitions are key elements of their contribution.

Conclusions
Next of kin complement healthcare professionals in all four potentials for resilient performance. The study suggests that the Resilience in Health Care framework takes into account the role of next of kin, as a stakeholder potential, because this has not previously been sufficiently considered.
Targeting Fallible Men: Communication Strategies and Moral Issues in a Pre-exposure Prophylaxis Trial
Authors: Trachman Mathieu , Girard Gabriel 
Published: October 2018

Abstract:
Based on the analysis of a French pre-exposure prophylaxis trial (Ipergay), and focusing on the communication strategies used to recruit volunteers, this article explores the figure who serves to justify the trial and who shapes the way in which populations concerned by this prevention tool are targeted. We show that this figure is that of the fallible man, a classic in moral philosophy: while aware of what is good or right for him, he is unable to put this knowledge into practice. The targeting of fallible men makes sense in the context of a resurgence of high-risk behaviors objectified in the late 1990s: qualifying gays who take risks as fallible individuals create a distance with respect to the “barebacker” who risks his life deliberately and has no intention of changing his behavior. Recognizing that certain gays are vulnerable to risk also provides justification for a preventive strategy that acknowledges the inadequacy of behavioral prevention, without giving up on prevention altogether. All in all, this analysis shows that the technological and epidemiological realism often highlighted in pre-exposure prophylaxis interventions is not without a moral dimension, attentive to individuals' contradictions and singularities, doubts and uncertainties, and to the risk of stigmatization inherent to the acknowledgement of risk-taking.
Being “False Positive”: An “Inconvenience”? Debates and Questions Regarding the Notion of Vaccine-Induced Seropositivity (VISP) in the Recruitment of Healthy Volunteers for a Preventive Anti-HIV Vaccine Trial
Authors: Couderc Mathilde 
Published: October 2018

Abstract:
This article considers a stage in the clinical trial process seldom documented in social sciences: recruitment of healthy volunteers for an HIV preventive vaccine trial through a media campaign. It analyzes one of the consequences of participating in such a clinical trial: the development of vaccine-induced seropositivity (VISP) and how this biomedical notion is mobilized both in recruitment procedures' normative discourses and from the volunteers' points of view, and its consequences on their decision to participate. The interpretations of VISP by volunteers depend on several factors: socialization, itinerary into the recruitment procedure, sexuality, etc., and generates diverse feelings such as indifference, doubt, or even fear. Fear of VISP represents the principal refusal reason for those who interrupted their participating step, just before inclusion stage. Addressing VISP phenomenon is important because it represents a major challenge for the information and the communication procedures for the next anti-HIV prophylactic trials recruitment campaigns.
Current Update on Desmoid Fibromatosis
Authors: Ganeshan Dhakshinamoorthy , Amini Behrang , Nikolaidis Paul , Assing Matthew , Vikram Raghunandan 
Published: October 2018

ObjectiveThe purpose of this article is to review the etiopathogenesis, molecular cytogenetics, histopathology, clinical features, and multimodality imaging features of desmoid fibromatosis. Recent advances in the management of desmoid fibromatosis will also be discussed.ConclusionsDesmoid fibromatosis is a rare soft tissue neoplasm with a high incidence of local recurrence. Imaging plays an important role in the diagnosis and management of this disease.
Accuracy of Quantification of Iodine and Hounsfield Unit Values on Virtual Monochromatic Imaging Using Dual-Energy Computed Tomography: Comparison of Dual-Layer Computed Tomography With Fast Kilovolt-Switching Computed Tomography
Authors: Washio Hayate , Ohira Shingo , Karino Tsukasa , Nitta Yuya , Hayashi Masaaki , Miyazaki Masayoshi , Teshima Teruki 
Published: October 2018

Objective
The aim of the study was to compare the accuracy of quantification of iodine and Hounsfield unit (HU) values on virtual monochromatic imaging (VMI) using dual-layer computed tomography (DLCT) and fast kilovolt-switching computed tomography (FKSCT).

Materials and Methods
This study was performed in 2 phantoms (large and small) using 16 rods representing different materials (iodine, calcium, blood, and adipose tissue) with different dimensions and concentrations. The absolute percentage errors (absolute ratio of measurement error to true iodine concentration) for iodine concentration and HU value on VMI at 50, 70, and 100 keV were compared between DLCT and FKSCT. The Mann–Whitney U test was used to assess statistical significance.

Results
Overall, the absolute percentage errors for iodine concentration and HU value on VMI were smaller for DLCT than for FKSCT.

Conclusions
Overall, the accuracy of iodine and HU values was higher for DLCT than for FKSCT.
Prevalence and Natural History of Coronary Ostial Aneurysms in Marfan Patients
Authors: Haroun Reham R. , Chu Linda C. , Fishman Elliot K. 
Published: October 2018

Objective
The aim of this study was to determine the prevalence and natural history of coronary ostial aneurysms in Marfan patients with aortic root replacement.

Methods
Thirty-one Marfan patients (mean age, 33.7 ± 11.8 years) who underwent aortic root replacement and postoperative electrocardiogram-gated computed tomographic (CT) angiograms between January 2007 and December 2015 were retrospectively identified. A subset of 15 patients underwent follow-up CT angiograms. Computed tomographic angiograms were postprocessed on 3-dimensional software to measure maximal coronary ostial diameter. Coronary ostial aneurysm was defined as diameter of greater than 10 mm.

Results
Right coronary ostial aneurysms were present in 45.2% (14/31) of patients, and left main coronary ostial aneurysms were present in 51.6% (16/31) of patients. Mean ostial diameter was 10.1 ± 1.9 mm for the right coronary artery and 10.0 ± 1.8 mm for the left coronary artery. In a subset of patients with follow-up CT angiograms, there was no significant change in coronary ostial diameter on follow-up examinations (P > 0.05).

Conclusions
Coronary ostial aneurysms were common in Marfan patients after aortic root replacement. These findings remain stable over time and may have little clinical consequence.
Myocardial Electrical Remodeling and the Arrhythmogenic Substrate in Hemorrhagic Shock-Induced Heart: Anti-Arrhythmogenic Effect of Liposome-Encapsulated Hemoglobin (HbV) on the Myocardium
Authors: Takase Bonpei , Higashimura Yuko , Hashimoto Kenichi , Asahina Haruka , Ishihara Masayuki , Sakai Hiromi 
Published: October 2018

ABSTRACT

Introduction:
Prolonged low blood pressure <40 mmHg in hemorrhagic shock (HS) causes irreversible heart dysfunction, ‘Shock Heart Syndrome’ (SHS), which is associated with lethal arrhythmias (ventricular tachycardia or ventricular fibrillation [VT/VF]) leading to a poor prognosis.

Methods:
To investigate whether the liposome-encapsulated human hemoglobin oxygen carrier (HbV) is comparable in effectiveness to autologous washed red blood cells (wRBCs) for improving arrhythmogenic properties in SHS, optical mapping analysis (OMP), electrophysiological study (EPS), and pathological examinations were performed in Sprague-Dawley rat hearts obtained from rats subjected to acute HS by withdrawing 30% of total blood volume. After acute HS, the rats were immediately resuscitated by transfusing exactly the same amount of saline (SAL), 5% albumin (5% ALB), HbV, or wRBCs. After excising the heart, OMP and EPS were performed in Langendorff-perfused hearts.

Results:
OMP showed a tendency for abnormal conduction and significantly impaired action potential duration dispersion (APDd) in both ventricles with SAL and 5% ALB. In contrast, myocardial conduction and APDd were substantially preserved with HbV and wRBCs. Sustained VT/VF was easily provoked by a burst pacing stimulus to the left ventricle with SAL and 5% ALB. No VT/VF was induced with HbV and wRBCs. Pathology showed myocardial structural damage characterized by worse myocardial cell damage and Connexin43 with SAL and 5% ALB, whereas it was attenuated with HbV and wRBCs.

Conclusions:
Ventricular structural remodeling after HS causes VT/VF in the presence of APDd. Transfusion of HbV prevents VT/VF, similarly to transfusion of wRBCs, by preventing electrical remodeling and preserving myocardial structures in HS-induced SHS.
Late Peaks of HMGB1 and Sepsis Outcome: Evidence For Synergy With Chronic Inflammatory Disorders
Authors: Karakike Eleni , Adami Maria-Evangelia , Lada Malvina , Gkavogianni Theologia , Koutelidakis Ioannis M. , Bauer Michael , Giamarellos-Bourboulis Evangelos J. , Tsangaris Iraklis 
Published: October 2018

ABSTRACT
High mobility group box 1 (HMGB1) is released from macrophages as a late biomarker of sepsis. Conditions associated with pre-existing macrophage activation may modify HMGB1 expression. This study aimed to assess the impact of HMGB1 kinetics on 28-day mortality. In a sub-study of a previous randomized clinical trial among patients with systemic inflammatory response syndrome and gram-negative infections, patients were classified in early and late HMGB1 peak groups. Serial measurements of HMGB1, ferritin and interferon-gamma (IFNγ) were performed in all available sera. Two hundred ten patients were included; 118 (46.5%) had at least one inflammatory disease (diabetes, chronic obstructive pulmonary disease, chronic heart failure, or chronic renal disease). Mortality after 28 days was higher among patients with a late peak of HMGB1 (OR 2.640; P = 0.026). Co-existence of late peak and inflammatory disease synergistically impacted mortality (odds ratio of logistic regression analysis 3.17; P: 0.027). Late peak was concomitantly associated with higher values of ferritin (P = 0.035), and IFNγ (P = 0.002) among patients with hyperferritinemia. It is concluded that late HMGB1 peak was associated with worse prognosis, especially in patients with underlying chronic inflammatory conditions.
Phototrophic co-cultures from extreme environments: community structure and potential value for fundamental and applied research
Authors: Shaw Claire , Brooke Charles , Hawley Erik , Connolly Morgan P. , Garcia Javier A. , Harmon-Smith Miranda , Shapiro Nicole , Barton Michael , Tringe Susannah G. , del Rio Tijana Glavina , Culley David E. , Castenholz Richard , Hess Matthias 
Published: October 2018

ABSTRACTCyanobacteria are found in most illuminated environments and are key players in global carbon and nitrogen cycling. Although significant efforts have been made to advance our understanding of this important phylum, still little is known about how members of the cyanobacteria affect and respond to changes in complex biological systems. This lack of knowledge is in part due to our dependence on pure cultures when determining the metabolism and function of a microorganism. In the work presented here we took advantage of the Culture Collection of Microorganisms from Extreme Environments (CCMEE), a collection of more than 1,000 publicly available photosynthetic co-cultures now maintained at the Pacific Northwest National Laboratory. To highlight some of their scientific potential, we selected 26 of these photosynthetic co-cultures from the CCMEE for 16S rRNA gene sequencing. We assessed if samples readily available from the CCMEE could be used to generate new insights into the role of microbial communities in global and local carbon and nitrogen cycling. Results from this work support the existing notion that culture depositories in general hold the potential to advance fundamental and applied research. If collections of co-cultures can be used to infer roles of the individual organisms remains to be seen and requires further investigation.
Alexidine dihydrochloride has broad spectrum a ctivities against diverse fungal pathogens
Authors: Mamouei Zeinab , Alqarihi Abdullah , Singh Shakti , Xu Shuying , Mansour Michael K. , Ibrahim Ashraf S , Uppuluri Priya 
Published: October 2018

AbstractInvasive fungal infections due to Candida albicans, Aspergillus fumigatus and Cryptococcus neoformans, constitute a substantial threat to hospitalized, immunocompromised patients. Further, the presence of drug-recalcitrant biofilms on medical devices, and emergence of drug-resistant fungi such as Candida auris, introduce treatment challenges with current antifungal drugs. Worse, currently there is no approved drug capable of obviating preformed biofilms which increases the chance of infection relapses. Here, we screened a small molecule Prestwick Chemical Library, consisting of 1200 FDA approved off-patent drugs, against C. albicans, C. auris and A. fumigatus, to identify those that inhibit growth of all three pathogens. Inhibitors were further prioritized for their potency against other fungal pathogens, and their ability to kill preformed biofilms. Our studies identified the bis-biguanide Alexidine dihydrochloride (AXD), as a drug with the highest antifungal and anti-biofilm activity against a diverse range of fungal pathogens. Finally, AXD significantly potentiated the efficacy of fluconazole against biofilms, displayed low mammalian cell toxicity, and eradicated biofilms growing in mice central venous catheters in vivo, highlighting its potential as a pan-antifungal drug.ImportanceThe prevalence of fungal infections has seen a rise in the past decades due to advances in modern medicine leading to an expanding population of device-associated and immunocompromised patients. Furthermore, the spectrum of pathogenic fungi has changed, with the emergence of multi-drug resistant strains such as C. auris. High mortality related to fungal infections point to major limitations of current antifungal therapy, and an unmet need for new antifungal drugs. We screened a library of repurposed FDA approved inhibitors to identify compounds with activities against a diverse range of fungi, in varied phases of growth. The assays identified Alexidine dihydrochloride (AXD) to have pronounced antifungal activity including against preformed biofilms, at concentrations lower than mammalian cell toxicity. AXD potentiated the activity of fluconazole and amphotericin B against Candida biofilms in vitro, and prevented biofilm growth in vivo. Thus AXD has the potential to be developed as a pan-antifungal, anti-biofilm drug.
Enhancing biochemical resolution by hyper-dimensional imaging microscopy
Authors: Esposito Alessandro , Venkitaraman Ashok R. 
Published: October 2018

AbstractTwo decades of high-paced innovation have improved the spatial resolution of fluorescence microscopy to enable molecular resolution combined with the low-invasiveness and specificity characteristic of optical microscopy. However, fluorescence microscopy also enables scientists and clinicians to map and quantitate the physico-chemical properties (e.g., analyte concentration, enzymatic activities and protein-protein interactions) of biological samples. But the optimization of the biochemical resolving power in fluorescence microscopy is not as well-developed compared to its spatial resolution. Typical techniques rely on the observation of individual properties of fluorescence thus limiting the opportunities for sensing and multiplexing. Aiming to overcome existing limitations, we demonstrate a new imaging paradigm — Hyper Dimensional Imaging Microscopy (HDIM) — that enables the orthogonal properties of fluorescence emission (excited state lifetime, polarization and spectra) in biological samples to be quantified simultaneously and efficiently. Therefore, akin to how multi-dimensional separation in mass-spectroscopy and multi-dimensional spectra in NMR impacted proteomics and structural biology, we envisage that HDIM spectra of unprecedented dimensionality will impact the fields of systems biology and medical diagnostics by maximizing the biochemical resolving power of fluorescence microscopy.