bluuebunny/crossref_metadata_2025_split huggingface dataset:
True Versus False Bacteremia in Infants and Children Less Than 3 Years of Age
Authors: Mannino Avila Elizabeth , Stucky Fisher Erin , Rhee Kyung 
Published: August 2018

Objective
The objective of this study was to examine patient history as well as clinical and laboratory features associated with true bacteremia versus false bacteremia in previously healthy febrile children ages 0 to 36 months in the era of polyvalent conjugate pneumococcal immunization.

Methods
Using retrospective chart review, we examined history, physical examination, and laboratory characteristics associated with true and false bacteremia. We included subjects under 3 years old, with a positive blood culture obtained in the emergency department or clinic from July 2011 to July 2013, and fever defined as a temperature of greater than or equal to 100.4°F by history or examination. We excluded those with a previously known underlying disease process that could increase the risk for positive blood culture, for example, immunodeficiency, cancer, cystic fibrosis, or significant skin disorders such as severe eczema, as well as patients with any indwelling central line, shunt, or other implanted device, or recent hospitalization for a febrile illness.

Results
Thirty subjects (24%) had true bacteremia, and 97 (76%) had false bacteremia. In the multivariable logistic regression analysis, exposure to sick contacts (odds ratio, 0.1; 95% confidence interval, 0.01–0.6; P = 0.01) and increased hours to positive blood culture (odds ratio, 0.8; 95% confidence interval, 0.8–0.9; P < 0.001) remained significant factors associated with false bacteremia. Age, maximum reported temperature, and reported days of fever were not associated with true bacteremia.

Conclusions
We found that previously healthy children with true bacteremia are more likely to grow bacteria faster on blood culture and lack exposure to sick contacts than children with false bacteremia.
Comparison of 4 Pediatric Intraosseous Access Devices
Authors: Szarpak Lukasz , Ladny Jerzy R. , Dabrowski Marek , Ladny Michael , Smereka Jacek , Ahuja Sanchit , Ruetzler Kurt 
Published: August 2018

Background
Obtaining intravascular access can be challenging or even impossible in several clinical situations. As an alternative, medications and fluids can be administered via the intraosseous (IO) route, which is a well-tolerated and established alternative, especially in the emergency setting.

Methods
Seventy-five novice physicians participated in this randomized simulation study. After a single educational session and 6 months without any clinical application, participants were asked to identify the correct puncture site and obtain IO access using 3 widely used mechanical devices (BIG Pediatric, Arrow EZ-IO, NIO Pediatric) and a manual device (Jamshidi needle) on a pediatric manikin and turkey bone, respectively.

Results
Sixty-eight participants correctly identified the puncture site and performed IO cannulations. First placement attempt success rate was similar with mechanical devices (NIO Pediatric, 100%; Arrow EZ-IO, 97%; and BIG Pediatric, 90%), whereas was only 43% using the manual Jamshidi device. Also, procedure time was much faster using mechanical devices (ranging between 18 and 23 seconds) compared with the manual Jamshidi device (34 seconds).

Conclusions
Although the efficacy of devices was demonstrated in simulated environment in novice users, further studies are needed to assess the efficacy and safety of devices in clinical comparative settings. With more experienced users, the success rate may differ considerably as compared with naive users.
The Public Health Uniform National Data System (PHUND$): A Platform for Monitoring Fiscal Health and Sustainability of the Public Health System
Authors: Honoré Peggy A. , Zometa Carlos , Thomas Craig , Edmiston Ashley 
Published: August 2018

Context:
Leaders of government agencies are responsible for stewardship over taxpayer investments. Stewardship strengthens agency performance that is critical to improving population health. Most industries, including health care, and public enterprises, such as education, have policies for uniform data reporting and financial systems for the application of theoretical analytical techniques to organizations and entire systems. However, this is not a mainstreamed practice in local and state government public health.

Program:
The Public Health Uniform National Data System (PHUND$) is a financial information system for local health departments that advances the application of uniform practices to close financial analytical gaps. A 10-year retrospective overview on the development, implementation, and utility of PHUND$ is provided and supported by documented program and agency improvements to validate the analytical features and demonstrate a best practice.

Results:
Benefits found from utilizing PHUND$ included reducing financial risks, supporting requests for increased revenues, providing comparative analysis, isolating drivers of costs and deficits, increasing workforce financial management skills, enhancing decision-making processes, and fostering agency sustainability to support continuous improvements in quality and population health. The PHUND$ financial data definitions in the data dictionary provided the structure needed for standardized data collection and confirmed the feasibility of a standardized public health chart of accounts.

Conclusion:
PHUND$ analysis provided evidence on the relationship between financial and operational performance, as well as informing strategies for managing risks and improving quality. Such analysis is critical to identifying financial and operational problems and essential to mitigating financial crisis, avoiding disruption of services, and fostering agency sustainability. PHUND$ additionally serves as an instrument that can guide development of standards that measure for agency sound financial management systems.
Associated Factors With Acute Transfusion Reaction From Hospital Online Reporting Events: A Retrospective Cohort Study
Authors: Yao Chao-Yuan , Chien Ju-Huei , Chuang Hsun-Yang , Ho Tsing-Fen 
Published: August 2018

Objectives
In our hospital’s hemovigilance system, a Wi-Fi–based vital signs monitor that automatically transmits data to ensure patient safety has been implemented. We derived the potential clinical characteristics for subsequent association of acute transfusion reactions (ATRs) using the hospital information system database.

Methods
We retrospectively analyzed multiple factors to identify the possible associations between clinical factors and developing ATRs. The following data were collected: recipient’s pretransfusion and posttransfusion vital signs, clinical and laboratory characteristics, and presence of ATRs.

Results
In all, 44,691 events were analyzed. Of these, ATR events occurred in 1586 (3.5%). Logistic regression analysis revealed that leukopenia (<5×103/μL) before transfusion was shown a statistically associated with developing mild ATRs (odds ratio [OR] = 2.38, 95% confidence interval [CI] = 1.68–3.35, P < 0.001). The association between elevated body temperature (forehead temperature > 37.5°C) and moderate ATRs was significant (OR = 1.55, 95% CI = 1.22–1.98, P < 0.001). In addition, the association between high diastolic pressure (>90 mm Hg) and severe ATRs was significant (OR = 1.78, 95% CI = 1.06–2.99, P = 0.03). Therefore, evaluated patient’s status such as vital signs before transfusion is very important. In addition, every hospital should established a complete hemovigilance program focus on effectively reporting and real-time monitoring ATRs to improve transfusion patient safety.

Conclusions
Vital signs monitoring and leukocyte counts before transfusion were significantly associated with the subsequent risk of ATRs. When patients with elevated body temperature, leukopenia, and high diastolic pressure who are scheduled to receive transfusion, clinicians should be aware of increasing the risk of ATRs in these patients.
Hepatic Involvement of IgG4-Related Disease Presenting as Multiple Hypermetabolic Masses on FDG PET/CT
Authors: Pan Qingqing , Wang Ying , Luo Yaping , Ma Yanru , Li Fang 
Published: August 2018

Abstract
A 45-year-old man was found with multiple hepatic masses in CT/MR, suggesting liver metastases of unknown origin. 18F-FDG PET/CT showed several hypermetabolic masses in the liver; patchy increased uptake in the pancreas; and FDG-avid lymph nodes in the neck, axilla, and mediastinum. Histopathology with biopsy revealed enriched IgG4-positive lymphoplasmacytic cells infiltrating in the liver, pancreas, and lymph nodes, which confirmed the diagnosis of IgG4-related disease. The lesions were diminished on follow-up PET/CT 3 months after treatment with prednisone. This case illustrated that multifocal FDG-avid hepatic mass might be the involvement of IgG4-related disease, which should be differentiated from malignancies.
Anthropometric Analysis of the Nigerian Face: Any Conformity to the Neoclassical Canons?
Authors: Olusanya Adeola Adenike , Aladelusi Timothy Olukunle , Adedokun Babatunde 
Published: August 2018

Abstract
This study defines the facial anthropometric and aesthetic measurements in young Nigerians. This is a prospective cohort study involving facial anthropometric measurement in young adults without craniofacial abnormalities. Ten anthropometric measurements (upper facial height (tr-n), mid-facial height (n-sn), lower facial height (sn-gn), height of auricle (sa-sba) bilaterally, intercanthal width (en-en), palpebral fissure width (en-ex) bilaterally, face width (zy-zy), nose width (al-al), mouth width (ch-ch) and the interincisal distance) were determined. Proportions were compared with neoclassic cannons, published North American and Asian norms 151 individuals consisting of 50 males and 51 females with age range from 16 to 31 (23.9 + 2.49) were enrolled. Only 1% of the study population had equal facial thirds, the midface was the shortest of the facial thirds and the male gender generally had larger mean values of the facial dimensions than the female gender. About half of the participants had the lower third > upper third > middle third, the intercanthal width was equal to the nasal width in only about a tenth of the participants and less than the nasal width in majority (88.1%) of the participants and the mean interincisal distance was 51.1 (SD ± 6.997). The anthropometric measurements from this Nigerian study do not conform to the neoclassical cannons. Racially sensitive facial canons and measurements are advocated during reconstructive and aesthetic interventions in the craniofacial region.
Syngnathia
Authors: Olusanya Adeola A. , Tongo Olukemi O. , Lawal Taiwo A. , Aladelusi Timothy O. , Daniel Adekunle , Awana Emily E. , Hamza Abdulhakeem 
Published: August 2018

Abstract
Syngnathia is a congenital fusion of the upper and lower jaws. Its occurrence poses a significant challenge to feeding and its management is challenging to both the surgeon and the anaesthetist. Reports in the literature are mainly clinical reports or case series. To the knowledge of the authors and from the available literature, this is only the fourth report from Nigeria. The presentation and successful management of a Nigerian female neonate with congenital syngnathia is described and reviewed with literature.
Part II: Minimum Quality Threshold in Preclinical Sepsis Studies (MQTiPSS) for Types of Infections and Organ Dysfunction Endpoints
Authors: Libert Claude , Ayala Alfred , Bauer Michael , Cavaillon Jean-Marc , Deutschman Clifford , Frostell Claes , Knapp Sylvia , Kozlov Andrey V. , Wang Ping , Osuchowski Marcin F. , Remick Daniel G. 
Published: August 2018

ABSTRACT
Although the clinical definitions of sepsis and recommended treatments are regularly updated, a systematic review has not been done for preclinical models. To address this deficit, a Wiggers-Bernard Conference on preclinical sepsis modeling reviewed the 260 most highly cited papers between 2003 and 2012 using sepsis models to create a series of recommendations. This Part II report provides recommendations for the types of infections and documentation of organ injury in preclinical sepsis models. Concerning the types of infections, the review showed that the cecal ligation and puncture model was used for 44% of the studies while 40% injected endotoxin. Recommendation #8 (numbered sequentially from Part I): endotoxin injection should not be considered as a model of sepsis; live bacteria or fungal strains derived from clinical isolates are more appropriate. Recommendation #9: microorganisms should replicate those typically found in human sepsis. Sepsis-3 states that sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection, but the review of the papers showed limited attempts to document organ dysfunction. Recommendation #10: organ dysfunction definitions should be used in preclinical models. Recommendation #11: not all activities in an organ/system need to be abnormal to verify organ dysfunction. Recommendation #12: organ dysfunction should be measured in an objective manner using reproducible scoring systems. Recommendation #13: not all experiments must measure all parameters of organ dysfunction, but investigators should attempt to fully capture as much information as possible. These recommendations are proposed as “best practices” for animal models of sepsis.
Acute Management of Optic Neuritis: An Evolving Paradigm
Authors: Horton Lindsay , Bennett Jeffrey L. 
Published: August 2018

Abstract:
The current management of acute optic neuritis (ON) is focused on expediting visual recovery through the use of high-dose intravenous corticosteroids. The recent identification of specific autoantibodies associated with central nervous system inflammatory disorders has provided novel insights into immune targets and mechanisms that impact the prognosis, treatment, and recurrence of ON. Therefore, neurologists and ophthalmologists need to be aware of clinical, laboratory, and imaging findings that may provide important clues to the etiology of ON and the potential need for aggressive management. Moving forward, rapid and accurate diagnosis of inflammatory ON will likely be critical for implementing clinical care that optimizes short-term and long-term therapeutic outcomes.
Visual Evoked Potentials as a Biomarker in Multiple Sclerosis and Associated Optic Neuritis
Authors: Leocani Letizia , Guerrieri Simone , Comi Giancarlo 
Published: August 2018

From the Section Editor: The next two installments in the JNO “Disease of the Year: Multiple Sclerosis” series focus on lessons that can be learned form the afferent visual pathway, as a putative model of MS. In their article entitled, “Visual evoked potentials as a biomarker in multiple sclerosis and associated optic neuritis” Leocani and colleagues highlight the role of visual evoked potential (VEP) testing as a means of capturing the effects of demyelination, remyelination, and associated neuroaxonal injury in the central nervous system (CNS). Conjointly, Horton and Bennett discuss the acute management of optic neuritis, which is aptly described as an “evolving paradigm.” In their state-of-the art overview of the topic, these authors explore the spectrum of inflammatory optic neuropathies, with emphasis on clinical features, neuroimaging findings, and serological markers that help refine diagnosis, and target appropriate treatment strategies. When considered holistically, these reviews prompt us to consider how VEP and other surrogate endpoints can be used to differentiate subtypes of optic neuritis that may ultimately herald a wide variety of CNS inflammatory disorders.

Abstract:
Multiple sclerosis (MS) is an inflammatory, degenerative disease of the central nervous system (CNS) characterized by progressive neurological decline over time. The need for better “biomarkers” to more precisely capture and track the effects of demyelination, remyelination, and associated neuroaxonal injury is a well-recognized challenge in the field of MS. To this end, visual evoked potentials (VEPs) have a role in assessing the extent of demyelination along the optic nerve, as a functionally eloquent CNS region. Moreover, VEPs testing can be used to predict the extent of recovery after optic neuritis (ON) and capture disabling effects of clinical and subclinical demyelination events in the afferent visual pathway. In this review, the evolving role of VEPs in the diagnosis of patients with ON and MS and the utility of VEPs testing in determining therapeutic benefits of emerging MS treatments is discussed.
Fine Tuning of Histone Demethylase KDM6A/B Improves the Development of Nuclear Transfer Embryo
Authors: Yang Lei , Song Lishuang , Liu Xuefei , Bai Lige , Li Guangpeng 
Published: August 2018

AbstractDespite the success of the production of animals by somatic cell nuclear transfer (SCNT) in many species, the method is limited by a low efficiency. After zygotic genome activation (ZGA), a large number of endogenous retroviruses (ERVs) are expressed, including the murine endogenous retrovirus-L (MuERVL/MERVL). In this study, we generated a series of MERVL-reporter mouse strains to detect the ZGA event in embryos. We found that the majority of SCNT embryos exhibited ZGA failure, and histone H3 lysine 27 trimethylation (H3K27me3) prevented SCNT reprogramming. Overexpression of the H3K27me3-specific demethylase KDM6A, but not KDM6B, improved the efficiency of SCNT. Conversely, knockdown KDM6B not only facilitate ZGA, but also impede ectopic Xist expression in SCNT reprogramming. Furthermore, the knockdown of KDM6B increased the rate of SCNT-derived Duchenne muscular dystrophy embryonic stem cell establishment, indicate that these results not only provide insight into the mechanisms underlying failures of SCNT, but also may extend the applications of SCNT.
Mechanistic and experimental models of cell migration reveal the importance of intercellular interactions in cell invasion
Authors: Matsiaka Oleksii M. , Baker Ruth E. , Shah Esha T. , Simpson Matthew J. 
Published: August 2018

AbstractMoving fronts of cells are essential for development, repair and disease progression. Therefore, understanding and quantifying the details of the mechanisms that drive the movement of cell fronts is of wide interest. Quantitatively identifying the role of intercellular interactions, and in particular the role of cell pushing, remains an open question. Indeed, perhaps the most common continuum mathematical idealization of moving cell fronts is to treat the population of cells, either implicitly or explicitly, as a population of point particles undergoing a random walk that neglects intercellular interactions. In this work, we report a combined experimental-modelling approach showing that intercellular interactions contribute significantly to the spatial spreading of a population of cells. We use a novel experimental data set with PC-3 prostate cancer cells that have been pretreated with Mitomycin-C to suppress proliferation. This allows us to experimentally separate the effects of cell migration from cell proliferation, thereby enabling us to focus on the migration process in detail as the population of cells recolonizes an initially-vacant region in a series of two-dimensional experiments. We quantitatively model the experiments using a stochastic modelling framework, based on Langevin dynamics, which explicitly incorporates random motility and various intercellular forces including: (i) long range attraction (adhesion); and (ii) finite size effects that drive short range repulsion (pushing). Quantitatively comparing the ability of this model to describe the experimentally observed population-level behaviour provides us with quantitative insight into the roles of random motility and intercellular interactions. To quantify the mechanisms at play, we calibrate the stochastic model to match experimental cell density profiles to obtain estimates of cell diffusivity,D, and the amplitude of intercellular forces,f0. Our analysis shows that taking a standard modelling approach which ignores intercellular forces provides a poor match to the experimental data whereas incorporating intercellular forces, including short-range pushing and longer range attraction, leads to a faithful representation of the experimental observations. These results demonstrate a significant role for intercellular interactions in cell invasion.Author summaryMoving cell fronts are routinely observed in various physiological processes, such as wound healing, malignant invasion and embryonic morphogenesis. We explore the effects of a previously overlooked mechanism that contributes to population-level front movement: pushing. Our framework is flexible and incorporates range of reasonable biological phenomena, such as random motility, cell-to-cell adhesion, and pushing. We find that neglecting finite size effects and intercellular forces, such as cell pushing, reduces our ability to mimic and predict our experimental observations.
POFUT2-mediated O-glycosylation of MIC2 is dispensable for Toxoplasma gondii tachyzoites
Authors: Khurana Sachin , Coffey Michael J. , John Alan , Uboldi Alessandro D. , Huynh My-Hang , Stewart Rebecca J. , Carruthers Vern B. , Tonkin Christopher J. , Goddard-Borger Ethan D. , Scott Nichollas E. 
Published: August 2018

AbstractToxoplasma gondii is a ubiquitous obligate intracellular eukaryotic parasite that causes congenital birth defects, disease of the immunocompromised and blindness. Protein glycosylation plays an important role in the infectivity and evasion of immune response of many eukaryotic parasites and is also of great relevance to vaccine design. Here, we demonstrate that MIC2, the motility-associated adhesin of T. gondii, has highly glycosylated thrombospondin repeat domains (TSR). At least seven C-linked and three O-linked glycosylation sites exist within MIC2, with >95% occupancy at O-glycosylation sites. We demonstrate that the addition of O-glycans to MIC2 is mediated by a protein O-fucosyltransferase 2 homologue (TgPOFUT2) encoded by TGGT1_273550. While POFUT2 homologues are important for stabilizing motility associated adhesins and host infection in other apicomplexan parasites, in T. gondii loss of TgPOFUT2 has only a modest impact on MIC2 levels and the wider proteome. Consistent with this, both plaque formation and tachyzoite infectivity are broadly similar in the presence or absence of TgPOFUT2. These findings demonstrate that TgPOFUT2 O-glycosylates MIC2 and that this glycan is dispensable in T. gondii tachyzoites.
Loss of leaf-out and flowering synchrony under global warming
Authors: Zohner Constantin M. , Mo Lidong , Renner Susanne S. 
Published: August 2018

AbstractThe temporal overlap of phenological stages, phenological synchrony, crucially influences ecosystem functioning. For flowering, among-individual synchrony influences gene flow. For leaf-out, it affects interactions with herbivores and competing plants. If individuals differ in their reaction to the ongoing change in global climate, this should affect population-level synchrony. Here, we use climate-manipulation experiments, Pan-European long-term (>15 years) observations, and common garden monitoring data on up to 72 woody and herbaceous species to study the effects of increasing temperatures on the extent of within-population leaf-out and flowering synchrony. Warmer temperatures reduce in situ leaf-out and flowering synchrony by up to 55%, and experiments on European beech provide a mechanism for how individual genetic differences may explain this finding. The rapid loss of reproductive and vegetative synchrony in European plants predicts changes in their gene flow and trophic interactions, but community-wide consequences remain largely unknown.