bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parental emotion and pain control behaviour when faced with child's pain: the emotion regulatory role of parental pain-related attention-set shifting and heart rate variability
Authors: Vervoort Tine , Karos Kai , Johnson Dan , Sütterlin Stefan , Van Ryckeghem Dimitri 
Published: September 2018

Abstract
This study investigated the moderating role of parental pain-related attention-set shifting and heart rate variability (HRV) for parental distress and pain control behaviour when faced with their child's pain. Participants were 54 schoolchildren and one of their parents. Parental HRV was assessed at study commencement followed by a cued-switching task indexing parental ability to flexibly shift attention between pain-related and neutral attentional sets. In a subsequent phase, parents observed their child perform a cold-pressor task [CPT], allowing for assessment of parental pain control behavior (indexed by latency to stop their child's CPT performance) and parental distress—assessed through self-report following observation of child CPT performance. Findings indicated that parental facilitated attentional shifting (ie, engage) towards a pain-related attentional set contributed to higher levels of pain control behaviour when faced with increasing levels of child facial display of pain. Pain control behaviour among parents who demonstrated impeded attentional shifting to a pain-related attentional set was equally pronounced regardless of low or high levels of child pain expression. Parental ability to shift attention away (ie, disengage) from a pain-related set to a neutral set did not impact findings. Results further indicated that although high levels of parental HRV buffer the impact of child facial pain display on parental emotional distress and pain control behaviour, low levels of HRV constitute a risk factor for higher levels of parental distress and pain control behaviour when faced with increased child facial pain display. Theoretical/clinical implications and further research directions are discussed.
Morphological and functional properties distinguish the substance P and gastrin-releasing peptide subsets of excitatory interneuron in the spinal cord dorsal horn
Authors: Dickie Allen C. , Bell Andrew M. , Iwagaki Noboru , Polgár Erika , Gutierrez-Mecinas Maria , Kelly Rosalind , Lyon Heather , Turnbull Kirsten , West Steven J. , Etlin Alexander , Braz Joao , Watanabe Masahiko , Bennett David L.H. , Basbaum Allan I. , Riddell John S. , Todd Andrew J. 
Published: September 2018

Abstract
Excitatory interneurons account for the majority of neurons in the superficial dorsal horn, but despite their presumed contribution to pain and itch, there is still limited information about their organisation and function. We recently identified 2 populations of excitatory interneuron defined by expression of gastrin-releasing peptide (GRP) or substance P (SP). Here, we demonstrate that these cells show major differences in their morphological, electrophysiological, and pharmacological properties. Based on their somatodendritic morphology and firing patterns, we propose that the SP cells correspond to radial cells, which generally show delayed firing. By contrast, most GRP cells show transient or single-spike firing, and many are likely to correspond to the so-called transient central cells. Unlike the SP cells, few of the GRP cells had long propriospinal projections, suggesting that they are involved primarily in local processing. The 2 populations also differed in responses to neuromodulators, with most SP cells, but few GRP cells, responding to noradrenaline and 5-HT; the converse was true for responses to the μ-opioid agonist DAMGO. Although a recent study suggested that GRP cells are innervated by nociceptors and are strongly activated by noxious stimuli, we found that very few GRP cells receive direct synaptic input from TRPV1-expressing afferents, and that they seldom phosphorylate extracellular signal–regulated kinases in response to noxious stimuli. These findings indicate that the SP and GRP cells differentially process somatosensory information.
Mannitol Role in the Management of Intradialytic Hypotension
Authors: Nguyen Timothy , Veltchev Kristiyan , Nguyen Thuy Vy 
Published: September 2018

Background, Areas of Uncertainty:
Intradialytic hypotension (IDH) is one of the most common complications of the hemodialysis procedure. Although there are no clear-cut answers as to the best strategy on the management of IDH, data suggest that the administration of osmotically active drugs may decrease the occurrence of blood pressure decline during dialysis. The use of mannitol for IDH management in hemodialysis patients is scarce. This article highlights the use and benefits of mannitol and to assess the role of mannitol role in the management of IDH.

Data Sources:
Primary literature identified through MEDLINE/PubMed database and Google Scholar with no restrictions. Relevant and current literatures related to mannitol and IDH were used.

Results and Data Synthesis:
Multiple studies have shown the benefits of mannitol for the management of IDH. Because of its oncotic effect, mannitol increases plasma osmolality to maintain adequate blood pressure and prevent the occurrence of IDH. Two observational studies and several reports were identified as being the most recent and applicable to clinical practice. Studies and data on the use of mannitol in IDH are scarce or outdated. The 2 studies used in this article conclude that mannitol carries benefits for both the adult and pediatric population. However, additional research in the future will be needed to confirm the evidence for various age groups. These 2 observational trials were also very small in number, and any future studies conducted should have a longer duration and larger population size. Although lacking data, these studies will suffice in introducing the benefits of mannitol in IDH.

Conclusions:
Mannitol may be considered for the management of IDH; however, additional studies are required to evaluate the long-term risk and benefits associated with mannitol, as it carries a risk of accumulation in the body.
Improving the Validity of Mathematical Models for HIV Elimination by Incorporating Empirical Estimates of Progression Through the HIV Treatment Cascade
Authors: Chang Angela Y. , Haber Noah , Bärnighausen Till , Herbst Kobus , Gareta Dickman , Pillay Deenan , Salomon Joshua A. 
Published: September 2018

Background:
Optimism regarding prospects for eliminating HIV by expanding antiretroviral treatment has been emboldened in part by projections from several mathematical modeling studies. Drawing from a detailed empirical assessment of rates of progression through the entire HIV care cascade, we quantify for the first time the extent to which models may overestimate health benefits from policy changes when they fail to incorporate a realistic understanding of the cascade.

Setting:
Rural KwaZulu-Natal, South Africa.

Methods:
We estimated rates of progression through stages of the HIV treatment cascade using data from a longitudinal population-based HIV surveillance system in rural KwaZulu-Natal. Incorporating empirical estimates in a mathematical model of HIV progression, infection transmission, and care, we estimated life expectancy and secondary infections averted under a range of treatment scale-up scenarios reflecting expanding treatment eligibility thresholds. We compared the results with those implied by the conventional assumptions that have been commonly adopted by existing models.

Results:
Survival gains from expanding the treatment eligibility threshold from CD4 350–500 cells/μL and from 500 cells/μL to treating everyone irrespective of their CD4 count may be overestimated by 3.60 and 3.79 times in models that fail to capture realities of the care cascade. HIV infections averted from raising the threshold from CD4 200 to 350, 350 to 500, and 500 cells/μL to treating everyone may be overestimated by 1.10, 2.65, and 1.18 times, respectively.

Conclusions:
Models using conventional assumptions about cascade progression may substantially overestimate health benefits. As implementation of treatment scale-up proceeds, it is important to assess the effects of required scale-up efforts in a way that incorporates empirical realities of how people move through the HIV cascade.
Predictors of Mortality Among Hospitalized Patients With Lower Respiratory Tract Infections in a High HIV Burden Setting
Authors: Worodria William , Chang Emily , Andama Alfred , Sanyu Ingvar , Byanyima Patrick , Musisi Emmanuel , Kaswabuli Sylvia , Zawedde Josephine , Ayakaka Irene , Sessolo Abdul , Lalitha Rejani , Davis John Lucian , Huang Laurence 
Published: September 2018

Introduction:Lower respiratory tract infections (LRTIs) are a leading cause of mortality in sub-Saharan Africa. Triaging identifies patients at high risk of death, but laboratory tests proposed for use in severity-of-illness scores are not readily available, limiting their clinical use. Our objective was to determine whether baseline characteristics in hospitalized participants with LRTI predicted increased risk of death.Methods:This was a secondary analysis from the Mulago Inpatient Non-invasive Diagnosis-International HIV-associated Opportunistic Pneumonias (MIND-IHOP) cohort of adults hospitalized with LRTI who underwent standardized investigations and treatment. The primary outcome was all-cause mortality at 2 months. Predictors of mortality were determined using multiple logistic regression.Results:Of 1887 hospitalized participants with LRTI, 372 (19.7%) died. The median participant age was 34.3 years (interquartile range, 28.0–43.3 years), 978 (51.8%) were men, and 1192 (63.2%) were HIV-positive with median CD4 counts of 81 cells/µL (interquartile range, 21–226 cells/µL). Seven hundred eleven (37.7%) participants had a microbiologically confirmed diagnosis. Temperature <35.5°C [adjusted odds ratio (aOR) = 1.77, 95% confidence intervals (CI): 1.20 to 2.60;P= 0.004], heart rate >120/min (aOR = 1.82, 95% CI: 1.37 to 2.43;P< 0.0001), oxygen saturation <90% (aOR = 2.74, 95% CI: 1.97 to 3.81;P< 0.0001), being bed-bound (aOR = 1.88, 95% CI: 1.47 to 2.41;P< 0.0001), and being HIV-positive (aOR = 1.49, 95% CI: 1.14 to 1.94;P= 0.003) were independently associated with mortality at 2 months.Conclusions:Having temperature <35.5°C, heart rate >120/min, hypoxia, being HIV-positive, and bed-bound independently predicts mortality in participants hospitalized with LRTI. These readily available characteristics could be used to triage patients with LRTI in low-income settings. Providing adequate oxygen, adequate intravenous fluids, and early antiretroviral therapy (in people living with HIV/AIDS) may be life-saving in hospitalized patients with LRTI.
Association of HIV Suppression With Kidney Disease Progression Among HIV-Positive African Americans With Biopsy-Proven Classic FSGS
Authors: McMahon Blaithin A. , Hanouneh Mohamad , Chedid Alice , Fine Derek M. , Chen Teresa K. , Foy Matthew , Lucas Gregory M. , Estrella Michelle M. , Atta Mohamed G. 
Published: September 2018

Background:
In the era of combined antiretroviral therapy, classic focal segmental glomerulosclerosis (FSGS) is the most common histopathological finding in African American HIV-positive patients with kidney disease. We sought to determine whether HIV suppression is associated with lower risk of progression to end-stage renal disease (ESRD) among HIV-positive African Americans with biopsy-confirmed classic FSGS.

Methods:
HIV-positive African Americans who underwent kidney biopsies at a single tertiary hospital between January 1996 and June 2011 were confirmed as having classic FSGS by the presence of segmental glomerulosclerosis without features of HIV-associated nephropathy. Multivariable Cox proportional hazards models were used to examine the independent association of viral suppression (HIV-RNA < 400 copies per milliliter at biopsy) with time to progression to ESRD.

Results:
Of the 55 HIV-positive African Americans with classic FSGS, 26 had suppressed viral loads at the time of biopsy. Compared to viremic patients, those who were virally suppressed had a significantly higher mean CD4+ cell count (452 vs. 260 cell/mm3, respectively; P = 0.02) and median estimated glomerular filtration rate (53.5 vs 35.5 mL/min/1.73 m2, respectively; P = 0.002). Adjusting for sex and baseline CD4+ cell count, estimated glomerular filtration rate, and proteinuria, those with HIV-RNA levels <400 copies per milliliter at baseline had a 75% lower risk of progressing to ESRD (hazard ratio = 0.25; 95% CI: 0.07 to 0.88) during a median follow-up time of 2.70 years (interquartile range: 0.80–5.15 years).

Conclusions:
HIV suppression is associated with significantly lower risk of progression to ESRD among HIV-infected African Americans with classic FSGS, supporting the potential role of combined antiretroviral therapy for this histopathology in addition to HIV-associated nephropathy among HIV-positive individuals.
Placental Structure in Preterm Birth Among HIV-Positive Versus HIV-Negative Women in Kenya
Authors: Obimbo Moses M. , Zhou Yan , McMaster Michael T. , Cohen Craig R. , Qureshi Zahida , Ong’ech John , Ogeng’o Julius A. , Fisher Susan J. 
Published: September 2018

Background:
Preterm birth (PTB) is a major cause of infant morbidity and mortality in developing countries. Recent data suggest that in addition to Human Immunodeficiency Virus (HIV) infection, use of antiretroviral therapy (ART) increases the risk of PTB. As the mechanisms remain unexplored, we conducted this study to determine whether HIV and ART were associated with placental changes that could contribute to PTB.

Setting:
We collected and evaluated placentas from 38 HIV-positive women on ART and 43 HIV-negative women who had preterm deliveries in Nairobi, Kenya.

Methods:
Anatomical features of the placentas were examined at gross and microscopic levels. Cases were matched for gestational age and compared by the investigators who were blinded to maternal HIV serostatus.

Results:
Among preterm placentas, HIV infection was significantly associated with thrombosis (P = 0.001), infarction (P = 0.032), anomalies in cord insertion (P = 0.02), gross evidence of membrane infection (P = 0.043), and reduced placental thickness (P = 0.010). Overall, preterm placentas in both groups were associated with immature villi, syncytial knotting, villitis, and deciduitis. Features of HIV-positive versus HIV-negative placentas included significant fibrinoid deposition with villus degeneration, syncytiotrophoblast delamination, red blood cell adhesion, hypervascularity, and reduction in both surface area and perimeter of the terminal villi.

Conclusions:
These results imply that HIV infection and/or ART are associated with morphological changes in preterm placentas that contribute to delivery before 37 weeks. Hypervascularity suggests that the observed pathologies may be attributable, in part, to hypoxia. Further research to explore potential mechanisms will help elucidate the pathways that are involved perhaps pointing to interventions for decreasing the risk of prematurity among HIV-positive women.
Ultrasonographic Features of Lower-Limb Joints in Gout
Authors: Zhang Weijing , Jin Zhibin , Xiang Wenjing , Wu Min , Wang Shiying , Zhang Huayong , Zhang Pingyang 
Published: September 2018

Objective
This observational cross-sectional study evaluated the distribution of ultrasound (US) features of lower-limb joints and the risk factors of tophus in gout patients.

Methods
We examined 588 joints including the bilateral knee, ankle, and first metatarsophalangeal (MTP) joints in 98 gout patients by US between March to August in 2017. The distribution of double-contour (DC), tophus, aggregates, synovitis, effusion and erosion in different joint, course, and age groups were investigated by Cochran Q and χ2 test. The risk factors of tophus were analyzed using logistic regression method.

Results
Double-contour was most commonly observed in the knee (p = 0.005). Tophus, aggregates, synovitis, and erosion were mostly detected in the first MTP (p < 0.001, p = 0.01, p = 0.001, p < 0.001, respectively). The prevalence rates of DC, tophus, and erosion in patients with a longer course were significantly higher (p = 0.029, p = 0.002, p < 0.001, respectively). Older patients had more detectable tophus and erosion than younger patients (p = 0.028, p = 0.021). Patients of older age (odds ratio [OR], 3.83; 95% confidence interval [CI], 1.27–11.48), with frequent attacks (OR, 3.80; 95% CI, 1.10–13.15), and with longer course (OR, 6.52; 95% CI, 1.37–30.96) had higher risks of tophus.

Conclusions
Most signs were detected by US in the first MTP, except that DC was most commonly observed in the knees. Patients of older age with frequent attacks and longer course may experience higher risks for tophus. Comprehensive assessment of the lower limbs, particularly the knee and first MTP, can significantly help diagnosis.
Changing Autonomy in Operative Experience Through UK General Surgery Training
Authors: Elsey Elizabeth J. , Griffiths Gareth , West Joe , Humes David J. 
Published: September 2018

Objectives:
To determine the operative experience of UK general surgery trainees and assess the changing procedural supervision and acquisition of competency assessments through the course of training.

Background:
Competency assessment is changing with concepts of trainee autonomy decisions (termed entrustment decisions) being introduced to surgical training.

Methods:
Data from the Intercollegiate Surgical Curriculum Programme and the eLogbook databases for all UK General Surgery trainees registered from August 1, 2007 who had completed training were used. Total and index procedures (IP) were counted and variation by year of training assessed. Recorded supervision codes and competency assessment outcomes for IPs were assessed by year of training.

Results:
We identified 311 trainees with complete data. Appendicectomy was the most frequently undertaken IP during first year of training [mean procedures (mp) = 26] and emergency laparotomy during final year of training (mp = 27). The proportion of all IPs recorded as unsupervised increased through training (P < 0.05) and varied between IPs with 91.2% of appendicectomies (mp = 20), 40.6% of emergency laparotomies (mp = 27), and 17.4% of segmental colectomies (mp = 15) recorded as unsupervised during the final year of training. Acquisition of competency assessments increased through training and varied by IP.

Conclusions:
The changing autonomy of trainees through the course of an entire training scheme, alongside formal competency assessments, may provide evidence of changing entrustment decisions made by trainers for different key procedures. Other countries utilizing electronic logbooks could adopt similar techniques to further understanding of competency attainment amongst their surgical trainees.
Cardiotrophin-1 Improves Kidney Preservation, Graft Function, and Survival in Transplanted Rats
Authors: García-Cenador Begoña , Blanco-Gozalo Víctor , López-Montañés Daniel , Sanz Giménez-Rico Juan R. , López-Novoa José M. , López-Hernández Francisco J. 
Published: September 2018

Background
Cold ischemia-reperfusion injury is unavoidable during organ transplantation, and prolonged preservation is associated with poorer function recovery. Cardiotrophin-1 (CT-1) is an IL-6 family cytokine with cytoprotective properties. This preclinical study in rats tested whether CT-1 mitigates cold renal ischemia-reperfusion injury in the context of the transplantation of long-time preserved kidneys.

Methods
Kidneys were flushed with cold (4°C) University of Wisconsin solution containing 0.2 μg/mL CT-1 and stored for several periods of time at 4°C in the same solution. In a second approach, kidneys were first cold-preserved for 6 hours and then were perfused with University of Wisconsin solution containing CT-1 (0, 16, 32, or 64 μg/mL) and further cold-preserved. Organ damage markers were measured in the kidneys at the end of the storage period. For renal transplantation, recipient consanguineous Fischer rats underwent bilateral nephrectomy and received a previously cold-preserved (24 hours) kidney as described above. Survival and creatinine clearance were monitored over 30 days.

Results
Cardiotrophin-1 in perfusion and preservation fluids reduced oxidative stress markers (superoxide anion and inducible nitric oxide synthase), inflammation markers (NF-κB and tumor necrosis factor-α), and vascular damage (vascular cell adhesion molecule-1) and activated leukemia inhibitory factor receptor and STAT-3 survival signaling. Transplantation of kidneys cold-preserved with CT-1 increased rat survival and renal function (ie, lower plasma creatinine and higher creatinine clearance) and improved kidney damage markers after transplantation (ie, lower superoxide anion, tumor necrosis factor-α, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 and higher NF-κB).

Conclusions
Cardiotrophin-1 represents a novel therapeutic strategy to reduce ischemia-reperfusion and cold preservation injury to rescue suboptimal kidneys and, consequently, to improve the clinical outcomes of renal transplantation.
Effects of annual rainfall on dengue incidence in the Indian state of Rajasthan
Authors: Salam Nasir 
Published: September 2018

AbstractDengue has become a major public health problem in the last few decades with India contributing significantly to the overall disease burden. Most of the cases of Dengue from India are reported during Monsoon season. The vector population of dengue is affected by seasonal rainfall, temperature and humidity fluctuations. Rajasthan is northwestern state of India, which has shown several dengue outbreaks in the past. In this paper we have tried to analyze the effects of annual cumulative rainfall on Dengue incidence in one of the largest and severely affected states of India. Retrospective data for Dengue incidence and Rainfall for the state of Rajasthan was collected and Pearson’s coefficient correlation was calculated as a measure of association between the variables. Our results indicate that annual cumulative rainfall shows a strong positive correlation with dengue incidence in the state of Rajasthan. Such analyses have the potential to inform public health official about the control and preparedness for vector control during monsoon season. This is the first study from the Indian state of Rajasthan to assess the impact of annual rainfall on dengue incidence, which has seen several dengue outbreaks in the past.