bluuebunny/crossref_metadata_2025_split huggingface dataset:
A low abundance of Bifidobacterium but not Lactobacillius in the feces of Chinese children with wheezing diseases
Authors: Liwen Zhang , Yu Wan , Liang Ma , Kaihong Xu , Baojin Cheng 
Published: October 2018

Abstract

Background:
The intestinal microbiota is linked with allergic reaction diseases. However, the difference in the fecal microbiota composition between sensitized wheezy and nonsensitized subjects in Chinese children remains unknown. The aim of this study was to quantitate the amounts of fecal microbiota in wheezy children, and to explore the correlation between fecal microbiota and serum Th1/Th2/Th17-type cytokines and total IgE in these patients.

Methods:
The amounts of Bifidobacterium and Lactobacillus were determined using a 16S-RNA real-time polymerase chain reaction (PCR) method in wheezy children (cases) and nonwheezy controls. Serum Th1/Th2/Th17-type cytokines levels were measured using flow a cytometric bead array assay. In addition, the concentrations of total serum IgE was also determined.

Results:
In comparison with that in the healthy control (HC), significantly lower abundance of Bifidobacterium and lower levels of Th1 cytokines (IFN-γ and TNF-α), but higher levels of Th2-type cytokines (IL-4, IL-5) and Th17-type (IL-17A) cytokine were detected in children with bronchiolitis and asthma. But there was no significant difference in the amounts of Lactobacillus. Interestingly, the amounts of fecal Bifidobacterium were correlated positively with serum Th1 cytokines IFN-γ, and correlated negatively with serum Th17 cytokines IL-17A, Th2 cytokines IL-4 and serum total IgE in these patients.

Conclusions:
Our findings demonstrated that lower quantity of Bifidobacterium, but not Lactobacillus, may be correlated with asthma and bronchiolitis in chinese children. These results also may provide guidance in choosing the proper probiotics for wheezing children.
Free Thyroxine Determination in the Emergency Department Is a Predictor of Acute Pancreatitis Evolution
Authors: Callejón Gonzalo , Redondo Emilia , Garcia-Aranda Marilina , Castilla-Alcalá José Antonio , Prados-Torres Alexandra , Redondo Maximino 
Published: October 2018

Objective
The aim of this study was to determine the prevalence and type of thyroid hormone levels alterations in patients with acute pancreatitis (AP) and analyze if variations are useful AP progression predictors.

Methods
Three groups of patients were analyzed: AP patients (n = 90), abdominal pain patients (n = 30), and healthy control subjects (n = 40). Usual blood parameters for AP diagnosis and prognosis, thyroid-stimulating hormone (or thyrotropin), FT4 (free thyroxine), FT3 (free triiodothyronine), and TT3 (total triiodothyronine) levels were analyzed.

Results
Thyroid hormone level alterations were detected only within the AP group (41% of total cases), being the reduction in T3 levels the most frequently detected deviation (15.6% of FT3 and 8.3% of TT3 cases). Alterations were not influenced by age or sex. Free thyroxine average values were also significantly higher in the AP group, compared with the healthy control group (P = 0.0005), resulting as independent predictors of both severity and mortality. Mortality in this group was 50%, with deceased patients showing FT4 levels above the reference limit.

Conclusions
Our results show that FT4 level determination during the initial clinical evaluation of patients admitted to the emergency service with AP can be included as a severity indicator to help determine the differential care of these cases.
The Relationship Between Life Purpose With Depression and Disability in Acute Low Back Pain Patients
Authors: Salt Elizabeth , Wiggins Amanda C. , Rayens Mary Kay , Johnson Rachele , Hardy Jaime K. , Segerstrom Suzanne , Crofford Leslie J. 
Published: October 2018

BACKGROUND:
Life purpose in acute low back pain patients is not well described in published literature.

METHODS/PURPOSE:
We used linear regression models to describe the relationship of life purpose with perceived functional disability and depression in persons with acute low back pain (N = 42) participating in a randomized clinical trial to prevent transition to chronic low back pain.

RESULTS:
In our predominantly female sample (81.8%) with a mean age of 53 years (SD = 11.6 years), 52% worked full-time. Adjusting for age, gender, and working status, life purpose was a significant correlate of depression (p = .007). For every 10-unit increase in life purpose score, the estimated depression score decreased by almost 2.5 points. A significant relationship between life purpose and perceived functional disability was not identified.

CONCLUSION:
Life purpose likely is a modifiable risk factor for depression in acute low back pain patients.
A Randomized Double-blind Placebo-Controlled Trial on the Effect of Local Analgesia on Postoperative Gluteal Pain in Patients Undergoing Sacrospinous Ligament Colpopexy
Authors: Ferrando Cecile A. , Walters Mark D. 
Published: October 2018

(Abstracted from Am J Obstet Gynecol 2018;218:599.e1–599.e8)
Sacrospinous ligament (SSL) colpopexy is widely used for the treatment of vaginal apex prolapse. The procedure has a subjective success rate of 84% to 99% and an objective success rate of 67% to 93%.
A Time-and-Motion Study of Clinical Trial Eligibility Screening in a Pediatric Emergency Department
Authors: Dexheimer Judith W. , Tang Huaxiu , Kachelmeyer Andrea , Hounchell Melanie , Kennebeck Stephanie , Solti Imre , Ni Yizhao 
Published: October 2018

Objective
Challenges with efficient patient recruitment including sociotechnical barriers for clinical trials are major barriers to the timely and efficacious conduct of translational studies. We conducted a time-and-motion study to investigate the workflow of clinical trial enrollment in a pediatric emergency department.

Methods
We observed clinical research coordinators during 3 clinically staffed shifts. One clinical research coordinator was shadowed at a time. Tasks were marked in 30-second intervals and annotated to include patient screening, patient contact, performing procedures, and physician contact. Statistical analysis was conducted on the patient enrollment activities.

Results
We conducted fifteen 120-minute observations from December 12, 2013, to January 3, 2014 and shadowed 8 clinical research coordinators. Patient screening took 31.62% of their time, patient contact took 18.67%, performing procedures took 17.6%, physician contact was 1%, and other activities took 31.0%.

Conclusions
Screening patients for eligibility constituted the most time. Automated screening methods could help reduce this time. The findings suggest improvement areas in recruitment planning to increase the efficiency of clinical trial enrollment.
Missed Diagnosis of Anaphylaxis in Patients With Pediatric Urticaria in the Emergency Department
Authors: Jung Woo Sung , Kim Sun Hyu , Lee Hyeji 
Published: October 2018

Objectives
This study was to determine the characteristics of missed diagnosis of pediatric anaphylaxis that were registered as urticaria only at the emergency department (ED) by comparing those who had only urticaria symptoms with those who had both anaphylaxis and urticaria symptoms.

Methods
Subjects were classified into missed anaphylaxis and urticaria group according to whether satisfied anaphylaxis diagnostic criteria or not. Anaphylaxis group, those who were initially registered as anaphylaxis with urticaria and anaphylaxis symptoms simultaneously, were further investigated.

Results
The missed anaphylaxis group included 37 patients of 1051 pediatric urticaria patients. The anaphylaxis group included 11 patients. The time from symptom onset to ED arrival in the missed anaphylaxis group was shorter than the urticaria group. More patients in the missed anaphylaxis group had a history of past food allergy. Seafood, egg, and milk were more common causes of allergy in the missed anaphylaxis group; however, idiopathic causes were more common in the urticaria group. Symptom was more severe in the missed anaphylaxis group than the urticaria group. More treatments except antihistamine were performed at ED in the missed anaphylaxis group. Cardiovascular symptoms were more common in the anaphylaxis group than the missed anaphylaxis group.

Conclusions
Of all pediatric urticaria patients, 3.5% of patients were not registered as anaphylaxis although they had anaphylaxis symptoms. Missed diagnosis of anaphylaxis in pediatric urticaria patients at ED was associated with a history of past food allergy, milk, egg, and seafood as causes of allergy, treated with fluid administration, steroid, and epinephrine.
Childhood Adversity and Pain Facilitation
Authors: You Dokyoung S. , Meagher Mary W. 
Published: October 2018

ABSTRACT

Objective
This study investigated whether childhood adversity would be associated with hypersensitivity on two measures of central pain facilitation: area of secondary allodynia and temporal summation of second pain (TSSP), and whether pain facilitation would be explained by adult posttraumatic stress disorder (PTSD) symptoms.

Method
Participants endorsing high (n = 31) and low (n = 31) childhood adversity underwent capsaicin-induced secondary allodynia and TSSP testing. The tests were conducted a week apart with test order counterbalanced.

Results
Larger areas of secondary allodynia were observed in the high adversity group compared with the low adversity group (F(1,60) = 4.81, p = .032). This group difference was largely (62%) explained by greater PTSD symptoms in the high adversity group. Although no overall difference was found in TSSP slopes (p = .886), this was attributed to an order by group interaction (F(1,58) = 5.07, p = .028) and low power. Subsequent analyses revealed positive TSSP slopes in the high adversity group when TSSP testing was performed first, and this order effect was associated with blunted sympathetic responses to TSSP on the first visit. The two facilitation measures were unrelated (p = .631).

Conclusions
Larger areas of secondary allodynia were observed in the high adversity group, which was explained largely by PTSD symptoms. This suggests that adversity-related changes in pain facilitation may underlie the association between childhood adversity and generalized widespread pain. Although TSSP was affected by previous testing, adversity-related pain facilitation was observed when TSSP testing occurred first. Finally, adversity was not associated with a consistent pattern of hypersensitivity across the two measures of central pain facilitation.
HIV Vaccine Trials: Ethical, Psychological, and Psychological-Social Aspects (1991–1996)
Authors: Giami Alain , Linard Françoise 
Published: October 2018

Abstract:
The authors, who took part in designing and conducting the first phase-1 clinical trials of the HIV vaccine between 1991 and 1996, discuss the history of this innovative program, in particular, the conditions under which volunteers were recruited. They recall its multidisciplinary aspects; the team included, along with clinicians who were used to performing such trials, epidemiologists, psychiatrists, psychoanalysts, social psychologists, and a philosopher specialized in ethics. When forming this team, officials at France's National Research Agency on AIDS (ANRS) were careful to identify the volunteers social characteristics and pay heed to their subjective motivations for participating, given the context, namely a rising incidence of HIV infection and the challenges that were undermining confidence in medicine. Important in this context was the application of the Huriet-Sérusclat Act (1988) with its provisions for protecting participants. These clinical trials led to reformulating several ethical questions, for instance, the tension between the need of such trials and the necessity to not expose volunteers to poorly known risks; the importance of precise scientific information for delivering free, informed consent; and the possibility for volunteers to take part on the basis of their autonomy and “risk choice.” The network of volunteers, which operated on this basis for nearly 25 years, is a rare example of collaboration between basic research in biomedicine, medical doctors, psychologists, psychoanalysts, and ethicists.
Postface: Meaning of the Experiment and Implications of the Experience
Authors: Le Marcis Frederic 
Published: October 2018

Abstract:
Discussing specifically on the involvement of social sciences in and on the issue of recruitment in HIV vaccine trials, the postface of this special issue reasserts the importance of social science engagement in clinical research. Three entry themes are underlying the discussion: the relationship between the individual and society in consent, the analysis of consent as a transaction, the examination of the basis, and the context of trust within trials.
Recruitment and Engagement in Preventive Clinical Trials: Interdependencies and Mediation
Authors: Ollivier-Yaniv Caroline 
Published: October 2018

Abstract:
This article takes a standpoint based in the human and social sciences to examine a decisive time in any research related to HIV-AIDS, ie, when healthy, seronegative individuals agree to take part in preventive clinical trials. The context of recruitment for such trials has been changing over the past several decades: the normalization of the epidemic after a period of sensationalism, the change in focus of social communities to other causes, the changes in the disease from a therapeutic point of view (new drug treatments and preventive drugs), the absence of compensation for participation in trials, the absence of any direct health benefits for the participants, and the fear of volunteers or the people in their lives of the idea of transforming their healthy body into a postexperimental body. Research on the prevention of HIV seems to be dependent on the consent of a limited number of people and groups because their reasons for taking part in such experiments, which are just as much personal as they are for the sake of science, are necessarily very particular. How can healthy individuals be recruited for preventive HIV trials? What is the social basis and what kind of mediation is involved in a mutual understanding between trial participants and investigators? Such questions are answered by the authors in this book, who approach the issues from a multidisciplinary and diachronic perspective.
Temporary Ectopic Implantation of an Amputated Leg Using the Distal Runoff Vessel of the Anterolateral Thigh Flap Followed by Subsequent Prefabricated Chimeric Replantation
Authors: Wang Kuan-Chih , Hung Kuo-Shu , Chang Tzu-Yen , Wu Po-Ting , Lee Yao-Chou 
Published: October 2018

Aim
Infrapopliteal replantation is indicated in selected patients. When the patient is hemodynamically unstable or the amputation site is severely contaminated, temporary ectopic implantation of the amputated limb is an option. To the best of our knowledge, this is the first case report using the distal runoff vessel of the anterolateral thigh flap for temporary ectopic implantation of an amputated leg followed by replantation with the prefabricated anterolateral thigh flap.

Patient and Methods
A 28-year-old male driver had left leg avulsion amputation after a car accident. Because of concerns about the high-energy trauma mechanism and extensive trauma zone, temporary ectopic implantation was planned to avoid a lengthy replantation procedure and to enable future replantation. The amputated leg was implanted to the thigh using the distal runoff vessel of the descending branch of the lateral circumflex femoral system in the preservation of proximal cutaneous perforator. When the patient became hemodynamically stable and the amputated stump was relatively clean and healthy, we replanted the amputated leg with the prefabricated anterolateral thigh flap on day 7.

Results
The replanted leg and anterolateral thigh flap survived well after the procedure. At the 15-month follow-up, the patient could walk independently. There was no need for custom-made shoes because there was no obvious leg length discrepancy and the flap was not bulky.

Conclusions
We believe that the distal runoff vessel of the descending branch of the lateral circumflex femoral system can not only serve as a recipient site for temporary ectopic implantation but also enable the harvest of a prefabricated anterolateral thigh flap with the amputated part at the replantation stage. This prefabricated tissue containing the anterolateral thigh flap and the amputated part needs only 1 set of vascular anastomosis to accomplish replantation and simultaneous revascularization of the anterolateral thigh flap. Most importantly, this ectopically prefabricated chimeric tissue minimizes the need for extensive bone shortening after radial debridement by providing sufficient soft tissue coverage at the replantation stage.
Alteration of Sciatic Nerve Histology and Electrical Function After Compression and After Neurolysis in a Diabetic Rat Model
Authors: Hu Junda , Tu Yiji , Ding Zuoyou , Chen Zenggan , Lee Dellon A. , Lineaweaver William C. , Zhang Feng 
Published: October 2018

Background
Diabetic rats are more sensitive to nerve entrapment. This study was conducted to evaluate nerve function and histological changes in diabetic rats after nerve compression and subsequent decompression.

Methods
A total of 35 Wistar rats were included. The experimental group was divided into diabetic sciatic nerve compression group (DSNC, n = 5) and diabetic sciatic nerve decompression group (DSND, n = 20). The DSNC model was created by wrapping a silicone tube circumferentially around the nerve for 4 weeks, and then the DSND group accepted nerve decompression and was followed up to 12 weeks. The DSND group was equally divided into DSND 3 weeks (DSND3), 6 weeks (DSND6), 9 weeks (DSND9), and 12 weeks (DSND12) groups. Five rats were taken as normoglycemic control group (CR, n = 5), and another 5 rats as diabetic control group (DM, n = 5). The mechanical hyperalgesia of rats was detected by Semmes-Weinstein nylon monofilaments (SWMs) and by motor nerve conduction velocity (MNCV). These 2 physiological indicators and histology of sciatic nerves were compared among different groups.

Results
The SWM measurements improved toward normal values after decompression. The SWM value was significantly lower (more normal) in the DSNC groups than in the DSND group (P < 0.05). The MNCV was 53.7 ± 0.8 m/s in the CR group, whereas it was 28.4 ± 1.0 m/s in the DSNC group (P < 0.001). Six weeks after decompression, the MNCV was significantly faster than that in the DSNC group (P < 0.001). Histological examination demonstrated chronic nerve compression, which responded toward normal after decompression, but with degree of myelination never recovering to normal.

Conclusions
Chronic compression of the diabetic sciatic nerve has measureable negative effects on sciatic nerve motor nerve function, associated with a decline of touch/pressure threshold and degeneration of myelin sheath and axon. Nerve decompression surgery can reverse these effects and partially restore nerve function.
A New Method for Double-Eyelid Blepharoplasty Using Orbital Septum
Authors: Li Gaofeng , Ding Wei , Tan Jun , Zhang Bo , Chen Xin , He Bin 
Published: October 2018

Background
This article presents a new method using orbital septum for double-eyelid blepharoplasty.

Methods
During double-eyelid blepharoplasty, we incised the orbital septum horizontally. Using the attachment site of the levator aponeurosis as a pedicle, the lower part of the dissected orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. We evaluated the efficacy of this double-eyelid surgical procedure in patients undergoing the procedure from December 2015 to October 2017.

Results
We included 462 eyes of 231 patients in the final analysis. Sutures were removed 7 days after surgery. All double-eyelid creases were well formed, and the eyelids closed well. Six-month follow-up results revealed that the double-eyelid shape was natural looking, and no patients experienced upper eyelid retraction or incomplete eye closure. Notched scars did not occur, and patient satisfaction was achieved in all cases. Two hundred eleven patients were fully satisfied with the surgical results, and 20 were basically satisfied with the surgical results.

Conclusions
Using the orbital septum is a good approach for double-eyelid blepharoplasty.
Immunosuppression is Inappropriately Qualifying the Immune Status of Septic and SIRS Patients
Authors: Cavaillon Jean-Marc , Giamarellos-Bourboulis Evangelos J. 
Published: October 2018

ABSTRACT
Immunosuppression is the most commonly used concept to qualify the immune status of patients with either sterile systemic inflammatory response syndrome (SIRS) or sepsis. In this review we attempt to demonstrate that the concept of immunosuppression is an oversimplification of the complex anti-inflammatory response that occurs in patients dealing with a severe sterile or infectious insult. Particularly, the immune status of leukocytes varies greatly depending on the compartment from where they are derived from. Furthermore, although certain functions of immune cells present in the blood stream or in the hematopoietic organs can be significantly diminished, other functions are either unchanged or even enhanced. This juxtaposition illustrates that there is no global defect. The mechanisms called reprogramming or trained innate immunity are probably aimed at preventing a generalized deleterious inflammatory reaction, and work to maintain the defense mechanisms at their due levels.
The Influence of Culture on Teamwork and Communication in a Simulation-Based Resuscitation Training at a Community Hospital in Honduras
Authors: Perry Madeline F. , Seto Teresa L. , Vasquez Juan Carlos , Josyula Srirama , Rule Amy R.L. , Rule David W. , Kamath-Rayne Beena D. 
Published: October 2018

Summary StatementCommunication and teamwork are important aspects of medicine and have been a recent focus of resuscitation. Culture can influence communication and teamwork, and these effects have not been studied in low-resource settings. Using a case study and the TEAM scale, we evaluated how culture influences teamwork and communication during resuscitation simulations, in addition to examining other challenges of simulation research in low-resource settings. We observed lower scores in leadership and communication skills than have been seen in other studies using the TEAM scale, which led us to evaluate the possible role of culture in influencing these skills. The high power distance and collectivism in Latin America can make communication difficult, especially during debriefing. Furthermore, in a male-biased medical hierarchy, female nurses may be less likely to voice concerns. Ultimately, this commentary provides advice for taking the influences of culture into account when planning future simulation training in low-resource settings.