bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pneumonia Risk Stratification Scores for Children in Low-Resource Settings
Authors: Deardorff Katrina V. , McCollum Eric D. , Ginsburg Amy Sarah 
Published: December 2017

Background:
Pneumonia is the leading infectious cause of death among children less than 5 years of age. Predictive tools, commonly referred to as risk scores, can be employed to identify high-risk children early for targeted management to prevent adverse outcomes. This systematic review was conducted to identify pediatric pneumonia risk scores developed, validated and implemented in low-resource settings.

Methods:
We searched CAB Direct, Cochrane Reviews, Embase, PubMed, Scopus and Web of Science for studies that developed formal risk scores to predict treatment failure or mortality among children less than 5 years of age diagnosed with a respiratory infection or pneumonia in low-resource settings. Data abstracted from articles included location and study design, sample size, age, diagnosis, score features and model discrimination.

Results:
Three pediatric pneumonia risk scores predicted mortality specifically, and 2 treatment failure. Scores developed using World Health Organization–recommended variables for pneumonia assessment demonstrated better predictive fit than scores developed using alternative features. Scores developed using routinely collected healthcare data performed similarly well as those developed using clinical trial data. No score has been implemented in low-resource settings.

Conclusions:
While pediatric pneumonia-specific risk scores have been developed and validated, it is yet unclear if implementation is feasible, what impact, if any, implemented scores may have on child outcomes, or how broadly scores may be generalized. To increase the feasibility of implementation, future research should focus on developing scores based on routinely collected data.
Interpretation of Nondiagnostic Vulvar Biopsies
Authors: Day Tania , Knight Veronica , Dyall-Smith Delwyn , Dennerstein Graeme , Pagano Ross , Tran Hong , Tan Yasmin , Yap Desiree , Weigner Julie , Scurry James 
Published: December 2017

Abstract

Objective
The aim of the study was to assess clinical and histopathologic characteristics of symptomatic women who underwent a nondiagnostic biopsy of the inner vulva.

Materials and Methods
Consecutive nondiagnostic biopsies from medial labia minora, posterior fourchette, and vestibule obtained from symptomatic women between 2011 and 2015 were reviewed for this retrospective histopathologic case series. Histopathologic assessment included site, basal layer appearance, lymphocytic infiltrate, and presence of fibrosis or sclerosis. Examination findings, treatment, initial impression, and final clinical diagnosis were recorded. Descriptive statistics were performed; clinical and histopathologic characteristics were compared with Fisher exact test.

Results
There were 85 cases; mean age was 53 years. Most women presented with painful erythema and underwent biopsy to confirm (30, 35%) or exclude (43, 51%) lichen planus. After clinical follow-up and histopathologic review, most cases had persistent diagnostic discordance. Final clinical diagnoses were available in 70 women: lichen planus in 27 (38%), vulvodynia in 15 (21%), and the other 28 (40%) had LS (8), plasma cell vulvitis (5), psoriasis (4), dermatitis (4), candidosis (3), estrogen deficiency (3), and aphthosis (1). Histopathologic review highlighted the difficulty in distinguishing mucosa-associated lymphoid tissue from an inflammatory infiltrate in 23 (27%) of cases. Compared with other sites, biopsies from the mucocutaneous junction were more likely to be associated with a positive culture for Candida albicans.

Conclusions
Nondiagnostic biopsies from the inner vulva should prompt thoughtful multidisciplinary review, but more research is required to resolve the problem of clinicopathologic discordance through better understanding of vulvar histology and pathophysiology.
Situation-Dependent Medical Device Risk Estimation: Design and Evaluation of an Equipment Management Center For Vendor-Independent Integrated Operating Rooms
Authors: Maktabi Marianne , Neumuth Thomas 
Published: December 2017

Objectives
The complexity of surgical interventions and the number of technologies involved are constantly rising. Hospital staff has to learn how to handle new medical devices efficiently. However, if medical device–related incidents occur, the patient treatment is delayed. Patient safety could therefore be supported by an optimized assistance system that helps improve the management of technical equipment by nonmedical hospital staff.

Methods
We developed a system for the optimal monitoring of networked medical device activity and maintenance requirements, which works in conjunction with a vendor-independent integrated operating room and an accurate surgical intervention Time And Resource Management System. An integrated situation-dependent risk assessment system gives the medical engineers optimal awareness of the medical devices in the operating room.

Results
A qualitative and quantitative survey among ten medical engineers from three different hospitals was performed to evaluate the approach. A series of 25 questions was used to evaluate various aspects of our system as well as the system currently used. Moreover, the respondents were asked to perform five tasks related to system supervision and incident handling. Our system received a very positive feedback. The evaluation studies showed that the integration of information, the structured presentation of information, and the assistance modules provide valuable support to medical engineers.

Conclusions
An automated operating room monitoring system with an integrated risk assessment and Time And Resource Management System module is a new way to assist the staff being outside of a vendor-independent integrated operating room, who are nevertheless involved in processes in the operating room.
Deficient autophagy drives aging inHydra
Authors: Tomczyk Szymon , Schenkelaars Quentin , Suknovic Nenad , Wenger Yvan , Ekundayo Kazadi , Buzgariu Wanda , Bauer Christoph , Fischer Kathleen , Austad Steven , Galliot Brigitte 
Published: December 2017

AbstractHydraexhibits a negligible senescence as its epithelial and interstitial stem cell populations continuously divide. Here we identified twoH. oligactisstrains that respond differently to interstitial stem cell loss. Cold-resistant(Ho_CR)animals adapt and remain healthy while cold-sensitive(Ho_CS)ones die within three months, after their epithelial stem cells lose their selfrenewal potential. InHo_CSbut not inHo_CRanimals, the autophagy flux is deficient, characterized by a low induction upon starvation, proteasome inhibition or Rapamycin treatment, and a constitutively repressed Ulk activity. In the non-agingHydra vulgaris, WIPI2 silencing suffices to induce aging. Rapamycin can delay aging by sustaining epithelial self-renewal and regeneration, although without enhancing the autophagy flux. Instead Rapamycin promotes engulfment in epithelial cells where p62/SQSTM1-positive phagocytic vacuoles accumulate. This study uncovers the importance of autophagy in the longevity of early-branched eumetazoans by maintaining stem cell renewal, and a novel anti-aging effect of Rapamycin via phagocytosis.
Hematology, biochemistry, and toxicology of wild hawksbill turtles (Eretmochelys imbricata) nesting in mangrove estuaries in the eastern Pacific Ocean
Authors: Tauer Aubrey M. , Liles Michael J. , Chavarría Sofía , Valle Melissa , Amaya Sada , Quijada Gabriela , Meléndez Oscar , Rodríguez Stanley , Lock Eric F. , Henríquez Ana V. , Gaos Alexander R. , Seminoff Jeffrey A. 
Published: December 2017

AbstractSea turtles are a keystone species and are highly sensitive to changes in their environment, making them excellent environmental indicators. In light of environmental and climate changes, species are increasingly threatened by pollution, changes in ocean health, habitat alteration, and plastic ingestion. There may be additional health related threats and understanding these threats is key in directing future management and conservation efforts, particularly for severely reduced sea turtle populations. Hawksbill turtles (Eretmochelys imbricata) are critically endangered, with those in the eastern Pacific Ocean (Mexico–Peru) considered one of the most threatened sea turtle populations in the world. This study establishes baseline health parameters in hematology and blood biochemistry as well as tested for heavy metals and persitent organic pollutants in eastern Pacific hawksbills at a primary nesting colony located in a mangrove estuary. Whereas hematology and biochemistry results are consistent with healthy populations of other species of sea turtles, we identified differences in packed cell volume, heterophils and lympohcyte counts, and glucose when comparing our data to other adult hawksbill analysis (1), (2), (3). Our analysis of heavy metal contamination revealed a mean blood level of 0.245 ppm of arsenic, 0.045 ppm of lead, and 0.008 ppm of mercury. Blood levels of persistent organic pollutants were below the laboratory detection limit for all turtles. Our results suggest that differences in the feeding ecology of eastern Pacific hawksbills in mangrove estuaries may make them less likely to accumulate persistent organic pollutants and heavy metals in their blood. These baseline data on blood values in hawksbills nesting within a mangrove estuary in the eastern Pacific offer important guidance for health assessments of the species in the wild and in clinical rehabilitation facilities, and underscore the importance of preventing contamination from point and non-point sources in mangrove estuaries, which represent primary habitat to hawksbills and myriad other marine species in the eastern Pacific Ocean.
Learning and Mapping Lyme Disease Patient Trajectories from Electronic Medical Data for Stratification of Disease Risk and Therapeutic Response
Authors: Ichikawa Osamu , Glicksberg Benjamin S. , Kidd Brian , Li Li , Dudley Joel T. 
Published: December 2017

ABSTRACTBackgroundLyme disease (LD) is an epidemic, tick-borne illness with approximately 329,000 incidences diagnosed each year in United States. Long-term use of antibiotics is associated with serious complications, including post-treatment Lyme disease syndrome (PTLDS). The landscape of comorbidities and health trajectories associated with LD and associated treatments is not fully understood. Consequently, there is an urgent need to improve clinical management of LD based on a more precise understanding of disease and patient stratification.MethodsWe used a precision medicine machine-learning approach based on high-dimensional electronic medical records (EMRs) to characterize the heterogeneous comorbidities in a LD population and develop systematic predictive models for identifying medications that influence the risk of subsequent comorbidities.FindingsWe identified 3, 16, and 17 comorbidities at broad disease categories associated with LD within 2, 5, and 10 years of diagnosis, respectively. At higher resolution of ICD-9 levels, we pinpointed specific co-morbid diseases on a timescale that matched the symptoms associated with PTLDS. We identified 7, 30, and 35 medications that influenced the risks of the reported comorbidities within 2, 5, and 10 years, respectively. These medications included six previously associated with the identified comorbidities and 29 new findings. For instance, the first-line antibiotic doxycycline exhibited a consistently protective effect for typical symptoms of LD, including ‘backache Not Otherwise Specified (NOS)’ and ‘chronic rhinitis’, but consistently increased the risk of ‘cataract NOS’, ‘tear film insufficiency NOS’, and ‘nocturia’.InterpretationOur approach and findings suggest new hypotheses for precision medicine treatments regimens and drug repurposing opportunities tailored to the phenotypic profiles of LD patients.FundingThe Steven & Alexandra Cohen Foundation
A divergent CheW confers plasticity to nucleoid-associated chemosensory arrays
Authors: Guiseppi Annick , Vicente Juan Jesus , Herrou Julien , Byrne Deborah , Barneoud Aurelie , Moine Audrey , Espinosa Leon , Basse Marie-Jeanne , Molle Virginie , Mignot Tâm , Roche Philippe , Mauriello Emilia M.F. 
Published: December 2017

ABSTRACTChemosensory systems are highly organized signaling pathways that allow bacteria to adapt to environmental changes. The Frz chemosensory system from M. xanthus possesses two CheW-like proteins, FrzA (the core CheW) and FrzB. We found that FrzB does not interact with FrzE (the cognate CheA) as it lacks the amino acid region responsible for this interaction. FrzB, instead, acts upstream of FrzCD in the regulation of M. xanthus chemotaxis behaviors and activates the Frz pathway by allowing the formation and distribution of multiple chemosensory clusters on the nucleoid. These results, together, show that the lack of the CheA-interacting region in FrzB confers new functions to this small protein.AUTHOR SUMMARYChemosensory systems are signaling complexes that are widespread in bacteria and allow the modulation of different cellular functions, such as taxis and development, in response to the environment. We show that the Myxococcus xanthus FrzB is a divergent CheW lacking the region involved in the interaction with the histidine kinase FrzE. Instead, it acts upstream of FrzCD to allow the formation of multiple distributed Frz chemosensory arrays at the nucleoid. The loss of the CheA-interacting region in FrzB might have been selected to confer plasticity to nucleoid-associated chemosensory systems. By unraveling a new accessory protein and its function, this work opens new insights into the knowledge of the regulatory potentials of bacterial chemosensory systems.
Deciphering the associations between soil microbial diversity and ecosystem multifunctionality driven by long‐term fertilization management
Authors: Luo Gongwen , Rensing Christopher , Chen Huan , Liu Manqiang , Wang Min , Guo Shiwei , Ling Ning , Shen Qirong 
Published: December 2017

Abstract

An increasing number of studies indicate that microbial diversity plays a crucial role in the mediation of ecosystem multifunctionality (EMF) in natural ecosystems. However, this point remains mostly overlooked in managed ecosystems, especially in agriculture.

Here, we compiled promising strategies for the targeted exploitation of the associations between microbial diversity and EMF of agricultural soils using samples from two long‐term (more than 30 years) experimental field sites in southern China. The two sites experienced a similar monsoon climate and fertilization management practices. We used high‐throughput amplicon sequencing, structural equation modelling and random forest analysis, to analyse our data and validate our hypotheses.

We found that soil physiochemical properties and the C‐, N‐, P‐ and S‐cycle enzyme activities were increased with the increase in microbial diversity. Specifically, a positive linear relationship was observed between microbial diversity and EMF, which was mediated by long‐term fertilization management via changes in soil microbial communities and physiochemical properties. Random forest analysis and SEM showed that the important role of microbial diversity on EMF was maintained even when simultaneously taking multiple multifunctionality drivers (soil physiochemical properties, soil aggregation and enzymatic patterns) into account. In addition, microbial diversity, C‐cycle enzyme activity and pH value are feasible predictors of EMF; these factors were shown to be the main drivers of EMF of arable soils.

Our findings suggest that there may be a limited degree of multifunctional redundancy in arable soils. The relationship we observed between microbial diversity and EMF suggests that management practices that foster more diverse soil microbial communities may have the potential to improve the functioning of agroecosystems.

A plain language summary is available for this article.
Brief telephone interventions for problem gambling: a randomized controlled trial
Authors: Abbott Max , Hodgins David C. , Bellringer Maria , Vandal Alain C. , Palmer Du Preez Katie , Landon Jason , Sullivan Sean , Rodda Simone , Feigin Valery 
Published: December 2017

AbstractBackground and aimsProblem gambling is a significant public health issue world‐wide. There is substantial investment in publicly funded intervention services, but limited evaluation of effectiveness. This study investigated three brief telephone interventions to determine whether they were more effective than standard helpline treatment in helping people to reduce gambling.DesignRandomized clinical trial.SettingNational gambling helpline in New Zealand.ParticipantsA total of 462 adults with problem gambling.Interventions and comparator(1) Single motivational interview (MI), (2) single motivational interview plus cognitive–behavioural self‐help workbook (MI + W) and (3) single motivational interview plus workbook plus four booster follow‐up telephone interviews (MI + W + B). Comparator was helpline standard care [treatment as usual (TAU)]. Blinded follow‐up was at 3, 6 and 12 months.MeasurementsPrimary outcomes were days gambled, dollars lost per day and treatment goal success.FindingsThere were no differences across treatment arms, although participants showed large reductions in gambling during the 12‐month follow‐up period [mean reduction of 5.5 days, confidence interval (CI) = 4.8, 6.2; NZ$38 lost ($32, $44; 80.6%), improved (77.2%, 84.0%)]. Subgroup analysis revealed improved days gambled and dollars lost for MI + W + B over MI or MI + W for a goal of reduction of gambling (versus quitting) and improvement in dollars lost by ethnicity, gambling severity and psychological distress (allP < 0.01). MI + W + B was associated with greater treatment goal success for higher gambling severity than TAU or MI at 12 months and also better for those with higher psychological distress and lower self‐efficacy to MI (allP < 0.01). TAU and MI were found to be equivalent in terms of dollars lost.ConclusionsIn treatment of problem gambling in New Zealand, brief telephone interventions are associated with changes in days gambling and dollars lost similar to more intensive interventions, suggesting that more treatment is not necessarily better than less. Some client subgroups, in particular those with greater problem severity and greater distress, achieve better outcomes when they receive more intensive treatment.
Association of intralipid intake in extremely low birthweight infants with neurodevelopmental outcomes
Authors: Oh William , Przystac Lynn , McKinley Leslie , Tucker Richard , McGowan Elisabeth C. , Vohr Betty R. 
Published: December 2017

AbstractAimTo determine whether high intake of intralipid (IL) in extremely low birthweight (ELBW) neonates is associated with higher rates of neuroimpairment and Bayley III scores at two years of corrected age.MethodsQuartiles of IL received by 389 ELBW infants were linked to neurodevelopmental outcomes. Logistic regression analyses, adjusted for confounders, were performed to determine the association between IL dose and neuroimpairment. Linear regression analyses were performed to predict Bayley III scores.ResultsNo association was found between IL dose and neuroimpairment A significant association was found between higher IL intake and lower Bayley Cognitive, motor and language scores. Adding breast milk intake to the linear regression eliminated the associations.ConclusionHigher IL intake was associated with lower cognitive, motor and language scores. Breast milk intake eliminated the latter associations, which underscores the important role of breast milk in developmental outcome.
Successful steroid withdrawal guided by surveillance biopsies—A single‐center experience
Authors: Wehmeier Caroline , Hirt‐Minkowski Patricia , Amico Patrizia , Georgalis Argyrios , Hopfer Helmut , Steiger Jürg , Dickenmann Michael , Schaub Stefan 
Published: December 2017

AbstractSteroid withdrawal following renal transplantation is challenging and widely debated. This retrospective study aimed at investigating the frequency and determinants of successful steroid withdrawal guided by surveillance biopsies. We analyzed 156 pretransplant DSA‐negative renal transplants receiving basiliximab induction and maintenance immunosuppression with tacrolimus‐mycophenolate‐steroids. The absence of rejection in surveillance biopsies at 3 or 6 months post‐transplant initiated steroid withdrawal, which was monitored by subsequent indication and/or surveillance biopsies. The primary outcome was the frequency of successful (i.e., rejection‐free) steroid withdrawal at 1 year post‐transplant. In the whole study population, successful steroid withdrawal was achieved in 73 of 156 patients (47%). Steroid withdrawal was initiated in 98 of 156 patients (63%) and successful in 73 of 98 patients (74%). Subsequent clinical rejection occurred in only one of 98 patients (1%), whereas 24 of 98 patients (24%) experienced subclinical rejection. Steroid withdrawal was not initiated in 58 of 156 patients (37%) mainly due to current or prior severe (Banff TCMR ≥IA) subclinical rejection. Prediction of successful steroid withdrawal by pretransplant or early post‐transplant parameters was poor. In conclusion, (sub)clinical rejection‐free steroid withdrawal can be expected in about half of pretransplant DSA‐negative patients. As successful steroid withdrawal cannot be well predicted by pre‐ and early post‐transplant parameters, guidance by surveillance biopsies is an attractive strategy.