bluuebunny/crossref_metadata_2025_split huggingface dataset:
Viral Pneumonias in Forensic Autopsies
Authors: Daş Taner , Sargan Aytül , Yağmur Gülhan , Yildirim Muzaffer , Topal Cumhur Selçuk , Gürler Ahmet Selçuk , Asliyüksek Hizir , Arslan Murat Nihat , Özdemirel Rifat 
Published: October 2016

Abstract
Lower respiratory infections are commonly due to viruses and are the third largest cause of death. Respiratory tract viruses have a tendency to target the specific regions in the lung and can harm the host via direct effect of the virus and the host's inflammatory response. In this study, relationships between morphologic changes in the lung and the viral agent type isolated in the lung by the polymerase chain reaction technique were investigated. This study was performed retrospectively at 113 autopsy cases in the Council of Forensic Medicine in Istanbul. Slides from the lung tissues diagnosed as interstitial pneumonia and detected viral agent in polymerase chain reaction were evaluated and reviewed under light microscope by 2 pathologists simultaneously according to predetermined bronchiolar, alveolar, and interstitial findings. Alveolar findings were detected in 108 cases (95.6%), whereas interstitial and bronchiolar findings were detected in 91 (80.5%) and 38 (33.6%) cases, respectively. Intra-alveolar edema was the most common alveolar finding. Some findings such as multinucleated syncytial cells and smudge cells can aid the search for etiologic agent. Interstitial inflammation was the most common histopathologic finding in the lung in viral infections and the most prominent clue to viral infections in the lung histopathologically without discrimination of viral agent type.
Urine KIM-1 as a Potential Biomarker of Acute Renal Injury After Circulatory Collapse in Children
Authors: Assadi Farahnak , Sharbaf Fatemeh Ghane 
Published: October 2016

Objectives
Serum creatinine (SCr) is a late marker of acute kidney injury (AKI) due to the lag time between initiating injury and loss of function. We assessed the ability of urinary interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) to predict AKI in critically ill children with circulatory collapse.

Methods
Serum creatinine, estimated creatinine clearance (eCrCL), urine IL-18, KIM-1, and NGAL values were measured in 86 children with circulatory collapse on the day of admission, and the results were compared with those obtained 6 days later. Acute kidney injury was defined as a decrease in eCrCL of greater than 25% within the first 48 hours of enrollment. Areas under the curve (AUC) for receiver operating characteristic curve were calculated for the early detection of AKI.

Results
Mean SCr concentration did not differ significantly during the first 6 days of hospital admission. In contrast, mean urine concentrations of IL-18, KIM-1, and NGAL rose significantly from day of admission to the sixth day of hospital stay (P < 0.001). Urinary KIM-1 emerged as having the strongest performance for the early detection of AKI, followed by NGAL, IL-18, and eCrCL. Urinary KIM-1 displayed the highest AUC of 0.81 (95% confidence interval [CI], 0.76-0.93; P < 0.001) for the early detection of AKI after circulatory collapse, followed by NGAL (0.77% CI, 0.70–0.84) and IL-18 (0.69% CI, 0.48–0.64).

Conclusions
Of a panel of 3 promising urinary biomarkers, KIM-1 demonstrated the best performance in predicting AKI in children with circulatory collapse before a change in SCr or eCrCL becomes apparent.
The Utility of Head Computed Tomography in the Evaluation of Apparent Life-Threatening Event
Authors: Stark Wayne , Rominger Annie , Warkentine Fred , Caperell Kerry 
Published: October 2016

Objective
This study aimed to evaluate the diagnostic utility of empiric head computed tomography (CT) in apparent life threatening event (ALTE).

Methods
This was a retrospective chart review of children younger than 12 months presenting to an urban pediatric hospital and its suburban satellite for an ALTE from October 2009 to December 2012. The ALTE cases were identified as having had a diagnosis of ALTE (International Classification of Diseases, 9th Revision 799.82) or as having had a constellation of studies performed consistent with our institutional protocol for ALTE evaluation. Exclusion criteria were known trauma and cases lacking an identifiable ALTE feature on review.

Results
There were 631 cases identified, of which 617 met inclusion and exclusion criteria. Of those, 537 had a head CT performed. Five patients were identified with clinically important head CT findings: a case of congenital toxoplasmosis, a case of intraventricular hemorrhage, and 3 cases of nonaccidental trauma (NAT). One of the NAT patients had a bruise on his forehead; the other patients had no historical, physical examination, and other laboratory or radiologic findings to raise concern for significant finding on head CT. The rate of clinically significant findings and occult clinically significant findings was 5/537 (0.93%) (95% confidence interval, 0.30%–2.16%; number needed to treat = 108) and 4/537 (0.75%) (95% confidence interval, 0.20%–1.90%; number needed to treat = 135), respectively.

Conclusions
The rate of clinically important head CT findings in ALTE evaluation was relatively rare, at 0.93%. Given the severe consequences of missing these cases, these data establish a role for empiric head CT in the evaluation of ALTE.
Implementation of a 2-Day Simulation-Based Course to Prepare Medical Graduates on Their First Year of Residency
Authors: Bragard Isabelle , Seghaye Marie-Christine , Farhat Nesrine , Solowianiuk Marie , Saliba Mariane , Etienne Anne-Marie , Schumacher Katharina 
Published: October 2016

Objectives
Residents beginning their specialization in pediatrics and emergency medicine (EM) are rapidly involved in oncall duties. Early acquisition of crisis resource management by novice residents is essential for patient safety, but traditional training may be insufficient. Our aim was to investigate the impact of a 2-day simulation-based course on residents to manage pediatric and neonatal patients.

Methods
First year residents participated in the course. They completed two questionnaires concerning perceived stress and self-efficacy in technical skills (TSs) and non-TSs (NTSs) at 3 times: before (T0), after (T1), and 6 weeks after the course (T2).

Results
Eleven pediatric and 5 EM residents participated. At T0, stress about “communicating with parents” (P = 0.022) and “coordinating the team” (P = .037) was significantly higher among pediatric compared with EM residents; self-efficacy was not different between the specialities. After training, perceived stress about “managing a critical ill child” and perceived stress total significantly decreased among EM residents, whereas it remained the same among pediatricians (respectively, P = 0.001 and P = 0.016). Regarding self-efficacy, it had significantly increased in both groups (P < 0.001). Specifically, the increase in TSs self-efficacy was significant after the training (p = .008) and after 6 weeks (p < .001), and the increase in NTs self-efficacy was only significant after 6 weeks (P = 0.014).

Conclusions
Our course improved perceived stress, TSs, and NTSs self-efficacy of residents. This encourages us to formalize this as a prerequisite for admission to the pediatric and EM residency.
Improved Team Performance During Pediatric Resuscitations After Rapid Cycle Deliberate Practice Compared With Traditional Debriefing
Authors: Lemke Daniel S. , Fielder Elaine K. , Hsu Deborah C. , Doughty Cara B. 
Published: October 2016

Introduction
Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods.

Objective
The aim of the study was to compare traditional and RCDP SBME.

Methods
Four pediatric resuscitation cases (3 for teaching and 1 for testing) were developed. For the RCDP arm, traditional cases were deconstructed into sequences of progressively difficult rounds. The last RCDP round served as the traditional arm scenario.
Learners received 1 type of instruction on 2 separate days. Pretest and posttest performance during simulation were video recorded and scored using the Simulation Team Assessment Tool; satisfaction surveys were collected.

Results
Pretest team performance was similar in both groups. Simulation Team Assessment Tool score improvement for RCDP was 7.2% (95% confidence interval, 3.4% to 11%) and traditional was 0.8% (95% confidence interval, −11% to 13%). The difference in improvement of the human factors subscore was statistically significant; RCDP improved 10.2% and traditional improved 1.7% (P = 0.013). The RCDP technique was well received by learners but caused fatigue.

Conclusions
This pilot study showed a trend toward greater improvement in team performance and significantly greater improvement for human factors with RCDP compared with traditional simulation. Future studies comparing RCDP with other methods are needed to identify best practices and applications of RCDP, including which learners and learning objectives are best suited to RCDP.
Identification of an epidermal keratinocyte AMPA glutamate receptor involved in dermatopathies associated with sensory abnormalities
Authors: Cabañero David , Irie Takeshi , Celorrio Marta , Trousdale Christopher , Owens David M. , Virley David , Albrecht Phillip J. , Caterina Michael J. , Rice Frank L. , Morón Jose A. 
Published: October 2016

Abstract

Introduction: Epidermal keratinocytes are increasingly recognized as active participants in the sensory transduction of itch and pain, processes known to involve primary afferent glutamatergic neurons. However, the role of keratinocyte glutamate signaling in sensory functioning is not fully understood. Here, we present the observation of α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid–type glutamate receptors (AMPARs) in epidermal keratinocytes.

Methods: Immunohistochemical and in situ hybridization analyses were conducted to assess the expression of AMPAR subunits in epidermal keratinocytes in mouse and human skin samples, and in organotypic cultures of human keratinocytes. In addition, reverse transcription PCR further confirmed the expression of GluA4-containing AMPAR in epidermal keratinocytes.

Results: We found prominent immunolabeling for the GluA4 subunit of AMPAR in keratinocytes of glabrous and hairy skin of mouse epidermis, as well as in human epidermal keratinocytes. Reverse transcription PCR confirmed Gria4 transcript expression in epidermal mouse keratinocytes. In addition, expression of GRIA4 mRNA was confirmed in epidermal human keratinocytes by in situ hybridization. Immunohistochemical studies conducted in human skin biopsies from patients with atopic dermatitis and postherpetic neuralgia demonstrate that keratinocyte expression of GluA4 can be altered under pathological conditions. Moreover, a decrease of GluA4 expression was observed in organotypic cultures of human keratinocytes after direct application of algogenic agents.

Conclusion: We provide evidence that GluA4-containing AMPARs are expressed in epidermal keratinocytes, that human pruritic and painful dermatopathologies have alterations in the keratinocyte expression levels of GluA4-containing AMPAR, and that itch- and pain-producing substances can directly regulate their production in keratinocytes.
New and emerging therapies for Clostridium difficile infection
Authors: Martin Jessica , Wilcox Mark 
Published: October 2016

Purpose of review

Clostridium difficile infection has attained high prominence given its prevalence and impacts on patients and healthcare institutions. Multiple new approaches to the prevention and treatment of C. difficile infection (CDI) are undergoing clinical trials.

Recent findings
Bezlotoxumab is a monoclonal antibody against toxin B that has successfully completed phase III studies, demonstrating a significant reduction in recurrent CDI when given with standard of care antibiotics. Antibiotics under development include cadazolid and ridinilazole, whereas surotomycin has had disappointing phase III results. Multiple live biotherapeutics are being developed, including freeze thawed and encapsulated versions of faecal microbiota transplantation to improve the practicality of treating patients with recurrent CDI. Alternatives to faecal microbiota transplantation, that aim to improve safety, including a microbial suspension, RBX2660, and a complex spore formulation, SER-109, have progressed to phase II studies. A nontoxigenic C. difficile strain has also shown promise to prevent recurrent CDI. In addition, three C. difficile vaccines have progressed to phase II/III clinical trials.

Summary
The diverse approaches to treating and preventing CDI offer substantial promise that new treatment options will soon emerge, particular ones that reduce the risk of recurrences.
The hepatitis D satellite virus of hepatitis B virus: half-opening a new era to control viral infection?
Authors: Abeywickrama-Samarakoon Natali , Cortay Jean-Claude , Dény Paul 
Published: October 2016

Purpose of review
To highlight new concepts and therapeutic approaches concerning hepatitis D virus (HDV) infection.

Recent findings
Common receptor for hepatitis B virus (HBV) and HDV has been elucidated, deciphering of HDV replication is still in progress, preliminary results of phase II proof-of-concept clinical assays for entry inhibitors and cellular farnesyl transferase inhibitors are now available.

Summary
Hepatitis D infection remains a severe acute and chronic liver illness with the only currently approved therapy (Peg-αIFN) achieving disappointingly low rates of sustained viral response and clinical improvement. Both sodium taurocolate cotransporting polypeptide and heparan sulphate glypican 5 are important for viral adsorption. Preliminary results of 6 months treatment with a subcutaneous HBV PreS1-derived myristoyled peptide as an entry inhibitor indicates an encouraging short-term response with low side-effects. In addition, the short-term use of oral farnesyl transferase inhibitors induces a log10 reduction of viral RNA in almost all treated patients, but is associated with gastrointestinal upset and weight loss (especially using 200 mg/day). Encouraging results are being reported using intravenous phosphorothioate nucleic acid polymers both in terms of HBV surface antigens (HBsAg) and HDV-RNA decline; interestingly, in some patients with a strong HBsAg decline, the appearance of anti-hepatitis Bs antibodies might suggest clinical end-point improvement.
Does nutrition support have a role in managing cancer cachexia?
Authors: Laviano Alessandro , Di Lazzaro Giraldi Gianluca , Koverech Angela 
Published: October 2016

Purpose of review
Cachexia is a negative prognostic factor in cancer patients. The pathogenesis is related to a variable combination of reduced food intake and metabolic changes. However, whether nutritional support may contribute to effectively prevent and treat cachexia remains a debated issue.

Recent findings
Consistent evidence demonstrates that anabolic windows of opportunity occur during the clinical trajectory of cancer patients. Also, the use of specific nutrients, namely omega-3 fatty acids, may enhance the efficacy of nutritional support when tumor-driven inflammatory response is high. Of greater interest, it is now becoming clearer that the use of nutritional support at key time points in the clinical journey of cancer patients (i.e., perioperative period) may extend its clinical benefits beyond those on nutritional status.

Summary
Nutritional support plays a role in managing cancer cachexia, when it is timely delivered, when it provides adequate amounts of calories and proteins, and when it is part of a concurrent palliative care approach. Specific nutrients, that is, omega-3 fatty acids, may help in those cancer patients with high-inflammatory response, and may also contribute to positively influence long-term clinical outcomes.
Cauda Equina Conduction Time Determined by F-Waves in Normal Subjects and Patients With Neurogenic Intermittent Claudication Caused by Lumbar Spinal Stenosis
Authors: Imajo Yasuaki , Kanchiku Tsukasa , Suzuki Hidenori , Funaba Masahiro , Nishida Norihiro , Fujimoto Kazuhiro , Taguchi Toshihiko 
Published: October 2016

Purpose:
Lumbar spinal stenosis typically presents with neurogenic intermittent claudication. The aim of this study was to investigate cauda equina conduction time (CECT) in patients with neurogenic intermittent claudication caused by lumbar spinal stenosis and its relationship with age and body height in normal subjects.

Methods:
The study included 172 normal subjects (group C) (mean age 44.1 ± 16.6 years; mean height 163.7 ± 8.9 cm). Forty-seven patients (group L) (mean age 71.3 ± 8.7 years; mean height 158.8 ± 11.2 cm) underwent surgery because of neurogenic intermittent claudication in cauda equina type of lumbar spinal stenosis. Motor-evoked potentials from the abductor hallucis were recorded. Magnetic stimulation was delivered at the S1 spinous process. Compound muscle action potentials (CMAPs) and F-waves were also recorded after supramaximal electric stimulation of tibial nerves. The peripheral motor conduction time (PMCT) was calculated from the latencies of CMAPs and F-waves as follows: (CMAPs + F-waves − 1)/2. The CECT was calculated by subtracting the onset latency of the motor-evoked potentials from PMCT.

Results:
The mean values for F-wave latencies, motor-evoked potential latencies, and CECT were 44.5 ± 3.3, 20.6 ± 1.8, and 3.4 ± 0.8 milliseconds, respectively. F-wave and motor-evoked potential latencies showed significant positive linear correlations with age and body height. However, no significant correlation was found between CECT and age (P = 0.43) or body height (P = 0.26). Mean CECT was 5.7 ± 1.5 in group L. There was a significant difference between groups C and L (P < 0.05).

Conclusions:
The CECT value of normal subjects was 3.4 ± 0.8 milliseconds regardless of age and body height. We suggest that CECT may be a useful factor to consider when evaluating patients with neurogenic intermittent claudication.
Electroconvulsive Therapy in Schizophrenia in China
Authors: Li Qian , Su Yun-Ai , Xiang Yu-Tao , Shu Liang , Yu Xin , Ungvari Gabor S. , Seiner Stephen J. , Chiu Helen F.K. , Ning Yu-Ping , Wang Gao-Hua , Zhang Ke-Rang , Li Tao , Sun Li-Zhong , Shi Jian-Guo , Chen Xian-Sheng , Mei Qi-Yi , Li Ke-Qing , Si Tian-Mei 
Published: October 2016

Objective
Little is known about electroconvulsive therapy (ECT) use in the treatment of schizophrenia in China. This study examined the frequency of ECT use, its trend between 2006 and 2012, and its independent demographic and clinical correlates in a nationwide survey in China.

Methods
A total of 5162 inpatients in 45 Chinese psychiatric hospitals/centers were interviewed (2696 in 2006 and 2466 in 2012). Patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure.

Results
Electroconvulsive therapy was used in 6.1% of the whole sample; 4.7% in 2006 and 7.7% in 2012 (P < 0.001) with wide interprovince variations. Multiple logistic regression analyses of the whole sample revealed that patients receiving ECT were more likely to be women, receive second-generation antipsychotics, treated in tertiary referral centers (level III hospitals), had a shorter illness duration, and more positive and depressive symptoms (R

2
= 0.181; P < 0.001).

Conclusions
Electroconvulsive therapy for schizophrenia has increased between 2006 and 2012 in China. Its percentage was higher than the figures reported in most other countries. Reasons for the substantial variations in the frequency of ECT across different provinces in China require further investigations.
Dissociable Roles of Ventromedial Prefrontal Cortex and Anterior Cingulate in Subjective Valuation of Prospective Effort
Authors: Hogan Patrick S. , Galaro Joseph K. , Chib Vikram S. 
Published: October 2016

ABSTRACTThe perceived effort level of an action shapes everyday decisions. Despite the importance of these perceptions for decision-making, the behavioral and neural representations of the subjective cost of effort are not well understood. While a number of studies have implicated anterior cingulate cortex (ACC) in decisions about effort/reward trade-offs, none have experimentally isolated effort valuation from reward and choice difficulty, a function that is commonly ascribed to this region. We used functional magnetic resonance imaging (fMRI) to monitor brain activity while human participants engaged in uncertain choices for prospective physical effort. Our task was designed to examine effort-based decision making in the absence of reward and separated from choice difficulty – allowing us to investigate the brain’s role in effort valuation, independent of these other factors. Participants exhibited subjectivity in their decision-making, displaying increased sensitivity to changes in subjective effort as objective effort levels increased. Analysis of blood-oxygenation level dependent (BOLD) activity revealed that the ventromedial prefrontal cortex (vmPFC) encoded the subjective valuation of prospective effort and ACC encoded choice difficulty. These results provide insight into the processes responsible for decision-making regarding effort, dissociating the roles of vmPFC and ACC in prospective valuation of effort and choice difficulty.
Aerodynamic design of gas turbine engine intake duct
Authors: Soemarwoto Bambang I. , Boelens Okko J. , Kanakis Toni 
Published: October 2016

Purpose
The purpose of this paper is to provide a design solution of an engine intake duct suitable for delivering air to the compressor of a gas turbine engine of a general aviation turboprop aircraft, where the initial duct shape suffers a problem of flow distortion due to flow separation at the compressor inlet.

Design/methodology/approach
Aerodynamic design uses a three-dimensional inverse-by-optimization approach where the deviation from a desirable target pressure distribution is minimized by means of the adjoint method.

Findings
By virtue of a minimization algorithm, the specified target pressure distribution does not necessarily have to be fully realizable to drive the initial pressure distribution towards one with a favourable pressure gradient. The resulting optimized engine intake duct features a deceleration region, in a diverging channel, followed by an acceleration region, in a contracting channel, inhibiting flow separation on the compressor inlet plane.

Practical implications
The flow separation at the compressor inlet has been eliminated allowing proper installation of the engine and flight testing of the aircraft.

Originality/value
Placement and shaping of the intake duct of a turboshaft and turboprop gas turbine engine is a common industrial problem which can be challenging when the available space is limited. The inverse-by-optimization approach based on a reduced flow model, i.e. inviscid flow based on the Euler equations, and a specification of a simple target pressure distribution constitutes an efficient method to overcome the challenge.