bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of a Genetic Test for the Diagnosis of Hypolactasia in Chilean Children
Authors: Alliende Francisco , Vial Cecilia , Espinoza Karen , Schnettle Daniela , Romero Victoria , Miquel Isabel , Arancibia Maria E. , Rios Gloria , Rodriguez Lorena , Quesada Soledad , Lucero Yalda , Repetto Gabriela M. 
Published: April 2016

ABSTRACTBackground:Lactase nonpersistence (LNP) in humans is a genetically determined trait. This age‐dependent decrease of lactase expression is most frequently caused by single nucleotide polymorphisms in the regulatory region of the lactase (LCT) gene. The homozygous LCT‐13,910C/C genotype (rs 4988235) predominates in Caucasian adults with LNP, and is useful for its diagnosis in this population. The accuracy of this genetic test (GT) has not been completely established in children or in a Latin‐American population.Objectives:The aim of the study was to determine diagnostic accuracy of GT for LNP in Chilean children using the lactose breath test (BT) as a reference, and to compare diagnostic yield in preschool‐ (<6 years) and in school‐age (≥6 years) children.Methods:Children referred for BT for diagnosis of lactose malabsorption to the Gastroenterology Laboratory at Clínica Alemana, Santiago, from October 2011 to March 2012 were invited to participate. After informed consent, symptom questionnaires, both historic and post lactose ingestion were completed. H2 and CH4 in expired air and −13,910 C>T single nucleotide polymorphism by polymerase chain reaction, restriction enzyme analysis, and/or Sanger sequencing were determined. GT accuracy was calculated compared to BT as reference method. Diagnostic yield of GT in preschool‐ and school‐age children was compared.Results:Lactose malabsorption was detected by BT in 42 of 60 children (70%). Genotype −13,910C/C was identified in 41 of 60 patients (68%). GT showed 80% sensitivity, 63% specificity, and 74% accuracy for LNP in the preschool population. In school‐age children values were higher, 85%, 80%, and 84%, respectively.Conclusions:GT results were significantly concordant with BT results for hypolactasia detection in Chilean children, particularly in those of age 6 years and older.
Pneumatosis Coli in Complex Neurodisability
Authors: West Rebecca , Dass Dipanker , Mordekar Santosh , Campbell David , Lindley Richard 
Published: April 2016

ABSTRACTThis case series describes our experience in managing 4 children with complex neurodisability, feed intolerance, and pneumatosis coli. In all of the 4 patients, symptoms and feed tolerance were substantially improved by the formation of a laparoscopically assisted defunctioning ileostomy. We describe our present management strategy and believe this is a promising treatment for those patients who can reduce long‐term dependence on parenteral nutrition, although we acknowledge that there is a long‐term risk of disuse colitits in the defunctioned bowel.
Hepatitis E in Children
Authors: Fischler Björn , Baumann Ulrich , Dezsofi Antal , Hadzic Nedim , Hierro Loreto , Jahnel Jörg , McLin Valérie , Nobili Valerio , Smets Francoise , Verkade Henkjan , Debray Dominique 
Published: April 2016

ABSTRACTBackground:Hepatitis E virus (HEV) is endemic in large parts of the developing world. Waterborne transmission of genotypes 1 or 2 commonly causes acute hepatitis, which is usually self‐limited in healthy individuals. In addition, acute HEV infections also occur outside endemic areas, mostly related to foodborne transmission of HEV genotype 3. A growing number of publications in the last decade have reported chronic infection progressing to cirrhosis in immunosuppressed patients. It has also been suggested that HEV transmission may occur via contaminated blood products. This publication aims to provide recommendations for diagnosis, prevention, and treatment of HEV infection, particularly in children after solid organ transplantation.Methods:A systematic PubMed literature search on HEV infection from 1990 to January 2016 was performed focusing on pediatric studies. The existing body of evidence was reviewed and recommendations were agreed upon following discussion and unanimous agreement by all members of the ESPGHAN Hepatology Committee during a consensus meeting in January 2016. In the absence of randomized controlled studies these recommendations were considered to be expert opinions.Key Recommendations:Immunocompetent children with increased transaminases and/or extrahepatic manifestations should be considered for testing for evidence of HEV infection. Immunocompromised children with increased aminotransferases should be repeatedly tested for HEV and may require therapeutic intervention.
The Relationship Between Inflammatory Biomarkers and Symptom Distress in Lung Cancer Patients Undergoing Chemotherapy
Authors: Chou Hsiu-Ling , Chao Tsu-Yi , Chen Tsan-Chi , Chu Chi-Ming , Hsieh Chen-Hsi , Yao Chung-Tay , Janckila Anthony J. 
Published: April 2016

Background:
Symptom distress often occurs in lung cancer patients undergoing chemotherapy. However, a biomarker has not been identified to reflect the severity of their symptom distress.

Objective:
The aim of this study was to investigate the relationship between symptom distress and serum inflammatory biomarkers in lung cancer patients undergoing chemotherapy.

Methods:
A longitudinal, repeated-measures design was used to assess subjective symptoms (fatigue, sleep disturbance, pain, depression, and confusion), serum biomarkers (tartrate-resistant acid phosphatase 5a [TRACP5a], interleukin 6 [IL-6], IL-8, and C-reactive protein), and white blood cells in 62 lung cancer patients recruited from a single medical center at 3 time points: T1 was the baseline, T2 was the eighth day after the first chemotherapy cycle, and T3 was prior to the second cycle. Symptom distress was measured individually by 5 questionnaires (General Fatigue Scale, Pittsburgh Sleep Quality Index, Brief Pain Inventory, Profile of Mood States–Depressive, and Confusion).

Results:
The trend of TRACP5a was positively correlated to the trend of the patients’ symptom distress. However, the trends of IL-6 and IL-8 did not correlate.

Conclusions:
Serum TRACP5a was associated with symptom distress in lung cancer patients. Therefore, TRACP5a might be a potential biomarker to assess symptom distress of lung cancer patients undergoing chemotherapy.

Implications for Practice:
Oncology nurses may be able to apply TRACP5a expression to predict or monitor multiple distress symptoms in lung cancer patients undergoing chemotherapy. Furthermore, nurses can use these study findings to better understand the patients who need more attention to improve their quality of life.
Implementation of a Ventilator-Associated Pneumonia Prevention Bundle in a Single PICU*
Authors: De Cristofano Analía , Peuchot Verónica , Canepari Andrea , Franco Victoria , Perez Augusto , Eulmesekian Pablo 
Published: April 2016

Objective:
Ventilator-associated pneumonia is considered the second most frequent infection in pediatric intensive care, and there is agreement on its association with higher morbidity and increased healthcare costs. The goal of this study was to apply a bundle for ventilator-associated pneumonia prevention as a process for quality improvement in the PICU of Hospital Italiano de Buenos Aires, Argentina, aiming to decrease baseline ventilator-associated pneumonia rate by 25% every 6 months over a period of 2 years.

Design:
Quasi-experimental uninterrupted time series.

Setting:
PICU of Hospital Italiano de Buenos Aires, Argentina.

Patients:
All mechanical ventilated patients admitted to the unit.

Intervention:
It consisted of the implementation of an evidence-based ventilator-associated pneumonia prevention bundle adapted to our unit and using the plan-do-study-act cycle as a strategy for quality improvement. The bundle consisted of four main components: head of the bed raised more than 30°, oral hygiene with chlorhexidine, a clean and dry ventilator circuit, and daily interruption of sedation.

Measurements and Main Results:
Ventilator-associated pneumonia prevention team meetings started in March 2012, and the ventilator-associated pneumonia bundle was implemented in November 2012 after it had been developed and made operational. Baseline ventilator-associated pneumonia rate for the 2 years before intervention was 6.3 episodes every 1,000 mechanical ventilation days. ventilator-associated pneumonia rate evolution by semester and during the 2 years was, respectively, 5.7, 3.2, 1.8, and 0.0 episodes every 1,000 mechanical ventilation days. Monthly ventilator-associated pneumonia rate time series summarized in a 51-point control chart showed the presence of special cause variability after intervention was implemented.

Conclusions:
The implementation over 2 years of a ventilator-associated pneumonia prevention bundle specifically adapted to our unit using quality improvement tools was associated with a reduction in ventilator-associated pneumonia rate of 25% every 6 months and a nil rate in the last semester.
Perforator Mapping and Optimizing Design of the Lateral Arm Flap: Anatomy Revisited and Clinical Experience
Authors: Chang Edward I. , Ibrahim Amir , Papazian Nazareth , Jurgus Abdo , Nguyen Alexander T. , Suami Hiroo , Yu Peirong 
Published: April 2016

Background:
The lateral arm flap remains an underused flap, especially as a free flap. In this article, the authors describe the perforator anatomy to optimize flap design and harvest.

Methods:
Perforator locations were mapped in 12 cadavers (24 arms), and a retrospective review was conducted of 51 patients undergoing lateral arm flap surgery.

Results:
One to three reliable perforators supply the lateral arm flap. Based on cadaveric dissections, from the deltoid insertion, the A, B, and C perforators were located at 7.2 ± 1.0 cm, 9.9 ± 1.2 cm, and 11.8 ± 0.8 cm, which was 0.44, 0.61, and 0.72 of the distance from the deltoid insertion, respectively. The average pedicle length was 7.0 ± 1.1 cm. The cadavers were entirely symmetric in the number and location of the perforators between the right and left arms. All 51 patients (24 male and 27 female patients) had at least one perforator with an average pedicle length of 7.0 ± 1.3 cm, an average arterial diameter of 1.7 ± 0.3 mm, and a vein diameter of 2.5 ± 0.5 mm. All but one flap was performed as a free flap for head and neck reconstruction, with one pedicled flap for shoulder reconstruction. The average flap size was 72.2 ± 37.1 cm2 (range, 21 to 165 cm2). The nondominant arm was used for all free flaps. There were no total or partial flap losses. Twenty-eight patients reported donor-site numbness, with one infection, one hematoma, and one wound dehiscence.

Conclusion:
The lateral arm flap can be harvested reliably based on well-defined perforators and anatomical landmarks with minimal donor-site morbidity and should be included among the techniques used by reconstructive microsurgeons.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Diagnosis and Disclosure of HIV Status: Implications for Women's Risk of Physical Partner Violence in the Postpartum Period
Authors: Maman Suzanne , Groves Allison K. , McNaughton Reyes H. Luz , Moodley Dhayendre 
Published: April 2016

Introduction:
This study prospectively examined whether HIV leads to elevated risk for intimate partner violence (IPV) for women and how this risk varies depending on HIV status disclosure to a partner.

Methods:
We ran a series of logistic regression models using data from 1092 pregnant and postpartum women enrolled in an RCT in Durban, South Africa. Model 1 assessed whether baseline HIV status predicted 14-week postpartum physical IPV, controlling for baseline physical IPV, disclosure to partner, and demographic and study covariates. Model 2 added the interaction between HIV status and disclosure.

Results:
HIV was not associated with 14-week physical IPV in the main effects model [adjusted odds ratio: 1.34, 95% confidence interval (CI): 0.88 to 2.05]. However, there was a statistically significant positive interaction between HIV and disclosure (adjusted odds ratio: 0.22, 95% CI: 0.05 to 0.96). Among women who disclosed their HIV status, HIV was not significantly associated with 14-week IPV (adjusted odds ratio: 1.12, 95% CI: 0.71 to 1.89). However, among women who had not disclosed, the odds of reporting IPV at 14 weeks was 5.15 times higher for HIV-positive women as compared with HIV-negative women (95% CI: 1.25 to 21.00).

Discussion:
Although we established that HIV does not increase incidence of IPV for all HIV-positive women, we found an elevated risk of IPV among the HIV-positive women who chose not to disclose their status to their partner. Nondisclosure is likely a marker for other problematic aspects of the relationship, and counselors should either find alternative safe options for disclosure or support women's decisions not to disclose.
Impact of Peer Support on Behavior Change Among Newly Diagnosed Australian Gay Men
Authors: Prestage Garrett , Brown Graham , Allan Brent , Ellard Jeanne , Down Ian 
Published: April 2016

Introduction:
Treatment as prevention relies on early uptake of HIV treatment, but onward transmission during primary HIV infection may be affected by changes in sexual risk behavior after diagnosis. What factors are associated with these changes in sexual risk behavior among gay and bisexual men?

Methods:
We surveyed gay and bisexual men recently diagnosed with HIV about changes to their sexual behavior since their diagnosis. In 2008–2010, 263 men described their sexual behavior during the 4 weeks before, and during the 4 weeks after, their HIV diagnosis. In 2010–2015, 301 men reported how they had changed their sexual behavior since their HIV diagnosis.

Results:
During 2008–2010, 26.6% engaged in condomless anal intercourse with non–HIV-positive casual partners during the 4 weeks before diagnosis, and 9.7% did so during the 4 weeks after diagnosis (P < 0.001). Only peer support from other people with HIV was associated with this change in behavior (OR = 1.42; 95% confidence interval = 1.07 to 1.88; P = 0.014). Peer support was also associated with partner reduction after diagnosis (P = 0.010). During 2010–2015, 31.9% reported that they had increasingly disclosed their HIV status to sex partners since their diagnosis, and 74.1% reported having reduced the number of men with whom they had sex. Peer support was associated with both these changes in behavior (P = 0.003 and P = 0.015, respectively).

Conclusions:
The risk of onward transmission is likely to be less affected by immediate versus early treatment than it is by earlier diagnosis and peer support for those newly diagnosed with HIV. Enhanced peer support may further reduce the likelihood of onward transmission after diagnosis.
High-Dose Naltrexone Treatment and Gender in Alcohol Dependence
Authors: Yoon Gihyun , Kim Suck Won , Petrakis Ismene Leonida , Westermeyer Joseph 
Published: April 2016

Objectives
Little is known about whether safety and effectiveness of high-dose naltrexone (150 mg/d) are different in alcohol-dependent women and men. This study investigated sex differences in safety and treatment outcomes in alcohol-dependent women and men on high-dose naltrexone (150 mg/d).

Methods
In this exploratory study, safety and effectiveness of high-dose naltrexone (150 mg/d) were examined in men and women with alcohol dependence (n = 24; 11 men and 13 women) treated in an 8-week outpatient setting.

Results
Women and men had similar dropout rates, adverse effects, tolerability, and hepatic function during high-dose naltrexone treatment (150 mg/d). Drinking outcomes were significantly improved in both women and men, but no sex differences were found.

Conclusions
High-dose naltrexone seems to be well tolerated, safe, and effective in both men and women with alcohol dependence in this small study. Given the small sample size of the current study, our results cannot be considered definitive, and larger trials with longer durations are needed to confirm these findings.
Development of prokaryotic cell-free systems for synthetic biology
Authors: Chiao Abel C. , Murray Richard M. , Sun Zachary Z 
Published: April 2016

ABSTRACTProkaryotic cell-free systems are currently heavily used for the production of protein that can be otherwise challenging to produce in cells. However, historically cell-free systems were used to explore natural phenomena before the advent of genetic modification and transformation technology. Recently, synthetic biology has seen a resurgence of this historical use of cell-free systems as a prototyping tool of synthetic and natural genetic circuits. For these cell-free systems to be effective prototyping tools, an understanding of cell-free system mechanics must be established that is not purely protein-expression driven. Here we discuss the development ofE. coli-based cell-free systems, with an emphasis on documenting published extract and energy preparation methods into a uniform format. We also discuss additional considerations when applying cell-free systems to synthetic biology.
Levels and patterns of genetic diversity differ between two closely related endemicArabidopsisspecies
Authors: Jacquemin Julie , Hohmann Nora , Buti Matteo , Selvaggi Alberto , Müller Thomas , Koch Marcus A. , Schmid Karl J. 
Published: April 2016

AbstractTheory predicts that a small effective population size leads to slower accumulation of mutations, increased levels of genetic drift and reduction in the efficiency of natural selection. Therefore endemic species should harbor low levels of genetic diversity and exhibit a reduced ability of adaptation to environmental changes.Arabidopsis pedemontanaandArabidopsis cebennensis, two endemic species from Italy and France respectively, provide an excellent model to study the adaptive potential of species with small distribution ranges. To evaluate the genome-wide levels and patterns of genetic variation, effective population size and demographic history of both species, we genotyped 53A. pedemontanaand 28A. cebennensisindividuals across the entire species ranges with Genotyping-by-Sequencing. SNPs data confirmed a low genetic diversity forA. pedemontanaalthough its effective population size is relatively high. Only a weak population structure was observed over the small distribution range ofA. pedemontana, resulting from an isolation-by-distance pattern of gene flow. In contrary,A. cebennensisindividuals clustered in three populations according to their geographic distribution. Despite this and a larger distribution, the overall genetic diversity was even lower forA. cebennensisthan forA. pedemontana.A demographic analysis demonstrated that both endemics have undergone a strong population size decline in the past, without recovery. The more drastic decline observed inA. cebennensispartially explains the very small effective population size observed in the present population. In light of these results, we discuss the adaptive potential of these endemic species in the context of rapid climate change.
Adaptation-induced blindness is orientation-tuned and monocular
Authors: Apthorp Deborah , Griffiths Scott , Alais David , Cass John 
Published: April 2016

AbstractWe examined the recently discovered phenomenon of Adaptation-Induced Blindness (AIB), in which highly visible gratings with gradual onset profiles become invisible after exposure to a rapidly flickering grating, even at very high contrasts. Using very similar stimuli to those in the original AIB experiment, we replicated the original effect across multiple contrast levels, with observers at chance in detecting the gradual onset stimuli at all contrasts. Then, using full-contrast target stimuli with either abrupt or gradual onsets, we tested both the orientation tuning and interocular transfer of AIB. If, as the original authors suggested, AIB were a high-level (perhaps parietally mediated) effect resulting from the ‘gating’ of awareness, we would not expect the effects of AIB to be tuned to the adapting orientation, and the effect should transfer interocularly. Instead, we find that AIB (which was present only for the gradual onset target stimuli) is both tightly orientation-tuned and shows absolutely no interocular transfer, suggesting a very early cortical locus.
On the importance of skewed offspring distributions and background selection in viral population genetics
Authors: Irwin Kristen K. , Laurent Stefan , Matuszewski Sebastian , Vuilleumier Séverine , Ormond Louise , Shim Hyunjin , Bank Claudia , Jensen Jeffrey D. 
Published: April 2016

AbstractMany features of virus populations make them excellent candidates for population genetic study, including a very high rate of mutation, high levels of nucleotide diversity, exceptionally large census population sizes, and frequent positive selection. However, these attributes also mean that special care must be taken in population genetic inference. For example, highly skewed offspring distributions, frequent and severe population bottleneck events associated with infection and compartmentalization, and strong purifying selection all affect the distribution of genetic variation but are often not taken in to account. Here, we draw particular attention to multiple-merger coalescent events and background selection, discuss potential mis-inference associated with these processes, and highlight potential avenues for better incorporating them in to future population genetic analyses.
Testing the impact of career motivation on knowledge gained versus skills learned for a sample of personal/home care aide trainees
Authors: Blau Gary , Chapman Susan A. , Neri Melinda 
Published: April 2016

Purpose
– The purpose of this paper is to distinguish knowledge gained vs skills learned as two learning-related training criteria; and to then test the impact of two career motivation variables, home care intent and stepping stone, for explaining these training criteria beyond controlled-for variables.

Design/methodology/approach
– The research used a sample of 720 personal/home care aides (P/HCAs) who filled out pre-training and post-training surveys. Training consisted of 25 modules, lasting approximately 100 hours on various P/HCA knowledge bases, with training sessions generally five to six hours/day, four to five days/week over a three to four week period. Factor analyses, correlation, and hierarchical regression analyses were used to test the hypotheses.

Findings
– Results showed that these two learning outcomes, knowledge gained vs skills learned, could be differentiated and reliably measured. Subsequent hierarchical regression analyses showed additional discriminant validity for these two learning outcomes. For the two measured career motivation variables, home care intent and stepping stone, home care intent was positively related to both learning outcomes but stepping stone only had a significant positive impact on skills learned. Training delivery was significantly related only to knowledge gained, while instructor rating was significantly related only to skills learned.

Originality/value
– A unique sample of P/HCA trainees was utilized to test for this previously untested learning outcome distinction. As the population ages and demand increases for P/HCAs, additional training and studies evaluating such training will be needed.