bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Noninvasive Neurally Adjusted Ventilatory Assist Versus Noninvasive Flow-Triggered Pressure Support Ventilation in Pediatric Acute Respiratory Failure: A Physiologic Randomized Controlled Trial*
Authors: Chidini Giovanna , De Luca Daniele , Conti Giorgio , Pelosi Paolo , Nava Stefano , Calderini Edoardo 
Published: October 2016

Objective:
Neurally adjusted ventilatory assist has been shown to improve patient-ventilator interaction in children with acute respiratory failure. Objective of this study was to compare the effect of noninvasive neurally adjusted ventilatory assist versus noninvasive flow-triggered pressure support on patient-ventilator interaction in children with acute respiratory failure, when delivered as a first-line respiratory support.

Design:
Prospective randomized crossover physiologic study.

Setting:
Pediatric six-bed third-level PICU.

Patients:
Eighteen children with acute respiratory failure needing noninvasive ventilation were enrolled at PICU admission.

Interventions:
Enrolled children were allocated to receive two 60-minutes noninvasive flow-triggered pressure support and noninvasive neurally adjusted ventilatory assist trials in a crossover randomized sequence.

Measurements and Main Results:
Primary endpoint was the asynchrony index. Parameters describing patient-ventilator interaction and gas exchange were also considered as secondary endpoints. Noninvasive neurally adjusted ventilatory assist compared to noninvasive flow-triggered pressure support: 1) reduced asynchrony index (p = 0.001) and the number of asynchronies per minute for each type of asynchrony; 2) it increased the neuroventilatory efficiency index (p = 0.001), suggesting better neuroventilatory coupling; 3) reduced inspiratory and expiratory delay times (p = 0.001) as well as lower peak and mean airway pressure (p = 0.006 and p = 0.038, respectively); 4) lowered oxygenation index (p = 0.043). No adverse event was reported.

Conclusions:
In children with mild early acute respiratory failure, noninvasive neurally adjusted ventilatory assist was feasible and safe. Noninvasive neurally adjusted ventilatory assist compared to noninvasive flow-triggered pressure support improved patient-ventilator interaction.
The Utility of Brain Natriuretic Peptide in Pediatric Cardiology: A Review
Authors: Neves Ana L. , Henriques-Coelho Tiago , Leite-Moreira Adelino , Areias José C. 
Published: October 2016

Objective:
The aim of this article is to evaluate the clinical utility of brain natriuretic peptide in pediatric patients, examining the diagnostic value, management, and prognostic relevance, by critical assessment of the literature.

Data Sources:
In December 2015, a literature search was performed (PubMed access to MEDLINE citations; http://www.ncbi.nlm.nih.gov/PubMed/) and included these Medical Subject Headings and text terms for the key words: “brain natriuretic peptide,” “amino-terminal pro-brain natriuretic peptide,” “children,” “neonate/s,” “newborn/s,” “infant/s,” and “echocardiography.”

Study Selection:
Each article title and abstract was screened to identify relevant studies. The search strategy was limited to published studies in English language concerning brain natriuretic peptide/amino-terminal pro-brain natriuretic peptide in pediatric patients.

Data Extraction:
Data on age, gender, type of clinical condition, brain natriuretic peptide assay method, cardiac function variables evaluated by echocardiography, and prognosis were extracted.

Data Synthesis:
Brain natriuretic peptide reference values in healthy newborns, infants, and children are presented. Brain natriuretic peptide diagnostic accuracy in newborns, infants, and children suspected to have congenital heart defects is discussed, and brain natriuretic peptide prognostic value reviewed. The data suggest that the determination of brain natriuretic peptide levels improves the diagnostic accuracy in the assessment of heart disease in the pediatric population. Brain natriuretic peptide assay may increase the accuracy of neonatal screening programs for diagnosing congenital heart defects. Echocardiographic variables correlated to brain natriuretic peptide levels. Additionally, brain natriuretic peptide levels predicted adverse outcomes in the postoperative period.

Conclusions:
Brain natriuretic peptide assessment is a reliable test to diagnose significant structural or functional cardiovascular disease in children. In the integrated follow-up of these cases, several physiologic and clinical variables must be considered; brain natriuretic peptide may be an additional helpful marker. Nevertheless, larger prospective studies are warranted to elucidate the true prognostic value of brain natriuretic peptide in pediatric patients.
Cervical Spine Injuries in Children Associated With Sports and Recreational Activities
Authors: Babcock Lynn , Olsen Cody S. , Jaffe David M. , Leonard Julie C. 
Published: October 2016

Objective
The aim of this study was to ascertain potential factors associated with cervical spine injuries in children injured during sports and recreational activities.

Methods
This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography. Cases had cervical spine injury from sports or recreational activities (n = 179). Comparison groups sustained (1) cervical spine injury from other mechanisms (n = 361) or (2) other injuries from sports and recreational activities but were free of cervical spine injury (n = 180).

Results
For children with sport and recreational activity–related cervical spine injuries, common injury patterns were subaxial (49%) and fractures (56%). These children were at increased odds of spinal cord injury without radiographic abnormalities compared with children with cervical spine injuries from other mechanisms (25% vs 6%). Children with sport and recreational activity–related trauma had increased odds of cervical spine injury if they had focal neurologic findings (odds ratio [OR], 5.7; 95% confidence interval [CI], 3.5–9.4), had complaints of neck pain (OR, 3.1; 95% CI, 1.9–5.0), were injured diving (OR, 43.5; 95% CI, 5.9–321.3), or sustained axial loading impacts (OR, 2.2; 95% CI, 1.3–3.5). Football (22%), diving (20%), and bicycle crashes (11%) were the leading activities associated with cervical spine injury.

Conclusions
In children injured during sports and recreational activities, focal neurologic findings, neck pain, axial loading impacts, and the possibility of spinal cord injury without radiographic abnormality should guide the diagnostic evaluation for potential cervical spine injuries. Certain activities have a considerable frequency of cervical spine injury, which may benefit from activity-specific preventive measures.
Association of Delay in Appendectomy With Perforation in Children With Appendicitis
Authors: Meltzer James A. , Kunkov Sergey , Chao Jennifer H. , Tay Ee Tein , George Jerry P. , Borukhov David , Alerhand Stephen , Harrison Prince A. , Hom Jeffrey , Crain Ellen F. 
Published: October 2016

Objective
The aim of this study was to assess whether increased time from emergency department (ED) triage to appendectomy is associated with a greater risk of children developing appendiceal perforation.

Methods
We performed a multicenter retrospective cohort study of children younger than 18 years hospitalized with appendicitis. To avoid enrolling patients who had perforated prior to ED arrival, we included only children who had a computed tomography (CT) scan demonstrating nonperforated appendicitis. Time to appendectomy was measured as time from ED triage to incision. The main outcome was appendiceal perforation as documented in the surgical report. Variables associated with perforation in bivariate analysis (P < 0.05) were adjusted for using logistic regression.

Results
Overall, 857 patients had a CT scan that demonstrated nonperforated appendicitis. The median age was 12 years (interquartile range, 9–15 years), and 500 (58%) were male. The median time to appendectomy was 11 hours (interquartile range, 8–15 hours). In total, 111 patients (13%) had perforated appendicitis at operation. Children who developed perforation were more likely to require additional CT scans and return to the ED and had a significantly longer length of stay. After adjusting for potential confounders, every hour increase in the time from ED triage to incision was independently associated with a 2% increase in the odds of perforation (P = 0.03; adjusted odds ratio, 1.02; 95% confidence interval, 1.00–1.04).

Conclusions
Delays in appendectomy were associated with an increase in the odds of perforation. These results suggest that prolonged delays to appendectomy might be harmful for children with appendicitis and should be minimized to prevent associated morbidity.
Distance to the Pediatric Emergency Department and Nonurgent Visits in Friuli Venezia Giulia, Italy
Authors: Valent Francesca , Busolin Anna 
Published: October 2016

Objectives
Our objective was to assess how the distance from home to the closest pediatric emergency department (ED) affects nonurgent emergency room visits among the child population of the Northeastern Italian region of Friuli Venezia Giulia.

Methods
The study was based on the administrative databases of the Regional Health Information System of Friuli Venezia Giulia. For the year 2014, we abstracted the records of all white-triage–tag visits of children younger than 16 years from the databases of the 3 regional pediatric EDs located in the 3 main cities. Those records were individually linked to the regional population's georeferenced address database through an anonymous univocal identifier. For each child younger than 16 years living within 20 km from an ED, we calculated the linear distance between the ED and home address. Distances were grouped into 7 circular distance bands: less than 2, 2 to 4, 4 to 6, 6 to 8, 8 to 10, 10 to 15, and 15 to 20 km. Within each band, we calculated the rate of ED visits during the year.

Results
In 2014, there were 12,055 white-triage–tag visits accounting for 24.7% of all visits in the regional pediatric EDs. Although the overall rate of ED visits was different among the EDs, it decreased significantly with increasing distance to the ED, with a 6-fold difference between the innermost and the outermost bands.

Conclusions
In Friuli Venezia Giulia, short distance is a prompter for inappropriate pediatric ED attendance. Further research is needed in this region to understand the parental standpoint to implement strategies promoting uniform behaviors within the regional boundaries.
Complete Recovery After Acute Zonisamide Overdose in an Adolescent Female
Authors: McStay Charlayne , Pierce Richard , Riley Carley 
Published: October 2016

Abstract
Zonisamide is a sulfonamide drug used primarily for the treatment of partial seizures in adults. We describe the case of a 15-year-old woman with a mood disorder who survived without complications after ingestion of an estimated 7.5 g of zonisamide. To the best of our knowledge, there are 4 case reports of individuals with intentional ingestion of more than 4 g of zonisamide as a single agent. Our patient developed coma and hypotension 4 hours after ingestion and was treated with a catecholamine infusion, endotracheal intubation, and mechanical ventilation. She had mild electrocardiographic abnormalities and fully recovered after 4 days. This report contributes to the understanding of acute zonisamide poisoning.
Delayed Salicylate Toxicity in a 17-Year-Old Girl With Initially Undetectable Salicylate Concentration 3.9 Hours After Ingestion
Authors: Beauchamp Gillian A. , Hendrickson Robert G. 
Published: October 2016

Abstract
We report the case of a 17-year-old girl with a 126-mg/kg nonenteric coated aspirin ingestion with nontoxic salicylate concentrations at 1.5 and 3.9 hours postingestion, who developed tinnitus and vomiting an estimated 8 hours postingestion, and who was subsequently found to have a toxic salicylate concentration at 22.7 hours postingestion. This case, as well as previous cases of delayed aspirin therapy, may prompt providers to consider educating patients and their care providers regarding the need to return for further testing if symptoms, such as vomiting or tinnitus, develop after an aspirin ingestion.
Gastric Perforation After a Dog Attack
Authors: Uchino Hayaki , Kuriyama Akira , Bruce John , Laing Grant , Clarke Damian , Oosthuizen George 
Published: October 2016

AbstractDog bites are a major cause of injury, especially in the pediatric population. Common anatomic sites of dog bites on children are the peripheries and the head and neck. The torso is reportedly injured less frequently, and only 2 cases of intra-abdominal injury secondary to dog bites have been reported. We recently encountered a 3-year-old boy presenting with peritonitis who had sustained multiple dog bites to his trunk and upper limbs. Emergency laparotomy was performed. Surgical findings revealed penetration of the peritoneum and single perforation of the anterior gastric wall with multiple tooth marks; thus, the gastric perforation was debrided and repaired. After receiving rabies prophylaxis and amoxicillin-clavulanate, the patient had an uneventful postoperative course. The principles of management of dog bites include debridement of wounds and use of prophylactic antibiotics. Because rabies is always fatal, postexposure prophylaxis should be considered in appropriate cases. Dog bites can be life-threatening, and prevention is the best approach to solve this problem. Clinicians need to be aware that some dog bites can be devastating and should be familiar with the principles of managing these wounds.
Dimensions of Socioeconomic Status and Childhood Asthma Outcomes: Evidence for Distinct Behavioral and Biological Associations
Authors: Chen Edith , Shalowitz Madeleine U. , Story Rachel E. , Ehrlich Katherine B. , Levine Cynthia S. , Hayen Robin , Leigh Adam K.K. , Miller Gregory E. 
Published: October 2016

ABSTRACT

Objectives
The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)—prestige and resources—and their associations with immune, behavioral, and clinical outcomes in childhood asthma.

Methods
Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation.

Results
Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to .27|, p values < .05). Higher prestige, but not resources, was associated with better home environment control behaviors and less exposure to smoke (β's from |.21 to .22|, p values < .05). Higher resources, but not prestige, was associated with more favorable immune regulation, as manifest in smaller peripheral blood mononuclear cell (PBMC) TH1 and TH2 cytokine responses (β's from −.18 to −.19; p values < .05), and smaller proinflammatory cytokine responses (β = −.19; p < .05) after ex vivo stimulation. Higher resources also were associated with more sensitivity to glucocorticoid inhibition of TH1 and TH2 cytokine production (β's from −.18 to −.22; p values < .05).

Conclusions
These results suggest that prestige and resources in childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.
Associations Between Psychological Constructs and Cardiac Biomarkers After Acute Coronary Syndrome
Authors: Celano Christopher M. , Beale Eleanor E. , Beach Scott R. , Belcher Arianna M. , Suarez Laura , Motiwala Shweta R. , Gandhi Parul U. , Gaggin Hanna , Januzzi James L. , Healy Brian C. , Huffman Jeff C. 
Published: October 2016

ABSTRACT

Objective
Psychological constructs are associated with cardiovascular health, but the biological mechanisms mediating these relationships are unknown. We examined relationships between psychological constructs and markers of inflammation, endothelial function, and myocardial strain in a cohort of post–acute coronary syndrome (ACS) patients.

Methods
Participants (N = 164) attended study visits 2 weeks and 6 months after ACS. During these visits, they completed self-report measures of depressive symptoms, anxiety, optimism, and gratitude; and blood samples were collected for measurement of biomarkers reflecting inflammation, endothelial function, and myocardial strain. Generalized estimating equations and linear regression analyses were performed to examine concurrent and prospective relationships between psychological constructs and biomarkers.

Results
In concurrent analyses, depressive symptoms were associated with elevated markers of inflammation (interleukin-17: β = .047; 95% confidence interval [CI] = .010–.083]), endothelial dysfunction (endothelin-1: β = .020; 95% [CI] = .004–.037]), and myocardial strain (N-terminal pro-B-type natriuretic peptide: β = .045; 95% [CI] = .008–.083]), independent of age, sex, medical variables, and anxiety, whereas anxiety was not associated with these markers in multivariable adjusted models. Optimism and gratitude were associated with lower levels of markers of endothelial dysfunction (endothelin-1: gratitude: β = −.009; 95% [CI] = −.017 to − .001]; optimism: β = −.009; 95% [CI] = −.016 to − .001]; soluble intercellular adhesion molecule-1: gratitude: β = −.007; 95% [CI] = −.014 to − .000]), independent of depressive and anxiety symptoms. Psychological constructs at 2 weeks were not prospectively associated with biomarkers at 6 months.

Conclusions
Depressive symptoms were associated with more inflammation, myocardial strain, and endothelial dysfunction in the 6 months after ACS, whereas positive psychological constructs were linked to better endothelial function. Larger prospective studies may clarify the directionality of these relationships.

Clinical Trial Registration
Clinicaltrials.gov identifier NCT01709669
Neolithic super-grandfather Y haplotypes, their related surnames, and autism spectrum disorder
Authors: He Pei , Chen Na , Hu Zhengmao , Zhu Zuobin , Xia Kun , Huang Shi 
Published: October 2016

AbstractRecent studies found three Neolithic super-grandfather Y haplotypes among Han Chinese, consistent with the legend of Yan and Huang Emperors. Individuals of royal and noble ancestry or high social economic status (SES) are known to practice assortative mating and consanguineous marriages, which can produce offspring of both higher and lower than average fitness. However, the roles of the super-grandfather Y haplotypes and their descendant lines in history, fitness, and the male biased autism spectrum disorder (ASD) remain unknown. Here we show a link between the super-grandfathers and the legend ofYan-HuangEmperors and between their descendant haplotypes and ASD. We found that subjects carrying the O3a1c and O3a2c1a super-grandfather haplotypes were enriched withYanandHuangrelated surnames, respectively, in two independent datasets of 1564 and 772 male Han subjects. We identified high and low SES descendant haplotypes of the super-grandfathers using the Han dataset of the 1000 genomes project based on two criteria: more descendant branches and fewer mutations before star-like expansions. By genotyping 505 fathers of ASD affected male children from the Autism Clinical and Genetic Resources in China with surnames either closely related to Huang (Ying group) or less related (Ji group), we found the high SES haplotypes within the O3a2c1a clade at ∼2 fold lower (odds ratio 2.05, 95% CI 1.28-3.26, P=0.0026) while the low SES haplotypes at ∼2 fold higher frequency (odds ratio 1.92, 95% CI 1.01-3.64, P = 0.046) in the fathers relative to 505 normal subjects. The fraction of low SES haplotypes was greater than that of high SES in ASD fathers of the Ying group, in contrast to Ying controls or the Ji fathers and Ji controls. Consistently, analysis of 2366 ASD affected children showed higher male to female ratio for Ying versus Ji group (6.52 +/-1.11 v 4.59 +/-0.41, P = 0.028, one tailed). These results provide evidence for the Yan-Huang legend and suggest a role for Y in ASD.
Heterogeneity of single-cell mechanical responses to tumorigenic factors
Authors: Leal-Egaña Aldo , Letort Gaelle , Martiel Jean-Louis , Christ Andreas , Vignaud Timothée , Roelants Caroline , Filhol Odile , Théry Manuel 
Published: October 2016

AbstractTumor development progresses through a complex path of biomechanical changes leading first to cell growth and contraction followed by cell de-adhesion, scattering and invasion. Tumorigenic factors may act specifically on one of these steps or have wider spectrum of actions, leading to a variety of effects and thus sometimes to apparent contradictory outcomes. Here we used micropatterned lines of collagen type-I/fibronectin on deformable surfaces to standardize cell behavior and to measure simultaneously cell size, speed of motion and the magnitude of the associated contractile forces at the level of a single cell. We analyzed and compared normal human breast cell line MCF10A in control conditions and in response to various tumorigenic factors. In all conditions, distinct populations of cells with a wide range of biomechanical properties were identified. Despite this heterogeneity, normal and transformed motile cells followed a common trend whereby size and contractile forces were negatively correlated with cell speed. Some tumorigenic factors, such as activation of ErbB2 or the loss of the beta subunit of casein kinase 2 (CK2), shifted the whole population towards a faster speed and lower contractility state. Treatment with transforming growth factor beta (TGF-β), induced some cells to adopt opposing behaviors such as extreme high contractility versus extreme low contractility. Thus, tumor transformation amplified the pre-existing population heterogeneity and led some cells to exhibit biomechanical properties that were more extreme than that observed with normal cells.