bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Response Team activation for pediatric patients on the acute pain service
Authors: Teets Maxwell , Tumin Dmitry , Walia Hina , Stevens Jenna , Wrona Sharon , Martin David , Bhalla Tarun , Tobias Joseph D. 
Published: October 2017

SummaryIntroductionUntreated pain or overly aggressive pain management may lead to adverse physiologic consequences and activation of the hospital's Rapid Response Team. This study is a quality improvement initiative that attempts to identify patient demographics and patterns associated with Rapid Response Team consultations for patients on the acute pain service.MethodsA retrospective review of all patients on the acute pain service from February 2011 until June 2015 was cross‐referenced with inpatients requiring consultation from the Rapid Response Team. Two independent practitioners reviewed electronic medical records to determine which events were likely associated with pain management interventions.ResultsOver a 4‐year period, 4872 patients were admitted to the acute pain service of whom 135 unique patients required Rapid Response Team consults. There were 159 unique Rapid Response Team activations among 6538 unique acute pain service consults. A subset of 27 pain management‐related Rapid Response Team consultations was identified. The largest percentage of patients on the acute pain service were adolescents aged 12‐17 (36%). Compared to this age group, the odds of Rapid Response Team activation were higher among infants <1 year old (odds ratio = 2.85; 95% confidence interval: 1.59, 5.10; P < .001) and adults over 18 years (odds ratio = 1.68; 95% confidence interval: 1.01, 2.80; P = .046).DiscussionIdentifying demographics and etiologies of acute pain service patients requiring Rapid Response Team consultations may help to identify patients at risk for clinical decompensation.
Pharmacokinetics of S‐ketamine during prolonged sedation at the pediatric intensive care unit
Authors: Flint Robert B. , Brouwer Carole N. M. , Kränzlin Anne S. C. , Lie‐A‐Huen Loraine , Bos Albert P. , Mathôt Ron A. A. 
Published: October 2017

SummaryBackgroundS‐ketamine is the S(+)‐enantiomer of the racemic mixture ketamine, an anesthetic drug providing both sedation and analgesia. In clinical practice, significant interpatient variability in drug effect of S‐ketamine is observed during long‐term sedation.AimsThe aim of this study was to evaluate the pharmacokinetic variability of S‐ketamine in children aged 0‐18 years during long‐term sedation. Twenty‐five children (median age: 0.42 years, range: 0.02‐12.5) received continuous intravenous administrations of 0.3‐3.6 mg/kg/h S‐ketamine for sedation during mechanical ventilation. Infusion rates were adjusted to the desired level of sedation and analgesia based on the COMFORT‐B score and Visual Analog Scale. Blood samples were drawn once daily at random time‐points, and at 1 and 4 hours after discontinuation of S‐ketamine infusion. Time profiles of plasma concentrations of S‐ketamine and active metabolite S‐norketamine were analyzed using nonlinear mixed‐effects modeling software. Clearance and volume of distribution were allometrically scaled using the ¾ power model.ResultsA total of 86 blood samples were collected. A 2‐compartment and 1‐compartment model adequately described the PK of S‐ketamine and S‐norketamine, respectively. The typical parameter estimates for clearance and central and peripheral volumes of distribution were: CLS‐KETAMINE=112 L/h/70 kg, V1S‐KETAMINE=7.7 L/70 kg, V2S‐KETAMINE=545L/70 kg, QS‐kETAMINE=196 L/h/70 kg, and CLS‐NORKETAMINE=53 L/h/70 kg. Interpatient variability of CLS‐KETAMINE and CLS‐NORKETAMINE was considerable with values of 40% and 104%, respectively, leading to marked variability in steady‐state plasma concentrations.ConclusionSubstantial interpatient variability in pharmacokinetics in children complicates the development of adequate dosage regimen for continuous sedation.
Infection prevention in pediatric anesthesia practice
Authors: Martin Lizabeth D. , Kallile Michael , Kanmanthreddy Siri , Zerr Danielle M. 
Published: October 2017

SummaryHealthcare‐associated infections are an important source of morbidity and mortality in pediatric patients. Anesthesiologists have a unique role in infection prevention. Hand hygiene and anesthesia workspace decontamination decrease infection rates in surgical patients. Standard protocols exist for insertion and handling of central lines, arterial lines, and regional procedures, which should be strictly adhered to in order to prevent infectious complications. Temperature control and timely administration of antibiotics contribute to the prevention of surgical site infections. Education, culture shift, staff engagement, and effective change management are necessary for successful implementation of infection prevention strategies.
Sternal malformations and anesthetic management
Authors: Nichols John H. , Nasr Viviane G. 
Published: October 2017

SummaryShamberger and Welch classify sternal malformations into four types: thoracic ectopia cordis, cervical ectopia cordis, thoraco‐abdominal ectopia cordis, and cleft sternum. Cleft sternum is the most common subset, with a reported incidence of 1 in 50,000 to 100,000 live births, representing 0.15% of all anterior chest wall malformations. Acostello et al further classify cleft sternum into complete or partial (superior, medium, inferior) with a simple superior partial cleft sternum being by far the most common with an orthotopic heart, intact pericardium, and normal skin coverage. Associated anomalies with superior partial cleft sternum are rare, but can include cervicofacial hemangiomas, midline raphe from the tip of the cleft to the umbilicus, and PHACES (posterior fossa malformations, facial hemangiomas, arterial anomalies with coarctation of aorta, cardiac defects, eye abnormalities, sternal cleft, and supraumbilical raphe) syndrome. The more rare inferior partial clefts are associated with thoraco‐abdominal ectopia cordis as part of the Pentalogy of Cantrell (omphalocele, anterior diaphragmatic hernia, sternal cleft, ectopia cordis, ventricular septal defect/left ventricular diverticulum). This review summarizes the current knowledge of all four types of sternal malformations, and provides guidance for optimal anesthetic and perioperative care of these children.
A prospective audit of pain profiles following general and urological surgery in children
Authors: Wilson Caroline A. , Sommerfield David , Drake‐Brockman Thomas F. E. , Lagrange Claudia , Ramgolam Anoop , von Ungern‐Sternberg Britta S. 
Published: October 2017

SummaryBackgroundPostoperative pain is frequently undertreated in children both in hospital and at home following discharge. Pain has both short‐ and long‐term consequences for children, their families, and the healthcare system. A greater understanding of procedure‐specific postoperative pain trajectories is required to improve pain management.AimTo determine the duration and severity of acute postoperative pain experienced by children undergoing 8 different general and urological procedures (primary outcomes). Behavioral disturbance rates, nausea and vomiting scores, and parental satisfaction were also examined during the follow‐up period (secondary outcomes).MethodFamilies of children (0‐18 years) undergoing common general and urological procedures were invited to enroll in the study. Children's pain scores, measured using a parental proxy 0‐10 numerical rating scale, were collected by telephone interview until pain was resolved. Analgesia prescribed and given, behavioral disturbance, nausea and vomiting scores, the method of medication education communication, and parental satisfaction were also measured.ResultsOf 360 patients recruited, 326 complete datasets were available. Patients underwent laparoscopic appendicectomy (57), open appendicectomy (19), circumcision (50), cystoscopy (52), hypospadias repair (22), inguinal hernia repair (51), orchidopexy (51), or umbilical hernia repair (24). Postoperative pain peaked on the day of or the day after surgery in all groups, and decreased over time. Pain lasted a median duration of 5 postoperative days following open appendicectomy, and 0‐2 postoperative days for other procedures. Behavioral disturbance rates closely followed pain scores. Analgesia administration at home varied widely between and within groups.ConclusionPain management was inadequate in most of the groups studied, particularly after appendicectomy or umbilical hernia repair, with most children experiencing at least moderate pain on the day of and day after surgery. There was a need for a standardized management, with increased dual analgesia prescribing, to ensure that children receive adequate postoperative analgesia in hospital and at home.
Seasonal below‐ground metabolism in switchgrass
Authors: Palmer Nathan A. , Saathoff Aaron J. , Scully Erin D. , Tobias Christian M. , Twigg Paul , Madhavan Soundararajan , Schmer Marty , Cahoon Rebecca , Sattler Scott E. , Edmé Serge J. , Mitchell Robert B. , Sarath Gautam 
Published: October 2017

SummarySwitchgrass (Panicum virgatum), a perennial, polyploid, C4 warm‐season grass is among the foremost herbaceous species being advanced as a source of biomass for biofuel end uses. At the end of every growing season, the aerial tissues senesce, and the below‐ground rhizomes become dormant. Future growth is dependent on the successful over‐wintering of the rhizomes. Although the importance of rhizome health to overall year‐upon‐year plant productivity has been long recognized, there is limited information on seasonal changes occurring during dormancy at both the transcriptome and metabolite levels. Here, global changes in transcriptomes and metabolites were investigated over two growing seasons in rhizomes harvested from field‐grown plants. The objectives were: (a) synthesize information on cellular processes that lead to dormancy; and (b) provide models that could account for major metabolic pathways present in dormant switchgrass rhizomes. Overall, metabolism during dormancy appeared to involve discrete but interrelated events. One was a response to abscisic acid that resulted in dehydration, increases in osmolytes and upregulation of autophagic processes, likely through the target of rapamycin complex and sucrose non‐fermentative‐related kinase‐based signaling cascades. Another was a recalibration of energy transduction through apparent reductions in mitochondrial oxidative phosphorylation, increases in substrate level generation of ATP and reducing equivalents, and recycling of N and possibly CO2 through refixation. Lastly, transcript abundances indicated that cold‐related signaling was also occurring. Altogether, these data provide a detailed overview of rhizome metabolism, especially during dormancy, which can be exploited in the future to improve winter survival in switchgrass.
RiceAntherNet: a gene co‐expression network for identifying anther and pollen development genes
Authors: Lin Hong , Yu Jing , Pearce Simon P. , Zhang Dabing , Wilson Zoe A. 
Published: October 2017

SummaryIn plants, normal anther and pollen development involves many important biological events and complex molecular regulatory coordination. Understanding gene regulatory relationships during male reproductive development is essential for fundamental biology and crop breeding. In this work, we developed a rice gene co‐expression network for anther development (RiceAntherNet) that allows prediction of gene regulatory relationships during pollen development. RiceAntherNet was generated from 57 rice anther tissue microarrays across all developmental stages. The microarray datasets from nine rice male sterile mutants, including msp1‐4, ostdl1a, gamyb‐2, tip2, udt1‐1, tdr, eat1‐1, ptc1 and mads3‐4, were used to explore and test the network. Among the changed genes, three clades showing differential expression patterns were constructed to identify genes associated with pollen formation. Many of these have known roles in pollen development, for example, seven genes in Clade 1 (OsABCG15, OsLAP5, OsLAP6, DPW, CYP703A3, OsNP1 and OsCP1) are involved in rice pollen wall formation. Furthermore, Clade 1 contained 12 genes whose predicted orthologs in Arabidopsis have been reported as key during pollen development and may play similar roles in rice. Genes in Clade 2 are expressed earlier than Clade 1 (anther stages 2–9), while genes in Clade 3 are expressed later (stages 10–12). RiceAntherNet serves as a valuable tool for identifying novel genes during plant anther and pollen development. A website is provided (https://www.cpib.ac.uk/anther/riceindex.html) to present the expression profiles for gene characterization. This will assist in determining the key relationships between genes, thus enabling characterization of critical genes associated with anther and pollen regulatory networks.
An international investigation into AB plasma administration in hospitals: how many AB plasma units were infused? The HABSWIN study
Authors: Zeller Michelle P. , Barty Rebecca , Dunbar Nancy M. , Elahie Allahna , Flanagan Peter , Garritsen Henk , Kutner José Mauro , Pagano Monica B. , Pogłód Ryszard , Rogers Thomas S. , Staves Julie , van Wordragen‐Vlaswinkel Maria , Zwaginga Jaap Jan , Murphy Michael F. , Heddle Nancy M. , Yazer Mark H. ,   on behalf of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative
Published: October 2017

BACKGROUNDTypical practice is to transfuse group‐specific plasma units; however, there are situations where group AB plasma (universal donor) is issued to group A, B, or O recipients. If demand for group AB plasma exceeds collections, there is potential for shortage. This project explored the patterns of group AB plasma utilization at hospitals around the world.STUDY DESIGN AND METHODSThe study had two phases: a survey that inquired about hospital group AB plasma inventory, policies, and transfusion practices and a retrospective review of 2014 calendar year data where participants submitted information on plasma disposition including ABO group of unit and recipient, transfusion location, and select indications. Recruitment occurred through snowball sampling. Descriptive analyses were performed.RESULTSSurvey data were received from 25 centers across 10 countries; of those, 15 participants contributed to the data collection component. These 15 centers transfused a total of 43,369 AB plasma units during the study period. Only 1496 of 5541 (27%) group AB plasma units were transfused to group AB recipients. Transfusion policies, practices, and patterns were variable across sites.CONCLUSIONGroup AB plasma units are frequently transfused to non‐AB recipients. Whether transfusing 73% of group AB plasma units to non‐AB recipients is the ideal inventory management strategy remains to be determined.
Funding blood safety in the 21st century
Authors: Ifland Luke , Bloch Evan M. , Pitman John P. 
Published: October 2017

BACKGROUNDSince 2000, there has been an historic increase in international development assistance, including blood safety projects. The result has been increased blood donations and infectious disease screening in many beneficiary countries. A comprehensive examination of international development assistance for blood safety has yet to be completed.STUDY DESIGN AND METHODSThis report examines publicly available information, including donor agency websites and databases and data from the 2008 and 2012 World Health Organization Global Database on Blood Safety.RESULTSBetween 2000 and 2015, from $602.4 million to $2.1 billion in international development assistance was allocated to blood safety programs worldwide, mostly as part of the global response to the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic. The US President's Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis, and Malaria were responsible for the majority of blood safety funding, which peaked in 2010 and declined through 2015.CONCLUSIONBetween 2000 and 2015, countries with high burdens of human immunodeficiency virus/acquired immunodeficiency syndrome received funding and technical assistance to improve national laboratories, increase blood component production, and strengthen clinical practice. Global trends in international development assistance at large, including aid for blood safety, suggest that funding will not rebound.
Role of Wall Shear Stress in Cryptosporidium parvum Oocyst Attachment to Environmental Biofilms
Authors: Luo Xia , Jedlicka Sabrina S. , Jellison Kristen L. 
Published: October 2017

ABSTRACT

This study investigated
Cryptosporidium parvum
oocyst deposition onto biofilms as a function of shear stress under laminar or turbulent flow. Annular rotating bioreactors were used to grow stabilized stream biofilms at shear stresses ranging from 0.038 to 0.46 Pa. These steady-state biofilms were then used to assess the impact of hydrodynamic conditions on
C. parvum
oocyst attachment.
C. parvum
deposition onto biofilms followed a pseudo-second-order model under both laminar (after a lag phase) and turbulent flows. The total number of oocysts attached to the biofilm at steady state decreased as the hydrodynamic wall shear stress increased. The oocyst deposition rate constant increased with shear stress but decreased at high shear, suggesting that increasing wall shear stress results in faster attachment of
Cryptosporidium
due to higher mass transport until the shear forces exceed a critical limit that prevents oocyst attachment. These data show that oocyst attachment in the short and long term are impacted differently by shear: higher shear (to a certain limit) may be associated with faster initial oocyst attachment, but lower shear is associated with greater numbers of oocysts attached at equilibrium.

IMPORTANCE
This research provides experimental evidence to demonstrate that shear stress plays a critical role in protozoan-pathogen transport and deposition in environmental waters. The data presented in this work expand scientific understanding of
Cryptosporidium
attachment and fate, which will further influence the development of timely and accurate sampling strategies, as well as advanced water treatment technologies, to target protozoan pathogens in surface waters that serve as municipal drinking water sources.
Formation of Staphylococcus aureus Biofilm in the Presence of Sublethal Concentrations of Disinfectants Studied via a Transcriptomic Analysis Using Transcriptome Sequencing (RNA-seq)
Authors: Slany M. , Oppelt J. , Cincarova L. 
Published: October 2017

ABSTRACT

Staphylococcus aureus
is a common biofilm-forming pathogen. Low doses of disinfectants have previously been reported to promote biofilm formation and to increase virulence. The aim of this study was to use transcriptome sequencing (RNA-seq) analysis to investigate global transcriptional changes in
S. aureus
in response to sublethal concentrations of the commonly used food industry disinfectants ethanol (EtOH) and chloramine T (ChT) and their combination (EtOH_ChT) in order to better understand the effects of these agents on biofilm formation. Treatment with EtOH and EtOH_ChT resulted in more significantly altered expression profiles than treatment with ChT. Our results revealed that EtOH and EtOH_ChT treatments enhanced the expression of genes responsible for regulation of gene expression (
sigB
), cell surface factors (
clfAB
), adhesins (
sdrDE
), and capsular polysaccharides (
cap8EFGL
), resulting in more intact biofilm. In addition, in this study we were able to identify the pathways involved in the adaptation of
S. aureus
to the stress of ChT treatment. Further, EtOH suppressed the effect of ChT on gene expression when these agents were used together at sublethal concentrations. These data show that in the presence of sublethal concentrations of tested disinfectants,
S. aureus
cells trigger protective mechanisms and try to cope with them.

IMPORTANCE
So far, the effect of disinfectants is not satisfactorily explained. The presented data will allow a better understanding of the mode of disinfectant action with regard to biofilm formation and the ability of bacteria to survive the treatment. Such an understanding could contribute to the effort to eliminate possible sources of bacteria, making disinfectant application as efficient as possible. Biofilm formation plays significant role in the spread and pathogenesis of bacterial species.
Conjugation-Mediated Horizontal Gene Transfer of Clostridium perfringens Plasmids in the Chicken Gastrointestinal Tract Results in the Formation of New Virulent Strains
Authors: Lacey Jake A. , Keyburn Anthony L. , Ford Mark E. , Portela Ricardo W. , Johanesen Priscilla A. , Lyras Dena , Moore Robert J. 
Published: October 2017

ABSTRACT

Clostridium perfringens
is a gastrointestinal pathogen capable of causing disease in a variety of hosts. Necrotic enteritis in chickens is caused by
C. perfringens
strains that produce the pore-forming toxin NetB, the major virulence factor for this disease. Like many other
C. perfringens
toxins and antibiotic resistance genes, NetB is encoded on a conjugative plasmid. Conjugative transfer of the
netB
-containing plasmid pJIR3535 has been demonstrated
in vitro
with a
netB
-null mutant. This study has investigated the effect of plasmid transfer on disease pathogenesis, with two genetically distinct transconjugants constructed under
in vitro
conditions, within the intestinal tract of chickens. This study also demonstrates that plasmid transfer can occur naturally in the host gut environment without the need for antibiotic selective pressure to be applied. The demonstration of plasmid transfer within the chicken host may have implications for the progression and pathogenesis of
C. perfringens
-mediated disease. Such horizontal gene transfer events are likely to be common in the clostridia and may be a key factor in strain evolution, both within animals and in the wider environment.

IMPORTANCE
Clostridium perfringens
is a major gastrointestinal pathogen of poultry.
C. perfringens
strains that express the NetB pore-forming toxin, which is encoded on a conjugative plasmid, cause necrotic enteritis. This study demonstrated that the conjugative transfer of the
netB
-containing plasmid to two different nonpathogenic strains converted them into disease-causing strains with disease-causing capability similar to that of the donor strain. Plasmid transfer of
netB
and antibiotic resistance was also demonstrated to occur within the gastrointestinal tract of chickens, with approximately 14% of the isolates recovered comprising three distinct,
in vivo
-derived, transconjugant types. The demonstration of
in vivo
plasmid transfer indicates the potential importance of strain plasticity and the contribution of plasmids to strain virulence.