bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resuscitators who compared four simulated infant cardiopulmonary resuscitation methods favoured the three‐to‐one compression‐to‐ventilation ratio
Authors: Boldingh Anne Marthe , Solevåg Anne Lee , Aasen Elisabeth , Nakstad Britt 
Published: January 2016

AbstractAimSuboptimal cardiopulmonary resuscitation (CPR) is associated with a poor outcome, and international guidelines state that resuscitators should optimise compression and ventilation techniques with as few interruptions as possible. We investigated compression and ventilation quality during simulated CPR with four compression‐to‐ventilation (C:V) methods.MethodsIn this crossover manikin study, 42 pairs of doctors, nurses, midwives and sixth‐year medical students from two Norwegian hospitals provided two‐minute resuscitation using the 3:1, 9:3 and 15:2 C:V methods and continuous chest compressions at 120 per minute with asynchronous ventilations (CCaV‐120). We measured chest compression, ventilation mechanics and the resuscitators' preferences.ResultsC:V methods 3:1 and 9:3 provided comparable chest compressions and ventilation mechanics, whereas 15:2 produced fewer ventilations and lower minute volumes. The CCaV‐120 method was significantly less effective than the 3:1 C:V ratio method: the chest compression depth was 1.9 mm lower, there were 25 fewer chest compressions and 21 fewer ventilations per minute, and the minute volume was 69 mL lower. The 3:1 C:V method also provided better coordination between resuscitators.ConclusionOur comparison of four simulated infant cardiopulmonary resuscitation methods favoured the 3:1 C:V method, and the multidisciplinary group of participants felt it offered the best level of coordination between resuscitators.
Identification of neonatal haemolysis: an approach to predischarge management of neonatal hyperbilirubinemia
Authors: Bhutani Vinod K. , Srinivas Shanmukha , Castillo Cuadrado Martin E. , Aby Janelle L. , Wong Ronald J. , Stevenson David K. 
Published: January 2016

AbstractAimRelative contributions of increased production [by end‐tidal carbon monoxide concentrations (ETCOc)] and decreased elimination of bilirubin to predischarge hour‐specific total bilirubin (TB) levels were assessed in healthy late‐preterm and term newborns. Secondly, we report predischarge ETCOc ranges to guide clinical management of hyperbilirubinemia.MethodsTB and ETCOc (≤3 timepoints) determinations of newborns aged between six hours and <6 days (n = 79) were stratified by postnatal age epochs. Hyperbilirubinemia risk was assessed by plotting TB values as a function of ETCOc.ResultsStratifications of ETCOc (in ppm, mean, median and interquartile ranges) by postnatal age epochs (0–24, 24–48 and 48–72) were as follows: 2.0, 1.9, 1.8–2.2 (n = 11); 1.6, 1.5, 1.1–2.0 (n = 58); and 2.0, 1.8, 1.6–2.3 (n = 9), respectively. Infants with ETCOc ≥ 2.5 were at high risk, between 1.5 and 2.5 at moderate risk and ≤1.5 were at low risk. Risk due to haemolysis alone was not independent (p < 0.01). For infants with TB >75th percentile (n = 31), 23% had ETCO ≤1.5, and 77% had ETCOc > 1.5 (p < 0.00003).ConclusionNear‐simultaneous ETCOc and TB measurements in infants with TB >75th percentile accurately identify haemolytic hyperbilirubinemia.
Estimating Treatment Effect in a Proportional Hazards Model in Randomized Clinical Trials with All-or-Nothing Compliance
Authors: Li Shuli , Gray Robert J. 
Published: January 2016

Summary
We consider methods for estimating the treatment effect and/or the covariate by treatment interaction effect in a randomized clinical trial under noncompliance with time-to-event outcome. As in Cuzick et al. (2007), assuming that the patient population consists of three (possibly latent) subgroups based on treatment preference: the ambivalent group, the insisters, and the refusers, we estimate the effects among the ambivalent group. The parameters have causal interpretations under standard assumptions. The article contains two main contributions. First, we propose a weighted per-protocol (Wtd PP) estimator through incorporating time-varying weights in a proportional hazards model. In the second part of the article, under the model considered in Cuzick et al. (2007), we propose an EM algorithm to maximize a full likelihood (FL) as well as the pseudo likelihood (PL) considered in Cuzick et al. (2007). The E step of the algorithm involves computing the conditional expectation of a linear function of the latent membership, and the main advantage of the EM algorithm is that the risk parameters can be updated by fitting a weighted Cox model using standard software and the baseline hazard can be updated using closed-form solutions. Simulations show that the EM algorithm is computationally much more efficient than directly maximizing the observed likelihood. The main advantage of the Wtd PP approach is that it is more robust to model misspecifications among the insisters and refusers since the outcome model does not impose distributional assumptions among these two groups.
Molecular and functional characterization of Kv7 channels in penile arteries and corpus cavernosum of healthy and metabolic syndrome rats
Authors: Jepps T A , Olesen S P , Greenwood I A , Dalsgaard T 
Published: January 2016

Background and PurposeKCNQ‐encoded voltage‐dependent potassium channels (Kv7) are involved in the regulation of vascular tone. In this study we evaluated the influence of Kv7 channel activation on smooth muscle relaxation in rat penile arteries and corpus cavernosum from normal and spontaneously hypertensive, heart failure‐prone (SHHF) rats – a rat model of human metabolic syndrome.Experimental ApproachQuantitative PCR and immunohistochemistry were used to determine the expression of KCNQ isoforms in penile tissue. Isometric tension was measured in intracavernous arterial rings and corpus cavernosum strips isolated from normal and SHHF rats.Key ResultsTranscripts for KCNQ3, KCNQ4 and KCNQ5 were detected in penile arteries and corpus cavernosum. KCNQ1 was only found in corpus cavernosum. Immunofluorescence signals to Kv7.4 and Kv7.5 were found in penile arteries, penile veins and corpus cavernosum. The Kv7.2–7.5 activators, ML213 and BMS204352, relaxed pre‐contracted penile arteries and corpus cavernosum independently of nitric oxide synthase or endothelium‐derived hyperpolarization. Relaxations to sildenafil, a PDE5 inhibitor, and sodium nitroprusside (SNP), an nitric oxide donor, were reduced by blocking Kv7 channels with linopirdine in penile arteries and corpus cavernosum. In SHHF rat penile arteries and corpus cavernosum, relaxations to ML213 and BMS204352 were attenuated, and the blocking effect of linopirdine on sildenafil‐induced and SNP‐induced relaxations reduced. KCNQ3, KCNQ4 and KCNQ5 were down‐regulated, and KCNQ1 was up‐regulated in corpus cavernosum from SHHF rats. KCNQ1–5 transcripts remained unchanged in penile arteries from SHHF rats.Conclusions and ImplicationsThese data suggest that Kv7 channels play a role in erectile function and contribute to the pathophysiology of erectile dysfunction, an early indicator of cardiovascular disease.
Cognitive Control as a Moderator of Temperamental Motivations Toward Adolescent Risk‐Taking Behavior
Authors: Youssef George J. , Whittle Sarah , Allen Nicholas B. , Lubman Dan I. , Simmons Julian G. , Yücel Murat 
Published: January 2016

Few studies have directly examined whether cognitive control can moderate the influence of temperamental positive and negative affective traits on adolescent risk‐taking behavior. Using a combined multimethod, latent variable approach to the assessment of adolescent risk‐taking behavior and cognitive control, this study examined whether cognitive control moderates the influence of temperamental surgency and frustration on risk‐taking behavior in a sample of 177 adolescents (Mage = 16.12 years, SD = 0.69). As predicted, there was a significant interaction between cognitive control and frustration, but not between cognitive control and surgency, in predicting risk‐taking behavior. These findings have important implications and suggest that the determinants of adolescent risk taking depend on the valence of the affective motivation for risk‐taking behavior.
Abundant cytomegalovirus (CMV) reactive clonotypes in the CD8+ T cell receptor alpha repertoire following allogeneic transplantation
Authors: Link C S , Eugster A , Heidenreich F , Rücker-Braun E , Schmiedgen M , Oelschlägel U , Kühn D , Dietz S , Fuchs Y , Dahl A , Domingues A M J , Klesse C , Schmitz M , Ehninger G , Bornhäuser M , Schetelig J , Bonifacio E 
Published: January 2016

Summary
Allogeneic stem cell transplantation is potentially curative, but associated with post-transplantation complications, including cytomegalovirus (CMV) infections. An effective immune response requires T cells recognizing CMV epitopes via their T cell receptors (TCRs). Little is known about the TCR repertoire, in particular the TCR-α repertoire and its clinical relevance in patients following stem cell transplantation. Using next-generation sequencing we examined the TCR-α repertoire of CD8+ T cells and CMV-specific CD8+ T cells in four patients. Additionally, we performed single-cell TCR-αβ sequencing of CMV-specific CD8+ T cells. The TCR-α composition of human leucocyte antigen (HLA)-A*0201 CMVpp65– and CMVIE-specific T cells was oligoclonal and defined by few dominant clonotypes. Frequencies of single clonotypes reached up to 11% of all CD8+ T cells and half of the total CD8+ T cell repertoire was dominated by few CMV-reactive clonotypes. Some TCR-α clonotypes were shared between patients. Gene expression of the circulating CMV-specific CD8+ T cells was consistent with chronically activated effector memory T cells. The CD8+ T cell response to CMV reactivation resulted in an expansion of a few TCR-α clonotypes to dominate the CD8+ repertoires. These results warrant further larger studies to define the ability of oligoclonally expanded T cell clones to achieve an effective anti-viral T cell response in this setting.
Low postoperative nonstimulated thyroglobulin as a criterion for the indication of low radioiodine activity in patients with papillary thyroid cancer of intermediate risk ‘with higher risk features’
Authors: Rosario Pedro Weslley , Mourão Gabriela Franco , Calsolari Maria Regina 
Published: January 2016

SummaryObjectiveThis study evaluated low‐activity 131I therapy in patients with papillary thyroid carcinoma (PTC) of intermediate risk ‘with higher risk features’ who had low nonstimulated thyroglobulin (Tg) after thyroidectomy.Design and PatientsThis was a prospective study including 102 patients with tumours >1 cm and aggressive histology; and/or >3 positive lymph node (LN) or LN >1·5 cm or exhibiting macroscopic extracapsular extension, and clinically apparent (cN1); and/or a combination of a tumour >4 cm, microscopic extrathyroidal extension and LN metastases (cN1). After thyroidectomy, all patients had nonstimulated Tg < 0·3 ng/ml and negative antithyroglobulin antibodies (TgAb) and neck ultrasonography (US). The patients were treated with a low activity of 131I (1110 or 1850 MBq).ResultsPost‐therapy whole‐body scanning (RxWBS) showed ectopic uptake in four patients. When evaluated 12 months after 131I therapy, nonstimulated Tg ≤ 0·2 ng/ml with negative TgAb and US, defined as excellent response to initial therapy, was achieved in 101 patients (99%). Only one patient with positive initial RxWBS had structural disease. During follow‐up, four patients (4%) relapsed, including LN metastases in two, pulmonary metastases in one, and elevated Tg in one. The other 98 patients remained with nonstimulated Tg ≤ 0·2 ng/ml and negative TgAb and US. There was no case of death due to the tumour.ConclusionsWe conclude that in intermediate‐risk patients ‘with higher risk features’, low nonstimulated Tg measured with a second‐generation assay can be used as criterion for the administration of low 131I activities (1850 MBq or less).
The consequences of poaching and anthropogenic change for forest elephants
Authors: Breuer Thomas , Maisels Fiona , Fishlock Vicki 
Published: January 2016

AbstractPoaching has devastated forest elephant populations (Loxodonta cyclotis), and their habitat is dramatically changing. The long‐term effects of poaching and other anthropogenic threats have been well studied in savannah elephants (Loxodonta africana), but the impacts of these changes for Central Africa's forest elephants have not been discussed. We examined potential repercussions of these threats and the related consequences for forest elephants in Central Africa by summarizing the lessons learned from savannah elephants and small forest elephant populations in West Africa. Forest elephant social organization is less known than the social organization of savannah elephants, but the close evolutionary history of these species suggests that they will respond to anthropogenic threats in broadly similar ways. The loss of older, experienced individuals in an elephant population disrupts ecological, social, and population parameters. Severe reduction of elephant abundance within Central Africa's forests can alter plant communities and ecosystem functions. Poaching, habitat alterations, and human population increase are probably compressing forest elephants into protected areas and increasing human–elephant conflict, which negatively affects their conservation. We encourage conservationists to look beyond documenting forest elephant population decline and address the causes of these declines when developing conversation strategies. We suggest assessing the effectiveness of the existing protected‐area networks for landscape connectivity in light of current industrial and infrastructure development. Longitudinal assessments of the effects of landscape changes on forest elephant sociality and behavior are also needed. Finally, lessons learned from West African elephant population loss and habitat fragmentation should be used to inform strategies for land‐use planning and managing human–elephant interactions.
Using perceptions as evidence to improve conservation and environmental management
Authors: Bennett Nathan James 
Published: January 2016

AbstractThe conservation community is increasingly focusing on the monitoring and evaluation of management, governance, ecological, and social considerations as part of a broader move toward adaptive management and evidence‐based conservation. Evidence is any information that can be used to come to a conclusion and support a judgment or, in this case, to make decisions that will improve conservation policies, actions, and outcomes. Perceptions are one type of information that is often dismissed as anecdotal by those arguing for evidence‐based conservation. In this paper, I clarify the contributions of research on perceptions of conservation to improving adaptive and evidence‐based conservation. Studies of the perceptions of local people can provide important insights into observations, understandings and interpretations of the social impacts, and ecological outcomes of conservation; the legitimacy of conservation governance; and the social acceptability of environmental management. Perceptions of these factors contribute to positive or negative local evaluations of conservation initiatives. It is positive perceptions, not just objective scientific evidence of effectiveness, that ultimately ensure the support of local constituents thus enabling the long‐term success of conservation. Research on perceptions can inform courses of action to improve conservation and governance at scales ranging from individual initiatives to national and international policies. Better incorporation of evidence from across the social and natural sciences and integration of a plurality of methods into monitoring and evaluation will provide a more complete picture on which to base conservation decisions and environmental management.
Personalized medicine in diabetes: the role of ‘omics’ and biomarkers
Authors: Pearson E. R. 
Published: January 2016

AbstractPersonalized medicine, otherwise called stratified or precision medicine, aims to better target intervention to the individual to maximize benefit and minimize harm. This review discusses how diabetes aetiology, pathophysiology and patient genotype influence response to or side effects of the commonly used diabetes treatments. C‐peptide is a useful biomarker that is underused to guide treatment choice, severe insulin deficiency predicts non‐response to glucagon‐like peptide‐1 receptor agonists, and thiazolidinediones are more effective in insulin‐resistant patients. The field of pharmacogenetics is now yielding clinically important results, with three examples outlined: sulphonylurea sensitivity in patients with HNF1A maturity‐onset diabetes of the young; sulphonylurea sensitivity in patients with Type 2 diabetes with reduced function alleles at CYP2C9, resulting in reduced metabolism of sulphonylureas; and severe metformin intolerance associated with reduced function organic cation transporter 1 (OCT1) variants, exacerbated by drugs that also inhibit OCT1. Genome‐wide approaches and the potential of other ‘omics’, including metagenomics and metabolomics, are then outlined, highlighting the complex interacting networks that we need to understand before we can truly personalize diabetes treatments.
DPD epitope‐specific glutamic acid decarboxylase (GAD)65 autoantibodies in children with Type 1 diabetes
Authors: Bansal N. , Hampe C. S. , Rodriguez L. , O'Brian Smith E. , Kushner J. , Balasubramanyam A. , Redondo M. J. 
Published: January 2016

AbstractAimTo study whether DPD epitope‐specific glutamate decarboxylase autoantibodies are found more frequently in children with milder forms of Type 1 diabetes.MethodsWe prospectively evaluated 75 children with new‐onset autoimmune Type 1 diabetes, in whom we collected demographic, anthropometric and clinical data and measured islet autoantibodies. Glutamate decarboxylase 65 autoantibody‐positive samples were analysed for epitope specificities using recombinant Fab against the DPD‐defined epitope of glutamate decarboxylase 65.ResultsAfter adjustment for age, positive DPD epitope recognition was significantly associated with higher C‐peptide levels at onset (P = 0.02, r2=0.21, n = 35), and high DPD recognition in the highest quartile tended to be associated with HbA1c ≤ 53 mmol/mol (7%) at the last follow‐up [mean (sd) follow‐up 1.3 (0.4) years; P = 0.07; for the model, P = 0.044, n = 30)]. Age‐ and sex‐adjusted BMI percentile was significantly correlated with recognition of the DPD‐defined epitope (P < 0.03, r2=0.14, n = 34), but this correlation was driven by the older age group (age ≥ 10 years; P = 0.016, r2=0.27, n = 21) and was not significant in younger children (P = 0.93, n = 13). There were no independent associations with sex, race/ethnicity, diabetic ketoacidosis, HbA1c, HLA DR3‐DQ2/DR4‐DQ8 or autoantibody number.ConclusionsOur findings suggest that recognition of the DPD‐defined glutamate decarboxylase 65 autoantibody epitope at Type 1 diabetes onset is directly associated with β‐cell function, BMI and age, which supports the hypothesis that immunological factors contribute to the clinical heterogeneity of Type 1 diabetes. Larger studies relating epitope‐specific glutamate decarboxylase 65 autoantibody to clinical phenotype in children with Type 1 diabetes are warranted.
Young people with Type 1 diabetes of non‐white ethnicity and lower socio‐economic status have poorer glycaemic control in England and Wales
Authors: Khanolkar A. R. , Amin R. , Taylor‐Robinson D. , Viner R. M. , Warner J. T. , Stephenson T. 
Published: January 2016

AbstractBackgroundThe impact of ethnicity and socio‐economic status (SES) on glycaemic control during childhood Type 1 diabetes is poorly understood in England and Wales.MethodsWe studied 18 478 children with Type 1 diabetes (< 19 years) attending diabetes clinics and included in the 2012–2013 National Paediatric Diabetes Audit. Self‐identified ethnicity was categorized as white, Asian, black, mixed, other and ‘not‐stated’ (did not to divulge ethnicity). A small area measure of SES was estimated from the Index of Multiple Deprivation. Multiple linear regression was used to assess associations between ethnicity, SES and glycaemic control (mean HbA1c levels) accounting for age, gender and diabetes duration. The impact of insulin pump use on the ethnicity/SES–HbA1c associations was tested in 13 962 children.ResultsAll children from minority ethnic groups had higher mean HbA1c compared with white children, with largest differences observed in black and mixed ethnicities [8 mmol/mol (2.9%), 95% CI 5–11 and 7 mmol/mol (2.8%), 95% CI 5–9, respectively]. Lower SES was associated with higher mean HbA1c with a dose effect. The lowest SES group had a mean HbA1c that was 7 mmol/mol (2.8%) (95% CI 6–8) higher compared with the highest SES group, adjusted for ethnicity. Estimates for ethnicity were attenuated, but significant on adjustment for SES. Fewer non‐white (white 20.3 vs. black 5.5%) and deprived (least deprived 21.1 vs. most deprived 13.2%) children were on insulin pump therapy. Ethnicity and SES remained significant predictors of HbA1c after accounting for insulin pump use.ConclusionThe association between ethnicity and glycaemic control persists after adjustment for deprivation and pump use. An alternative approach to intensive insulin therapy might benefit these vulnerable children.
Guidelines for managing diabetes in Ramadan
Authors: Ali S. , Davies M. J. , Brady E. M. , Gray L. J. , Khunti K. , Beshyah S. A. , Hanif W. 
Published: January 2016

AbstractBackgroundGlobally there are approximately 90 million Muslims with diabetes of which approximately 400 000 reside within the UK. The holy month of Ramadan is a fundamental practice of this religion of which fasting from sun‐rise to sun‐set is an integral part. This poses many potential risks for those with diabetes who wish to observe Ramadan.MethodsThe evidence base for best clinical management of Type 1 and Type 2 diabetes during Ramadan was reviewed. We reviewed current and previous recommendations for safe fasting during Ramadan.ResultsThe risks associated with fasting in those with diabetes and preparing your patient for Ramadan are discussed. We have reviewed the evidence around diet‐controlled diabetes and therapies including; metformin, acarbose, metglitinides, sulfonylureas, thiazolidinidiones, dipeptidyl peptidase‐4 inhibitor (DPP‐4), sodium glucose co‐transporter ‐2 (SGLT‐2) inhibitors, glucagon‐like peptide ‐1 (GLP‐1) receptor agonists and insulin.ConclusionUp to date guidelines for the management of treatment regimes are set‐out for those with Type 1 and Type 2 diabetes who wish to fast during Ramadan.