bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe Sarcopenia and Increased Fat Stores in Pediatric Patients With Liver, Kidney, or Intestine Failure
Authors: Mangus Richard S. , Bush Weston J. , Miller Christina , Kubal Chandrashekhar A. 
Published: June 2017

ABSTRACTObjectives:Malnutrition and wasting predict clinical outcomes in children with severe chronic illness. Objectively calculated malnutrition in children with end‐stage organ failure has not been well studied. This analysis compares children with kidney, liver or intestine failure to healthy controls to quantitate the disparity in muscle and fat stores.Methods:Children younger than 19 years with end‐stage liver, kidney, or intestine failure and with pretransplant computed tomography (CT) imaging were selected from the transplant database. Age‐ and sex‐matched healthy controls were selected from the trauma database. Measures of nutrition status included a scaled scoring of core muscle mass, and visceral and subcutaneous fat stores. Analysis was conducted using the pooled and individually matched subject‐control differences.Results:There were 81 subjects included in the final analysis (liver [n = 35], kidney [n = 20], and intestine [n = 26]). Children with end‐stage liver disease had a 23% reduction in muscle mass, a 69% increase in visceral fat, and a 29% increase in subcutaneous fat. End‐stage renal disease patients had a 19% reduction in muscle mass and a 258% increase in subcutaneous fat. Intestine failure patients had a 24% reduction in muscle mass, a 30% increase in visceral fat, and a 46% increase in subcutaneous fat.Conclusions:These results demonstrate significant sarcopenia and increased fat stores in end‐stage organ failure patients, which supports the idea of an active physiologic mechanism to store fat while losing muscle mass. Sarcopenia may be related to total protein loss from a catabolic state, or from decreased synthesis (liver), wasting (kidney), or malabsorption (intestine).
Mineral Intake and Status of Cow's Milk Allergic Infants Consuming an Amino Acid‐based Formula
Authors: Harvey Bryan M. , Eussen Simone R.B.M. , Harthoorn Lucien F. , Burks A. Wesley 
Published: June 2017

ABSTRACTData on the mineral status of infants with cow's milk allergy (CMA) consuming an amino acid‐based formula (AAF) have not been published. The present study aims to assess mineral status of term infants age 0 to 8 months diagnosed with CMA receiving an AAF for 16 weeks. Serum concentrations of calcium, phosphorus, chloride, sodium, potassium, magnesium, and ferritin were determined in 82 subjects at baseline and in 66 subjects after 16 weeks on AAF using standard methods and evaluated against age‐specific reference ranges. In addition to this, individual estimated energy and mineral intakes were compared to Adequate Intakes defined by the European Food Safety Authority and the US Institute of Medicine. The results of this study show that the AAF was effective in providing an adequate mineral status in infants with CMA. The vast majority of infants aged 0 to 6 months (formula only) and aged 6 to 12 months (formula and complementary foods) had adequate mineral intakes.
Moral Distress in PICU and Neonatal ICU Practitioners: A Cross-Sectional Evaluation*
Authors: Larson Charles Philip , Dryden-Palmer Karen D. , Gibbons Cathy , Parshuram Christopher S. 
Published: June 2017

Objectives:
To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty.

Design:
Cross-sectional survey.

Setting:
A large pediatric tertiary care center.

Subjects:
Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience.

Interventions:
A 41-item questionnaire examining moral distress, burnout, and uncertainty.

Measurements and Main Results:
The main outcome was moral distress measured with the Revised Moral Distress Scale. Secondary outcomes were frequency and intensity Revised Moral Distress Scale subscores, burnout measured with the Maslach Burnout Inventory depersonalization subscale, and uncertainty measured with questions adapted from Mishel’s Parent Perception of Uncertainty Scale. Linear regression models were used to examine associations between participant characteristics and the measures of moral distress, burnout, and uncertainty. Two-hundred six analyzable surveys were returned. The median Revised Moral Distress Scale score was 96.5 (interquartile range, 69–133), and 58% of respondents reported significant work-related moral distress. Revised Moral Distress Scale items involving end-of-life care and communication scored highest. Moral distress was positively associated with burnout (r
2 = 0.27; p < 0.001) and uncertainty (r
2 = 0.04; p = 0.008) and inversely associated with perceived hospital supportiveness (r
2 = 0.18; p < 0.001). Nurses reported higher moral distress intensity than physicians (Revised Moral Distress Scale intensity subscores: 57.3 vs 44.7; p = 0.002). In nurses only, moral distress was positively associated with increasing years of ICU experience (p = 0.02) and uncertainty about whether their care was of benefit (r
2 = 0.11; p < 0.001) and inversely associated with uncertainty about a child’s prognosis (r
2 = 0.03; p = 0.03).

Conclusions:
In this single-center, cross-sectional study, we found that moral distress is present in PICU and neonatal ICU health practitioners and is correlated with burnout, uncertainty, and feeling unsupported.
Adverse Events Detection Through Global Trigger Tool Methodology: Results From a 5-Year Study in an Italian Hospital and Opportunities to Improve Interrater Reliability
Authors: Mortaro Alberto , Moretti Francesca , Pascu Diana , Tessari Lorella , Tardivo Stefano , Pancheri Serena , Marta Garon , Romano Gabriele , Mazzi Mariangela , Montresor Paolo , Naessens James M. 
Published: June 2017

Objective
Global Trigger Tool (GTT) has been proposed as a low-cost method to detect adverse events (AEs). The validity of the methodology has been questioned because of moderate interrater agreement. Continuous training has been suggested as a means to improve consistency over time. We present the main findings of the implementation of the Italian version of the GTT and evaluate efforts to improve the interrater reliability over time.

Methods
The Italian version of the GTT was developed and implemented at the San Bonifacio Hospital, a 270-bed secondary care acute hospital in Verona, Italy. Ten clinical records randomly selected every 2 weeks were reviewed from 2009 to 2014. Two-stage interrater reliability assessment between team members was conducted on 2 subsamples of 50 clinical records before and after the implementation of specific review rules and staff training.

Results
Among 1320 medical records reviewed, a total of 366 AEs were found with at least 1 AE on 20.2% of all discharges, 27.7 AEs/100 admissions, and 30.6 AEs/1000 patient-days. Adverse events with harm score E and F were respectively 58.2% (n = 213) and 38.8% (n = 142). First round interrater reliability was comparable with other international studies. The interrater agreement improved significantly after intervention (κ interrater I = 0.52, κ interrater II = 0.80, P < 0.001).

Conclusions
Despite the improvements in the interrater consistency, overall results did not show any significant trend in AEs over time. Future studies may be directed to apply and adapt the GTT methodology to more specific settings to explore how to improve its sensitivity.
Characteristics and Risk Behaviors of Men Who Have Sex With Men and Women Compared With Men Who Have Sex With Men—20 US Cities, 2011 and 2014
Authors: Shadaker Shaun , Magee Matthew , Paz-Bailey Gabriela , Hoots Brooke E. ,   for the NHBS Study Group
Published: June 2017

Background:
Men who have sex with men (MSM) are heterogeneous with respect to sexual behavior. We examined differences in sex behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO).

Methods:
Data for this analysis were from MSM who participated in National HIV Behavioral Surveillance in 2011 and 2014. We used the combined years to evaluate demographic and behavioral differences between MSMW and MSMO. Using log-linked Poisson regression models, adjusted prevalence ratios (aPR) were calculated for behavioral outcomes.

Results:
Overall, 2042 (11.9%) participants were classified as MSMW. MSMW were less likely than MSMO to have condomless sex with male partners [aPR 0.77; 95% confidence interval (CI): 0.74 to 0.81] and to have been diagnosed with another sexually transmitted disease (aPR 0.83; 95% CI: 0.72 to 0.95). MSMW were more likely than MSMO to have given money or drugs for sex (aPR 2.85; 95% CI: 2.52 to 3.24) or received money or drugs for sex (aPR 2.64; 95% CI: 2.37 to 2.93) and to ever have injected drugs (aPR 2.05; 95% CI: 1.80 to 2.34). MSMW had more total sex partners (median 6, interquartile range: 4–11 vs. 3, 2–8), casual sex partners (5, 2–10 vs. 3, 1–7), and condomless sex partners (2, 1–4 vs. 1, 0–2) in the last 12 months (P < 0.01 for all comparisons).

Conclusions:
MSMW have distinct sexual risk behaviors from MSMO and may contribute to HIV transmission among women. MSMW could benefit from tailored interventions to reduce HIV risk behaviors.
Trends in Internet Use Among Men Who Have Sex With Men in the United States
Authors: Paz-Bailey Gabriela , Hoots Brooke E. , Xia Mingjing , Finlayson Teresa , Prejean Joseph , Purcell David W. ,   for the NHBS Study Group
Published: June 2017

Background:
Internet-based platforms are increasingly prominent interfaces for social and sexual networking among men who have sex with men (MSM).

Methods:
MSM were recruited through venue-based sampling in 2008, 2011, and 2014 in 20 US cities. We examined changes in internet use (IU) to meet men and in meeting the last partner online among MSM from 2008 to 2014 using Poisson regression with generalized estimating equations to calculate adjusted prevalence ratios (APRs). We also examined factors associated with increased frequency of IU using data from 2014. IU was categorized as never, infrequent use (<once a week), and frequent use (≥once a week).

Results:
Frequent IU increased from 21% in 2008 to 44% in 2014 (APR = 1.39, 95% confidence interval: 1.36 to 1.42), and having met the last partner online increased from 19% in 2008 to 32% in 2014 (APR = 1.30, 95% confidence interval: 1.26 to 1.34). Those who never used the internet had fewer partners (median of 2 in the past 12 months, interquartile range: 1–4) compared with infrequent (4, 2–7) and frequent users (5, 3–12). HIV testing in the past 12 months also increased with increasing IU (58%, 68%, and 71%, respectively, P < 0.0001). Among HIV-positive participants, the percent HIV-positive awareness increased as IU increased (71%, 75%, and 79%, P < 0.005).

Conclusions:
Both IU to meet men and meeting the last partner online increased since 2008. Although men who used the internet more frequently reported more partners in the past 12 months, they were also more likely to report testing in the past 12 months and were more likely to be HIV-positive aware.
A Decline in HIV Testing Among Persons Who Inject Drugs in the Seattle Area, 2004–2015
Authors: Burt Richard D. , Tinsley Joe , Glick Sara Nelson 
Published: June 2017

Background:
Promoting HIV testing is a key component of the public health response to HIV. Assessing HIV testing frequency among persons who inject drugs (PWID) monitors the status of these efforts and can identify unmet needs and opportunities to more effectively promote testing.

Methods:
Data were combined from 4 Seattle-area surveys of PWID from the National HIV Behavioral Surveillance (NHBS) program (2005–2015) and 6 surveys of Needle Exchange clients (2004–2015).

Results:
The proportion of PWID reporting an HIV test in the previous 12 months declined from 64% in 2005% to 47% in 2015 in the NHBS surveys and from 72% to 58% in the Needle Exchange surveys. These declines persisted in multivariate analyses controlling for differences in the study populations in age, race, sex, area of residence, education, current homelessness, drug most frequently injected, daily injection frequency, and combined male-to-male sex and amphetamine injection status. The proportion of NHBS participants reporting not knowing the HIV status of their last injection partner increased from 38% to 45%. The proportion not knowing the HIV status of their last sex partner increased from 27% to 38%.

Conclusions:
A decrease in HIV testing was found in 2 independent Seattle-area study populations. This was complemented by increases in the proportions not knowing the HIV status of their last sex and last injection partners. Research is needed to ascertain if such declines are observed elsewhere, the reasons for the decline, and appropriate means to effectively attain optimal HIV testing frequency among PWID.
Self-Reported Decline in Everyday Function, Cognitive Symptoms, and Cognitive Function in People With HIV
Authors: Laverick Rosanna , Haddow Lewis , Daskalopoulou Marina , Lampe Fiona , Gilson Richard , Speakman Andrew , Antinori Andrea , Bruun Tina , Vassilenko Anna , Collins Simon , Rodger Alison ,   for the Cognitive Impairment in People with HIV in the European Region (CIPHER) Study Group
Published: June 2017

Background:We determined factors associated with self-reported decline in activities of daily living (ADLs) and symptoms of cognitive impairment in HIV positive adults in 5 European clinics.Methods:HIV+ adults underwent computerized and pen-and-paper neuropsychological tests and questionnaires of cognitive symptoms and ADLs. We considered cognitive function in 5 domains, psychosocial factors, and clinical parameters as potentially associated with symptoms. Separate regression analyses were used to determine factors associated with a decline in ADL (defined as self-reported decline affecting ≥2 ADLs and attributed to cognitive difficulties) and self-reported frequency of symptoms of cognitive impairment. We also estimated the diagnostic accuracy of both questionnaires as tests for cognitive impairment.Results:Four hundred forty-eight patients completed the assessments [mean age 45.8 years, 84% male, 87% white, median CD4 count 550 cells/mm3, median time since HIV diagnosis 9.9 years, 81% virologically suppressed (HIV-1 plasma RNA <50 copies/mL)]. Ninety-six (21.4%) reported decline in ADLs and attributed this to cognitive difficulties. Self-reported decline in ADLs and increased symptoms of cognitive impairment were both associated with worse performance on some cognitive tests. There were also strong associations with financial difficulties, depressive and anxiety symptoms, unemployment, and longer time since HIV diagnosis. Both questionnaires performed poorly as diagnostic tests for cognitive impairment.Conclusions:Patients' own assessments of everyday function and symptoms were associated with objectively measured cognitive function. However, there were strong associations with other psychosocial issues including mood and anxiety disorders and socioeconomic hardship. This should be considered when assessing HIV-associated cognitive impairment in clinical care or research studies.
Treating pain on skin graft donor sites: Review and clinical recommendations
Authors: Sinha Sarthak , Schreiner Amanda J. , Biernaskie Jeff , Nickerson Duncan , Gabriel Vincent A. 
Published: June 2017

ABSTRACT
Split-thickness skin grafting is the most common reconstructive procedure in managing burn injuries. Harvesting split-thickness skin creates a new partial thickness wound referred to as the donor site. Pain at the donor site is reported to be one of the most distressing symptoms during the early postoperative period. Here, we (a) identify strategies for managing donor site pain, (b) assess the quality of individual studies, and (c) formulate evidence-based recommendations based on the amount and consistency of evidence. Our analysis revealed five distinct approaches to minimize donor site pain. These include: continuous subcutaneous local anesthetic infusion (three studies), subcutaneous anesthetic injection (five studies), topical agents (six studies), nonpharmacological interventions (three studies), and wound dressings (18 studies). Available randomized control trials typically evaluated pain on standardized scales (i.e. Visual Analog Scale, Numerical Rating Scale), and compared the experimental group with standard care. Recommended treatments include: (a) subcutaneous anesthetic injection of adrenaline-lidocaine; (b) ice application; (c) topical agents, such as lidocaine and bupivacaine; and (d) hydrocolloid- and polyurethane-based wound dressings accompanied with fibrin sealant. Methodologically sound randomized control trials examining the efficacy of modified tumescent solution, ropivacaine, plasma therapy, noncontact ultrasound, and morphine gels are lacking and should be a priority for future research.
Amplitude-Integrated EEG and Brain Sparing in Preterm Small-for-Gestational-Age Infants
Authors: Benavente-Fernández Isabel , Lubián-López Simón P. , Zafra-Rodríguez Pamela , Alonso-Ojembarrena Almudena , Segado-Arenas Antonio , Lechuga-Sancho Alfonso M. 
Published: June 2017

Purpose:
Preterm small-for-gestational-age (SGA) infants are at risk for a high mortality rate and impaired cognitive development. Only a few studies have focused on amplitude-integrated EEG (aEEG) in preterm SGA infants. They have been shown to have a slower rate of brain maturation, but these findings have not consistently been related to neurodevelopmental outcomes. The aim of our study was to evaluate early aEEG monitoring in SGA compared with adequate-for-gestational-age preterms.

Methods:
This prospective cohort study enrolled infants with very low birth weight who were admitted to the neonatal intensive care unit at Hospital Puerta del Mar, Cádiz, Spain, from June 2009 to September 2012. This study was a subanalysis of SGA from the global cohort previously described by our group. Adverse outcome included severe intraventricular hemorrhage and/or death. Cerebral function was monitored using aEEG recordings during the first 72 hours of life.

Results:
Preterm SGA infants (18 SGA in the global cohort of 92 patients) had lower 1- and 5-minute Apgar scores, higher score for neonatal acute physiology perinatal extension II scores, and higher proportion of adverse outcomes. When comparing preterm adequate-for-gestational-age infants with SGA infants with good prognosis, those with SGA had more mature and continuous aEEG patterns. Low margin amplitude depression was not as severe in these patients, and a higher proportion of these patients developed sleep–wake cycles.

Conclusions:
The results of our study suggest that SGA infants with a good prognosis have a more mature aEEG pattern than preterm adequate-for-gestational-age patients with the same outcome. These findings support the brain sparing theory in SGA infants.
Women’s estimated HIV infections from sex in trials of pre-exposure prophylaxis in Africa: Implications for HIV prevention strategies
Authors: Gisselquist David 
Published: June 2017

AbstractIntroductionDuring 2004-15, nine randomized controlled trials (RCT) for HIV prevention tested pre-exposure prophylaxis (PrEP) with oral drugs, vaginal gels, or vaginal rings among more than 17,000 women in Africa.MethodsThis study uses information from the nine RCTs to estimate the proportions of HIV from sexual and bloodborne risks, to consider reasons for success or failure with oral PrEP, and to consider risks with vaginal PrEP.ResultsEstimating from women’s reported frequencies of unprotected coital acts in six RCTs, only a minority of women’s infections came from sex. Oral PrEP may have succeeded in at least one trial by reducing infections from both bloodborne and sexual risks. Oral PrEP may have failed in several trials, at least in part, because some women used oral PrEP when they had sexual risks rather than daily as advised. Relatively high incidence with PrEP vaginal gels and rings vs. oral placebo suggests vaginal PrEP had little impact at best and may have been harmful.DiscussionEvidence from this and other studies challenges the common belief most HIV in Africa comes from sex. This challenge has implications for HIV prevention strategies, including: warning about bloodborne risks; and reconsidering PrEP for young women.
Ecological characterization and infection of Anophelines (Diptera: Culicidae) of the Atlantic Forest in the southeast of Brazil over a 10 year period: Has the behaviour of the autochthonous malaria vector changed?
Authors: Buery Julyana Cerqueira , Rezende Helder Ricas , Natal Licia , Santana da Silva Leonardo , Maria Tironi de Menezes Regiane , Fux Blima , dos Santos Malafronte Rosely , Falqueto Aloisio , Cerutti Crispim 
Published: June 2017

ABSTRACTIn the south and southeast of Brazil, autochthonous malaria cases can be found near Atlantic Forest fragments. The transmission is not totally clarified; thus, the behaviour of the possible vectors in those regions must be observed. An entomological and natural infection study was performed on anophelines (Diptera: Culicidae) captured in the municipalities of the mountainous region of Espírito Santo state in 2004-2005. Similarly, between the years 2014 and 2015, 12 monthly collections were performed at the permanent trapping station of the study mentioned above (Valsugana Velha, Santa Teresa, ES). Light traps with CO2(CO2-baited Center for Disease Control [CDC] traps) were set in open areas, at the edge of the forest (canopy and ground) and inside the forest (canopy and ground), whereas Shannon traps were set on the edge of the forest. A total of 1,414 anophelines were collected from 13 species.Anopheles (Kerteszia) cruziiDyar and Knab remained the most captured species in the CO2-baited CDC traps set in the forest canopy and was also the vector with the highest prevalence ofPlasmodium vivaxinfection according to molecular PCR techniques. Regarding mosquitoes of the subgenusNyssorhynchus,P. vivaxwas found only in abdomens, weakening the hypothesis that this subgenus also plays a role in malaria transmission in this specific region.SponsorshipEspírito Santo Research Foundation (Fundação de Amparo à Pesquisa e Inovação do Espírito Santo – FAPES).
Neural dynamics of real-world object vision that guide behaviour
Authors: Cichy Radoslaw M. , Kriegeskorte Nikolaus , Jozwik Kamila M. , van den Bosch Jasper J.F. , Charest Ian 
Published: June 2017

1AbstractVision involves complex neuronal dynamics that link the sensory stream to behaviour. To capture the richness and complexity of the visual world and the behaviour it entails, we used an ecologically valid task with a rich set of real-world object images. We investigated how human brain activity, resolved in space with functional MRI and in time with magnetoencephalography, links the sensory stream to behavioural responses. We found that behaviour-related brain activity emerged rapidly in the ventral visual pathway within 200ms of stimulus onset. The link between stimuli, brain activity, and behaviour could not be accounted for by either category membership or visual features (as provided by an artificial deep neural network model). Our results identify behaviourally-relevant brain activity during object vision, and suggest that object representations guiding behaviour are complex and can neither be explained by visual features or semantic categories alone. Our findings support the view that visual representations in the ventral visual stream need to be understood in terms of their relevance to behaviour, and highlight the importance of complex behavioural assessment for human brain mapping.