bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Drowning
Authors: Best Rebecca R. , Harris Benjamin H.L. , Walsh Jason L. , Manfield Timothy 
Published: May 2017

Objectives
Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children.

Methods
A literature review on the management of pediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of pediatric drowning.

Results
A concise standard operating procedure was developed for resuscitation following pediatric submersion. Specific recommendations include the following: the Heimlich maneuver should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended.

Conclusions
This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration.
Evaluation of Patients With Febrile Seizure: Risk Factors, Reccurence, Treatment and Prognosis
Authors: Renda Rahime , Yüksel Deniz , Gürer Y.K. Yavuz 
Published: May 2017

Introduction
Febrile convulsion (FC) is the most common neurological disorder in childhood. The aim of this study was to determine the risk factors for recurrence and the development of epilepsy from the demographic data of these patients.

Methods
A retrospective study was made of 680 patients with FC who presented to our hospital. Patients with only FC were defined as group 1 and those who developed epilepsy after FC as group 2. Comparisons were made between the 2 groups of the demographic parameters, parental consanguinity, familial history of FCs or epilepsy, criteria for starting prophylactic treatment, response to treatment, risk factors for recurrence, and results of electroencephalogram.

Results
The study included a total of 680 patients comprising 399 males (59%) and 281 females (41%). A diagnosis of FC was made in 652 cases (95.8%, group 1), and epilepsy was diagnosed in 28 (4.2%, group 2). A positive familial history of FCs was determined statistically significantly higher in group 1. On the other hand, a history of pathological birth and parental consanguinity was found higher in group 2. Prophylactic treatment was administered to 89.3% of group 2 and 40.3% of group 1.

Conclusions
Febrile convulsions create fear and panic in the family and are a significant health problem in Turkey. The conclusion that has been reached is that the unnecessary administration of prophylactic treatment could be prevented with education of the families on the subject of fever and correct identification of patients at risk of developing epilepsy.
The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa
Authors: Manne-Goehler Jennifer , Montana Livia , Gómez-Olivé Francesc Xavier , Rohr Julia , Harling Guy , Wagner Ryan G. , Wade Alisha , Kabudula Chodziwadziwa W. , Geldsetzer Pascal , Kahn Kathleen , Tollman Stephen , Berkman Lisa F. , Bärnighausen Till W. , Gaziano Thomas A. 
Published: May 2017

Background:
The prevalence of diabetes and hypertension has increased in HIV-positive populations, but there is limited understanding of the role that antiretroviral therapy (ART) programs play in the delivery of services for these conditions. The aim of this study is to assess the relationship between ART use and utilization of health care services for diabetes and hypertension.

Methods:
Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa is a cohort of 5059 adults. The baseline study collects biomarker-based data on HIV, ART, diabetes, and hypertension and self-reported data on health care utilization. We calculated differences in care utilization for diabetes and hypertension by HIV and ART status and used multivariable logistic regressions to estimate the relationship between ART use and utilization of services for these conditions, controlling for age, sex, body mass index, education, and household wealth quintile.

Results:
Mean age, body mass index, hypertension, and diabetes prevalence were lower in the HIV-positive population (all P < 0.001). Multivariable logistic regression showed that ART use was significantly associated with greater odds of blood pressure measurement [adjusted odds ratio (aOR) 1.27, 95% confidence interval (CI): 1.04 to 1.55] and blood sugar measurement (aOR 1.26, 95% CI: 1.05 to 1.51), counseling regarding exercise (aOR 1.57, 95% CI: 1.11 to 2.22), awareness of hypertension diagnosis (aOR 1.52, 95% CI: 1.12 to 2.05), and treatment for hypertension (aOR 1.63, 95% CI: 1.21 to 2.19).

Conclusions:
HIV-positive patients who use ART are more likely to have received health care services for diabetes and hypertension. This apparent ART advantage suggests that ART programs may be a vehicle for strengthening health systems for chronic care.
Increasing Levels of Positive End-expiratory Pressure Improve the Left Ventricular Strain
Authors: Ruiz-Bailén Manuel , Cobo-Molinos Jesús , Castillo-Rivera Ana M. , Iniesta-Carricondo María C. , Pola Gallego de Guzmán María D. , Cárdenas-Cruz Antonio 
Published: May 2017

Purpose:
The goal of this study was to evaluate possible changes in the left myocardial performance of patients with cardiogenic shock (CS) during ascending levels of positive end-expiratory pressure (PEEP) using speckle-tracking echocardiography.

Materials and Methods:
This was an interventional clinical study performed on CS patients under mechanical ventilation. These patients underwent echocardiography after 15 to 30 minutes of progressive increases in PEEP zero end-expiratory pressure (ZEEP) (PEEP 5, PEEP 10, PEEP 15 cm H2O). We evaluated the changes caused by these increasing levels of PEEP on the E/E′ ratio and the parameters of left ventricular systolic and diastolic functions, including longitudinal strain (S) and strain rate (SR). Analyses of mean values were carried out using analysis of variance.

Results:
A total of 65 CS patients were included. Their mean age was 68.58±14.61 years. Progressive increases in PEEP induced a significant decrease in the E/E′ ratio (ZEEP=12.87±1.81; PEEP=5, 8.39±3.61; PEEP=10, 6.34±1.73; and PEEP=15, 7.10±0.37; P<0.0001). Although we did not find significant changes in left ventricular ejection fraction, a clear increase in left ventricular S and SR occurred (ZEEP=−13, 15±1.27; PEEP=5, −16.97±4.01; PEEP=10, −16.89±0.46; PEEP=15, −15.39±4.21; and ZEEP=−1.02±0.02; PEEP=5, −1.49±0.13; PEEP=10, −1.57±0.21; PEEP=15, −1.24±0.29, respectively; all values were significant).

Conclusions:
Increasing levels of PEEP improve the left ventricular S and SR. PEEP levels could modify the performance of left ventricular fibers.
Effect of Beta Blockers on Mortality After Open Repair of Abdominal Aortic Aneurysm
Authors: Alshaikh Husain N. , Canner Joseph K. , Malas Mahmoud 
Published: May 2017

Objective:
To assess the effect of perioperative beta blocker (BB) use on postoperative in-hospital mortality after open repair of abdominal aortic aneurysm (OAR).

Background:
Postoperative mortality after OAR ranges from 3.0% to 4.5%. Insight about the effect of BBs on postoperative mortality after OAR is currently lacking.

Methods:
This is a retrospective study of patients undergoing OAR from 2009-Q3 to 2015-Q1 in the Premier Healthcare Database. The Premier Healthcare Database includes data representing 20% of all inpatient US discharges annually. Patients under 45 years, admitted after a trauma or who underwent multiple aortic repair procedures, were excluded. Multivariable logistic regression models were created to assess the relationship between perioperative BB use and postoperative in-hospital mortality.

Results:
Of 6515 patients admitted for OAR, 5423 (83.2%) received perioperative BBs. Patients who received BBs were more likely to develop major adverse events compared with those who did not (45.6% vs 35.2%; P < 0.001); however, failure to rescue was lower among BB users (7.6% vs 19.5%; P < 0.001). In a multivariable logistic regression model, BB use was associated with 57% [odds ratio 0.43, 95% confidence interval (CI) 0.31–0.56, P = 0.001) and 81% (odds ratio 0.19, 95% CI 0.11–0.31, P < 0.001) lower odds of mortality among patients without and with a history of coronary artery disease, respectively. The predicted mortality (95% CI) for patients who did not receive BBs, or received low, intermediate, or high-intensity BBs was 11.6% (8.0%–15.2%), 5.4% (4.4%–6.5%), 2.5% (1.9%–3.0%), and 3.3% (2.3%–4.3%), respectively.

Conclusions:
In-hospital use of BBs was associated with a significant reduction in postoperative mortality after OAR. This is the first study to demonstrate a dose–response relationship between BBs and postoperative mortality after OAR.
Effect of Surgeon Age on Bariatric Surgery Outcomes
Authors: Stevens Haley , Carlin Arthur M. , Ross Rachel , Stricklen Amanda , Wood Michael H. , Ghaferi Amir A. 
Published: May 2017

Objective:
This study sought to explore the relationship of bariatric surgeon age and patient outcomes.

Background:
Regulators, policy makers, and patient advocacy groups have recently been pushing to establish clear guidelines for physician retirement in the United States. Although it is often assumed that increasing physician age leads to worse patient outcomes, the relationship is lacking robust evidence, and is still unclear.

Methods:
We conducted a study analyzing all bariatric surgeons in Michigan who participated in a statewide collaborative quality improvement program (n = 71) who performed primary laparoscopic Roux-en-Y Gastric Bypass, or sleeve gastrectomy operations, and data on their patients (n = 60430) over the past 10 years. Our primary outcomes were 30-day postoperative complications. Odds ratios for overall complications and serious complications were calculated for each age group, and surgery type.

Results:
Late career surgeons had more bariatric surgery experience and had a higher average annual case volume than early career surgeons. Considering all cases in the past 10 years, older surgeons performed more Roux-en-Y Gastric Bypass (40%) and less sleeve gastrectomy (38.8%) than younger surgeons (34.7% and 51.5%). When adjusting for patient and surgeon characteristics, there were no statistically significant differences in overall or serious complication rates for either procedure among surgeon age groups.

Conclusions:
When evaluating bariatric surgeons in the State of Michigan, we found no statistically significant association between surgeon age and patient outcomes. Our findings do not provide evidence for age-specific retirement cut-offs, but support the development of guidelines which are holistic, and focus on evaluating and improving physician outcomes at all career levels.
Pain, Neuropsychiatric Symptoms, and Quality of Life of Nursing Home Residents With Advanced Dementia in The Netherlands
Authors: van Kooten Janine , van der Wouden Johannes C. , Sikkes Sietske A.M. , Smalbrugge Martin , Hertogh Cees M.P.M. , Stek Max L. 
Published: May 2017

Background:
Many studies have investigated factors associated with quality of life (QoL) in nursing home residents with dementia. Both pain and neuropsychiatric symptoms (NPS) are clinically relevant and individually associated with a lower QoL; however, there are no studies that investigated pain and NPS together in relation to QoL.

Purpose:
In this study, we explored the relationship of pain and NPS with QoL in nursing home residents with dementia by investigating the association between pain concurrently with NPS, and QoL.

Methods and Patients:
Secondary data analyses of cross-sectional data from 199 residents were collected by observations at dementia special care units of 10 nursing homes. QoL was measured with Qualidem, pain with the Mobilization Observation Behavior Intensity Dementia (MOBID-2) Pain Scale and NPS with the Neuropsychiatric Symptoms Inventory. The relation of pain and NPS to QoL was studied using multiple linear regression analyses. Analyses were adjusted for age, sex, activities of daily living, comorbidity, medication use, and dementia severity.

Results:
Regression models with pain and NPS, showed no independent relationship between pain and QoL subdomains, but NPS, in particular agitation and depressive symptoms, were significantly associated with lower QoL subdomain scores. Agitation was related to lower scores on the subdomains “relationship” [95% confidence interval (CI), −0.083 to −0.059], “positive affect” (95% CI, −0.037 to −0.013), “restless tense behavior” (95% CI, −0.003 to −0.004), and “social relations” (95% CI, −0.033 to −0.009), whereas depression was related to lower scores on the subdomains “positive affect” (95% CI, −0.054 to −0.014), “negative affect” (95% CI, −0.114 to −0.074), “restless tense behavior” (95% CI, −0.075 to −0.025), and “social relations” (95% CI, −0.046 to −0.002).

Conclusions:
Only NPS were significantly associated with QoL in nursing home residents with dementia. Further longitudinal research is needed to estimate the nature of the relationship between pain, NPS, and QoL.
Extreme weather and climate events with ecological relevance: a review
Authors: Ummenhofer Caroline C. , Meehl Gerald A. 
Published: May 2017

Robust evidence exists that certain extreme weather and climate events, especially daily temperature and precipitation extremes, have changed in regard to intensity and frequency over recent decades. These changes have been linked to human-induced climate change, while the degree to which climate change impacts an individual extreme climate event (ECE) is more difficult to quantify. Rapid progress in event attribution has recently been made through improved understanding of observed and simulated climate variability, methods for event attribution and advances in numerical modelling. Attribution for extreme temperature events is stronger compared with other event types, notably those related to the hydrological cycle. Recent advances in the understanding of ECEs, both in observations and their representation in state-of-the-art climate models, open new opportunities for assessing their effect on human and natural systems. Improved spatial resolution in global climate models and advances in statistical and dynamical downscaling now provide climatic information at appropriate spatial and temporal scales. Together with the continued development of Earth System Models that simulate biogeochemical cycles and interactions with the biosphere at increasing complexity, these make it possible to develop a mechanistic understanding of how ECEs affect biological processes, ecosystem functioning and adaptation capabilities. Limitations in the observational network, both for physical climate system parameters and even more so for long-term ecological monitoring, have hampered progress in understanding bio-physical interactions across a range of scales. New opportunities for assessing how ECEs modulate ecosystem structure and functioning arise from better scientific understanding of ECEs coupled with technological advances in observing systems and instrumentation.
This article is part of the themed issue ‘Behavioural, ecological and evolutionary responses to extreme climatic events’.
How birds cope physiologically and behaviourally with extreme climatic events
Authors: Wingfield John C. , Pérez Jonathan H. , Krause Jesse S. , Word Karen R. , González-Gómez Paulina L. , Lisovski Simeon , Chmura Helen E. 
Published: May 2017

As global climate change progresses, the occurrence of potentially disruptive climatic events such as storms are increasing in frequency, duration and intensity resulting in higher mortality and reduced reproductive success. What constitutes an extreme climatic event? First we point out that extreme climatic events in biological contexts can occur in any environment. Focusing on field and laboratory data on wild birds we propose a mechanistic approach to defining and investigating what extreme climatic events are and how animals cope with them at physiological and behavioural levels. The life cycle of birds is made up of life-history stages such as migration, breeding and moult that evolved to match a range of environmental conditions an individual might expect during the year. When environmental conditions deteriorate and deviate from the expected range then the individual must trigger coping mechanisms (emergency life-history stage) that will disrupt the temporal progression of life-history stages, but enhance survival. Using the framework of allostasis, we argue that an extreme climatic event in biological contexts can be defined as when the cumulative resources available to an individual are exceeded by the sum of its energetic costs—a state called allostatic overload. This allostatic overload triggers the emergency life-history stage that temporarily allows the individual to cease regular activities in an attempt to survive extreme conditions. We propose that glucocorticoid hormones play a major role in orchestrating coping mechanisms and are critical for enduring extreme climatic events.This article is part of the themed issue ‘Behavioural, ecological and evolutionary responses to extreme climatic events’.
Micropatterned substrates to promote and dissect reprogramming of human somatic cells
Authors: Carlson-Stevermer Jared , Harkness Ty , Prestil Ryan , Seymour Stephanie , Knight Gavin , Ashton Randolph , Saha Krishanu 
Published: May 2017

ABSTRACTReprogramming of human somatic cells to induce pluripotent stem cells (iPSCs) generates valuable precursors for disease modeling and regenerative medicine. However, the reprogramming process can be inefficient and noisy, creating many partially reprogrammed cells in addition to fully reprogrammed iPSCs. To address these shortcomings, we developed a micropatterned substrate that allows for dynamic live-cell microscopy of thousands of cell subpopulations undergoing reprogramming. Micropatterning facilitated a change in shape, size and clustering of nuclei to promote somatic identity erasure. Increased proliferation, cell density and decreased intercellular YAP signaling accompanied these nuclear changes. A combination of eight nuclear characteristics could be used to track reprogramming progression and distinguish partially reprogrammed cells from those that were fully reprogrammed.Micropatterned substrates constitute a new tool for facile iPSC production and can be used in high-throughput to probe and understand the subcellular changes that accompany human cell fate transitions.
Assessment of the Potential Role ofStreptomycesin Cave Moonmilk Formation
Authors: Maciejewska Marta , Adam Delphine , Naômé Aymeric , Martinet Loïc , Tenconi Elodie , Całusińska Magdalena , Delfosse Philippe , Hanikenne Marc , Baurain Denis , Compère Philippe , Carnol Monique , Barton Hazel , Rigali Sébastien 
Published: May 2017

AbstractMoonmilk is a karstic speleothem mainly composed of fine calcium carbonate crystals (CaCO3) with different textures ranging from pasty to hard, in which the contribution of biotic rock-building processes is presumed to involve indigenous microorganisms. The real bacterial input in the genesis of moonmilk is difficult to assess leading to controversial hypotheses explaining the origins and the mechanisms (biotic versus abiotic) involved. In this work we undertook a comprehensive approach in order to assess the potential role of filamentous bacteria, particularly a collection of moonmilk-originatingStreptomyces, in the genesis of this speleothem. Scanning electron microscopy (SEM) confirmed that indigenous filamentous bacteria could indeed participate in moonmilk development by serving as nucleation sites for CaCO3deposition. The metabolic activities involved in CaCO3transformation were furthermore assessedin vitroamong the collection of moonmilkStreptomyces, which revealed that peptides/amino acids ammonification, and to a lesser extend ureolysis, could be privileged metabolic pathways participating in carbonate precipitation by increasing the pH of the bacterial environment. Additionally,in silicosearch for the genes involved in biomineralization processes including ureolysis, dissimilatory nitrate reduction to ammonia, active calcium ion transport, and reversible hydration of CO2allowed to identify genetic predispositions for carbonate precipitation inStreptomyces. Finally, their biomineralization abilities were confirmed by environmental SEM, which allowed to visualize the formation of abundant mineral deposits under laboratory conditions. Overall, our study provides novel evidences that filamentous Actinobacteria could be key protagonists in the genesis of moonmilk through a wide spectrum of biomineralization processes.
6S RNA supports recovery from nitrogen depletion inSynechocystissp. PCC 6803
Authors: Heilmann Beate , Hakkila Kaisa , Georg Jens , Tyystjärvi Taina , Hess Wolfgang R. , Axmann Ilka M. , Dienst Dennis 
Published: May 2017

AbstractBackgroundThe 6S RNA is a global transcriptional riboregulator, which is exceptionally widespread among most bacterial phyla. While its role is well-characterized in some heterotrophic bacteria, we subjected a cyanobacterial homolog to functional analysis, thereby extending the scope of 6S RNA action to the special challenges of photoautotrophic lifestyles.ResultsPhysiological characterization of a 6S RNA deletion strain (ΔssaA) demonstrates a delay in the recovery from nitrogen starvation. Significantly decelerated phycobilisome reassembly and glycogen degradation are accompanied with reduced photosynthetic activity compared to the wild type.Transcriptome profiling further revealed that predominantly genes encoding photosystem components, ATP synthase, phycobilisomes and ribosomal proteins were negatively affected in ΔssaA.In vivopull-down studies of the RNA polymerase complex indicated a promoting effect of 6S RNA on the recruitment of the cyanobacterial housekeeping σ factor SigA, concurrently supporting dissociation of group 2 σ factors during recovery from nitrogen starvation.ConclusionsThis study reveals 6S RNA as an integral part of the cellular response ofSynechocystissp. PCC 6803 to changing nitrogen availability. According to these results, 6S RNA supports a rapid acclimation to changing nitrogen supply by regulating the switch from group 2 σ factors SigB, SigC and SigE to SigA- dependent transcription.
Interacting Learning Processes during Skill Acquisition: Learning to control with gradually changing system dynamics
Authors: Ludolph Nicolas , Giese Martin A. , Ilg Winfried 
Published: May 2017

ABSTRACTThere is increasing evidence that sensorimotor learning under real-life conditions relies on a composition of several learning processes. Nevertheless, most studies examine learning behaviour in relation to one specific learning mechanism. In this study, we examined the interaction between reward-based skill acquisition and motor adaptation to changes of object dynamics. Thirty healthy subjects, split into two groups, acquired the skill of balancing a pole on a cart in virtual reality. In one group, we gradually increased the gravity, making the task easier in the beginning and more difficult towards the end. In the second group, subjects had to acquire the skill on the maximum, most difficult gravity level. We hypothesized that the gradual increase in gravity during skill acquisition supports learning despite the necessary adjustments to changes in cart-pole dynamics. We found that the gradual group benefits from the slow increment, although overall improvement was interrupted by the changes in gravity and resulting system dynamics, which caused short-term degradations in performance and timing of actions. In conclusion, our results deliver evidence for an interaction of reward-based skill acquisition and motor adaptation processes, which indicates the importance of both processes for the development of optimized skill acquisition schedules.