bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calibrating actigraphy to improve sleep efficiency estimates
Authors: Khan Christina T. , Woodward Steven H. 
Published: October 2017

SummaryActigraphy (ACT) can enhance treatment for insomnia by providing objective estimates of sleep efficiency; however, only two studies have assessed the accuracy of actigraphy‐based estimates of sleep efficiency (ACT‐SE) in sleep‐disordered samples studied at home. Both found poor correspondence with polysomnography‐based estimates (PSG‐SE). The current study tested that concordance in a third sample and piloted a method for improving ACT‐SE. Participants in one of four diagnostic categories (panic disorder, post‐traumatic stress disorder, comorbid post‐traumatic stress and panic disorder and controls without sleep complaints) underwent in‐home recording of sleep using concurrent ambulatory PSG and actigraphy. Precisely synchronized PSG and ACT recordings were obtained from 41 participants. Sleep efficiency was scored independently using conventional methods, and ACT‐SE/PSG‐SE concordance examined. Next, ACT data recorded initially at 0.5 Hz were resampled to 30‐s epochs and rescaled on a per‐participant basis to yield optimized concordance between PSG‐ and ACT‐based sleep efficiency estimates. Using standard scoring of ACT, the correlation between ACT‐SE and PSG‐SE across participants was statistically significant (r = 0.35, P < 0.025), although ACT‐SE failed to replicate a main effect of diagnosis. Individualized calibration of ACT against a night of PSG yielded a significantly higher correlation between ACT‐SE and PSG‐SE (r = 0.65, P < 0.001; z = 1.692, P = 0.0452, one‐tailed) and a significant main effect of diagnosis that was highly correspondent with the effect on PSG‐SE. ACT‐based estimates of sleep efficiency in sleep‐disordered patients tested at home can be improved significantly by calibration against a single night of concurrent PSG.
Enhanced natural killer cell activity is found in exposed uninfected recipients of hepatitis C‐contaminated blood
Authors: Ow M. M. , Hegazy D. , Warshow U. M. , Cramp M. E. 
Published: October 2017

SummaryA minority of injecting drug users, termed exposed uninfected, are resistant to hepatitis C (HCV) infection despite repeated low‐dose exposures. We identify for the first time a cohort of blood recipients who remained uninfected despite large‐dose exposure to HCV‐contaminated blood and characterize immune factors that may confer protection. Of 1340 blood recipients from the English Look Back database who were transfused HCV‐contaminated blood, we identified 8 who remained uninfected. In these 8 exposed uninfecteds, we characterized their natural killer (NK) cell populations and HCV‐specific T‐cell responses. Findings were compared with 10 spontaneous resolvers of HCV infection, 10 patients with chronic HCV infection and 10 healthy controls. Exposed uninfecteds had significantly greater numbers of NK cells with the activating receptor NKp30+ on CD56bright and CD56dim subsets compared with other groups (P < .05). Following interleukin‐2 activation, NK cells of exposed uninfecteds had enhanced cytotoxicity that positively correlated with NKp30 expression (P = .02). Differences in NKp80 and KIR2DL3 expression were also observed. HCV‐specific T‐cell responses were observed in some exposed uninfecteds but of low amplitude. Exposure without infection following transfusion of HCV‐contaminated blood is a very rare phenomenon and suggests a high level of resistance to infection. Enhanced NK cell activation and killing, with weak HCV‐specific T‐cell responses, were observed many years after exposure in uninfected recipients and may contribute to protection from HCV acquisition, although additional protective factors are being sought in this important cohort.
A report on the mosquitoes of mainland Åland, southwestern Finland and revised list of Finnish mosquitoes
Authors: CULVERWELL C. L. 
Published: October 2017

AbstractTo successfully implement surveillance or control strategies for mosquitoes, up‐to‐date knowledge of regional species composition is vital. The last report regarding mosquitoes (Diptera: Culicidae) in the Åland archipelago, southwestern Finland listed 19 species (Utrio, 1979). To determine the current species diversity, one collection trip was made to mainland Åland in 2015 and three in 2016. Mosquitoes (n = 3286) were collected as both adult and immature life stages from 88 collections within 29 1‐km2 areas. Fifteen of the 19 previously reported species were obtained, leaving the current status of four species uncertain. At least 11 species previously not reported from Åland, but confirmed on the Finnish mainland, were collected. Aedes geminus Peus was identified based on examination of the gonostylus, and represents a new species distribution for Finland. Anopheles maculipennis s.s. Meigen was confirmed from cytochrome c oxidase subunit I (COI) and internal transcribed spacer 2 (ITS2) sequence data and is reinstated on the list of Finnish species, along with Ochlerotatus sticticus (Meigen). Dahliana geniculata (Olivier) was found in two locations, in 2 months, indicating that there is an established population in Åland. The present data confirm that at least 27 species inhabit mainland Åland, rising to 31 when historical data are included. The Finnish mosquito fauna is increased from 38 to 41 species.
In vitro antifungal activity of amphotericin B and 11 comparators against Aspergillus terreus species complex
Authors: Vaezi Afsane , Fakhim Hamed , Arastehfar Amir , Shokohi Tahereh , Hedayati Mohammad T. , Khodavaisy Sadegh , Rezaei‐Matehkolaei Ali , Badiee Parisa , Hagen Ferry , Lass‐Flörl Cornelia , Dannaoui Eric , Meis Jacques F. , Badali Hamid 
Published: October 2017

SummaryAspergillus terreus infections are difficult to treat because of the intrinsic resistance to amphotericin B, and higher mortality compared to infections caused by other Aspergillus species. The aim of the present study was to determine the in vitro antifungal activity of amphotericin B and 11 comparators against clinical (n = 36) and environmental (n = 45) A. terreus isolates. In vitro antifungal susceptibility was performed using the CLSI M38‐A2 procedure. Amphotericin B exhibited the highest MICs (MIC range, 0.125‐4 μg/mL; MIC90, 2 μg/mL), followed by terbinafine (MIC range, 0.002‐1 μg/mL; MIC90, 1 μg/mL). Only one isolate (1/81) showed amphotericin B MIC above the epidemiologic cut‐off value (ECV; 4 μg/mL). None of the isolates had a MIC of ≥ ECV for voriconazole, itraconazole and posaconazole. The reasons for the difference in amphotericin B susceptibility patterns between studies remain unknown. The genetic and species diversity, clinical, environmental and ecological factors in Terrei section on various amphotericin B susceptibility profiles in different countries should be considered more as the main reasons associated with these differences.
Theoretical development in the context of nursing—The hidden epistemology of nursing theory
Authors: Hoeck Bente , Delmar Charlotte 
Published: October 2017

AbstractThis article is about nursing theories, the development of nursing knowledge and the underlying, hidden epistemology. The current technical–economical rationality in society and health care calls for a specific kind of knowledge based on a traditional Western, Socratic view of science. This has an immense influence on the development of nursing knowledge. The purpose of the article was therefore to discuss the hidden epistemology of nursing knowledge and theories seen in a broad historical context and point to an alternative epistemology for a future context. It is a question about which nursing theories and what nursing knowledge should be developed in order to benefit patients and relatives of the future. We suggest that future knowledge development in nursing be developed in an interchange between theory and practice and guided by philosophy like a kind of pendulum where all three elements are treated as equals. We suggest a framework for the development of nursing knowledge based on a caring‐ethical practice, a theory on life phenomena in suffering and relationship‐based nursing, and thereby, we may be able to help patients to be cured, to recover, to be alleviated or comforted when suffering.
Adolescent mothers’ anthropometrics and grandmothers’ schooling predict infant anthropometrics in Ethiopia, India, Peru, and Vietnam
Authors: Schott Whitney , Aurino Elisabetta , Penny Mary E. , Behrman Jere R. 
Published: October 2017

AbstractWe investigated intergenerational associations of adolescent mothers’ and grandmothers’ anthropometrics and schooling with adolescent mothers’ offspring's anthropometrics in Ethiopia, India, Peru, and Vietnam. We examined birthweight (n = 283), birthweight Z‐score (BWZ), conditional growth in weight‐for‐age Z‐score (cWAZ, residuals from a regression of WAZ at last survey round on BWZ, sex, and age), and height‐for‐age Z‐score (HAZ) of children born to older cohort adolescent girls in the Young Lives study. Our key independent variables were adolescent mothers’ body size: HAZ and body‐mass‐index‐for‐age Z‐score (BMIZ) at age 8, conditional HAZ (cHAZ, residuals from a regression of HAZ at the end of a growth period on prior HAZ, age, and sex), conditional BMIZ growth (cBMIZ, calculated analogously), and grandmaternal BMIZ, HAZ, and schooling. We adjusted for child, maternal, and household characteristics. Adolescent mothers’ cHAZ (ages 8–15) predicted birthweight ( = 130 g, 95% confidence interval (CI) 31–228), BWZ ( = 0.31, CI 0.09–0.53), and cWAZ ( = 0.28, CI 0.04–0.51). Adolescent mothers’ BMIZ at age 8 predicted birthweight ( = 79 g, CI 16–43) and BWZ ( = 0.22, CI 0.08–0.36). Adolescent mothers’ cBMIZ (ages 12–15) predicted child cWAZ and HAZ. Grandmothers’ schooling predicted grandchild birthweight ( = 22 g, CI 1–44) and BWZ ( = 0.05, CI 0.01–0.10).
Wearable cardioverter defibrillators in schools: A guide for parents and educators
Authors: Burch Ashley E. , Spar David S. , Sears Samuel F. 
Published: October 2017

AbstractKeeping children safe is a goal for everyone. To stay safe, some children need a wearable cardioverter defibrillator (WCD). WCDs protect individuals who are at risk for life‐threatening arrhythmias. The LifeVest® (ZOLL, Pittsburgh, PA, USA) is a WCD that identifies, records, and treats potentially life‐threatening abnormal heartbeats, or arrhythmias. The WCD will provide electrical energy to the heart with up to five high‐energy shocks if a potentially dangerous cardiac arrhythmia is detected. This type of arrhythmia, if not treated within a short time period (less than 2 minutes), can result in disruption of blood flow to the brain and other vital organs (that is, a sudden cardiac arrest), and death can occur within minutes. A shock delivered by the LifeVest can terminate an arrhythmia and restore a normal heart rhythm and blood flow to the body. In December 2015, the Food and Drug Administration approved the LifeVest for patients under 18 years old. The purpose of this guide is to serve as a resource for parents and educators, to promote awareness of the LifeVest, and to answer questions about the safety of the LifeVest in schools.
Role of ultrasound measuring position and ventilation pressure in determining correct tube size in children
Authors: Schramm Christoph , Eisleben Luzie S. , Kessler Jens , Jensen Katrin , Plaschke Konstanze 
Published: October 2017

SummaryBackgroundUltrasound measurements of the airway are useful for determining correctly sized, uncuffed endotracheal tubes in children.AimsThe primary objective of this study was to evaluate the influence of ventilation pressure on the sonographically measured tracheal diameter at different levels.MethodsA total of 100 patients (under 7 years) were enrolled in this study. Six sonographic measurements of minimal transverse diameters at 3 locations (vocal chords, cricoid cartilage, and proximal trachea) and at 2 different ventilation pressures (0 and 15 mbar) were performed before the intubation procedure. The intubating anesthesiologists were blinded to the results of the ultrasound measurements. The rate of agreement of the outer diameter of the correctly sized endotracheal tube (reference) with the 6 sonographic diameters was determined. In addition, the correct tube sizes were compared with the results of traditional prediction methods (Penlington's and Cole's formula in children ≥1 year and a decision table in children <1 year).ResultsBest rate of agreement resulted from cricoid cartilage (70% and 83% at 0 and 15 mbar).ConclusionThe airway level selected for ultrasound and airway pressure during measurement determines the rate of agreement between the measurement result and correct ETT size.
A quality improvement initiative to increase the safety of pediatric emergency airway management
Authors: Long Elliot , Cincotta Domenic R. , Grindlay Joanne , Sabato Stefano , Fauteux‐Lamarre Emmanuelle , Beckerman David , Carroll Terry , Quinn Nuala 
Published: October 2017

SummaryBackgroundEmergency airway management is commonly associated with life‐threatening hypoxia and hypotension which may be preventable.AimsThe aim of this quality improvement study was to reduce the frequency of intubation‐related hypoxia and hypotension.MethodsThis prospective quality improvement study was conducted over 4 years in the Emergency Department of The Royal Children's Hospital, Melbourne, Australia. A preintervention cohort highlighted safety gaps and was used to design study interventions, including an emergency airway algorithm, standardized airway equipment, a preintubation checklist and equipment template, endtidal carbon dioxide monitoring, postintubation team debriefing, and multidisciplinary team training. Following implementation, a postintervention cohort was used to monitor the impact of study interventions on clinical process and patient outcome. Process measures were as follows: use of a preintubation checklist, verbalization of an airway plan, adequate resuscitation prior to intubation, induction agent dose titration, use of apneic oxygenation, and use of endtidal carbon dioxide to confirm endotracheal tube position. The primary outcome measure was first pass success rate without hypoxia or hypotension. Potential harms from study interventions were monitored.ResultsForty‐six intubations were included over one calendar year in the postintervention cohort (compared to 71 in the preintervention cohort). Overall clinical uptake of the 6 processes measures was 85%. First pass success rate without hypoxia or hypotension was 78% in the postintervention cohort compared with 49% in the preintervention cohort (absolute risk reduction: 29.0%; 95% confidence interval 12.3%‐45.6%, number needed to treat: 3.5). No significant harms from study interventions were identified.ConclusionQuality improvement initiatives targeting emergency airway management may be successfully implemented in the emergency department and are associated with a reduction in adverse intubation‐related events.
Intrathecal Drug Delivery Systems for the Management of Chronic Noncancer Pain: A Systematic Review of Economic Evaluations
Authors: Duarte Rui V. , Lambe Tosin , Raphael Jon H. , Eldabe Sam , Andronis Lazaros 
Published: October 2017

AbstractBackgroundIntrathecal drug delivery (ITDD) systems are one of a limited number of management options for chronic noncancer pain, cancer pain, and spasticity. Concerns over their effectiveness and high initial costs led National Health Service (NHS) England to decommissionITDDfor patients with chronic noncancer pain. However, the extent to which this decision is in line with existing economic evidence is unclear. The aim of this systematic review was to identify and review the existing evidence on the cost effectiveness ofITDDfor chronic noncancer pain.MethodsFull and partial economic evaluations onITDDwere identified through systematic searches inMEDLINE, Embase, Web of Science, and the NHS for Reviews and Dissemination databases. Database searches were complemented by hand searching of reference lists of relevant studies and searches of grey literature. Study selection was carried out by 2 assessors, independently. Study quality assessment was performed to inform critical appraisal of health economics studies. Data were extracted using a data extraction form developed for the purposes of this study.ResultsFour thousand four hundred and sixty‐four unique studies were identified, of which 7 met the inclusion criteria. With the exception of 1 study, the studies foundITDDto be either cost saving or cost effective compared to conventional medical management.ITDDbecame cost ineffective in 1 further study following price year adjustment to 2016.ConclusionsStudy findings showedITDDto be not cost effective only in extremely conservative scenarios. There is limited evidence on the effectiveness ofITDDin noncancer pain; however, the available economic evidence controverts arguments to refute the treatment on economic grounds.
Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress
Authors: Itokawa Masanari , Miyashita Mitsuhiro , Arai Makoto , Dan Takashi , Takahashi Katsuyoshi , Tokunaga Taro , Ishimoto Kayo , Toriumi Kazuya , Ichikawa Tomoe , Horiuchi Yasue , Kobori Akiko , Usami Satoshi , Yoshikawa Takeo , Amano Naoji , Washizuka Shinsuke , Okazaki Yuji , Miyata Toshio 
Published: October 2017

AimThe aim of this clinical trial was to obtain proof of concept for high‐dose pyridoxamine as a novel treatment for schizophrenia with enhanced carbonyl stress.MethodsTen Japanese schizophrenia patients with high plasma pentosidine, which is a representative biomarker of enhanced carbonyl stress, were recruited in a 24‐week, open trial in which high‐dose pyridoxamine (ranging from 1200 to 2400 mg/day) was administered using a conventional antipsychotic regimen. Main outcomes were the total change in Positive and Negative Syndrome Scale score and the Brief Psychiatric Rating Scale score from baseline to end of treatment at week 24 (or at withdrawal).ResultsDecreased plasma pentosidine levels were observed in eight patients. Two patients showed marked improvement in their psychological symptoms. A patient who harbors a frameshift mutation in the Glyoxalase 1 gene also showed considerable reduction in psychosis accompanied with a moderate decrease in plasma pentosidine levels. A reduction of greater than 20% in the assessment scale of drug‐induced Parkinsonism occurred in four patients. Although there was no severe suicide‐related ideation or behavior, Wernicke's encephalopathy‐like adverse drug reactions occurred in two patients and were completely suppressed by thiamine supplementation.ConclusionHigh‐dose pyridoxamine add‐on treatment was, in part, effective for a subpopulation of schizophrenia patients with enhanced carbonyl stress. Further randomized, placebo‐controlled trials with careful monitoring will be required to validate the efficacy of high‐dose pyridoxamine for these patients.
Short‐ and long‐term evaluation of cognitive functions after electroconvulsive therapy in a Japanese population
Authors: Takagi Shunsuke , Takeuchi Takashi , Yamamoto Naoki , Fujita Munehisa , Furuta Ko , Ishikawa Hiroyo , Motohashi Nobutaka , Nishikawa Toru 
Published: October 2017

AimWhile electroconvulsive therapy (ECT) is a well‐established, safe, and effective treatment for mental illnesses, the potential for adverse effects on cognitive functions remains controversial. We aimed to evaluate multiple cognitive functions in different time periods before and after ECT in a Japanese population.MethodsA battery of five neurocognitive tests was administered to patients who underwent a course of ECT treatment at three time points: before, immediately after, and 4 weeks after ECT.ResultsA transient but significant decline in letter fluency function was observed immediately after ECT, but had recovered well by 4 weeks. We also observed a significant improvement in the trail‐making task at 4 weeks after ECT.ConclusionIn a Japanese population, adverse effects of ECT on verbal fluency function‐related and other cognitive impairments were transient. Over the longer term, we detected significant improvements in the performance of tasks that presumably reflected information processing speed and executive functions.
Everolimus‐associated perianal ulcers in an eight‐month‐old heart transplant recipient
Authors: Spehl Marco S. , Fleck Thilo , Schauer Franziska , Meiss Frank , Stiller Brigitte 
Published: October 2017

AbstractmTOR inhibitors have a wide spectrum of therapeutic applications in adults and children. Little is known, however, about serious adverse effects in children undergoing mTOR inhibitor therapy. Oral ulcers are common and sometimes severe, but no other gastrointestinal involvement has been reported so far. Here we present a case of everolimus‐associated perianal ulcers in an eight‐month‐old infant, 3 months after heart transplantation, which necessitated the drug's discontinuation. In a thorough series of diagnostic tests, we identified no other cause for the progressive perianal ulceration. The recognition and appropriate management of mTOR inhibitors' adverse effects in pediatric patients are essential and remain challenging.
Repeated ultraviolet irradiation induces the expression of Toll‐like receptor 4, IL‐6, and IL‐10 in neonatal human melanocytes
Authors: Song Hee Jin , Lee Si Hyub , Choi Gwang Seong , Shin Jeonghyun 
Published: October 2017

SummaryBackgroundHuman melanocytes express Toll‐like receptor 4 (TLR4), which regulates ultraviolet (UV)‐induced cutaneous immunosuppression in Langerhans cells. Lipopolysaccharide (LPS) stimulation increases melanocyte pigmentation and TLR4 expression, while inducing local innate inflammatory responses.AimsWe investigated whether UV radiation induces TLR4 expression in neonatal human melanocytes (NHMs) and how this affects the immune system.MethodsWe cultured NHMs with LPS treatment or with one‐time or repeated UVA or UVB exposure, and investigated and compared the effects on TLR4 expression, melanin contents, and cytokine production.ResultsNHMs in the resting state did not express TLR4. LPS stimulation induced TLR4 expression and increased pigmentation. TLR4 expression was not detected after single‐dose UVA or UVB treatment, but pigmentation increased. Repeated UV treatment induced TLR4 expression and increased pigmentation. LPS stimulation and repeated UV treatment increased IL‐6 secretion, and repeated UVB treatment increased IL‐10 secretion.ConclusionThese results suggest that human melanocytes may actively participate in UV‐induced immune modulation.
The intestinal nematode inhibits T‐cell reactivity by targeting P‐GP activity
Authors: Donskow‐Łysoniewska K. , Krawczak K. , Kozłowska E. , Doligalska M. 
Published: October 2017

SummaryHost immunosuppression occurs during chronic nematode infection, partly due to effector T‐cell hyporesponsiveness. The role of P‐glycoprotein (P‐gp), a member of the ABC transporter family, has been assessed in T‐cell activity. This study assesses the possible role of P‐gp in T‐cell activity during nematode infection. Our findings indicate that blockade of P‐gp in vivo increased protection against Heligmosomoides polygyrus nematode infection and was associated with the enhanced T‐cell activity. Three P‐gp‐inhibitors, verapamil (VRP), cyclosporine (CsA) and tariquidar (XR9576), were used to determine the influence of nematode infection on the P‐gp function of T cells. The influence of the nematode on the uptake, efflux and kinetics of extrusion in T‐cell subsets CD4+ and CD8+ was assessed by the accumulation of Rho123 dye. The results indicate that H. polygyrus infection contributes to the inhibition of T‐cell function by elevating P‐gp activity. The blockade of P‐gp in the T cells of infected mice led to an impressive increase in T‐cell proliferation and IL‐4 cytokine release through the upregulation of NF‐κB activation. These results provide the first evidence that the P‐gp function of T cells is altered during nematode infection to open the way for further studies aiming to explore the role of P‐gp in host‐parasite interactions.