bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary artery anomalies in children: what is the risk?
Authors: Brothers Julie A. 
Published: July 2016

Purpose of review
To better understand the risk of sudden death from coronary anomalies.

Recent findings
Most coronary anomalies are benign, but there are certain coronary anomalies that increase the risk of sudden cardiac death (SCD) in the young, notably anomalous aortic origin of a coronary artery from the wrong sinus. Previously, the risk of SCD attributed to certain coronary anomalies was felt to be quite high, as the risk assessment was based on autopsy series. Recent studies have shown that the risk attributed to anomalous coronary arteries is much lower than once believed. Risk appears to be highest with anomalous left coronary artery from the right sinus of Valsalva with interarterial course, notably when the young patient is participating in vigorous physical exertion, such as with competitive sports.

Summary
Treatment strategies may include exercise restriction or surgical repair. Management decisions should be based on a complete understanding of the risk for SCD because of anomalous coronary arteries. Future directions should focus on better methods to risk stratify these pediatric patients.
Outcomes of Children With and Without Hepatic Encephalopathy From the Pediatric Acute Liver Failure Study Group
Authors: Ng Vicky L. , Li Ruosha , Loomes Kathleen M. , Leonis Mike A. , Rudnick David A. , Belle Steven H. , Squires Robert H. ,   Pediatric Acute Liver Failure Study Group (PALFSG)
Published: July 2016

ABSTRACTObjectives:Hepatic encephalopathy (HE) is challenging to identify in children with acute liver failure and was not a requirement for enrollment into the Pediatric Acute Liver Failure Study Group (PALFSG). The outcomes of PALFSG participants presenting with and without HE are presented.Methods:PALFSG participants were classified based on daily assessment of HE during the first 7 days following study enrollment: group 1—never developed HE; group 2—no HE at enrollment with subsequent HE development; and group 3—HE at study enrollment. Clinical and biochemical parameters and outcomes of death, spontaneous recovery, or liver transplantation were compared between groups.Results:Data from 769 PALFSG (54% boys; median age 4.2 years; range 0–17.9 years) participants were analyzed, with 277 in group 1 (36%), 83 in group 2 (11%), and 409 in group 3 (53%). Mortality occurred in 11% of all participants and was highest among group 3 participants who demonstrated persistent grade III–IV HE (55%) or showed progression of HE (26%). Eleven (4%) group 1 participants died within 21 days of enrollment. Spontaneous recovery was highest in group 1 (79%) and lowest in group 2 (25%; P < 0.001).Conclusions:Mortality 21 days after enrollment was highest in participants enrolled with severe HE (grades III or IV) or demonstrating HE progression. Four percent of participants without recorded clinical HE in the 7 days after enrollment, however, died within 21 days. Improved assessment of neurological injury and pediatric acute liver failure prognostication schema are needed.
Early Microbe Contact and Obesity Risk
Authors: Isolauri Erika , Salminen Seppo , Rautava Samuli 
Published: July 2016

ABSTRACTThe industrialized societies worldwide are in the middle of epidemics of diet‐related chronic diseases, obesity being the common denominator. Lately, these conditions have been linked with a distinct microbiota composition in affected individuals different from that of healthy individuals. In particular, dysbiosis during critical stages of development induces lasting alterations in the immune and metabolic phenotype. The compositional development of the gut microbiota, again, is highly sensitive to environmental influences such as maternal health and nutrition, the mode of delivery, early feeding and antibiotic use. Shifts in the microbiota by high‐energy diet increase energy extraction and storage, provoke a low‐grade inflammatory response and impair gut barrier function, and, consequently, result in obesity and metabolic disease. A lower abundance of butyrate‐producing bacteria and lower overall richness of bacteria has been associated with increased metabolic disease risk in humans. Recent reports suggest that Akkermansia type bacteria or butyrate producing microbes may have anti‐inflammatory potential and enhance intestinal barrier function, which may both alleviate obesity and related metabolic complications. Thus we are not directly what we eat or our mother eats, but what our microbiota eat and how the collective composition of the microbiome is modified by the diet. On this basis, altering the intestinal microecosystem may be taken as a key target to attain prophylactic or therapeutic effects in metabolic and inflammatory conditions. Tools for such modulation include specific probiotic bacteria and potentially also non‐digestible carbohydrate components able to modify microbiota composition and activity.
Serum Lipid Profile, Prevalence of Dyslipidaemia, and Associated Risk Factors Among Northern Mexican Adolescents
Authors: Bibiloni Maria del Mar , Salas Rogelio , De la Garza Yolanda E. , Villarreal Jesus Z. , Sureda Antoni , Tur Josep A. 
Published: July 2016

ABSTRACTBackground:The increase in overweight and obese children and adolescents may be linked to increased rates of dyslipidaemia. The aim was to assess the serum lipid profile, the prevalence of dyslipidaemia, and associated risk factors among the North Mexican adolescent population.Methods:Two hundred and ninety‐three subjects (47.8% girls) ages 11 to 16 years took part in the Nuevo León State Survey of Nutrition and Health 2011–2012. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, dyslipidaemia was defined as a presence of ≥1 of the following levels (mg/dL): Total cholesterol ≥200, low‐density lipoprotein cholesterol ≥130, non–high‐density lipoprotein cholesterol <40, and triglyceride ≥130.Results:The overall frequency of dyslipidaemia was 48.8% with no differences between sexes. Adolescents with high body mass index were more likely to have at least 1 abnormal lipid level (overweight: odds ratio [OR]: 2.07; 95% confidence interval [CI]: 1.14–3.77, P < 0.05; obesity: OR: 2.21, 95% CI: 1.11–4.41, P < 0.05) than those with normal weight. Abdominally subjects with obesity were also more likely to have at least 1 abnormal lipid level (OR: 2.30; 95% CI: 1.35–3.91, P < 0.01) than their leaner counterparts.Conclusions:Half of Mexican adolescents living in the State of Nuevo León have at least 1 abnormal lipid concentration. Low HDL‐chol level was the most common dyslipidaemia. Body mass index and abdominal obesity were associated with the prevalence of at least 1 abnormal lipid level.
The Dark Side of Addiction
Authors: Koob George F. 
Published: July 2016

Abstract
W. Horsley Gantt and Joseph V. Brady laid a rich foundation for understanding the concept of emotion, derived from 2 prominent traditions of physiology and psychology: classic conditioning and operant conditioning, respectively. This framework guided my fierce interest in motivation in general and the interaction between reward and stress, which began at John Hopkins with my thesis work under the guidance of Drs. Zoltan Annau, Solomon Synder, and Joseph Brady, among many others. Using the study of the neurobiology of addiction as a framework, I argue that drug addiction not only involves positive reinforcement associated with the rewarding effects of drugs of abuse but also involves another major source of reinforcement, specifically negative reinforcement driven by negative emotional states (termed the “dark side” of addiction). Excessive activation of the brain reward systems leads to antireward or a decrease in the function of normal reward-related neurocircuitry and persistent recruitment of the brain stress systems, both of which may be neurobiologically linked. Understanding the neuroplasticity of the neurocircuitry that comprises the negative reinforcement associated with addiction is a key to understanding negative emotional states in general and their pathophysiology.
Social Support and Relationship Satisfaction as Moderators of the Stress-Mood-Alcohol Link Association in US Navy Members
Authors: Kelley Michelle L. , Milletich Robert J. , Hollis Brittany F. , Veprinsky Anna , Robbins Allison T. , Snell Alicia K. 
Published: July 2016

Abstract
The present study examined associations between stress and problematic alcohol use among US Navy members anticipating deployment, whether depressive symptoms mediated the stress-alcohol link, and whether social support and relationship satisfaction moderated associations between stress, depressive symptoms, and problematic alcohol use. Participants were 108 US Navy members assigned to an Arleigh Burke–class destroyer anticipating an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Stress was indirectly related to problematic alcohol use such that higher levels of stress were associated with higher levels of depressive symptoms, which were further associated with higher levels of alcohol use. The indirect effect of stress to problematic alcohol use via depressive symptoms was tested at different levels of social support and relationship satisfaction. At higher levels of social support and relationship satisfaction, the association between stress and problematic alcohol use via depressive symptoms decreased. Results help identify targets for alcohol prevention efforts among current military members.
Myopia—What is Old and What is New?
Authors: Schaeffel Frank 
Published: July 2016

ABSTRACTThe recent “boom of myopia,” described predominantly for East Asia, is assumed to result from increasingly demanding education programs that include extensive near work (and perhaps also extensive use of computers) and little exposure to bright light as found outdoors. Already in 1892, Hermann Cohn stated that the prevalence of myopia is related to the educational level which is related to the economic status of a country. It is not much appreciated that the rates of myopia were already high among school children in central Europe in the middle of the 19th century, as described by Hermann Cohn. From extensive research in recent times, three major approaches have emerged to interfere with myopia progression in children: (1) promoting exposure to bright light and enforce outdoor activity, (2) adapting/improving optical corrections and visual behavior to generate inhibitory signals for eye growth in the retina, and (3) applying atropine eye drops at low doses. However, Hermann Cohn had already proposed that low luminances during school work promote myopia development and requested that lighting in the classrooms needs to be at least “10 meter candles” (equivalent to an illuminance of 10 lux). Different from today, he explained the link between low light and myopia by shorter reading distances that he observed at low luminances of the reading surface (<<1 cd/m2). He suggested that short reading distances should be avoided in children and described several devices to control them. He further suggested that reading duration should be limited and urged myopes to choose professions that do not involve extensive near work. He also studied the effects of atropine against myopia but concluded that the side effects make it less useful than simply “3–4 weeks without reading.” In summary, a number of his findings were re-discovered today, but they are now much better supported by data, and their interpretations have changed, at least in some aspects.
The Case for Lens Treatments in the Control of Myopia Progression
Authors: Troilo David 
Published: July 2016

ABSTRACT

Myopia is on the rise in the United States and around the world, and with its progression comes increasing risk of a wide variety of associated vision-threatening conditions. Fortunately, several evidence-based treatments for myopia control are currently available and show promise. Basic research on the visual control of eye growth and the development of refractive state is being successfully translated to clinical studies on lens and drug treatments, and patients are already benefiting. Evidence-based practice is transforming the clinical care for myopia from correction to treatment. In this commentary on the role of lens treatments for myopia control from the 15th International Myopia Conference, the author considers bifocals, progressive addition lenses, multifocal contact lenses, and orthokeratology to make the case that lens treatments, particularly using multifocal contact lenses, are effective for myopia control and should be considered as a first-line treatment. A number of areas for further research and treatment optimization are also identified.
What Do Animal Studies Tell Us about the Mechanism of Myopia—Protection by Light?
Authors: Norton Thomas T. 
Published: July 2016

ABSTRACT

Human studies have provided strong evidence that exposure to time outdoors is protective against the onset of myopia. A causal factor may be that the light levels outdoors (30,000–130,000 lux) are much higher than light levels indoors (typically less than 500 lux). Studies using animal models have found that normal animals exposed to low illuminance levels (50 lux) can develop myopia. The myopia and axial elongation, produced in animals by monocular form deprivation, is reduced by light levels in the 15,000 to 25,000 range. Myopia induced with a negative-power lens seems less affected, perhaps because the lens provides a powerful target for the emmetropization mechanism. Animal studies suggest that raising the light levels may have their effect by increasing retinal dopamine activity, probably via the D2 receptor pathway, altering gene expression in the retina and reducing the signals that produce axial elongation.
An Autopsy Checklist
Authors: Shkrum Michael James , Kent Jessica 
Published: July 2016

Abstract
Any autopsy has safety and risk management issues, which can arise in the preautopsy, autopsy, and postautopsy phases. The London Health Sciences Department of Pathology and Laboratory Medicine Autopsy Checklist was developed to address these issues. The current study assessed 1 measure of autopsy safety: the effectiveness of the checklist in documenting pathologists’ communication of the actual or potential risk of blood-borne infections to support staff. Autopsy checklists for cases done in 2012 and 2013 were reviewed. The frequency of communication, as recorded in checklists, by pathologists to staff of previously diagnosed blood-borne infections (hepatitis B/C and human immunodeficiency virus) or the risk of infection based on lifestyle (eg, intravenous drug abuse) was tabulated. These data were compared with medical histories of the deceased and circumstances of their deaths described in the final autopsy reports. Information about blood-borne infections was recorded less frequently in the checklists compared with the final reports. Of 4 known human immunodeficiency virus cases, there was no checklist documentation in 3. All 11 hand injuries were documented. None of these cases had known infectious risks. The Autopsy Checklist is a standardized means of documenting safety and risk issues arising during the autopsy process, but its effectiveness relies on accurate completion.
Estimation and Preparation of the Hypervariable Regions I/II Templates for Mitochondrial DNA Typing From Human Bones and Teeth Remains Using Singleplex Quantitative Polymerase Chain Reaction
Authors: Le Thien Ngoc , Van Phan Hieu , Dang Anh Tuan Mai , Nguyen Vy Thuy 
Published: July 2016

AbstractA method was designed for estimating and sequencing of mitochondrial DNA (mtDNA) that effectively and more quickly provides a complete mtDNA profile. In this context, we have developed this novel strategy for typing mtDNA from 10 bones and teeth remains (3 months to 44 years). The quantification of mtDNA was achieved by singleplex real-time polymerase chain reaction of the hypervariable region I fragment (445 bp) and hypervariable region II fragment (617 bp). Combined with the melting curve analysis, we have determined as little as 10−4pg of mtDNA template that is suitable for sequence analysis. Furthermore, quantitative polymerase chain reaction products were directly used for following step of mtDNA typing by Sanger sequencing. This method allows the profile to be completely provided for faster human identification.
Diagnosis of a Cerebral Arteriovenous Malformation Using Isolated Brain Computed Tomography Angiography
Authors: Qian Hui , Shao Yu , Li Zhengdong , Huang Ping , Zou Donghua , Liu Ningguo , Chen Yijiu , Wan Lei 
Published: July 2016

Abstract
This report presents a case of a 40-year-old woman who was found dead in her house. The examination of the body revealed no external injuries. The whole body was scanned by multi–detector-row computed tomography (CT) before autopsy, revealing massive hemorrhage in the right frontal extending into the ventricular system. At autopsy, the brain parenchyma was removed. Then CT angiography was carried on the isolated brain. Computed tomography angiography suggested a mass of irregular, tortuous vessels in areas of hemorrhage in the right frontal lobe of the brain. Finally, histological examination confirmed the result of CT angiography due to an arteriovenous malformation. Hence, postmortem CT angiography played an important role in diagnosis of the cerebral arteriovenous malformation that was responsible for a massive hemorrhage in the skull.
A Pediatric Sedation Protocol for Mechanically Ventilated Patients Requires Sustenance Beyond Implementation*
Authors: Yaghmai Beryl F. , Di Gennaro Jane L. , Irby Gretchen A. , Deeter Kristina H. , Zimmerman Jerry J. 
Published: July 2016

Objectives:
To reevaluate the effect of a nursing-driven sedation protocol for mechanically ventilated patients on analgesic and sedative medication dosing durations. We hypothesized that lack of continued quality improvement efforts results in increased sedation exposure, as well as mechanical ventilation days, and ICU length of stay.

Design:
Quasi-experimental, uncontrolled before-after study.

Setting:
Forty-five–bed tertiary care, medical-surgical-cardiac PICU in a metropolitan university-affiliated children’s hospital.

Patients:
Children requiring mechanical ventilation longer than 48 hours not meeting exclusion criteria.

Interventions:
During both the intervention and postintervention periods, analgesia and sedation were managed by nurses following an algorithm-based sedation protocol with a targeted comfort score.

Measurement and Main Results:
The intervention cohort includes patients admitted during a 12-month period following initial protocol implementation in 2008–2009 (n = 166). The postintervention cohort includes patients meeting identical inclusion and exclusion criteria admitted during a 12-month period in 2012–2013 (n = 93). Median duration of total sedation days (IV plus enteral) was 5 days for the intervention period and 10 days for the postintervention period (p < 0.0001). The postintervention cohort received longer duration of mechanical ventilation (6 vs 5 d; p = 0.0026) and ICU length of stay (10 vs 8.5 d; p = 0.0543). After adjusting for illness severity and cardiac and surgical status, Cox proportional hazards regression analysis demonstrated that at any point in time, patients in the postintervention group were 58% more likely to be receiving sedation (hazard ratio, 1.58; p < 0.001) and 34% more likely to remain in the ICU (hazard ratio, 1.34; p = 0.019).

Conclusions:
Sedation quality improvement measures related to the use of opiate infusions, total days of sedation exposure, PICU length of stay, and mechanical ventilation days all deteriorated following initial successful implementation of a PICU sedation protocol. Implementation of a protocol alone may not lead to sustained quality improvement without routine monitoring and ongoing education to ensure effectiveness.
Epidemiology of Sepsis in Children Admitted to PICUs in South America*
Authors: de Souza Daniela Carla , Shieh Huei Hsin , Barreira Eliane Roseli , Ventura Andrea Maria Cordeiro , Bousso Albert , Troster Eduardo Juan 
Published: July 2016

Objectives:
To report the prevalence of sepsis within the first 24 hours at admission and the PICU sepsis-related mortality among critically ill children admitted to PICU in South America.

Design:
A prospective multicenter cohort study.

Setting:
Twenty-one PICU, located in five South America countries.

Patients:
All children from 29 days to 17 years old admitted to the participating PICU between June 2011 and September 2011. Clinical, demographic, and laboratory data were registered within the first 24 hours at admission. Outcomes were registered upon PICU discharge or death.

Interventions:
None.

Measurements and Main Results:
Of the 1,090 patients included in this study, 464 had sepsis. The prevalence of sepsis, severe sepsis, and septic shock were 42.6%, 25.9%, and 19.8%, respectively. The median age of sepsis patients was 11.6 months (interquartile range, 3.2–48.7) and 43% had one or more prior chronic condition. The prevalence of sepsis was higher in infants (50.4%) and lower in adolescents (1.9%). Sepsis-related mortality was 14.2% and was consistently higher with increased disease severity: 4.4% for sepsis, 12.3% for severe sepsis, and 23.1% for septic shock. Twenty-five percent of deaths occurred within the first 24 hours at PICU admission. Multivariate analysis showed that higher Pediatric Risk of Mortality and Pediatric Logistic Organ Dysfunction scores, the presence of two or more chronic conditions, and admission from pediatric wards were independently associated with death.

Conclusions:
We observed high prevalence of sepsis and sepsis-related mortality among this sample of children admitted to PICU in South America. Mortality was associated with greater severity of illness at admission and potentially associated with late PICU referral.