bluuebunny/crossref_metadata_2025_split huggingface dataset:
Levels of Silicon in Maternal, Cord, and Newborn Serum and Their Relation With Those of Zinc and Copper
Authors: Díaz‐Gómez N. Marta , Bissé Emmanuel , Senterre Thibault , González‐González Nieves L. , Domenech Eduardo , Lindinger Gabriele , Epting Thomas , Barroso Flora 
Published: June 2016

ABSTRACTBackground:Evidence of silicon's importance to health has been gradually accumulating. Nevertheless, there are few studies comparing serum silicon levels in newborns with maternal levels. Likewise, little is known concerning the inter‐relation between silicon and other trace elements.Objective:The present study evaluated maternal and newborn levels of serum silicon and their relation to those of zinc and copper.Methods:We measured serum silicon, copper, and zinc in 66 pregnant women, in the umbilical cord of their infants, and in 44 newborns, by atomic absorption spectrophotometry. All the samples were from fasted subjects.Results:Serum silicon level in term newborns (20.6 ± 13.2 μmol/L) was significantly higher than in umbilical cord (8.9 ± 3.5 μmol/L; P < 0.0001). Mean serum silicon level in maternal vein (7.7 ± 3.4 μmol/L) was lower than that in umbilical cord, although differences were not significant. We also found higher levels of zinc (P = 0.008) and lower levels of copper (P < 0.0001) in cord blood compared with maternal blood. Umbilical venous/maternal venous level ratios of zinc, copper, and silicon were 1.5 ± 0.5, 0.2 ± 0.1, and 1.3 ± 0.7, respectively. There was a positive correlation between silicon and zinc levels (r = 0.32), and a negative correlation between copper and zinc levels (r = −0.35).Conclusions:It seems that there is a positive gradient of silicon from the mother to her fetus. Silicon levels were higher in newborn than in cord blood, and correlated significantly with that of zinc but not copper. Additional investigations are needed to further define the role of silicon and its interaction with other trace elements during the perinatal period.
Persistent Fatigue in Hematopoietic Stem Cell Transplantation Survivors
Authors: Hacker Eileen Danaher , Fink Anne M. , Peters Tara , Park Chang , Fantuzzi Giamila , Rondelli Damiano 
Published: June 2016

Background:
Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment.

Objective:
The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25).

Methods:
Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance.

Results:
Survivors of HCT reported increased physical (P < .001), mental (P < .001), and overall (P < .001) fatigue as well as increased anxiety (P < .05) and depression (P < .01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P < .001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P < .001) and interleukin-6 (P < .05) levels were significantly higher in HCT survivors.

Conclusions:
Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers.

Implications for Practice:
This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.
Evaluation of Pain Intensity Assessment Tools Among Elderly Patients With Cancer in Taiwan
Authors: Chang Hsien-Chen , Lai Yeur-Hur , Lin Kuan-Chia , Lee Tzu-Ying , Lin Hung-Ru 
Published: June 2016

Background:
Effective pain management requires careful assessment of pain. Auditory, visual, cognitive, and motor impairments in elderly people may affect their ability to use pain assessment tools.

Objective:
The aim of this study was to evaluate the reliability, validity, and no-response rate of pain scales among elderly patients with cancer pain, as well as patient preference for the scales.

Methods:
A cross-sectional correlational design was used with a convenience sample of 73 elderly cancer patients recruited at a cancer-based hospital in southern Taiwan. Participants were asked to rate their pain by using a numeric rating scale (NRS-11), a facial pain scale (FPS), a verbal descriptor scale (VDS), and a mixed scale (consisting of NRS-11, FPS, and VDS) on 2 consecutive days.

Results:
Test-retest reliability, as indicated by Spearman rank correlation coefficients for the 24-hour interval pain ratings, ranged from 0.426 to 0.683. The criterion-related validity of the scales was supported by significant Spearman rank-order correlation. The time taken to respond to the scales ranged from 40.3 to 16.2 seconds. The no-response rates for the scales decreased in the order NRS-11 > FPS > mixed scale > VDS. Patient preference for the scales decreased in the order mixed scale > VDS > NRS-11 > FPS.

Conclusions:
All 4 scales were reliable and valid for assessing cancer pain among elderly patients.

Implications for Practice:
Because the no-response rates for the scales depended on educational level and cognitive function, nurses should exercise good judgment in choosing pain intensity assessment tools for use with elderly patients.
Application of Microbeam X-Ray Fluorescence Spectrometry in the Diagnosis of Suspected Electrocution by High-Voltage Direct Current
Authors: Wang Tao , Zou Donghua , Zhang Jianhua , Chen Yijiu 
Published: June 2016

Abstract
Electrocution cases reported in the literature were mainly caused by low-voltage alternating current, with few cases associated with high-voltage direct current. In this article, we report the case of a 48-year-old woman who unexpectedly and suddenly died in the wild because of electric shock by a high-voltage direct current while hunting. The postmortem inspection found a suspected current mark on her right upper thigh, and histological examination of the suspected current mark revealed a slight elongation of the epidermal cell nuclei and separation of the corneous layer. Metal elements analysis by microbeam x-ray fluorescence spectrometry demonstrated a peak concentration of iron in the suspected current-injured skin surface, which was in line with the metal wire at the scene. In addition, the deceased had coronary atherosclerotic heart disease, which can increase the body's risk to the current damage. Our results indicated the usefulness of microbeam x-ray fluorescence spectrometry for the forensic diagnosis of electrocution.
The Effects of Pediatric Advanced Life Support Guidelines on Pediatric Trauma Airway Management
Authors: Sperka Jana , Hanson Sheila J. , Hoffmann Raymond G. , Dasgupta Mahua , Meyer Michael T. 
Published: June 2016

Objective
Recent Pediatric Advanced Life Support (PALS) guidelines have deemphasized the use of advanced airways in short transport. It is unclear if guideline recommendations have altered practice. We sought to determine if a temporal change exists in the number of prehospital pediatric trauma intubations since the 2005 PALS guidelines update.

Methods
This is an institutional review board–approved, retrospective, single-center study. Reviewed all pediatric trauma activations where patients younger than 19 years were intubated at the scene, en route or at the level 1 trauma center during 2006 to 2011. Specific complications collected were esophageal intubations, mainstem intubations and need for re-intubations.

Results
There were 1012 trauma activations, 1009 pediatric patients, 300 (29.7%) intubated during transport to Children's Hospital of Wisconsin Pediatric Trauma Center (PTC) or upon arrival. Mean age of 9.5 ± 5.9 years. Fifty-seven percent (n = 172) were intubated before PTC, 31.7% (n = 95) field intubations, 25.7% (n = 77) outside facility intubations. 44% (n = 132) at PTC. Age was not a significant variable. There was no difference in the proportion of injured children requiring intubation who were intubated before arrival to the PTC. Those intubated in the field versus a facility had significantly increased mortality (P = 0.0002), longer hospital days (P = 0.0004) including intensive care unit days (P = 0.0003) and ventilator days (P = 0.0003) even when adjusted for illness severity.

Conclusions
There was no significant change in the proportion of pretrauma room intubations following the 2005 PALS guidelines even when adjusted for illness or injury severity. Children injured farther from the PTC and more severely injured children were more likely to be intubated before arrival at the PTC.
Importance of Clinical Decision Making by Experienced Pediatric Surgeons When Children Are Suspected of Having Acute Appendicitis
Authors: Bal Alkan , Anil Murat , Nartürk Müge , Özdemir Tunç , Arikan Ahmet , Köylüoğlu Gökhan , Polat Burak , Erdoğan Nuri , Bayol Umit , Özgüzer Alp , Çolak Ayfer 
Published: June 2016

Objective
The aim of the present study was to compare the pediatric appendicitis score (PAS), the Alvarado score (AS), white blood cell count (WBC), absolute neutrophil count (ANC), C-reactive protein (CRP) level, procalcitonin level, and ultrasound (US) data, with the appendectomy decisions of pediatric surgeons diagnosing acute appendicitis (AA) in a real-life setting; this was a top-level, high-volume pediatric emergency department (PED) in a developing country.

Methods
The study was conducted prospectively between January 2012 and June 2013 in the PED of the Tepecik Teaching and Research Hospital in Izmir, Turkey. The study was observational in nature; no attempt was made to influence indications for exploration or the timing thereof. Children aged 4 to 18 years presenting to the PED on suspicion of AA were included. The WBC, ANC, CRP level, and procalcitonin level were measured, and US was performed on all patients on admission. The PAS and AS were calculated. An operative decision was made by each pediatric surgeon who had the results of laboratory and radiological tests. The criterion standard for AA was histopathological assessment.

Results
Upon receiver operating curve (ROC) analysis, the areas under the ROCs (AUROCs) of the WBC, ANC, CRP level, procalcitonin level, US positivity, PAS, AS, and decisions of pediatric surgeons supported by laboratory and US data were 0.734, 0.741, 0.671, 0.675, 0.670, 0.831, 0.794, and 0.910, respectively. When US data were employed only in cases with PASs 4 to 7, the sensitivity increased but specificity decreased. The sensitivity and specificity of pediatric surgical decisions were 100% and 82.50%, respectively. The difference between the PAS AUROC and the pediatric surgeon decision-making AUROC was significant (P = 0.0393; 95% confidence interval, 0.0470–0.226).

Conclusions
Good pediatric surgical decision making supported by laboratory and US data for those suspected of AA may be the most effective diagnostic tool in a high-volume PED in a developing country.
Identification of Inpatient Falls Using Automated Review of Text-Based Medical Records
Authors: Shiner Brian , Neily Julia , Mills Peter D. , Watts Bradley V. 
Published: June 2016

Objectives
Although falls are among the most common adverse event in hospitals, they are difficult to measure and often unreported. Mechanisms to track falls include incident reporting and medical records review. Because of limitations of each method, researchers suggest multimodal approaches. Although incident reporting is commonly used, medical records review is limited by the need to read a high volume of clinical notes. Natural language processing (NLP) is 1 potential mechanism to automate this process.

Method
We compared automated NLP to manual chart review and incident reporting as a method to detect falls among inpatients. First, we developed an NLP algorithm to identify inpatient progress notes describing falls. Second, we compared the NLP algorithm to manual records review in identifying inpatient progress notes that describe falls. Third, we compared the NLP algorithm to the incident reporting system in identifying falls.

Results
When examining individual inpatient notes, our NLP algorithm was highly specific (0.97) but had low sensitivity (0.44) when compared with our manual records review. However, when considering groups of inpatient notes, all describing the same fall, our NLP algorithm had a large improvement in sensitivity (0.80) with some loss of specificity (0.65) compared with incident reporting.

Conclusions
National language processing represents a promising method to automate review of inpatient medical records to identify falls.
Employing Demand-Based Volumetric Forecasting to Identify Potential for and Roles of Devices in Scale-Up of Medical Male Circumcision in Zambia and Zimbabwe
Authors: Fram Francine , Church Fred , Sundaram Maaya , Sgaier Sema K. , Ridzon Renee , Eletskaya Maria , Nanga Alice , Gumede-Moyo Sehlulekile , Tambatamba Bushimbwa , Mugurungi Owen , Ncube Getrude , Xabayu Sinokuthemba , Odawo Patrick , Kretschmer Steve 
Published: June 2016

Introduction:
Devices for male circumcision (MC) are becoming available in 14 priority countries where MC is being implemented for HIV prevention. Understanding potential impact on demand for services is one important programmatic consideration because countries determine whether to scale up devices within MC programs.

Methods:
A population-based survey measuring willingness to undergo MC, assuming availability of surgical MC and 3 devices, was conducted among 1250 uncircumcised men, ages 10–49 years in Zambia and 1000 uncircumcised men, ages 13–49 years in Zimbabwe. Simulated Test Market methodology was used to estimate incremental MC demand and the extent to which devices might be preferred over surgery, assuming availability of: surgical MC in both countries; the devices PrePex, ShangRing, and Unicirc in Zambia; and PrePex in Zimbabwe.

Results:
Modeled estimates indicate PrePex has the potential to provide an overall increase in MC demand ranging from an estimated 13%–50%, depending on country and WHO prequalification ages, replacing 11%–41% of surgical procedures. In Zambia, ShangRing could provide 8% overall increase, replacing 45% of surgical procedures, and Unicirc could provide 30% overall increase, replacing 85% of surgical procedures.

Conclusions:
In both countries, devices have potential to increase overall demand for MC, assuming wide scale awareness and availability of circumcision by the devices. With consideration for age and country, PrePex may provide the greatest potential increase in demand, followed by Unicirc (measured in Zambia only) and ShangRing (also Zambia only). These results inform one program dimension for decision making on potential device introduction strategies; however, they must be considered within the broader programmatic context.
Mortality in the First 3 Months on Antiretroviral Therapy Among HIV-Positive Adults in Low- and Middle-income Countries: A Meta-analysis
Authors: Brennan Alana T. , Long Lawrence , Useem Johanna , Garrison Lindsey , Fox Matthew P. 
Published: June 2016

Abstract:
Previous meta-analyses reported mortality estimates of 12-month post-antiretroviral therapy (ART) initiation; however, 40%–60% of deaths occur in the first 3 months on ART, a more sensitive measure of averted deaths through early ART initiation. To determine whether early mortality is dropping as treatment thresholds have increased, we reviewed studies of 3 months on ART initiation in low- to middle-income countries. Studies of 3-month mortality from January 2003 to April 2016 were searched in 5 databases. Articles were included that reported 3-month mortality from a low- to middle-income country; nontrial setting and participants were ≥15. We assessed overall mortality and stratified by year using random effects models. Among 58 included studies, although not significant, pooled estimates show a decline in mortality when comparing studies whose enrollment of patients ended before 2010 (7.0%; 95% CI: 6.0 to 8.0) with the studies during or after 2010 (4.0%; 95% CI: 3.0 to 5.0). To continue to reduce early HIV-related mortality at the population level, intensified efforts to increase demand for ART through active testing and facilitated referral should be a priority. Continued financial investments by multinational partners and the implementation of creative interventions to mitigate multidimensional complex barriers of accessing care and treatment for HIV are needed.
HIV-1 Drug Resistance by Ultra-Deep Sequencing Following Short Course Zidovudine, Single-Dose Nevirapine, and Single-Dose Tenofovir with Emtricitabine for Prevention of Mother-to-Child Transmission
Authors: Samuel Reshmi , Julian Marc Noguera , Paredes Roger , Parboosing Raveen , Moodley Pravi , Singh Lavanya , Naidoo Anneta , Gordon Michelle 
Published: June 2016

Abstract:
Antiretroviral drug resistance following pMTCT strategies remains a significant problem. With rapid advancements in next generation sequencing technologies, there is more focus on HIV drug-resistant variants of low frequency, or the so-called minority variants. In South Africa, AZT monotherapy for pMTCT, similar to World Health Organization option A, has been used since 2008. In 2010, a single dose of co-formulated TDF/FTC was included in the strategy for prevention of resistance conferred by single-dose nevirapine (sd NVP). The study was conducted in KwaZulu-Natal, South Africa, among pMTCT participants who received AZT monotherapy from 14 weeks of gestation, intrapartum AZT and sd NVP, and postpartum sd TDF/FTC. Twenty-six specimens collected at 6 weeks post-delivery were successfully sequenced using 454 ultra-deep sequencing. Non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance was detected in 17 of 26 (65%) patients, 2 (7%) had Thymidine analogue mutations, and 3 (11%) had K65R. Of the 17 patients with NNRTI resistance, 11 (65%) had high-level NNRTI resistance, whereas 6 (35%) had intermediate NNRTI resistance. The levels of NNRTI resistance are much higher than would be expected, given the inclusion of antepartum AZT and postpartum TDF/FTC. This high level of NNRTI resistance could impact future NNRTI-containing treatment for a large proportion of pMTCT-exposed women. The detection of Thymidine analogue mutations highlights the need to understand the clinical impact of these on AZT-containing antiretroviral treatment in women exposed to AZT monotherapy.
Epigenetic divergence is sufficient to trigger heterosis inArabidopsis thaliana
Authors: Lauss Kathrin , Wardenaar René , van Hulten Marieke H.A. , Guryev Victor , Keurentjes Joost J.B , Stam Maike , Johannes Frank 
Published: June 2016

AbstractDespite the importance and wide exploitation of heterosis in commercial crop breeding, the molecular mechanisms behind this phenomenon are not well understood. Interestingly, there is growing evidence that beside genetic also epigenetic factors contribute to heterosis. Here we used near-isogenic but epigenetically divergent parents to create epigenetic F1 hybrids (epiHybrids) in Arabidopsis, allowing us to quantify the contribution of epigenetics to heterosis. We measured traits such as leaf area (LA), growth rate (GR), flowering time (FT), main stem branching (MSB), rosette branching (RB) and final plant height (HT) and observed several strong positive and negative heterotic phenotypes among the epiHybrids. For LA and HT mainly positive heterosis was observed, while FT and MSB mostly displayed negative heterosis. Heterosis for FT, LA and HT could be associated with several heritable, differentially methylated regions (DMRs) in the parental genomes. These DMRs contain 35 (FT and LA) and 14 (HT) genes, which may underlie the heterotic phenotypes observed. In conclusion, our study indicates that epigenetic divergence can be sufficient to cause heterosis.Author SummaryCrossing two genetically distinct parents generates hybrid offspring. Sometimes hybrids are performing better than their parents in particular traits and this is referred to as heterosis. Hybridization and heterosis are naturally occurring processes and crop breeders intentionally cross genetically different parental lines in order to generate hybrids with maximized traits such as yield or stress tolerance. So far, the mechanisms behind heterosis are not well understood. In this study we focused on the effect of epigenetic variation onto heterosis in hybrids, and for this purpose we created epigenetic hybrids (epiHybrids) by crossing wildtype plants with a selection of genetically very similar but epigenetically divergent lines. An extensive phenotypic analysis of the epiHybrids and their parental lines showed that epigenetic divergence between parental genomes can be a major determinant of heterosis. Importantly, multiple heterotic phenotypes could be associated with meiotically heritable differentially methylated regions (DMRs) in the parental genomes, allowing us to map epigenetic quantitative trait loci (QTLs) for heterosis. Our results indicate that epigenetic variation can contribute to heterosis and suggests that heritable epigenetic variation could be exploited for the improvement of crop traits.
Architecture of fully occupied Glua2 Ampa receptor – TARP complex elucidated by single particle cryo-electron microscopy
Authors: Zhao Yan , Chen Shanshuang , Yoshioka Craig , Baconguis Isabelle , Gouaux Eric 
Published: June 2016

SummaryFast excitatory neurotransmission in the mammalian central nervous system is largely carried out by AMPA-sensitive ionotropic glutamate receptors. Localized within the postsynaptic density of glutamatergic spines, AMPA receptors are composed of heterotetrameric receptor assemblies associated with auxiliary subunits, the most common of which are transmembrane AMPA-receptor regulatory proteins (TARPs). The association of TARPs with AMPA receptors modulates the kinetics of receptor gating and pharmacology, as well as trafficking. Here we report the cryo-EM structure of the homomeric GluA2 AMPA receptor saturated with TARP γ2 subunits, showing how the TARPs are arranged with four-fold symmetry around the ion channel domain, making extensive interactions with the M1, M2 and M4 TM helices. Poised like partially opened ‘hands’ underneath the two-fold symmetric ligand binding domain (LBD) ‘clamshells’, one pair of TARPs are juxtaposed near the LBD dimer interface, while the other pair are near the LBD dimer-dimer interface. The extracellular ‘domains’ of TARP are positioned to not only modulate LBD ‘clamshell’ closure, but also to affect conformational rearrangements of the LBD layer associated with receptor activation and desensitization, while the TARP transmembrane (TM) domains buttress the ion channel pore.