bluuebunny/crossref_metadata_2025_split huggingface dataset:
Male‐specific Association Between Fat‐Free Mass Index and Fecal Microbiota in 2‐ to 3‐Year‐Old Australian Children
Authors: Smith‐Brown Paula , Morrison Mark , Krause Lutz , Davies Peter S.W. 
Published: October 2017

ABSTRACTObjectives:Maturation of the gut microbiota has been shown to influence childhood growth, whereas alterations in microbiota composition are proposed to be causally related to the development of overweight and obesity. The objective of this study is to explore the association between microbiota profile, body size, and body composition in young children.Methods:Fecal microbiota was examined by 16S rRNA gene sequencing, whereas body composition was assessed using the deuterium oxide dilution technique in a cohort of 37 well‐nourished 2‐ to 3‐year‐old Australian children.Results:Microbiota composition (weighted UniFrac distance) was shown to be significantly associated with FFMI (fat‐free mass index) z score (P = 0.027, adonis) in boys but not girls. In boys, FFMI z score was significantly correlated with the relative abundance of an OTU (Operational Taxonomic Unit) belonging to the Ruminococcaceae family (Rho = 0.822, P < 0.001, pFDR (false discovery rate adjusted P value) = 0.002, n = 18). At a FDR <0.2, FFMI z score in boys was positively associated with the relative abundance of OTU related to Dorea formicigenerans and Faecalibacterium prausnitzii and negatively correlated to an OTU related to Bacteroides cellulosilyticus.Conclusions:These results suggest that previously reported associations between microbiota composition and body size may be driven by an association with fat‐free mass, particularly in males.
Donor Human Milk and Fortifier Use in United States Level 2, 3, and 4 Neonatal Care Hospitals
Authors: Perrin Maryanne T. 
Published: October 2017

ABSTRACTObjective:In 2011, the United States Surgeon General issued a call to action to “identify and address obstacles to greater availability of safe banked donor milk for fragile infants.” The purpose of the present study is to analyze patterns in donor human milk (DHM) and fortifier use in level 2, 3, and 4 neonatal facilities in 2015 and to identify factors associated with nonuse.Methods:Data from the 2015 Maternity Practices in Infant Nutrition and Care survey, conducted by the Center for Disease Control and Prevention, were analyzed for questions about feeding practices within neonatal hospitals.Results:The percentage of neonatal facilities that reported using DHM in 2015 was 38.3%, up 74% from 2011. The majority of level 3 and level 4 facilities reported using DHM (65.7% and 73.3%, respectively) and fortifiers (96.1% and 91.9%, respectively). Within DHM‐using facilities, a wide range of DHM feeding patterns was reported. The prevalence of DHM use was higher in facilities that had the highest rates of mother's own milk feedings (P < 0.001), in facilities that were participating in the Baby Friendly Hospital Initiative (P < 0.001), and in facilities that were in a state with an operating milk bank (P < 0.001).Conclusions:DHM use continues to increase in advanced care neonatal settings, with significant difference based on acuity level, facility size, breast‐feeding culture, and proximity to a milk bank. Geographic gaps in DHM use provide the opportunity for targeted efforts to improve access.
Impact of Race and Ethnicity on Outcomes for Children Waitlisted for Pediatric Liver Transplantation
Authors: Mogul Douglas B. , Luo Xun , Chow Eric K. , Massie Allan B. , Purnell Tanjala S. , Schwarz Kathleen B. , Cameron Andrew M. , Bridges John F.P. , Segev Dorry L. 
Published: October 2017

ABSTRACTObjective:African Americans and other minorities are known to face barriers to health care influencing their access to organ transplantation but it is not known whether these barriers exist among pediatric liver transplant waitlist candidates. We sought to determine whether outcomes on the waitlist (ie, mortality, deceased donor liver transplantation [DDLT], and living‐donor liver transplantation [LDLT]) varied by race/ethnicity.Methods:National registry data were studied to estimate the race/ethnicity‐specific risk of waitlist mortality, DDLT and LDLT in children (<18 years) waitlisted between March 2002 and March 2015.Results:There was no evidence of racial/ethnic disparities in waitlist mortality. Compared to Caucasians, LDLT varied by race/ethnicity, with only 6.7% African Americans and 10.3% Hispanic children receiving LDLT compared with 12.4% Caucasian, 13.3% Asian, and 9.4% mix/other children. In an adjusted Cox proportional hazards model, African Americans were half as likely as Caucasians to use LDLT (hazard ratio [HR]: 0.410.550.73) but had similar use of DDLT (HR: 0.981.061.16). In a model that considered mortality, DDLT, and LDLT as competing risks, African Americans had significantly reduced incidence of LDLT (subhazard ratio [sHR]: 0.410.560.75) compared to Caucasians, but increased use of DDLT (sHR: 1.061.161.26).Conclusions:Compared to Caucasian children, African‐American children are less likely to use LDLT but have higher rates of DDLT and similar survival on the waitlist. Additional research is necessary to understand the clinical and socioeconomic factors contributing to lower utilization of LDLT among African‐American children awaiting transplantation.
The Prevalence and Investigation of Risk Factors of Oral Mucositis in a Pediatric Oncology Inpatient Population; a Prospective Study
Authors: Allen Gabrielle , Logan Richard , Revesz Tom , Keefe Dorothy , Gue Sam 
Published: October 2017

Background:
Oral mucositis can be a frequent and severe complication of chemotherapy in children. It can result in pain, infection, depression, prolonged admission, treatment delays, increase in patient morbidity, and increased costs.

Aim:
To record the prevalence and severity of oral mucositis among inpatients and explore the relationship of risks factors and the development of oral mucositis.

Design:
During an 18-month period 643 clinical inpatient assessments were completed on 73 children who were admitted and had received chemotherapy in the last 14 days.

Results:
There were 43 episodes of oral mucositis in 31 children; 42.5% of the inpatient population. World Health Organization assessment identified 32.6% of episodes were grade 1, 34.9% grade 2, 14.0% grade 3, and 18.6% grade 4. Analysis revealed significant associations between patient diagnosis (P<0.0001), chemotherapy cycles (P<0.0001), day 8 and 9 of the chemotherapy cycle (P<0.05), and neutropenia (P<0.0001) and oral mucositis. Children had increased length of admission with increasing severity of oral mucositis (P=0.0005).

Conclusions:
The prevalence of oral mucositis was 42.5% among inpatients and admission length was increased with increasing severity. Patient diagnosis, chemotherapy treatment block, day of chemotherapy cycle, and neutropenic status were shown to influence the risk of developing oral mucositis.
Respectful Disposition After Miscarriage
Authors: Levang Elizabeth , Limbo Rana , Ziegler Tammara Ruiz 
Published: October 2017

Abstract
Compassionate clinical practice guidelines for healthcare providers for respectful disposition after miscarriage are presented. When woven into the whole of a clinician's practice, these guidelines provide the framework for giving women and their families the care they want and deserve when experiencing miscarriage. Relying on theoretical concepts of personhood, place, and protection, care providers can assess the unique meaning a woman assigns to her early pregnancy loss and offer interventions that embrace the concept of respectful disposition. Respectful methods of disposition involve a continuum of care that shows respect for remains and relies on person-, family-, and culture-centered nursing care. Policies, practices, and perspectives that flow from respectful disposition have women and families at their core and flexibility to cocreate care. This involves courage and competence. Several states have enacted fetal disposition laws, but these mandates are of questionable benefit because the expertise of healthcare leaders, nurses, physicians, chaplains, and other stakeholders must be involved in this sensitive and important area of care. Compassionate care cannot be legislated. We offer a practical approach to respectful disposition, including how to handle and prepare remains and examples of burial and memorial services, which will give clinicians the ability to respond empathetically and respectfully to the heart-rending plea of a woman who asks, “Where is my baby?”
Newborn Safety Bundle to Prevent Falls and Promote Safe Sleep
Authors: Lipke Bethann , Gilbert Gael , Shimer Heather , Consenstein Larry , Aris Christine , Ponto Lynne , Lafaver Susan , Kowal Christopher 
Published: October 2017

Abstract

Purpose:
At our Baby-Friendly USA hospital, with at least 80% of mothers breastfeeding and rooming-in, it is not uncommon for mothers to fall asleep in their hospital bed while feeding. The aim of this study was to develop a newborn infant safety bundle and evaluate its efficacy in helping reduce unsafe sleep situations while simultaneously preventing newborn falls.

Study Design and Method:
Data were collected in March 2015 using an infant at risk-to-fall instrument prior to nurses initiating the newborn infant safety bundle. The bundle included: (a) a parent safety agreement; (b) education, teach-back, and role modeling of safe sleep practices; and (c) implementation of a reporting and debriefing system for infant falls. All new mothers were eligible for inclusion. Data were collected over a random month every quarter for four quarters (through June 2016).

Results:
Fourteen percent (n = 23) of babies born at the hospital in March 2015 were found to be exposed to risk-to-fall situations; over half of their mothers were found asleep and still holding the baby. Following bundle implementation, identified unsafe sleep situations during June 2015 to June 2016 have trended down with no reports of an infant fall through May 2017.

Clinical Implications:
Increasing parental awareness, understanding, and participation in safe sleep practice creates and maintains a safer infant environment in the hospital setting.
In Vitro Effect of Lysozyme on Albumin Deposition to Hydrogel Contact Lens Materials
Authors: Babaei Omali Negar , Subbaraman Lakshman N. , Heynen Miriam , Fadli Zohra , Coles-Brennan Chantal , Jones Lyndon W. 
Published: October 2017

SIGNIFICANCE
Albumin deposition on contact lenses could be detrimental to contact lens (CL) wear because this may increase the risk of bacterial binding and reduce comfort. Lysozyme deposition on selected lens materials would reduce albumin deposition on lenses.

PURPOSE
This study aims to determine if lysozyme deposition on CLs could act as a barrier against subsequent albumin adsorption, using an in vitro model.

METHODS
Six hydrogel CL materials (etafilcon A, polymacon, nelfilcon A, omafilcon A, ocufilcon B, and nesofilcon A) were evaluated. Four CLs of each type were soaked in lysozyme solution for 16 hours at 37°C. Lysozyme-coated lenses were then placed in vials with 1.5 mL of artificial tear solution containing 125I-labeled albumin for 16 hours at 37°C with shaking. Four uncoated lenses of each type were used as controls. Lenses soaked in radiolabeled albumin were rinsed in a phosphate-buffered saline solution, and radioactive counts were measured directly on lenses using a gamma counter. Albumin uptake on lenses was measured using a calibration curve by plotting radioactive counts versus protein concentration.

RESULTS
Results are reported as mean ± SD. Lysozyme-coated etafilcon A lenses exhibited lower levels of deposited albumin than uncoated etafilcon A lenses (58 ± 12 vs. 84 ± 5 ng/lens; P < .05). There were no differences in albumin adsorption between control (uncoated) and lysozyme-coated polymacon (105 ± 10 vs. 110 ± 34 ng/lens), nelfilcon A (51 ± 7 vs. 42 ± 20 ng/lens), omafilcon A (90 ± 20 vs. 80 ± 38 ng/lens), ocufilcon B (87 ± 20 vs. 115 ± 50 ng/lens), and nesofilcon A (170 ± 29 vs. 161 ± 10 ng/lens) lens materials (P > .05). Uncoated nesofilcon A lenses deposited the highest amount of albumin when compared with other uncoated lenses (P < .05).

CONCLUSIONS
This study demonstrates that lysozyme deposited onto etafilcon A resists the deposition of albumin, which may potentially be beneficial to CL wearers.
Measurement of Retinal Vessels as a Biomarker of Cerebrovascular Aging in Older HIV-Positive Men Compared With Controls
Authors: Haddow Lewis , Laverick Rosanna , Leung Irene , Post Frank , Vera Jaime , Gilson Richard , Williams Ian , Boffito Marta , Sabin Caroline , Winston Alan , Peto Tunde ,   on behalf of the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study group
Published: October 2017

Background:
To compare retinal vascular measurements, biomarkers of cerebral small vessel disease, in HIV-positive men aged 50 years and older with similarly aged HIV-negative men and younger HIV-positive men.

Methods:
We recruited white, nondiabetic men into a cross-sectional substudy of a larger cohort including 3 demographically matched groups. Optic disc–centered 45-degree color fundus photographs were used to calculate central retinal arterial and venous caliber and the arterial–venous ratio (AVR). We used univariate and multivariable linear regression to compare retinal vessel measurements in the 3 groups and to identify factors associated with AVR.

Results:
All HIV-positive men were virologically suppressed. In a multivariable model, study group was not associated with AVR [adjusted β 0.010 for HIV-positive men <50 (n = 39) compared with HIV-positive men aged ≥50 years (n = 120), 95% confidence interval [CI] −0.018 to 0.038, P = 0.47; adjusted β 0.00002 for HIV-negative men ≥50 years (n = 52), 95% CI −0.022 to 0.022, P = 0.99]. Factors associated with lower AVR were systolic blood pressure (adjusted β −0.009 per +10 mm Hg, 95% CI −0.015 to −0.003, P = 0.002), history of stroke or transient ischemic attack (adjusted β −0.070, 95% CI −0.12 to −0.015, P = 0.01), and recent recreational drug use (adjusted β −0.037, 95% CI −0.057 to −0.018, P = 0.0002).

Conclusions:
There were no differences in retinal vascular indices between HIV-positive men aged ≥50 years and HIV-negative men aged ≥50 years or HIV-positive men aged <50 years, suggesting that HIV is not associated with an increased burden of cerebral small vessel disease.
Proposal of a Budget-Friendly Camera Holder for Endoscopic Ear Surgery
Authors: Ozturan Orhan , Yenigun Alper , Aksoy Fadlullah , Ertas Burak 
Published: October 2017

Abstract
Endoscopic ear surgery (EES) is increasingly a preferred technique in otologic society. It offers excellent visualization of the anatomical structures directly and behind the corners with variable angled telescopes. It also provides reduced operative morbidity due to being able to perform surgical interventions with less invasive approaches. Operative preparation and setup time and cost of endoscopy system are less expensive compared with surgical microscopes. On the other hand, the main disadvantage of EES is that the surgery has to be performed with 1 single hand. It is certainly restrictive for an ear surgeon who has been operating with 2 hands under otologic microscopic views for years and certainly requires a learning period and perseverance. Holding the endoscope by a second surgeon is not executable because of insufficient surgical space.
Endoscope/camera holders have been developed for those who need the comfort and convenience afforded by double-handed microscopic ear surgery. An ideal endoscope holder should be easy-to-set up, easily controlled, providing a variety of angled views, allowing the surgeon to operate with 2 hands and, budget-friendly. In this article, a commercially available 11-inch magic arm camera holder is proposed by the authors to be used in EES due to its versatile, convenient, and budget-friendly features. It allows 2-handed EES through existing technology and is affordable for surgeons looking for a low-cost and practical solution.
Longitudinal Assessment of Developmental Outcomes in Infants Undergoing Late Craniosynostosis Repair
Authors: Fontana Stefani C. , Belinger Skylar , Daniels Debby , Tuttle Margaret , Camarata Paul J. , Andrews Brian T. 
Published: October 2017

Abstract
Evaluation of infants with craniosynostosis for surgical intervention, as opposed to conservative management, remains a challenge within the field of craniofacial surgery. Studies have consistently demonstrated that surgical repair of craniosynostosis is ideally performed between 3 and 12 months of age. As such, there is limited data regarding neurocognitive development in infants who initially present with uncorrected craniosynostosis after 12 months of age. Moreover, the impact of cranial vault surgery on neurocognitive development at all ages remains under investigation. A prospective, nonrandomized study was performed. All children with nonsyndromic craniosynostosis who presented for initial evaluation after 12 months of age were enrolled. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) was utilized to assess pre- and postoperative cognitive development and comparisons were made to normative values. Developmental delay is defined as scoring < 85. Five infants, average age 26 months (13–43 months) at initial presentation, underwent cranial vault remodeling and developmental testing. Fused cranial sutures involved: metopic (n = 4), and right coronal (n = 1). Cognitive testing demonstrated that 4 of 5 infants (80%) were developmentally delayed at presentation (scores: 60, 70, 72, and 80), and 1 infant was within normal limits (score: 100). Postoperative testing was performed between 2 and 12 months postoperatively. Universal improvement was observed in infants who were delayed prior to surgery (80, 80, 75, and 90, respectively). The infant who was not delayed prior to surgery remained within normal limits after surgery. This study demonstrates an association between cranial vault surgery and cognitive improvement in infants presenting late with developmental delay.
Extragingival Pregnancy Pyogenic Granuloma on the Lip
Authors: Canivell-Zabaleta Maitena , Martin-Lozano Guiomar , Olmos-Juarez Erika , Fontillon-Alberdi Maria , Infante-Cossio Pedro 
Published: October 2017

Abstract
Pregnancy pyogenic granuloma is considered a benign common growth that usually develops on the gingiva in the second and third trimester of gestation, in response to local irritation, trauma or hormonal factors. Here, the authors report a case of a primigravida who presented an extragingival pyogenic granuloma with a rapid progression in the post-partum. The occurrence on the lower lip in the first few days after delivery was a relatively rarity in the present case which provoked a meaningful state of anxiety and cancerophobia to the female. Complete excision was curative and brought immediate relief of pain and discomfort. This clinical report highlights the possibility of pyogenic granuloma presenting like a rapid-growing mass on the lip and the importance of clinical differential diagnosis of such presentation in this atypical location.
Vasopressor Cumulative Dose Requirement and Risk of Early Death During Septic Shock: An Analysis From The EPISS Cohort
Authors: Dargent Auguste , Nguyen Maxime , Fournel Isabelle , Bourredjem Abderrahmane , Charles Pierre-Emmanuel , Quenot Jean-Pierre 
Published: October 2017

ABSTRACT
Septic shock is the primary cause of death in intensive care units, with about 20% of patients dying in the first 3 days. To design future trials focused on early mortality, we require knowledge of early indicators that can detect patients at high risk of early death from refractory septic shock. The aim of this study was to assess whether the cumulative dose of vasopressors (CDV), calculated as the cumulative dose of epinephrine + norepinephrine, is a predictor of early death (within 72 h) attributable to refractory septic shock (EDASS). This substudy of the EPISS trial was based on 370 patients admitted to a French ICU for septic shock between 2009 and 2011. The area under the receiving operating characteristic curve was calculated for the CDV at 6, 12, 24, 36, and 48 h after vasopressor initiation, and a strategy to predict the risk of EDASS was built based on selected times and thresholds. Among the 370 patients included, 51 (14%) died within the first 72 h with 40 (11%) EDASS. A strategy in two steps (CDV ≥ 800 μg/kg at 6 h and/or CDV ≥ 2,600 μg/kg at 24 h) was able to predict EDASS with sensitivity of 45%, specificity 97%, positive predictive value 78% and negative predictive value 94%. Overall, our results confirm that early death directly attributable to septic shock could be effectively predicted by the CDV in the first hours of treatment. These results will help to select patients eligible for innovative therapies aimed at improving early mortality in septic shock.
Geospatial mapping can be used to identify geographic areas and social factors associated with intentional injury as targets for prevention efforts distinct to a given community
Authors: Lasecki CH , Mujica FC , Stutsman S , Williams AY , Ding L , Simmons JD , Brevard SB 
Published: October 2017

BACKGROUND
Geographic information systems (GIS) have proven effective in studying intentional injury in various communities; however, GIS is not implemented widely for use by Level I trauma centers in understanding patient populations. Our study of intentional injury combines the capabilities of GIS with a Level I trauma center registry to determine the spatial distribution of victims and correlated socioeconomic factors.

METHODS
One thousand ninety-nine of 3,109 total incidents of intentional trauma in the trauma registry from 2005 to 2015 had sufficient street address information to be mapped in GIS. Comparison of these data, coupled with demographic data at the block group level, determined if any clustering or spatial patterns existed. Geographic information systems delivered these comparisons using several spatial statistics including kernel density, ordinary least squares test, and Moran’s index.

RESULTS
Kernel density analysis identified four major areas with significant clustering of incidents. The Moran’s I value was 0.0318. Clustering exhibited a positive z-score and significant p value (p < 0.01). Examination of socioeconomic factors by spatial correlation with the distribution of intentional injury incidents identified three significant factors: unemployment, single-parent households, and lack of a high school degree. Tested factors did not exhibit substantial redundancy (variance inflation factor < 7.5). Nonsignificant tested factors included race, proximity to liquor stores and bars, median household income, per capita income, rate with public assistance, and population density.

CONCLUSION
Spatial representation of trauma registry data using GIS effectively identifies high-risk areas for intentional injury. Analysis of local socioeconomic data identifies factors unique to those high-risk areas in the observed community. Implications of this study may include the routine use of GIS by Level I trauma centers in assessing intentional injury in a given community, the use of that data to guide the development of trauma prevention, and the assessment of other mechanisms of trauma using GIS.

LEVEL OF EVIDENCE
Epidemiological, level IV.