bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluid Bolus Over 15–20 Versus 5–10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock: A Randomized Controlled Trial*
Authors: Sankar Jhuma , Ismail Javed , Sankar M. Jeeva , C.P. Suresh , Meena Rameshwar S. 
Published: August 2017

Objectives:
To compare the effect of administration of 40–60 mL/kg of fluids as fluid boluses in aliquots of 20 mL/kg each over 15–20 minutes with that over 5–10 minutes each on the composite outcome of need for mechanical ventilation and/or impaired oxygenation—increase in oxygenation index by 5 from baseline in the initial 6 and 24 hours in children with septic shock.

Design:
Randomized controlled trial.

Setting:
Pediatric emergency and ICU of a tertiary care institute.

Patients:
Children (< 18 yr old) with septic shock.

Interventions:
We randomly assigned participants to 15–20 minutes bolus (study group) or 5–10 minutes bolus groups (control group).

Measurements and Main Results:
We assessed the composite outcomes in the initial 6 and 24 hours after fluid resuscitation in both groups. We performed logistic regression to evaluate factors associated with need for ventilation in the first hour. Data were analyzed using Stata 11.5. Of the 96 children, 45 were randomly assigned to “15–20 minutes group” and 51 to “5–10 minutes group.” Key baseline characteristics were not different between the groups. When compared with 5–10 minutes group, fewer children in 15–20 minutes group needed mechanical ventilation or had an increase in oxygenation index in the first 6 hours (36% vs 57%; relative risk, 0.62; 95% CI, 0.39–0.99) and 24 hours (43% vs 68%; relative risk, 0.63; 95% CI, 0.42–0.93) after fluid resuscitation. We did not find any difference in secondary outcomes such as death (1.2; 0.70–2.03), length of stay (mean difference: 0.52; –1.72 to 2.7), or resolution of shock (0.98; 0.63–1.53).

Conclusion:
Children receiving fluid boluses over 5–10 minutes each had a higher risk of intubation than those receiving boluses over 15–20 minutes each. Notwithstanding the lack of difference in risk of mortality and the possibility that a lower threshold of intubation and mechanical ventilation was used in the presence of fluid overload, our results raise concerns on the current recommendation of administering boluses over 5–10 minutes each in children with septic shock.
Point-of-Care Ultrasound Identification of an Abdominal Hernia
Authors: Alfonzo Michael , von Reinhart Anna , Riera Antonio 
Published: August 2017

Abstract
Pediatric emergency medicine physicians may be able to use point-of-care ultrasound (POCUS) as a tool to evaluate abdominal wall masses. We present a case of a 2-month-old infant with a lower abdominal mass identified as a hernia sac by POCUS. It was initially thought to represent a Spigelian-type abdominal wall hernia but subsequently determined to be an unusual presentation of an inguinal hernia with testicular entrapment. We review each of these diagnoses in addition to relevant POCUS findings.
Orphanhood and Self-Esteem: An 18-Year Longitudinal Study From an HIV-Affected Area in Tanzania
Authors: De Weerdt Joachim , Beegle Kathleen , Dercon Stefan 
Published: August 2017

Background:
The HIV epidemic exacerbated the prevalence of prime-aged adult death in many parts of sub-Saharan Africa, resulting in increased rates of orphanhood. Little is known about whether this will coincide with adverse psychosocial well-being in adulthood for those who were orphaned at childhood.

Methods:
We studied a cohort of 1108 children from Kagera, a region of Tanzania that was heavily affected by HIV early in the epidemic. During the baseline data collection in 1991–1994, these children were aged 0–16 years and had both parents alive. We followed them roughly 16–19 years later in 2010, by which time 531 children (36%) had lost either one or both parents before their 19th birthday. We compared the 2010 10-item Rosenberg Self-Esteem Scale (RSES) score between children who lost a parent before the age of 19 and those who did not. We used the baseline data to control for preorphanhood confounders. This is important because we find that children who will lose their fathers in the future before age 19 came from somewhat lower socioeconomic backgrounds.

Results:
We found no correlation between maternal death and self-esteem measured through RSES. Paternal death was strongly correlated with lower levels of self-esteem (0.2 SDs lower RSES 95% confidence interval: 0.059 to 0.348), and the correlation was stronger when the death occurred during the child's teenage years. These effects are a net of socioeconomic differences that existed before the orphanhood event.

Conclusions:
Our study supports the further development and piloting of programs that address psychosocial problems of orphans.
Feasibility, Acceptability, and Adherence with Short-Term HIV Preexposure Prophylaxis in Female Sexual Partners of Migrant Miners in Mozambique
Authors: Lahuerta Maria , Zerbe Allison , Baggaley Rachel , Falcao Joana , Ahoua Laurence , DiMattei Pietro , Morales Fernando , Ramiro Isaias , El-Sadr Wafaa M. 
Published: August 2017

Background:
Preexposure prophylaxis (PrEP) offers protection from HIV acquisition if taken as prescribed. We evaluated the feasibility, acceptability, and adherence with short-term PrEP among female sexual partners of migrant miners in Mozambique.

Methods:
HIV-negative female sexual partners of migrant miners were offered daily tenofovir/emtricitabine (TDF/FTC) for 6 weeks concurrent with miners' return home. Study visits occurred at baseline, week 4, 6, and 8. Dried blood spots (DBSs) were collected at week 4 and 6.

Results:
Seventy-four women (median age: 42 years) were enrolled, 95% reported having 1 sexual partner and 80% reported never or rarely using condoms. At baseline, 41% had never tested for HIV; 65% were unaware of partners' HIV status. Of all women, 72 (97%) initiated PrEP, 7 (9%) discontinued PrEP before week 6; only 1 due to adverse events. Missed doses in the last week were self-reported by 8% and 3% of women at week 4 and 6, respectively. Of 66 (89%) women with DBS at week 4, 79% had detectable tenofovir diphosphate (TFV-DP) and 44% had levels consistent with ≥4 pills/wk (≥700 fmol/punch). Of 63 (88%) women with DBS at week 6, 76% had detectable TFV-DP and 42% had levels consistent with ≥4 pills/wk.

Conclusions:
In this first study assessing the use of short-term PrEP, a high percent of female partners of migrant workers initiated PrEP and had detectable DP levels during follow-up. Further efforts are needed to enhance adherence to ensure protection from HIV acquisition. Short-term PrEP offers promise for populations who are at high risk of HIV during specific periods of time.
Genome-wide characterization of Phytophthora infestans metabolism: a systems biology approach
Authors: Rodenburg Sander Y.A. , Seidl Michael F. , de Ridder Dick , Govers Francine 
Published: August 2017

AbstractGenome-scale metabolic models (GEMs) provide a functional view of the complex network of biochemical reactions in the living cell. Initially mainly applied to reconstruct the metabolism of model organisms, the availability of increasingly sophisticated reconstruction methods and more extensive biochemical databases now make it possible to reconstruct GEMs for less characterized organisms as well, and have the potential to unravel the metabolism in pathogen-host systems. Here we present a GEM for the oomycete plant pathogen Phytophthora infestans as a first step towards an integrative model with its host. We predict the biochemical reactions in different cellular compartments and investigate the gene-protein-reaction associations in this model to get an impression of the biochemical capabilities of P. infestans. Furthermore, we generate life stage-specific models to place the transcriptomic changes of genes encoding metabolic enzymes into a functional context. In sporangia and zoospores there is an overall downregulation, most strikingly reflected in the fatty acid biosynthesis pathway. To investigate the robustness of the GEM, we simulate gene deletions to predict which enzymes are essential for in vitro growth. While there is room for improvement, this first model is an essential step towards an understanding of P. infestans and its interactions with plants as a system, which will help to formulate new hypotheses on infection mechanisms and disease prevention.
Navigating infection risk during oviposition and larval foraging in a holometabolous insect
Authors: Siva-Jothy Jonathon A. , Monteith Katy M. , Vale Pedro F. 
Published: August 2017

AbstractDeciding where to eat and raise offspring carries important fitness consequences for all animals, especially if foraging, feeding and reproduction increase the risk of exposure to pathogens. In insects with complete metamorphosis, foraging occurs mainly during the larval stage, while oviposition decisions are taken by adult-stage females. Selection for infection avoidance behaviours may therefore be developmentally uncoupled. Using a combination of experimental infections and behavioural choice assays, here we tested ifDrosophila melanogasterfruit flies avoid potentially infectious environments at distinct developmental stages. When given conspecific fly carcasses as a food source, larval-stage flies did not discriminate between carcasses that were clean or infected with the pathogenic Drosophila C Virus (DCV), even though scavenging was a viable route of DCV transmission. Adult females however, discriminated between different oviposition sites, laying more eggs near a clean rather than an infectious carcass if they were healthy; DCV-infected females did not discriminate between the two environments. While potentially risky, laying eggs near potentially infectious carcasses was always preferred to sites containing only fly medium. Our findings suggest that infection avoidance can play an important role in how mothers provision their offspring, and underline the need to consider infection avoidance behaviours at multiple life-stages.
Genome-reconstruction for eukaryotes from complex natural microbial communities
Authors: West Patrick T. , Probst Alexander J. , Grigoriev Igor V. , Thomas Brian C. , Banfield Jillian F. 
Published: August 2017

AbstractMicrobial eukaryotes are integral components of natural microbial communities and their inclusion is critical for many ecosystem studies yet the majority of published metagenome analyses ignore eukaryotes. In order to include eukaryotes in environmental studies we propose a method to recover eukaryotic genomes from complex metagenomic samples. A key step for genome recovery is separation of eukaryotic and prokaryotic fragments. We developed a kmer-based strategy, EukRep, for eukaryotic sequence identification and applied it to environmental samples to show that it enables genome recovery, genome completeness evaluation and prediction of metabolic potential. We used this approach to test the effect of addition of organic carbon on a geyser-associated microbial community and detected a substantial change of the community metabolism, with selection against almost all candidate phyla bacteria and archaea and for eukaryotes. Near complete genomes were reconstructed for three fungi placed within the eurotiomycetes and an arthropod. While carbon fixation and sulfur oxidation were important functions in the geyser community prior to carbon addition, the organic carbon impacted community showed enrichment for secreted proteases, secreted lipases, cellulose targeting CAZymes, and methanol oxidation. We demonstrate the broader utility of EukRep by reconstructing and evaluating relatively high quality fungal, protist, and rotifer genomes from complex environmental samples. This approach opens the way for cultivation-independent analyses of whole microbial communities.
Perceived consumption vulnerability of elderly citizens
Authors: Roy Subhadip , Sanyal Shamindra Nath 
Published: August 2017

PurposeThis study aims to explore the dimensions of perceived consumption vulnerability (PCV) for the elderly citizens (EC) in India and its consequences. Consumer vulnerability is a recent and important construct for marketers and policymakers to understand the consumption behavior of the EC.Design/methodology/approachTo achieve the study objectives, the authors conducted 50 in-depth interviews and six focus group discussions of ECs in two large cities in India. The authors used grounded theory methodology to understand the PCV construct.FindingsThe findings suggest a five-dimensional formative PCV construct with the dimensions being Physical, Financial, Social, Technological and Service Vulnerability contributing to PCV. The findings also suggest a relationship between PCV and consumption variables such as search cost, choice evaluation, consumption and overall satisfaction.Research limitations/implicationsThe major contribution of the present study is the exploration of the PCV construct for the EC and its dimensions. The propositions developed in the study could be tested in future studies using a quantitative approach.Practical implicationsThe findings call for compassion from the marketers while dealing with the ECs and a separate service strategy that addresses the specific needs of the ECs.Social implicationsThe findings call for public policy action to protect the consumption rights of the ECs to reduce their consumption vulnerability.Originality/valueThe present study is a novel attempt to explore the PCV construct and its role in defining consumer behavior of the ECs.
A preliminary study of the use of a Raman laser sensor to monitor coagulation and syneresis for the online control of cheesemaking
Authors: Puerta Fernando , Wessel Winja , García Victor , López Eva , Rovira Silvia , Alvarez Daniel , Roa Isidro , López Maria Belen 
Published: August 2017

The objective of this article was to apply a novel laser Raman sensor for the control of on line cheesemaking, mainly focusing on coagulation but with an initial test of syneresis. By means of a novel Raman laser sensor, the spectrum of cheese curd was seen to be slightly higher than that of milk in the 800–1200 cm−1 Raman shift range, with a sigmoid increase in intensity until a constant value was reached. As regards syneresis, the response of the Raman laser sensor and the moisture content both followed first‐order kinetics. These initial results confirm that the laser sensor is able to determine the changes that take place in the cheesemaking process, during the coagulation and whey drainage steps, and point to the potential usefulness of this sensor for the online control of cheesemaking.
Unplanned Complex Suicide—A Consideration of Multiple Methods
Authors: Ateriya Navneet , Kanchan Tanuj , Shekhawat Raghvendra Singh , Setia Puneet , Saraf Ashish 
Published: August 2017

AbstractDetailed death investigations are mandatory to find out the exact cause and manner in non‐natural deaths. In this reference, use of multiple methods in suicide poses a challenge for the investigators especially when the choice of methods to cause death is unplanned. There is an increased likelihood that doubts of homicide are raised in cases of unplanned complex suicides. A case of complex suicide is reported where the victim resorted to multiple methods to end his life, and what appeared to be an unplanned variant based on the death scene investigations. A meticulous crime scene examination, interviews of the victim's relatives and other witnesses, and a thorough autopsy are warranted to conclude on the cause and manner of death in all such cases.
Munchausen by Proxy: A Qualitative Investigation into Online Perceptions of Medical Child Abuse
Authors: Anderson Anoushka P. A. , Feldman Marc D. , Bryce Joanne 
Published: August 2017

AbstractIn Munchausen by proxy (MBP) maltreatment, increasingly termed “medical child abuse” (MCA), a caregiver fabricates or induces illness in another. The perpetrator's goal for the behavior is to meet personal emotional needs by forcing unnecessary or misguided medical or psychological treatment. Generally, a mother is the perpetrator and her child is the victim. There is a serious lack of research into most aspects of MCA, and this study is the first to utilize the anonymity of an Internet forum to investigate victims' first‐hand experiences of, and the public's opinions about, suspected and confirmed MCA. Three‐hundred and fifty‐six posts by 348 members were explored and coded using formal qualitative content analysis. By accessing an open‐thought online forum, this paper acquired information regarding social perceptions about the nonperpetrating partners who are unaware of the maltreatment; the disturbing and counterintuitive phenomenon of MCA itself; and the resistance often faced by those who attempt to report it.
Business Motives in Global Multi‐Stakeholder Initiatives: Exploring Corporate Participation in Sustainable Energy for All
Authors: Lundsgaarde Erik 
Published: August 2017

AbstractPublic sector actors express rising interest in multi‐stakeholder initiatives as a means of expanding private sector contributions to address sustainable development goals. Private sector interests in participating in such initiatives have however received limited attention. This article examines business motives for associating with global multi‐stakeholder initiatives by analyzing corporate engagement with the Energy Efficiency Accelerator Platform of the Sustainable Energy for All (SEforALL) initiative. The analysis of the characteristics of participating firms highlights that the platform has mainly attracted companies based in Europe and those with a broad geographical reach. The article identifies clear economic rationales for companies to participate. The analysis emphasizes that indirect gains to firms through activities designed to shape the market for the uptake of energy efficient technologies and direct gains related to connecting with potential customers through networking activities are key motives for business participation. This case indicates that multi‐stakeholder initiatives can provide a platform for transforming markets by facilitating interactions between private sector actors and national and subnational governments.
Risk factors for peripheral nerve injuries following neuraxial labour analgesia: a nested case–control study
Authors: Haller G. , Pichon I. , Gay F.‐O. , Savoldelli G. 
Published: August 2017

BackgroundPost‐partum lower extremity motor and sensory dysfunctions occur in 0.1–9.2‰ of deliveries. While macrosomia, lithotomy position and forceps use are well‐identified causes of peripheral nerve injuries, additional contributors such as patient condition and anaesthesia care may also have to be considered.MethodsWe performed a case–control study nested in a cohort of 19,840 patients having neuraxial anaesthesia for childbirth. Cases were all patients who developed motor or sensory dysfunction of lower extremities in the post‐partum period. These were compared, using Chi‐square, Fisher's exact test, logistic regression and time series, to a random sample of controls without any neurological symptoms or injury.ResultsWe identified 19 (0.96‰) patients with peripheral nerve injuries of which 15 (0.76‰) were likely associated with obstetrical care. In four additional cases (0.20‰), a nerve root injury due to the Tuohy needle was suspected. Univariate risk factors were: a gestational age ≥ 41 weeks, Odds Ratio (OR) 3.8; 95% CI: 1.1–13.1, late initiation of neuraxial anaesthesia OR 8.2; 95% CI: 1.8–37.9, a repeated anaesthetic procedure OR 2.8; 95% CI: 1.0–7.8, assisted delivery with forceps OR 9.8; 95% CI: 1.2–114.1 and newborn birth weight > 3.5 kg with an OR 6.8; 95% CI: 2.0–22.5.ConclusionObstetrical related factors are the most prominent risk associated with peripheral nerve injuries. This study highlights however that patient and anaesthesia‐related factors may also contribute to peripheral nerve injuries.
Social functioning in patients with depressive and anxiety disorders
Authors: Saris I. M. J. , Aghajani M. , van der Werff S. J. A. , van der Wee N. J. A. , Penninx B. W. J. H. 
Published: August 2017

ObjectiveAdaptive social functioning is severely impeded in depressive and anxiety disorders, even after remission. However, a comprehensive overview is still lacking.MethodUsing data from the Netherlands Study of Depression and Anxiety (NESDA), behavioural (network size, social activities, social support) and affective (loneliness, affiliation, perceived social disability) indicators of social functioning were analyzed in patients with anxiety (N = 540), depressive (N = 393), comorbid anxiety and depressive disorders (‘comorbid’, N = 748), remitted participants (N = 621), and healthy control subjects (N = 650).ResultsAnalyses revealed an increasing trend of social dysfunction among patient groups, in patients with comorbid anxiety and depressive disorders, showing the most severe impairments, followed by depressed and anxious patients (P's < 0.001 for all social functioning indicators). Affective indicators showed the largest effect sizes (Cohen's d range from 0.13 to 1.76). We also found impairments in social functioning among remitted patients. Furthermore, perceived social disability among patients was predictive of still having a depressive and/or anxiety diagnosis 2 years later (P < 0.01).ConclusionsBehavioural but especially affective indicators of social functioning are impaired in patients with anxiety or depressive disorders and most in patients with comorbid disorders. After remission of affective psychopathology, residual impairments tend to remain, while social dysfunction in patients seems predictive of future psychopathology.
Semi‐Automatic Electronic Stent Register: a novel approach to preventing ureteric stents lost to follow up
Authors: Macneil James W. H. , Michail Peter , Patel Manish I. , Ashbourne Julie , Bariol Simon V. , Ende David A. , Hossack Tania A. , Lau Howard , Wang Audrey C. , Brooks Andrew J. 
Published: August 2017

BackgroundUreteric stents are indispensable tools in modern urology; however, the risk of them not being followed‐up once inserted poses medical and medico‐legal risks. Stent registers are a common solution to mitigate this risk; however, manual registers are logistically challenging, especially for busy units.MethodsWestern Sydney Local Health District developed a novel Semi‐Automatic Electronic Stent Register (SAESR) utilizing billing information to track stent insertions. To determine the utility of this system, an audit was conducted comparing the 6 months before the introduction of the register to the first 6 months of the register.ResultsIn the first 6 months of the register, 457 stents were inserted. At the time of writing, two of these are severely delayed for removal, representing a rate of 0.4%. In the 6 months immediately preceding the introduction of the register, 497 stents were inserted, and six were either missed completely or severely delayed in their removal, representing a rate of 1.2%. A non‐inferiority analysis found this to be no worse than the results achieved before the introduction of the register.ConclusionThe SAESR allowed us to improve upon our better than expected rate of stents lost to follow up or severely delayed. We demonstrated non‐inferiority in the rate of lost or severely delayed stents, and a number of other advantages including savings in personnel costs. The semi‐automatic register represents an effective way of reducing the risk associated with a common urological procedure. We believe that this methodology could be implemented elsewhere.