bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of health-related quality of life and psychological well-being of children and adolescents with obesity enrolled in a New Zealand community-based intervention programme: an observational study
Authors: Anderson Yvonne C , Wynter Lisa E , Treves Katharine F , Grant Cameron C , Stewart Joanna M , Cave Tami L , Wouldes Trecia A , Derraik José G B , Cutfield Wayne S , Hofman Paul L 
Published: August 2017

ObjectiveTo describe health-related quality of life (HRQOL) and psychological well-being of children and adolescents at enrolment in a multidisciplinary community-based obesity programme and to determine association with ethnicity. This programme targeted indigenous people and those from most deprived households. Further, this cohort was compared with other populations/normative data.MethodsThis study examines baseline demographic data of an unblinded randomised controlled clinical trial. Participants (recruited from January 2012-August 2014) resided in Taranaki, New Zealand, and for this study we only included those with a body mass index (BMI) ≥98th percentile (obese). HRQOL and psychological well-being were assessed using the Pediatric Quality of Life Inventory (PedsQL V.4.0TM) (parent and child reports), and Achenbach’s Child Behavior Checklist (CBCL)/Youth Self Report (YSR).ResultsAssessments were undertaken for 233 participants (45% Māori, 45% New Zealand European, 10% other ethnicities, 52% female, 30% from the most deprived household quintile), mean age 10.6 years. The mean BMI SD score (SDS) was 3.12 (range 2.01–5.34). Total PedsQL generic scaled score (parent) was lower (mean=63.4, SD 14.0) than an age-matched group of Australian children without obesity from the Health of Young Victorians study (mean=83.1, SD 12.5). In multivariable models, child and parental generic scaled scores decreased in older children (β=−0.70 and p=0.031, β=−0.64 and p=0.047, respectively). Behavioural difficulties (CBCL/YSR total score) were reported in 43.5% of participants, with the rate of emotional/behavioural difficulties six times higher than reported norms (p<0.001).ConclusionsIn this cohort, children and adolescents with obesity had a low HRQOL, and a concerning level of psychological difficulties, irrespective of ethnicity. Obesity itself rather than ethnicity or deprivation appeared to contribute to lower HRQOL scores. This study highlights the importance of psychologist involvement in obesity intervention programmes.Trial registration numberAustralian NZ Clinical Trials Registry ANZCTR 12611000862943; Pre-results.
Improving waiting times in the orthopaedic outpatient clinic
Authors: Street Julia , Khan Wajeeha , Tong Aureola , Shanbhag Vasudev 
Published: August 2017

BackgroundReducing waiting times for patients is a worthy goal for all healthcare professionals. The means and ability to carry out nerve conduction studies in the hand outpatient clinic has the potential to reduce waiting times between appointments for patients with upper limb neural compression.MethodsWe assessed the pathway of patients presenting with upper limb neural compression in the Aneurin Bevan Trust. Overall, 115 patients were included, being assessed in four different patient pathway groups.ResultsWe found that by implementing a nerve conduction clinic, and then that of a one stop clinic, we were able to reduce the median waiting times from referral to surgical intervention, to 133 days.ConclusionThe introduction of nerve conduction clinics allowed the one stop clinic to be established, achieving the goal of reducing patient waiting times.
Implementing the WHO Safe Childbirth Checklist: lessons learnt on a quality improvement initiative to improve mother and newborn care at Gobabis District Hospital, Namibia
Authors: Kabongo Leonard , Gass Jonathon , Kivondo Beatrice , Kara Nabihah , Semrau Katherine , Hirschhorn Lisa R 
Published: August 2017

BackgroundAlthough there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time of birth, there remains a gap between what is known and the care received. This know-do gap is a source of preventable maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices (EBPs).MethodsWe implemented the SCC with support from leadership, coaching and organisational redesign. Implementation was led by a facility champion supported by a QI team and adapted through a series of three 8-week Plan–Do–Study–Act (PDSA) cycles.ResultsDuring the 6-month period, we observed an improvement of average EBPs delivered from 68% to 95%. We also found reductions in perinatal mortality rates from 22 deaths/1000 deliveries to 13.8/1000 deliveries largely due to a drop in fresh stillbirths.ConclusionWe conclude that replicating the programme is feasible, acceptable and effective in areas where gaps exist, but it requires local leadership, ongoing coaching and adaptation through PDSA cycles.
The importance of early life family factors in the association between cardiovascular risk factors and early cardiovascular mortality
Authors: Kjøllesdal Marte K R , Ariansen Inger , Mortensen Laust H , Næss Øyvind 
Published: August 2017

ObjectiveTo explore the importance of early life factors shared by siblings, such as parental socioeconomic position, parental practices, housing and neighbourhood, for the association between cardiovascular disease (CVD) risk factors and mortality from CVD, ischaemic heart disease (IHD) and cerebrovascular disease.MethodsNorwegian health surveys (1974–2003) were linked with data from the Norwegian Family Based Life Course Study and the Cause of Death Registry. Participants with at least one full sibling among survey participants (n=2 71 643) were included. Data on CVD risk factors, body mass index (BMI), height, systolic blood pressure (SBP) and total cholesterol (TC) were stratified into ‘low’, ‘medium’ and ‘high’ risk, and smoking to ‘daily smoking’ and ‘not daily smoking’.ResultsMean age of participants was 41 years, mean follow-up time was 19 years and during follow-up 2512 died from CVD. For each category of increased risk factor level, the per step HR of CVD mortality was increased by 1.91 (95% CI 1.78 to 2.05) for SBP, 1.67 (1.58 to 1.76) for TC, 1.44 (1.36 to 1.53) for BMI, 1.26 (1.18 to 1.35) for height and 2.89 (2.66 to 3.14) for smoking. In analyses where each sibship (groups of full siblings) had a group-specific baseline hazard, these associations were attenuated to 1.74, 1.51, 1.29, 1.18 and 2.63, respectively. The associations between risk factors and IHD mortality followed the same pattern.ConclusionEarly life family factors explained a small part of the association between risk factors and mortality from CVD and IHD in a relatively young sample.
High-pitch versus conventional cardiovascular CT in patients being assessed for transcatheter aortic valve implantation: a real-world appraisal
Authors: Ismail Tevfik F , Cheasty Emma , King Laurence , Naaseri Sahar , Lazoura Olga , Gartland Natalie , Padley Simon , Rubens Michael B , Castellano Isabel , Nicol Edward D 
Published: August 2017

ObjectiveHigh-pitch protocols are increasingly used in cardiovascular CT assessment for transcatheter aortic valve implantation (TAVI), but the impact on diagnostic image quality is not known.MethodsWe reviewed 95 consecutive TAVI studies: 44 (46%) high-pitch and 51 (54%) standard-pitch. Single high-pitch scans were performed regardless of heart rate. For standard-pitch acquisitions, a separate CT-aortogram and CT-coronary angiogram were performed with prospective gating, unless heart rate was ≥70 beats/min, when retrospective gating was used. The aortic root and coronary arteries were assessed for artefact (significant artefact=1; artefact not limiting diagnosis=2; no artefact=3). Aortic scans were considered diagnostic if the score was >1; the coronaries, if all three epicardial arteries scored >1.ResultsThere was no significant difference in diagnostic image quality for either the aorta (artefact-free high-pitch: 31 (73%) scans vs standard-pitch: 40 (79%), p=0.340) or the coronary tree as a whole (10 (23%) vs 15 (29%), p=0.493). However, proximal coronary arteries were less well visualised using high-pitch acquisitions (16 (36%) vs 30 (59%), p=0.04). The median (IQR) radiation dose was significantly lower in the high-pitch cohort (dose-length product: 347 (318–476) vs 1227 (1150–1474) mGy cm, respectively, p<0.001), and the protocol required almost half the amount of contrast.ConclusionsThe high-pitch protocol significantly reduces radiation and contrast doses and is non-inferior to standard-pitch acquisitions for aortic assessment. For aortic root assessment, the high-pitch protocol is recommended. However, if coronary assessment is critical, this should be followed by a conventional standard-pitch, low-dose, prospectively gated CT-coronary angiogram if the high-pitch scan is non-diagnostic.
Firing rate estimation using infinite mixture models and its application to neural decoding
Authors: Shibue Ryohei , Komaki Fumiyasu 
Published: August 2017

Neural decoding is a framework for reconstructing external stimuli from spike trains recorded by various neural recordings. Kloosterman et al. proposed a new decoding method using marked point processes (Kloosterman F, Layton SP, Chen Z, Wilson MA. J Neurophysiol 111: 217–227, 2014). This method does not require spike sorting and thereby improves decoding accuracy dramatically. In this method, they used kernel density estimation to estimate intensity functions of marked point processes. However, the use of kernel density estimation causes problems such as low decoding accuracy and high computational costs. To overcome these problems, we propose a new decoding method using infinite mixture models to estimate intensity. The proposed method improves decoding performance in terms of accuracy and computational speed. We apply the proposed method to simulation and experimental data to verify its performance. NEW & NOTEWORTHY We propose a new neural decoding method using infinite mixture models and nonparametric Bayesian statistics. The proposed method improves decoding performance in terms of accuracy and computation speed. We have successfully applied the proposed method to position decoding from spike trains recorded in a rat hippocampus.
Clinical Characteristics and Long-Term Outcome of Hypertrophic Cardiomyopathy in Individuals With a MYBPC3 (Myosin-Binding Protein C) Founder Mutation
Authors: van Velzen Hannah G. , Schinkel Arend F.L. , Oldenburg Rogier A. , van Slegtenhorst Marjon A. , Frohn-Mulder Ingrid M.E. , van der Velden Jolanda , Michels Michelle 
Published: August 2017

Background—

MYBPC3
(Myosin-binding protein C) founder mutations account for 35% of hypertrophic cardiomyopathy (HCM) cases in the Netherlands. We compared clinical characteristics and outcome of
MYBPC3
founder mutation (FG+) HCM with nonfounder genotype-positive (G+) and genotype-negative (G−) HCM.

Methods and Results—

The study included 680 subjects: 271 FG+ carriers, 132 G+ probands with HCM, and 277 G− probands with HCM. FG+ carriers included 134 FG+ probands with HCM, 54 FG+ relatives diagnosed with HCM after family screening, 74 FG+/phenotype-negative relatives, and 9 with noncompaction or dilated cardiomyopathy. The clinical phenotype of FG+ and G+ probands with HCM was similar. FG+ and G+ probands were younger with less left ventricular outflow tract obstruction than G− probands, however, had more hypertrophy, and nonsustained ventricular tachycardia. FG+ relatives with HCM had less hypertrophy, smaller left atria, and less systolic and diastolic dysfunction than FG+ probands with HCM. After 8±6 years, cardiovascular mortality in FG+ probands with HCM was similar to G+ HCM (22% versus 14%; log-rank
P
=0.14), but higher than G− HCM (22% versus 6%; log-rank
P
<0.001) and FG+ relatives with HCM (22% versus 4%;
P
=0.009). Cardiac events were absent in FG+/phenotype-negative relatives; subtle HCM developed in 11% during 6 years of follow-up.

Conclusions—
Clinical phenotype and outcome of FG+ HCM was similar to G+ HCM but worse than G− HCM and FG+ HCM diagnosed in the context of family screening. These findings indicate the need for more intensive follow-up of FG+ and G+ HCM versus G− HCM and FG+ HCM in relatives.
Denervated Myocardium Is Preferentially Associated With Sudden Cardiac Arrest in Ischemic Cardiomyopathy
Authors: Fallavollita James A. , Dare Jonathan D. , Carter Randolph L. , Baldwa Sunil , Canty John M. 
Published: August 2017

Background—
Previous studies have identified multiple risk factors that are associated with total cardiac mortality. Nevertheless, identifying specific factors that distinguish patients at risk of arrhythmic death versus heart failure could better target patients likely to benefit from implantable cardiac defibrillators, which have no impact on nonsudden cardiac death.

Methods and Results—

We performed a pilot competing risks analysis of the National Institutes of Health–sponsored PAREPET trial (Prediction of Arrhythmic Events with Positron Emission Tomography). Death from cardiac causes was ascertained in subjects with ischemic cardiomyopathy (n=204) eligible for an implantable cardiac defibrillator for the primary prevention of sudden cardiac arrest after baseline clinical evaluation and imaging at enrollment (positron emission tomography and 2-dimensional echo). Mean age was 67±11 years with an ejection fraction of 27±9%, and 90% were men. During 4.1 years of follow-up, there were 33 sudden cardiac arrests (arrhythmic death or implantable cardiac defibrillator discharge for ventricular fibrillation or ventricular tachycardia >240 bpm) and 36 nonsudden cardiac deaths. Sudden cardiac arrest was correlated with a greater volume of denervated myocardium (defect of the positron emission tomography norepinephrine analog
11
C-hydroxyephedrine), lack of angiotensin inhibition therapy, elevated B-type natriuretic peptide, and larger left ventricular end-diastolic volume index. In contrast, nonsudden cardiac death was associated with a higher resting heart rate, older age, elevated creatinine, larger left atrial volume index, and larger left ventricular end-diastolic volume index.

Conclusions—
Distinct clinical, laboratory, and imaging variables are associated with cause-specific cardiac mortality in primary-prevention candidates with ischemic cardiomyopathy. If prospectively validated, these multivariable associations may help target specific therapies to those at the greatest risk of sudden and nonsudden cardiac death.

Clinical Trial Registration—

URL:
https://clinicaltrials.gov
. Unique identifier: NCT01400334.
Bifidobacterium breve M‐16V as a Probiotic for Preterm Infants: A Strain‐Specific Systematic Review
Authors: Athalye‐Jape Gayatri , Rao Shripada , Simmer Karen , Patole Sanjay 
Published: August 2017

AbstractIntroduction: Bifidobacterium breve M‐16V has been used as a probiotic in preterm infants. Probiotic strain‐specific data are essential to guide clinical practice. Objective: To assess effects of B breve M‐16V in preterm neonates. Design: A systematic review of randomized controlled trials (RCTs) and non‐RCTs of B breve M‐16V in preterm infants was conducted. Multiple databases, proceedings of Pediatric Academy Society, and other relevant conferences were searched in September 2016 and on January 5, 2017. Results: Five RCTs (n = 482) and 4 non‐RCTs (n = 2496) were included. Of the 5 RCTs, 4 carried high/unclear risk of bias in many domains. Meta‐analysis (fixed effects model) of RCTs showed no significant benefits on stage ≥2 necrotizing enterocolitis, late‐onset sepsis, mortality, and postnatal age at full feeds. Meta‐analysis of non‐RCTs showed significant benefits on (1) late‐onset sepsis—3 studies (n = 2452), odds ratio = 0.56 (95% CI, 0.45–0.71), P < .0001; (2) mortality—2 studies (n = 2319), odds ratio = 0.61 (95% CI, 0.44–0.84), P = .002; and (3) postnatal age at full feeds (days)—2 studies (n = 361), mean difference, −2.42 (95% CI, −2.55 to −2.3), P < .00001. There were no adverse effects from B breve M‐16V. On Grading of Recommendations, Assessment, Development, and Evaluation analysis, the overall quality of evidence was deemed very low. Conclusions: Current evidence is limited regarding the potential of B breve M‐16V in preterm neonates. Adequately powered, preferably cluster RCTs are needed to confirm these findings.
Phase 1 study of the anti-CD22 immunotoxin moxetumomab pasudotox for childhood acute lymphoblastic leukemia
Authors: Wayne Alan S. , Shah Nirali N. , Bhojwani Deepa , Silverman Lewis B. , Whitlock James A. , Stetler-Stevenson Maryalice , Sun Weili , Liang Meina , Yang Jie , Kreitman Robert J. , Lanasa Mark C. , Pastan Ira 
Published: August 2017

Key Points
A phase 1 trial of the anti-CD22 immunotoxin moxetumomab pasudotox was conducted in children with ALL. A 32% objective response rate was observed, including 11 composite complete responses (23%), 5 of which were minimal residual disease negative.
The deubiquitylating enzyme Ubp12 regulates Rad23-dependent proteasomal degradation
Authors: Gödderz Daniela , Giovannucci Tatiana A. , Laláková Jana , Menéndez-Benito Victoria , Dantuma Nico P. 
Published: August 2017

ABSTRACT
The consecutive actions of the ubiquitin-selective segregase Cdc48 and the ubiquitin shuttle factor Rad23 result in the delivery of ubiquitylated proteins at the proteasome. Here, we show that the deubiquitylating enzyme Ubp12 interacts with Cdc48 and regulates proteasomal degradation of Rad23-dependent substrates in Saccharomyces cerevisiae. Overexpression of Ubp12 results in stabilization of Rad23-dependent substrates. We show that Ubp12 removes short ubiquitin chains from the N-terminal ubiquitin-like domain (UbL) of Rad23. Preventing ubiquitylation of Rad23 by mutation of lysine residues within the UbL domain, Rad23UbLK0, does not affect the non-proteolytic role of Rad23 in DNA repair but causes an increase in ubiquitylated cargo bound to the UBA2 domain of Rad23, recapitulating the stabilization of Rad23-dependent substrates observed upon overexpression of Ubp12. Expression of Rad23UbLK0 or overexpression of Ubp12 impairs the ability of yeast to cope with proteotoxic stress, consistent with inefficient clearance of misfolded proteins by the ubiquitin–proteasome system. Our data suggest that ubiquitylation of Rad23 plays a stimulatory role in the degradation of ubiquitylated substrates by the proteasome.
Gastroenteritis Aggressive Versus Slow Treatment For Rehydration (GASTRO). A pilot rehydration study for severe dehydration: WHO plan C versus slower rehydration
Authors: Houston Kirsty A. , Gibb Jack G. , Mpoya Ayub , Obonyo Nchafatso , Olupot-Olupot Peter , Nakuya Margeret , Evans Jennifer A , George Elizabeth C , Gibb Diana M , Maitland Kathryn 
Published: August 2017

Background: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy. Those findings warrant a detailed physiological study of children’s responses to rehydration therapy incorporating quantification of myocardial performance and haemodynamic changes. Methods: GASTRO is a multi-centre, unblinded Phase II randomised controlled trial of 120 children aged 2 months to 12 years admitted to hospital with severe dehydration secondary to AGE. Children with severe malnutrition, chronic diarrhoea and congenital/rheumatic heart disease are excluded. Children will be enrolled over 18 months in 3 centres in Kenya and Uganda and followed until 7 days post-discharge. The trial will randomise children 1:1 to standard rapid rehydration using Ringers Lactate (WHO plan ‘C’ – 100mls/kg over 3-6 hours according to age, plus additional 0.9% saline boluses for children presenting in shock) or to a slower rehydration regimen (100mls/kg given over 8 hours and without the addition of fluid boluses). Enrolment started in November 2016 and is on-going. Primary outcome is frequency of adverse events, particularly related to cardiovascular compromise and neurological sequelae. Secondary outcomes focus on clinical, biochemical, and physiological measures related to assessment of severity of dehydration, and response to treatment by intravenous rehydration. Discussion: Results from this pilot will contribute to generating robust definitions of outcomes (in particular for non-mortality endpoints) for a larger Phase III trial.
Experience using closed incision negative pressure wound therapy in sternotomy patients
Authors: Philip B. , McCluskey P. , Hinchion J. 
Published: August 2017

Objective: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre. Method: A retrospective record review identified 10 patients (4 females, 6 males) where ciNPT was used following sternotomy for cardiac surgery or other mediastinal surgery between January 2012 and March 2013. Results: The patients had an average age of 71.5±14.18 years (range: 44–89 years). Patient comorbidities included obesity, hypertension, active tobacco use, chronic obstructive pulmonary disease, and diabetes mellitus. Patients underwent coronary artery bypass grafting (CABG), aortic valve replacement (AVR), AVR and CABG, or removal of a thymic mass or mediastinal cyst. ciNPT was left in place for an average of 6±0.82 days. All incisions healed without complications. Conclusion: ciNPT use should be considered for patients at risk for postoperative SSI development or other wound complications.
Concordance and acceptability of electric stimulation therapy: a randomised controlled trial
Authors: Miller C. , McGuiness W. , Wilson S. , Cooper K. , Swanson T. , Rooney D. , Piller N. , Woodward M. 
Published: August 2017

Objective:A pilot single-blinded randomised controlled trial (RCT) was conducted to examine concordance with and acceptability of electric stimulation therapy (EST) in patients with venous leg ulcers (VLUs) who had not tolerated moderate to high compression.Method:Participants were randomised to the intervention group (n=15) or a placebo control group (n=8) in which EST was used four times daily for 20 minutes per session. Participants were monitored for eight weeks during which time concordance with the treatment and perceptions of the treatment were assessed.Results:Concordance with the total recommended treatment time was 71.4% for the intervention group and 82.9% for the control group; a difference that was not statistically significant. Participants rated EST as acceptable (84.6% intervention; 83.3% control), only two participants, both from the placebo control group, would not be willing to use EST again. The majority considered EST easier to use than compression (68.4%).Conclusion:EST was a practical and acceptable treatment among people who have been unable to tolerate moderate to high compression therapy.