bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of early dyspnoea relief in acute heart failure and the association with 30‐day outcomes: findings from ASCEND‐HF
Authors: Mentz Robert J. , Hernandez Adrian F. , Stebbins Amanda , Ezekowitz Justin A. , Felker G. Michael , Heizer Gretchen M. , Atar Dan , Teerlink John R. , Califf Robert M. , Massie Barry M. , Hasselblad Vic , Starling Randall C. , O'Connor Christopher M. , Ponikowski Piotr 
Published: November 2012

AimsTo examine the characteristics associated with early dyspnoea relief during acute heart failure (HF) hospitalization, and its association with 30‐day outcomes.Methods and resultsASCEND‐HF was a randomized trial of nesiritide vs. placebo in 7141 patients hospitalized with acute HF in which dyspnoea relief at 6 h was measured on a 7‐point Likert scale. Patients were classified as having early dyspnoea relief if they experienced moderate or marked dyspnoea improvement at 6 h. We analysed the clinical characteristics, geographical variation, and outcomes (mortality, mortality/HF hospitalization, and mortality/hospitalization at 30 days) associated with early dyspnoea relief. Early dyspnoea relief occurred in 2984 patients (43%). In multivariable analyses, predictors of dyspnoea relief included older age and oedema on chest radiograph; higher systolic blood pressure, respiratory rate, and natriuretic peptide level; and lower serum blood urea nitrogen (BUN), sodium, and haemoglobin (model mean C index = 0.590). Dyspnoea relief varied markedly across countries, with patients enrolled from Central Europe having the lowest risk‐adjusted likelihood of improvement. Early dyspnoea relief was associated with lower risk‐adjusted 30‐day mortality/HF hospitalization [hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.68–0.96] and mortality/hospitalization (HR 0.85; 95% CI 0.74–0.99), but similar mortality.ConclusionClinical characteristics such as respiratory rate, pulmonary oedema, renal function, and natriuretic peptide levels are associated with early dyspnoea relief, and moderate or marked improvement in dyspnoea was associated with a lower risk for 30‐day outcomes.
The role of behavioural flexibility in a whole of ecosystem model
Authors: van Putten Ingrid E. , Gorton Rebecca J. , Fulton Elizabeth A. , Thebaud Olivier 
Published: November 2012

Abstractvan Putten, I. E., Gorton, R. J., Fulton, E. A., and Thebaud, O. 2013. The role of behavioural flexibility in a whole of ecosystem model. – ICES Journal of Marine Science, 70:150–163. The predictive accuracy of complex fisheries models developed to anticipate the effects of changing fishery regulations appears to depend on a solid understanding of the processes and feedback systems linking biological and physical information to resource user. Many fisher decisions are modelled in the human component of the models, including inertia, or location choice flexibility. We unpack a whole of ecosystem system model and explore how location choice flexibility in fleet behaviour (sticking to the same seasonal and spatial distribution of fishing) affects outcomes such as catches and income levels and variability. Our analysis shows that the interpretation is not straightforward, and the relationship between behavioural flexibility and income level and income variability has to be considered in the context of three main fleet characteristics: profitability; how diversified the fleet is; and growing or declining target species biomass. We contend that making behavioural flexibility sensitive to the health of the stock and fleet profitability could potentially improve accuracy of large whole of ecosystem models such as Atlantis.
Mid-term Outcomes of Anterior Cervical Fusion for Cervical Spondylosis With Sympathetic Symptoms
Authors: Li Jun , Jiang Dong-jie , Wang Xin-wei , Yuan Wen , Liang Lei , Wang Zhan-chao 
Published: November 2012

Study Design:
Prospective study.

Objective:
The purpose of this study is to elucidate mid-term outcomes of anterior cervical fusion for cervical spondylosis with sympathetic symptoms (CSSS).

Summary of Background Date:
The terminology, pathogenesis, diagnosis, and treatment of CSSS remain controversial. Surgical treatment of CSSS has been rarely reported. This is the first prospective study to evaluate the mid-term outcome of surgical treatment of CSSS.

Methods:
Thirty-one patients who were diagnosed with CSSS in 2006 were evaluated prospectively. All patients were assigned to undergo anterior cervical fusion with posterior longitudinal ligament (PLL) resection and followed up for ≥5 years. Sympathetic symptoms such as vertigo, headache, and tinnitus, etc. were evaluated using the sympathetic symptom 20-point score. Neurological status was assessed using the Japanese Orthopedic Association (JOA) score. Clinical and radiologic data were prospectively collected before surgery, and at 1 week, 2 months, 6 months, 2 years, and 5 years after surgery. Surgical complications and morbidities of other diseases during the follow-up were also recorded.

Results:
The mean 20-point score decreased significantly from 7.3±3.5 before surgery to 2.2±2.7 at the final follow-up (P<0.001), giving a mean recovery rate of 66.1%±50.3%. Good to excellent results were attained in 80.6% of these patients. The sympathetic symptoms were relieved in 23 of the 31 patients in the early postoperative period, and 5 patients in 2 months. No relief of sympathetic symptoms was found in 3 patients. The mean JOA score improved significantly from 12.0±1.9 before surgery to 14.8±1.5 by the end of the follow-up (P<0.001). No late neurological deterioration was found in this group.

Conclusions:
The mid-term outcomes of anterior cervical fusion with PLL resection for CSSS have been satisfactory. Differential diagnosis before surgery is of great importance. PLL may play a role in presenting sympathetic symptoms.
Immune Factors in Breast Milk and the Development of Atopic Disease
Authors: Iyengar Shuba R. , Walker W.A. 
Published: November 2012

ABSTRACTBreast‐feeding provides protection against infections and contains numerous factors that modulate and promote the development of the infant immune system. These factors include secretory IgA, antimicrobial proteins like CD14, cytokines, and fatty acids. Studies examining the role of breast‐feeding in the development of allergic disease in infants demonstrate potentially protective as well as neutral or nonprotective effects, likely due to the heterogeneity in their study design. In this overview, we explore the potential role of immune factors in the breast milk, as well as selected probiotics, in the development of allergy.
Probiotics to Adolescents With Obesity
Authors: Gøbel Rikke Juul , Larsen Nadja , Jakobsen Mogens , Mølgaard Christian , Michaelsen Kim Fleischer 
Published: November 2012

ABSTRACTObjectives:The connections between gut microbiota, energy homeostasis, and inflammation and its role in the pathogenesis of obesity‐related disorders are increasingly recognized. We aimed to investigate the effect of the probiotic strain Lactobacillus salivarius Ls‐33 on a series of biomarkers related to inflammation and the metabolic syndrome (MS) in adolescents with obesity.Methods:The study was a double‐blind placebo‐controlled trial including 50 adolescents with obesity randomized to Ls‐33 (1010 CFU) or placebo daily for 12 weeks.Results:The average body mass index‐for‐age z‐score was 2.6 ± 0.5. There were no differences in biomarkers of inflammation and parameters related to the MS at baseline between the probiotic and placebo groups. Furthermore, there were no differences in changes from baseline to 12‐week intervention with regard to any anthropometric measures, blood pressure (systolic and diastolic), fasting glucose and insulin, homeostasis model assessment of insulin resistance, C‐peptide, cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, triglyceride, free fatty acids, C‐reactive protein, interleukin‐6, tumor necrosis factor alpha, or fecal calprotectin, despite the increased values of biomarkers of inflammation and of several parameters related to the MS at baseline when compared with normal‐weight adolescents. The levels of L salivarius in fecal samples from the probiotic group in the present study were comparable with the levels reported for the other probiotic lactobacilli and bifidobacteria using quantitative polymerase chain reaction.Conclusions:It was not possible to detect any beneficial effect of the probiotic intervention with Ls‐33 on inflammatory markers or parameters related to the MS in adolescents with obesity being in a state of low‐grade systemic inflammation.
Polyethylene Glycol Powder Solution Versus Senna for Bowel Preparation for Colonoscopy in Children
Authors: Terry Natalie A. , Chen‐Lim Mei Lin , Ely Elizabeth , Jatla Muralidhar , Ciavardone Denise , Esch Salina , Farace Lisa , Jannelli Frances , Puma Anita , Carlow Dean , Mamula Petar 
Published: November 2012

ABSTRACTObjectives:Safety and effectiveness of large‐volume polyethylene glycol‐based solution (PEG‐ES) have been documented, but the taste and volume can be barriers to successful colonoscopy preparation. Efficacy and safety of small‐volume electrolyte‐free (PEG‐P) preparation (Miralax) for colonoscopy preparation have been rarely studied, although presently used at many pediatric centers. The primary objective of the present study was to determine whether PEG‐P results in a more efficacious and safe colonoscopy preparation as compared with senna.Methods:The study design was prospective, randomized, and single‐blinded. Patients ages 6 to 21 years were randomized to a 2‐day clean‐out regimen of PEG‐P at a dose of 1.5 g/kg divided twice per day for 2 days versus senna 15 mL daily (ages 6–12) or 30 mL daily (ages 12–21) for 2 days. Both preparations required 1 day of clear liquids whereas senna preparation required an additional day of full liquid diet. A blinded endoscopist graded the quality of preparation with a standardized cleanliness tool (Aronchick scale). Serum chemistry panels were obtained. Patients or parents rated symptoms and ease of preparation. The anticipated number of subjects was 166; however, the interim analysis demonstrated inferiority of senna preparation.Results:Thirty patients were evaluated in the present study. Of the patients in the PEG‐P arm, 88% (14/16) received an excellent/good score compared with 29% (4/14), with the senna preparation (P = 0.0022). Both preparations were well‐tolerated by patient‐graded ease of preparation. Demographics and laboratory values did not differ significantly across the 2 groups. No serious adverse events were noted.Conclusions:PEG‐P is an effective colonoscopy preparation whereas senna preparation was insufficient. Both were well‐tolerated and appear safe in a pediatric population.
Assessment of Nutrition Education Among Pediatric Gastroenterologists
Authors: Lin Henry C. , Kahana Doron , Vos Miriam B. , Black Dennis , Port Zack , Shulman Robert , Scheimann Ann , Mascarenhas Maria R. 
Published: November 2012

ABSTRACTBackground and Aim:Pediatric gastroenterology is the only pediatric subspecialty with nutrition as part of its official curriculum and objective; however, pediatric gastroenterology fellows believe that their baseline knowledge in nutrition is suboptimal. The purpose of the present study was to assess the perceived effectiveness of nutrition training among pediatric gastroenterologists, identify areas of need for additional education, and determine the perceived role of the gastroenterologist in obesity management.Methods:A survey was sent to members and fellows of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition to assess general nutrition education as well as obesity management and educational needs.Results:A total of 272 responses were received, for an overall response rate of 15.2% (272/1784). Most responders reported having average or above‐average knowledge base in all nutritional topics. There was strong interest in additional resources and a continuing medical education (CME) module on several nutrition topics including nutritional requirements in specific gastrointestinal (GI) disease, failure to thrive/growth failure, and parenteral nutrition support, with the format of CME dependent on the topic. There was also a strong interest in additional CME on the management of pediatric obesity (67%), as most responders believed that the management of obesity in children requires subspecialty care. The perceived role of the pediatric gastroenterologist was, however, one of support to treat the GI and hepatic comorbidities of obesity rather than serve as the main provider of comprehensive obesity care.Conclusions:Pediatric gastroenterologists identified gaps in their nutrition knowledge base that may be attributed to the present nutrition education training during fellowship. Multiple topics were identified for additional nutrition education, including obesity management. The nutrition management challenges of today necessitate improved baseline nutrition knowledge and this focus on nutrition should begin at the fellowship level.
Continuous 13C‐Methacetin Breath Test Differentiates Biliary Atresia From Other Causes of Neonatal Cholestasis
Authors: Shteyer Eyal , Lalazar Gadi , Hemed Nilla , Pappo Orit , Granot Esther , Yerushalmi Baruch , Gross Eitan 
Published: November 2012

ABSTRACTBackground and Aim:Distinguishing biliary atresia (BA) from other causes of neonatal cholestasis (NC) is challenging. Continuous BreathID 13C‐methacetin breath test (MBT) is a novel method that determines liver function. Methacetin is metabolized uniquely by the liver and 13CO2 is measured passively, through a nasal cannula in the exhaled breath. The aim of this study was to assess the ability of MBT to differentiate BA from other causes of NC.Methods:MBT was performed in infants with NC before any invasive procedure. Percent dose recovered (PDR) peak and time to peak (TTPP) of 13C recovered were correlated with blood test results and degree of fibrosis on liver biopsy.Results:Fifteen infants were enrolled in the study. Eight were eventually diagnosed as having BA. MBT showed that infants with NC from various causes reached the PDR peak after 44.5 ± 6.7 minutes, whereas infants with BA reached the PDR peak value after 54.7 ± 4.3 minutes (P < 0.005). This suggested low cytochrome P450 1A2 activity in the BA group. The area under the curve (AUC) was 0.95 (95% confidence interval [CI] 0.83–1), sensitivity of 88%, and specificity of 100%.Conclusions:This pilot study shows that MBT can differentiate between BA and other causes of NC by time to peak of methacetin metabolism. The results suggest that MBT may be used as part of the diagnostic algorithm in infants with liver disease. Larger‐scale studies should be conducted to confirm these initial observations.
Newborn Lamb as a New Model for Studying Gastroesophageal Reflux
Authors: Djeddi Djamal , Samson Nathalie , Boudaa Nadia , Praud Jean‐Paul 
Published: November 2012

ABSTRACTWe aimed to determine whether the newborn lamb at term is a valid model for studying gastroesophageal reflux. Seven bottle‐fed lambs, ages 2 to 3 days, underwent esophageal multichannel intraluminal impedance‐pH monitoring (MII‐pH). A total of 196 reflux episodes were recorded, including 73% alkaline and 27% weakly acidic. No acid refluxes were observed. Median bolus clearance time was 4 seconds (3; 5.5), and proximal reflux extent was 35% (26). This first report of MII‐pH in the newborn mammal sets the foundations for future studies with physiological and clinical relevance to human neonates.
Amoxicillin‐Clavulanic Acid Hepatotoxicity in Children
Authors: Hita Esther Ocete , García Jose Antonio Martín , Gonzalez Jose Carlos Flores , Molina Ana Abril , Cordero MJosé Aguilar , Escobar Javier Salmerón , Ruiz‐Extremera Angela 
Published: November 2012

ABSTRACTObjectives:The objectives of the present study were to determine the importance of amoxicillin‐clavulanic acid (AC) hepatotoxicity in the paediatric population and to characterise the episodes identified and potential host‐specific factors. This was addressed via a prospective observational study in which 8 Spanish hospitals participated.Methods:A total of 11 cases were examined. For each patient included in the study, a structured and codified data‐collection protocol was complied with, taking note of patient demographics, characteristics of the treatment assumed to provoke the reaction, concomitant medication, course and outcome of the episode, and laboratory variables during the reaction. The latter were determined every 6 months from the outset to the eventual resolution of the case.Results:A total of 11 cases of AC hepatotoxicity were detected, affecting 9 boys and 2 girls, ages 1 to 11 years. Causality criteria were assessed using the Council for International Organizations of Medical Sciences scale.Conclusions:We conclude that the introduction of hepatotoxicity record systems in paediatric care, together with the continuing study and development of existing systems, would contribute to improving our epidemiological knowledge about the harmful effects of drugs on the liver.
Antibodies Against Deamidated Gliadin Peptides and Tissue Transglutaminase for Diagnosis of Pediatric Celiac Disease
Authors: Olen Ola , Gudjónsdóttir Audur H. , Browaldh Lars , Hessami Mozaffar , Elvin Kerstin , Liedberg Ann‐Sofie , Neovius Martin , Grahnquist Lena 
Published: November 2012

ABSTRACTObjectives:The aim of the present study was to evaluate diagnostic performance and actual costs in clinical practice of immumoglobulin (Ig)G/IgA deamidated gliadin peptide antibodies (DGP) as a complement to IgA antibodies against tissue transglutaminase (tTG) for the diagnosis of pediatric celiac disease (CD).Methods:All of the consecutive patients younger than 18 years tested for tTG and/or DGP, who underwent duodenal biopsy because of suspected CD in Stockholm and Gothenburg, Sweden, from 2008 to 2010, were included. Medical records were reviewed.Results:Of 537 children who underwent duodenal biopsy, 278 (52%) had CD. A total of 71 (13%) were younger than 2 years and 16 (4%) had IgA deficiency. Sensitivity and specificity for tTG were 94% and 86%, respectively. Corresponding values for DGP were 91% and 26%. Positive predictive values (PPV) were 88% for tTG and 51% for DGP. There were 148 children who were tTG‐negative and DGP‐positive, of which only 5% (8/148) had villous atrophy. Among children younger than 2 years with normal IgA, PPV was 96% (25/26) for tTG and 48% (24/50) for DGP. In 16 IgA‐deficient children, 11 were DGP positive, of which 5 had CD (PPV 45%). Eight of 278 cases of CD would possibly have been missed without DGP. The cost of adding DGP and consequently more biopsies to be able to detect 8 extra cases of CD was €399,520 or €49,940 per case.Conclusions:For diagnosing CD, tTG is superior to DGP, even in children younger than 2 years. Combining tTG and DGP does not provide a better tradeoff between number of missed cases of CD, number of unnecessary duodenal biopsies, and cost than tTG alone.
Abnormal Gut Integrity Is Associated With Reduced Linear Growth in Rural Malawian Children
Authors: Weisz Ariana J. , Manary Micah J. , Stephenson Kevin , Agapova Sophia , Manary Faith G. , Thakwalakwa Chrissie , Shulman Robert J. , Manary Mark J. 
Published: November 2012

ABSTRACTThe aim of the present study was to investigate the relation of environmental enteropathy, as measured by the dual sugar absorption test, to linear growth faltering in 2‐ to 5‐year‐old Malawian children. Dietary quality, food insecurity, anthropometry, and site‐specific sugar testing were measured in 418 children, and anthropometry was reassessed 3 months later. A linear regression model predicting linear growth was created. Better growth was associated with less urinary lactulose excretion, more clean water usage, not sleeping with animals, and no previous history of malnutrition. Eighty‐seven percent of children studied demonstrated evidence of environmental enteropathy. In conclusion, abnormal gut integrity is associated with reduced linear growth in a population of rural African preschool‐age children.
ESPGHAN Guidance on Coeliac Disease 2012
Authors: Egner William , Shrimpton Anna , Sargur Ravishankar , Patel Dina , Swallow Kirsty 
Published: November 2012

ABSTRACTThe updated ESPGHAN guidance on coeliac disease recommends the use of common multiples of the upper limit of normal (ULN) for IgA tissue transglutaminase antibodies (TG2) when deciding which diagnostic pathway to follow. The current lack of standardisation between assays makes it difficult to harmonise results between centres as different performance characteristics are observed with each assay. This variability is shown in data from external quality assessment distributions. As a result, the updated guidance is too generalised for use with all the commercial TG2 kits and is therefore not translatable for use in all centres.
Navigating the Gluten‐free Diet in College
Authors: Panzer Rebecca M. , Dennis Melinda , Kelly Ciaran P. , Weir Dascha , Leichtner Alan , Leffler Daniel A. 
Published: November 2012

ABSTRACTFactors that affect adherence to the gluten‐free diet (GFD) are reported in children and adults; however, there is little data regarding young adults. The objective of the present study is to explore adherence challenges experienced by young adults in college. Responses from the online survey (N = 50), interview (N = 21), and focus group (N = 7) indicate students were motivated to adhere but experience challenges related to dining services and social situations. Dining services from 6 colleges reported a variety of accommodations for students with celiac disease, but request increased student involvement. Tools and strategies that facilitate communication between students and dining services may improve adherence.
Aminotransferase Upper Reference Limits and the Prevalence of Elevated Aminotransferases in the Korean Adolescent Population
Authors: Park Seung Ha , Park Ha Young , Kang Jong Woo , Park Jinse , Shin Kyong Jin 
Published: November 2012

ABSTRACTObjectives:For the pediatric population, upper reference limits (URLs) for aminotransferase levels have not been established. The prevalence of high aminotransferase levels provides important information regarding the burden of liver disease in the current childhood obesity endemic.Methods:We set the URL of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) for participants ages 10 to 19 years (n = 2746) from the 2007 to 2009 Korea National Health and Nutrition Examination Survey at the 97.5th percentile of that population who were determined to be at low risk for liver disease (n = 1717; low risk was defined as testing negative for hepatitis B virus surface antigens, the absence of alcohol use disorder, having normal body mass index, and having normal lipid or carbohydrate metabolism).Results:The URLs for ALT were 33 IU/L for boys and 25 IU/L for girls, and the corresponding limits for AST were 33 IU/L for boys and 28 IU/L for girls. The weighted prevalence of elevated ALT levels was 6.5% in the sample, 8.2% in boys and 4.5% in girls. The prevalence of elevated AST levels was 3.9% and had no sex differences. We also found that elevated ALT levels are associated with male sex, older age, obesity, and presence of abnormal lipid levels. Having elevated AST levels is associated with obesity, younger age, and exhibiting laboratory indicators of abnormal lipid metabolism.Conclusions:Aminotransferase URLs are being established for the first time, and our results may be useful in determining a baseline level for monitoring the secular trends of liver disease in future studies of adolescent populations.