bluuebunny/crossref_metadata_2025_split huggingface dataset:
MIG1Regulates Resistance of Candida albicans against the Fungistatic Effect of Weak Organic Acids
Authors: Cottier Fabien , Tan Alrina Shin Min , Xu Xiaoli , Wang Yue , Pavelka Norman 
Published: August 2015

ABSTRACTCandida albicansis the leading cause of fungal infections; but it is also a member of the human microbiome, an ecosystem of thousands of microbial species potentially influencing the outcome of host-fungal interactions. Accordingly, antibacterial therapy raises the risk of candidiasis, yet the underlying mechanism is currently not fully understood. We hypothesize the existence of bacterial metabolites that normally controlC. albicansgrowth and of fungal resistance mechanisms against these metabolites. Among the most abundant microbiota-derived metabolites found on human mucosal surfaces are weak organic acids (WOAs), such as acetic, propionic, butyric, and lactic acid. Here, we used quantitative growth assays to investigate the dose-dependent fungistatic properties of WOAs onC. albicansgrowth and found inhibition of growth to occur at physiologically relevant concentrations and pH values. This effect was conserved across distantly related fungal species both inside and outside the CTG clade. We next screened a library of transcription factor mutants and identified several genes required for the resistance ofC. albicansto one or more WOAs. A single gene,MIG1, previously known for its role in glucose repression, conferred resistance against all four acids tested. Consistent with glucose being an upstream activator of Mig1p, the presence of this carbon source was required for WOA resistance in wild-typeC. albicans. Conversely, aMIG1-complemented strain completely restored the glucose-dependent resistance against WOAs. We conclude that Mig1p plays a central role in orchestrating a transcriptional program to fight against the fungistatic effect of this class of highly abundant metabolites produced by the gastrointestinal tract microbiota.
Head injury from falls in children younger than 6 years of age
Authors: Burrows P , Trefan L , Houston R , Hughes J , Pearson G , Edwards R J , Hyde P , Maconochie I , Parslow R C , Kemp A M 
Published: August 2015

The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described.MethodCross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results.ResultsOf 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65).ConclusionsMost HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known.
Should children with overweight or obesity be excluded from height references?
Authors: Júlíusson Pétur B , Brannsether Bente , Kristiansen Hege , Hoppenbrouwers Karel , Bjerknes Robert , Roelants Mathieu 
Published: August 2015

Background and objectivesGrowth reference charts are usually based on measurements of children free from a medical condition that affects growth. However, samples collected during the past decades often contain a large proportion of overweight or obese children. Because obesity increases linear growth, the question arises to what extent the percentiles curves for length/height are affected by the presence of children with overweight or obesity.MethodsData from two cross-sectional samples of 2-year-old to 18-year-old children were analysed: 12 252 Belgian children, measured in 2002–2004, and 6159 Norwegian children, measured in 2003–2006. The LMS method was used to estimate height-for-age curves with and without children considered overweight or obese according to the International Obesity Task Force thresholds.ResultsThe prevalence of overweight (including obesity) and obesity was 13.0% and 2.8% in the Belgian and 13.8% and 2.3% in the Norwegian sample. Children were taller when overweight (+0.49 and 0.43 SD, in the Belgian and Norwegian sample, respectively) or obese (+0.73 and 0.72 SD in the Belgian and Norwegian sample, respectively). Effect sizes were smaller in younger and older children, which points to an advanced age of maturation as a possible cause. Excluding overweight and obese children had only a minor impact on the growth curves with largest difference in mean height SD scores −0.09 in the Belgian and −0.12 in the Norwegian sample with a corresponding increase of up to 0.5% and 1.2% in number of children >+2 SD.ConclusionsCurrent Belgian and Norwegian growth references for length/height were found to be largely unaffected by the current proportion of overweight and obese children. There is, therefore, no need for revised height charts that exclude overweight or obese children.
Presentation of childhood cancers to a paediatric shared care unit
Authors: Roskin Jeremy , Diviney James , Nanduri Vasanta 
Published: August 2015

ObjectiveTo describe the pathways by which children with cancer present to a shared care oncology unit.DesignA population-based retrospective cohort study of children diagnosed with cancer between the years 2004 and 2014.SettingDistrict General Hospital with a level 2 Paediatric Oncology Shared Care Unit.Patients93 children aged 0–15 years.Outcome measuresTime to presentation (TTP) was defined as time from initial symptoms to time seen by secondary paediatrics. Time to diagnosis (TTD) was defined as time from initial symptoms to diagnosis at a Principal Treatment Centre. Patient pathways to diagnosis were mapped and routes for different cancers were compared.ResultsOnly 2/93 cases (2.1%) in 10 years were referred via the 2-week pathway. Most presentations were acute via immediate general practitioner (GP) referral or self-referral to the emergency department 62/93 (67%). Leukaemia presented acutely and via the GP more often than via self-presentation to the emergency department 21/28 (75% vs 25%), while solid tumours were self-referred to the emergency department 21/34 (62% vs 38%) more often than via the GP. TTP and TTD were calculated for 87 patients. Wilms’ tumour demonstrated the shortest median TTP of 7 days and TTD of 16 days. Lymphoma had the longest TTD, with TTP 107 days and TTD 120 days. Pathways to diagnosis via other specialties were longer.ConclusionThe majority of children diagnosed with cancer present via acute services, with the route varying between tumour types. Only two cases in 10 years were referred via the 2-week pathway, thus challenging its relevance in the paediatric population.
Risk factors for under-5 mortality: evidence from Bangladesh Demographic and Health Survey, 2004–2011
Authors: Abir Tanvir , Agho Kingsley Emwinyore , Page Andrew Nicolas , Milton Abul Hasnat , Dibley Michael John 
Published: August 2015

ObjectiveThe aim of this study was to identify factors associated with mortality in children under 5 years of age using a nationally representative sample of singleton births for the period of 2004–2011.Design, setting and participantsPooled 2004, 2007 and 2011 cross-sectional data sets of the Bangladesh Demographic and Health Surveys were analysed. The surveys used a stratified two-stage cluster sample of 16 722 singleton live-born infants of the most recent birth of a mother within a 3-year period.Main outcome measuresOutcome measures were neonatal mortality (0–30 days), postneonatal mortality (1–11 months), infant mortality (0–11 months), child mortality (1–4 years) and under-5 mortality (0–4 years).ResultsSurvival information for 16 722 singleton live-born infants and 522 deaths of children <5 years of age included: 310 neonatal deaths, 154 postneonatal deaths, 464 infant deaths, 58 child deaths and 522 under-5 deaths. Multiple variable analysis showed that, over a 7-year period, mortality reduced significantly by 48% for postneonatal deaths, 33% for infant deaths and 29% for under-5 deaths, but there was no significant reduction in neonatal deaths (adjusted OR (AOR)=0.79, 95% CI 0.59 to 1.06) or child deaths (AOR=1.00, 95% CI 0.51 to 1.94). The odds of neonatal, postneonatal, infant, child and under-5 deaths decreased significantly among mothers who used contraceptive and mothers who had other children aged 3 years or older. The risk of neonatal, postneonatal, infant, child and under-5 deaths was significantly higher in mothers who reported a previous death of a sibling.ConclusionsOur study suggests that family planning is needed to further reduce the overall rate of under-5 deaths in Bangladesh. To reduce childhood mortality, public health interventions that focus on child spacing and contraceptive use by mothers may be most effective.
The impact of distance and duration of travel on participation rates and participants’ satisfaction: results from a pilot study at one study centre in Pretest 2 of the German National Cohort
Authors: Schweitzer Aparna , Akmatov Manas K , Kindler Florentina , Kemmling Yvonne , Kreienbrock Lothar , Krause Gérard , Pessler Frank 
Published: August 2015

ObjectivesIn this pilot study within the Pretest 2 phase of the German National Cohort, we aimed to (1) test the hypothesis that distance and duration of travel to a study centre may affect participation rates and participants’ satisfaction and (2) to obtain data that would help to select recruitment areas around the study centre Hannover with the greatest projected participation rate for the main study.SettingMixed urban/suburban environment in Northern Germany with approximately 600 000 inhabitants. 4 recruitment areas with divergent estimated mean distances (range, 7–40 km) and duration of travel to the study centre Hannover were selected.Participants1050 men and women (ratio, 1:1), aged 20–69 years, were randomly selected from the population registries of the 4 recruitment areas and invited by mail to participate in the Pretest 2 study programme at the study centre Hannover, covering a variety of questionnaire-based and physical assessments. 166 individuals participated (16%).InterventionsAll 166 participants completed a travel questionnaire containing 5 items relating to travel duration and satisfaction, amounting to a participation rate of 100% in the questionnaire-based part of the study.ResultsParticipation rates in the Pretest 2 programme at the study centre Hannover by area ranged from 11% (area farthest from the study centre, estimated median distance 38 km) to 18% (nearest area, 2 km). The odds of non-participation were highest in the area farthest from the study centre (adjusted OR 2.06; p=0.01; CI 1.28 to 3.32). Nonetheless, 97% of participants were satisfied with travel duration.ConclusionsIncreasing distance was associated with a lower participation rate. However, acceptance of duration of travel was high, irrespective of distance or duration. Thus, recruiting in farther away locations may select individuals with a greater frustration tolerance for travel to the study centre, perhaps due to a greater interest in participating in health-oriented studies and thus different health-related behaviour.
Role of overweight and obesity in low back disorders among men: a longitudinal study with a life course approach
Authors: Frilander Heikki , Solovieva Svetlana , Mutanen Pertti , Pihlajamäki Harri , Heliövaara Markku , Viikari-Juntura Eira 
Published: August 2015

ObjectivesTo assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course.DesignA longitudinal and cross-sectional study.SettingA nationwide health survey supplemented with data from records of prior compulsory military service.ParticipantsPremilitary health records (baseline) were searched for men aged 30–50 years (n=1385) who participated in a national health examination survey (follow-up).Methods and outcome measuresHeight and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica.ResultsBaseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m2) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m2). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP.ConclusionsOur findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented.
Remote ischaemic conditioning on recipients of deceased renal transplants, effect on immediate and extended kidney graft function: a multicentre, randomised controlled trial protocol (CONTEXT)
Authors: Krogstrup Nicoline V , Oltean Mihai , Bibby Bo M , Nieuwenhuijs-Moeke Gertrude J , Dor Frank J M F , Birn Henrik , Jespersen Bente 
Published: August 2015

IntroductionDelayed graft function due to ischaemia-reperfusion injury is a frequent complication in deceased donor renal transplantation. Experimental evidence indicates that remote ischaemic conditioning (RIC) provides systemic protection against ischaemia-reperfusion injury in various tissues.Methods and analysis‘Remote ischaemic conditioning in renal transplantation—effect on immediate and extended kidney graft function’ (the CONTEXT study) is an investigator initiated, multicentre, randomised controlled trial investigating whether RIC of the leg of the recipient improves short and long-term graft function following deceased donor kidney transplantation. The study will include 200 kidney transplant recipients of organ donation after brain death and 20 kidney transplant recipients of organ donation after circulatory death. Participants are randomised in a 1:1 design to RIC or sham-RIC (control). RIC consists of four cycles of 5 min occlusion of the thigh by a tourniquet inflated to 250 mm Hg, separated by 5 min of deflation. Primary end point is the time to a 50% reduction from the baseline plasma creatinine, estimated from the changes of plasma creatinine values 30 days post-transplant or 30 days after the last performed dialysis post-transplant. Secondary end points are: need of dialysis post-transplant, measured and estimated-glomerular filtration rate (GFR) at 3 and 12 months after transplantation, patient and renal graft survival, number of rejection episodes in the first year, and changes in biomarkers of acute kidney injury and inflammation in plasma, urine and graft tissue.Ethics and disseminationThe study is approved by the local ethical committees and national data security agencies. Results are expected to be published in 2016.Trial registration numberNCT01395719.
RITPBC: B-cell depleting therapy (rituximab) as a treatment for fatigue in primary biliary cirrhosis: study protocol for a randomised controlled trial
Authors: Jopson Laura , Newton Julia L , Palmer Jeremy , Floudas Achilleas , Isaacs John , Qian Jessica , Wilkinson Jennifer , Trenell Mike , Blamire Andrew , Howel Denise , Jones David E 
Published: August 2015

IntroductionPrimary biliary cirrhosis (PBC) is an autoimmune liver disease with approximately 50% of patients experiencing fatigue. This can be a particularly debilitating symptom, affecting quality of life and resulting in social isolation. Fatigue is highlighted by patients as a priority for research and patient support groups were involved in designing this trial. This is the first randomised controlled trial to investigate a treatment for fatigue in PBC. The trial protocol is innovative as it utilises novel magnetic resonance spectroscopy (MRS) techniques as an outcome measure. The protocol will be valuable to research groups planning clinical trials targeting fatigue in PBC and also transferrable to other conditions associated with fatigue.Methods and analysisRITPBC is a Medical Research Council (MRC) and National Institute for Health Research (NIHR) Efficacy and Mechanism Evaluation Programme (EME)-funded project. It is a phase II, single-centre, randomised controlled, double-blinded trial comparing rituximab with placebo in fatigued PBC patients. 78 patients with PBC and moderate to severe fatigue will be randomised to receive two infusions of rituximab or placebo. The study aims to assess whether rituximab improves fatigue in patients with PBC, the safety, and tolerability of rituximab in PBC and the sustainability of any beneficial actions. The primary outcome will be an improvement in fatigue domain score of the PBC-40, a disease-specific quality of life measure, evaluated at 12-week assessment. Secondary outcome measures include novel MRS techniques assessing muscle bioenergetic function, physical activity, anaerobic threshold and symptom, and quality of life measures. The trial started recruiting in October 2012 and recruitment is ongoing.Ethics and disseminationThe trial has ethical approval from the NRES Committee North East, has Clinical Trial Authorisation from MHRA and local R&D approval. Trial results will be communicated to participants, presented at national and international meetings and published in peer-reviewed journals.Trial registration numberISRCTN03978701.
Association between lymphocyte-to-monocyte ratio (LMR) and the mortality of HBV-related liver cirrhosis: a retrospective cohort study
Authors: Zhang Jie , Feng Guofang , Zhao Ying , Zhang Juanwen , Feng Limin , Yang Jing 
Published: August 2015

ObjectiveInfection with hepatitis B virus (HBV) remains a major cause of liver cirrhosis (LC) in China. Recent reports suggest that the lymphocyte-to-monocyte ratio (LMR) is a potential biomarker for predicting clinical outcomes. In our study, we investigated if LMR can be used as a prognostic marker of mortality in patients with HBV-related LC.DesignA retrospective cohort study.SettingHBV-infected patients with LC and patients with chronic hepatitis B infection (CHB) from the Department of Infectious Disease were enrolled and 240 healthy individuals were recruited from the healthcare centre at the First Affiliated Hospital of Zhejiang University.Participants479 HBV-infected patients with LC, 134 patients with CHB and 240 healthy individuals were enrolled.Primary and secondary outcome measuresThe receiver operating characteristic (ROC) curve and multivariable logistic regression analysis after adjusting for total protein, albumin, total bilirubin and the model for end-stage liver disease (MELD) score were used to evaluate the power of LMR for predicting 1 year mortality in patients with LC.ResultsThe LMR was statistically lower in patients with LC. The MELD score and mortality were statistically higher in patients with LC compared with the CHB and control groups. The area under the ROC curve, cut-off values, sensitivity and specificity of LMR for predicting mortality LC in the training cohort were 0.817 (95% CI 0.746 to 0.888; p<0.001), 2.10, 82.6 and 78.8%, and these data were confirmed in the validation cohort. The multivariate logistic regression analysis showed that LMR was an independent predictive factor of mortality in LC (OR 2.370, 95% CI (1.070 to 5.249); p=0.033).ConclusionsOur results strongly suggest that low LMR can be considered as an independent biomarker for predicting mortality in patients with LC.
Data linkage errors in hospital administrative data when applying a pseudonymisation algorithm to paediatric intensive care records
Authors: Hagger-Johnson Gareth , Harron Katie , Fleming Tom , Gilbert Ruth , Goldstein Harvey , Landy Rebecca , Parslow Roger C 
Published: August 2015

ObjectivesOur aim was to estimate the rate of data linkage error in Hospital Episode Statistics (HES) by testing the HESID pseudoanonymisation algorithm against a reference standard, in a national registry of paediatric intensive care records.SettingThe Paediatric Intensive Care Audit Network (PICANet) database, covering 33 paediatric intensive care units in England, Scotland and Wales.ParticipantsData from infants and young people aged 0–19 years admitted between 1 January 2004 and 21 February 2014.Primary and secondary outcome measuresPICANet admission records were classified as matches (records belonging to the same patient who had been readmitted) or non-matches (records belonging to different patients) after applying the HESID algorithm to PICANet records. False-match and missed-match rates were calculated by comparing results of the HESID algorithm with the reference standard PICANet ID. The effect of linkage errors on readmission rate was evaluated.ResultsOf 166 406 admissions, 88 596 were true matches (where the same patient had been readmitted). The HESID pseudonymisation algorithm produced few false matches (n=176/77 810; 0.2%) but a larger proportion of missed matches (n=3609/88 596; 4.1%). The true readmission rate was underestimated by 3.8% due to linkage errors. Patients who were younger, male, from Asian/Black/Other ethnic groups (vs White) were more likely to experience a false match. Missed matches were more common for younger patients, for Asian/Black/Other ethnic groups (vs White) and for patients whose records had missing data.ConclusionsThe deterministic algorithm used to link all episodes of hospital care for the same patient in England has a high missed match rate which underestimates the true readmission rate and will produce biased analyses. To reduce linkage error, pseudoanonymisation algorithms need to be validated against good quality reference standards. Pseudonymisation of data ‘at source’ does not itself address errors in patient identifiers and the impact these errors have on data linkage.