bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple intravenous doses of paracetamol result in a predictable pharmacokinetic profile in very preterm infants
Authors: van Ganzewinkel C , Derijks L , Anand KJS , van Lingen RA , Neef C , Kramer BW , Andriessen P 
Published: March 2014

AbstractAimThe therapeutic options available to treat neonatal pain are limited, and one alternative for nonopioid systemic treatment is paracetamol. However, pharmacokinetic data from prolonged administration of intravenous paracetamol in neonates are limited. The aim of this study was to present pharmacokinetics after multiple dose of intravenous paracetamol in very preterm infants of <32 weeks' gestation.MethodsFifteen very preterm infants received five, six‐hourly doses of intravenous paracetamol (7.5 mg/kg). Blood samples were taken to measure paracetamol, glutathione and hepatic function, together with urine samples for paracetamol metabolites.ResultsA two‐compartment pharmacokinetic model gave the best fit for all individual patients and resulted in a predictable pharmacokinetic profile. The estimated pharmacokinetic population parameters were volume of distribution 0.764 ± 0.225 L/kg, elimination rate constant (ke) 0.117 ± 0.091/h and intercompartment rate constants k12 0.607 ± 0.734/h and k21 1.105 ± 0.762/h.ConclusionOur study found that multiple doses of intravenous paracetamol resulted in a predictable pharmacokinetic profile in very preterm infants. Increases in postmenstrual age and weight were associated with increased clearance. No evidence of hepatotoxicity was found.
Rapid Assessment to Identify and Quantify the Risk of Intimate Partner Violence During Pregnancy
Authors: Bianchi Ann L. , McFarlane Judith , Nava Angeles , Gilroy Heidi , Maddoux John , Cesario Sandra 
Published: March 2014

AbstractBackgroundAbuse during pregnancy is common and affects upwards of one in six pregnant women worldwide. The objective of this study is to describe the demographics, frequency, and severity of abuse, and the risk of murder for women who report abuse during pregnancy compared with women who do not report abuse.MethodsA total of 300 women seeking assistance for partner abuse were recruited to participate in a 7‐year prospective study. Of the 300 women, 50 reported they had been pregnant within the last 4 months; 25 of the women (50%) reported they were “beaten” during the pregnancy; and 25 women (50%) reported they had not been “beaten.” Analysis was completed on differential severity for abuse and risk for murder between the two groups.ResultsWomen reporting abuse during pregnancy had statistically significant (p < 0.001) higher scores for Threat of abuse, F(1, 49) = 14.37, p < 0.001; Physical abuse, F(1, 49) = 21.21, p < 0.001; and Danger for murder weighted F(1, 49) = 22.99, p < 0.001. All effects sizes were large.ConclusionWomen abused during pregnancy are at greater risk for further abuse and in severe danger for murder. To ensure the safety of pregnant women, screening policies are essential.
Management of Occiput Posterior Position in the Second Stage of Labor: A Survey of Midwifery Practice in Australia
Authors: Phipps Hala , de Vries Brad , Jagadish Ujvala , Hyett Jon 
Published: March 2014

AbstractBackgroundThe management of the occiput posterior (OP) position has been controversial for many years. Manual rotation can be performed by midwives and could reduce cesarean sections and instrumental births. We aimed to determine current midwifery views, knowledge, and practice of manual rotation.MethodA de‐identified, self‐reported questionnaire was e‐mailed to all Australian College of Midwives full members (n = 3,997).ResultsOf 3,182 surveyed, 57 percent (1,817) responded, of whom 51 percent (920) were currently practicing midwifery. Seventy‐seven percent of midwives thought that manual rotation at full dilatation was a valid intervention. Sixty‐four percent stated the procedure was acceptable before instrumental delivery, but 30 percent were unsure. Most practicing midwives (93%) had heard of manual rotation, but only 18 percent had performed one in the last year. Midwives would support the routine performance of manual rotation for OP position if it reduced operative births from 68 to 50 percent and would support manual rotation for occiput transverse (OT) position if it reduced operative births from 39 to 25 percent.ConclusionThis study indicates that manual rotation is considered acceptable by most midwives in Australia, yet is only performed by a minority. Midwives would be willing to perform prophylactic manual rotation if it was known to facilitate normal vaginal births suggesting a scope to introduce this procedure into widespread clinical practice.
Influence of Counseling Sessions on the Prevalence of Breastfeeding in the First Year of Life: A Randomized Clinical Trial with Adolescent Mothers and Grandmothers
Authors: Bica Olga Claudino , Giugliani Elsa Regina Justo 
Published: March 2014

AbstractBackgroundAdolescent mothers living with their mothers may be at greater risk of early weaning. This study aims to assess the influence of a breastfeeding promotion strategy directed at adolescent mothers living with their mothers on the prevalence of breastfeeding in the first year of life.MethodA randomized clinical trial with 323 adolescent mothers. Participants were divided into two groups: those who lived with their mothers and those who did not. Participants were randomly assigned to control or intervention groups. Intervention consisted of breastfeeding counseling sessions held at the maternity ward and at home (at 7, 15, 30, 60, and 120 days postpartum). The intervention effect was assessed by comparing survival curves for breastfeeding in the first 12 months of life.ResultsThe risk of weaning before 12 months of age was significantly lower in the intervention group for adolescent mothers not living with their mothers; whereas the risk was not statistically different between intervention and control groups for those living with their mothers.ConclusionsThe positive influence of systematic counseling sessions on the prevalence of breastfeeding in the first year of life was significant for adolescent mothers. Living with their mothers reduced such influence.
PI3Kγ integrates cAMP and Akt signalling of the μ‐opioid receptor
Authors: Madishetti Sreedhar , Schneble Nadine , König Christian , Hirsch Emilio , Schulz Stefan , Müller Jörg P , Wetzker Reinhard 
Published: March 2014

Background and PurposeThe μ‐opioid receptor has been characterized as the main mediator of opioid signalling in neuronal cells. Opioid‐induced pain suppression was originally proposed to be mediated by μ‐opioid receptor‐induced inhibitory effects on cAMP, which is known to mediate inflammatory hypernociception. Recent investigations revealed PI3Kγ and Akt (PKB) as additional elements of μ‐opioid receptor signalling. Hence, we investigated the interaction between pronociceptive cAMP and antinociceptive PI3K/Akt signalling pathways.Experimental ApproachThe human neuroblastoma cell line SK‐N‐LO and primary dorsal root ganglia (DRG) cells from mice were used to elucidate mediators of μ‐opioid receptor signalling. In both cellular systems cAMP was manipulated by stimulation of adenylate cyclase and consequent effects on PI3K/Akt signalling were analysed.Key ResultsMorphine stimulated Akt phosphorylation on Ser473 and Thr308 in a dose‐ and time‐dependent manner indicating a functional μ‐opioid receptor/Akt signalling pathway in μ‐SK‐N‐LO cells. This effect of morphine was suppressed by the μ‐opioid receptor inhibitor, naloxone, Pertussis toxin, an inhibitor of Gi heterotrimeric G‐proteins, and the pan PI3K inhibitor wortmannin. cAMP‐elevating agents also suppressed μ‐opioid receptor‐dependent stimulation of PI3Kγ lipid kinase and Akt activities in SK‐N‐LO cells and DRG.Conclusions and ImplicationsThe data unveil a hitherto unknown interaction of pronociceptive cAMP and antinociceptive PI3K/Akt signalling pathways in neuronal cells. PI3Kγ was identified as a mediator of the inhibitory action of cAMP on Akt in SK‐N‐LO cells and DRG. The data indicate that PI3Kγ has a critical role in cAMP‐mediated inflammatory hypernociception and analgesic signalling via μ‐opioid receptors and PI3K/Akt in neuronal cells.
Antidepressant and anxiolytic profiles of newly synthesized arginine vasopressin V1B receptor antagonists: TASP0233278 and TASP0390325
Authors: Iijima M , Yoshimizu T , Shimazaki T , Tokugawa K , Fukumoto K , Kurosu S , Kuwada T , Sekiguchi Y , Chaki S 
Published: March 2014

Background and PurposeVasopressin V1B receptor antagonists may be effective for the treatment of depression and anxiety and the objective of this study was to characterize the pharmacological profiles of two newly synthesized arginine vasopressin receptor 1B (V1B receptor) antagonists, TASP0233278 and TASP0390325.Experimental ApproachWe investigated the in vitro profiles of TASP0233278 and TASP0390325. In addition, the effect of TASP0390325 on the increase in plasma adrenocorticotropic hormone (ACTH) levels induced by corticotropin‐releasing factor (CRF)/desmopressin (dDAVP) was investigated. We also investigated the antidepressant and anxiolytic profiles of TASP0233278 and TASP0390325 in animal models.Key ResultsBoth TASP0233278 and TASP0390325 showed a high affinity and potent antagonist activity for V1B receptors. Oral administration of TASP0390325 antagonized the increase in plasma ACTH levels induced by CRF/dDAVP in rats, indicating that TASP0390325 blocks the anterior pituitary V1B receptor in vivo. Oral administration of TASP0233278 or TASP0390325 also exerted antidepressant effects in two models of depression (a forced swimming test and an olfactory bulbectomy model). Moreover, TASP0233278 improved depressive‐like behaviour induced by repeated treatment with corticosterone, a model that has been shown to be resistant to treatment with currently prescribed antidepressants. In addition to depression models, TASP0233278 or TASP0390325 exerted anxiolytic effects in several anxiety models (social interaction, elevated plus‐maze, stress‐induced hyperthermia, separation‐induced ultrasonic vocalization and sodium lactate‐induced panic‐like responses in panic‐prone rats).ConclusionTASP0233278 and TASP0390325 are potent and orally active V1B receptor antagonists with antidepressant and anxiolytic activities in rodents.
Cognitive development in children with new onset epilepsy
Authors: Rathouz Paul J , Zhao Qianqian , Jones Jana E , Jackson Daren C , Hsu David A , Stafstrom Carl E , Seidenberg Michael , Hermann Bruce P 
Published: March 2014

AimTo characterize the prospective trajectory of cognitive development in children with new or recent onset epilepsy from baseline to 5 to 6 years after diagnosis.MethodSixty‐nine children (40 males, 29 females; age 8–18y), with new or recent onset epilepsies underwent neuropsychological assessment shortly after diagnosis (Wave 1), 2 years (Wave 2), and 5 to 6 years after diagnosis (Wave 3). Intelligence, academic achievement, language, executive function, and psychomotor speed were evaluated. Sixty‐two children (28 males, 34 females; age 8–18) with typical development served as a comparison group at each time point. The cognitive data were examined by syndrome (localization‐related epilepsy [LRE]; idiopathic generalized epilepsy [IGE]; comparison group). Mixed effect regression models compared trajectories among groups with respect to time since diagnosis.ResultsCognitive abnormalities exhibited by children with epilepsy in arithmetic computation, response inhibition, attention, fine motor dexterity, and psychomotor speed (all p values <0.001), are detectable at or near the time of diagnosis and largely remain stable over the ensuing 5 to 6 years without evidence of progressive worsening or recovery. This course is evident across both LRE and IGE groups, with the LRE group performing better for some outcomes (arithmetic, response inhibition, psychomotor speed) and never worse than the IGE group.InterpretationCognitive development in children with LRE and IGE is not characterized by progressive deterioration or lack of age‐appropriate development; rather, development lags behind that of children with typical development. Cognitive abnormalities, when detected, are present near the time of diagnosis, persist over time, and require early intervention.
Substantial reductions in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced costs after structured education in adults with Type 1 diabetes
Authors: Elliott J. , Jacques R. M. , Kruger J. , Campbell M. J. , Amiel S. A. , Mansell P. , Speight J. , Brennan A. , Heller S. R. 
Published: March 2014

AbstractAimsTo determine the impact of structured education promoting flexible intensive insulin therapy on rates of diabetic ketoacidosis, and the costs associated with emergency treatment for severe hypoglycaemia and ketoacidosis in adults with Type 1 diabetes.MethodsUsing the Dose Adjustment For Normal Eating research database we compared the rates of ketoacidosis and severe hypoglycaemia during the 12 months preceding Dose Adjustment For Normal Eating training with the rates during the 12‐month follow‐up after this training. Emergency treatment costs were calculated for associated paramedic assistance, Accident and Emergency department attendance and hospital admissions.ResultsComplete baseline and 1‐year data were available for 939/1651 participants (57%). The risk of ketoacidosis in the 12 months after Dose Adjustment For Normal Eating training, compared with that before training, was 0.39 (95% CI: 0.23 to 0.65, P < 0.001), reduced from 0.07 to 0.03 episodes/patient/year. For every 1 mmol/mol unit increase in HbA1c concentration, the risk of a ketoacidosis episode increased by 6% (95% CI: 5 to 7%; 88% for a 1% increase), and for each 5‐year increase in diabetes duration, the relative risk reduced by 20% (95% CI: 19 to 22%). The number of emergency treatments decreased for ketoacidosis (P < 0.001), and also for severe hypoglycaemia, including paramedic assistance (P < 0.001), Accident and Emergency department attendance (P = 0.029) and hospital admission (P = 0.001). In the study cohort, the combined cost of emergency treatment for ketoacidosis and severe hypoglycaemia fell by 64%, from £119,470 to £42,948.ConclusionsStructured training in flexible intensive insulin therapy is associated with a 61% reduction in the risk of ketoacidosis and with 64% lower emergency treatment costs for ketoacidosis and severe hypoglycaemia.
Use of hospital admissions data to quantify the burden of emergency admissions in people with diabetes mellitus
Authors: Gibbons D. C. , Soljak M. A. , Millett C. , Valabhji J. , Majeed A. 
Published: March 2014

AbstractAimsAccurate measurement of emergency diabetes admissions is essential for healthcare delivery and research. This study examines whether current approaches to identifying diabetes‐related admissions may underestimate the true burden on hospital care.MethodsData spanning the period 1 January 2006 to 31 December 2010 inclusive were extracted from Hospital Episode Statistics data for England. Emergency admissions citing diabetes (E10, E11, E13 or E14) in any diagnosis position in adults (≥ 17 years) were included. E10 and E11 were considered analogous to Type 1 and Type 2 diabetes mellitus respectively; E13 and E14 were grouped as ‘other or unspecified’ diabetes mellitus. For admissions citing diabetes multiple times, those with concordant citations were classified as appropriate; discordant citations were assigned to the ‘other or unspecified’ group. Frequencies of diabetes classifications and complications for each diagnosis position and frequencies of all International Classification of Diseases 10th revision codes for the primary diagnosis field were calculated.ResultsIn total, 2 443 046 admissions were identified. Diabetes was cited as the primary diagnosis in 6.2% and most commonly cited as the third diagnosis (23.1%). Type 2 diabetes mellitus was the most common (85.0%). The majority of diabetes citations were ‘without complication’ (2 188 965, 89.6%). The most common primary diagnosis was ‘chest pain, unspecified’ (R07.4, 99 678, 4.1%).ConclusionsReliance on the primary diagnosis field to identify emergency admissions in people with diabetes grossly underestimates the true burden placed on hospital care and leads to underestimates of effect sizes in studies utilizing admission rates as outcome measures. An alternative strategy to identify such admissions is required.
Disturbance from pond management obscures local and regional drivers of assemblages of primary producers
Authors: Gallego Irene , Davidson Thomas A. , Jeppesen Erik , Pérez‐Martínez Carmen , Fuentes‐Rodríguez Francisca , Juan Melchor , Casas J. Jesús 
Published: March 2014

Summary

Ponds have significant conservation value due to their potentially high contribution to local and regional diversity. However, most ponds are located in anthropogenically influenced areas, and their biodiversity is constantly threatened by human activities. Thus, knowledge of the effect of pond management on biodiversity is essential for designing effective conservation strategies.

Here, we study the main drivers of diversity of three functional groups of primary producers (phytoplankton, filamentous green algae and submerged macrophytes) in 87 ponds distributed across a large region (c. 90000 km2) in Southern Spain. We hypothesised that spatial effects would increase with increasing propagule size. However, given the regional extent of the study, we anticipated that both spatial and environmental controls would be significant.

We determined α‐, β‐ and γ‐components of biodiversity for each functional group and pond type (embankment ponds, excavated ponds and artificial ponds) and assessed the influence of environmental and spatial drivers on diversity with generalised additive models (GAMs). Redundancy analyses (RDAs) with variation partitioning were used to determine the relative contribution of environmental and spatial predictors of the community assembly. Spatial variables were calculated by applying distance‐based Moran's eigenvector maps (db‐MEM).

Both α‐ and β‐diversities of phytoplankton and filamentous green algae varied significantly with pond type. Generally, environmental predictors of diversity were more important than spatial variables. Assemblage structure was controlled by water chemistry and eutrophication, with a marked influence of pond type. Spatial variables included broad‐scale variation for the three groups of primary producers, which were also strongly influenced by the management regime.

Limited management activities, as occurs at embankment ponds, promoted the local richness of phytoplankton and contributed importantly to the regional diversity of macrophytes. Moreover, the relative contribution of environmental and spatial variables was similar between embankment ponds and natural ecosystems, that is, dispersal limitation increasing with propagule size. Excavated and artificial ponds also contributed importantly to regional diversity by enhancing phytoplankton and filamentous green algal β‐diversity. However, spatial patterns in the latter pond type did not meet our expectations, most likely due to the intensive disturbance from pond management hampering the development of macrophytes.
Eutrophication decreases distance decay of similarity in diatom communities
Authors: Goldenberg Vilar Alejandra , van Dam Herman , van Loon Emiel E. , Vonk J. Arie , van Der Geest Harm G. , Admiraal Wim 
Published: March 2014

Summary

The distance–decay relationship has been claimed to be a predictor for biological diversity because it unites several ecological phenomena such as dispersal ability and environmental structure. The effect of long‐term disturbances on distance decay, however, has been widely overlooked, especially for microorganisms.

We examine the effect of eutrophication on the distance–decay relationship in communities of attached diatoms in three peatland areas: mesotrophic, eutrophic and hypertrophic. The study follows a spatially explicit sampling scheme, collecting evenly spaced samples along 6‐km sampling tracks.

The three areas shared 24% of the total number of species, but the different nutrient levels in the three areas are reflected by the prominence of low profile and planktonic diatom species.

Our study demonstrates that eutrophication can affect distance–decay relationships by decreasing turnover rates in microorganisms. Diatom communities are shown to be constrained by both environmental and spatial features, whose relative importance depends on the degree of eutrophication. Under eutrophic conditions, species are filtered from the regional species pool and community structure responds strongly to environmental factors (water chemistry variables and depth), while in mesotrophic environments, purely spatial processes play a prominent role in structuring diatom communities. These findings reveal that homogenisation of communities triggered by environmental disturbance is an ecological phenomenon of importance in the microbial world.
Unclassified cases of behavioral variant of major frontotemporal neurocognitive disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition
Authors: Fukuda Koji , Hattori Hideyuki 
Published: March 2014

AimIn the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‐5), the behavioral variant of major frontotemporal neurocognitive disorder (bvFT‐NCD) is subclassified into “probable bvFT‐NCD” or “possible bvFT‐NCD.” When genetic evidence is unavailable, cases without clinical neuroimaging are subclassified into “possible bvFT‐NCD,” whereas cases whose clinical images show the typical characteristics are subclassified into “probable bvFT‐NCD.” Thus, the cases that meet the diagnostic criteria of bvFT‐NCD based on their symptoms, but lack the neuroimaging characteristics, fall between the two categories of probable and possible bvFT‐NCD. These cases herein are defined as “unclassified bvFT‐NCD,” and the present study aims at considering an appropriate diagnostic approach to such cases, that is, whether unclassified bvFT‐NCD should be included in bvFT‐NCD as a third subcategory, or whether it should be classified into diseases other than bvFT‐NCD.MethodsAll patients who presented at the Department of Psychiatry of the National Center for Geriatrics and Gerontology with suspicion of the behavioral variant of frontotemporal dementia between 1 May 2011 and 30 April 2013 were retrospectively rediagnosed based on the DSM‐5 criteria.ResultsA total of 16 cases met the criteria of bvFT‐NCD, and among them, eight cases corresponded to unclassified bvFT‐NCD. From a cross‐sectional and clinical perspective, all eight cases of unclassified bvFT‐NCD fulfilled the symptomatic criteria for bvFT‐NCD, although the possibilities of Alzheimer's disease and other mental disorders could not be ruled out completely.ConclusionsTo establish clinical diagnostic criteria for unclassified bvFT‐NCD, accumulation of cases and evidence will be required along with longitudinal observation using various diagnostic technologies and post‐mortem examination. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 35–44.