bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limited professional guidance and literature are available to guide the safe use of neuromuscular block in infants
Authors: Honsel Maik , Giugni Cristina , Brierley Joe 
Published: May 2014

AbstractAimNeuromuscular blocking agents (NMBAs) are used in a range of critical illnesses in neonates and infants, despite a lack of guidelines and professional standards. This study reviewed the current evidence base and ascertained UK practice regarding the continuous use of these agents in this age range.MethodsWe reviewed the literature and carried out a telephone questionnaire of all tertiary units in England and specialist children's hospital neonatal units in the UK.ResultsNo best practice guidelines or general consensus statements were found, and the only randomised trial to feature an NMBA protocol expressed concerns about its use in such young babies. Of the 56 units contacted, 54 (96.4%) shared information. Only three of the 56 (5.4%) used intermittent boluses of NMBAs, 91.1% used NMBA infusions, 11 (19.6%) routinely used regular neuromuscular blocker pause to assess depth, and only one (1.8%) used peripheral nerve stimulation monitoring. All the units carried out clinical assessments, but only one (1.8%) had a written protocol.ConclusionThere is a paucity of literature and professional standards to guide the safe use of NMBAs in infants. Of the 54 units who participated in the survey, only one had a protocol for using NMBAs in babies.
A randomised controlled trial of an automated oxygen delivery algorithm for preterm neonates receiving supplemental oxygen without mechanical ventilation
Authors: Zapata James , Gómez John Jairo , Araque Campo Robinson , Matiz Rubio Alejandro , Sola Augusto 
Published: May 2014

AbstractAimProviding consistent levels of oxygen saturation (SpO2) for infants in neonatal intensive care units is not easy. This study explored how effectively the Auto‐Mixer® algorithm automatically adjusted fraction of inspired oxygen (FiO2) levels to maintain SpO2 within an intended range in extremely low birth weight infants receiving supplemental oxygen without mechanical ventilation.MethodsTwenty extremely low birth weight infants were randomly assigned to the Auto‐Mixer® group or the manual intervention group and studied for 12 h. The SpO2 target was 85–93%, and the outcomes were the percentage of time SpO2 was within target, SpO2 variability, SpO2 >95%, oxygen received and manual interventions.ResultsThe percentage of time within intended SpO2 was 58 ± 4% in the Auto‐Mixer® group and 33.7 ± 4.7% in the manual group, SpO2 >95% was 26.5% vs 54.8%, average SpO2 and FiO2 were 89.8% vs 92.2% and 37% vs 44.1%, and manual interventions were 0 vs 80 (p < 0.05). Brief periods of SpO2 < 85% occurred more frequently in the Auto‐Mixer® group.ConclusionThe Auto‐Mixer® effectively increased the percentage of time that SpO2 was within the intended target range and decreased the time with high SpO2 in spontaneously breathing extremely low birth weight infants receiving supplemental oxygen.
Children with asthma have significantly lower long‐term cortisol levels in their scalp hair than healthy children
Authors: Kamps Arvid W.A. , Molenmaker Marco , Kemperman Ramses , van der Veen Betty S. , Bocca Gianni , Veeger Nic J.G.M. 
Published: May 2014

AbstractAimNoninvasive measurement of long‐term cortisol levels is a useful way of evaluating the effect of chronic disease on the hypothalamic‐pituitary‐adrenal axis in children. The aim of this pilot study was to compare hair cortisol levels in children using inhaled corticosteroids for asthma and healthy children and to determine the association with short‐term salivary cortisol levels.MethodsCortisol levels were measured in the scalp hair and saliva of prepubertal children with asthma (n = 10) and without asthma (n = 10). Asthma control was assessed using an asthma questionnaire and pulmonary function tests.ResultsThe median (95% CI) cortisol level in the scalp hair of the children with asthma (2.0 pg/mg; 1.4–4.1) was significantly lower than the healthy children (4.3 pg/mg; 1.8–5.9). Morning salivary cortisol levels were significantly lower for the children with asthma (5.9 nmol/L; 3.2–11.1) than the healthy children (9.0 nmol/L; 4.4–31.6). There was no significant association between cortisol levels in hair and saliva.ConclusionLong‐term cortisol levels were significantly lower in children with asthma than healthy children. Measuring long‐term cortisol levels in scalp hair is an attractive, noninvasive tool that can evaluate the effect of asthma and its treatment on the hypothalamic‐pituitary‐adrenal axis.
Noninvasive evaluation of swallowing sound is an effective way of diagnosing feeding maturation in newborn infants
Authors: Ince Deniz Anuk , Ecevit Ayşe , Acar Banu Oskay , Saracoglu Ahmet , Kurt Abdullah , Tekindal Mustafa Agah , Tarcan Aylin 
Published: May 2014

AbstractAimDespite extensive research, there is still controversy regarding the time at which sucking and swallowing functions mature in preterm infants. This study aimed to evaluate maturation using the noninvasive method of swallowing sound.MethodsWe compared 52 preterm infants of between 27 and 36 weeks' gestational age with a control group of 42 healthy full‐term infants. Feeding performance was based on swallowing data collected during two‐minute audio recordings. The following variables were generated for each evaluation: total number of swallows, total number of rhythmic swallows, total number of resting intervals, average time between resting intervals, average time between swallows, average time between rhythmic swallows, maximum number of rhythmic swallows and volume of milk ingested. The dependency of the variables on postmenstrual age was also investigated.ResultsThe volume of milk ingested by the preterm infants and the maximum number of rhythmic swallows were positively correlated with postmenstrual age (PMA). The preterm infants reached the 10th percentile of the control infants at 34–35 weeks' PMA and were not significantly different from the control infants at 38–40 weeks' PMA.ConclusionSwallowing sound can be used to assess feeding maturation in preterm infants during neonatal intensive care unit follow‐up.
Sensilla on antenna, ovipositor and leg of Eriborus applicitus (Hymenoptera: Ichneumonidae), a parasitoid wasp of Holcocerus insularis staudinger (Lepidoptera: Cossidae)
Authors: Zhang Lu , Feng Yu‐qian , Ren Li‐li , Luo You‐qing , Wang Feng , Zong Shi‐xiang 
Published: May 2014

AbstractEriborus applititus Sheng & Sun (Hymenoptera: Ichneumonidae) is a specialist parasitoid of the small carpenter moth Holcocerus insularis Staudinger (Lepidoptera: Cossidae). Each year damages to trees caused by H. insularis lead to extensive economic and ecological losses. E. applititus is thus a promising candidate for use as a biocontrol agent against H. insularis. To investigate the means by which E. applititus locates and parasitizes H. insularis, we used scanning electron microscopy to determine the morphology and distribution of sensilla on antenna, ovipositor and leg of male and female E. applititus. Eight different sensilla types were found: sensilla chaetica, sensilla trichodea, sensilla placodea, sensilla basiconica, sensilla coeloconica, sensilla pit basiconica, sensilla campaniformia and Böhm's bristles. The sensilla types were differently distributed in the three organs. In addition, differences between sexes were found in the distribution of sensilla trichodea type 2, sensilla placodea and sensilla chaetica type 4. Putative functions of the sensilla are discussed based on the morphological and location data and on previous research. Chemosensitive sensilla are putatively involved in host detection, pheromone detection and host discrimination processes. Mechanoreceptive sensilla likely function as vibrational sensors and are thought to be critical for accurate ovipositor positioning.
Dental anomalies within extant members of the mammalian Order Pilosa
Authors: McAfee Robert K. 
Published: May 2014

AbstractRecent discovery of a supernumerary dental anomaly in two‐toed sloths led to an extensive review of extant sloth specimens to look for additional anomalies. In total, 881 museum specimens were examined. These revealed two primary types of anomalies, hyperdontia (extra teeth) and anodontia (loss of teeth), occurring at a rate of 2.4% (n = 21). Two‐toed sloths,Choloepus, were more likely to have hyperdontia in the anterior dentition, whereas three‐toed sloths,Bradypus, experienced anodontia more frequently with the upper caniniforms. Both genera experienced both anomalies. The majority affected the upper dentition, with only three specimens exhibiting mandibular anomalies. Beyond the patterns of tooth positioning, all anomalies were random with respect to age, sex and geography. A few specimens not counted in the initial assessment expressed incomplete anodontia, indicating that the loss occurred postnatally and was not an embryological anomaly. ForBradypus, the findings provide new support for the hypothesis that the taxon represents a neotenic lineage and opens new possibilities about its relationship to the extinct ground sloths with a suggested rooting above that of the basal position it typically occupies for Folivora.
Early urinary continence recovery after robot‐assisted radical prostatectomy in older Australian men
Authors: Basto Marnique Y. , Vidyasagar Chinni , te Marvelde Luc , Freeborn Helen , Birch Emma , Landau Adam , Murphy Declan G. , Moon Daniel 
Published: May 2014

ObjectiveTo compare the recovery of urinary continence (UC) after robot‐assisted radical prostatectomy (RARP) in men aged ≥70 and <70 years at 1‐year follow‐up and to assess for preoperative predictors ofUCrecovery, as older, healthy men with localised prostate cancer are often denied curative surgical treatment on the grounds of worseUCrecovery.Patients and methodsIn all, 262 patients with prostate cancer having undergoneRARPbetweenMay 2008 andSeptember 2012, under the care of two consultant urological surgeons at three Melbourne hospitals, were identified. Patients were categorised based on their age ≥70 and <70 years and compared with regards to two endpoints; percentage fully continent and mean pads/day at 4–6 weeks, and 3, 6, 9 and 12 months afterRARP.ResultsOf the 262 men, 9% (24) were aged ≥70 years. Older men had higherPSAlevels (P= 0.007) and clinical stages (P< 0.001) compared with the younger cohort. There were more non‐nerve sparing procedures in the older group (P= 0.009) and a shorter mean operative time (P= 0.004). At 4–6 weeks afterRARP, the number of pads used per day was greater in older men (P= 0.03) and there was a trend towards fewer older men being fully continent (P= 0.08) than their younger counterparts; however, by 3 months and all time‐points thereafter there was no difference. The 12‐monthUCrates were 89% and 92% for men aged <70 and ≥70 years, respectively. Neither age, body mass index, D'Amico risk group, nerve sparing nor use of Rocco suture were predictors of time toUCrecovery.ConclusionUCrecovery afterRARPin men aged ≥70 years appears comparable to younger men and therefore not a reason to deny older men with a reasonable life‐expectancy curative surgical treatment of localised prostate cancer.
The role of adjuvant chemotherapy for lymph node‐positive upper tract urothelial carcinoma following radical nephroureterectomy: a retrospective study
Authors: Lucca Ilaria , Kassouf Wassim , Kapoor Anil , Fairey Adrian , Rendon Ricardo A. , Izawa Jonathan I. , Black Peter C. , Fajkovic Harun , Seitz Christian , Remzi Mesut , Nyirády Peter , Rouprêt Morgan , Margulis Vitaly , Lotan Yair , de Martino Michela , Hofbauer Sebastian L. , Karakiewicz Pierre I. , Briganti Alberto , Novara Giacomo , Shariat Shahrokh F. , Klatte Tobias 
Published: May 2014

ObjectiveTo evaluate the effect of adjuvant chemotherapy (AC) on mortality after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) with positive lymph nodes (LNs) and to identify patient subgroups that are most likely to benefit from AC.Patients and methodsWe retrospectively analysed data of 263 patients with LN‐positive UTUC, who underwent full surgical resection. In all, 107 patients (41%) received three to six cycles of AC, while 156 (59.3%) were treated with RNU alone. UTUC‐related mortality was evaluated using competing‐risks regression models.ResultsIn all patients (Tall N+), administration of AC had no significant impact on UTUC‐related mortality on univariable (P = 0.49) and multivariable (P = 0.11) analysis. Further stratified analyses showed that only N+ patients with pT3–4 disease benefited from AC. In this subgroup, AC reduced UTUC‐related mortality by 34% (P = 0.019). The absolute difference in mortality was 10% after the first year and increased to 23% after 5 years. On multivariable analysis, administration of AC was associated with significantly reduced UTUC‐related mortality (subhazard ratio 0.67, P = 0.022). Limitations of this study are the retrospective non‐randomised design, selection bias, absence of a central pathological review and different AC protocols.ConclusionsAC seems to reduce mortality in patients with pT3–4 LN‐positive UTUC after RNU. This subgroup of LN‐positive patients could serve as target population for an AC prospective randomised trial.
The ‘double‐bind of dependency’: early relationships in men with learning disabilities in secure settings
Authors: Rayner Kelly , Wood Harry , Beail Nigel 
Published: May 2014

Accessible Summary

This research project is about social lives.

Ten men with learning disabilities who had broken the law and who lived in hospital talked about their social lives.

We asked the 10 men about the people who had been in their lives before they broke the law.

This research project matters to people with learning disabilities because it tries to find out how different experiences affected the 10 men who were interviewed.

This could help us understand all people with learning disabilities better and could make services better for everyone.

SummaryAlthough the development of secure attachments has been shown to be more problematic for people with learning disabilities, there is a shortage of research into the attachment experience of people with learning disabilities who have broken the law. The present study used thematic analysis to explore the attachment experiences of 10 men with learning disabilities in secure settings. Attention was paid to formative relationship experiences in early life, along with an exploration of current relationships, with the content and direction of interviews being guided by participants. Two superordinate themes emerged from the analysis: ‘disempowerment’ and ‘ineffective care’. Results suggest that participants experienced a ‘double‐bind of dependency’ in which they felt a strong need for others, but had experienced unhelpful or harmful relationships. The clinical and practical implications for this are discussed.
Incidence of multiple primary cancers and interval between first and second primary cancers
Authors: Utada Mai , Ohno Yuko , Hori Megumi , Soda Midori 
Published: May 2014

In this retrospective study, we aimed to clarify the risk of developing a second primary cancer and to determine the periods of high risk of second primary cancers. Subjects were all patients who had been diagnosed with a first primary cancer and registered with the Nagasaki Prefecture Cancer Registry between 1985 and 2007. We calculated the standardized incidence ratio (SIR) of second primary cancer according to site and years after diagnosis of the first primary cancer. A second primary cancer developed in 14 167 of 174 477 subjects (8.1%) during a median follow‐up of 1.8 years. The SIR of all cancer was 1.10 (95% confidence interval, 1.08–1.11). Some specific relationships were observed between sites with risk factors in common, such as smoking, drinking, and hormone status. The SIRs were relatively high after approximately 10 years for all sites, and trends differ among cancer sites. We showed that cancer patients are at higher risk of a second primary cancer than the general population. In respect of the risk of a second primary cancer, physicians should be alert for cancers that have risk factors in common with the first primary cancer.
Immunophenotypic features of metastatic lymph node tumors to predict recurrence in N2 lung squamous cell carcinoma
Authors: Matsuwaki Rie , Ishii Genichiro , Zenke Yoshitaka , Neri Shinya , Aokage Keiju , Hishida Tomoyuki , Yoshida Junji , Fujii Satoshi , Kondo Haruhiko , Goya Tomoyuki , Nagai Kanji , Ochiai Atsushi 
Published: May 2014

Patients with mediastinal lymph node metastasis (N2) in squamous cell carcinoma (SqCC) of the lung have poor prognosis after surgical resection of the primary tumor. The aim of this study was to clarify predictive factors of the recurrence of pathological lung SqCC with N2 focusing on the biological characteristics of both cancer cells and cancer‐associated fibroblasts (CAFs) in primary and metastatic lymph node tumors. We selected 64 patients with pathological primary lung N2 SqCC who underwent surgical complete resection and investigated the expressions of four epithelial–mesenchymal transition‐related markers (caveolin, clusterin, E‐cadherin, ZEB2), three cancer stem cell‐related markers (ALDH‐1, CD44 variant6, podoplanin) of cancer cells, and four markers of CAFs (caveolin, CD90, clusterin, podoplanin) in both primary and matched metastatic lymph node tumors in the N2 area. In the primary tumors, the expressions of all the examined molecules were not related to recurrence. However, in the metastatic lymph node tumors, high clusterin and ZEB2 expressions in the cancer cells and high podoplanin expression in the CAFs were significantly correlated with recurrence (P = 0.03, 0.04, and 0.007, respectively). In a multivariate analysis, only podoplanin expression in the CAFs in metastatic lymph node tumors was identified as a significantly independent predictive factor of recurrence (P = 0.03). Our study indicated that the immunophenotypes of both cancer cells and CAFs in metastatic lymph node tumors, but not primary tumors, provide useful information for predicting the recurrence of pathological N2 lung SqCC.
Phase I / II study of brentuximab vedotin in Japanese patients with relapsed or refractory CD30‐positive Hodgkin's lymphoma or systemic anaplastic large‐cell lymphoma
Authors: Ogura Michinori , Tobinai Kensei , Hatake Kiyohiko , Ishizawa Kenichi , Uike Naokuni , Uchida Toshiki , Suzuki Tatsuya , Aoki Tomohiro , Watanabe Takashi , Maruyama Dai , Yokoyama Masahiro , Takubo Takatoshi , Kagehara Hideaki , Matsushima Takafumi 
Published: May 2014

Brentuximab vedotin is an antibody–drug conjugate that selectively delivers the antimicrotubule agent monomethyl auristatin E into CD30‐expressing cells. To assess its safety, pharmacokinetics, and efficacy in Japanese patients with refractory or relapsed CD30‐positive Hodgkin's lymphoma or systemic anaplastic large‐cell lymphoma, we carried out a phase I/II study. Brentuximab vedotin was given i.v. on day 1 of each 21‐day cycle up to 16 cycles. In the phase I part of a dose‐escalation design, three patients per cohort were treated at doses of 1.2 and 1.8 mg/kg. In the phase II part, a dose of 1.8 mg/kg was given to 14 patients (nine with Hodgkin's lymphoma and five with systemic anaplastic large‐cell lymphoma). The median number of treatment cycles was 16 (range, 4–16). In the phase I part, no dose‐limiting toxicity event was observed. In the total population, common adverse events included lymphopenia (80%), neutropenia (65%), leukopenia (65%), and peripheral sensory neuropathy (60%). Grade 3/4 adverse events in more than two patients were lymphopenia (50%) and neutropenia (15%). The pharmacokinetic profile was similar to that observed in the previous studies in the USA. In the phase II part, six patients (67%) with Hodgkin's lymphoma achieved an objective response with 56% of complete response rate, and five patients (100%) with systemic anaplastic large‐cell lymphoma achieved an objective response with 80% of complete response rate. These results show that brentuximab vedotin has an acceptable safety profile and promising antitumor activity in the Japanese population. This trial was registered in JAPIC Clinical Trials Information (JapicCTI‐111650).
Size‐ and shape‐dependent pleural translocation, deposition, fibrogenesis, and mesothelial proliferation by multiwalled carbon nanotubes
Authors: Xu Jiegou , Alexander David B. , Futakuchi Mitsuru , Numano Takamasa , Fukamachi Katsumi , Suzui Masumi , Omori Toyonori , Kanno Jun , Hirose Akihiko , Tsuda Hiroyuki 
Published: May 2014

Multiwalled carbon nanotubes (MWCNT) have a fibrous structure similar to asbestos, raising concern that MWCNT exposure may lead to asbestos‐like diseases. Previously we showed that MWCNT translocated from the lung alveoli into the pleural cavity and caused mesothelial proliferation and fibrosis in the visceral pleura. Multiwalled carbon nanotubes were not found in the parietal pleura, the initial site of development of asbestos‐caused pleural diseases in humans, probably due to the short exposure period of the study. In the present study, we extended the exposure period to 24 weeks to determine whether the size and shape of MWCNT impact on deposition and lesion development in the pleura and lung. Two different MWCNTs were chosen for this study: a larger sized needle‐like MWCNT (MWCNT‐L; l = 8 μm, d = 150 nm), and a smaller sized MWCNT (MWCNT‐S; l = 3 μm, d = 15 nm), which forms cotton candy‐like aggregates. Both MWCNT‐L and MWCNT‐S suspensions were administered to the rat lung once every 2 weeks for 24 weeks by transtracheal intrapulmonary spraying. It was found that MWCNT‐L, but not MWCNT‐S, translocated into the pleural cavity, deposited in the parietal pleura, and induced fibrosis and patchy parietal mesothelial proliferation lesions. In addition, MWCNT‐L induced stronger inflammatory reactions including increased inflammatory cell number and cytokine/chemokine levels in the pleural cavity lavage than MWCNT‐S. In contrast, MWCNT‐S induced stronger inflammation and higher 8‐hydroxydeoxyguanosine level in the lung tissue than MWCNT‐L. These results suggest that MWCNT‐L has higher risk of causing asbestos‐like pleural lesions relevant to mesothelioma development.