bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Outcomes for Children With Cervical Spine Injury Based on Destination Hospital From Scene of Injury
Authors: Anders Jennifer F. , Adelgais Kathleen , Hoyle John D. , Olsen Cody , Jaffe David M. , Leonard Julie C. 
Published: January 2014

AbstractBackgroundPediatric cervical spine injury is rare. As a result, evidence‐based guidance for prehospital triage of children with suspected cervical spine injuries is limited. The effects of transport time and secondary transfer for specialty care have not previously been examined in the subset of children with cervical spine injuries.ObjectivesThe primary objective was to determine if prehospital destination choice affects outcomes for children with cervical spine injuries. The secondary objectives were to describe prehospital and local hospital interventions for children ultimately transferred to pediatric trauma centers for definitive care of cervical spine injuries.MethodsThe authors searched the Pediatric Emergency Care Applied Research Network (PECARN) cervical spine injury data set for children transported by emergency medical services (EMS) from scene of injury. Neurologic outcomes in children with cervical spine injuries transported directly to pediatric trauma centers were compared with those transported to local hospitals and later transferred to pediatric trauma centers, adjusting for injury severity, indicated by altered mental status, focal neurologic deficits, and substantial comorbid injuries. In addition, transport times and interventions provided in the prehospital, local hospital, and pediatric trauma center settings were compared. Multiple imputation was used to handle missing data.ResultsThe PECARN cervical spine injury cohort contains 364 patients transported from scene of injury by EMS. A total of 321 met our inclusion criteria. Of these, 180 were transported directly to pediatric trauma centers, and 141 were transported to local hospitals and later transferred. After adjustments for injury severity, odds of a normal outcome versus death or persistent neurologic deficit were higher for patients transported directly to pediatric trauma centers (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.03 to 3.47). EMS transport times to first hospital did not differ and did not affect outcomes. Prehospital analgesia was very infrequent.ConclusionsInitial destination from scene (pediatric trauma center vs. local hospital) appears to be associated with neurologic outcome of children with cervical spine injuries. Markers of injury severity (altered mental status and focal neurologic findings) are important predictors of poor outcome in children with cervical spine injuries and should remain the primary guide for prehospital triage to designated trauma centers.
Long‐term Retention of Cardiopulmonary Resuscitation Skills After Shortened Chest Compression–only Training and Conventional Training: A Randomized Controlled Trial
Authors: Nishiyama Chika , Iwami Taku , Kitamura Tetsuhisa , Ando Masahiko , Sakamoto Tetsuya , Marukawa Seishiro , Kawamura Takashi 
Published: January 2014

AbstractObjectivesIt is unclear how much the length of a cardiopulmonary resuscitation (CPR) training program can be reduced without ruining its effectiveness. The authors aimed to compare CPR skills 6 months and 1 year after training between shortened chest compression–only CPR training and conventional CPR training.MethodsParticipants were randomly assigned to either the compression‐only CPR group, which underwent a 45‐minute training program consisting of chest compressions and automated external defibrillator (AED) use with personal training manikins, or the conventional CPR group, which underwent a 180‐minute training program with chest compressions, rescue breathing, and AED use. Participants' resuscitation skills were evaluated 6 months and 1 year after the training. The primary outcome measure was the proportion of appropriate chest compressions 1 year after the training.ResultsA total of 146 persons were enrolled, and 63 (87.5%) in the compression‐only CPR group and 56 (75.7%) in the conventional CPR group completed the 1‐year evaluation. The compression‐only CPR group was superior to the conventional CPR group regarding the proportion of appropriate chest compression (mean ± SD = 59.8% ± 40.0% vs. 46.3% ± 28.6%; p = 0.036) and the number of appropriate chest compressions (mean ± SD = 119.5 ± 80.0 vs. 77.2 ± 47.8; p = 0.001). Time without chest compression in the compression‐only CPR group was significantly shorter than that in the conventional CPR group (mean ± SD = 11.8 ± 21.1 seconds vs. 52.9 ± 14.9 seconds; p < 0.001).ConclusionsThe shortened compression‐only CPR training program appears to help the general public retain CPR skills better than the conventional CPR training program.
Risk factors and health during pregnancy among women previously exposed to sexual violence
Authors: Gisladottir Agnes , Harlow Bernard L. , Gudmundsdottir Berglind , Bjarnadottir Ragnheidur I. , Jonsdottir Eyrun , Aspelund Thor , Cnattingius Sven , Valdimarsdottir Unnur A. 
Published: January 2014

AbstractObjectiveTo determine whether women exposed to sexual violence in adolescence or adulthood are at increased risk of adverse maternal characteristics during subsequent pregnancies.DesignRegister‐based cohort study.SettingIceland.PopulationWe identified 586 women who attended a Rape Trauma Service (RTS) between 1993 and 2008 and all subsequent births of these women up to April 2011 (n = 915). These pregnancies were compared with 1641 randomly selected pregnancies of women who had not attended the RTS and who gave birth during the same calendar month.MethodsInformation on maternal smoking, body mass index and illicit drug use was obtained from maternal charts. We used Poisson regression to obtain multivariable adjusted relative risks (aRR) with 95% CI contrasting prevalence of outcomes in the two groups.Main outcome measuresCharacteristics and risk factors during pregnancy, including maternal smoking, body mass index, weight gain during pregnancy, illicit drug use.ResultsCompared with unexposed women, sexually assaulted women were younger and more often primiparous in subsequent pregnancy, more likely not to be employed (7.8% vs. 4.3%; aRR 2.42, 95% CI 1.49–3.94), not cohabiting (45.6% vs. 14.2%; aRR 2.15, 95% CI 1.75–2.65), smokers (45.4% vs. 13.5%; aRR 2.68, 95% CI 2.25–3.20), and more likely to have used illicit drugs during pregnancy (3.4% vs. 0.4%; aRR 6.27, 95% CI 2.13–18.43). Exposed primiparas were more likely to be obese (15.5% vs. 12.3%; aRR 1.56, 95% CI 1.15–2.12).ConclusionsWomen with a history of sexual violence are more likely to have risk factors during pregnancy that may affect maternal health and fetal development.
Is it time to challenge the established theories surrounding type 1 diabetes?
Authors: Ludvigsson Johnny 
Published: January 2014

AbstractType one diabetes (T1D) seems a well‐defined disease, but its classification may be difficult. Evidence is weak that an autoimmune process with insulitis causes loss of the beta cells in all patients. Some scientists propose that it may be caused by a virus, increased hygiene or the early introduction of cow's milk or gluten, while views about the nerve supply, vascular function and the beta cells own role tend to be disregarded. Immune interventions have had limited success. There are differences, but also similarities, between T1D and type 2 diabetes (T2D).ConclusionSeveral views on T1D have become so widely accepted that they may actually hamper progress into the true cause of this disease. Research on T1D needs to be carried out with an open mind, and clinicians might be wise to recommend a lifestyle that aims to decrease both the risk of T1D and T2D.
Severity of anaemia is associated with bone marrow haemozoin in children exposed to Plasmodium falciparum
Authors: Aguilar Ruth , Moraleda Cinta , Achtman Ariel H. , Mayor Alfredo , Quintó Llorenç , Cisteró Pau , Nhabomba Augusto , Macete Eusebio , Schofield Louis , Alonso Pedro L. , Menéndez Clara 
Published: January 2014

SummaryThere are no large‐scale ex vivo studies addressing the contribution of Plasmodium falciparum in the bone marrow to anaemia. The presence of malaria parasites and haemozoin were studied in bone marrows from 290 anaemic children attending a rural hospital in Mozambique. Peripheral blood infections were determined by microscopy and polymerase chain reactions. Bone marrow parasitaemia, haemozoin and dyserythropoiesis were microscopically assessed. Forty‐two percent (123/290) of children had parasites in the bone marrow and 49% (111/226) had haemozoin, overlapping with parasitaemia in 83% (92/111) of cases. Sexual and mature asexual parasites were highly prevalent (62% gametocytes, 71% trophozoites, 23% schizonts) suggesting their sequestration in this tissue. Sixteen percent (19/120) of children without peripheral infection had haemozoin in the bone marrow. Haemozoin in the bone marrow was independently associated with decreased Hb concentration (P = 0·005) and was more common in dyserythropoietic bone marrows (P = 0·010). The results of this ex vivo study suggest that haemozoin in the bone marrow has a role in the pathogenesis of malarial‐anaemia through ineffective erythropoiesis. This finding may have clinical implications for the development of drugs targeted to prevent and treat malarial‐anaemia.
A novel mitochondrial nuclease‐associated protein: A major executor of the programmed nuclear death in Tetrahymena thermophila
Authors: Osada Eriko , Akematsu Takahiko , Asano Tomoya , Endoh Hiroshi 
Published: January 2014

Background InformationProgrammed nuclear death (PND) in the ciliate Tetrahymena is an apoptosis‐like phenomenon that occurs in a restricted space of cytoplasm during conjugation. In the process, only the parental macronucleus is selectively eliminated from the progeny cytoplasm, in conjunction with differentiation of new macronuclei for the next generation. For the last decade, mitochondria have been elucidated to be a crucial executioner like apoptosis: apoptosis‐inducing factor and yet‐unidentified nucleases localised in mitochondria are major factors for PND.ResultsTo identify such nucleases, we performed a DNase assay in a PAGE (SDS‐DNA‐PAGE) using total mitochondrial proteins. Some proteins showed DNase activity, but particularly a 17 kDa protein exhibited the highest and predominant activity. Mass spectrometric analysis revealed a novel mitochondrial nuclease, named TMN1, whose homologue has been discovered only in the ciliate Paramecium tetraurelia, but not in other eukaryotes. Gene disruption of TMN1 led to a drastic reduction of mitochondrial nuclease activity and blocked nuclear degradation during conjugation, but did not affect accumulation of autophagic and lysosomal machinery around the parental macronucleus.ConclusionsThese observations strongly suggest that the mitochondrial nuclease‐associated protein plays a key role in PND as a major executor. Taking the novel protein specific to ciliates in consideration, Tetrahymena would have diverted a different protein from common apoptotic factors shared in eukaryotes to PND in the course of ciliate evolution.
Immune deficiency in Ataxia-Telangiectasia: a longitudinal study of 44 patients
Authors: Chopra C , Davies G , Taylor M , Anderson M , Bainbridge S , Tighe P , McDermott E M 
Published: January 2014

Summary
Ataxia-Telangiectasia (A-T) is a genetic condition leading to neurological defects and immune deficiency. The nature of the immune deficiency is highly variable, and in some cases causes significant morbidity and mortality due to recurrent sinopulmonary infections. Although the neurological defects in A-T are progressive, the natural history of the immune deficiency in A-T has not been evaluated formally. In this study we analyse the clinical history and immunological data in 44 patients with A-T who attended the National Ataxia-Telangiectasia clinic in Nottingham between 2001 and 2011. Using patient medical records and Nottingham University Hospitals (NUH) National Health Service Trust medical IT systems, data regarding clinical history, use of immunoglobulin replacement therapy, total immunoglobulin levels, specific antibody levels and lymphocyte subset counts were obtained. T cell receptor spectratyping results in some patients were already available and, where possible, repeat blood samples were collected for analysis. This study shows that subtle quantitative changes in certain immunological parameters such as lymphocyte subset counts may occur in patients with A-T over time. However, in general, for the majority of patients the severity of immune deficiency (both clinically and in terms of immunological blood markers) does not seem to deteriorate significantly with time. This finding serves to inform the long-term management of this cohort of patients because, if recurrent respiratory tract infections present later in life, then other contributory factors (e.g. cough/swallowing difficulties, underlying lung disease) should be investigated aggressively. Our findings also offer some form of reassurance for parents of children with A-T, which is otherwise a progressively severely debilitating condition.
Toll-like receptors and CD40 modulate each other's expression affecting Leishmania major infection
Authors: Chandel H S , Pandey S P , Shukla D , Lalsare K , Selvaraj S K , Jha M K , Saha B 
Published: January 2014

Summary
Toll-like receptors (TLRs) recognize pathogen-associated molecular patterns and results in innate immune system activation that results in elicitation of the adaptive immune response. One crucial modulator of the adaptive immune response is CD40. However, whether these molecules influence each other's expression and functions is not known. Therefore, we examined the effects of TLRs on CD40 expression on macrophages, the host cell for the protozoan parasite Leishmania major. While polyinosinic-polycytidylic acid [poly (I:C)], a TLR-3 ligand, lipopolysaccharide (LPS), a TLR-4 ligand, imiquimod, a TLR-7/8 ligand and cytosine–phosphate–guanosine (CpG), a TLR-9 ligand, were shown to enhance CD40 expression, CD40 stimulation enhanced only TLR-9 expression. Therefore, we tested the synergism between CD40 and CpG in anti-leishmanial immune response. In Leishmania-infected macrophages, CpG was found to reduce CD40-induced extracellular stress-regulated kinase (ERK)1/2 activation; with the exception of interleukin (IL)-10, these ligands had differential effects on CD40-induced IL-1α, IL-6 and IL-12 production. CpG significantly enhanced the anti-leishmanial function of CD40 with differential effects on IL-4, IL-10 and interferon (IFN)-γ production in susceptible BALB/c mice. Thus, we report the first systematic study on CD40–TLR cross-talk that regulated the experimental L. major infection.
Effect of continuous positive airway pressure therapy on sexual function and serum testosterone in males with type 2 diabetes and obstructive sleep apnoea
Authors: Knapp Arthur , Myhill Paul C. , Davis Wendy A. , Peters Kirsten E. , Hillman David , Hamilton Emma J. , Lim Ee Mun , Davis Timothy M. E. 
Published: January 2014

SummaryObjectiveThere have been no studies of the effect of continuous positive airway pressure (CPAP) therapy on erectile dysfunction (ED) and serum testosterone in men with type 2 diabetes and obstructive sleep apnoea (OSA), a patient group at increased risk of ED and hypogonadism. The aim of this study was to determine whether CPAP improves sexual and gonadal function in males with type 2 diabetes and a pre‐CPAP apnoea–hypopnoea index >15/h.DesignSubstudy of a trial assessing the effect of 3 months of CPAP on cardiovascular risk in type 2 diabetes.PatientsOf 35 males starting CPAP, 27 (mean ± SD age 65·4 ± 9·6 years, median [interquartile range] diabetes duration 12·1 [5·2–15·3] years) completed the trial.MeasurementsSerum total and free testosterone, responses to the Androgen Deficiency in the Aging Aale (ADAM) and Sexual Health Inventory for Men (SHIM) questionnaires.ResultsThere were no significant changes in mean total or free testosterone (baseline concentrations 12·7 ± 4·5 nm and 0·26 ± 0·07 pm, respectively), or SHIM score (baseline 13 [5–17]), after 3 months of CPAP (P > 0·20). The ADAM score (baseline 6·2 ± 2·1) fell after 1 month (to 5·0 ± 2·6) and was maintained at this level at 3 months (P = 0·015). The Epworth Sleepiness Scale score decreased and self‐reported physical activity increased over 3 months (P ≤ 0·017) without a change in body mass index (P = 1·00).ConclusionsThese findings imply that CPAP therapy improves somnolence and promotes exercise in men with type 2 diabetes, but that there is no direct benefit for gonadal or sexual function.
Mass Media Influence and the Regulation of Illegal Practices in the Seafood Market
Authors: Mariani Stefano , Ellis Jamie , O'Reilly Amy , Bréchon Amanda L. , Sacchi Carlotta , Miller Dana D. 
Published: January 2014

AbstractFollowing media exposure on the issue of seafood mislabeling in Ireland, results of repeated forensic testing of cod product labeling suggest that media attention played an important role in determining significant improvements in the supermarket retail sector, but had no detectable effect on “take‐away” food services. Differences in the chains of production and in compliance requirements to European labeling laws may explain the divergent responses of the two sectors. The findings from this study indicate that it may be possible for mass media to occupy an influential role in fisheries and environmental management and policy, provided that (i) primary research findings are correctly reported by popular media and (ii) governmental agencies follow up the short‐term reaction to media exposure with appropriate enforcement measures.
Local adaptation and the potential effects of a contaminant on predator avoidance and antipredator responses under global warming: a space‐for‐time substitution approach
Authors: Janssens Lizanne , Dinh Van Khuong , Debecker Sara , Bervoets Lieven , Stoks Robby 
Published: January 2014

AbstractThe ability to deal with temperature‐induced changes in interactions with contaminants and predators under global warming is one of the outstanding, applied evolutionary questions. For this, it is crucial to understand how contaminants will affect activity levels, predator avoidance and antipredator responses under global warming and to what extent gradual thermal evolution may mitigate these effects. Using a space‐for‐time substitution approach, we assessed the potential for gradual thermal evolution shaping activity (mobility and foraging), predator avoidance and antipredator responses when Ischnura elegans damselfly larvae were exposed to zinc in a common‐garden warming experiment at the mean summer water temperatures of shallow water bodies at southern and northern latitudes (24 and 20°C, respectively). Zinc reduced mobility and foraging, predator avoidance and escape swimming speed. Importantly, high‐latitude populations showed stronger zinc‐induced reductions in escape swimming speed at both temperatures, and in activity levels at the high temperature. The latter indicates that local thermal adaptation may strongly change the ecological impact of contaminants under global warming. Our study underscores the critical importance of considering local adaptation along natural gradients when integrating biotic interactions in ecological risk assessment, and the potential of gradual thermal evolution mitigating the effects of warming on the vulnerability to contaminants.
Innovative Environmental Tracer Techniques for Evaluating Sources of Spring Discharge from a Carbonate Aquifer Bisected by a River
Authors: Heilweil Victor M. , Sweetkind Donald S. , Gerner Steven J. 
Published: January 2014

AbstractLittlefield Springs discharge about 1.6 m3/s along a 10‐km reach of the Virgin River in northwestern Arizona. Understanding their source is important for salinity control in the Colorado River Basin. Environmental tracers suggest that Littlefield Springs are a mixture of older groundwater from the regional Great Basin carbonate aquifer and modern (post‐1950s) seepage from the Virgin River. While corrected 14C apparent ages range from 1 to 9 ka, large amounts of nucleogenic 4He and low 3He/4He ratios suggest that the carbonate aquifer component is likely even older Pleistocene recharge. Modeled infiltration of precipitation, hydrogeologic cross sections, and hydraulic gradients all indicate recharge to the carbonate aquifer likely occurs in the Clover and Bull Valley Mountains along the northern part of the watershed, rather than in the nearby Virgin Mountains. This high‐altitude recharge is supported by relatively cool noble‐gas recharge temperatures and isotopically depleted δ2H and δ18O. Excess (crustal) SF6 and 4He precluded dating of the modern component of water from Littlefield Springs using SF6 and 3H/3He methods. Assuming a lumped‐parameter model with a binary mixture of two piston‐flow components, Cl−/Br−, Cl−/F−, δ2H, and CFCs indicate the mixture is about 60% Virgin River water and 40% groundwater from the carbonate aquifer, with an approximately 30‐year groundwater travel time for Virgin River seepage to re‐emerge at Littlefield Springs. This suggests that removal of high‐salinity sources upstream of the Virgin River Gorge would reduce the salinity of water discharging from Littlefield Springs into the Virgin River within a few decades.
Natural Attenuation of Perchlorate in Denitrified Groundwater
Authors: Robertson William D. , Roy James W. , Brown Susan J. , Van Stempvoort Dale R. , Bickerton Greg 
Published: January 2014

AbstractMonitoring of a well‐defined septic system groundwater plume and groundwater discharging to two urban streams located in southern Ontario, Canada, provided evidence of natural attenuation of background low level (ng/L) perchlorate (ClO4−) under denitrifying conditions in the field. The septic system site at Long Point contains ClO4− from a mix of waste water, atmospheric deposition, and periodic use of fireworks, while the nitrate plume indicates active denitrification. Plume nitrate (NO3−‐N) concentrations of up to 103 mg/L declined with depth and downgradient of the tile bed due to denitrification and anammox activity, and the plume was almost completely denitrified beyond 35 m from the tile bed. The ClO4− natural attenuation occurs at the site only when NO3−‐N concentrations are <0.3 mg/L, after which ClO4− concentrations decline abruptly from 187 ± 202 to 11 ± 15 ng/L. A similar pattern between NO3−‐N and ClO4− was found in groundwater discharging to the two urban streams. These findings suggest that natural attenuation (i.e., biodegradation) of ClO4− may be commonplace in denitrified aquifers with appropriate electron donors present, and thus, should be considered as a remediation option for ClO4− contaminated groundwater.
Reverse Water‐Level Fluctuations Associated with Fracture Connectivity
Authors: Gellasch Christopher A. , Wang Herbert F. , Bradbury Kenneth R. , Bahr Jean M. , Lande Lauren L. 
Published: January 2014

AbstractReverse water‐level fluctuations (RWFs), a phenomenon in which water levels rise briefly in response to pumping, were detected in monitoring wells in a fractured siliciclastic aquifer system near a deep public supply well. The magnitude and timing of RWFs provide important information that can help interpret aquifer hydraulics near pumping wells. A RWF in a well is normally attributed to poroelastic coupling between the solid and fluid components in an aquifer system. In addition to revealing classical pumping‐induced poroelastic RWFs, data from pressure transducers located at varying depths and distances from the public supply well suggest that the RWFs propagate rapidly through fractures to influence wells hundreds of meters from the pumping well. The rate and cycling frequency of pumping is an important factor in the magnitude of RWFs. The pattern of RWF propagation can be used to better define fracture connectivity in an aquifer system. Rapid, cyclic head changes due to RWFs may also serve as a mechanism for contaminant transport.