bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Practical Tranexamic Acid Dosing Scheme Based on Population Pharmacokinetics in Children Undergoing Cardiac Surgery
Authors: Grassin-Delyle Stanislas , Couturier Roland , Abe Emuri , Alvarez Jean Claude , Devillier Philippe , Urien Saïk 
Published: January 2013

Abstract

Background:
Pediatric cardiac surgery patients are at high risk for bleeding, and the antifibrinolytic drug tranexamic acid (TA) is often used to reduce blood loss. However, dosing schemes remain empirical as a consequence of the absence of pharmacokinetic study in this population. The authors’ objectives were thus to investigate the population pharmacokinetics of TA in pediatric cardiac surgery patients during cardiopulmonary bypass (CPB).

Methods:
Twenty-one patients were randomized to receive TA either continuously (10 mg/kg followed by an infusion of 1 mg·kg−1·h−1 throughout the operation, and 10 mg/kg into the CPB) or discontinuously (10 mg/kg, then 10 mg/kg into the CPB and 10 mg·kg−1·h−1 at the end of CPB). Serum concentrations were measured at eight time points with chromatography–mass spectrometry and the data were modeled using Monolix (Lixoft, Orsay, France).

Results:
Tranexamic acid pharmacokinetics was ascribed to a two-compartment open model. The main covariate effects were body weight and CPB. Representative pharmacokinetic parameters adjusted to a 70-kg body weight were as follows: systemic clearance, 2.45 l/h; volume of distribution in the central compartment, 14.1 l; intercompartmental clearance, 5.74 l/h; and peripheral volume, 32.8 l. In accordance with this model, the authors proposed a weight-adjusted dosing scheme to maintain effective TA concentrations in children during surgery, consisting of one loading dose followed by a continuous infusion.

Conclusions:
The authors report for the first time the pharmacokinetics of TA in children undergoing cardiac surgery with CPB, and propose a dosing scheme for optimized TA administration in those children.
Calcium Ameliorates Diarrhea in Immunocompromised Children
Authors: Cheng Sam X. , Bai Harrison X. , Gonzalez‐Peralta Regino , Mistry Pramod K. , Gorelick Fred S. 
Published: January 2013

ABSTRACTTreatment of infectious diarrheas remains a challenge, particularly in immunocompromised patients in whom infections usually persist and resultant diarrhea is often severe and protracted. Children with infectious diarrhea who become dehydrated are normally treated with oral or intravenous rehydration therapy. Although rehydration therapy can replace the loss of fluid, it does not ameliorate diarrhea. Thus, during the last decades, there has been continuous effort to search for ways to safely stop diarrhea. Herein, we report 3 immunocompromised children who developed severe and/or protracted infectious diarrhea. Their diarrheas were successfully “halted” within 1 to 2 days following the administration of calcium.
Lack of Nonspecific Protection Against All‐Cause Nonrotavirus Gastroenteritis by Vaccination with Orally Administered Rotavirus Vaccine
Authors: Grant Lindsay , Watt James , Moulton Lawrence , Weatherholtz Robert , Reid Raymond , Santosham Mathuram , O'Brien Katherine 
Published: January 2013

ABSTRACTObjectives:Acute gastroenteritis (AGE) is recognized as a global, common threat to child survival, especially in developing countries. Rotavirus, in particular, has been implicated as a leading cause of severe AGE; however, there are numerous other pathogens that also cause AGE. Several studies have demonstrated that oral vaccination against rotavirus has generated the unanticipated benefit of protecting against AGE caused by nonrotavirus pathogens.Methods:Safety and efficacy of the pentavalent bovine‐human reassortant rotavirus vaccine were studied in multiple populations, including children of the Navajo and White Mountain Apache tribes in the southwestern United States. Stool specimens were collected from children with AGE and tested for rotavirus using an enzyme immunoassay. Analyses were conducted to detect the presence or absence of a vaccine effect on incidence, severity, and duration of AGE in which rotavirus was not detected.Results:The majority of AGE (N = 558: 472 nonrotavirus vs 86 rotavirus) occurred between August 2002 and March 2004 among children ranging from ages 4 to 23 months. The incidence of nonrotavirus AGE was similar by vaccine groups with an incidence rate ratio of 1.07 (incidence rate ratio = vaccinated/unvaccinated, 95% confidence interval 0.89–1.29). The hazards of first, second, third, or any AGE in which rotavirus was not detected differed little by vaccination status (P > 0.05). Duration of symptoms and severity of nonrotavirus AGE were similar by vaccine group.Conclusions:There was no vaccine effect on frequency or severity of nonrotavirus AGE.
Near‐Infrared Spectroscopy Measurements of Splanchnic Tissue Oxygenation During Continuous Versus Intermittent Feeding Method in Preterm Infants
Authors: Dani Carlo , Pratesi Simone , Barp Jacopo , Bertini Giovanna , Gozzini Elena , Mele Laura , Parrini Letizia 
Published: January 2013

ABSTRACTObjectives:The aim of the present study was to compare the effects of continuous and intermittent bolus milk feeding on splanchnic regional oxygenation (rSO2S) in small‐for‐gestational age (SGA) and appropriate‐for‐gestational age (AGA) preterm infants.Methods:Infants with gestational age <32 weeks were prospectively studied by near‐infrared spectroscopy. Each infant was given a milk bolus in ∼10 minutes (intermittent feeding) followed after 3 hours by a 3‐hour continuous feeding. rO2S and splanchnic fractional oxygen extraction ratio (FOES [S = splanchnic]) were recorded 30 minutes before (T0) and 30 minutes after the beginning of bolus feeding (T1), 30 minutes before (T2), at the end (T3), and 30 minutes after the continuous feeding period (T4).Results:rSO2S increased at T1 in both AGA and SGA groups, whereas FOES did not vary during the study period. Moreover, we found that rSO2S was higher and FOES was lower at T1 and T3 in the AGA than in the SGA group.Conclusions:Bolus milk feeding increases splanchnic oxygenation in both AGA and SGA infants, whereas continuous feeding does not. Splanchnic oxygenation is higher in AGA than in SGA infants both during bolus and continuous feeding. Continuous enteral feeding could help to limit the risk of hypoxic‐ischemic gut damage in preterm infants in critical condition, especially in AGA infants.
Forest‐poverty nexus: Exploring the contribution of forests to rural livelihoods in Kenya
Authors: Kabubo‐Mariara Jane 
Published: January 2013

AbstractThis paper explores the contribution of forests to the livelihoods of local communities in Kenya. The paper uses survey data to explore resource extraction and the economic reliance of households on forests. The results suggest that both rich and poor households depend on forests, and that membership in forest user groups, and therefore participation in forest activities, may be based on a household's monetary rather than asset income. The results imply that forests support the living standards of the poor through the diversification of household income sources. The econometric results point to the role of household heterogeneity in private resource endowments in influencing dependence on forests. Participation in collective action and farm size are also significant determinants of forest dependence. The results call for a balanced policy approach to forest management that facilitates both access to forests by poor households and forest conservation.
Chronic Hemodialysis Patients Without Marked Elevation of Intact Parathyroid Hormone Are Also Good Candidates for Early Intervention With Cinacalcet
Authors: Nishida Hayato , Masakane Ikuto , Kudo Kenichi , Ito Minoru , Tanida Hideki , Koshika Masataka , Nishida Wakako , Tomita Yoshihiko 
Published: January 2013

AbstractManagement of calcium (Ca) and phosphorus (P) metabolism is crucial in chronic hemodialysis (HD) patients. Cinacalcet is usually used for chronic kidney disease‐mineral and bone disorders (CKD‐MBD) patients with elevated intact parathyroid hormone (iPTH) levels. However, a certain number of CKD‐MBD patients have normal iPTH levels and are not subjected to cinacalcet therapy. Here, we evaluated the efficacy of a new treatment algorithm of early initiation of cinacalcet therapy in this subgroup of patients, mainly for correcting Ca and P metabolism. Seventy‐one HD patients, including 44 patients without marked elevation of iPTH (102 < iPTH ≤ 300 pg/mL), who received cinacalcet therapy, were enrolled in this study. Serum parameters relating to CKD‐MBD patient metabolism, doses of phosphate binders, and type of vitamin D sterols were compared between pre‐ and post‐cinacalcet administration retrospectively. Sixty‐four of 71 patients did not require discontinuation of cinacalcet. In these 64 patients, serum Ca (P = 0.0003), P (P = 0.0153), and iPTH (P < 0.0001) levels were significantly reduced after cinacalcet administration, even in those without marked elevation of iPTH (Ca; P < 0.0001, P; P = 0.0422, and iPTH; P = 0.0018). The proportion of patients who received vitamin D sterols was unchanged (P = 0.5930) but the proportion of patients who received maxacalcitol was significantly reduced after cinacalcet administration (P = 0.0108). The new treatment algorithm of early initiation of cinacalcet is considered to be well tolerated and effective for controlling hypercalcemia, and/or hyperphosphatemia and/or increased iPTH of CKD‐MBD patients.
Estimating consensus and associated uncertainty between inherently different species distribution models
Authors: Gritti Emmanuel S. , Duputié Anne , Massol Francois , Chuine Isabelle 
Published: January 2013

Summary

Forecasting shifts in biome and species distribution is crucially needed in the current context of global change. So far, most projections of vegetation distribution rely on correlative species distribution models (SDMs). Yet, process‐based or hybrid models based on explicit physiological description may be more robust to extrapolation under future climatic conditions. Differences between model projections may be wide, leading to scepticism among environmental stakeholders.

Here, we propose to combine outputs of several distribution models based on physiological responses, to produce both consensual maps of occurrences and maps of associated uncertainty. The consensus map relies on the conditional projections of each SDM. Because the models used are based on processes, their errors are likely to vary consistently with climate as some processes not implemented in a model might be important under a given set of climatic conditions. Uncertainty of the consensus model is thus assessed through multimodel regression of deviance maps with respect to current climatic conditions, and can be extrapolated to forecast climates.

We illustrate this approach using three SDMs, on three widely distributed European trees (Fagus sylvatica L., Quercus robur L. and Pinus sylvestris L.), and project their distributions under two scenarios. The conditional consensus outperforms classical methods of model consensus (i.e. to use the mean, the median or a weighted average of individual SDM outputs) in projecting current occurrences.

Consistently, with the results of individual SDMs, the conditional consensus projects that the suitable areas for F. sylvatica and Q. robur will expand towards north‐eastern Europe, while that of P. sylvestris will contract. Projections of future occurrence are most uncertain towards the margins of the distribution (particularly the trailing edge).

Our approach can help modellers identify the limitations of each SDM and stakeholders pinpoint the regions of models agreement and highest certainty.
Pain characteristics and management of inpatients admitted to a comprehensive cancer centre: a cross‐sectional study
Authors: KURITA G. P. , TANGE U. B. , FARHOLT H. , SONNE N. M. , STRÖMGREN A. S. , ANKERSEN L. , KRISTENSEN L. , BENDIXEN L. , GRØNVOLD M. , PETERSEN M. A. , NORDLY M. , CHRISTRUP L. , NIEMANN C. , SJØGREN P. 
Published: January 2013

AimsThis prospective, cross‐sectional study aimed to assess cancer pain and its management in an inpatient setting at a comprehensive cancer centre in Denmark.MethodsOne hundred and eighty‐eight inpatients with cancer were invited to participate (May/June 2011). Demographics, diagnoses, World Health Organization performance status, health‐related quality of life, pain and data regarding analgesic treatment were registered.ResultsOne hundred and thirty‐four (71.3%) patients agreed to participate in the study. Most frequent diagnoses were leukaemia (27.6%) and lung cancer (14.2%). A high prevalence of pain was observed, 65.7%. Thirty‐two per cent reported moderate to severe pain when it was at its worst, 96% reported no or mild pain when it was at its least. Nearly 22% reported moderate to severe pain when the pain was categorised as average. Breakthrough pain episodes were reported by 30.5%. Adjuvant medication was sparsely used and not always correctly indicated. Out of 88 patients with pain, 62.5% were left untreated according to the Electronic Medication System. Higher health‐related quality of life was associated with lower pain intensity. The use of opioids with or without adjuvants was associated with higher pain intensity and higher number of breakthrough pain episodes.ConclusionsApproximately two thirds of inpatients reported pain and one third had breakthrough pain. A substantial number of patients with pain were left untreated. Opioid‐treated patients reported highest pain intensity and number of breakthrough episodes; however, analgesic medication seemed to be underused. Measures to improve pain assessment and management are highly required.
Incidence of neuraxial haematoma after total hip or knee surgery: RECORD programme (rivaroxaban vs. enoxaparin)
Authors: ROSENCHER N. , LLAU J. V. , MUECK W. , LOEWE A. , BERKOWITZ S. D. , HOMERING M. 
Published: January 2013

BackgroundPatients receiving anticoagulants could be at higher risk of compressive haematoma with neuraxial anaesthesia use. The phase III RECORD programme compared rivaroxaban with enoxaparin for prevention of venous thromboembolism after total hip or knee replacement surgery in more than 12,500 patients. This observational analysis evaluated the risk of neuraxial haematoma after neuraxial anaesthesia in patients receiving rivaroxaban or enoxaparin using pooled RECORD1–4 data.MethodsThe incidences of intraspinal bleeding or haemorrhagic puncture were recorded as part of the criteria for major bleeding (the primary safety outcome in the RECORD studies). Incidences of allogeneic transfusion and venous thromboembolism by type of anaesthesia were also recorded.ResultsNo compressive haematomas occurred in rivaroxaban‐treated patients (10 mg once daily started 6–8 h after surgery) who underwent neuraxial anaesthesia (n = 4086). Among enoxaparin‐treated patients (n = 4090), one compressive spinal haematoma requiring laminectomy occurred after epidural catheter removal in an elderly female patient with renal insufficiency undergoing total knee replacement. Total venous thromboembolism rates did not differ according to type of anaesthesia.ConclusionAlthough no issues were observed with the use of neuraxial anaesthesia in this population of 4086 patients receiving rivaroxaban after total hip or knee replacement, it is important to remain aware of the risk of compressive haematoma. This may be of particular concern in elderly patients with renal insufficiency receiving an anticoagulant predominantly eliminated via the kidneys.
Influence of the forest caterpillar hunter Calosoma sycophanta on the transmission of microsporidia in larvae of the gypsy moth Lymantria dispar
Authors: Goertz Dörte , Hoch Gernot 
Published: January 2013

The behaviour of predators can be an important factor in the transmission success of an insect pathogen. We studied how Calosoma sycophanta influences the interaction between its prey [Lymantria dispar (L.) (Lepidoptera, Lymantriidae)] and two microsporidian pathogens [Nosema lymantriae (Microsporidia, Nosematidae) and Vairimorpha disparis (Microsporidia, Burellenidae)] infecting the prey.
Using laboratory experiments, C. sycophanta was allowed to forage on infected and uninfected L. dispar larvae and to disseminate microsporidian spores when preying or afterwards with faeces.
The beetle disseminated spores of N. lymantriae and V. disparis when preying upon infected larvae, as well as after feeding on such prey. Between 45% and 69% of test larvae became infected when C. sycophanta was allowed to disseminate spores of either microsporidium.
Laboratory choice experiments showed that C. sycophanta did not discriminate between Nosema‐infected and uninfected gypsy moth larvae. Calosoma sycophanta preferred Vairimorpha‐infected over uninfected gypsy moth larvae and significantly influenced transmission.
When C. sycophanta was allowed to forage during the latent period on infected and uninfected larvae reared together on caged, potted oak saplings, the percentage of V. disparis infection among test larvae increased by more than 70%. The transmission of N. lymantriae was not affected significantly in these experiments.
Beetles never became infected with either microsporidian species after feeding on infected prey.
We conclude that the transmission of N. lymantriae is not affected. Because no V. disparis spores are released from living larvae, feeding on infected larvae might enhance transmission by reducing the time to death and therefore the latent period.
Interleukin‐6 gene polymorphism (−174 G/C) is associated with toxoplasmic retinochoroiditis
Authors: Cordeiro Cynthia A. , Moreira Paula R. , Bessa Thais F. , Costa Germano C. , Dutra Walderez O. , Campos Wesley R. , Oréfice Fernando , Young Lucy H. , Teixeira Antônio L. 
Published: January 2013

Abstract.Purpose:  Experimental data have demonstrated a relevant role for IL‐6 in the modulation of acute ocular toxoplasmosis. Therefore, we aim to investigate the possible association between the IL‐6 gene polymorphism at position ‐174 and toxoplasmic retinochoroiditis (TR) in humans.Methods:  Ninety‐seven patients with diagnosed TR were recruited from the Uveitis Section, Federal University of Minas Gerais. For comparison, 83 healthy blood donors with positive serology for toxoplasmosis and without retinal signs of previous TR were included in the study. Genomic DNA was obtained from oral swabs of individuals and amplified using polymerase chain reaction (PCR) with specific primers flanking the locus −174 of IL‐6 (−174G/C). PCR products were submitted to restriction endonuclease digestion and analysed by polyacrylamide gel electrophoresis to distinguish allele G and C of the IL‐6 gene, allowing the detection of the polymorphism and determination of genotypes.Results:  There was a significant difference in the genotype (χ2 = 12.9, p = 0.001) and allele (χ2 = 6.62, p = 0.01) distribution between TR patients and control subjects. In a subgroup analysis, there was no significant difference in genotypes and allele frequencies regarding TR recurrence.Conclusions:  This study suggests that the genotypes related with a lower production of IL‐6 may be associated with the occurrence of TR.
Characterization of corneal tangent modulus in vivo
Authors: Ko Match W. L. , Leung Leo K. K. , Lam David C. C. , Leung Christopher K. S. 
Published: January 2013

Abstract.Purpose:  Intraocular pressure (IOP) measured using Goldmann Applanation Tonometry (GAT) changes with individual’s corneal properties, but the method to measure the in vivo corneal material properties to account for individual variation in GAT IOP is not available. In this study, a new method to measure the IOP‐dependent corneal tangent modulus in vivo is developed to address this research gap.Methods:  Instrumented indentation and analysis were developed to measure the corneal tangent modulus. The validity of the method and procedure was verified using model silicone eye pressurized to different IOP. In addition, 15 porcine eyes and 3 rabbit eyes were tested using the corneal indentation at different set intraocular pressure and different indentation rates.Results:  The results from silicone eye showed that the measured tangent modulus is in good agreement with the standard silicone rubber modulus. The results on the porcine eyes and rabbit eyes showed that the method can be used to measure corneal tangent modulus in vivo in the human range of intraocular pressure from 10 to 40 mmHg.Conclusions:  An indentation method to measure the corneal tangent modulus in vivo was developed, and the IOP dependence of the corneal tangent modulus was characterized. The developed indentation method provides a new means to measure the in vivo corneal tangent modulus to account for individual and pressure variations in measurement of intraocular pressure.
Variation in genes in the endothelin pathway and endothelium‐dependent and endothelium‐independent vasodilation in an elderly population
Authors: Lind L. , Syvänen A.‐C. , Axelsson T. , Lundmark P. , Hägg S. , Larsson A. 
Published: January 2013

AbstractAimIndirect evidences by blockade of the endothelin receptors have suggested a role of endothelin in endothelium‐dependent vasodilation. This study aimed to investigate whether circulating levels of endotehlin‐1 or genetic variations in genes in the endothelin pathway were related to endothelium‐dependent vasodilation.MethodsIn 1016 seventy‐year‐old participants of the population‐based Prospective Study of the Vasculature in Uppsala Seniors (PIVUS) study (52% women), we measured endothelium‐dependent vasodilation using the invasive forearm technique with acetylcholine given in the brachial artery (EDV) and the brachial artery ultrasound technique with measurement of flow‐mediated dilatation (FMD). Plasma endothelin‐1 levels were measured and 60 SNPs in genes in the endothelin pathway (ECE1, EDN1, EDNRA, EDNRB) were genotyped.ResultsNo significant associations were found between circulating endothelin levels and EDV or FMD. No single genotype was related to EDV or FMD following adjustment for multiple testing, but a genotype score for 3 SNPs (rs11618266 in EDNRB, rs17675063 in EDNRA, rs3026868 in ECE1) was significantly related to EDV (beta coefficient 0.070, 95% CI 0.025–0.12, P = 0.002) when adjusting for gender, systolic blood pressure, HDL and LDL cholesterol, serum triglycerides, BMI, diabetes, smoking, antihypertensive medication or statins and CRP. This score was also related to nitroprusside‐induced vasodilation in the forearm.ConclusionA combination of genotypes in the endothelin pathway was related to both endothelium‐dependent and endothelium‐independent vasodilation in forearm resistance vessels, but not in the brachial artery in an elderly population, giving evidence for a role of the endothelin system in resistance vessel reactivity independent of major cardiovascular risk factors.