bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delirium as a predictor of sepsis in post-coronary artery bypass grafting patients: a retrospective cohort study
Authors: Martin Billie-Jean , Buth Karen J , Arora Rakesh C , Baskett Roger JF 
Published: September 2010

Abstract
Introduction
Delirium is the most common neurological complication following cardiac surgery. Much research has focused on potential causes of delirium; however, the sequelae of delirium have not been well investigated. The objective of this study was to investigate the relationship between delirium and sepsis post coronary artery bypass grafting (CABG) and to determine if delirium is a predictor of sepsis.

Methods
Peri-operative data were collected prospectively on all patients. Subjects were identified as having agitated delirium if they experienced a short-term mental disturbance marked by confusion, illusions and cerebral excitement. Patient characteristics were compared between those who became delirious and those who did not. The primary outcome of interest was post-operative sepsis. The association of delirium with sepsis was assessed by logistic regression, adjusting for differences in age, acuity, and co-morbidities.

Results
Among 14,301 patients, 981 became delirious and 227 developed sepsis post-operatively. Rates of delirium increased over the years of the study from 4.8 to 8.0% (P = 0.0003). A total of 70 patients of the 227 with sepsis, were delirious. In 30.8% of patients delirium preceded the development of overt sepsis by at least 48 hours. Multivariate analysis identified several factors associated with sepsis, (receiver operating characteristic (ROC) 79.3%): delirium (odds ratio (OR) 2.3, 95% confidence interval (CI) 1.6 to 3.4), emergent surgery (OR 3.3, CI 2.2 to 5.1), age (OR 1.2, CI 1.0 to 1.3), pre-operative length of stay (LOS) more than seven days (OR 1.6, CI 1.1 to 2.3), pre-operative renal insufficiency (OR 1.9, CI 1.2 to 2.9) and complex coronary disease (OR 3.1, CI 1.8 to 5.3).

Conclusions
These data demonstrate an association between delirium and post-operative sepsis in the CABG population. Delirium emerged as an independent predictor of sepsis, along with traditional risk factors including age, pre-operative renal failure and peripheral vascular disease. Given the advancing age and increasing rates of delirium in the CABG population, the prevention and management of delirium need to be addressed.
Clinical Outcome of Children With Newly Diagnosed Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia Treated Between 1995 and 2005
Authors: Aricò Maurizio , Schrappe Martin , Hunger Stephen P. , Carroll William L. , Conter Valentino , Galimberti Stefania , Manabe Atsushi , Saha Vaskar , Baruchel André , Vettenranta Kim , Horibe Keizo , Benoit Yves , Pieters Rob , Escherich Gabriele , Silverman Lewis B. , Pui Ching-Hon , Valsecchi Maria Grazia 
Published: September 2010

Purpose In a previous analysis of 326 children with Philadelphia chromosome (Ph) –positive acute lymphoblastic leukemia (ALL) treated between 1986 and 1996, hematopoietic stem-cell transplantation from HLA-matched related donors, but not from unrelated donors, offered a superior outcome than chemotherapy alone. To evaluate the impact of recent improvements in chemotherapy and transplantation, we performed a similar analysis on patients treated in the following decade. Patients and Methods We analyzed 610 patients with Ph-positive ALL treated between 1995 and 2005 without tyrosine kinase inhibitor therapy. The median follow-up duration was 6.3 years. Results Complete remission was achieved in 89% of patients. The 7-year event-free survival and overall survival rates were superior in the present cohort compared with the previous cohort (32.0% ± 2.0% v 25.0% ± 3.0, respectively, P = .007; and 44.9% ± 2.2% v 36.0% ± 3.0%, respectively, P = .017). Compared with chemotherapy alone, transplantation with matched related donors or unrelated donors in first remission (325 patients) showed an advantage with increasing follow-up, suggesting greater protection against late relapses (hazard ratio at 5 years, 0.37; P < .001). In the multivariate Cox regression analysis accounting for treatment (transplantation v no transplantation), age, leukocyte count, and early response had independent impact on treatment outcome. Conclusion Clinical outcome of children and adolescents with Ph-positive ALL has improved with advances in transplantation and chemotherapy. Transplantations with matched related donors and unrelated donors were equivalent and offered better disease control compared with chemotherapy alone. Age, leukocyte count, and early treatment response were independent prognostic indicators. The results of this study will serve as a historical reference to evaluate the therapeutic impact of tyrosine kinase inhibitors on the outcome of Ph-positive ALL.
A Variational Monte Carlo Study of Positronic Compounds Using Inhomogeneous Backflow Transformations
Authors: Kita Yukiumi , Tachikawa Masanori , Drummond Neil D , Needs Richard J 
Published: September 2010

Abstract
A variational Monte Carlo study using inhomogeneous backflow transformations is reported for the [H−;e+] and [Li−;e+] positronic compounds. The backflow transformations greatly improve the total energies, positron affinities, and two-photon annihilation rates. The Slater–Jastrow-backflow trial wave function is well suited to the theoretical analysis of positronic compounds.
Electrocatalytic O2 Evolution from Water at an ITO Electrode Modified with [Ru(terpy){4,4′-(CH2PO3H2)2-2,2′-bpy}(OH2)]2+: Evidence for a Unimolecular Pathway
Authors: Kiyota Josaku , Yokoyama Junpei , Yoshida Masaki , Masaoka Shigeyuki , Sakai Ken 
Published: September 2010

Abstract
An ITO (indium tin oxide) electrode modified with [Ru(terpy){4,4′-(CH2PO3H2)2-2,2′-bpy}(OH2)]2+ was prepared to gain insight into the mechanism of O2 evolution from water catalyzed by a series of mononuclear aquaruthenium complexes, such as [Ru(terpy)(bpy)(OH2)]2+. The modified ITO electrode showed a clear decrease in overpotential for O2 evolution (1.35 V in an aqueous 0.1 M Na2SO4/H2SO4 solution, pH 4.0), indicating that the O2 evolution proceeds in a unimolecular fashion without having any intermolecular associations.
Ein modellbasiertes Konzept zur Antriebsstrangregelung für ein Parallelhybridfahrzeug
Authors: Alt Benedikt , Antritter Felix , Svaricek Ferdinand , Schultalbers Matthias 
Published: September 2010

Zusammenfassung
In diesem Beitrag wird ein modellbasierter Ansatz zur Antriebsstrangregelung für ein Parallelhybridfahrzeug vorgestellt. Dabei wird eine Antriebsstrangkonfiguration betrachtet, bei der kein eigener elektrischer Startermotor für den Verbrennungsmotor verwendet wird. Der Synchronisationsvorgang des Verbrennungsmotors erfolgt stattdessen über den Elektromotor der Antriebswelle sowie über eine Ansteuerung der Trennkupplung. Für diese Konfiguration wird ein flachheitsbasiertes Steuerungskonzept vorgestellt, mit dem die Drehzahlen des Verbrennungsmotors und des Elektromotors unabhängig voneinander eingestellt werden können. Im Zusammenspiel mit zwei entkoppelten Folgereglern ergibt sich zudem ein Regelungskonzept, das hervorragende Robustheitseigenschaften gegenüber Modellunsicherheiten besitzt.
Powermanagement eines hybridelektrischen Antriebs — Auslegung, Optimierung und Leistungsregelung
Authors: Söffker Dirk , Özbek Markus , Marx Matthias 
Published: September 2010

Zusammenfassung
Dieser Beitrag diskutiert verschiedene Aspekte zur Bewertung hybridelektrischer Antriebe. Anhand eines brennstoffzellenbasierten Hybridsystems wird der Einfluss des Powermanagements auf Kenngrößen wie z. B. System- und Komponenteneffizienz und -verfügbarkeit erörtert. Durch experimentelle Untersuchungen wird für einen gegebenen Fahrzyklus anhand einfacher Betriebsstrategien ein Optimierungsansatz dargestellt, wobei mit verschiedenen Kennwerten das Systemverhalten bewertet und nachfolgende Iterationsschritte bestimmt werden. Dabei kann bereits mit wenigen Iterationen ein Optimum erzielt werden.
Phenotypic Consequences of Aneuploidy inArabidopsis thaliana
Authors: Henry Isabelle M , Dilkes Brian P , Miller Eric S , Burkart-Waco Diana , Comai Luca 
Published: September 2010

AbstractAneuploid cells are characterized by incomplete chromosome sets. The resulting imbalance in gene dosage has phenotypic consequences that are specific to each karyotype. Even in the case of Down syndrome, the most viable and studied form of human aneuploidy, the mechanisms underlying the connected phenotypes remain mostly unclear. Because of their tolerance to aneuploidy, plants provide a powerful system for a genome-wide investigation of aneuploid syndromes, an approach that is not feasible in animal systems. Indeed, in many plant species, populations of aneuploid individuals can be easily obtained from triploid individuals. We phenotyped a population of Arabidopsis thaliana aneuploid individuals containing 25 different karyotypes. Even in this highly heterogeneous population, we demonstrate that certain traits are strongly associated with the dosage of specific chromosome types and that chromosomal effects can be additive. Further, we identified subtle developmental phenotypes expressed in the diploid progeny of aneuploid parent(s) but not in euploid controls from diploid lineages. These results indicate long-term phenotypic consequences of aneuploidy that can persist after chromosomal balance has been restored. We verified the diploid nature of these individuals by whole-genome sequencing and discuss the possibility that trans-generational phenotypic effects stem from epigenetic modifications passed from aneuploid parents to their diploid progeny.
Antagonistic Roles of PP2A-Pab1 and Etd1 in the Control of Cytokinesis in Fission Yeast
Authors: Lahoz Aurelia , Alcaide-Gavilán María , Daga Rafael R , Jimenez Juan 
Published: September 2010

Abstract
In Schizosaccharomyces pombe, Etd1 is a positive regulator of the septation initiation network (SIN), a conserved GTPase-regulated kinase cascade that triggers cytokinesis. Here we show that a mutation in the pab1 gene, which encodes the B-regulatory subunit of the protein phosphatase 2A (PP2A), suppresses mutations in the etd1 gene. Etd1 is required for the function of the GTPase Spg1, a key regulator of SIN signaling. Interestingly, the loss of Pab1 function restored the activity of Spg1 in Etd1-deficient cells. This result suggests that PP2A-Pab1–mediated dephosphorylation inhibits Spg1, thus antagonizing Etd1 function. The loss of pab1 function also rescues the lethality of mutants of other genes in the SIN cascade such as mob1, sid1, and cdc11. Two-hybrid assays indicate that Pab1 physically interacts with Mob1, Sid1, Sid2, and Cdc11, suggesting that the phosphatase 2A B-subunit is a component of the SIN complex. Together, our results indicate that PP2A-Pab1 plays a novel role in cytokinesis, regulating SIN activity at different levels. Pab1 is also required to activate polarized cell growth. Thus, PP2A-Pab1 may be involved in coordinating polar growth and cytokinesis.
Temporal and Spatial Regulation of Gene Expression During Asexual Development ofNeurospora crassa
Authors: Greenwald Charles J , Kasuga Takao , Glass N Louise , Shaw Brian D , Ebbole Daniel J , Wilkinson Heather H 
Published: September 2010

AbstractIn this study we profiled spatial and temporal transcriptional changes during asexual sporulation in the filamentous fungus Neurospora crassa. Aerial tissue was separated from the mycelium to allow detection of genes specific to each tissue. We identified 2641 genes that were differentially expressed during development, which represents ∼25% of the predicted genes in the genome of this model fungus. On the basis of the distribution of functional annotations of 1102 of these genes, we identified gene expression patterns that define key physiological events during conidial development. Not surprisingly, genes encoding transcription factors, cell wall remodeling proteins, and proteins involved in signal transduction were differentially regulated during asexual development. Among the genes differentially expressed in aerial tissues the majority were unclassified and tended to be unique to ascomycete genomes. This finding is consistent with the view that these genes evolved for asexual development in the Pezizomycotina. Strains containing deletions of several differentially expressed genes encoding transcription factors exhibited asexual development-associated phenotypes. Gene expression patterns during asexual development suggested that cAMP signaling plays a critical role in the transition from aerial growth to proconidial chain formation. This observation prompted us to characterize a deletion of the gene encoding a high-affinity cAMP phosphodiesterase (NCU00478). NCU00478 was determined to be allelic to aconidiate-2, a previously identified genetic locus controlling conidiation.
H2B- and H3-Specific Histone Deacetylases Are Required for DNA Methylation in Neurospora crassa
Authors: Smith Kristina M , Dobosy Joseph R , Reifsnyder Jennifer E , Rountree Michael R , Anderson D C , Green George R , Selker Eric U 
Published: September 2010

Abstract
Neurospora crassa utilizes DNA methylation to inhibit transcription of heterochromatin. DNA methylation is controlled by the histone methyltransferase DIM-5, which trimethylates histone H3 lysine 9, leading to recruitment of the DNA methyltransferase DIM-2. Previous work demonstrated that the histone deacetylase (HDAC) inhibitor trichostatin A caused a reduction in DNA methylation, suggesting involvement of histone deacetylation in DNA methylation. We therefore created mutants of each of the four classical N. crassa HDAC genes and tested their effect on histone acetylation levels and DNA methylation. Global increases in H3 and H4 acetylation levels were observed in both the hda-3 and the hda-4 mutants. Mutation of two of the genes, hda-1 and hda-3, caused partial loss of DNA methylation. The site-specific loss of DNA methylation in hda-1 correlated with loss of H3 lysine 9 trimethylation and increased H3 acetylation. In addition, an increase in H2B acetylation was observed by two-dimensional gel electrophoresis of histones of the hda-1 mutant. We found a similar increase in the Schizosaccharomyces pombe Clr3 mutant, suggesting that this HDAC has a previously unrecognized substrate and raising the possibility that the acetylation state of H2B may play a role in the regulation of DNA methylation and heterochromatin formation.
Rescue of a Dominant Mutant With RNA Interference
Authors: Wu Yongrui , Messing Joachim 
Published: September 2010

Abstract
Maize Mucronate1 is a dominant floury mutant based on a misfolded 16-kDa γ-zein protein. To prove its function, we applied RNA interference (RNAi) as a dominant suppressor of the mutant seed phenotype. A γ-zein RNAi transgene was able to rescue the mutation and restore normal seed phenotype. RNA interference prevents gene expression. In most cases, this is used to study gene function by creating a new phenotype. Here, we use it for the opposite purpose. We use it to reverse the creation of a mutant phenotype by restoring the normal phenotype. In the case of the maize Mucronate1 (Mc1) phenotype, interaction of a misfolded protein with other proteins is believed to be the basis for the Mc1 phenotype. If no misfolded protein is present, we can reverse the mutant to the normal phenotype. One can envision using this approach to study complex traits and in gene therapy.
Long-term Outcomes of Acute Encephalitis in Childhood
Authors: Fowler Åsa , Stödberg Tommy , Eriksson Margareta , Wickström Ronny 
Published: September 2010

OBJECTIVES:
The aims of this study were to investigate the long-term outcomes of childhood encephalitis and to examine possible prognostic factors.

METHODS:
Of 93 children who were treated for acute encephalitis in 2000–2004, 71 were eligible for follow-up evaluations. A structured interview, using 2 questionnaires, was conducted with the parents. Fifteen of the children with the most-severe symptoms at the time of discharge also underwent electroencephalographic recording and tests of reaction times and working memory.

RESULTS:
Persisting symptoms were reported by 54% of children. The predominant symptoms were personality changes and cognitive problems. Children who made a complete recovery did so within 6 to 12 months. The only significant risk factor for sequelae was disease severity leading to admission to the ICU. The risk of subsequent epilepsy was increased for children with seizures at presentation. Most follow-up electroencephalograms showed improvement, but results had not normalized for 9 of 15 children. Children with encephalitis had slower reaction times, compared with control subjects, but no difference in working memory could be seen.

CONCLUSION:
Persisting symptoms after childhood encephalitis were present for a substantial number of children. Seizures increased the risk of subsequent epilepsy; the only other prognostic marker was admission to the ICU. Even children who were considered fully recovered at discharge reported persisting symptoms at follow-up evaluations. Children who made a full recovery did so within 6 to 12 months, which suggests that all children with encephalitis should be monitored for 1 year after the acute illness.
Trends in Admissions for Pediatric Status Asthmaticus in New Jersey Over a 15-Year Period
Authors: Hartman Mary E. , Linde-Zwirble Walter T. , Angus Derek C. , Watson R. Scott 
Published: September 2010

OBJECTIVE:Status asthmaticus accounts for a large portion of the morbidity and mortality associated with asthma, but we know little about its epidemiology. We describe here the hospitalization characteristics of children with status asthmaticus, how they changed over time, and how they differed between hospitals with and without PICUs.PATIENTS AND METHODS:We used administrative data from New Jersey that included all hospitalizations in the state from 1992, 1995, and 1999–2006. We identified children with status asthmaticus by using International Classification of Diseases, Ninth Revision, diagnosis codes that indicate status asthmaticus and the use of mechanical ventilation by using procedure codes. We designated hospitals with a PICU as “PICU hospitals” and those without as “adult hospitals.”RESULTS:We identified 28 309 admissions of children with status asthmaticus (22.8% of all asthma hospitalizations). From 1992 to 2006, the rate of hospital admissions decreased by half (from 1.98 in 1000 to 0.93 in 1000 children), and there was a 70% decrease in the number of children admitted to adult hospitals. The rate of ICU care in PICU hospitals more than tripled. However, the rate of mechanical ventilation remained low, and the number of deaths was small and unchanged (n = 14 total). Hospital costs climbed from $6.6 million to $9.5 million.CONCLUSIONS:Although fewer children are being admitted with status asthmaticus, the proportion of patients managed in PICUs is climbing. There has been no substantial change in rates of mechanical ventilation or death. Additional research is needed to better understand how patients and physicians decide on the appropriate site for hospital care and how that choice affects outcome.
Cost-effectiveness of Epinephrine and Dexamethasone in Children With Bronchiolitis
Authors: Sumner Amanda , Coyle Douglas , Mitton Craig , Johnson David W. , Patel Hema , Klassen Terry P. , Correll Rhonda , Gouin Serge , Bhatt Maala , Joubert Gary , Black Karen J. L. , Turner Troy , Whitehouse Sandra , Plint Amy C. ,   for Pediatric Emergency Research Canada
Published: September 2010

OBJECTIVE:Using data from the Canadian Bronchiolitis Epinephrine Steroid Trial we assessed the cost-effectiveness of treatments with epinephrine and dexamethasone for infants between 6 weeks and 12 months of age with bronchiolitis.METHODS:An economic evaluation was conducted from both the societal and health care system perspectives including all costs during 22 days after enrollment. The effectiveness of therapy was measured by the duration of symptoms of feeding problems, sleeping problems, coughing, and noisy breathing. Comparators were nebulized epinephrine plus oral dexamethasone, nebulized epinephrine alone, oral dexamethasone alone, and no active treatment. Uncertainty around estimates was assessed through nonparametric bootstrapping.RESULTS:The combination of nebulized epinephrine plus oral dexamethasone was dominant over the other 3 comparators in that it was both the most effective and least costly. Average societal costs were $1115 (95% credible interval [CI]: 919–1325) for the combination therapy, $1210 (95% CI: 1004–1441) for no active treatment, $1322 (95% CI: 1093–1571) for epinephrine alone, and $1360 (95% CI: 1124–1624) for dexamethasone alone. The average time to curtailment of all symptoms was 12.1 days (95% CI: 11–13) for the combination therapy, 12.7 days (95% CI: 12–13) for no active treatment, 13.0 days (95% CI: 12–14) for epinephrine alone, and 12.6 days (95% CI: 12–13) for dexamethasone alone.CONCLUSION:Treating infants with bronchiolitis with a combination of nebulized epinephrine plus oral dexamethasone is the most cost-effective treatment option, because it is the most effective in controlling symptoms and is associated with the least costs.
Prenatal Alcohol Exposure and Risk of Birth Defects
Authors: O'Leary Colleen M. , Nassar Natasha , Kurinczuk Jennifer J. , de Klerk Nicholas , Geelhoed Elizabeth , Elliott Elizabeth J. , Bower Carol 
Published: September 2010

OBJECTIVE:The goal was to examine the associations between dose, pattern, and timing of prenatal alcohol exposure (PAE) and birth defects.METHODS:Data from a randomly selected, population-based cohort of nonindigenous women who gave birth to a live infant in Western Australia (WA) between 1995 and 1997 (N = 4714) were linked to WA Midwives Notification System and WA Birth Defects Registry data. We assessed the associations of PAE before pregnancy, in the first trimester, and in late pregnancy with any birth defect and with birth defects classified as alcohol-related birth defects (ARBDs) by the Institute of Medicine (IOM), by using logistic regression.RESULTS:The prevalence of birth defects classified as ARBDs by the IOM was low. Compared with abstinence, heavy PAE in the first trimester was associated with increased odds of birth defects classified as ARBDs (adjusted odds ratio: 4.6 [95% confidence interval: 1.5–14.3]), with similar findings after validation through bootstrap analysis. There was no association between low or moderate PAE and birth defects.CONCLUSIONS:A fourfold increased risk of birth defects classified as ARBDs was observed after heavy PAE in the first trimester. Many individual birth defects included in the IOM classification for ARBDs either were not present in this cohort or were not associated with PAE. Large, population-based studies are needed to strengthen the evidence base for ARBDs.
The Pediatrician's Role in Child Maltreatment Prevention
Authors: Flaherty Emalee G. , Stirling John ,   The Committee on Child Abuse and Neglect
Published: September 2010

This Clinical Report was revised. See https://doi.org/10.1542/peds.2024-067608.
It is the pediatrician's role to promote the child's well-being and to help parents raise healthy, well-adjusted children. Pediatricians, therefore, can play an important role in the prevention of child maltreatment. Previous clinical reports and policy statements from the American Academy of Pediatrics have focused on improving the identification and management of child maltreatment. This clinical report outlines how the pediatrician can help to strengthen families and promote safe, stable, nurturing relationships with the aim of preventing maltreatment. After describing some of the triggers and factors that place children at risk for maltreatment, the report describes how pediatricians can identify family strengths, recognize risk factors, provide helpful guidance, and refer families to programs and other resources with the goal of strengthening families, preventing child maltreatment, and enhancing child development.