bluuebunny/crossref_metadata_2025_split huggingface dataset:
Density of ghrelin-producing cells is higher in the gastric mucosa of morbidly obese patients
Authors: Maksud Fabiana A N , Alves Jairo S , Diniz Marco T C , Barbosa Alfredo J A 
Published: May 2011

BackgroundGhrelin is a peptide mainly secreted by gastric mucosa and has been implicated in the regulation of eating behavior and weight balance. Obesity and Helicobacter pylori infection are associated with changes in plasma ghrelin levels.ObjectiveThis study was designed to evaluate the density of ghrelin-producing cells in the gastric mucosa of morbidly obese and dyspeptic non-obese patients, with and without H. pylori infection.MethodsGastric biopsies of the antral and oxyntic mucosa were obtained from 50 morbidly obese patients (BMI >40, 21 with metabolic syndrome (MS)), 17 dyspeptic overweight subjects (25<BMI<30), and 33 lean individuals (BMI<25) and processed for histology and immunohistochemistry.ResultsGhrelin-immunoreactive cell densities in the oxyntic mucosa were similar in morbidly obese patients with MS and in overweight and lean patients, whereas morbidly obese patients without MS presented higher ghrelin-immunoreactive cell density. The number of ghrelin cells in the oxyntic mucosa was significantly lower in obese and non-obese H. pylori-infected subjects. Ghrelin-immunoreactive cells, although sparse in the antral mucosa, were found more frequently in obese patients and their numbers did not seem to be affected by H. pylori infection.ConclusionsThe higher expression of ghrelin-immunoreactive cells in the oxyntic mucosa of morbidly obese patients compared with non-obese subjects or with morbidly obese subjects with MS and the finding of a higher number of small foci of ghrelin cells in the antral mucosa of obese patients may indicate an adaptive mechanism or an individual factor to be considered in the pathogenesis of obesity.
A Left/Right Asymmetric Neuronal Differentiation Program Is Controlled by the Caenorhabditis elegans LSY-27 Zinc-Finger Transcription Factor
Authors: Zhang Feifan , O'Meara M Maggie , Hobert Oliver 
Published: May 2011

Abstract
Functional diversification across the left/right axis is a common feature of many nervous systems. The genetic programs that control left/right asymmetric neuron function and gene expression in the nervous system are, however, poorly understood. We describe here the molecular characterization of two phenotypically similar mutant Caenorhabditis elegans strains in which left/right asymmetric gene expression programs of two gustatory neurons, called ASEL and ASER, are disrupted such that the differentiation program of the ASER neuron is derepressed in the ASEL neuron. We show that in one mutant strain the LIM homeobox gene lim-6 is defective whereas in another strain a novel member of a nematode-specific, fast-evolving family of C2H2 zinc-finger transcription factors, lsy-27, is mutated, as revealed by whole-genome sequencing. lsy-27 is broadly and exclusively expressed in the embryo and acts during the initiation, but not during the maintenance phase of ASE asymmetry control to assist in the initiation of lim-6 expression.
Abnormal High-Density Lipoproteins in Overweight Adolescents With Atherogenic Dyslipidemia
Authors: Medina-Urrutia Aida , Juarez-Rojas Juan G. , Cardoso-Saldaña Guillermo , Jorge-Galarza Esteban , Posadas-Sánchez Rosalinda , Martínez-Alvarado Rocio , Caracas-Portilla Nacú , Mendoza Pérez Enrique , Posadas-Romero Carlos 
Published: May 2011

OBJECTIVE:This study aimed to evaluate high-density lipoprotein functionality and the cardiovascular risk factor profile in the overweight pediatric population. We hypothesized that overweight adolescents with low high-density lipoprotein cholesterol and elevated triglyceride plasma levels have metabolic abnormalities and dysfunctional high-density lipoprotein particles, similar to those reported in adults.PATIENTS AND METHODS:Overweight adolescents with (group 1 [n = 21]) and without (group 2 [n = 36]) atherogenic dyslipidemia (high-density lipoprotein cholesterol: ≤40 mg/dL and triglycerides: ≥150 mg/dL) and normal-weight normolipidemic subjects, as a reference (group 3 [n = 36]), were included. The cardiovascular risk factor profile (lipids, lipoproteins, high-sensitivity C-reactive protein, and insulin), high-density lipoprotein subclass distribution, composition, and cholesterol efflux capacity were studied.RESULTS:Group 1 adolescents showed abnormalities in high-density lipoprotein subclass distribution and high-density lipoprotein chemical composition, as well as a significantly lower capacity to promote cholesterol efflux (14.8 ± 2.8, 16.5 ± 3.8, 20.4 ± 3.5, for groups 1, 2 and 3, respectively). High-density lipoprotein2a (R2 = 0.212, β = 0.472, P &lt; .0001) and the Tanner score (R2 = 0.054, β = −0.253, P = .02) were the independent predictors of cholesterol efflux. Group 1 also showed a higher degree of cardiovascular abnormalities (an adverse lipoprotein profile, greater insulin resistance and systemic inflammation; and lower low-density lipoprotein size) than group 2, even after BMI and Tanner score adjustment.CONCLUSIONS:This study suggests that atherogenic dyslipidemia identifies overweight adolescents with quantitative, qualitative, and functional high-density lipoprotein abnormalities. Atherogenic dyslipidemia seems to be a marker of an increased risk for developing cardiovascular disease and indicates that those adolescents should be a target of aggressive prevention programs and lipid management guidelines.
Epidemiology of 15-Day Readmissions to a Children's Hospital
Authors: Gay James C. , Hain Paul D. , Grantham John A. , Saville Benjamin R. 
Published: May 2011

OBJECTIVE:To describe the population of pediatric patients readmitted to a children's hospital within 15 days of discharge.PATIENTS AND METHODS:Medical records were reviewed to identify characteristics of patients and their hospitalizations for all children hospitalized during calendar years 2007–2008 who were readmitted up to and including 15 days after a previous discharge.RESULTS:Of 30 188 total hospital admissions during the study period, 2546 (8.4%) were followed by a readmission within 15 days of discharge. The age groups with the greatest number of readmissions were infants (aged 31–364 days, 20.8% of readmissions) and patients aged &gt;10 years (31.3% of readmissions). Most readmitted patients (78.0%) had an underlying chronic illness, and patients with malignancies were most likely to be readmitted, followed by newborns and patients with neurologic conditions. Patients with malignancies also experienced the greatest number of readmissions per patient (4.1). Most patients who were readmitted had only 1 readmission (71.5%), but the small subset of patients with 3 or more readmissions accounted for 43.7% of all 15-day readmissions. Disease recurrence and natural course of the original diagnosis were the most common reasons for readmission (44.9%), followed by planned readmissions (20.6%) and readmissions for a new, unrelated illness (7.7%).CONCLUSIONS:This report is the first description of the epidemiology of all 15-day pediatric readmissions at a children's hospital. The results of this study serve as a basis for additional analysis to determine the extent to which readmissions in the pediatric population may or may not be preventable.
Outcomes for Children Hospitalized With Abusive Versus Noninflicted Abdominal Trauma
Authors: Lane Wendy Gwirtzman , Lotwin Irwin , Dubowitz Howard , Langenberg Patricia , Dischinger Patricia 
Published: May 2011

BACKGROUND:
Abusive abdominal trauma (AAT) is the second leading cause of child abuse mortality. Previous outcome studies have been limited to data from trauma centers.

OBJECTIVES:
The goals of this study were (1) to examine mortality, length of hospitalization, and hospital charges among a national sample of children hospitalized for AAT; and (2) to compare these outcomes with children with noninflicted abdominal trauma.

METHODS:
Hospitalization data for children aged 0 to 9 years were obtained from the 2003 and 2006 Kids' Inpatient Database. Cases were identified using International Classification of Diseases, Ninth Revision, Clinical Modification and external cause of injury codes. Multivariable regression analyses were used to compare outcomes of children with AAT versus those with noninflicted injury.

RESULTS:
Children with AAT were younger, and more often insured by Medicaid. Among children surviving to discharge, those with AAT had longer hospitalizations (adjusted mean [95% confidence interval (CI)] length of stay: 7.9 (6.6–9.3) vs 6.4 (6.1–6.7) days, P &lt; .01) and higher charges (adjusted mean [95% CI] costs: $24 343 [$20 952–$28 567] vs $19 341 [$18 770–$20 131]; P &lt; .01). Among children aged 1 to 9 years, those with AAT had higher mortality (adjusted rate [95% CI]: 9.2% [5.0%–16.1%] vs 2.7% [2.2%–3.2%], P &lt; .01). There was no significant difference in mortality for children aged younger than 1 year.

CONCLUSIONS:
Children hospitalized for AAT generally had poorer short-term outcomes compared with children with noninflicted abdominal trauma. Studies to explain these differences are needed. In addition, efforts to prevent these injuries and to assist families at risk should be supported.
Linezolid-Associated Peripheral and Optic Neuropathy in Children
Authors: Nambiar Sumathi , Rellosa Neil , Wassel Ronald T. , Borders-Hemphill Vicky , Bradley John S. 
Published: May 2011

OBJECTIVE:
Peripheral neuropathy (PN) and optic neuropathy (ON) associated with linezolid use are described in the adult literature; however limited information is available in pediatrics. The purpose of this communication is to summarize pediatric cases of linezolid-associated neuropathy and to increase awareness of these neurologic side effects so that clinicians can most appropriately balance the benefits and risks of linezolid in the pediatric population.

METHODS:
A search of the FDA Adverse Events Reporting System was performed for all pediatric cases of neuropathy from April 2000–2009. AERS includes both inpatient and outpatient data. Inpatient utilization patterns for linezolid were also assessed from January 2000 to December 2008.

RESULTS:
Eight pediatric cases of linezolid-associated neuropathy were identified. Treatment duration ranged from 4 weeks to 1 year. Five patients had PN alone, one had only ON and two had both. Symptoms of PN included pain, numbness, weakness, and paresthesias. Symptoms of ON included decreased visual acuity and color vision. Three children had other adverse events associated with linezolid including acidosis, anemia, and leukopenia. Outcomes were reported in 5 cases. Resolution of symptoms occurred between 2 weeks and 6 months after discontinuation of linezolid. Utilization data showed that during the study period, overall inpatient utilization of linezolid had increased.

CONCLUSIONS:
While linezolid may be used to treat serious infections often needing extended courses of therapy, potential safety concerns should be kept in mind. In the circumstance of prolonged use of linezolid in children, it is likely that more cases of neuropathy may occur.
Cord Blood Vitamin D Deficiency Is Associated With Respiratory Syncytial Virus Bronchiolitis
Authors: Belderbos Mirjam E. , Houben Michiel L. , Wilbrink Berry , Lentjes Eef , Bloemen Eltje M. , Kimpen Jan L. L. , Rovers Maroeska , Bont Louis 
Published: May 2011

BACKGROUND:Respiratory syncytial virus (RSV) is the most important pathogen causing severe lower respiratory tract infection (LRTI) in infants. Epidemiologic and basic studies suggest that vitamin D may protect against RSV LRTI.OBJECTIVE:To determine the association between plasma vitamin D concentrations at birth and the subsequent risk of RSV LRTI.DESIGN:A prospective birth cohort study was performed in healthy term neonates. Concentrations of 25-hydroxyvitamin D (25-OHD) in cord blood plasma were related to RSV LRTI in the first year of life, defined as parent-reported LRTI symptoms in a daily log and simultaneous presence of RSV RNA in a nose-throat specimen.RESULTS:The study population included 156 neonates. Eighteen (12%) developed RSV LRTI. The mean plasma 25-OHD concentration was 82 nmol/L. Overall, 27% of neonates had 25-OHD concentrations &lt;50 nmol/L, 27% had 50-74 nmol/L and only 46% had 25-OHD 75 nmol/L. Cord blood 25-OHD concentrations were strongly associated with maternal vitamin D3 supplementation during pregnancy. Concentrations of 25-OHD were lower in neonates who subsequently developed RSV LRTI compared with those who did not (65 nmol/L versus 84 nmol/L, P = .009). Neonates born with 25-OHD concentrations &lt;50 nmol/L had a sixfold (95% confidence interval: 1.6-24.9; P = .01) increased risk of RSV LRTI in the first year of life compared with those with 25-OHD concentrations ≥75 nmol/L.CONCLUSIONS:Vitamin D deficiency in healthy neonates is associated with increased risk of RSV LRTI in the first year of life. Intensified routine vitamin D supplementation during pregnancy may be a useful strategy to prevent RSV LRTI during infancy.
Pediatric Palliative Care Patients: A Prospective Multicenter Cohort Study
Authors: Feudtner Chris , Kang Tammy I. , Hexem Kari R. , Friedrichsdorf Stefan J. , Osenga Kaci , Siden Harold , Friebert Sarah E. , Hays Ross M. , Dussel Veronica , Wolfe Joanne 
Published: May 2011

OBJECTIVE:
To describe demographic and clinical characteristics and outcomes of patients who received hospital-based pediatric palliative care (PPC) consultations.

DESIGN, SETTING, AND PATIENTS:
Prospective observational cohort study of all patients served by 6 hospital-based PPC teams in the United States and Canada from January to March 2008.

RESULTS:
There were 515 new (35.7%) or established (64.3%) patients who received care from the 6 programs during the 3-month enrollment interval. Of these, 54.0% were male, and 69.5% were identified as white and 8.1% as Hispanic. Patient age ranged from less than one month (4.7%) to 19 years or older (15.5%). Of the patients, 60.4% lived with both parents, and 72.6% had siblings. The predominant primary clinical conditions were genetic/congenital (40.8%), neuromuscular (39.2%), cancer (19.8%), respiratory (12.8%), and gastrointestinal (10.7%). Most patients had chronic use of some form of medical technology, with gastrostomy tubes (48.5%) being the most common. At the time of consultation, 47.2% of the patients had cognitive impairment; 30.9% of the cohort experienced pain. Patients were receiving many medications (mean: 9.1). During the 12-month follow-up, 30.3% of the cohort died; the median time from consult to death was 107 days. Patients who died within 30 days of cohort entry were more likely to be infants and have cancer or cardiovascular conditions.

CONCLUSIONS:
PPC teams currently serve a diverse cohort of children and young adults with life-threatening conditions. In contrast to the reported experience of adult-oriented palliative care teams, most PPC patients are alive for more than a year after initiating PPC.
Prediction of the Mass Sensitivity of Phage-Coated Magnetoelastic Biosensors for the Detection of Single Pathogenic Bacteria
Authors: Horikawa Shin , Li Suiqiong , Chai Yating , Petrenko Valerly A. , Chin Bryan A. 
Published: May 2011

ABSTRACTFreestanding, strip-shaped magnetoelastic (ME) biosensors are a class of wireless, mass-based biosensors that are being developed for the real-time detection of pathogenic bacteria for food safety and bio-security. The mass sensitivity of these biosensors operating in longitudinal-vibration modes is known to be largely dependent on the position of masses attached to the sensor surfaces. Hence, considering this dependence is crucial to the detection of low-concentration target pathogens, including single pathogenic bacteria, because their local attachment may cause varying sensor responses. In a worst case scenario, the resultant sensor responses (i.e., mass-induced resonance frequency changes of the sensor) may be too small to be detected despite the attachment of the target pathogenic masses. To address the issue, phage-coated ME biosensors (magnetostrictive strips (4 mm × 0.8 mm × 30 μm) coated with a phage probe specifically binding streptavidin protein) with localized masses (streptavidin-coated polystyrene beads) were fabricated, and mass-position-dependence of the sensor’s sensitivity under the fundamental-mode vibration was experimentally measured. In addition, three-dimensional finite element (FE) modal analysis was performed using the CalculiX software to simulate the phenomena. The experimental and theoretical results show close agreement: (1) the mass sensitivity was low when the mass was positioned in the middle of the sensor’s longest dimension and (2) a much higher mass sensitivity was, by contrast, obtained for the equivalent masses placed at both ends of the strip-shaped sensor. Furthermore, FE models were constructed for differently sized, phage-coated ME biosensors (100 – 500 μm in length with different widths and thicknesses) loaded with a single bacterial mass (2 μm × 0.4 μm × 0.4 μm, 1.05 g/cm3) at varying longitudinal positions. The mass sensitivity was found to be approximated by a mass-position-dependent Boltzmann function whose amplitude is inversely proportional to the length squared, width, and thickness of the sensor.
The Development of Business Standardization and Integrated Management Systems
Authors: Majstorović Vidosav , Marinković Valentina 
Published: May 2011

The Development of Business Standardization and Integrated Management SystemsAt the beginning of the 21st century, business standardization has been experiencing intense development, while technical standardization has been moved to the background. Globalization, the development and application of IT technology, the global economic crisis and severe conditions in business have only contributed to this development. Today, the most current standards to be applied are ISO 9000, 14000, 17000, 18000, 20000, 22000, 27000, 31000 and others. At this point the basic question that arises is how to apply these standards in an integrated fashion. Integrated management systems are the answer, which should connect at least two standards or at best all of them - from five to seven. This paper deals with the development of individual models of business standardization, and their integration in the design and implementation of IMS, from the viewpoint of quality management requirements, environmental protection, the safety and health protection of employees and some other demands.
Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth Restriction
Authors: Višnjevac Nemanja , Segedi Ljiljana , Ćurčić Aleksandar , Višnjevac Jovana , Stajić Dragan 
Published: May 2011

Blood Ferritin Levels in Pregnant Women and Prediction of the Development of Fetal Intrauterine Growth RestrictionIntrauterine growth restriction is one of the leading causes of perinatal morbidity and mortality. Prediction of intrauterine growth restriction is one of the priority tasks of perinatal protection. The purpose of this study was to evaluate the levels of serum ferritin in pregnant women, which could point to a group of patients in whom possible development of fetal growth restriction could have been expected. In this investigation, we conducted a prospective study of healthy pregnant women between 30 and 32 gestational weeks, who were estimated for ferritin values. Newborn infants of low birth weight for gestational age were recorded in 8.1%. Anemia was not present in any of the patients who delivered low birth weight babies. Ferritin serum levels in mothers of the babies with low birth weight were on average 6.42 μg/L higher than in the mothers with appropriate for gestational age babies (p<0.005). ROC analysis of newborn infants birth weight and maternal blood ferritin levels showed that blood ferritin level had good predictive value. In case the recorded maternal blood ferritin values are above 13.6 μg/L, we can assume with the sensitivity of 64.7% and specificity of 91.7%, that the pregnant woman will develop a condition of intrauterine growth restriction. The missing decrease of ferritin values, erythrocytes, hemoglobin and hematocrit in the blood of healthy pregnant women between 30 and 32 gestational weeks, can with high probability point to the development of fetal intrauterine growth restriction.
Immunopathological Characteristics of Cryptoglandular and Crohn's Anorectal Fistulas
Authors: Hadzhiev Bozhidar , Murdjeva Mariana 
Published: May 2011

Immunopathological Characteristics of Cryptoglandular and Crohn's Anorectal FistulasAnorectal fistulas are quite common proctologic disorders. They can be either of cryptoglandular origin or can be associated with Crohn's disease and chronic ileocolitis. Mechanical obstruction and local infections are prime causes of this pathological condition. Genetic predisposition and inadequate immune response with overproduction of pro-inflammatory cytokines appear prominently in the course of Crohn's disease. Interferon-γ, a Th1 type cytokine, reflecting the engagement of cellular immune mechanisms, is the first to be produced in the intestinal mucosa. The inflammatory process in the colon mucosa induced by the abundant microbial flora is sustained and turned chronic by the gradual elevation of the local TNF-α and regulatory cytokines levels (interleukin-10, transforming growth factor-β). The number of activated local memory T cells CD4+CD45RBloincreases significantly. The regulatory CD4+CD25+ T lymphocytes producing interleukin-10 increase also trying to counterbalance the cytokine reaction. The chronic inflammatory infiltrates of the colon mucosa are represented by lymphocytes, plasma cells, macrophages. The long-term activation of macrophages by the released interferon-γ leads to tissue damage and potentiation of angiogenesis - a risk factor for carcinoma development. Management of anorectal abscesses and fistulas is complex aiming to alleviate the symptoms, prevent relapses, reduce the risk of sphincter damage and improve quality of life. The main approach (surgery) should be combined with antimicrobial infection control and immunomodulation by intravenous or local administration of anti-TNF-α antibodies.
Murine Guanylate Cyclase C Regulates Colonic Injury and Inflammation
Authors: Steinbrecher Kris A. , Harmel-Laws Eleana , Garin-Laflam Monica P. , Mann Elizabeth A. , Bezerra Lucas D. , Hogan Simon P. , Cohen Mitchell B. 
Published: May 2011

Abstract
Guanylate cyclase C (GUCY2C or GC-C) and its ligands, guanylin (GUCA2A or Gn) and uroguanylin (GUCA2B or Ugn), are expressed in intestinal epithelial cells and regulate ion secretion, intestinal barrier function, and epithelial monolayer homeostasis via cGMP-dependent signaling pathways. The aim of this study was to determine whether GC-C and its ligands direct the course of intestinal inflammation. In this article, we show that dextran sodium sulfate (DSS)-induced clinical disease and histological damage to the colonic mucosa were significantly less severe in GC-C−/− mice and moderately reduced in Gn−/− animals. Relative to wild-type controls, GC-C−/− and Gn−/− mice had reduced apoptosis and increased proliferation of intestinal epithelial cells during DSS colitis. Basal and DSS-induced production of resistin-like molecule β (RELMβ) was substantially diminished in GC-C−/− mice. RELMβ is thought to stimulate cytokine production in macrophages in this disease model and, consistent with this, TNF-α and IFN-γ production was minimal in GC-C−/− animals. RELMβ and cytokine levels were similar to wild-type in Gn−/− mice, however. Colonic instillation of recombinant RELMβ by enema into GC-C−/− mice restores sensitivity to DSS-mediated mucosal injury. These findings demonstrate a novel role for GC-C signaling in facilitating mucosal wounding and inflammation, and further suggest that this may be mediated, in part, through control of RELMβ production.