bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic impact of fecal pH in critically ill patients
Authors: Osuka Akinori , Shimizu Kentaro , Ogura Hiroshi , Tasaki Osamu , Hamasaki Toshimitsu , Asahara Takashi , Nomoto Koji , Morotomi Masami , Kuwagata Yasuyuki , Shimazu Takeshi 
Published: July 2012

Abstract
Introduction
We have reported that altered gut flora is associated with septic complications and eventual death in critically ill patients with systemic inflammatory response syndrome. It is unclear how fecal pH affects these patients. We sought to determine whether fecal pH can be used as an assessment tool for the clinical course of critically ill patients.

Methods
Four hundred ninety-one fecal samples were collected from 138 patients who were admitted to the Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Japan. These patients were treated in the intensive care unit for more than 2 days. Fecal pH, fecal organic acids, and fecal bacteria counts were measured and compared by survived group and nonsurvived group, or nonbacteremia group and bacteremia group. Logistic regression was used to estimate relations between fecal pH, age, sex, or APACHE II score and mortality, and incidence of bacteremia. Differences in fecal organic acids or fecal bacteria counts among acidic, neutral, and alkaline feces were analyzed.

Results
The increase of fecal pH 6.6 was significantly associated with the increased mortality (odds ratio, 2.46; 95% confidence interval, 1.25 to 4.82) or incidence of bacteremia (3.25; 1.67 to 6.30). Total organic acid was increased in acidic feces and decreased in alkaline feces. Lactic acid, succinic acid, and formic acid were the main contributors to acidity in acidic feces. In alkaline feces, acetic acid was significantly decreased. Propionic acid was markedly decreased in both acidic and alkaline feces compared with neutral feces. No differences were noted among the groups in bacterial counts.

Conclusions
The data presented here demonstrate that the fecal pH range that extended beyond the normal range was associated with the clinical course and prognosis of critically ill patients.
Steroidogenesis in the adrenal dysfunction of critical illness: impact of etomidate
Authors: Molenaar Nienke , Bijkerk Ronald M , Beishuizen Albertus , Hempen Christel M , de Jong Margriet FC , Vermes Istvan , van der Sluijs Veer Gertjan , Girbes Armand RJ , Groeneveld AB Johan 
Published: July 2012

Abstract
Introduction
This study was aimed at characterizing basal and adrenocorticotropic hormone (ACTH)-induced steroidogenesis in sepsis and nonsepsis patients with a suspicion of critical illness-related corticosteroid insufficiency (CIRCI), taking the use of etomidate-inhibiting 11β-hydroxylase into account.

Method
This was a prospective study in a mixed surgical/medical intensive care unit (ICU) of a university hospital. The patients were 62 critically ill patients with a clinical suspicion of CIRCI. The patients underwent a 250-μg ACTH test (n = 67). ACTH, adrenal steroids, substrates, and precursors (modified tandem mass spectrometry) also were measured. Clinical characteristics including use of etomidate to facilitate intubation (n = 14 within 72 hours of ACTH testing) were recorded.

Results
At the time of ACTH testing, patients had septic (n = 43) or nonseptic critical illness (n = 24). Baseline cortisol directly related to sepsis and endogenous ACTH, independent of etomidate use. Etomidate was associated with a lower baseline cortisol and cortisol/11β-deoxycortisol ratio as well as higher 11β-deoxycortisol, reflecting greater 11β-hydroxylase inhibition in nonsepsis than in sepsis. Cortisol increases < 250 mM in exogenous ACTH were associated with relatively low baseline (HDL-) cholesterol, and high endogenous ACTH with low cortisol/ACTH ratio, independent of etomidate. Although cortisol increases with exogenous ACTH, levels were lower in sepsis than in nonsepsis patients, and etomidate was associated with diminished increases in cortisol with exogenous ACTH, so that its use increased, albeit nonsignificantly, low cortisol increases to exogenous ACTH from 38% to 57%, in both conditions.

Conclusions
A single dose of etomidate may attenuate stimulated more than basal cortisol synthesis. However, it may only partly contribute, particularly in the stressed sepsis patient, to the adrenal dysfunction of CIRCI, in addition to substrate deficiency.
Feasibility of monitoring hydraulic fracturing using time-lapse audio-magnetotellurics
Authors: He Lanfang , Hu Xiumian , Xu Ligui , He Zhanxiang , Li Weili 
Published: July 2012

Hydraulic fracturing is widely used for initiating and subsequently propagating fractures in reservoir strata by means of a pressurized fluid to release oil and gas or to store industry waste. Downhole or surface microseismic monitoring is commonly used to characterize the hydraulically induced fractures. However, in some cases, downhole microseismic monitoring can be difficult due to the limitation imposed by boreholes. Surface microseismic monitoring often faces difficulties acquiring high signal-to-noise ratio data because of the on-site noise from hydraulic fracturing process. Research and field observations indicate that injecting conductive slurry or water into a strata may generate distinct time-lapse electromagnetic anomalies between pre- and posthydraulic fracturing. These anomalies provide a means for characterizing the hydraulic fracturing using time-lapse electromagnetic methods. We examined the time-lapse variation over an hour, one day, one month, and two years of observed audio-magnetotellurics (AMT) resistivity and the 1D and 3D AMT modeling result of the variation pre- and posthydraulic fracturing. There is also a successful case history of applying the time-lapse AMT to map hydraulic fractures. Observed data indicate that the variation of AMT resistivity is normally less than 6% apart from the data of the dead band and some noisy data. Modeling results show the variation pre- and posthydraulic fracturing is larger than 30% at the frequency point lower than 100 Hz. The case history indicates that time-lapse magnetotelluric monitoring may form a new way to characterize the hydraulic fracture.
Incomplete Intrapulmonary Lymph Node Retrieval After Routine Pathologic Examination of Resected Lung Cancer
Authors: Ramirez Robert A. , Wang Christopher G. , Miller Laura E. , Adair Courtney A. , Berry Allen , Yu Xinhua , O'Brien Thomas F. , Osarogiagbon Raymond U. 
Published: July 2012

Purpose Pathologic nodal stage affects prognosis in patients with surgically resected non–small-cell lung cancer (NSCLC). Unlike examination of mediastinal lymph nodes (LNs), which depends on surgical practice, accurate examination of intrapulmonary (N1) nodes depends primarily on pathology practice. We investigated the completeness of N1 LN examination in NSCLC resection specimens and its potential impact on stage. Patients and Methods We performed a case-control study of a special pathologic examination (SPE) protocol using thin gross dissection with retrieval and microscopic examination of all LN-like material on remnant NSCLC resection specimens after routine pathologic examination (RPE). We compared LNs retrieved by the SPE protocol with nodes examined after RPE of the same lung specimens and with those of an external control cohort. Results We retrieved additional LNs in 66 (90%) of 73 patient cases and discovered metastasis in 56 (11%) of 514 retrieved LNs from 27% of all patients. We found unexpected LN metastasis in six (12%) of 50 node-negative patients. Three other patients had undetected satellite metastatic nodules. Pathologic stage was upgraded in eight (11%) of 73 patients. The time required for the SPE protocol decreased significantly with experience, with no change in the number of LNs found. Conclusion Standard pathology practice frequently leaves large numbers of N1 LNs unexamined, a clinically significant proportion of which harbor metastasis. By improving N1 LN examination, SPE can have an impact on prognosis and adjuvant management. We suggest adoption of the SPE to improve pathologic staging of resected NSCLC.
First-Line Erlotinib Followed by Second-Line Cisplatin-Gemcitabine Chemotherapy in Advanced Non–Small-Cell Lung Cancer: The TORCH Randomized Trial
Authors: Gridelli Cesare , Ciardiello Fortunato , Gallo Ciro , Feld Ronald , Butts Charles , Gebbia Vittorio , Maione Paolo , Morgillo Floriana , Genestreti Giovenzio , Favaretto Adolfo , Leighl Natasha , Wierzbicki Rafal , Cinieri Saverio , Alam Yasmin , Siena Salvatore , Tortora Giampaolo , Felletti Raffaella , Riccardi Ferdinando , Mancuso Gianfranco , Rossi Antonio , Cantile Flavia , Tsao Ming-Sound , Saieg Mauro , da Cunha Santos Gilda , Piccirillo Maria Carmela , Di Maio Massimo , Morabito Alessandro , Perrone Francesco 
Published: July 2012

Purpose Erlotinib prolonged survival of unselected patients with advanced non–small-cell lung cancer (NSCLC) who were not eligible for further chemotherapy, and two phase II studies suggested it might be an alternative to first-line chemotherapy. A randomized phase III trial was designed to test whether first-line erlotinib followed at progression by cisplatin-gemcitabine was not inferior in terms of survival to the standard inverse sequence. Patients and Methods Patients with stage IIIB (with pleural effusion or supraclavicular nodes) to IV NSCLC and performance status of 0 to 1 were eligible. With a 95% CI upper limit of 1.25 for the hazard ratio (HR) for death, 80% power, a one-sided α = .025, and two interim analyses, a sample size of 900 patients was planned. Results At the first planned interim analysis with half the events, the inferiority boundary was crossed, and the Independent Data Monitoring Committee recommended early termination of the study. Seven hundred sixty patients (median age, 62 years; range, 27 to 81 years) had been randomly assigned. Baseline characteristics were balanced between study arms. As of June 1, 2011, median follow-up was 24.3 months, and 536 deaths were recorded (263 in the standard treatment arm and 273 in the experimental arm). Median survival was 11.6 months (95% CI, 10.2 to 13.3 months) in the standard arm and 8.7 months (95% CI, 7.4 to 10.5 months) in the experimental arm. Adjusted HR of death in the experimental arm was 1.24 (95% CI, 1.04 to 1.47). There was no heterogeneity across sex, smoking habit, histotype, and epidermal growth factor receptor (EGFR) mutation. Conclusion In unselected patients with advanced NSCLC, first-line erlotinib followed at progression by cisplatin-gemcitabine was significantly inferior in terms of overall survival compared with the standard sequence of first-line chemotherapy followed by erlotinib.
American Society of Clinical Oncology Clinical Practice Guidelines: Formal Systematic Review–Based Consensus Methodology
Authors: Loblaw D. Andrew , Prestrud Ann Alexis , Somerfield Mark R. , Oliver Thomas K. , Brouwers Melissa C. , Nam Robert K. , Lyman Gary H. , Basch Ethan 
Published: July 2012

The American Society of Clinical Oncology (ASCO) guidelines program employs a systematic review–based methodology to produce evidence-based guidelines. This is consistent with the stance of the Institute of Medicine on guideline development, which is that high-quality evidence syntheses form the basis for recommendation development. In the absence of high-quality evidence, recommendation development becomes more complex. One option is to provide no recommendations or withdraw a guideline topic. However, it is often the areas of greatest uncertainty in which the evidentiary base is incomplete, and thus, guidelines are needed most. To provide recommendations in such circumstances, an explicit methodology is needed to ensure that a credible process is undertaken, and rigorous, reliable advice is provided. In 2010, the ASCO Board of Directors approved development of guideline recommendations using consensus methodology. A modified Delphi approach to recommendation development, based on the best available data identified in a systematic review, was piloted with an ASCO guideline. Consensus was achieved through the rating of a series of recommendations by a large group of clinicians, including academic and community-based content and methodology experts. A prespecified threshold of agreement was determined to indicate when consensus was achieved. Consensus was defined as agreement by ≥ 75% of raters. The formal consensus methodology used by ASCO enabled development of guideline recommendations on a challenging clinical issue based on limited evidence using a rigorous, transparent, and explicit method. This methodology is proposed for development of future ASCO guidelines on topics for which limited evidence is available.
Comprehensive One-Step Molecular Analyses of Mitochondrial Genome by Massively Parallel Sequencing
Authors: Zhang Wei , Cui Hong , Wong Lee-Jun C 
Published: July 2012

AbstractBACKGROUNDMitochondrial diseases are clinically and genetically heterogeneous, with variable penetrance, expressivity, and differing age of onset. Disease-causing point mutations and large deletions in the mitochondrial genome often exist in a heteroplasmic state. Current molecular analyses require multiple different and complementary methods for the detection and quantification of mitochondrial DNA (mtDNA) mutations. We developed a novel approach to analyze the mtDNA in 1 step.METHODSThe entire human mitochondrial genome was enriched by a single amplicon long-range PCR followed by massively parallel sequencing to simultaneously detect mtDNA point mutations and large deletions with heteroplasmic levels of the mutations and variants quantified. QC samples were designed and analyzed along with each sample. A total of 45 samples were analyzed for the evaluation of analytic sensitivity and specificity.RESULTSOur analysis demonstrated 100% diagnostic sensitivity and specificity of base calls compared to the results from Sanger sequencing. The deep coverage allowed the detection and quantification of heteroplasmy at every single nucleotide position of the 16 569-bp mitochondrial genome. Moreover, the method also detected large deletions with the breakpoints mapped.CONCLUSIONSThis “deep” sequencing approach provides a 1-step comprehensive molecular analysis of the whole mitochondrial genome for patients in whom a mitochondrial disease is suspected.
Diabetes, metformin use, and colon cancer: a population-based cohort study in Taiwan
Authors: Tseng Chin-Hsiao 
Published: July 2012

ObjectiveA retrospective cohort study, using a population-based reimbursement database, was conducted for investigating the relationship between diabetes and colon cancer and assessing whether metformin had a protective effect.MethodsOverall, 493 704 men and 502 139 women, covered by the National Health Insurance, without colon cancer were followed from 2003 to 2005. Cox regression evaluated the adjusted relative risk (RR), considering confounders and detection examinations.ResultsEven though diabetes patients had a significantly higher probability of receiving examinations that could lead to the detection of colon cancer, they had a significantly higher risk (24%) of this cancer after adjustment. Metformin users had a significantly lower risk (27%) of colon cancer. While comparing patients with diabetes for <1, 1–3, and ≥3 years to nondiabetes individuals, the adjusted RR (95% confidence interval) was 1.308 (1.020–1.679), 1.087 (0.900–1.313), and 1.185 (1.055–1.330) respectively. The higher risk among those with diabetes for <1 year suggested a possible reverse causality or a link with prediabetes. However, diabetes still might play some role in the development of colon cancer in those with diabetes for ≥3 years. The duration of metformin use showed an inverse trend, with a significant RR of 0.643 (0.490–0.845) in users for ≥3 years, when compared with nonusers. In addition, metformin may reduce colon cancer risk associated with chronic obstructive pulmonary disease (a surrogate for smoking).ConclusionsFollowing adjustment for potential detection bias and other covariates, diabetes remains a significant risk factor for colon cancer. Metformin may protect against colon cancer.
Clinical and Radiographic Characteristics Associated With Abusive and Nonabusive Head Trauma: A Systematic Review
Authors: Piteau Shalea J. , Ward Michelle G.K. , Barrowman Nick J. , Plint Amy C. 
Published: July 2012

BACKGROUND AND OBJECTIVE:To systematically review the literature to determine which clinical and radiographic characteristics are associated with abusive head trauma (AHT) and nonabusive head trauma (nAHT) in children.METHODS:We searched MEDLINE, EMBASE, PubMed, conference proceedings, and reference lists to identify relevant studies. Two reviewers independently selected studies that compared clinical and/or radiographic characteristics including historical features, physical exam and imaging findings, and presenting signs or symptoms in hospitalized children ≤6 years old with AHT and nAHT.RESULTS:Twenty-four studies were included. Meta-analysis was complicated by inconsistencies in the reporting of characteristics and high statistical heterogeneity. Notwithstanding these limitations, there were 19 clinical and radiographic variables that could be meta-analyzed and odds ratios were determined for each variable. In examining only studies deemed to be high quality, we found that subdural hemorrhage(s), cerebral ischemia, retinal hemorrhage(s), skull fracture(s) plus intracranial injury, metaphyseal fracture(s), long bone fracture(s), rib fracture(s), seizure(s), apnea, and no adequate history given were significantly associated with AHT. Epidural hemorrhage(s), scalp swelling, and isolated skull fracture(s) were significantly associated with nAHT. Subarachnoid hemorrhage(s), diffuse axonal injury, cerebral edema, head and neck bruising, any bruising, and vomiting were not significantly associated with either type of trauma.CONCLUSIONS:Clinical and radiographic characteristics associated with AHT and nAHT were identified, despite limitations in the literature. This systematic review also highlights the need for consistent criteria in identifying and reporting clinical and radiographic characteristics associated with AHT and nAHT.
Influence of Motion Picture Rating on Adolescent Response to Movie Smoking
Authors: Sargent James D. , Tanski Susanne , Stoolmiller Mike 
Published: July 2012

OBJECTIVE:To examine the association between movie smoking exposure (MSE) and adolescent smoking according to rating category.METHODS:A total of 6522 US adolescents were enrolled in a longitudinal survey conducted at 8-month intervals; 5503 subjects were followed up at 8 months, 5019 subjects at 16 months, and 4575 subjects at 24 months. MSE was estimated from 532 recent box-office hits, blocked into 3 Motion Picture Association of America rating categories: G/PG, PG-13, and R. A survival model evaluated time to smoking onset.RESULTS:Median MSE in PG-13–rated movies was ∼3 times higher than median MSE from R-rated movies, but their relation with smoking was essentially the same, with adjusted hazard ratios of 1.49 (95% confidence interval [CI]: 1.23–1.81) and 1.33 (95% CI: 1.23–1.81) for each additional 500 occurrences of MSE respectively. MSE from G/PG-rated movies was small and had no significant relationship with adolescent smoking. Attributable risk estimates showed that adolescent smoking would be reduced by 18% (95% CI: 14–21) if smoking in PG-13–rated movies was reduced to the fifth percentile. In comparison, making all parents maximally authoritative in their parenting would reduce adolescent smoking by 16% (95% CI: 12–19).CONCLUSIONS:The equivalent effect of PG-13-rated and R-rated MSE suggests it is the movie smoking that prompts adolescents to smoke, not other characteristics of R-rated movies or adolescents drawn to them. An R rating for movie smoking could substantially reduce adolescent smoking by eliminating smoking from PG-13 movies.
Adolescent Dating Violence: A National Assessment of School Counselors’ Perceptions and Practices
Authors: Khubchandani Jagdish , Price James H. , Thompson Amy , Dake Joseph A. , Wiblishauser Michael , Telljohann Susan K. 
Published: July 2012

BACKGROUND AND OBJECTIVES:
Adolescent dating violence (ADV) is a significant public health problem that, according to various estimates, affects 9% to 34% of adolescents in the United States. Schools can play an important role in preventing ADV. However, little is known about school personnel\x{2019}s practices and perceptions regarding ADV. This study assessed high school counselors' knowledge, training, perceptions, and practices on dealing with ADV incidents.

METHODS:
A national random sample (n = 550) of high school counselors who were members of the American School Counselors Association were sent a valid and reliable questionnaire on ADV. A 3-wave mailing procedure was used to increase the response rate, which was 58%. Statistically significant differences (P &lt; .05) were calculated by using t tests, χ2 tests, analysis of variance, and logistic regression.

RESULTS:
A majority of the school counselors reported that they did not have a protocol in their schools to respond to an incident of ADV (81.3%). Additionally, the majority (90%) of counselors reported that in the past 2 years, training to assist survivors of teen dating abuse has not been provided to personnel in their schools, their school did not conduct periodic student surveys that include questions on teen dating abuse behaviors (83%), and their school did not have a committee that meets periodically to address health and safety issues that include teen dating abuse (76%).

CONCLUSIONS:
The results of this study indicate that schools do not find ADV a high-priority issue to be addressed in their student populations.
Caffeine Intake During Pregnancy and Risk of Problem Behavior in 5- to 6-Year-Old Children
Authors: Loomans Eva M. , Hofland Laura , van der Stelt Odin , van der Wal Marcel F. , Koot Hans M. , Van den Bergh Bea R. H. , Vrijkotte Tanja G. M. 
Published: July 2012

BACKGROUND AND OBJECTIVE:
Human studies that have investigated the association between caffeine intake during pregnancy and offspring’s behavioral outcomes are scant and inconclusive. We prospectively investigated the association between maternal caffeine intake during pregnancy and children’s problem behavior at age 5 to 6 years. Mediation by fetal growth restriction and gestational age as well as effect modification by the child’s gender and maternal smoking was tested.

METHODS:
In a community based multiethnic birth cohort, dietary caffeine intake (coffee, caffeinated tea, and cola) was measured (maternal self-report, n = 8202) around the 16th week of gestation. At age 5, children’s overall problem behavior, emotional problems, conduct problems, hyperactivity/inattention problems, peer relationship problems, and prosocial behavior were rated by both mother and teacher (n = 3439) with the Strengths and Difficulties Questionnaire. Analyses were adjusted for maternal age, ethnicity, cohabitant status, education, smoking and alcohol consumption during pregnancy, child’s gender, family size, and prenatal maternal anxiety.

RESULTS:
Caffeine intake was not associated with a higher risk for behavior problems or with suboptimal prosocial behavior. No evidence was found for mediation by fetal growth restriction or gestational age, nor for effect modification by the child’s gender.

CONCLUSIONS:
Results did not provide evidence for developmental programming influences of intrauterine exposure to caffeine on offspring’s problem behavior at age 5. Present results give no indication to advise pregnant women to reduce their caffeine intake to prevent behavior problems in their children.