pinecone/core-2020-05-10-deduplication huggingface dataset:
Bronchodilator responsiveness in wheezy infants and toddlers is not associated with asthma risk factors

Background  There are limited data assessing bronchodilator responsiveness (BDR) in infants and toddlers with recurrent wheezing, and factors associated with a positive response.    Objectives  In a multicenter study of children ≤ 36 months old, we assessed the prevalence of and factors associated with BDR among infants/toddlers with recurrent episodes of wheezing.    Methods  Forced expiratory flows and volumes using the raised‐volume rapid thoracic compression method were measured in 76 infants/toddlers [mean (SD) age 16.8 (7.6) months] with recurrent wheezing before and after administration of albuterol. Prior history of hospitalization or emergency department treatment for wheezing, use of inhaled or systemic corticosteroids, physician treatment of eczema, environmental tobacco smoke exposure, and family history of asthma or allergic rhinitis were ascertained.    Results  Using the published upper limit of normal for post bronchodilator change (FEV 0.5  ≥ 13% and/or FEF 25–75  ≥ 24%) in healthy infants, 24% (n = 18) of children in our study exhibited BDR. The BDR response was not associated with any clinical factor other than body size. Dichotomizing subjects into responders (defined by published limits of normal) or by quartile to identify children with the greatest change from baseline (4th quartile vs. other) did not identify any other factor associated with BDR.    Conclusions  Approximately one quarter of infants/toddlers with recurrent wheezing exhibited BDR at their clinical baseline. However, BDR in wheezy infants/toddlers was not associated with established clinical asthma risk factors. Pediatr Pulmonol. 2012; 47:421–428. © 2011 Wiley Periodicals, Inc
Role of spontaneous breathing trial in predicting successful extubation in premature infants

Background  The ability of clinicians to predict successful extubation in mechanically ventilated premature neonates is limited. Identifying objective criteria for predicting successful extubation may reduce the incidence of failed extubation and the duration of mechanical ventilation.    Objective  To evaluate the validity of objective measures of lung function and spontaneous breathing trial (SBT) in predicting successful extubation among premature neonates with attempted extubations within the first 3 weeks of life.    Methods  Respiratory compliance (Crs) along with SBT was performed prior to elective extubations within 3 weeks of age in premature infants ≤32 weeks. Extubation was considered successful if patients remained extubated for >72 hr. Ventilator settings including mean airway pressure (MAP), set rate, and fraction of inspired oxygen (FiO 2 ) 24 hr after re‐intubation were compared with pre‐extubation settings, in patients requiring re‐intubation.    Results  Thirty‐nine of 49 infants (80%) were successfully extubated. Of 41 babies who passed SBT, only 5 infants failed extubation. SBT had 92% sensitivity, 50% specificity, 88% positive predictive, and 63% negative predictive value for successful extubation. Crs was comparable between infants who were successfully extubated and those who were not.    Conclusions  A SBT prior to extubation may be a practical objective adjunct in predicting successful extubation in ventilated premature infants. Pediatr Pulmonol. 2013; 48:443–448. © 2012 Wiley Periodicals, Inc
Evaluation of a cystic fibrosis transition program from pediatric to adult care

Purpose  As the cystic fibrosis (CF) patient population median survival increase, the need for transitioning their care to adult care centers increase as well. We have a structured transition program since the early 1980s. The purpose of this study is to evaluate the experiences and opinions of patients in our adult CF center who went through a formal transition versus those who did not, in an attempt to evaluate the overall process and to identify means for improvement.    Methods  A questionnaire was given to adult CF patients at the University of Michigan during a clinic visit or inpatient hospitalization, after consent was obtained. Inclusion criteria included diagnosis of CF in childhood, previous care in a pediatric center, and current participation in our adult CF clinic.    Results  A total of 91 patients completed the questionnaire. 44 went through our structured transition program. On average, patients who participated in a formal transition process had higher satisfaction with both CF programs, perceived health status, and independence but no differences in their level of anxiety about transferring to the adult program. Patient opinions regarding when to transfer care were considered more often in patients who participated in a transition program (88% vs. 62% and  P  = 0.02).    Conclusion  Although structured transitions programs do not appear to decrease patient anxiety during this stressful period, it does appear to improve patient satisfaction, perceived health status, and independence. These findings suggest that establishing a transition program could be important in optimizing patient health, continuity of care and improving adherence. Pediatr Pulmonol. 2013; 48:658–665. © 2012 Wiley Periodicals, Inc
Increased lung volume in infants and toddlers at high compared to low altitude

Children and adults residing at high altitude (HA) compared to low altitude (LA) have larger lung volumes; however, it is unknown whether this response to chronic hypoxia begins early in life. Our objective was to determine whether infants and toddlers at HA have larger lung volumes compared to infants and toddlers at LA. Oxygen saturation (SaO2 ), functional residual capacity (FRC), as well as serum levels of vascular endothelial growth factor (VEGF) and erythropoietin (EPO) were measured in infants and toddlers from HA (N = 50; 3,440 m) and LA (N = 35; 440 m). There were no significant differences in somatic size for HA and LA subjects; however, HA subjects had significantly lower SaO2 (88.5% vs. 96.7%; P < 0.0001). Subjects at HA had significantly greater FRC compared to subjects at LA (group mean: 209 and 157 ml; P < 0.0001), adjusting for body length. Male infants at HA had a significantly greater FRC compared to males at LA (57 ml; P-value < 0.001); however, the increase in FRC for females at HA compared to LA was not significant (20 ml; P-value = 0.101). VEGF and EPO were significantly higher for subjects at HA compared to LA with no gender differences. In summary, infants and toddlers at HA have lower oxygen saturations, higher serum levels of VEGF and EPO, and higher FRC compared to subjects at LA; however, chronic hypoxia appears to generate a more robust response in lung growth in male compared to female infants early in life
Differing associations of BMI and body fat with asthma and lung function in children.

Current evidence suggests that in children there is a significant, albeit weak, association between asthma and obesity. Studies generally use body mass index (BMI) in evaluating body adiposity, but there are limitations to its use.Children from a population-based study attending follow-up (age 11 years) were weighed, measured and had percent body (PBF) and truncal (PTF) fat assessed using bioelectrical impedance. They were skin prick tested and completed spirometry. Parents completed a validated respiratory questionnaire. Children were defined as normal or overweight according to BMI and PBF cut-offs. We tested the association between these adiposity markers with wheeze, asthma, atopy, and lung-function.Six hundred forty-six children (339 male) completed follow-up. BMI z-score, PBF, and PTF were all positively associated with current wheeze (odds ratio [95% CI]: 1.27 [1.03, 1.57], P = 0.03; 1.05 [1.00, 1.09], P = 0.03; 1.04 [1.00, 1.08], P = 0.04, respectively). Similar trends were seen with asthma. However, when examining girls and boys separately, significant positive associations were found with PBF and PTF and asthma but only in girls (gender interaction P = 0.06 and 0.04, respectively). Associations between being overweight and wheezing and asthma were stronger when overweight was defined by PBF (P = 0.007, 0.03) than BMI (P > 0.05). Higher BMI was significantly associated with an increase in FEV(1) and FVC, but only in girls. Conversely, increasing body fat (PBF and PTF) was associated with reduced FEV(1) and FVC, but only in boys. No associations between adiposity and atopy were found.All adiposity measures were associated with wheeze, asthma, and lung function. However, BMI and PBF did not have the same effects and girls and boys appear to be affected differently
Lack of concordance in parapneumonic effusion management in children in central Europe

Treatment of parapneumonic effusion in children remains controversial in the literature and in clinical practice. The aim of this study was to determine whether mutual consensus exists in the diagnosis and treatment of parapneumonic effusion in Central European countries. A questionnaire was sent to all directors of pediatric respiratory units in four adjacent Central European countries (Austria, France, Germany, Switzerland). The response rate was 61.8%. Responses reflected acceptable agreement regarding initial diagnostic procedures, as most centers performed chest X-ray and biological exams, followed by ultrasound, thoracocentesis, or computed tomography. However, antibiotic regimens were very heterogeneous, and the survey revealed complete lack of agreement on the indications and effusion volume threshold for invasive procedures, such as fibrinolytic instillation and thoracoscopy. In conclusion, apart from initial diagnostic procedures, this study showed a lack of mutual consensus among the four countries regarding the management of pediatric parapneumonic effusion. Multicenter prospective trials are clearly needed to acquire more evidence on the management of childhood parapneumonic effusion, enabling the development of evidence-based algorithms that could help to avoid unnecessary examinations with potential long-term side effects, such as radiation exposure at a young age. Pediatr Pulmonol. © 2015 Wiley Periodicals, Inc
A randomized trial of nebulized 3% hypertonic saline with salbutamol in the treatment of acute bronchiolitis in hospitalized infants

OBJECTIVE:
Acute bronchiolitis is a common disorder of infants that often results in hospitalization. Apart from supportive care, no therapy has been shown to influence the course of the disease, except for a possible effect of nebulized hypertonic saline (HS). To determine whether this does have beneficial effects on length of stay in hospital or on severity scores, we undertook a double-blind, randomized, controlled trial in a pediatric department of a Portuguese hospital.
METHODS:
Previously healthy infants, younger than 12 months, hospitalized with mild-to-moderate acute viral bronchiolitis were randomized to receive either nebulized 3% (hypertonic, HS) or 0.9% (normal, NS) saline during their entire hospital stay. Primary endpoints were: length of hospital stay and severity scores on each day of hospitalization. Need for supplemental oxygen, further add-on medications and adverse effects were also analyzed.
RESULTS:
Sixty-eight patients completed the study (HS: 33; NS: 35). The median length of hospital stay did not differ between groups: HS: 5.6 ± 2.3 days; NS: 5.4 ± 2.1 days (P = 0.747). We found no difference between groups in severity scores from day 1 to day 4. There were no differences in need for supplemental oxygen or add-on medications. Patients in HS group had significantly more cough (46% vs. 20%, P = 0.025) and rhinorrhoe (58% vs. 31%, P = 0.30).
CONCLUSION:
This study does not support the use of nebulized HS over NS in therapy of hospitalized children with mild-to-moderate acute viral bronchioliti
Risk factors for adverse outcomes of Indigenous infants hospitalized with bronchiolitis

Hospitalized bronchiolitis imposes a signiﬁcant burden among infants,\ud
particularly among Indigenous children. Traditional or known risk factors for severe disease are\ud
well described, but there are limited data on risks for prolonged hospitalization and persistent\ud
symptoms. Our aims were to determine factors (clinical and microbiological) associated with (i)\ud
prolonged length of stay (LOS); (ii) persistent respiratory symptoms at 3 weeks; (iii) bronchiectasis\ud
up to 24 months post-hospitalisation; and (iv) risk of respiratory readmissions within 6 months.\ud
Methods: Indigenous infants hospitalized with bronchiolitis were enrolled at Royal Darwin Hospital\ud
between 2008 and 2013. Standardized forms were used to record clinical data. A nasopharyngeal\ud
swab was collected at enrolment to identify respiratory viruses and bacteria. Results: The median\ud
age of 232 infants was 5 months (interquartile range 3–9); 65% male. On multivariate regression,\ud
our 12 point severity score (including accessory muscle use) was the only factor associated with\ud
prolonged LOS but the effect was modest (þ 3.0 hr per point, 95%CI: 0.7, 5.1, P ¼ 0.01). Presence\ud
of cough at 3 weeks increased the odds of bronchiectasis (OR 3.0, 95%CI: 1.1, 7.0, P ¼ 0.03).\ud
Factors associated with respiratory readmissions were: previous respiratory hospitalization (OR\ud
2.3, 95%CI: 1.0, 5.4, P ¼ 0.05) and household smoke (OR 2.6, 95%CI: 1.0, 6.3, P ¼ 0.04).\ud
Conclusion: Increased severity score is associated with prolonged LOS in Indigenous children\ud
hospitalized with bronchiolitis. As persistent symptoms at 3 weeks post-hospitalization are\ud
associated with future diagnosis of bronchiectasis, optimising clinical care beyond hospitalization\ud
is needed to improve long-term respiratory outcomes for infants at risk of respiratory disease.\ud
Pediatr Pulmonol. 2016;51:613–623.\ud
ß 2015 Wiley Periodicals, In
Genetic medicines for CF: hype versus reality

Since identification of the CFTR gene over 25 years ago, gene therapy for cystic fibrosis (CF) has been actively developed. More recently gene therapy has been joined by other forms of “genetic medicines” including mRNA delivery, as well as genome editing and mRNA repair-based strategies. Proof-of-concept that gene therapy can stabilize the progression of CF lung disease has recently been established in a Phase IIb trial. An early phase study to assess the safety and explore efficacy of CFTR mRNA repair is ongoing, while mRNA delivery and genome editing-based strategies are currently at the pre-clinical phase of development. This review has been written jointly by some of those involved in the various CF “genetic medicine” fields and will summarize the current state-of-the-art, as well as discuss future developments. Where applicable, it highlights common problems faced by each of the strategies, and also tries to highlight where a specific strategy may have an advantage on the pathway to clinical translation. We hope that this review will contribute to the ongoing discussion about the hype versus reality of genetic medicine-based treatment approaches in CF
Maternal hemoglobin and hematocrit levels during pregnancy and childhood lung function and asthma. The Generation R Study

Objective: To examine the associations of maternal hemoglobin and hematocrit levels during pregnancy with childhood lung function and asthma, and whether adverse pregnancy outcomes and atopic predisposition modify the associations. Methods: In a population-based prospective cohort study among 3672 subjects, we measured maternal hemoglobin and hematocrit levels in early pregnancy, and lung function by spirometry and current asthma by questionnaire at age 10 years. Results: Higher maternal hematocrit levels, both continuously and categorized into clinical cut-offs, were associated with lower forced expiratory flow at 75% of forced vital capacity (FEF75) in children (Z-score (95%CI): −0.04 (−0.07, −0.01), per increase of 1 SDS in hematocrit level; Z-score (95%CI) difference: −0.11 (−0.20, −0.03) compared with normal hematocrit levels, respectively), taking lifestyle and socio-economic factors into account. Adverse pregnancy outcomes and atopic predisposition did not modify the results. No associations of maternal hemoglobin and hematocrit with current asthma were observed. Conclusion: Higher maternal hematocrit levels during pregnancy are associated with lower childhood lung function but not with risk of asthma. Adverse pregnancy outcomes and atopic predisposition do not modify these associations. Underlying mechanisms need to be further studied
Children with severe acute asthma admitted to Dutch PICUs: A changing landscape

The number of children requiring pediatric intensive care unit (PICU) admission for severe acute asthma (SAA) around the world has increased. Objectives: We investigated whether this trend in SAA PICU admissions is present in the Netherlands. Methods: A multicenter retrospective cohort study across all tertiary care PICUs in the Netherlands. Inclusion criteria were children (2-18 years) hospitalized for SAA between 2003 and 2013. Data included demographic data, asthma diagnosis, treatment, and mortality. Results: In the 11-year study period 590 children (660 admissions) were admitted to a PICU with a threefold increase in the number of admissions per year over time. The severity of SAA seemed unchanged, based on the first blood gas, length of stay and mortality rate (0.6%). More children received highflow nasal cannula (P<0.001) and fewer children needed invasive ventilation (P<0.001). In 58% of the patients the maximal intravenous (IV) salbutamol infusion rate during PICU admission was 1mcg/kg/min. However, the number of patients treated with IV salbutamol in the referring hospitals increased significantly over time (P=0.005). The proportion of steroid-naïve patients increased from 35% to 54% (P=0.004), with a significant increase in both age groups (2-4 years [P=0.026] and 5-17 years [P=0.036]). Conclusions: The number of children requiring PICU admission for SAA in the Netherlands has increased. We speculate that this threefold increase is explained by an increasing number of steroid-naïve children, in conjunction with a lowered threshold for PICU admission, possibly caused by earlier use of salbutamol IV in the referring hospitals
Observing Serendipity in Digital Information Environments

We often interact with digital information environments to find useful information. But sometimes useful information finds us unexpectedly, propelling us in new and exciting directions. We might come across information serendipitously when looking for information on something else, or when we are not looking for anything in particular. In previous studies, people have self-reported that they come across information serendipitously. However, there has been limited success in directly observing people doing so. To see if we could have more success, we conducted naturalistic observations of 45 users interacting with different types of digital information environments. Without priming them about serendipity, we asked the users to conduct self-chosen naturalistic information tasks, which varied from broad tasks such as browsing online news to narrow tasks such as finding a particular product to buy. We noted several examples where users either 1) stated they were looking for information on a particular topic or product and unexpectedly found useful/potentially useful information about something else or 2) unexpectedly found useful/potentially useful information when not looking for anything in particular. Our findings suggest that, with a carefully-considered approach, serendipity-related information interaction behaviour can be directly observed. Direct observation allows designers of digital information environments to better understand this behaviour and use this understanding to reason about ways of designing new or improving existing support for serendipity
An Investigation of Retracted Articles in the Biomedical Literature

A major challenge to formal scientific communication is the retraction of published works. This study includes a detailed analysis of retracted articles in biomedical literature, including categorization of the reasons for retraction. The examination covers the years 2010-2014. Analysis also includes citations to articles retraction between 2001 and 2005. The totality of the investigation is couched within the context of communication in the biomedical sciences and, to a lesser extent, of the formulation of theories of citation
Information in crisis : health & technology-related information behaviors of parents in emergency departments

This research examined the information behavior of parents (including legal guardians) during an emergent health situation with a child. Although many studies examine health-related information behaviors, very few explore health consumers' information practices during moments of health crisis. This study explored parents' information needs, source use, and source preferences during a visit to the emergency department. An online questionnaire was administered using iPads given to 897 parents with children at one of 32 participating general emergency departments (ED) across Canada. Before taking their child to the ED, only 38.8% (n=348) of parents looked for information; those who did search looked most frequently for information about specific symptoms or severity of illness. Prior to visiting the ED the sources most frequently accessed were the internet and direct contact with healthcare professionals. At the emergency department, parents' information needs centred on immediate concerns, including explanations of their child's illness, treatments, and care instructions. Household income, education level, and parents' age were factors that affected information seeking in emergent health situations. Overwhelmingly, speaking to a healthcare professional in person is the typical and preferred way to obtain health information when facing a health crisis involving a child. The results have implications for how and when healthcare information is shared; the findings add to the limited research on parents' information behavior, particularly their roles as information proxies for their children
Investigating perceptions and support for transparency and openness in research: Using card sorting in a pilot study with academic librarians

Copyright © 2016 by Association for Information Science and Technology This paper explores the role of academic librarians as advocates for research transparency and open research. We describe the design and piloting of a qualitative card-sorting research protocol that investigates academic librarians' attitudes, awareness and practices related to research transparency. We report on preliminary results from interviews with librarians, presenting their conceptualizations of research transparency and open research, existing library services that support and advocate for both concepts, and potential services that would augment this support and advocacy. Library activities they feel are most important to the advancement of transparency and openness are identified and perceptions of disciplinary differences are noted
Pienapple search : an integrated search interface to support finding, refinding and sharing

Pienapple is a search interface that aims to combine bookmarking and searching within a blended experience to facilitate improved access, serendipity, and sharing. While personal and social bookmarking platforms already exist, they are often separated from the search system, resulting in an increased effort and complexity because two or more systems need to be used. Instead, Pienapple attempts to lower the overall effort of bookmarking, (re)accessing and sharing by bringing these activities together to provide a more supportive search interface