PROGNOSTIC ACCURACY OF MACHINE LEARNING MODELS FOR IN-HOSPITAL MORTALITY AMONG CHILDREN WITH PHOENIX SEPSIS ADMITTED TO THE PEDIATRIC INTENSIVE CARE UNIT.

Objective: The Phoenix sepsis criteria define sepsis in children with suspected or confirmed infection who have ≥2 in the Phoenix Sepsis Score. The adoption of the Phoenix sepsis criteria eliminated the Systemic Inflammatory Response Syndrome criteria from the definition of pediatric sepsis. The objective of this study is to derive and validate machine learning models predicting in-hospital mortality for children with suspected or confirmed infection or who met the Phoenix sepsis criteria for sepsis and septic shock.

RNA Sequencing Analysis of Monocytes Exposed to Airway Fluid From Children With Pediatric Acute Respiratory Distress Syndrome.

Objectives: Monocytes are plastic cells that assume different polarization states that can either promote inflammation or tissue repair and inflammation resolution. Polarized monocytes are partially defined by their transcriptional profiles that are influenced by environmental stimuli. The airway monocyte response in pediatric acute respiratory distress syndrome (PARDS) is undefined.

RNA Sequencing Analysis of CD4 T Cells Exposed to Airway Fluid From Children With Pediatric Acute Respiratory Distress Syndrome.

Unlabelled: CD4 T cells contribute to lung inflammation in acute respiratory distress syndrome. The CD4 T-cell response in pediatric acute respiratory distress syndrome (PARDS) is unknown.

Objectives: To identify differentially expressed genes and networks using a novel transcriptomic reporter assay with donor CD4 T cells exposed to the airway fluid of intubated children with mild versus severe PARDS.

Identification of a pediatric acute hypoxemic respiratory failure signature in peripheral blood leukocytes at 24 hours post-ICU admission with machine learning.

Background: There is no generalizable transcriptomics signature of pediatric acute respiratory distress syndrome. Our goal was to identify a whole blood differential gene expression signature for pediatric acute hypoxemic respiratory failure (AHRF) using transcriptomic microarrays within twenty-four hours of diagnosis. We used publicly available human whole-blood gene expression arrays of a Berlin-defined pediatric acute respiratory distress syndrome (GSE147902) cohort and a sepsis-triggered AHRF (GSE66099) cohort within twenty-four hours of diagnosis and compared those children with a PO/FO < 200 to those with a PO/FO ≥ 200.

Cluster analysis of plasma cytokines identifies two unique endotypes of children with asthma in the pediatric intensive care unit.

Children with life-threatening asthma exacerbations who are admitted to a pediatric intensive care unit (PICU) are a heterogeneous group with poorly studied inflammatory features. We hypothesized that distinct clusters of children with asthma in a PICU would be identified based on differences in plasma cytokine levels and that these clusters would have differing underlying inflammation and asthma outcomes within 1 year. Plasma cytokines and differential gene expression were measured in neutrophils isolated from children admitted to a PICU for asthma.

Expression Patterns of Airway Fluid Cytokines From Intubated Children With Pediatric Acute Respiratory Distress Syndrome.

Unlabelled: Pediatric acute respiratory distress syndrome (PARDS) is a heterogeneous illness affecting 6% of mechanically ventilated children and with an overall mortality of 17%. Studies in PARDS have mainly focused on plasma biomarkers which may not reflect airway biomarkers. We lack adequate understanding of the inflammatory mediators and underlying immune responses in the airways of PARDS patients.

Temperamental Emotionality Attributes as Antecedents of Children's Social Information Processing.

This study examined temperament dimensions of emotion as precursors of children's social information processing (SIP) of stressful peer events. Two hundred and forty-three preschool children (M = 4.60 years) and their primary caregivers participated in two measurement occasions spaced 2 years apart.

The Impact of Centrosome Pathologies on Prostate Cancer Development and Progression.

The significant role of centrosomes in cancer cell proliferation has been well recognized (reviewed in Schatten H, Histochem Cell Biol 129:667-86 (2008); Schatten H, Sun Q-Y, Microsc Microanal 17(4):506-512 (2011); Schatten H, Sun Q-Y, Reprod Fertil Dev. https://doi.org/10.

Interparental hostility and children's externalizing symptoms: Attention to anger as a mediator.

This study examined children's attention biases to negative emotional stimuli as mediators of associations between interparental hostility and children's externalizing symptoms. Participants included 243 children (Mage = 4.60 years) and their parents and teachers across three annual measurement occasions.

The distinctive sequelae of children's coping with interparental conflict: Testing the reformulated emotional security theory.

Two studies tested hypotheses about the distinctive psychological consequences of children's patterns of responding to interparental conflict. In Study 1, 174 preschool children (M = 4.0 years) and their mothers participated in a cross-sectional design.

Text message interventions for follow up of infants born to mothers positive for Chagas disease in Tucumán, Argentina: a feasibility study.

Background: Diagnosis of congenital Chagas disease occurs at 9 months of age, making effective treatment challenging due to loss to follow-up. Mobile health (mHealth) has been utilized to improve communication and treatment adherence in many chronic diseases, although no studies of mHealth in Trypanosoma cruzi-infected individuals have been conducted. Text message interventions, a subset of mHealth, has shown to improve appointment attendance and is relatively simple to set up, thus making it an ideal mechanism to facilitate communication with individuals in low-resource settings.

Activation of c-Myc and Cyclin D1 by JCV T-Antigen and β-catenin in colon cancer.

During the last decade, mounting evidence has implicated the human neurotropic virus JC virus in the pathology of colon cancer. However, the mechanisms of JC virus-mediated oncogenesis are still not fully determined. One candidate to mediate these effects is the viral early transcriptional product T-Antigen, which has the ability to inactivate cell cycle regulatory proteins such as p53.

[Correlation between the changes of oxidation reduction potential values and postmortem interval of heart blood in rabbits after death].

Objective: To investigate correlation between the changes of oxidation reduction potential (ORP) values of heart blood in rabbits after death and postmortem interval (PMI) at different temperatures.

Methods: Forty-eight rabbits were randomly divided into 6 groups and sacrificed by air embolism. Blood samples were taken from the right ventricle of each rabbit and stored at different temperatures of 10, 15, 20, 25, 30 and 35 degrees C, respectively.

Preliminary study on diffuse axonal injury by Fourier transform infrared spectroscopy histopathology imaging.

The objective of this study was to evaluate the application of Fourier transform infrared (FTIR) spectroscopy for detecting diffuse axonal injury (DAI) in a mouse model. Brain tissues from DAI mouse model were prepared with H&E, silver, and β-amyloid precursor protein (β-APP) immunohistochemistry stains and were also studied with FTIR. The infrared spectrum images showed high absorption of amide II in the subcortical white matter of the experimental mouse brain, while there was no obvious expression of amide II in the control mouse brain.

Methylenedioxypyrovalerone ("bath salts"), related death: case report and review of the literature.

Cathinone derivatives (bath salts) have emerged as the latest drugs of abuse. 3,4-methylenedioxypyrovalerone (MDPV) is the primary active ingredient in bath salts used in this country. This article presents the second reported cause of death by MDPV intoxication alone.

Anaphylaxis after the injection of buprenorphine.

Cause of death rulings in cases when the concentration of a drug or drugs is higher than observed following therapeutic use are generally straightforward "drug deaths." However, when toxicology testing identifies drug concentrations consistent with therapeutic use or detects no drugs at all, then the cause of death determination is more complicated. Given the rapidity and protean manifestations of anaphylaxis, it should be considered in deaths where no other cause of death is apparent in a suspected drug death.

Mammalian complex I pumps 4 protons per 2 electrons at high and physiological proton motive force in living cells.

Mitochondrial complex I couples electron transfer between matrix NADH and inner-membrane ubiquinone to the pumping of protons against a proton motive force. The accepted proton pumping stoichiometry was 4 protons per 2 electrons transferred (4H(+)/2e(-)) but it has been suggested that stoichiometry may be 3H(+)/2e(-) based on the identification of only 3 proton pumping units in the crystal structure and a revision of the previous experimental data. Measurement of proton pumping stoichiometry is challenging because, even in isolated mitochondria, it is difficult to measure the proton motive force while simultaneously measuring the redox potentials of the NADH/NAD(+) and ubiquinol/ubiquinone pools.

Acute mitochondrial inhibition by mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK) 1/2 inhibitors regulates proliferation.

The Ras-MEK1/2-ERK1/2 kinase signaling pathway regulates proliferation, survival, and differentiation and, because it is often aberrant in tumors, is a popular target for small molecule inhibition. A novel metabolic analysis that measures the real-time oxidation state of NAD(H) and the hemes of the electron transport chain and oxygen consumption within intact, living cells found that structurally distinct MEK1/2 inhibitors had an immediate, dose-dependent effect on mitochondrial metabolism. The inhibitors U0126, MIIC and PD98059 caused NAD(H) reduction, heme oxidation, and decreased oxygen consumption, characteristic of complex I inhibition.

Measurement of the oxidation state of mitochondrial cytochrome c from the neocortex of the mammalian brain.

Diffuse optical remission spectra from the mammalian neocortex at visible wavelengths contain spectral features originating from the mitochondria. A new algorithm is presented, based on analytically relating the first differential of the attenuation spectrum to the first differential of the chromophore spectra, that can separate and calculate the oxidation state of cytochrome c as well as the absolute concentration and saturation of hemoglobin. The algorithm is validated in phantoms and then tested on the neocortex of the rat during an anoxic challenge.

Diabetic ketoacidosis: a silent death.

Diabetic ketoacidosis (DKA) results from severe insulin deficiency and can be diagnosed at autopsy despite no known history of the disease. Diabetic ketoacidosis may be the initial manifestation of type 1 diabetes or may result from increased insulin requirement in type 1 diabetic patients. The purpose of this study was to determine the percentage of DKA death investigated by the Office of Chief Medical Examiner that was not associated with a known history of diabetes.

Cardiomegaly is a common arrhythmogenic substrate in adult sudden cardiac deaths, and is associated with obesity.

Background: Both coronary artery disease (CAD) and cardiomyopathy may present with sudden cardiac death (SCD). It is generally accepted that CAD is the most common cause of SCD in adults, but the frequency of cardiomegaly as a primary or contributing cause is less known.

Methods: We retrospectively studied the cardiac findings of all cases of adult SCD attributed to cardiomegaly, severe atherosclerosis, or both, in the absence of specific cardiomyopathy.

Measurement of the mitochondrial membrane potential and pH gradient from the redox poise of the hemes of the bc1 complex.

The redox potentials of the hemes of the mitochondrial bc(1) complex are dependent on the proton-motive force due to the energy transduction. This allows the membrane potential and pH gradient components to be calculated from the oxidation state of the hemes measured with multi-wavelength cell spectroscopy. Oxidation states were measured in living RAW 264.

[Analysis of death cases involved in TASER in the State of Maryland].

Objective: To evaluate the features of autopsy cases involved in electronic weapon (TASER) in the State of Maryland, and to discuss the appraisable points.

Methods: Thirteen autopsy cases involving TASER were collected from 2004 to 2011 in the Office of the Chief Medical Examiner, State of Maryland. All the cases include detailed scene investigations, complete autopsy, toxicological analysis and histopathological examination.

The role of focal myocardial inflammation in sudden unexpected cardiac and noncardiac deaths--a clinicopathological study.

The significance of focal myocardial inflammation in sudden death is poorly understood, because there are few studies addressing its frequency in noncardiac and cardiac arrhythmic deaths. We prospectively assessed inflammation in 384 consecutive hearts seen in consultation from a single medical examiners' office. Hearts were received intact and sectioned uniformly in five areas and reviewed histologically by a single pathologist.

Spectral components of the α-band of cytochrome oxidase.

Oxidative redox titrations of the mitochondrial cytochromes were performed in near-anoxic RAW 264.7 cells by inhibiting complex I. Cytochrome oxidation changes were measured with multi-wavelength spectroscopy and the ambient redox potential was calculated from the oxidation state of endogenous cytochrome c.