bluuebunny/crossref_metadata_2025_split huggingface dataset:
DOZ047.81: Neurodevelopmental outcome in infants with AE: developmental trajectories in the first year of life
Authors: Bevilacqua F , Ragni B , Valfrè L , Conforti A , Braguglia A , Bagolan P , Aite L 
Published: June 2019

Abstract

Background
Esophageal atresia (EA) prognosis have improved significantly over the past three decades. Research and clinical attention has shifted to neurodevelopmental outcomes and quality of life.

Aim
The aim of this study wasto examine neurodevelopmental outcomes and to identify clinical and sociodemographic risk factors in a cohort of infants with EA.

Methods
An observational prospective longitudinal study was conducted between 2009 and 2017. Neurodevelopment was assessed at 6 and 12 months by Bayley Scales of Infants and Toddler Development—3rd Edition. Clinical and sociodemographic variables included were gender, birthweight, gestational age, associated malformations, number of hospitalizations, surgeries and dilatations at 12 months, days of mechanical ventilation, parental age, education level, and socioeconomic status.

Results
Ninety-six infants were enrolled in the study at 6 months and 73 of them were evaluated also at 12 months. Analysis showed significant differences between motor development at 6 and 12 months (M6 = 95.39, SD = 15.71; M12 = 91.83, SD = 12.87; t = 0.245, P = 0.017); significant differences emerged also between cognitive development at 6 and 12 months (M6 = 91.80, SD = 11.70; M12 = 100.92, SD = 15.39; t = −5.10, p = .000). Infants with long-gap AE achieved the worst scores in cognitive (r = -.28, P < .01) and motor scales (r = -.36, P < .01) at 6 months and in motor scale at 12 months (r = −0.30, P < 0.05). More days of mechanical ventilation were related to a lower score in both the cognitive (6 months r = −0.26, P < 0.05; 12 months r = −0.26, P < 0.05) and motor scale (6 months: r = −0.38, P < 0.01; 12 months r = −0.42, P < 0.01). A major number of interventions in the first year of life were related to lower scores in the motor scale at 12 months (r = −0.43, P < 0.01).

Conclusions
Infants operated on for AE are at risk of neurodevelopmental impairment in the first year of life. Findings support the association between neurodevelopmental outcomes and clinical risk factors. Careful interdisciplinary follow-up is essential for early detection of neurodevelopmental delay.
DOZ047.82: Outcome of thoracoscopic repair of type C esophageal atresia: single-center experience from North Africa
Authors: Elbarbary M , Shalaby A , Elseoudi M , Ragab M , Fares A E , Khairy D , Wishahy A M K , Seleim H , Eltagy G , Bahaaeldin K 
Published: June 2019

Abstract

Background and Aim
Thoracoscopic repair of esophageal atresia is gaining popularity worldwide owing to the availability of and advances in minimally invasive instruments. This report presents our early experience of thoracoscopic esophageal atresia repair (EA/TEF) in a single institute.

Methods
A prospective study on short-gap type C EA/TEF was conducted at Cairo University Specialized Pediatric Hospital from April 2016. The technique was standardized in all cases: patients placed in the fully prone position, and using a 5 mm 30° scope with 3 mm instruments and carried out by four experts in minimally invasive surgery. Data was collected to include patient demographics and operative time. The main outcome was survival. Secondary outcomes were leak rate and postoperative stricture.

Results
Over a period of 24 months (April 2016–April 2018) 136 cases of EA/TEF were admitted. Thoracoscopy was attempted in 76 cases. Thirty cases with pure atresia or long-gap anomaly were excluded from this study for gap length, leaving 46 (60%) nonconsecutive neonates who underwent thoracoscopic repair of their short-gap EA/TEF. Five cases (10.8%) were converted to open surgery via right thoracotomy. A primary anastomosis was possible in all cases, leaving the azygos intact. The mean age at operation was 8.7 days (range 2–32), the mean weight was 2.6 kg (range 1.8–3.6), and the mean operative time was 108.3 minutes (range 80–180). In the fully thoracoscopic patients the survival was 85.4% (n = 35). An anastomotic leak occurred in 17% (n = 7); it was managed conservatively in 2 and with esophagostomy and gastrostomy in 5 cases. Followup was at one week, one and three months postdischarge. A stricture developed in 5 (16.6%) of the 30 surviving patients who kept their native esophagus.

Conclusions
Thoracoscopic repair is a feasible alternative even in a low-resource setting. The better outcome compared to traditional open repair in our center may be due to patient selection bias.
DOZ047.85: Percutaneous tracheostomy guided by endoscopy in pediatric patients
Authors: Urquizo M , Lobos P , Coraglia C , Mercado P , Gallegos D F 
Published: June 2019

Abstract

Objective
Tracheostomy is one of the most frequently performed surgical procedures in chronically ill pediatric patients and mechanical ventilatory assistance. This study presents our experience in percutaneous tracheostomy (PT) guided by endoscopy in children.

Methodology
A retrospective descriptive analysis was carried out in which the PT guided by endoscopy from December 2010 to October 2017 at Pediatric Surgery Service of the Hospital Italiano de Buenos Aires were considered. The variables analyzed were age, gender, basic pathology, tracheostomy indication, size of the cannula placed, surgical complications, and follow-up. At the same time, an updated bibliographical search on the subject was carried out. All the parents of the patients gave written consent.

Results and Discussion
A total of 50 PT guided by endoscopy were performed. The average age was 9.4 years (05–19 years). The male/female ratio was 1 (25 men, 25 women). The tracheostomy indications were prolonged orotracheal intubation (n: 41), lack of airway protection (n: 4), laryngomalacia (n: 2), difficult airway (n: 2), and laryngotracheal stenosis (n: 1). The endoscopic findings include glottic lesion, subglottic stenosis, vocal cord injury, and tracheal lesions by decubitus. There were no intraoperative complications. The average surgical time was 44 minutes (r: 10–60 min). The rate of postoperative complications was 6% (n: 3), among which were accidental decannulation, desaturation, and leakage. Distant complications such as tracheitis or granulomas occurred in 8% of patients (n: 4). The definitive decannulation was achieved in 19 patients in an average time of 15 days.

Conclusions
PT is feasible in children with a margin of safety comparable to tracheostomy by conventional technique. Simultaneous endoscopic vision is recommended for the control of complications during the procedure, in part because it offers firmness to the anterior wall of the trachea. At the same time it allows us to diagnose preexisting laryngotracheal lesions or anomalies. The size of the tracheostomy kit should be adjusted to the age of the patient to perform a safe tracheostomy. Due to the small diameter of the trachea and its weakness, it is not recommended by us to perform percutaneous tracheostomy in patients under 2 years of age.
DOZ047.89: Thoracoscopic (TS) management of early complications after esophageal atresia (EA) correction: single center experience
Authors: Andreetta M , Erculiani M , Leon F F , Gamba P 
Published: June 2019

Abstract

Background
Early complications and their surgical management after esophageal atresia (EA) correction aren’t largely described in the literature. Anastomotic stricture and anastomotic leakage are the most commonly described. Those, along with iatrogenic chylothorax, are safely managed with a conservative approach. Surgery is indicated for nonresponding cases and often carries major invasiveness. This study reports thoracoscopy use for EA complications at our center in a 2-year period (2017–2018).

Case Reports
Case 1, birth weight (BW) 1550 gr, presented respiratory difficulties 6 days after open surgery: chest X-ray revealed right diaphragmatic eventration probably due to phrenic nerve damage; Case 2 (BW 3420 gr) presented anastomotic dehiscence with salivary traces in drainage tube, 9 days after thoracoscopic (TS) repair with azygos vein sparing; Case 3 (BW 2530 gr) developed right chylothorax 13 days after right thoracotomy following primary TS left approach for dextrocardia (5 days after oral feeding was started) resistant to Octreotide treatment. All cases were successfully treated with TS technique. Case 1 underwent TS right diaphragmatic plication after an initial conservative approach. In case 2 we performed TS anastomosis revision with bovine pericardium patch apposition. Case 3 underwent right TS cruentation and glueing of the right costophrenic recess (6 weeks after surgery) for chylothorax persistence despite 22 days of Octreotide therapy. No intra- or postoperative complication occurred. A TS approach for EA repair is replacing open surgery, which is nowadays limited to selected neonates. The open technique seems to increase the risk of postoperative early complications, probably because thoracoscopy allows optimal anatomy visualization and minimal tissue handling. It is also postulated that TS azygos sparing may be a preventive factor against anastomotic leakage, even though it can be technically demanding. Furthermore, thoracoscopy can reduce invasiveness in the case of a diagnostic maneuver such as left anatomy exploration.

Conclusions
Early surgical complications after EA repair are rare, and can be safely treated with a TS approach, regardless of the primary surgical technique. If properly managed, they have good prognosis. Benefits of TS EA repair are widely known, and early reintervention for complications with this technique seems to be safe and justified in centers where neonatal MIS is the –first-choice approach.
Successful treatment of cardiac haemangiomas with oral propranolol: a case series of two patients
Authors: Polymerou Ioannis , Ojala Tiina , Bonou Pipina , Martelius Laura , Tzifa Aphrodite 
Published: June 2019

AbstractBackgroundCardiac haemangiomas are extremely rare tumours with equivocal surgical outcomes. Haemangiomas appearing on other sites of the body have been successfully treated with oral propranolol. To the best of our knowledge, such treatment has not been tried to date for cardiac location of haemangiomas.Case summaryWe report two cases of neonatal cardiac haemangiomas, and we describe their presentation and characteristics, as well as how these were successfully treated with oral propranolol, with complete regression of the tumours within the 1st year of life.DiscussionDespite the rarity of cardiac haemangiomas, their presentation and complications could be dramatic with side-effects spanning from intracardiac space occupying phenomena to Kasabach–Merritt syndrome. Propranolol therapy, having been established for long now in the treatment of skin haemangiomas, should also be considered in cases of cardiac haemangiomas, particularly in the neonatal and infantile population.
Elastica degeneration and intimal hyperplasia lead to Contegra® conduit failure
Authors: Peivandi Armin Darius , Seiler Martina , Mueller Klaus-Michael , Martens Sven , Malec Edward , Asfour Boulos , Lueck Sabrina 
Published: June 2019

Abstract

OBJECTIVES
Currently, Contegra® grafts (processed bovine jugular vein conduits) are widely used for reconstructive surgery of the right ventricular outflow tract in patients with congenital heart disease (CHD). We analysed explanted Contegra conduits from 2 institutions histologically to get a possible hint at the underlying pathomechanisms of degenerative alterations and to find histological correlations of graft failure. Additionally, we compared the explants with a non-implanted processed graft and a native jugular vein obtained from a young bull.

METHODS
The explanted Contegra grafts were gathered during reoperations of 13 patients (male: n = 9, 69.2%; female: n = 4, 30.8%). After standardized histological preparation, samples were stained with dyes haematoxylin and eosin and Elastica van Gieson. Additionally, X-ray pictures revealed the extent of calcification and chelaplex (III)-descaling agent was used to decalcify selected explants.

RESULTS
Processing of the native jugular vein leads to tissue loosening and a loss of elastic fibres. For graft failure after implantation, 2 pathomechanisms were identified: original graft alteration as well as intimal hyperplasia. Elastica degeneration and rearrangement with interfibrillary matrix structures were the main developments observed within the graft itself. Intimal hyperplasia was characterized by fibrous tissue apposition, calcification and heterotopic ossification.

CONCLUSIONS
Regression of the elastic fibre network leads to rigidification of the conduit. In Contegra grafts, atherosclerosis-like changes can be considered the leading cause of graft stenosis and insufficiency. We conclude that both observed mechanisms lead to early reoperation in CHD patients.
A Single Dose of Dietary Nitrate Increases Maximal Knee Extensor Angular Velocity and Power in Healthy Older Men and Women
Authors: Coggan Andrew R , Hoffman Richard L , Gray Derrick A , Moorthi Ranjani N , Thomas Deepak P , Leibowitz Joshua L , Thies Dakkota , Peterson Linda R 
Published: June 2019

Abstract

Background
Aging results in reductions in maximal muscular strength, speed, and power, which often lead to functional limitations highly predictive of disability, institutionalization, and mortality in elderly adults. This may be partially due to reduced nitric oxide (NO) bioavailability. We, therefore, hypothesized that dietary nitrate (NO3−), a source of NO via the NO3− → nitrite (NO2−) → NO enterosalivary pathway, could increase muscle contractile function in older subjects.

Methods
Twelve healthy older (age 71 ± 5 years) men and women were studied using a randomized, double-blind, placebo-controlled, crossover design. After fasting overnight, subjects were tested 2 hours after ingesting beetroot juice containing or devoid of 13.4 ± 1.6 mmol NO3−. Plasma NO3− and NO2− and breath NO were measured periodically, and muscle function was determined using isokinetic dynamometry.

Results
N O 3 − ingestion increased (p &lt; .001) plasma NO3−, plasma NO2−, and breath NO by 1,051% ± 433%, 138% ± 149%, and 111% ± 115%, respectively. Maximal velocity of knee extension increased (p &lt; .01) by 10.9% ± 12.1%. Maximal knee extensor power increased (p &lt; .05) by 4.4% ± 7.8%.

Conclusions
Acute dietary NO3− intake improves maximal knee extensor angular velocity and power in older individuals. These findings may have important implications for this population, in whom diminished muscle function can lead to functional limitations, dependence, and even premature death.
Viral DNA Loads in Various Blood Components of Patients With Epstein-Barr Virus–Positive T-Cell/Natural Killer Cell Lymphoproliferative Diseases
Authors: Kawada Jun-ichi , Kamiya Yasuko , Sawada Akihisa , Iwatsuki Keiji , Izutsu Koji , Torii Yuka , Kimura Hiroshi , Ito Yoshinori 
Published: June 2019

AbstractTo evaluate diagnostic values for Epstein-Barr virus (EBV) DNA loads in different blood components of patients with EBV-positive T-cell/natural killer cell lymphoproliferative diseases, EBV DNA loads were compared among disease categories in each blood component from 59 patients. Plasma viral loads were significantly higher in “active” disease in chronic active EBV infection. EBV DNA was not detected in the plasma from 7 patients in whom EBV DNA was detected in peripheral blood mononuclear cells and whole blood. Diagnostic cutoff values for whole blood EBV DNA loads of patients with chronic active EBV infection compared with those of infectious mononucleosis was 104.2 (15 800) IU/mL.
High relative reliability and responsiveness of the forgotten joint score-12 in patients with femoroacetabular impingement undergoing hip arthroscopic treatment. A prospective survey-based study
Authors: Bramming Ida Birgitte , Kierkegaard Signe , Lund Bent , Jakobsen Stig S , Mechlenburg Inger 
Published: June 2019

AbstractThe forgotten joint score-12 (FJS-12) may be an advantageous questionnaire in young patients with high hip function and a low level of pain. We investigated the reliability and the responsiveness of the FJS-12 in patients with femoroacetabular impingement undergoing hip arthroscopic treatment. Fifty patients were included in the reliability study and 34 patients were included in the responsiveness study. Test–retest reliability was assessed with intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). Responsiveness was assessed from testing correlations between the FJS-12 and the Copenhagen Hip and Groin Outcome Score (HAGOS) of the change score, effect size (ES) and standardized response mean (SRM). Floor and ceiling effect were defined as present if the number of patients obtaining the maximum (100) and minimum score (0) exceeded 15%. The relative reliability was high (ICC = 0.9, 95% CI: 0.8–0.9) and the absolute reliability was low (SEM = 11, MDCindividual = 32, MDCgroup = 4.5). The responsiveness was high, and the change score was highly correlated with the subscale ‘pain’ from the HAGOS and moderately correlated with the subscale ‘ADL’. Furthermore, the FJS-12 exceeded or equalled the HAGOS subscales in ES and SRM. Below 15% of the patients scored the maximum or minimum score. The FJS-12 has high reliability, high responsiveness to change and shows no floor or ceiling effect.
Hybrid LWFA–PWFA staging as a beam energy and brightness transformer: conceptual design and simulations
Authors: Martinez de la Ossa A. , Assmann R. W. , Bussmann M. , Corde S. , Couperus Cabadağ J. P. , Debus A. , Döpp A. , Ferran Pousa A. , Gilljohann M. F. , Heinemann T. , Hidding B. , Irman A. , Karsch S. , Kononenko O. , Kurz T. , Osterhoff J. , Pausch R. , Schöbel S. , Schramm U. 
Published: June 2019

We present a conceptual design for a hybrid laser-driven plasma wakefield accelerator (LWFA) to beam-driven plasma wakefield accelerator (PWFA). In this set-up, the output beams from an LWFA stage are used as input beams of a new PWFA stage. In the PWFA stage, a new witness beam of largely increased quality can be produced and accelerated to higher energies. The feasibility and the potential of this concept is shown through exemplary particle-in-cell simulations. In addition, preliminary simulation results for a proof-of-concept experiment in Helmholtz-Zentrum Dresden-Rossendorf (Germany) are shown.
This article is part of the Theo Murphy meeting issue ‘Directions in particle beam-driven plasma wakefield acceleration’.
NON-RANDOM TIMING OF ECOLOGICAL SHIFTS ON CARIBBEAN CORAL REEFS SUGGESTS REGIONAL CAUSES OF CHANGE
Authors: Precht William F. , Aronson Richard B. , Gardner Toby A. , Gill Jennifer A. , Hawkins Julie P. , Hernández-Delgado Edwin A. , Jaap Walter C. , Mcclanahan Tim R. , Mcfield Melanie D. , Murdoch Thaddeus J.T. , Nugues Maggy M. , Roberts Callum M. , Schelten Christiane K. , Watkinson Andrew R. , Côté Isabelle M. 
Published: June 2019

AbstractCaribbean reefs have experienced unprecedented changes in the past four decades. Of great concern is the perceived widespread shift from coral to macroalgal dominance and the question of whether it represents a new, stable equilibrium for coral-reef communities. The primary causes of the shift -- grazing pressure (top-down), nutrient loading (bottom-up) or direct coral mortality (side-in) -- still remain somewhat controversial in the coral reef literature. We have attempted to tease out the relative importance of each of these causes. Four insights emerge from our analysis of an early regional dataset of information on the benthic composition of Caribbean reefs spanning the years 1977–2001. First, although three-quarters of reef sites have experienced coral declines concomitant with macroalgal increases, fewer than 10% of the more than 200 sites studied were dominated by macroalgae in 2001, by even the most conservative definition of dominance. Using relative dominance as the threshold, a total of 49 coral-to-macroalgae shifts were detected. This total represents ∼35% of all sites that were dominated by coral at the start of their monitoring periods. Four shifts (8.2%) occurred because of coral loss with no change in macroalgal cover, 15 (30.6%) occurred because of macroalgal gain without coral loss, and 30 (61.2%) occurred owing to concomitant coral decline and macroalgal increase. Second, the timing of shifts at the regional scale is most consistent with the side-in model of reef degradation, which invokes coral mortality as a precursor to macroalgal takeover, because more shifts occurred after regional coral-mortality events than expected by chance. Third, instantaneous observations taken at the start and end of the time-series for individual sites showed these reefs existed along a continuum of coral and macroalgal cover. The continuous, broadly negative relationship between coral and macroalgal cover suggests that in some cases coral-to-macroalgae phase shifts may be reversed by removing sources of perturbation or restoring critical components such as the herbivorous sea urchin Diadema antillarum to the system. The five instances in which macroalgal dominance was reversed corroborate the conclusion that macroalgal dominance is not a stable, alternative community state as has been commonly assumed. Fourth, the fact that the loss in regional coral cover and concomitant changes to the benthic community are related to punctuated, discrete events with known causes (i.e. coral disease and bleaching), lends credence to the hypothesis that coral reefs of the Caribbean have been under assault from climate-change-related maladies since the 1970s.
Deep data mining reveals variable abundance and distribution of microbial reproductive manipulators within and among diverse host species
Authors: Medina Paloma , Russell Shelbi L , Aswadhati Kavya , Corbett-Detig Russell 
Published: June 2019

AbstractBacterial symbionts that manipulate the reproduction of their hosts are important factors in invertebrate ecology and evolution. Studying the genomic and phenotypic diversity of reproductive manipulators can improve efforts to control infectious diseases and contribute to our understanding of host-symbiont evolution. Despite the vast genomic and phenotypic diversity of reproductive manipulators, only a handful of strains are used as biological control agents because little is known about the broad scale infection frequencies and densities of these bacteria in nature. Here we develop a data mining approach to quantify the number of arthropod and nematode host species infected withWolbachiaand other reproductive manipulators such asRickettsiaandSpiroplasma. Across the entire Sequence Read Archive (SRA) database, we found reproductive manipulators infected 2,083 arthropod and 119 nematode samples, representing 240 and 8 species, respectively. After accounting for sampling and infection frequency differences among species, we estimated thatWolbachiainfects approximately 44% of all arthropod species and 34% of all nematode species. In contrast, we estimated other reproductive manipulators infect 1-8% of arthropod and nematode species. Next, we explored another important biological parameter: the relative bacterial density, or titer, within hosts. We found variation in titer within and between arthropod species to be large, and that host species explains approximately 36% of variation in titer across our dataset. This suggests bacterial strain and/or host species plays a role in shaping bacterial densities within and between host species. By leveraging the model systemDrosophila melanogaster, we also found a number of host SNPs associated with titer in genes potentially relevant to host interactions withWolbachia, suggesting bacterial induced host genome evolution. Our study demonstrates that data mining is a powerful tool to understand host-symbiont co-evolution and opens an array of previously inaccessible questions for further analysis.