bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary Evaluation of a Brief Autism Screener for Young Children
Authors: Zahorodny Walter , Shenouda Josephine , Mehta Uday , Yee Emily , Garcia Patricia , Rajan Mangala , Goldfarb Madeleine 
Published: January 2018

ABSTRACT:

Objective:
Our objective was to assess the operating characteristics of the Psychological Development Questionnaire-1 (PDQ-1), an autism screener for use with young children.

Methods:
In Phase 1, we evaluated the concordance of the PDQ-1 with established autism scales, determined test-retest reliability, and identified a risk threshold score. In Phase 2, a population of 1959 toddler-age children was prospectively screened through multiple pediatric practices in a diverse metropolitan region, using the new instrument. Screen-positive children were referred for diagnostic evaluation. Screened children received follow-up at age 4 years to identify autism cases missed by screening and to specify the scale's psychometric properties.

Results:
By screening a diverse population of low risk children, age 18 to 36 months, with the PDQ-1, we detected individuals with autism who had not come to professional attention. Overall, the PDQ-1 showed a positive predictive value (PPV) of 88%, with a sensitivity of 85% and specificity of 99% in a low risk population. High specificity, good sensitivity, and PPV were observed across the 18 to 36 month age-range.

Conclusion:
The findings provide preliminary empirical support for this parent report–based indicator of toddler psychological development and suggest that the PDQ-1 may be a useful supplement to developmental surveillance of autism. Additional research is needed with high risk samples and large, unselected populations under real-world conditions.
Genomics of Cardiovascular Measures of Autonomic Tone
Authors: Sigurdsson Martin I. , Waldron Nathan H. , Bortsov Andrey V. , Smith Shad B. , Maixner William 
Published: January 2018

Abstract:The autonomic nervous system exerts broad control over the involuntary functions of the human body through complex equilibrium between sympathetic and parasympathetic tone. Imbalance in this equilibrium is associated with a multitude of cardiovascular outcomes, including mortality. The cardiovascular static state of this equilibrium can be quantified using physiological parameters such as heart rate (HR), blood pressure, and by spectral analysis of HR variability. Here, we review the current state of knowledge of the genetic background of cardiovascular measurements of autonomic tone. For most parameters of autonomic tone, a large portion of variability is explained by genetic heritability. Many of the static parameters of autonomic tone have also been studied through candidate-gene approach, yielding some insight into how genotypes of adrenergic receptors affect variables such as HR. Genome-wide approaches in large cohorts similarly exist for static variables such as HR and blood pressure but less is known about the genetic background of the dynamic and more specific measurements, such as HR variability. Furthermore, because most autonomic measures are likely polygenic, pathway analyses and modeling of polygenic effects are critical. Future work will hopefully explain the control of autonomic tone and guide individualized therapeutic interventions.
Clinical and Environmental Risk Factors for Bipolar Disorder: Review of Prospective Studies
Authors: Marangoni Ciro , Faedda Gianni L. , Baldessarini Ross J. 
Published: January 2018

Learning objectives
After participating in this activity, learners should be better able to:
• Evaluate factors that have been identified in prospective studies as predicting the onset of bipolar disorder

Abstract
The prodromal phase of bipolar disorder (BD) remains incompletely characterized, limiting early detection of BD and delaying interventions that might limit future morbidity and disability. Retrospective and family-risk studies have consistently found evidence of prodromal psychopathology in subjects later diagnosed with BD. Here, we review prospective studies of clinical risk factors and exposures identified before diagnosis of BD: our findings are consistent with those from retrospective and family-risk studies. Affective psychopathology often precedes diagnosis to suggest a homotypic trajectory in developing BD. Early non-affective (heterotypic) psychopathological disturbances, including anxiety and disruptive behavior disorders, as well as environmental factors and exposures, have been found in prospective studies to increase the risk of BD, but tend to lack specificity in predicting BD. Findings from prospective studies are encouragingly similar to those of retrospective and family-risk studies.
MACULAR HOLE HYDRODISSECTION
Authors: Felfeli Tina , Mandelcorn Efrem D. 
Published: January 2018

Purpose:To present a new technique, macular hole hydrodissection, that increases the likelihood of closure for challenging macular holes (MHs) with multiple risk factors.Methods:A retrospective review of all consecutive eyes with idiopathic Stage 3 and 4 MHs that were either persistent (failed previous vitrectomy surgery), chronic (symptoms of central vision loss of ≥2 years or a clinical diagnosis for ≥1 year), and/or large (aperture diameter of ≥400μm), having undergone the macular hole hydrodissection surgical technique between January 1, 2014, and May 1, 2017, from an institutional practice setting was conducted. This technique lyses retina-retinal pigment epithelium adhesions by injecting fluid into the MH and allows for successful closure as the mobile edges are then brought closer together.Results:Thirty-nine eyes of 39 patients with mean MH aperture and base diameters of 549.1 ± 159.47μm and 941.97 ± 344.14 were included. Complete anatomical closure was achieved in 87.2% (34/39) of MHs. Vision improvement was observed in 94.9% (37/39) and gain of ≥2 lines was achieved in 79.5% (31/39). Of the MHs that achieved anatomical success, 100% (34/34) had a Type 1 closure. The mean postoperative follow-up was 320.33 ± 269.04 days.Conclusion:The macular hole hydrodissection surgical technique improves anatomical and functional outcomes of persistent, chronic, and/or large MHs.
Systemic Absorption of Mitomycin-C When Used in Pterygium Surgery
Authors: Yulish Michael , Khatib Ahmed , Pikkel Joseph 
Published: January 2018

Purpose:
To determine whether scleral topical application of mitomycin-C (MMC) results in measurable plasma levels of systemic absorption.

Methods:
The study comprised 27 patients who were treated with MMC 0.2 mg/mL (0.02%) for 60 seconds during pterygium surgery. Blood samples were taken 30 minutes after surgery and evaluated by the human plasma liquid chromatography tandem-mass spectrometry method to determine the presence of MMC.

Results:
The amount of MMC in 27 samples tested was determined as below 0.25 ppb (ng/mL).

Conclusions:
In this study of 27 patients treated with topical application of MMC for pterygium surgery, there was no measurable evidence of systemic drug absorption. Although systemic absorption has been found with the use of larger quantities of MMC, there is an extremely low likelihood of systemic absorption or toxicity of MMC after pterygium surgery.
Trypan Blue for the Assessment of Filtering Bleb Function During Cataract Surgery
Authors: Yung Edward S. , Moster Marlene R. , Sanvicente Carina , Pluta John , Rahmatnejad Kamran , Patel Arjun S. , Williams Alice , Abramowitz Ben , Katz L. Jay , Pro Michael 
Published: January 2018

Purpose:
Phacoemulsification has been cited as a possible cause of bleb failure in eyes with prior trabeculectomy. No method has been developed to directly evaluate the risk of bleb failure after phacoemulsification. We investigate the use of trypan blue during cataract surgery in the setting of a preexisting trabeculectomy to evaluate the functional status of the bleb and predict postoperative bleb function.

Materials and Methods:
In total, 14 patients contributing 1 eye each with a history of prior trabeculectomy with mitomycin C undergoing phacoemulsification with intraocular lens implantation were enrolled in this prospective, nonrandomized clinical trial. At the time of phacoemulsification, trypan blue was instilled into the anterior chamber before capsulorhexis creation. Staining of the bleb was grouped as being mild or diffuse using intraoperative photographs. These eyes were followed for 1 year postoperatively and evaluated for intraocular pressure (IOP) control.

Results:
The change in IOP was not significantly different between the 2 groups (P=0.14). A trend towards greater need for IOP-lowering medications was noted (P<0.10) in eyes with mild bleb staining. No statistically significant difference in rates of decreased bleb function was noted at 1-year follow-up after phacoemulsification.

Conclusion:
The intensity of bleb staining with trypan blue during phacoemulsification is not associated with changes in IOP postoperatively. A trend towards decreased need for IOP-lowering medications was noted in eyes with diffuse bleb staining at 1 year after cataract surgery.
A New Device for Securing Sternal Wires after Median Sternotomy
Authors: Danter Matthew R. , Saari Amy , Gao Min , Cheung Anson , Lichtenstein Samuel V. , Abel James G. 
Published: January 2018

Objective Morbidity due to sternotomy continues to be a significant clinical problem. Poor approximation of the sternum may lead to complications such as sternal dehiscence, infection, and pain. A device to assist in tensioning and twisting standard steel wires during sternal closure has been developed (TORQTM sternal closure device). Manually tightened interrupted wire closures were compared with those tightened and secured with the aid of the device. Performance of the device was assessed clinically. Methods Four cardiovascular surgeons performed manual and device-assisted closures on a biofidelic model. Closure force was measured to determine the residual force and its intraoperator variation. A retrospective review of patients treated before and after the introduction of the device was conducted. Predicted and actual outcomes were compared for the two groups (manual closure and deviceassisted closure). Results Biomechanical testing measured a 75% increase in residual closure force ( P < 0.001) and a significant reduction in the variability of the closure force ( P = 0.045) for device-assisted closures compared with manual closures. In the retrospective study, 3 of 173 manually closed patients had sterile sternal dehiscence and 1 of 173 had a deep sternal wound infection. In the device closure group, 2 of 127 had a sterile sternal dehiscence and no deep sternal wound infections were reported. No other device-related serious adverse events were reported. Conclusions Biomechanical data showed stronger, more consistent closure forces with the device. The retrospective data attest to the performance of the device.
Streamlining the Process for Intravenous Tissue Plasminogen Activator
Authors: Lawrence Erin , Merbach Dawn , Thorpe Sherry , Llinas Rafael H. , Marsh Elisabeth B. 
Published: January 2018

ABSTRACT

Background: For ischemic stroke, the chance of improved recovery is directly impacted by length of time from symptom onset to administration of intravenous tissue plasminogen activator (IV tPA). Despite the importance of rapid treatment, stroke centers struggle with achieving consistent door-to-needle times of less than 60 minutes. Methods: We implemented a change in our response to the acute stroke patient by adding a dedicated stroke nurse and a nursing flow sheet focused on critical benchmarks before treatment. We collected data on patients treated with IV tPA preintervention and postintervention to determine whether our process increased the number of patients receiving tPA in less than 60 minutes. One hundred thirty-eight patients (n = 78 pre and 60 post) treated between 2009 and 2013 were included. Student t tests and χ2 tests were used to compare door-to-needle times preintervention and postintervention. Results: By implementing this new approach, the mean time to treatment decreased from 82 to 78 minutes (P = .583). The percentage of patients successfully treated within 60 minutes of arrival improved from 28% to 52% (P = .005). Stroke severity and need for additional imaging were associated with increased time to treatment. Conclusion: The use of a stroke nurse and a nursing flow sheet as part of the acute stroke assessment significantly increases the proportion of patients treated with IV tPA within 60 minutes from hospital arrival.
Involvement of Nucleotide-Binding and Oligomerization Domain-Like Receptors in the Intestinal Injury of Severe Acute Pancreatitis in Rats
Authors: Xu Shan , Wei Shuqing , Guo Yu , Cui Donglai , Yao Jinfeng 
Published: January 2018

Objectives
The aim of the study was to observe the role of nucleotide-binding and oligomerization domain (NOD)-like receptors (NLR) in intestinal injury of severe acute pancreatitis (SAP) in rats.

Methods
Severe acute pancreatitis was induced by retrograde infusion of sodium taurocholate into the biliopancreatic duct. Rats were divided into the following 6 groups: sham operation, SAP treated with saline, and SAP treated with interleukin 1β (IL-1β)-converting enzyme inhibitor, killed at 6 or 12 hours after operation. Serum IL-18 and IL-1β concentrations were measured. mRNA expression and protein levels of NOD1, NOD2, and NLRP3 in the intestine were measured.

Results
Severe acute pancreatitis resulted in significantly higher serum IL-18 and IL-1β concentration, higher mRNA expression, and protein levels of NOD1, NOD2, and NLRP3 in intestine in SAP treated with saline groups compared with sham operation groups. This effect was attenuated by administration of IL-1β–converting enzyme inhibitor.

Conclusions
The NLRs, including NOD1, NOD2, and NLRP3, were involved in the intestinal injury in SAP through a caspase-1 pathway.
Transforming Growth Factor-β and Bone Morphogenetic Protein 2 Regulation of MicroRNA-200 Family in Chronic Pancreatitis
Authors: Yu Peter , Liu Ka , Gao Xuxia , Karmouty-Quintana Harry , Bailey Jennifer M. , Cao Yanna , Ko Tien C. 
Published: January 2018

Objectives
To investigate regulation of microRNA (miR)-200 family (a, b, c, 141, and 429) in chronic pancreatitis (CP). This was accomplished by examining miR-200 family levels in a mouse model in vivo and their regulation in pancreatic cells in vitro.

Methods
Chronic pancreatitis was induced by cerulein for 4 weeks (50 μg/kg, 5 hourly intraperitoneal injections/day, and 3 days/week). Control mice received normal saline. The pancreata were harvested for fibrosis assessment by Sirius red staining and for miRNA, collagen, and fibronectin levels by quantitative PCR. In vitro, human primary pancreatic stellate cells and human primary pancreatic fibroblast (hPFBs), and rat pancreatic epithelial AR42J cells were treated with vehicle, transforming growth factor (TGF)-β (1 ng/mL), or BMP2 (50 ng/mL) for 24 hours and then harvested for miRNA analysis.

Results
In CP, miR-200s were decreased by 56% to 70% and inversely correlated with pancreatic fibrosis, miR-21, and miR-31 (P < 0.05). In vitro, TGF-β inhibited miR-200b in AR42J cells by 62%, whereas BMP2 increased miR-200b in all 3 cell types in a range of 1.5- to 3.4-fold and inhibited miR-21 in hPFBs by 21% (P < 0.05).

Conclusions
Both in vivo and in vitro studies suggest an antifibrogenic function of miR-200s in CP. The TGF-β and BMP2 may function through inverse regulation of miR-200b levels.
Histone Deacetylase Inhibition Restores Expression of Hypoxia-Inducible Protein NDRG1 in Pancreatic Cancer
Authors: Tiffon Céline 
Published: January 2018

Objectives
N-myc downstream-regulated gene-1 (NDRG1) is a hypoxia-inducible and differentiation-related protein and candidate biomarker in pancreatic cancer. As NDRG1 expression is lost in high-grade tumors, the effects of the differentiating histone deacetylase inhibitor trichostatin A (TSA) were examined in human pancreatic cancer cell lines representing different tumor grades.

Methods
PANC-1 (poorly differentiated) and Capan-1 (moderately to well-differentiated) cells were treated with TSA. Effects were assessed in vitro by microscopic analysis, colorimetric assays, cell counts, real-time polymerase chain reaction, and Western blotting.

Results
Treatment of PANC-1 cells over 4 days with 0.5 μM TSA restored cellular differentiation, inhibited proliferation, and enhanced p21Cip1 protein expression. Trichostatin A upregulated NDRG1 mRNA and protein levels under normoxia from day 1 and by 6-fold by day 4 (P < 0.01 at all time points). After 24 hours under hypoxia, NDRG1 expression was further increased in differentiated cells (P < 0.01). Favorable changes were identified in the expression of other hypoxia-regulated genes.

Conclusions
Histone deacetylase inhibitors offer a potential novel epidrug approach for pancreatic cancer by reversing the undifferentiated phenotype and allowing patients to overcome resistance and better respond to conventional cytotoxic treatments.
Efficacy and Safety of Adalimumab in Pediatric Ulcerative Colitis
Authors: Aloi Marina , Bramuzzo Matteo , Arrigo Serena , Romano Claudio , D'Arcangelo Giulia , Lacorte Doriana , Gatti Simona , Illiceto Maria T. , Zucconi Francesca , Dilillo Dario , Zuin Giovanna , Knafelz Daniela , Ravelli Alberto , Cucchiara Salvatore , Alvisi Patrizia ,   SIGENP IBD Working Group
Published: January 2018

ABSTRACTObjectives:The aim of this study was to evaluate the effectiveness and safety of adalimumab (ADA) in children with ulcerative colitis (UC) previously treated with infliximab (IFX).Methods:Retrospective study including children with UC from a national registry who received ADA therapy. The primary endpoint was the rate of corticosteroid‐free remission at week 52. Secondary outcomes were the rate of sustained clinical remission, primary nonresponse, and loss of response at weeks 12, 30, and 52 and rate of mucosal healing and side effects at week 52.Results:Thirty‐two children received ADA (median age 10 ± 4 years). Median disease duration before ADA therapy was 27 months. All patients received previous IFX (43% intolerant, 50% nonresponders [37.5% primary, 42.5% secondary nonresponders], 6.7% positive anti‐IFX antibodies). Fifty‐two weeks after ADA initiation, 13 patients (41%) were in corticosteroid‐free remission. Mucosal healing occurred in 9 patients (28%) at 52 weeks. The cumulative probability of a clinical relapse‐free course was 69%, 59%, and 53% at 12, 30, and 52 weeks, respectively. Ten patients (31%) had a primary failure and 5 (15%) a loss of response to ADA. No significant differences in efficacy were reported between not‐responders and intolerant to IFX (P = 1.0). Overall, 19 patient (59%) maintained ADA during 52‐week follow‐up. Seven patients (22%) experienced an adverse event, no serious side effects were observed and none resulted in ADA discontinuation.Conclusions:Based on our data, ADA seems to be effective in children with UC, allowing to recover a significant percentage of patients intolerant or not‐responding to IFX. The safety profile was good.
Assessment of Humoral Immunity to Hepatitis B, Measles, Rubella, and Mumps in Children After Chemotherapy
Authors: Keskin Yildirim Zuhal , Buyukavci Mustafa 
Published: January 2018

Background:
Cancer survival rates and longevity of patients after therapy have significantly improved during the last few decades. Therefore, lasting protection against infections should be provided.

Procedure:
A total of 162 children diagnosed with acute lymphoblastic leukemia, acute myelogenous leukemia, solid tumors, non-Hodgkin lymphoma, and Hodgkin lymphoma were enrolled in the study. Antibody levels against hepatitis B virus was assessed both at the time of diagnosis and within 6 months after completion of chemotherapy. However, measles, mumps, and rubella (MMR) antibodies levels were measured just within 6 months after completion of chemotherapy.

Results:
Anti-HBs antibody titers had decreased below the protective level after treatment in 25 of 96 patients having protective antibody levels for hepatitis B virus before therapy. In 66 patients without pretreatment protective levels of antibody, in spite of the immunization during chemotherapy, only 6 of them were found to be anti-HBS positive after treatment. In 153 patients previously vaccinated with MMR, 19 had protective antibody titers after treatment. MMR seropositivities were negatively correlated to age as expected.

Conclusions:
Our data demonstrate that a significant number of children lose preexisting humoral immunity against MMR and hepatitis B after completion of chemotherapy.
Complications in Orthognathic Surgery
Authors: Olate Sergio , Sigua Eder , Asprino Luciana , de Moraes Márcio 
Published: January 2018

Abstract
The aim of this study was to analyze the presence of complications related to orthognathic surgery performed by surgeons in train. A retrospective study was conducted between 2005 and 2014, analyzing the clinical records of patients treated in the authors’ Department. Patients who underwent orthognathic surgery were included, under a bidimensional analysis and with the conventional orthosurgical sequence; intraoperative complications were identified, such as the occurrence of a bad split, bleeding, tissue injury, among others and postoperative variables such as impaired sensation, infection, and alterations in the osteosynthesis systems. A statistical analysis was done using χ
2 and Student t tests, considering a statistical significance when P < 0.05. Two hundred fifty patients were included with an average follow-up of 13 months; 62.8% were women and 37.2% were men; 18.8% of the subjects presented some type of intraoperative or postoperative complication; excluding relapse and complications due to loss of bonding of the orthodontic device, a 12.4% complication rate was observed; intraoperative complications were 8% and postoperative complications 10.4%. Only the sensorineural alterations were associated with the mandibular surgery (P < 0.05). Finally, orthognathic surgery is relatively safe and produces a low number of complications when it is performed by surgeons in train.