bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Age, Sex, and Race Characteristics of Velopharyngeal Structures in 4- to 9-Year-Old Children Using Magnetic Resonance Imaging
Authors: Perry Jamie L. , Kollara Lakshmi , Kuehn David P. , Sutton Bradley P. , Fang Xiangming 
Published: January 2018

Objective: The purpose of this study was to quantify the growth of the various craniofacial and velopharyngeal structures and examine sex and race effects. Methods: Eight-five healthy children (53 white and 32 black) with normal velopharyngeal anatomy between 4 and 9 years of age who met the inclusion criteria and successfully completed the magnetic resonance imaging (MRI) scans were included in the study. Results: Developmental normative mean values for selected craniofacial and velopharyngeal variables by race and sex are reported. Facial skeleton variables (face height, nasion to sella, sella to basion, palate height, palate width) and velopharyngeal variables (levator muscle length, angle of origin, sagittal angle, velar length, velar thickness, velar knee to posterior pharyngeal wall, and posterior nasal spine to levator muscle) demonstrated a trend toward a decrease in angle measures and increase in linear measures as age increased (with the exception of posterior nasal spine to levator muscle). Only hard palate width and levator muscle length showed a significant sex effect. However, 2 facial skeleton and 6 velopharyngeal variables showed a significant race effect. The interactions between sex, race, and age were not statistically significant across all variables, with the exception of posterior nasal spine to posterior pharyngeal wall. Conclusion: Findings established a large age- and race-specific normative reference for craniofacial and velopharyngeal variables. Data reveal minimal sexual dimorphism among variables used in the present study; however, significant racial effects were observed.
Academic Achievement Among Children With Nonsyndromic Orofacial Clefts
Authors: Watkins Stephanie E. , Meyer Robert E. , Aylsworth Arthur S. , Marcus Jeffrey R. , Allori Alexander C. , Pimenta Luiz , Lipinski Robert J. , Strauss Ronald P. 
Published: January 2018

Objective: Children with orofacial clefts (OFCs) may experience poor reading proficiency, learning disabilities, and academic underachievement. We examined the association between nonsyndromic (NS) OFCs and end-of-grade (EOG) performance in reading and math from third through eighth grade in a sample subgroup. Participants: We identified a cohort of 559 children with NS-OFCs and 6822 children without birth defects, classifying cleft type by cleft lip alone, with or without cleft alveolar ridge (CL); cleft lip with cleft palate (CL+P); and cleft palate only (CP). Main Outcome Measures: Using logistic regression, we estimated the odds of not meeting grade-level standards among children with NS-OFCs compared to unaffected peers. Using longitudinal analyses, we estimated the odds of not meeting grade-level standards and average change in test scores through eighth grade. Results: Children with NS-OFCs were 1.22 (95% CI: 0.96, 1.83) times as likely not to meet grade-level standards in reading compared to unaffected peers. The effect was similar for math (OR: 1.17; 95% CI: 0.92, 1.48). Children with CL+P were 1.33 (95% CI: 0.86, 1.83) and 1.74 (95% CI: 1.19, 2.56) times as likely not to meet grade-level standard in reading and in both subjects, respectively, compared to unaffected peers. The average rate of change in both scores was similar for children with and without OFCs. Conclusions: Poor academic performance appears greatest for children with CL+P, a finding compatible with previous observations and hypothesized mechanisms associating orofacial clefts with subtle abnormalities in brain development. Academic performance monitoring and referral for academic assistance is warranted.
Facial Growth at 5 and 10 Years After Veau-Wardill-Kilner Versus Minimal-Incision Technique Repair of Isolated Cleft Palate
Authors: Parikakis Konstantinos , Larson Ola , Larson Margareta , Karsten Agneta 
Published: January 2018

Objective: To compare the Veau-Wardill-Kilner technique with the Minimal-Incision technique repair of isolated clefts of the hard and soft palate regarding facial growth at 5 and 10 years of age. Design: Retrospective study of lateral cephalograms. Setting: Hospital and university based. Patients: A consecutive series of 145 Caucasian nonsyndromic children born with isolated cleft palate between 1980 and 1996 were studied. Children with Pierre Robin sequence (PRS) were included in the study. The patients were divided into 4 groups: 2 groups regarding surgical technique and 2 groups regarding cleft length. Intervention: Veau-Wardill-Kilner or Minimal-Incision palatoplasty. Main Outcome Measures: Eleven skeletal and 1 soft tissue measurement were evaluated from lateral cephalograms taken at 5 and 10 years of age. Results: Only minor differences in cephalometric morphology were found between the Veau-Wardill-Kilner technique group and the Minimal-Incision technique group. Similar results were found independent of cleft length or the inclusion of PRS in the sample. Conclusion: The craniofacial cephalometric morphology at 5 and 10 years of age in patients with isolated cleft palate is similar between the Veau-Wardill-Kilner and the Minimal-Incision technique group.
Maternal Representations and Parenting Style in Children Born With and Without an Orofacial Cleft
Authors: Habersaat Stephanie , Turpin Helene , Möller Cecile , Borghini Ayala , Ansermet François , Müller-Nix Carole , Urben Sébastien , Hohlfeld Judith 
Published: January 2018

Objective: To investigate the evolution of maternal representations (ie, the way parents perceive their child in term of temperament, character, behaviors, etc) of children with a cleft at 3 major milestones: before/after reconstructive surgeries and at school age. Parenting style was also analyzed and compared with parents of children born without a cleft. Design and participants: The sample was composed of 30 mothers of children with an orofacial cleft and 14 mothers of children without a cleft. Maternal representations were assessed when the child was 2 months (before surgery), 12 months (after surgery), and 5 years of age (when starting school) using semistructured interviews that were transcribed and coded according to the subscales of the Working Model of the Child Interview and the Parental Development Interview. At the 5-year appointment, mothers also completed a questionnaire about parenting style. Results: Results showed no difference across groups (cleft/noncleft) in maternal representations at the 2-month, 12-month, and 5-year assessments. In the cleft group, significant differences were shown between 2 and 12 months in caregiving sensitivity, perceived infant difficulty, fear for the infant’s safety, and parental pride, all factors being higher at 12 months. Those differences in parental representations over time were not found in the noncleft group. Additionally, mothers of the cleft group were significantly more authoritarian than mothers of children without a cleft. Conclusion: The absence of differences across cleft and noncleft groups suggests that having a child with a cleft does not affect maternal representations and emotions between 2 months and 5 years of the child’s age. However, parenting style seems to be influenced by the presence of a cleft in the present sample.
Surgical Closure of the Cleft Palate Has a Transient Obstructive Effect on the Upper Airway in Children
Authors: Prado Priscila Capelato , de Bragança Lopes Fernandes Marilyse , dos Santos Trettene Armando , Graziela Noronha Silva Salgueiro Alícia , Kiemle Trindade-Suedam Ivy , Trindade Inge Elly Kiemle 
Published: January 2018

Objective: To prospectively investigate the occurrence of respiratory symptoms related to obstructive sleep apnea (OSA) following primary palatoplasty in children with cleft palate (CP). Method: Fifty-six nonsyndromic children presenting CP with a previously repaired cleft lip (CL) or without CL were assessed before and after palate repair. Twenty nonsyndromic children with isolated CL were analyzed as controls before and after lip repair. Respiratory symptoms were investigated preoperatively, and at early and late postoperative periods. Based on the parent reports of “difficulty of breathing (D), apnea events (A) and/or snoring (S) during sleep, a validated OSA index (1.42D + 1.41A + 0.71S – 3.83) was used to predict absence of OSA, possible OSA, and presence of OSA, at the 3 periods analyzed. Results: Screening for OSA showed that the CP group exhibited an increased mean index at the early postoperative assessment, suggesting “possible OSA,” and a higher frequency of snoring at the early and late postoperative assessments, as compared to the CL group ( P < .05). Sleep apnea events were not reported. Conclusions: Surgical closure of the palate has an obstructive effect on the upper airway in the short term, causing OSA-related respiratory symptoms, mostly transient. However, the high prevalence of snoring still observed in the long term indicate that children with a palatal cleft who undergo surgical repair are at risk for OSA. The results support the conclusion that OSA is underappreciated in this population.
Genetic basis for relapse rate in multiple sclerosis: Association with LRP2 genetic variation
Authors: Hilven Kelly , Vandebergh Marijne , Smets Ide , Mallants Klara , Goris An , Dubois Bénédicte 
Published: January 2018

Background: In contrast to successes for multiple sclerosis (MS) susceptibility, the genetic basis for clinical heterogeneity remains largely unresolved. Objectives: We investigate the first reported genetic association with relapse rate. Methods: We genotyped variant rs12988804 in LRP2 in a homogeneous study population of 527 Belgian MS patients with 970 documented relapses. Results: The rs12988804*T allele is associated with a 1.16-fold increased hazard rate for a relapse occurring ( P = 0.0078) and a higher baseline relapse rate prior to immunomodulatory treatment ( P = 0.044). Conclusion: Variant rs12988804 in LRP2, the first example of a genome-wide significant association with relapse rate in MS, is replicated in an independent study.
Secondary multifocal intraocular lens implantation: A novel management strategy for white cataracts
Authors: Ling Jiawen , Qian Yiyong , Lu Peirong 
Published: January 2018

Objectives: This study was designed to analyse the outcomes of secondary multifocal intraocular lens implantation in eyes with white cataracts. Methods: White cataract patients undergoing secondary multifocal intraocular lens implantation between June 2014 and January 2015 were evaluated prospectively. As opposed to a conventional primary intraocular lens implantation for an optimal patient, the white cataract was first extracted, followed by optical biometry measurements. Whether or not the patient had adequate visual acuity was identified, and the multifocal intraocular lens was implanted secondarily. A total of five appropriate white cataract patients were enrolled in this secondary multifocal intraocular lens implantation study and were retrospectively reviewed. Results: All five secondary implantations of the multifocal intraocular lenses were successful, without obvious adverse events. The uncorrected near visual acuity LogMAR was 0.4–0.5, and the distance visual acuity was −0.1 to 0.1 after 12 months of the multifocal intraocular lens implantation. All patients achieved satisfactory near and distance visual acuities and spectacle freedom. Conclusion: Two-stage multifocal intraocular lens implantation is a safe and novel technique for the management of white cataract patients to optimise near and distance visual acuities.
Economic burden of nosocomial infections caused by vancomycin-resistant enterococci
Authors: Puchter Laura , Chaberny Iris Freya , Schwab Frank , Vonberg Ralf-Peter , Bange Franz-Christoph , Ebadi Ella 
Published: January 2018

AbstractBackgroundNosocomial infections due to vancomycin-resistantenterococci(VRE) have become a major problem during the last years. The purpose of this study was to investigate the economic burden of nosocomial VRE infections in a European university hospital.MethodsA retrospective matched case-control study was performed including patients who acquired nosocomial infection with either VRE or vancomycin-susceptible enterococci (VSE) within a time period of 3 years. 42 cases with VRE infections and 42 controls with VSE infections were matched for age, gender, admission and discharge within the same year, time at risk for infection, Charlson comorbidity index (±1), stay on intensive care units and non-intensive care units as well as for the type of infection, using criteria of the Centers for Disease Control and Prevention.ResultsThe median overall costs per case were significantly higher than for controls (EUR 57,675 vs. EUR 38,344;p = 0.030). Costs were similar between cases and controls before onset of infection (EUR 17,893 vs. EUR 16,600;p = 0.386), but higher after onset of infection (EUR 37,971 vs. EUR 23,025;p = 0.049). The median attributable costs per case for vancomycin-resistance were EUR 13,157 (p = 0.036). The most significant differences in costs between cases and controls turned out to be for pharmaceuticals (EUR 6030 vs. EUR 2801;p = 0.008) followed by nursing staff (EUR 8956 vs. EUR 4621;p = 0.032), medical products (EUR 3312 vs. EUR 1838;p = 0.020), and for assistant medical technicians (EUR 3766 vs. EUR 2474;p = 0.023). Furthermore, multivariate analysis revealed that costs were driven independently by vancomycin-resistance (1.4 fold;p = 0.034).ConclusionsThis analysis suggested that nosocomial VRE infections significantly increases hospital costs compared with VSE infections. Therefore, hospital personal should implement control measures to prevent VRE transmission.
Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study
Authors: Ali Solomon , Birhane Melkamu , Bekele Sisay , Kibru Gebre , Teshager Lule , Yilma Yonas , Ahmed Yesuf , Fentahun Netsanet , Assefa Henok , Gashaw Mulatu , Gudina Esayas Kebede 
Published: January 2018

Abstract
Background
Healthcare associated infection (HAI) is alarmingly increasing in low income settings. In Ethiopia, the burden of HAI is still not well described.

Methods
Longitudinal study was conducted from May to September, 2016. All wards of Jimma University Medical Centre were included. The incidence, prevalence and risk factors of healthcare associated infection were determined. A total of 1015 admitted patients were followed throughout their hospital stay. Biological specimens were collected from all patients suspected to have hospital aquired infection. The specimens were processed by standard microbiological methods to isolate and identify bacteria etiology. Clinical and laboratory data were collected using structured case report formats.

Results
The incidence rate of hospital acquired infection was 28.15 [95% C.I:24.40,32.30] per 1000 patient days while the overall prevalence was 19.41% (95% C.I: (16.97–21.85). The highest incidence of HAI was seen in intensive care unit [207.55 (95% C.I:133.40,309.1) per 1000 patient days] and the lowest incidence was reported from ophthalmology ward [0.98 (95% C.I: 0.05,4.90) per 1000patient days]. Among patients who underwent surgical procedure, the risk of HAI was found to be high in those with history of previous hospitalization (ARR = 1.65, 95% C.I:1.07, 2.54). On the other hand, young adults (18 to 30-year-old) had lower risk of developing HAI (ARR = 0.54 95% C.I: 0.32,0.93) Likewise, among non-surgical care groups, the risk of HAI was found to be high in patients with chest tube (ARR = 4.14, 95% C.I: 2.30,7.46), on mechanical ventilation (ARR = 1.99, 95% C.I: 1.06,3.74) and with underlying disease (ARR = 2.01, 95% C.I: 1.33,3.04). Furthermore, hospital aquired infection at the hosoital was associated with prolonged hospital stay [6.3 more days, 95% C.I: (5.16,7.48), t = 0.000] and increased in hospital mortality (AOR, 2.23, 95% CI:1.15,4.29).

Conclusion
This study revealed high burden and poor discharge outcomes of healthcare associated infection at Jimma University Medical Centre. There is a difference in risk factors between patients with and without surgery. Hence, any effort to control the observed high burden of HAI at the hospital should consider these differences for better positive out put.
(Re)considering sovereignty in the European integration process
Authors: Kaplan Yılmaz 
Published: January 2018

AbstractThe World War II (WWII) as a great shock significantly weakened the European nation-state paradigm and gave the European elites a chance to achieve a ‘paradigm shift’ from ‘the nation-state paradigm’ to a ‘federalist paradigm’. However, the nation-state’s strong institutionalization did not allow a paradigm shift and the WWII actually created a ‘paradigm duplication’ in the European integration process. In this two-layered atmosphere, ‘democracy’ was conceptualized under the influence of ‘federalist intellectual paradigm’ but its implementation had to be achieved in the nation-state paradigm. Therefore, this anomaly has played a significant role in the recent stalemate the European integration process has faced. For example, the literature clearly shows the relationship between the sensitivity of European nations towards their national sovereignty and the rise of Euroscepticism in the European integration process. Moreover, the institutional and legitimate strength of the nation-state gives the nation-state paradigm a gravitational power, which gradually weakens the feasibility of the ideas originating from the federalist paradigm. As a result, this article argues that a more symbiotic institutionalization of democracy and sovereignty is necessary to make the European integration more attractive again.
Prolines in the α-helix confer the structural flexibility and functional integrity of importin-β
Authors: Kumeta Masahiro , Konishi Hide A. , Zhang Wanzhen , Sakagami Sayuri , Yoshimura Shige H. 
Published: January 2018

ABSTRACT
The karyopherin family of nuclear transport receptors is composed of a long array of amphiphilic α-helices and undergoes flexible conformational changes to pass through the hydrophobic crowding barrier of the nuclear pore. Here, we focused on the characteristic enrichment of prolines in the middle of the outer α-helices of importin-β. When these prolines were substituted with alanine, nuclear transport activity was reduced drastically in vivo and in vitro, and caused a severe defect in mitotic progression. These mutations did not alter the overall folding of the helical repeat or affect its interaction with cargo or the regulatory factor Ran. However, in vitro and in silico analyses revealed that the mutant lost structural flexibility and could not undergo rapid conformational changes when transferring from a hydrophilic to hydrophobic environment or vice versa. These findings reveal the essential roles of prolines in ensuring the structural flexibility and functional integrity of karyopherins.
A self-inhibitory interaction within Nup155 and membrane binding are required for nuclear pore complex formation
Authors: De Magistris Paola , Tatarek-Nossol Marianna , Dewor Manfred , Antonin Wolfram 
Published: January 2018

ABSTRACT
Nuclear pore complexes (NPCs) are gateways through the nuclear envelope. How they form into a structure containing three rings and integrate into the nuclear envelope remains a challenging paradigm for coordinated assembly of macro-complexes. In vertebrates, the cytoplasmic and nucleoplasmic rings of NPCs are mostly formed by multiple copies of the Nup107–Nup160 complex, whereas the central, or inner ring is composed of Nup53, Nup93, Nup155 and the two paralogues Nup188 and Nup205. Inner ring assembly is only partially understood. Using in vitro nuclear assembly reactions, we show that direct pore membrane binding of Nup155 is crucial for NPC formation. Replacing full-length Nup155 with its N-terminal β-propeller allows assembly of the outer ring components to the NPC backbone that also contains Nup53. However, further assembly, especially recruitment of the Nup93 and Nup62 complexes, is blocked. Self-interaction between the N- and C-terminal domains of Nup155 has an auto-inhibitory function that prevents interaction between the N-terminus of Nup155 and the C-terminal region of Nup53. Nup93 can overcome this block by binding to Nup53, thereby promoting formation of the inner ring and the NPC.
Bayesian penalised likelihood reconstruction (Q.Clear) of 18F-fluciclovine PET for imaging of recurrent prostate cancer: semi-quantitative and clinical evaluation
Authors: Teoh Eugene J , McGowan Daniel R , Schuster David M , Tsakok Maria T , Gleeson Fergus V , Bradley Kevin M 
Published: January 2018

Objective:
18F-Fluciclovine (FACBC) is an amino acid PET radiotracer approved for recurrent prostate cancer imaging. We investigate the use of Bayesian penalised likelihood (BPL) reconstruction for 18F-fluciclovine PET.

Methods:
15 18F-fluciclovine scans were reconstructed using ordered subset expectation maximisation (OSEM), OSEM + point spread function (PSF) modelling and BPL using β-values 100–600. Lesion maximum standardised uptake value (SUVmax), organ SUVmean and standard deviation were measured.
Deidentified reconstructions (OSEM, PSF, BPL using β200–600) from 10 cases were visually analysed by two readers who indicated their most and least preferred reconstructions, and scored overall image quality, noise level, background marrow image quality and lesion conspicuity.

Results:
Comparing BPL to OSEM, there were significant increments in lesion SUVmax and signal-to-background up to β400, with highest gain in β100 reconstructions (mean ΔSUVmax 3.9, p &lt; 0.0001). Organ noise levels increased on PSF, β100 and β200 reconstructions. Across BPL reconstructions, there was incremental reduction in organ noise with increasing β, statistically significant beyond β300–500 (organ-dependent). Comparing with OSEM and PSF, lesion signal-to-noise was significantly increased in BPL reconstructions where β ≥ 300 and ≥ 200 respectively.
On visual analysis, β 300 had the first and second highest scores for image quality, β500 and β600 equal highest scores for marrow image quality and least noise, PSF and β 200 had first and second highest scores for lesion conspicuity. For overall preference, one reader preferred β 300 in 9/10 cases and the other preferred β 200 in all cases.

Conclusion:
BPL reconstruction of 18F-fluciclovine PET images improves signal-to-noise ratio, affirmed by overall reader preferences. On balance, β300 is suggested for 18F-fluciclovine whole body PET image reconstruction using BPL.

Advances in knowledge:
The optimum β is different to that previously published for 18F-fluorodeoxyglucose, and has practical implications for a relatively new tracer in an environment with modern reconstruction technologies.