bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iron Status in Pediatric Celiac Disease
Authors: Popov Jelena , Baldawi Mina , Mbuagbaw Lawrence , Gould Michelle , Mileski Heather , Brill Herbert , Pai Nikhil 
Published: September 2017

ABSTRACTThe present study assessed the role of serum ferritin as a noninvasive biomarker in the diagnosis and monitoring of pediatric celiac disease. A retrospective chart review was performed on patients younger than 18 years old at time of diagnosis (n = 193) between 1998 and 2015. A total of 653 paired values demonstrated a weak negative correlation between serum ferritin and tissue transglutaminase‐immunoglobulin A (r = −0.114; P = 0.004), necessitating further evaluation. A significant relationship was found between reduction of tissue transglutaminase‐immunoglobulin A and increase in serum ferritin after institution of a gluten‐free diet (P < 0.0001), suggesting that resolution of villous damage is necessary for promoting adequate iron absorption.
Growth Trajectory in Children With Short Bowel Syndrome During the First 2 Years of Life
Authors: McLaughlin Cory M. , Channabasappa Nandini , Pace Jesse , Nguyen Hoa , Piper Hannah G. 
Published: September 2017

ABSTRACTObjectives:Infants with short bowel syndrome (SBS) require diligent nutritional support for adequate growth. Enteral independence is a primary goal, but must be balanced with ensuring sufficient nutrition. We aimed to describe growth trajectory in infants with SBS as function of nutritional intake during first 2 years of life.Methods:Infants with SBS were reviewed (2008–2016). z Scores for weight, height, and head circumference (HC) were recorded at birth, 3, 6, 12, 18, and 24 months. Nutritional intake, serum liver enzyme, and bilirubin levels were assessed at all time points. Pearson correlation coefficients were used to measure association with P < 0.05 considered significant.Results:Forty‐one infants were included, with median gestational age of 34 weeks (interquartile range [IQR] 29–36 weeks). Median small bowel length was 36 cm (IQR 26–52 cm) and median % expected small bowel length was 28% (IQR 20%–42%). Mean z scores for weight and length were >0 at birth, but <0 from 3 months to 2 years. HC remained <0 throughout the study. Mean z scores at 2 years for weight, length, HC, and weight‐for‐length were −0.90 (SD 1.1), −1.33 (SD 1.4), −0.67 (SD 1.2), and −0.12 (SD 1.2), respectively. Percentage calories from PN was positively correlated with weight in the first 3 months of life (P = 0.01).Conclusions:Babies with SBS are high risk for poor growth during the first 2 years of life. Although weaning PN is important for these patients, doing so too quickly in infancy may contribute to compromised growth. The long‐term impact on overall development is not known.
Sonographically Occult Abscesses of the Buttock and Perineum in Children
Authors: Nelson Courtney E. , Kaplan Summer , Bellah Richard D. , Chen Aaron E. 
Published: September 2017

Background
Ultrasound (US) is used to differentiate abscess from cellulitis. At our institution, we observed children who had purulent fluid obtained after a negative abscess US. We sought to determine the incidence of sonographically occult abscess (SOA) of the buttock and perineum, and identify associated clinical and demographic characteristics.

Methods
Retrospective chart review including children younger than 18 years old presenting to pediatric emergency department with soft tissue infection of the buttock or perineum and diagnostic radiology US read as negative for abscess. We defined SOA as wound culture growing pathogenic organism obtained within 48 hours of the US. Clinical and demographic characteristics included age, sex, race, ethnicity, fever, history of spontaneous drainage, duration of symptoms, previous methicillin resistant Staphylococcus aureus (MRSA) infection, or previous abscess. We used univariate and multivariate logistic regression to assess correlation between these characteristics and SOA.

Results
A total of 217 children were included. Sixty-one (28%) children had SOA; 33 of 61 (54%) had incision and drainage within 4 hours of the US. Of children with SOA, 49 (80%) grew MRSA and 12 (20%) grew methicillin-sensitive S. aureus. In univariate analysis, a history of MRSA, symptom duration 4 days or less, age of younger than 4 years, and Hispanic ethnicity increased the odds of having SOA. In multivariate analysis, history of MRSA and duration of 4 days or less were associated with SOA.

Conclusions
Twenty-eight percent of children in our institution with US of the buttock and perineum negative for abscess had clinical abscess within 48 hours, most within 4 hours. History of MRSA and shorter symptom duration increased the odds of SOA.
Comparing Unimanual and Bimanual Training in Upper Extremity Function in Children With Unilateral Cerebral Palsy
Authors: Klepper Susan E. , Clayton Krasinski Debra , Gilb Meaghan C. , Khalil Nashwa 
Published: September 2017

Purpose:
This systematic review compared intensive bimanual therapy (IBT) and modified constraint-induced movement therapy (mCIMT) in upper limb function in children with unilateral cerebral palsy (CP).

Methods:
Four electronic databases were searched from 2009 through October 2015 for randomized control trials comparing IBT with mCIMT.

Results:
Eight articles met the inclusion criteria; 5 randomized clinical trials with 221 participants with unilateral CP, ages 1.5 to 16 years, who received the intervention in a day camp, clinical, or preschool setting were included. The IBT group performed bimanual motor activities; the mCIMT group performed unilateral motor activities.

Conclusion:
There was a strong, nonspecific recommendation for either approach to improve quality of unimanual movement, bimanual capacity, and movement efficiency. There was a weak, specific recommendation for IBT in improving movement quality and a specific but weak recommendation favoring IBT to improve the child's performance on parent-reported outcomes.
Gross Motor Outcomes After Dynamic Weight-Bearing in 2 Children With Trunk Hypotonia: A Case Series
Authors: Ardolino Elizabeth , Flores Megan , Manella Kathleen 
Published: September 2017

Introduction:
Children with trunk hypotonia may have limited ability to maintain an upright weight-bearing position, resulting in decreased postural control and a delay in achieving gross motor milestones.

Purpose:
The purpose of this case series is to report the effect of a home-based dynamic standing program on postural control and gross motor activity in 2 children with trunk hypotonia.

Descriptions:
Child 1 (aged 24 months, Gross Motor Function Classification Scale Level IV) and Child 2 (aged 21 months, Gross Motor Function Classification Scale Level V) participated in a standing program using the Upsee harness at home 3 days per week for 12 weeks.

Outcomes:
Both children improved their gross motor function, and Child 1 demonstrated improved trunk control in sitting.

What this case adds:
The use of the Upsee harness was an effective intervention for these children with trunk hypotonia to achieve weight-bearing and improve gross motor abilities.
Implementation of a Multifaceted Interactive Electrodiagnostic Medicine Workshop in a Physical Medicine and Rehabilitation Residency Program
Authors: Donovan Jayne , van de Rijn Marc , McCabe Elizabeth L. , Shih Shirley , Paganoni Sabrina 
Published: September 2017

Abstract
Electrodiagnostic medicine is a required component of Physical Medicine and Rehabilitation residency education, but limited resources exist to guide curriculum development. Our objective was to create a focused workshop to enhance our residency program's electrodiagnostic curriculum. We created two separate 1.5-day workshops, one basic and one advanced, for all residents. Each workshop included didactic sessions, case discussion, question and answer sessions, demonstrations, and hands-on participation with direct supervision and feedback. Presurveys and postsurveys were administered to evaluate the value of the workshops. We also assessed trends in electrodiagnostic self-assessment examination scores. Residents reported clinical electrodiagnostic rotations to be more valuable to their education than previous didactic sessions and independent learning. Self-reported knowledge of electrodiagnostic concepts, resident comfort level in planning, performing, and interpreting studies, and perceived value in independent learning of electrodiagnostic medicine improved after implementation of the workshops. There was a 7% improvement in the American Association of Neuromuscular and Electrodiagnostic Medicine electrodiagnostic self-assessment examination score compared with the previous year and a 15% improvement in the Physical Medicine and Rehabilitation self-assessment examination electrodiagnostic subscore compared with the previous 5 yrs. All participants recommended similar educational experience for other residents. This successful workshop may serve as a resource for other training programs.
Demonstrating Improved Surgical Communication and HAndoveR Generates Earlier Discharges (DISCHARGED)
Authors: Dean Jonathon , Phillips Georgina , Turner Warren , Refson Jonathan 
Published: September 2017

Background
Weekend surgical handover at the Princess Alexandra Hospital NHS Trust in Harlow, Essex, did not fully comply with Royal College of Surgeons England guidelines. Out-of-hours care is under increased scrutiny, and we implemented a quality improvement intervention of a mandatory, standardized weekend handover form to streamline weekend care. This was shown to increase discharges and decrease lengths of stay for patients whose hospital stay included a weekend.

Methods
Data were collected for 15-week preimplementation and postimplementation. The number of patients handed over for senior weekend review was recorded, and for each, the presence or absence of a working diagnosis, relevant investigations, a management plan, and any outstanding tasks was recorded. A standardized weekend handover form was implemented, and these criteria as well numbers of discharges and lengths of stay were compared.

Results
An average of 32 patients was handed over each weekend before and after implementation. The average number of handovers with a listed working diagnosis (19.20 to 30.80, Δ11.60, P < 0.0001), management plan (16.40 to 31.73, Δ15.33, P < 0.0001), and tasks (16.60 to 29.13, Δ12.53, P < 0.0001) significantly increased. Average weekend discharges increased (39.07 to 48.93, Δ9.86, P = 0.0034). Average lengths of stay for emergency patients whose stays included a weekend shortened by 1.96 days (11.11 to 9.15 days, Δ−1.96, P = 0.0192) in keeping with the length of a weekend, with estimated annual cost-savings of between £740 000 and £3.82 million.

Conclusions
Implementation of a standardized weekend handover form resulted in an increase in compliance to national guidelines as well as an increase in weekend discharges and decreased length of stay for emergency patients with significant cost-savings.
Local Flap Technique After Removing Premaxilla for Closure of Oronasal Fistula
Authors: Fernandes Ighor Andrade , Douglas-de-Oliveira Dhelfeson Willya , Falci Saulo Gabriel Moreira , Santos Cássio Roberto Rocha dos 
Published: September 2017

Abstract
This letter aimed to describe a surgical technique for oronasal fistula closure that promotes efficient healing and minimizes recurrence. The oronasal fistula was repaired by buccal flap. The technique proved to be simple and efficient.
Rapid Prototyping as an Auxiliary in Mandibular Reconstructions
Authors: Sales Pedro Henrique da Hora , Cetira Filho Edson Luiz , Oliveira Neto Jair Queiroz de , Silva Julianne Coelho da , Aguiar Andrea Silvia Walter de , Mello Manoel de Jesus Rodrigues 
Published: September 2017

Abstract
The reconstruction of mandible is a challenge with regard to aesthetic and reconstructive demands. The etiology of mandibular fractures is variable, trauma, pathology, bone infections. There are many materials that provide an excellent form of rehabilitation for these defects, where the autogenous graft presents important characteristics that favor a greater success rate. Furthermore, the rapid prototyping method is quite interesting, because it brings a series of advantages to the surgeon, like reducing the operative time, among others. The purpose of the present article is to describe a clinical case of a patient with mandible bone defect caused by gunshot perforation, treated through iliac crest bone graft with planning through rapid prototyping. The mandibular reconstruction can present a real challenge for the surgeon. Biomodels should be required in complex cases because they help to decrease surgical time and to increase the predictability of the procedure.
A Rare Cause of Headache: Pneumatized Nasal Septum Osteoma
Authors: Erdoğan Osman , Ismi Onur , Tezer Mesut Sabri 
Published: September 2017

Abstract
Paranasal sinus osteomas are among the rare causes of headache and they are most commonly seen in the frontal and ethmoid sinuses. In this report, we presented the first case of pneumatized nasal septum osteoma causing headache, successfully treated with endoscopic transnasal approach.
Mucosal Melanoma Originating From the Eustachian Tube
Authors: Kim Jeong Hong , Lim Gil-Chai , Kang Ju Wan 
Published: September 2017

Abstract
A 77-year-old man was referred with a 4-month history of hearing impairment and ear fullness of the left ear. Otoscopic examination revealed an effusion in the left middle ear, and nasal endoscopic examination revealed a dark polypoid lesion at the opening of the left Eustachian tube. In addition to the lesion of the Eustachian tube, a dark mucosal lesion was seen at the posterior choana and the posterior end of the nasal septum. Endoscopic biopsy was done and pathologic result was consistent with malignant melanoma. Wide surgical excision with postoperative radiotherapy was performed; multiple metastases were detected 4 months after the treatment. Mucosal melanoma originating from nasopharynx was extremely rare, but careful examination of nasopharyngeal area should be considered when the patient presents with unilateral middle ear effusion, especially in older age.
Bony Changes in a Unilateral Maxillary Sinus Fungal Ball
Authors: Jun Young Joon , Shin Jae Min , Lee Jae Yong , Baek Byoung Joon 
Published: September 2017

Objectives:
In the paranasal sinus fungal ball (SFB), changes that occur in the underlying bone have not been well described. Recently, bacterial coinfection has been reported in patients with paranasal SFB. We evaluated whether bone changes occur in patients with unilateral maxillary SFB, and also how bacteria in an SFB affect the bony wall of the sinus.

Methods:
A retrospective study of patients with a unilateral maxillary SFB undergoing endoscopic sinus surgery was conducted from July 2009 to December 2015. Preoperative computed tomography images of the patients were reviewed. Wall thickness (WT) and wall density (WD) of the diseased sinus were measured and compared to the normal sinus. Specimens of the sinus aspirates were obtained during surgery for aerobic and anaerobic cultures.

Results:
Forty-three patients were included (mean, 55.7 ± 12.8 years). Thirty-one cultures (72.1%) were positive for bacteria. Thickening was evident in the anterior, lateral, and posterior walls of the diseased sinus. The average WT was 1.69 ± 0.45 mm on the diseased sinus and 1.14 ± 0.31 mm on the normal sinus (P < 0.001). In the diseased sinus, the difference in the average WT between the culture-positive and culture-negative groups was not significant (P = 0.44). The average WD on the diseased sinus was higher than that on the normal sinus (P < 0.001).

Conclusions:
Osteitic change occurred in most patients with a unilateral maxillary SFB. The presence of bacteria in sinus secretions does not greatly affect the development of osteitic changes in unilateral maxillary SFB.
Dorsal Augmentation of Saddle Nose Deformity With Toothpick-Shaped Costal Cartilage Grafts in the Secondary Septorhinoplasty
Authors: Cevizci Raşit , Üstün Bezgin Selin , Çakir Burak Ömür , Kersin Burak , Bayazit Yildirim Ahmet 
Published: September 2017

Abstract
Saddle nose deformity is a challenging complication of septoplasty or septorhinoplasty, characterized by underprojected cartilaginous dorsum. Nasal dorsal augmentation is a significant part of reconstructive surgery of saddle nose deformities. In this study, the authors aimed to discuss the results of using toothpick-shaped costal cartilage grafts in nasal dorsal augmentation of saddle nose deformity. Twelve patients who underwent nasal dorsal augmentation due to moderate to severe saddle nose deformity secondary to the previous septoplasty or septorhinoplasty were retrospectively reviewed. Costal cartilage grafts prepared in the shape of toothpicks were used in all patients. Costal cartilage was used as toothpick-shaped free grafts in 12 patients (female: 7, male: 5) with a mean age of 42 (range: 24–56) for dorsal augmentation in the secondary septorhinoplasty. All patients had a history of previous surgery (septoplasty, n = 9; and septorhinoplasty, n = 3). All patients were operated under general anesthesia with open technique septorhinoplasty. The mean follow-up was 18 (range: 9–48) months. In only 1 of the 12 patients, a postoperative complication was observed including an infection of the tip area in the second postoperative week. None of the patients experienced donor site complications or major graft resorption. All patients were satisfied with functional and esthetic outcomes. No revision surgery was needed in any patient. Toothpick-shaped costal cartilage grafts are useful in nasal dorsal augmentation of moderate to severe saddle nose deformity. This technique offers smooth camouflage, satisfactory accordance with the recipient region, and shorter operation time. In addition, it avoids the side effects from wrapping techniques such as foreign body reaction or additional donor site morbidities.
Epidemiology of Open Globe Injury in Children
Authors: Batur Muhammed , Seven Erbil , Akaltun Mahmut Nedim , Tekin Serek , Yasar Tekin 
Published: September 2017

Purpose:
The purpose of this study was to evaluate the epidemiology and outcomes of pediatric open globe injury (OGI).

Method:
The medical records of all patients diagnosed with OGI in the authors’ clinic between 1996 and 2015 were screened retrospectively. A total of 893 eyes of 892 patients aged 16 years or younger were included in the study. Open globe injury was classified according to the ocular trauma classification (OTS). Age, sex, history, cause and month of trauma, treatment received, visual acuity at presentation, final visual acuity, and cause of vision loss were recorded.

Results:
Children aged 16 years or younger comprised 67.7% of all OGI patients within the studied time period. The annual incidence of OGI in children was 5.16 per 100,000 overall, with 6.12 per 100,000 boys and 4.14 per 100,000 girls. Open globe injuries occurred most frequently in the 3 to 7 year age group and in the summer months. The most common scene of injury was playgrounds (50.2%). A strong, linear, negative correlation was found between OTS values and final visual acuity in logMAR (rp = −0.550, P = 0.0001).

Conclusion:
The authors’ study revealed that a high proportion of all OGIs in the authors’ region occurred in children under 17 years old. As with adults, OGI in children often results in significant vision loss. However, considering the varying degrees of visual recovery demonstrated by some of the authors’ patients, particularly those with no light perception at admission, the authors believe an eye-sparing approach is warranted in pediatric OGI.
Rare Enterorectal Pelvic Floor Hernia—A Cadaveric Study
Authors: Hocking Jennifer C. , Hyakutake Momoe , Webber Christine A. 
Published: September 2017

Abstract
We present a cadaveric case study of an 88-year-old woman with an unusual posterior perineal hernia containing small bowel, rectum, and mesentery. Dissection revealed several loops of the small bowel occupying the presacral space and displacement of the rectum into a large perineal evagination. The intestinal mucosa appeared to have been healthy at the time of death, and we did not find any indication of rectal prolapse. There was also no evidence of past surgery, suggestive of a primary hernia. We conclude this patient had a posterior enterorectal perineal hernia. Suggestions for surgical repair are described.
Performance of an Ambulatory DRY-EEG Device for Auditory Closed-Loop Stimulations in the Home Environment
Authors: Debellemaniere E. , Chambon S. , Pinaud C. , Thorey V. , Léger D. , Chennaoui M. , Arnal P.J. , Galtier M.N. 
Published: September 2017

ABSTRACTObjectiveRecent research has shown that auditory closed-loop stimulations can enhance sleep slow oscillations (SO) to improve N3 sleep quality and cognition. Previous studies have been conducted in a lab environment and on a small sample size. The present study aimed at validating and assessing the performance of a novel ambulatory wireless dry-EEG device (WDD), for auditory closed-loop stimulations of SO during N3 sleep at home.Material and MethodsThe performance of the WDD to detect N3 sleep automatically and to send auditory closed-loop stimulations on SO were tested on 20 young healthy subjects who slept with both the WDD and a miniaturized polysomnography (part 1) in both stimulated and sham nights within a double blind, randomized and crossover design.The electrophysiological effects of auditory closed-loop stimulation on delta power increase were assessed after 1 and 10 nights of stimulations on an observational pilot study in the home environment including 90 middle-aged subjects (part 2).ResultsThe sensitivity and specificity of the WDD to automatically detect N3 sleep in real-time were 0.70 and 0.90, respectively. The stimulation accuracy of the SO ascending-phase targeting was 45±52°. The stimulation protocol induced an increase of 39.5 % of delta power after the stimulations. The increase of SO response to auditory stimulations remained at the same level after 10 consecutive nights.ConclusionThe WDD shows good performances to automatically detect in real-time N3 sleep and to send auditory closed-loop stimulations on SO accurately. These stimulations increased the SO amplitude during N3 sleep without any adaptation effect after 10 consecutive nights. This tool provides new perspectives to figure out novel sleep EEG biomarkers in longitudinal studies and can be interesting to conduct broad studies on the effects of auditory stimulations during sleep.
Human olfactory cortex contributes to emotional and perceptual aspects of aversive associative learning and memory
Authors: You Yuqi , Novak Lucas R. , Clancy Kevin , Li Wen 
Published: September 2017

ABSTRACTThe role of the sensory cortex, beyond the amygdala, has been increasingly recognized in animal associative learning and memory. Here, we examined olfactory cortical plasticity in human olfactory associative learning and memory, while elucidating related changes in emotional and perceptual responses. Psychophysical and neurometric analyses were conducted across an odor-morphing continuum, with the two extreme levels differentially conditioned with aversive and neutral stimuli. Conditioned odors acquired distinct emotional values, tracked by ensemble response patterns in the orbitofrontal (high-level) olfactory cortex. Also observed were enhanced perceptual discrimination and divergent ensemble neuronal response patterns in the anterior and posterior piriform (low-to-intermediate-level) olfactory cortices. Whereas emotional-learning-related changes, both behavioral and neural, maintained 8 days later, perceptual-learning-related changes, also both behavioral and neural, recovered by then, highlighting the human aptitude of forming persistent emotional memory and related sensory cortical plasticity in contrast to transient perceptual alterations of sensory stimuli associated with mild aversive experiences.