bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified Furlow Palatoplasty Using Small Double-Opposing Z-Plasty: Surgical Technique and Outcome
Authors: Yamaguchi Kazuaki , Lonic Daniel , Lee Che-Hsiung , Yun Claudia , Lo Lun-Jou 
Published: May 2016

Background:
A smaller Z-plasty is applied in a modified Furlow palatoplasty. The purpose of this study was to assess its surgical and functional outcome.

Methods:
The surgical technique included mucoperiosteal flap elevation in the hard palate, complete pedicle dissection and release, double-opposing Z-plasty using 5-mm limbs and muscle dissection in the soft palate, and the buccal fat pad covering lateral relaxing wounds. A retrospective chart review was conducted for 231 consecutive nonsyndromic patients undergoing modified palatoplasty from May of 2007 to December of 2014. The demographic, postoperative, and follow-up data were collected. Statistical analyses were performed.

Results:
Average age at palatoplasty was 8.3 months. The overall oronasal fistula rate was 0.4 percent; oronasal fistula occurred in only one case with bilateral cleft. Other complications included postoperative bleeding in two cases (0.8 percent), postoperative airway obstruction in one case (0.4 percent), obstructive sleep apnea in one case (0.4 percent), stitch abscess in one case (0.4 percent), and distal uvula dehiscence in two cases (0.8 percent). One hundred twenty-seven patients had full speech evaluation, and seven (5.5 percent) were diagnosed with velopharyngeal insufficiency requiring surgical correction.

Conclusion:
This modified palatoplasty using a small double-opposing Z-plasty provided adequate cleft palate closure, with a low fistula rate and satisfactory speech outcome.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
The Effects of Mucoperichondrial Flap Elevation on Septal L-Strut Cartilage: A Biomechanical and Histologic Analysis in a Rabbit Model
Authors: Basaran Karaca , Basat Salih Onur , Ozel Asuman , Yazar Memet , Bozdag Ergun , Tuna Meral , Sar Mehmet , Pilanci Ozgur 
Published: May 2016

Background:
The harvesting of septal cartilage following mucoperichondrial flap elevation has almost become a standard step in rhinoplasty. However, the strength of the remaining septum has not yet been evaluated. In the current experimental study of a rabbit rhinoplasty model, the remaining septum following a graft harvest was analyzed both biomechanically and pathologically.

Methods:
Forty New Zealand rabbits were classified into four equal groups. Group 1 consisted of the animals in which unilateral elevation of the mucoperichondrial flaps was undertaken before the graft harvest, group 2 consisted of the animals in which bilateral elevation was undertaken, group 3 included the animals where the septum was exposed and left untouched after a bilateral mucosal flap elevation, and group 4 was designated as the control group. Specimens were analyzed under light microscopy for multiple parameters. Biomechanical analyses were performed with a universal testing device at the Department of Engineering, Biomechanical Laboratories, Istanbul Technical University.

Results:
Biomechanical analysis in terms of maximum tension revealed significant results among the groups (p = 0.008). Although insignificant results were observed overall using a pathologic analysis, the amount of chondrocytes was lower in group 2 than in group 1 (p = 0.099). The amounts of matrix collagen (p = 0.184) and fibrosis were (p = 0.749) higher in group 2 than in group 1.

Conclusions:
From these data, the authors conclude that mucoperichondrium integrity plays a crucial role in the biomechanical strength of the septum. More sophisticated studies with further pathologic analysis are required to determine the exact mechanism of strength loss observed with mucoperichondrial flap elevation.
Chikungunya Virus Disease
Authors: Vijayan Vini , Sukumaran Sukesh 
Published: May 2016

Abstract
Chikungunya is caused by an alphavirus that is transmitted to humans via the Aedes species mosquito. Chikungunya is endemic to tropical Africa and South and Southeast Asia, but over the past decade, the geographic distribution of the virus has been expanding rapidly. The disease is characterized by fever and severe polyarthritis, and although symptoms typically resolve within 7 to 10 days, some patients experience persistent arthritis and arthralgias for months to years.
In December 2013, the first local transmission of chikungunya virus in the Americas was identified in the Caribbean Island of Saint Martin. Since then, the number of afflicted individuals has spread throughout the Caribbean and Central America, as well as into South America. The United States reported 2788 chikungunya virus disease cases among travelers returning from affected areas in 2014. In addition, 11 locally acquired cases were reported in Florida. Further spread and establishment of the disease in the Americas are likely considering the high levels of viremia in infected individuals, widespread distribution of effective vectors, lack of immunity among people living in the Americas, and the popularity of international travel.
Considering the prominent rheumatic manifestations of chikungunya, rheumatologists are likely to encounter patients with the disease in their practice. We recommend that rheumatologists consider chikungunya in their differential diagnosis when evaluating patients presenting with fever and joint pain following travel to a chikungunya endemic area. Early diagnosis would ensure timely management and reduction of polypharmacy and its associated complications. In this article, we briefly describe the epidemiology of chikungunya, the clinical features, laboratory testing, prevention, and treatment of disease.
Does a Simplified 6-Joint Ultrasound Index Correlate Well Enough With the 28-Joint Disease Activity Score to Be Used in Clinical Practice?
Authors: Rosa Javier , Ruta Santiago , Saucedo Carla , Navarta David A. , Catoggio Luis J. , García-Mónaco Ricardo , Soriano Enrique R. 
Published: May 2016

Objective
Ultrasound (US) has become an important tool in the management of rheumatoid arthritis (RA) but it is time consuming in clinical practice. We compared 3 US indices (with different numbers of joints) with disease activity measured by the 28-Joint Disease Activity Score (DAS28) in order to find the most parsimonious index still useful in clinical practice.

Methods
Sixty consecutive RA patients were included. The DAS28 score was calculated by the attending rheumatologist, and later in the day, they underwent US examination by another rheumatologist trained in US (bilateral gray-scale and power Doppler examination of the wrist and metacarpophalangeal and proximal interphalangeal joints). Three different US indices were constructed: index A (22 joints), index B (10 joints), and index C (6 joints).

Results
All 3 US indices were significantly higher in patients with active disease versus inactive disease (P < 0.05 for all 3). Ultrasound index C showed the best correlation with DAS28 (rho = 0.5020, P < 0.0001) and a very good discriminative value for moderate to high disease activity (DAS28 >3.2) and for absence of remission (DAS28 >2.6) (areas under receiver operating characteristic curve = 0.75 and 0.80, respectively). A cutoff value of 3 in US index C showed sensitivity of 88.89% and specificity of 66.67% for absence of remission. Correlation between the 3 US indices was excellent.

Conclusions
A US index of 6 joints (both wrists and second and third metacarpophalangeal joints bilaterally) correlated well with disease activity measured by DAS28 and may be used to evaluate RA patients in daily practice.
Joint Hypermobility and Joint Range of Motion in Young Dancers
Authors: Steinberg Nili , Hershkovitz Israel , Zeev Aviva , Rothschild Bruce , Siev-Ner Itzhak 
Published: May 2016

Background
Joint range of motion (ROM) refers to the extent of movement of the joint, recorded using standard goniometers. Joint hypermobility (JHM) is a condition in which most of the synovial joints move beyond the “normal” limits. Joint hypermobility is recognized as a feature of heritable disorders of the connective tissue and can be identified mostly by the Beighton scale. Data on the possible relationship between JHM and joint ROM are lacking in the literature. The main objective of the present study was to evaluate the relationship between JHM and joint ROM in the different lower-extremity joints in young dancers.

Methods
Joint hypermobility and ROM were assessed among 240 female dancers, aged 8 to 16 years, and 226 nondancers of similar age.

Results
The prevalence of JHM is significantly higher among dancers compared with the control subjects (P < 0.001). Joints’ ROM is higher among dancers with JHM compared with dancers without JHM (P < 0.05). This phenomenon, however, is age dependent; as in young dancers (aged 8–10 years), this pertains only to the ankle dorsiflexion ROM. In adolescent dancers (aged 11–13 years), this relationship has been observed in most joints: ankle/foot en pointe, ankle dorsiflexion, hip external rotation, hip abduction, and hip extension. In mature dancers (aged 14–16 years), dancers with JHM had greater ROM in ankle/foot en pointe, hip abduction, and knee flexion (P < 0.05).

Conclusions
(1) Joint ROM and JHM are associated one with the other; (2) the relationship between joint ROM and JHM is age dependent; and (3) JHM is common among young nonprofessional dancers compared with control subjects. The main clinical implications of the current study are to try and reduce the risk of injuries among JHM dancers by developing proprioceptive trainings to improve the correct alignment of the hyperextended joints, to increase their muscle strength for better stabilization of the hypermobile joints, and to provide them additional balancing and stabilizing exercises for their supporting muscles.
Anti-Angiotensin II Type 1 Receptor and Anti-Endothelial Cell Antibodies: A Cross-Sectional Analysis of Pathological Findings in Allograft Biopsies
Authors: Philogene Mary Carmelle , Bagnasco Serena , Kraus Edward S. , Montgomery Robert A. , Dragun Duska , Leffell Mary S. , Zachary Andrea A. , Jackson Annette M. 
Published: May 2016

Background
This is a cross-sectional study designed to evaluate the histologic characteristics of graft injury in the presence of anti-angiotensin II type 1 receptor antibody (AT1R-Ab) and anti-endothelial cell antibody (AECA).

Methods
Non-HLA antibody testing was included in the posttransplant evaluation for 70 kidney recipients. Biopsies were performed for cause for 47 patients and as protocol for the remaining 23 patients. Biopsy-proven rejection was defined according to the Banff 2009-2013 criteria. AT1R-Ab was measured on an ELISA platform. Patients were divided into 3 groups based on AT1R-Ab levels (>17, 10-17, and <10 U/ml). AECA was evaluated using an endothelial cell crossmatch (ECXM) in patients whose HLA antibody level was insufficient to cause a positive flow cytometric crossmatch.

Results
AT1R-Ab levels were higher in patients diagnosed with antibody mediated rejection compared to those with no rejection (P = 0.004). Glomerulitis (g) and peritubular capillaritis (ptc) scores were independently correlated with increased AT1R-Ab concentrations in the presence or absence of HLA-DSA (P = 0.007 and 0.03 for g scores; p = 0.005 and 0.03 for ptc scores). Patients with a positive ECXM had higher AT1R-Ab levels compared to those with a negative ECXM (P = 0.005). Microcirculation inflammation (MCI = g + ptc score) was higher in patients with a positive ECXM and with AT1R-Ab >17 U/ml, although this did not reach statistical significance (P = 0.07).

Conclusions
The data show an association between non-HLA antibodies detected in the ECXM and AT1R ELISA and microvascular injury observed in antibody mediated rejection.
The Prevalence of Electroconvulsive Therapy Use Since 1973
Authors: Lesage Alain , Lemasson Morgane , Medina Karen , Tsopmo Jackson , Sebti Nedjma , Potvin Stephane , Patry Simon 
Published: May 2016

Objectives
A formal meta-analysis of the use of electroconvulsive therapy (ECT) has never been conducted before in literature reviews or syntheses. Such a study would be hampered by heterogeneity and potential reporting biases. However, it would provide a single comparable measure to allow an analysis of statistical key dimensions such as trends across time and psychiatric resources available. It would also help planners and decision makers to set standards and benchmarks for national and regional guidelines for quality assurance and research in health services.

Methods
We surveyed different databases for relevant studies, limited from 1973 to October 2013. Data were extracted independently by 4 reviewers. The articles retrieved were peerreviewed studies (data-based studies or surveys) presenting ECT population rates (annual patient rates calculated from the general population) or number of patients receiving ECT during or after 1973 and attending a psychiatric establishment (either hospitals or approved ECT delivery centers for inpatients and outpatients in well-defined geographic areas).

Results
This meta-analysis includes a total of 18 studies from 12 countries. A composite event rate of 16.9/100,000 inhabitants emerged, characterized by high heterogeneity. Across the countries assessed, the prevalence of ECT was higher in older studies.

Conclusions
By its prevalence, ECT remains rare to exceptional as a specialist treatment for mental disorders. Heterogeneity across regions or countries could best be explained by insufficient standardization of ECT procedures and practices. Linked health databases and audits could help strengthen the effectiveness of ECT in relation to primary outcomes such as suicide and help determine the gap in ECT provision, if any.
Disentangling endogenous versus exogenous pattern formation in spatial ecology: a case study of the ant
Azteca sericeasur
in southern Mexico
Authors: Li Kevin , Vandermeer John H. , Perfecto Ivette 
Published: May 2016

Spatial patterns in ecology can be described as reflective of environmental heterogeneity (exogenous), or emergent from dynamic relationships between interacting species (endogenous), but few empirical studies focus on the combination. The spatial distribution of the nests of
Azteca sericeasur
, a keystone tropical arboreal ant, is thought to form endogenous spatial patterns among the shade trees of a coffee plantation through self-regulating interactions with controlling agents (i.e. natural enemies). Using inhomogeneous point process models, we found evidence for both types of processes in the spatial distribution of
A. sericeasur
. Each year's nest distribution was determined mainly by a density-dependent relationship with the previous year's lagged nest density; but using a novel application of a Thomas cluster process to account for the effects of nest clustering, we found that nest distribution also correlated significantly with tree density in the later years of the study. This coincided with the initiation of agricultural intensification and tree felling on the coffee farm. The emergence of this significant exogenous effect, along with the changing character of the density-dependent effect of lagged nest density, provides clues to the mechanism behind a unique phenomenon observed in the plot, that of an increase in nest population despite resource limitation in nest sites. Our results have implications in coffee agroecological management, as this system provides important biocontrol ecosystem services. Further research is needed, however, to understand the effective scales at which these relationships occur.
Clostridium baratii: a rare case of pneumonia associated with an Alzheimer patient in Rio de Janeiro, Brazil
Authors: Lima Carla Ormundo Gonçalves Ximenes , da Rocha Vinicius Magno , Ferreira Eliane de Oliveira , Filho Joaquim Santos , Serradas Lucia Rodrigues , Silva Rodrigo Otávio Silveira , Lobato Francisco Carlos Faria , Domingues Regina Maria Cavalcanti Pilotto 
Published: May 2016

Introduction:

Clostridium baratii is rarely associated with human diseases. Infection is usuallcaused by ingestion of contaminated food, and infant botulism is the most common clinical presentation.

Case Report:
Here we report a case of pneumonia by a non-toxigenic strain of C. baratii in an Alzheimer 70-year-old male with sepsis in Rio de Janeiro, Brazil. The micro-organism was identified by phenotypical tests, mass spectrometry (MALDI-TOF), DNA amplification (PCR) and sequencing of the 16S rRNA gene. Testing for the presence of botulinum F toxin was made using multiplex PCR. Bioassay for a large number of colonies was performed in mice to evaluate the production of any lethal toxin, but the results were negative.

Conclusion:
To our knowledge, there are no cases of C. baratii infection reported in Brazil and we highlight the importance of anaerobic lab tests in the standard routine of diagnosis.
Monomorphic genotypes within a generalist lineage ofCampylobacter jejunishow signs of global dispersion
Authors: Llarena Ann-Katrin , Zhang Ji , Minna Vehkala , Välimäki Niko , Hakkinen Marjaana , Hänninen Marja-Liisa , Roasto Mati , Mäesaar Mihkel , Taboada Eduardo , Barker Dillon , Garfolo Giuliano , Cammà Cesare , Di Giannatale Elisabetta , Corander Jukka , Rossi Mirko 
Published: May 2016

AbstractThe decreased costs of genome sequencing have increased capability to apply whole-genome sequence on epidemiological surveillance of zoonoticCampylobacter jejuni. However, knowledge about how genetically similar epidemiologically linked isolates can be is vital for correct application of this methodology. To address this issue inC. jejuniwe investigated the spatial and temporal signals in the genomes of a major clonal complex and generalist lineage, ST-45 CC, by exploiting the population structure and genealogy and applying genome-wide association analysis of 340 isolates from across Europe collected over a wide time-range. The occurrence and strength of the geographical signal varied between sublineages and followed the clonal frame when present, while no evidence of a temporal signal was found. Certain sublineages of ST-45 CC formed discrete and genetically isolated clades to which geography and time had left only negligible traces in the genomes. We hypothesize that these ST-45 CC clades form globally expanded monomorphic clones possibly spread across Europe by migratory birds. In addition, we observed an incongruence between the genealogy of the strains and MLST typing, thereby challenging the existing clonal complex definition and use of a common MLST-based nomenclature for the ST-45 CC ofC. jejuni.
Dissection of Major Depressive Disorder using polygenic risk scores for Schizophrenia in two independent cohort
Authors: Whalley HC , Adams MJ , Hall LS , Clarke T-K , Fernandez-Pujals AM , Gibson J , Wigmore E , Hafferty Jonathan , Hagenaars SP , Davies G , Campbell A , Hayward C , Lawrie SM , Porteous DJ , Deary IJ , McIntosh AM 
Published: May 2016

AbstractMajor depressive disorder (MDD) is known for its substantial clinical and suspected causal heterogeneity. It is characterised by low mood, psychomotor slowing, and increased levels of the personality trait neuroticism; factors which are also associated with schizophrenia (SCZ). It is possible that some cases of MDD may have a substantial genetic loading for SCZ. A sign of the presence of SCZ-like MDD sub-groups would be indicated by an interaction between MDD status and polygenic risk of SCZ on cognitive, personality and mood measures. In the current study, we hypothesised that higher SCZ-polygenic risk would define larger MDD case-control differences in cognitive ability, and smaller differences in distress and neuroticism. Polygenic risk scores (PGRS) for SCZ and their association with cognitive variables, neuroticism, mood, and psychological distress were estimated in a large population-based cohort (Generation Scotland: Scottish Family Health Study, GS:SFHS). Individuals were divided into those with, and without, depression (n=2587 & n=16,764 respectively) to test whether there was an interaction between MDD status and schizophrenia risk. Replication was sought in UK Biobank (n=33,525). In both GS:SFHS and UK Biobank we found significant interactions between SCZ-PGRS and MDD status for measures of psychological distress and neuroticism. In both cohorts there was a reduction of case-control differences on a background of higher genetic risk of SCZ. These findings suggest that depression on a background of high genetic risk for SCZ may show attenuated associations with distress and neuroticism. This may represent a causally distinct form of MDD more closely related to SCZ.
Activity flow over resting-state networks shapes cognitive task activations
Authors: Cole Michael W. , Ito Takuya , Bassett Danielle S. , Schultz Douglas H. 
Published: May 2016

AbstractResting-state functional connectivity (FC) has helped reveal the intrinsic network organization of the human brain, yet its relevance to cognitive task activations has been unclear. Uncertainty remains despite evidence that resting-state FC patterns are highly similar to cognitive task activation patterns. Identifying the distributed processes that shape localized cognitive task activations may help reveal why resting-stateFC is so strongly related to cognitive task activations. We found that estimating task-evoked activity flow (the spread of activation amplitudes) over resting-state FC networks allows prediction of cognitive task activations in a large-scale neural network model. Applying this insight to empirical functional MRI data, we found that cognitive task activations can be predicted in held-out brain regions (and held-out individuals via estimated activity flow over resting-state FC networks. This suggests that task-evoked activity flow over intrinsic networks is a large-scale mechanism explaining the relevance of resting-state FC to cognitive task activations.
Playing with science
Authors: Greenhill Anita , Holmes Kate , Woodcock Jamie , Lintott Chris , Simmons Brooke D , Graham Gary , Cox Joe , Oh Eun Young , Masters Karen 
Published: May 2016

Purpose
– The purpose of this paper is to examine intrinsic forms of motivation and particular incidents of play, socialisation, fun and amusement on an online crowdsourced citizen science platform. The paper also investigates gamised activity (Greenhill et al., 2014) as a form of intrinsic motivation adding a sense of play to work and tasks (Xu et al., 2012). These concepts are explored through close scrutiny of the online citizen science platform Zooniverse.org.

Design/methodology/approach
– Qualitative techniques with an interpretivist approach are used to analyse online content found within citizen science platforms, related forums and social media by examining incidents of play, socialisation, fun and amusement to investigate how these aspects are applied as a form of user motivation.

Findings
– The authors find that when users classify crowdsourced tasks voluntarily it does not matter how users are classifying as long as it is accurately. However, what does matter is why they are doing it particularly because of the complex processes that builds relationships between users and the platform. The authors present a conceptual model to enable deeper understandings of how forms of social interaction and play are motivating users contributing to citizen science project to participate in the online processes.

Practical implications
– The findings of this paper provide practical implications for how citizen science, and also other crowdsourcing platforms, can engage with notions of play and gamification to motivate participation.

Originality/value
– Using detailed examples of online content, the authors reveal how participants of the Zooniverse.org demonstrate aspects of “gamised” behaviour. The authors argue that the exploration of gaming as well as play provides evidence that contributing to citizen science projects can be both utilitarian and hedonic.