bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous pneumomediastinum and subcutaneous emphysema as a complication of asthma in children: case report and literature review
Authors: Tortajada-Girbés Miguel , Moreno-Prat Miriam , Ainsa-Laguna David , Mas Silvia 
Published: September 2016

Background: Spontaneous pneumomediastinum (SPM) is an uncommon disorder. It is rarely reported in paediatric patients and may be accompanied by subcutaneous emphysema. It is usually benign and self-limiting, with only supportive therapy being needed, but severe cases may require invasive measures. Asthma exacerbations have classically been described as a cause of SPM. However, detailed descriptions in asthmatic children are scarce. We aimed at improving the current understanding of the features of SPM and subcutaneous emphysema, and outcomes, by means of a case report and a systematic review. Methods: For the systematic review a literature search was performed in PubMed to identify reported cases of SPM in asthmatic children. Results: The case a 10-year-old asthmatic girl with SPM is reported. The patient received an inhaled corticosteroid and long-acting beta2 agonist, in addition to sublingual immunotherapy (SLIT) with eventual control of asthma symptoms. Review: A total of 114 published cases were found since 1995, most of them in teenagers; no sex differences were observed. Clinical presentation was associated with an asthma exacerbation in a number of cases. Other presenting features were chest pain, dyspnoea, cough, and particularly acute swelling of the face, neck, and upper chest. Subcutaneous emphysema was present in most patients. Overall, three cases of pneumothorax and two cases of pneumorrhachis were reported. Therapy was mainly based on supportive care, rest, oxygen therapy, analgesics, steroids, and bronchodilators. All patients recovered spontaneously, in spite of a small initial increase in SPM in a few cases. Conclusions: Early identification of patients at risk of SPM would avoid the high number of under-diagnosed cases. Patients should be treated not only with supportive therapy but also with measures to achieve control of the underlying cause (such as poorly controlled asthma).
Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes
Authors: Gilbert Frances C. , Burdette G. Trey , Joyner A. Barry , Llewellyn Tracy A. , Buckley Thomas A. 
Published: September 2016

Background: Concussions have been associated with elevated musculoskeletal injury risk; however, the influence of unreported and unrecognized concussions has not been investigated. Hypothesis: The purpose of this study was to examine the association between concussion and lower extremity musculoskeletal injury rates across a diverse array of sports among collegiate student-athletes at the conclusion of their athletic career. The hypothesis was that there will be a positive association between athletes who reported a history of concussions and higher rates of lower extremity injuries. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Student-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from 13 sports completed a reliable injury history questionnaire. Respondents indicated the total number of reported, unreported, and potentially unrecognized concussions as well as lower extremity injuries including ankle sprains, knee injuries, and muscle strains. Chi-square analyses were performed to identify the association between concussion and lower extremity injuries. Results: There were significant associations between concussion and lateral ankle sprain ( P = 0.012), knee injury ( P = 0.002), and lower extremity muscle strain ( P = 0.031). There were also significant associations between reported concussions and knee injury ( P = 0.003), unreported concussions and knee injury ( P = 0.002), and unrecognized concussions and lateral ankle sprain ( P = 0.001) and lower extremity muscle strains ( P = 0.006), with odds ratios ranging from 1.6 to 2.9. Conclusion: There was a positive association between concussion history and lower extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at the conclusion of their intercollegiate athletic careers. Clinical Relevance: Clinicians should be aware of these elevated risks when making return-to-participation decisions and should incorporate injury prevention protocols.
Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis
Authors: Ahmadizar Fariba , Vijverberg Susanne J.H. , Arets Hubertus G.M. , de Boer Anthonius , Lang Jason E. , Kattan Meyer , Palmer Colin N.A. , Mukhopadhyay Somnath , Turner Steve , Maitland-van der Zee Anke H. 
Published: September 2016

To estimate the association between obesity and poor asthma control or risk of exacerbations in asthmatic children and adolescents, and to assess whether these associations are different by sex.A meta-analysis was performed on unpublished data from three North-European paediatric asthma cohorts (BREATHE, PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) and PAGES (Pediatric Asthma Gene Environment Study)) and 11 previously published studies (cross-sectional and longitudinal studies). Outcomes were poor asthma control (based on asthma symptoms) and exacerbations rates (asthma-related visits to the emergency department, asthma-related hospitalisations or use of oral corticosteroids). Overall pooled estimates of the odds ratios were obtained using fixed- or random-effects models.In a meta-analysis of 46 070 asthmatic children and adolescents, obese children (body mass index ≥95th percentile) compared with non-obese peers had a small but significant increased risk of asthma exacerbations (OR 1.17, 95% CI 1.03–1.34; I2: 54.7%). However, there was no statistically significant association between obesity and poor asthma control (n=4973, OR 1.23, 95% CI 0.99–1.53; I2: 0.0%). After stratification for sex, the differences in odds ratios for girls and boys were similar, yet no longer statistically significant.In asthmatic children, obesity is associated with a minor increased risk of asthma exacerbations but not with poor asthma control. Sex does not appear to modify this risk.
Impairment of Wnt11 function leads to kidney tubular abnormalities and secondary glomerular cystogenesis
Authors: Nagy Irina I. , Xu Qi , Naillat Florence , Ali Nsrein , Miinalainen Ilkka , Samoylenko Anatoly , Vainio Seppo J. 
Published: September 2016

Abstract
Background
Wnt11 is a member of the Wnt family of secreted signals controlling the early steps in ureteric bud (UB) branching. Due to the reported lethality of Wnt11 knockout embryos in utero, its role in later mammalian kidney organogenesis remains open. The presence of Wnt11 in the emerging tubular system suggests that it may have certain roles later in the development of the epithelial ductal system.

Results
The Wnt11 knockout allele was backcrossed with the C57Bl6 strain for several generations to address possible differences in penetrance of the kidney phenotypes. Strikingly, around one third of the null mice with this inbred background survived to the postnatal stages. Many of them also reached adulthood, but urine and plasma analyses pointed out to compromised kidney function. Consistent with these data the tubules of the C57Bl6 Wnt11
−/−
mice appeared to be enlarged, and the optical projection tomography indicated changes in tubular convolution. Moreover, the C57Bl6 Wnt11
−/−
mice developed secondary glomerular cysts not observed in the controls. The failure of Wnt11 signaling reduced the expression of several genes implicated in kidney development, such as Wnt9b, Six2, Foxd1 and Hox10. Also Dvl2, an important PCP pathway component, was downregulated by more than 90 % due to Wnt11 deficiency in both the E16.5 and NB kidneys. Since all these genes take part in the control of UB, nephron and stromal progenitor cell differentiation, their disrupted expression may contribute to the observed anomalies in the kidney tubular system caused by Wnt11 deficiency.

Conclusions
The Wnt11 signal has roles at the later stages of kidney development, namely in coordinating the development of the tubular system. The C57Bl6 Wnt11
−/−
mouse generated here provides a model for studying the mechanisms behind tubular anomalies and glomerular cyst formation.
Mechanisms of mesenchymal stem/stromal cell function
Authors: Spees Jeffrey L. , Lee Ryang Hwa , Gregory Carl A. 
Published: September 2016

AbstractThe past decade has seen an explosion of research directed toward better understanding of the mechanisms of mesenchymal stem/stromal cell (MSC) function during rescue and repair of injured organs and tissues. In addition to delineating cell–cell signaling and molecular controls for MSC differentiation, the field has made particular progress in defining several other mechanisms through which administered MSCs can promote tissue rescue/repair. These include: 1) paracrine activity that involves secretion of proteins/peptides and hormones; 2) transfer of mitochondria by way of tunneling nanotubes or microvesicles; and 3) transfer of exosomes or microvesicles containing RNA and other molecules. Improved understanding of MSC function holds great promise for the application of cell therapy and also for the development of powerful cell-derived therapeutics for regenerative medicine. Focusing on these three mechanisms, we discuss MSC-mediated effects on immune cell responses, cell survival, and fibrosis and review recent progress with MSC-based or MSC-derived therapeutics.
Multilayer approach to minimax theorems
Authors: Lin Yen-Cherng , Lai Hang-Chin 
Published: September 2016

AbstractIn this research, a multihierarchical methodology works by taking a whole intersection property to establish a fixed point theorem. Using such a whole intersection property to let multihierarchical procedures of set-valued mappings can work on a Hausdorff topological vector space. Some examples are proposed in order to illustrate our theory.
Vitamin D-Mediated Hypercalcemia: Mechanisms, Diagnosis, and Treatment
Authors: Tebben Peter J. , Singh Ravinder J. , Kumar Rajiv 
Published: September 2016

AbstractHypercalcemia occurs in up to 4% of the population in association with malignancy, primary hyperparathyroidism, ingestion of excessive calcium and/or vitamin D, ectopic production of 1,25-dihydroxyvitamin D [1,25(OH)2D], and impaired degradation of 1,25(OH)2D. The ingestion of excessive amounts of vitamin D3 (or vitamin D2) results in hypercalcemia and hypercalciuria due to the formation of supraphysiological amounts of 25-hydroxyvitamin D [25(OH)D] that bind to the vitamin D receptor, albeit with lower affinity than the active form of the vitamin, 1,25(OH)2D, and the formation of 5,6-trans 25(OH)D, which binds to the vitamin D receptor more tightly than 25(OH)D. In patients with granulomatous disease such as sarcoidosis or tuberculosis and tumors such as lymphomas, hypercalcemia occurs as a result of the activity of ectopic 25(OH)D-1-hydroxylase (CYP27B1) expressed in macrophages or tumor cells and the formation of excessive amounts of 1,25(OH)2D. Recent work has identified a novel cause of non-PTH-mediated hypercalcemia that occurs when the degradation of 1,25(OH)2D is impaired as a result of mutations of the 1,25(OH)2D-24-hydroxylase cytochrome P450 (CYP24A1). Patients with biallelic and, in some instances, monoallelic mutations of the CYP24A1 gene have elevated serum calcium concentrations associated with elevated serum 1,25(OH)2D, suppressed PTH concentrations, hypercalciuria, nephrocalcinosis, nephrolithiasis, and on occasion, reduced bone density. Of interest, first-time calcium renal stone formers have elevated 1,25(OH)2D and evidence of impaired 24-hydroxylase-mediated 1,25(OH)2D degradation. We will describe the biochemical processes associated with the synthesis and degradation of various vitamin D metabolites, the clinical features of the vitamin D-mediated hypercalcemia, their biochemical diagnosis, and treatment.
Poor maternal nutrition and accelerated postnatal growth induces an accelerated aging phenotype and oxidative stress in skeletal muscle of male rats
Authors: Tarry-Adkins J. L. , Fernandez-Twinn D. S. , Chen J. H. , Hargreaves I. P. , Neergheen V. , Aiken C. E. , Ozanne S. E. 
Published: September 2016

‘Developmental programming’, as a consequence of suboptimal in-utero and early environments can be associated with metabolic dysfunction in later life, including increased incidence of cardiovascular disease and type 2 diabetes and predisposition of older men to sarcopenia. However, the molecular mechanisms underpinning these associations are poorly understood. Many conditions associated with ‘developmental programming’ are also known to be associated with the aging process. We therefore utilized our well-established rat model of low-birth weight and accelerated postnatal catch-up growth (termed ‘recuperated’) in this study to establish the effects of suboptimal maternal nutrition on age-associated factors in skeletal muscle. We demonstrated accelerated telomere shortening (a robust marker of cellular aging) as evidenced by reduced frequency of long telomeres (48.5-8.6kb) and increased frequency of short telomeres (4.2-1.3kb) in vastus-lateralis muscle from aged recuperated offspring compared to controls. This was associated with increased protein expression of the DNA damage repair marker 8-oxoguanine-glycosylase (OGG1) in recuperated offspring.
Recuperated animals also demonstrated an oxidative stress phenotype, with decreased citrate synthase activity, increased electron-transport complex activities of complex I, complex II-III and complex IV (all markers of functional mitochondria), increased xanthine oxidase (XO), p67phox and Nuclear-factor kappa-light-chain-enhancer of activated B-cells (NF-κB). Recuperated offspring also demonstrated increased antioxidant defense capacity with increased protein expression of manganese superoxide dismutase (MnSOD), copper-zinc superoxide dismutase (CuZnSOD), Catalase and heme oxygenase-1 (HO1), all of which are known targets of NF-κB and may be upregulated as a consequence of oxidative stress. Recuperated offspring also had a pro-inflammatory phenotype as evidenced by increased tumor necrosis factor-α (TNFα) and interleukin-1β (IL1β) protein levels. Taken together, we demonstrate for the first time, to our knowledge, an accelerated aging phenotype in skeletal muscle in the context of developmental programming. These findings may pave the way for suitable interventions in at-risk populations.
Upregulation of the Nr2f1-A830082K12Rik gene pair in murine neural crest cells results in a complex phenotype reminiscent of Waardenburg syndrome type 4
Authors: Bergeron Karl-F. , Nguyen Chloé M. A. , Cardinal Tatiana , Charrier Baptiste , Silversides David W. , Pilon Nicolas 
Published: September 2016

ABSTRACT
Waardenburg syndrome is a neurocristopathy characterized by a combination of skin and hair depigmentation, and inner ear defects. In the type 4 form, these defects show comorbidity with Hirschsprung disease, a disorder marked by an absence of neural ganglia in the distal colon, triggering functional intestinal obstruction. Here, we report that the Spot mouse line – obtained through an insertional mutagenesis screen for genes involved in neural crest cell (NCC) development – is a model for Waardenburg syndrome type 4. We found that the Spot insertional mutation causes overexpression of an overlapping gene pair composed of the transcription-factor-encoding Nr2f1 and the antisense long non-coding RNA A830082K12Rik in NCCs through a mechanism involving relief of repression of these genes. Consistent with the previously described role of Nr2f1 in promoting gliogenesis in the central nervous system, we further found that NCC-derived progenitors of the enteric nervous system fail to fully colonize Spot embryonic guts owing to their premature differentiation in glial cells. Taken together, our data thus identify silencer elements of the Nr2f1-A830082K12Rik gene pair as new candidate loci for Waardenburg syndrome type 4.
Practical aspects of compression therapy – Update 2016
Authors: Heyer K. , Protz K. 
Published: September 2016

SummaryCompression therapy is a complex form of therapy. It requires equally practical abilities and theoretical knowledge, as well as an understanding of available materials and the methods in question. All these mentioned aspects of today’s practical compression therapy show deficits.This article shows the current status of treatment of patients with venous leg ulcers in Germany. Based on this, strategies are described, which aim to improve the status of information of the patients, the expertise of the users and the further spread of modern and specialized materials.It is possible and appropriate to better the individual status of treatment of patients through further qualification of carers. This should include the proper usage of materials and methods.
Treatment of infantile haemoangioma – Update 2016
Authors: Mangatter A. , Ruef P. 
Published: September 2016

Summary
Aim Complicated infantile hemangioma need early, safe and effective treatment. The aim of this study was to provide greater insight into systemic and topical propranolol treatment efficacy and side effects.
Methods We report our retrospective experiences of 207 paediatric patients treated with systemic propranolol and of 148 paediatric patients treated with propranolol gel topically photographed and analysed with a specific hemangioma score.
Results Propranolol treatment was successful in >99 % of the patients. The hemangioma score showed a significant decrease during systemic treatment (8.3 ± 3.3 at beginning and 1.5± 1.4 after 6 months) and during topical treatment (4.2 ± 1,6 at beginning and 2.2 ± 1.3 after three months). Systemic treatment did not show any differences when distributed according to different localizations or to the patient`s ages. During topical propranolol treatment relevant serum levels were not determined. Relevant side effects that may have made it necessary to discontinue the treatment were not observed. However, there was a statistically significant reduction in heart rate but not in mean arterial blood pressure during the first six in-hospital systemic drug applications.
Conclusion Systemic propranolol treatment is highly effective and nearly always safe. Topical treatment with propranolol gel (off-label) is suitable for specific hemangioma in addition to cryotherapy and systemic treatment with propranolol. These findings provide highly valuable information on this drug treatment for complicated infantile hemangioma in infants.
Reality of outpatient care with medical compression stockings
Authors: Marshall M. , Murena-Schmidt R. , Doppel W. , Hahn S. , Schwahn-Schreiber C. 
Published: September 2016

SummaryBackground The mediven observational study demonstrated that outpatient prescription of medical compression stockings (MCS) is not sufficiently guided by the medical needs of venous patients. In this follow-up analysis, we therefore evaluated the frequency of prescriptions of MCS and donning aids. Moreover, we asked whether MCS are differentially prescribed according to the patients’ CEAP classification and BMI.Results Approximately one third of patients did not receive a prescription for a second pair of MCS at the beginning of the study and approximately one third of patients were not given a six-monthly repeat prescription. Moreover, donning aids were only rarely prescribed. These factors had an impact on compliance, since high MCS wearing frequencies were associated with both frequent MCS re-prescriptions and, at least for patients aged 61 years or above, prescription of donning aids. Prescribed MCS were mostly of light MCS quality, irrespective of the patient’s CEAP and BMI. Importantly, improvements of the CEAP classification of patients in CEAP category C3 occurred more frequently with medium and firm MCS qualities (BMI >25: 30.9 %; <25: 41.7 %) than with light MCS qualities (BMI >25: 22.4 %; <25: 13.3 %). In obese patients, constriction furrows occurred less frequently when medium or firm MCS qualities were used.Conclusion With regard to the number and type of MCS prescriptions, there is still significant need for improvement. If required by the patients’ medical needs, medium and firm MCS qualities should be considered to a much greater extent.
A INFLUÊNCIA DAS VARIÁVEIS AMBIENTAIS E ORGANIZACIONAIS NO DESEMPENHO DE STARTUPS
Authors: Miranda Juliana Queirós , Santos Júnior Carlos Denner , Dias Alexandre Teixeira 
Published: September 2016

Os novos negócios de base inovadora e tecnológica, e as startups têm conferido uma alavancagem para a economia dos países. Apesar disso, as startups estão mais suscetíveis a fracassarem devido à sua vulnerabilidade inicial, considerando que enfrentam mais riscos, possuem menos recursos e têm pouca legitimidade. Dessa forma, identificou-se a relevância em analisar os fatores que influenciam no desempenho das startups através de variáveis ambientais e organizacionais e suas relações entre si e com o desempenho desses negócios inovadores. Desenvolveu-se assim um modelo teórico com base nas duas principais correntes téoricas da literatura de estratégia empresarial, isto é, considerando os fatores internos à organização e externos de seu ambiente. O método utilizado foi o levantamento (survey), enviado para mais de 700 startups em todo o Brasil, obtendo uma amostra válida de 92 respondentes. A análise dos dados foi baseada na modelagem de equações estruturais, realizada por meio do software SmartPLS. Os resultados indicaram ausência de significância estatística nas hipóteses analisadas, indicando que não há relação entre as variáveis ambientais e organizacionais e o desempenho das startups, potencialmente contribuindo para as teorias utilizadas e que, normalmente, foram desenvolvidas através da análise de grandes empreendimentos. Esta pesquisa busca, assim, contribuir para os estudos organizacionais, ao apresentar uma diferença relacionada com o desempenho no contexto das startups.
Sobolev homeomorphisms with gradients of low rank via laminates
Authors: Faraco Daniel , Mora-Corral Carlos , Oliva Marcos 
Published: September 2016

Abstract
Let

Ω
⊂

ℝ
n

{\Omega\subset\mathbb{R}^{n}}

be a bounded open set. Given

2
≤
m
≤
n

{2\leq m\leq n}

, we construct a convex function

u
:

Ω
→
ℝ

{u\colon\Omega\to\mathbb{R}}

whose gradient

f
=

∇
⁡
u

{f=\nabla u}

is a Hölder continuous homeomorphism, f is the identity on

∂
⁡
Ω

{\partial\Omega}

, the derivative Df has rank

m
-
1

{m-1}

a.e. in Ω and Df is in the weak

L
m

{L^{m}}

space

L

m
,
w

{L^{m,w}}

. The proof is based on convex integration and staircase laminates.