bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recommendations for Lengthening of Magnetically Controlled Growing Rods in Children With Pacemakers
Authors: Tan Kimberly-Anne , Sewell Mathew D. , Clarke Andrew J. , Chan Daniel , Stokes Oliver M. , Khan Shahid N. , Hutton Michael 
Published: September 2016

Purpose of the Study:
Pacemakers are currently identified as a contraindication for the use of magnetic growth rods (MGRs). This arises from concern that magnetic fields generated by the MGR external remote controller (ERC) during lengthening procedures may induce pacemaker dysfunction. We investigated (1) whether MGR lengthening affects pacemaker function, and (2) if the magnetic field of a pacemaker affects MGR lengthening.

Methods:
MGRs were tested in conjunction with an magnetic resonance imaging-compatible pacemaker, which was connected to a virtual patient under continuous cardiac monitoring. To determine whether pacemaker function was affected during MGR lengthening, the electrocardiogram trace was monitored for arrhythmias, whereas an ERC was applied to lengthen the MGRs at varying distances from the pacemaker. To investigate if MGR lengthening was affected by the presence of a pacemaker, at the start and end of the experiment, the ability of the rods to fully elongate and shorten was tested to check for conservation of function.

Results:
When the pacemaker was in normal mode, <16 cm away from the activated ERC during MGR lengthening, pacemaker function was affected by the ERC’s magnetic forces. At this distance, prophylactically switching the pacemaker to tonic mode before lengthening prevented occurrence of inappropriate pacing discharges. No deleterious effect of the pacemaker’s magnetic field on the MGR lengthening mechanism was identified.

Conclusions:
Magnetic resonance imaging-compatible pacemakers appear safe for concomitant use with MGRs, provided a pacemaker technician prophylactically switches the pacemaker to tonic function before outpatient lengthening procedures.

Clinical Relevance:
This experiment was designed to provide the first safety information on MGR lengthening in children with pacemakers. Although currently a rare clinical scenario, with increasing use of MGRs, this clinical scenario may arise more frequently in the future.
Knee Pain and Activity Outcomes After Femoral Derotation Osteotomy for Excessive Femoral Anteversion
Authors: Stambough Jeffrey B. , Davis Lauren , Szymanski Deborah A. , Smith June C. , Schoenecker Perry L. , Gordon J. Eric 
Published: September 2016

Background:
Excessive femoral anteversion is a developmental condition that can become symptomatic into adolescence and manifest as anterior knee pain, tripping, and or problems with sports. Femoral derotational osteotomy about an antegrade intramedullary nail (IMN) is an accepted option to treat this condition. This is the first report of the clinical and functional outcomes of treatment of excessive anteversion with femoral derotational osteotomy stabilized with an IMN.

Methods:
We prospectively enrolled 28 consecutive patients between 2013 and 2014 who underwent derotational osteotomy. Physical examination measures were used to calculate the amount of angular correction with focus on internal and external rotation of the hip, as well as the trochanteric prominence angle test of femoral anteversion. The International Knee Documentation Committee-9, Marx, and Tegner activity scales were 3 patient-reported outcomes recorded.

Results:
After femoral derotation osteotomy over an IMN, femoral anteversion, as measured by the trochanteric prominence angle, improved an average of 29 degrees (P<0.0001). At 1-year minimum follow-up, 22 of 28 subjects (78.5%) demonstrated a mean significant improvement of 13 points for International Knee Documentation Committee-9 (SD=15.4, P=0.0007), which surpassed the level of minimal clinically important change. Furthermore, the Tegner inventory scores for the cohort improved by an average of 1.9 activity levels (SD=2.4, P=0.0012).

Conclusions:
For adolescents with symptomatic excessive femoral anteversion, derotational osteotomy over an IMN offers a reliable surgical option that provides predictable deformity correction and significant improvements in both function and pain scales.

Levels of Evidence:
Level II—prospective, consecutive, nonrandomized, internally controlled cohort study.
Olfactomedin-4 Is a Candidate Marker for a Pathogenic Neutrophil Subset in Septic Shock
Authors: Alder Matthew N. , Opoka Amy M. , Lahni Patrick , Hildeman David A. , Wong Hector R. 
Published: September 2016

Objectives:
Heterogeneity in sepsis-related pathobiology presents a significant challenge. Resolving this heterogeneity presents an opportunity to understand pathobiology and improve patient care. Olfactomedin-4 is a neutrophil subset marker and may contribute to sepsis heterogeneity. Our objective was to evaluate the expression of olfactomedin-4 and characterize neutrophil heterogeneity in children with septic shock.

Design:
Single-center, prospective cohort, as well as secondary analysis of existing transcriptomic and proteomic databases.

Setting:
Tertiary care PICU.

Patients:
Patients from 5 days to 18 years old with septic shock were enrolled. Data collected included the expression of olfactomedin-4 messenger RNA, serum protein concentrations, and percentage of neutrophils that express olfactomedin-4.

Interventions:
None.

Measurements and Main Results:
Secondary analysis of existing transcriptomic data demonstrated that olfactomedin-4 is the most highly expressed gene in nonsurvivors of pediatric septic shock, compared with survivors. Secondary analysis of an existing proteomic database corroborated these observations. In a prospectively enrolled cohort, we quantified the percentage of olfactomedin-4+ neutrophils in patients with septic shock. Patients with a complicated course, defined as greater than or equal to two organ failures at day 7 of septic shock or 28-day mortality, had a higher percentage of olfactomedin-4+ neutrophils, compared with those without a complicated course. By logistic regression, the percentage of olfactomedin-4+ neutrophils was independently associated with increased risk of a complicated course (odds ratio, 1.09; 95% CI, 1.01–1.17; p = 0.024).

Conclusions:
Olfactomedin-4 identifies a subpopulation of neutrophils in patients with septic shock, and those with a high percentage of olfactomedin-4+ neutrophils are at higher risk for greater organ failure burden and death. Olfactomedin-4 might serve as a marker of a pathogenic neutrophil subset in patients with septic shock.
Preradiation Chemotherapy for Adult High-risk Medulloblastoma
Authors: Moots Paul L. , O’Neill Anne , Londer Harold , Mehta Minesh , Blumenthal Deborah T. , Barger Geoffrey R. , Grunnet Margaret L. , Grossman Stuart , Gilbert Mark R. , Schiff David 
Published: September 2016

Objectives:
To assess the long-term outcomes and objective response (OR) to preradiation chemotherapy and radiation in adult high-risk medulloblastoma.

Materials and Methods:
In this prospective phase II trial, adults with high-risk medulloblastoma were treated with 3 cycles of preradiation cisplatin, etoposide, cyclophosphamide, and vincristine followed by craniospinal radiation (CSI). OR, progression-free survival (PFS), overall survival (OS), and toxicities were assessed.

Results:
Eleven patients were enrolled over a 6-year period. Six (55%) had subarachnoid metastases. Two (18%) had an OR to preradiation chemotherapy. Two (18%) progressed while on chemotherapy. Completion of CSI was not compromised. The OR rate after chemotherapy and radiation was 45% (5/11). Nonevaluable patients at both time-points weakened the response data conclusions. Median PFS was 43.8 months. Five-year PFS was 27%. Five-year OS was 55%. Nonmetastatic (M0) and metastatic (M+) patients had similar outcomes.

Conclusions:
The OR to this preradiation chemotherapy regimen is lower than anticipated from the adult and pediatric literature raising a question about comparative efficacy of chemotherapy in different age groups. The OS achieved is similar to retrospective adult series, but worse than pediatric outcomes. Although this regimen can be administered without compromising delivery of CSI, our results do not provide support for the use of this neoadjuvant chemotherapy for adult medulloblastoma.
Transscleral Selective Laser Trabeculoplasty Without a Gonioscopy Lens
Authors: Geffen Noa , Ofir Shay , Belkin Avner , Segev Fani , Barkana Yaniv , Kaplan Messas Audrey , Assia Ehud I. , Belkin Michael 
Published: September 2016

Purpose of the Study:
The purpose of the study was to investigate results of selective laser trabeculoplasty (SLT) performed directly on the sclera without a gonioscopy lens.

Design:
Interventional case series, prospective, randomized, masked, controlled clinical trial.

Methods:

Setting: Meir Medical Center, Kfar-Saba, Israel. Study population: Adults with uncontrolled primary open angle or pseudoexfoliation glaucoma randomized into 2 groups. Intervention: The controls underwent conventional SLT with 100 spots delivered using a gonioscopy lens for 360 degrees of the trabecular meshwork. The study group underwent irradiation using the same parameters with the laser applications administered on the perilimbal sclera. Study visits: 1 hour, 1, 7, 30, 60, 180, and 365 days postprocedure. Main Outcome Measures: Intraocular pressure (IOP) and side effects.

Results:
Thirty adults were randomized into 2 groups. The mean (±SD) pretreatment IOP was 20.21±3.19 mm Hg for the study group (n=14) and 21.14±2.98 mm Hg for the controls (n=14; P =0.43), dropping to 15.50±3.77 and 15.00±4.08 mm Hg (P =0.74) after 6 months and to 16.00±3.31 and 14.00±2.45 mm Hg (P =0.22) after 12 months. The average IOP reduction after 6 and 12 months was 23.4% and 20.83% for the study group and 27.1% and 33.77% for the controls (P=0.528). Success (a decrease of ≥15% at 6 months with no additional medications, laser, or glaucoma surgery) was achieved in 12 (85.7%) study patients and 9 (69.2%) controls (P=0.385). Complications were mild and transient (n=30), although significantly higher in the controls (n=15; P <0.0001).

Conclusions:
SLT applied directly to the perilimbal sclera may be as efficacious as the conventional procedure for 1 year.
Rates of Positive Findings on Positron Emission Tomography and Bone Marrow Biopsy in Patients With Ocular Adnexal Lymphoma
Authors: Thuro Bradley A. , Ning Jing , Peng S. Andrew , Pace Stanley T. , Dudeja Gagan , Ozgur Omar , Turturro Franceso , Samaniego Felipe , Hagemeister Fredrick B. , Fayad Luis E. , Fowler Nathan H. , Pinnix Chelsea C. , Debnam J. Matthew , Esmaeli Bita 
Published: September 2016

Purpose:
The aim of this study was to determine rates of positive findings on positron emission tomography (PET) and bone marrow biopsy performed during staging workup for ocular adnexal lymphoma (OAL).

Methods:
A retrospective review of OAL patients was conducted. Demographics, primary versus secondary OAL, histologic subtype, and findings on PET and bone marrow biopsy performed as part of the initial staging workup for OAL were recorded.

Results:
The study included 119 patients with OAL. There were 85 primary and 34 secondary OALs. The main histologic subtypes of lymphoma were mucosa-associated lymphoid tissue (n = 61), follicular (n = 26), diffuse large B-cell (n = 17), and mantle cell (n = 10). Positive PET findings were seen in 42 of 68 patients (62%) with primary OAL and 19 of 24 (79%) with secondary OAL. Positive PET findings were seen in 24 of 47 patients (51%) with mucosa-associated lymphoid tissue, 13 of 17 (76%) with follicular, 14 of 15 (93%) with diffuse large B-cell, and 9 of 10 (90%) with mantle cell lymphoma. Positive findings on bone marrow biopsy were seen in 7 of 59 patients (12%) with mucosa-associated lymphoid tissue, 4 of 23 (17%) with follicular, 1 of 17 (6%) with diffuse large B-cell, and 2 of 9 (22%) with mantle cell lymphoma.

Conclusions:
Our findings suggest that a significant proportion of patients with primary and secondary OAL have positive findings on PET and bone marrow biopsy at initial diagnosis, suggesting a reasonable yield for these tests as part of the initial staging workup in patients with a new diagnosis of OAL.
The indirect costs of back problems (dorsopathies) in Australians aged 45 to 64 years from 2015 to 2030: results from a microsimulation model, Health&WealthMOD2030
Authors: Schofield Deborah , Cunich Michelle M. , Shrestha Rupendra N. , Tanton Robert , Veerman Lennert , Kelly Simon J. , Passey Megan E. 
Published: September 2016

Abstract
This study projected the indirect costs of back problems through lost productive life years (PLYs) from the individual's perspective (lost disposable income), the governmental perspective (reduced taxation revenue, greater welfare spending), and the societal perspective (lost gross domestic product, GDP) from 2015 to 2030, using Health&WealthMOD2030—Australia's first microsimulation model on the long-term impacts of ill-health. Quantile regression analysis was used to examine differences in median weekly income, welfare payments, and taxes of people unable to work due to back problems with working full-time without back problems as comparator. National costs and lost GDP resulting from missing workers due to back problems were also projected. We projected that 90,000 people have lost PLYs due to back problems in 2015, increasing to 104,600 in 2030 (16.2% increase). People with lost PLYs due to back problems are projected to receive AU$340.91 less in total income and AU$339.77 more in welfare payments per week than full-time workers without back problems in 2030 and pay no income tax on average. National costs consisted of a loss of AU$2931 million in annual income in 2015, increasing to AU$4660 million in 2030 (60% increase). For government, extra annual welfare payments are projected to increase from AU$1462 million in 2015 to AU$1709 million in 2030 (16.9% increase), and lost annual taxation revenue to increase from AU$671 million in 2015 to $961 million in 2030 (43.2% increase). We projected losses in GDP of AU$10,543 million in 2015, increasing to AU$14,522 million in 2030 due to back problems.
A population-based study of quantitative sensory testing in adolescents with and without chronic pain
Authors: Tham See Wan , Palermo Tonya M. , Holley Amy Lewandowski , Zhou Chuan , Stubhaug Audun , Furberg Anne-Sofie , Nielsen Christopher Sivert 
Published: September 2016

Abstract
Quantitative sensory testing (QST) has been used to characterize pain sensitivity in individuals with and without pain conditions. Research remains limited in pediatric populations, hindering the ability to expand the utility of QST toward its potential application in clinical settings and clinical predictive value. The aims of this study were to examine pain sensitivity using QST in adolescents with chronic pain compared to adolescents without chronic pain and identify predictors of pain sensitivity. A population-based study conducted from 2010 to 2011 provided data on 941 adolescents, 197 were classified as having chronic pain and 744 were classified without chronic pain. Self-reported data on pain characteristics, psychological functioning, and QST responses were examined. The findings revealed lower pressure pain threshold and tolerance on the trapezius (P's = 0.03) in adolescents with chronic pain compared to adolescents without chronic pain, but no differences on heat or cold-pressor pain tasks. Female sex (P's = 0.02) and poorer psychological functioning (P's = 0.02) emerged as significant predictors of greater pain sensitivity across all pain modalities. Exploratory analyses revealed several associations between clinical pain characteristics and QST responses within the chronic pain cohort. Findings from this large pediatric sample provide comprehensive data that could serve as normative data on QST responses in adolescents with and without chronic pain. These findings lay the groundwork toward developing future QST research and study protocols in pediatric populations, taking into consideration sex and psychological distress.
Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data
Authors: Southern Danielle A. , Burnand Bernard , Droesler Saskia E. , Flemons Ward , Forster Alan J. , Gurevich Yana , Harrison James , Quan Hude , Pincus Harold A. , Romano Patrick S. , Sundararajan Vijaya , Kostanjsek Nenad , Ghali William A. 
Published: September 2016

Background:
Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses.

Objective:
We undertook de novo PSI development through a data-driven approach that drew upon “diagnosis timing” information available in some countries’ administrative hospital data.

Research Design:
Administrative database analysis and modified Delphi rating process.

Subjects:
All hospitalized adults in Canada in 2009.

Measures:
We queried all hospitalizations for ICD-10-CA diagnosis codes arising during hospital stay. We then undertook a modified Delphi panel process to rate the extent to which each of the identified diagnoses has a potential link to suboptimal quality of care. We grouped the identified quality/safety-related diagnoses into relevant clinical categories. Lastly, we queried Alberta hospital discharge data to assess the frequency of the newly defined PSI events.

Results:
Among 2,416,413 national hospitalizations, we found 2590 unique ICD-10-CA codes flagged as having arisen after admission. Seven panelists evaluated these in a 2-round review process, and identified a listing of 640 ICD-10-CA diagnosis codes judged to be linked to suboptimal quality of care and thus appropriate for inclusion in PSIs. These were then grouped by patient safety experts into 18 clinically relevant PSI categories. We then analyzed data on 2,381,652 Alberta hospital discharges from 2005 through 2012, and found that 134,299 (5.2%) hospitalizations had at least 1 PSI diagnosis.

Conclusion:
The resulting work creates a foundation for a new set of PSIs for routine large-scale surveillance of hospital and health system performance.
Pediatric sialendoscopy indications and outcomes
Authors: Ogden Margaret A. , Rosbe Kristina W. , Chang Jolie L. 
Published: September 2016

Purpose of review
Chronic sialadenitis can affect patients of all age ranges and typically presents as recurrent or chronic painful swelling of the salivary glands. In children, the most common cause of sialadenitis is juvenile recurrent parotitis. Salivary stones, or sialolithiasis, are a much less common cause. Historically, for patients with chronic sialadenitis who failed conservative management, salivary gland removal was the standard treatment option. Recently, however, sialendoscopy has emerged as an effective gland-preserving procedure for sialadenitis evaluation and treatment in adults and children. The aim of this review is to discuss pediatric sialadenitis evaluation and treatment, including sialendoscopy indications, technique, and outcomes.

Recent findings
Sialendoscopy is a well tolerated and effective treatment for sialadenitis Sialendoscopy and salivary duct irrigation have been shown to improve frequency and severity of sialadenitis episodes in patients with juvenile recurrent parotitis. Salivary stones are managed successfully with endoscopic and combined endoscopic-assisted open approaches. Minimally invasive approaches with sialendoscopy have improved the ability to preserve salivary glands in patients with recurrent sialadenitis.

Summary
Sialendoscopy is a well tolerated and effective procedure for recurrent sialadenitis in children.
NASPGHAN Capsule Endoscopy Clinical Report
Authors: Friedlander Joel A. , Liu Quin Y. , Sahn Benjamin , Kooros Koorosh , Walsh Catharine M. , Kramer Robert E. , Lightdale Jenifer R. , Khlevner Julie , McOmber Mark , Kurowski Jacob , Giefer Matthew J. , Pall Harpreet , Troendle David M. , Utterson Elizabeth C. , Brill Herbert , Zacur George M. , Lirio Richard A. , Lerner Diana G. , Reynolds Carrie , Gibbons Troy E. , Wilsey Michael , Liacouras Chris A. , Fishman Douglas S. ,   Endoscopy Committee
Published: September 2016

ABSTRACTWireless capsule endoscopy (CE) was introduced in 2000 as a less invasive method to visualize the distal small bowel in adults. Because this technology has advanced it has been adapted for use in pediatric gastroenterology. Several studies have described its clinical use, utility, and various training methods but pediatric literature regarding CE is limited. This clinical report developed by the Endoscopic and Procedures Committee of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition outlines the current literature, and describes the recommended current role, use, training, and future areas of research for CE in pediatrics.
Gut microbiota and metabolic disease: from pathogenesis to new therapeutic strategies
Authors: Kang Yongbo , Zhang Xiaofang , Cai Yue , Su Junhong , Kong Xiangyang 
Published: September 2016

Gut microbiota is well known to regulate and maintain host metabolic and immune function. Change in stability and diversification of gut microbiota can affect progression of many metabolic diseases such as obesity, diabetes, liver disease, and so on. Studies on the association of the gut microbiota and host diseases are therefore significant, shedding light on the understanding of the role of gut microbiota in the development of such disease. In particular, human and animal model studies have explained how qualitative and quantitative alterations in the composition of gut microbiota are able to have an influence on the intestinal barrier, immune regulation, substance metabolism, nutrient absorption, energy distribution, toxin education, and so on. At the same time, these data suggest that species of intestinal commensal bacteria may play either a pathogenic or protective role in the development of metabolic diseases. The oral probiotic/prebiotic represents a possible therapeutic for improving metabolic diseases. However, the available data in this field remain limited, and the relevant scientific work has only just begun; especially, at present, new technologies have allowed the attempt at a systematic intestinal bacterial flora study, giving more realistic information about its composition and its pathological variance.In this review, we summarize the aggravation or improvement of metabolic diseases by the role of gut microbiota, and probiotic/prebiotic treatment with the help of available literature.