bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing Incidence and Altered Presentation in a Population‐based Study of Pediatric Celiac Disease in North America
Authors: Almallouhi Eyad , King Katherine S. , Patel Bhavisha , Wi Chung , Juhn Young J. , Murray Joseph A. , Absah Imad 
Published: February 2017

ABSTRACTObjectives:Celiac disease (CD) is a common immune‐mediated disorder that affects up to 1% of the general population. Recent reports suggest that the incidence of CD has reached a plateau in many countries. We aim to study the incidence and altered presentation of childhood CD in a well‐defined population.Methods:Using the Rochester Epidemiology Project, we retrospectively reviewed Mayo Clinic and Olmsted Medical Center medical records from January 1994 to December 2014. We identified all CD cases of patients ages 18 years or younger at the time of diagnosis. Incidence rates were calculated by adjusting for age, sex, and calendar year and standardizing to the 2010 US white population.Results:We identified 100 patients with CD. Incidence of CD has increased from 8.1 per 100,000 person‐years (2000–2002) to 21.5 per 100,000 person‐years (2011–2014). There was an increase in CD prevalence in children from 2010 (0.10%) to 2014 (0.17%). Thirty‐four patients (34%) presented with classical CD symptoms, 43 (43%) had nonclassical CD, and 23 (23%) were diagnosed by screening asymptomatic high‐risk patients. Thirty‐six patients (36%) had complete villous atrophy, 51 (51%) had partial atrophy, and 11 (11%) had increased intraepithelial lymphocytes. Two patients were diagnosed without biopsy. Most patients (67%) had a normal body mass index, 17% were overweight/obese, and only 9% were underweight.Conclusions:Both incidence and prevalence of CD have continued to increase in children during the past 15 years in Olmsted County, Minnesota. Clinical and pathologic presentations of CD are changing over time (more nonclassical and asymptomatic cases are emerging).
Abdominal Arterial Anomalies in Children With Alagille Syndrome
Authors: Kohaut Jules , Pommier Romain , Guerin Florent , Pariente Danièle , Jacquemin Emmanuel , Martelli Hélène , Branchereau Sophie 
Published: February 2017

ABSTRACTObjectives:Angiogenic defects secondary to gene mutations of JAG1 and NOTCH2, causing arterial anomalies in Alagille syndrome (AGS), are well described in the literature. The study analyzes the frequency of abdominal arterial anomalies in children with AGS with an emphasis on outcomes following liver transplantation (LT).Methods:Between 1988 and 2013, 242 children with AGS were treated at our institution. We performed a retrospective analysis of 55 who underwent LT during the study period. Preoperative abdominal arterial findings, operative reports, arterial reconstruction technique, and early as well as late complications following LT were reviewed specifically focusing on arterial thrombosis.Results:Twenty‐five patients had preoperative imaging available for analysis. Twelve of these patients showed celiac trunk stenosis (48.0%), 2, a superior mesenteric artery stenosis (8.0%) and one a stenosis of both renal arteries. Twenty patients (36.3%) underwent standard hepatic reconstruction using the native recipient hepatic artery. Thirty‐five patients (63.7%) underwent aortic conduit reconstruction (ACR) from the infrarenal aorta using donor arterial conduits. Hepatic artery thrombosis occurred in 9 patients (16.3%). This number was higher in the standard arterial anastomosis group 7/20 (35.0%) than in those with ACR 2/35 (5.7%, P = 0.0079).Conclusions:In this series, children with AGS pretransplant have a high prevalence of abdominal arterial anomalies. Preoperative abdominal vascular imaging makes it possible to anticipate whether or not a classical arterial revascularization can be performed or whether an ACR is required.
Simple Urine Test to Evaluate Adherence to Oral 5‐ASA in Teenagers With Ulcerative Colitis
Authors: Dijkstra Alie , Touw Daan J. , van Rheenen Patrick F. 
Published: February 2017

ABSTRACTObjectives:5‐Aminosalicylic acid (5‐ASA) is an important maintenance drug for patients with ulcerative colitis. A proportion of the ingested dose is excreted in the urine. Measuring 5‐ASA and its metabolites in urine requires mass spectrometry, which is not widely available for this purpose. Urinary 5‐ASA can be measured by colorimetry using the serum salicylic acid assay and is a surrogate marker of recent 5‐ASA ingestion. We evaluated whether measuring 5‐ASA in first morning voids or in random spot urine samples correctly identifies teenagers with poor adherence to oral 5‐ASA.Methods:Teenagers who were prescribed a current regimen including >40 mg · kg−1 · day−1 of 5‐ASA were invited to collect their spot urine with various time lapses since their last presumed 5‐ASA ingestion. Classification of adherence was based on a composite method that included a patient‐reported adherence scale and 6‐thioguanine levels in erythrocytes.Results:Teenagers who were classified as “good adherers” had 66 of 69 (96%; 95% confidence interval 87%–99%) spot urine samples with detectable 5‐ASA levels. “Poor adherers” had 30 of 45 (67%; 95% confidence interval 52%–79%) spot urine samples with undetectable 5‐ASA levels. The “good adherers” with false‐negative urine tests were on a once daily dosing regimen and had collected a spot urine sample shortly before the next dosage. Their first morning voids had detectable 5‐ASA levels.Conclusions:Undetectable 5‐ASA levels in the first morning void confirms short‐term nonadherence to oral 5‐ASA.
Fecal Calprotectin and Eosinophil‐derived Neurotoxin in Healthy Children Between 0 and 12 Years
Authors: Roca María , Rodriguez Varela Ana , Donat Ester , Cano Francisco , Hervas David , Armisen Ana , Vaya Maria J. , Sjölander Anders , Ribes‐Koninckx Carmen 
Published: February 2017

ABSTRACTObjectives:In young children, the use of fecal calprotectin (fCP) as a biomarker is limited because reference values have not been widely accepted up to now. Moreover, reference values for fecal eosinophil–derived neurotoxin (fEDN) in children have not been established. The aim of the present study was to investigate fCP and fEDN levels in young healthy children to establish reference values.Methods:Stool samples were obtained from healthy children ages 0 to 12 years. fCP and fEDN levels were analyzed using the EliA Calprotectin 2 assay (Phadia AB) and a novel research assay (on the ImmunoCAP platform), respectively.Results:In the 174 included children (87 boys), 95th Percentile values ranged from 1519 mg/kg at 0 months to 54.4 mg/kg at 144 months for fCP and from 9.9 mg/kg at 0 months to 0.2 mg/kg at 144 months for fEDN. There was a statistically significant association between age and fCP concentrations (P < 0.001) and age and fEDN concentrations (P < 0.001). We also found a statistically significant association between fEDN and fCP concentrations (rho = 0.52, P < 0.001). According to our results, we provide a nomogram and we suggest 3 different age groups for evaluation of fCP and fEDN concentrations, the 95th percentile being respectively 910.3 and 7.4 mg/kg for 0–12 months, 285.9 and 2.9 mg/kg for >1 to 4 years, and 54.4 and 0.2 mg/kg for >4 to 12 years.Discussion:By using an improved analytical method, we have confirmed that young healthy children have higher fCP concentrations than healthy adults. We, for the first time, report reference values for fEDN concentrations in a pediatric population. The proposed nomograms and reference values for fCP and fEDN are aimed at facilitating the applicability of biomarkers for both neutrophil‐ and eosinophil‐mediated intestinal inflammation in children in clinical practice.
Career Development Support in Pediatric Critical Care Medicine: A National Survey of Fellows and Junior Faculty*
Authors: Cifra Christina L. , Balikai Shilpa S. , Murtha Tanya D. , Hsu Benson , Riley Carley L. 
Published: February 2017

Objectives:
To determine the perceptions of current pediatric critical care medicine fellows and junior faculty regarding the extent and quality of career development support received during fellowship training.

Design:
Web-based cross-sectional survey open from September to November 2015.

Setting:
Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs.

Subjects:
Pediatric critical care medicine fellows (second yr or higher) and junior faculty (within 5 yr of completing a pediatric critical care medicine fellowship program).

Interventions:
None.

Measurements and Main Results:
There were 129 respondents to the survey, representing 63% of Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs. Respondents were evenly divided between fellows and junior faculty. Nearly, half (49%) of respondents reported that their pediatric critical care medicine fellowship program provided a formal career development curriculum. Ideal career tracks chosen included academic clinician educator (64%), physician-scientist (27%), community-based (nonacademic) clinician (11%), and administrator (11%). There was a disparity in focused career development support provided by programs, with a minority providing good support for those pursuing a community-based clinician track (32%) or administrator track (16%). Only 43% of fellows perceived that they have a good chance of obtaining their ideal pediatric critical care medicine position, with the most common perceived barrier being increased competition for limited job opportunities. Most respondents expressed interest in a program specific to pediatric critical care medicine career development that is sponsored by a national professional organization.

Conclusions:
Most pediatric critical care medicine fellows and junior faculty reported good to excellent career development support during fellowship. However, important gaps remain, particularly for those pursuing community-based (nonacademic) and administrative tracks. Fellows were uncertain regarding future pediatric critical care medicine employment and their ability to pursue ideal career tracks. There may be a role for professional organizations to provide additional resources for career development in pediatric critical care medicine.
Micro Free Orbital Fat Grafts to the Tear Trough Deformity during Lower Blepharoplasty
Authors: Miranda Suzette G. , Codner Mark A. 
Published: February 2017

Background:
The tear trough deformity is challenging in lower eyelid rejuvenation. Surgical treatment has evolved, with more modern techniques preserving orbital fat and using autologous fat transposition. The senior author (M.A.C.) reviewed his own experience in targeting the tear trough in lower lid blepharoplasty and presents a new technique that incorporates the addition of micro free fat grafts that adds direct volume to the underlying anatomical depression using a transcutaneous skin-muscle approach.

Methods:
Medical records of lower lid blepharoplasty patients performed from February of 2011 to February of 2016 were reviewed. Patients who had tear trough deformities with the addition of micro free fat grafts were included. Standard patient characteristics were collected, complications were identified, and assessment of postoperative results was performed.

Results:
There were 32 patients included in the study, with a median follow-up of 392 days (range, 45 to 1709 days). Scleral show requiring operative correction occurred in one patient (3 percent). Additional complications included chemosis in four patients (13 percent), which resolved in all patients. No patients had infections, ectropion, lid retraction, or palpable or visible grafts.

Conclusion:
The use of micro free orbital fat grafts is an effective and safe technique to treat the tear trough deformity without increased complication rates and good patient and surgeon satisfaction and should be considered a surgical adjunct during an open blepharoplasty technique.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease
Authors: Molenkamp Sanne , Schouten Tanneke A. M. , Broekstra Dieuwke C. , Werker Paul M. N. , Moolenburgh J. Daniel 
Published: February 2017

Background:
Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account.

Methods:
The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively. The authors described the early postoperative results of percutaneous needle fasciotomy and applied linear mixed models to compare mean correction of passive extension deficit between joints and efficacy of primary versus secondary percutaneous needle fasciotomy.

Results:
Mean preoperative passive extension deficits at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 37, 40, and 31 degrees, respectively. Mean preoperative total passive extension deficit was 54 degrees. Results were excellent, with a mean total passive extension deficit correction of 85 percent. Percutaneous needle fasciotomy was most effective for metacarpophalangeal joints and less effective for proximal interphalangeal and distal interphalangeal joints. Secondary percutaneous needle fasciotomy was as effective as primary percutaneous needle fasciotomy. Complications were rare and mostly minor.

Conclusion:
The results of this study confirm that percutaneous needle fasciotomy is an effective and safe treatment modality for patients with mild to moderate disease who prefer a minimally invasive procedure.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
A New Classification of Helix Fabrication Methods with Autogenous Costal Cartilage in Microtia Reconstruction
Authors: Xu Zhicheng , Xu Feng , Zhang Ruhong , Zhang Qun , Li Datao , Li Yiyuan 
Published: February 2017

Background:
Recreating the complex architecture of the auricle poses one of the most demanding challenges for the plastic surgeon. The fabrication of the prominent helix is crucial to the final contour of the constructed ear. The success of helix carving depends greatly on the complicated characteristics of the cartilage used, which is commonly the eighth costal cartilage. The authors elaborate on the relevant details for helix sculpting based on different qualities of cartilage.

Methods:
A series of 415 microtia patients underwent autogenous costal cartilage auricular reconstruction between 2012 and 2015. Because the cartilage used for helix reconstruction is always imperfect or insufficient for the fabrication of anatomical structures, they have devised perfect helix duplication by using individualized eighth rib cartilage with different cartilage lengths, widths, and flexibilities. Four possible scenarios in helix fabrication have been elaborated, and the corresponding methods were introduced.

Results:
Selective methods for different scenarios in helix fabrication have been shown to produce favorable results. The results reveal that a harmonious helix was achieved and provide a cohesive framework for the integrity of a reconstructed ear.

Conclusions:
A new classification of helix fabrication methods with autogenous costal cartilage is elaborated, and a favorable framework with harmonious proportions is achieved by precise carving using corresponding measures for different cartilage characteristics. This approach enhances helix aesthetics and helps attain a satisfactory contour of the auricle.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Laparoscopic and Open Surgical Treatment in Gastroduodenal Perforations: Our Experience
Authors: Laforgia Rita , Balducci Giovanni , Carbotta Giuseppe , Prestera Antonio , Sederino Maria Grazia , Casamassima Giulia , Minafra Marina , Sallustio Pierluca , Palasciano Nicola 
Published: February 2017

Introduction:
Peptic ulcer perforation (PPU) is a common surgical emergency and the mortality rate ranges 10% to 40%, especially in elderly patients. Laparoscopic repair achieved encouraging results.

Materials and Methods:
We enrolled patients performing surgical repair for PPU from January 2007 to December 2015 in our surgical unit. The aim of this retrospective observational study was to compare the results of PPU laparoscopic repair with open technique. The following characteristics of patients were evaluated: age, sex and American Society of Anesthesiologists classification. The site and the diameter of perforation were recorded: gastric, pyloric, duodenal, and the location on the anterior or posterior wall.

Results:
In total, 59 patients (39 males and 20 females) with a mean age of 58.85 years (±SD) were treated surgically. Laparoscopic repair was accomplished in 21 patients. The mean operative time for laparoscopic repair was 72 minutes (±SD), significantly shorter than open repair time (180 min ±SD). The results demonstrated that laparoscopic repair is associated with a shorter operative time, reduced postoperative pain (4.75 vs. 6.42) and analgesic requirements, a shorter hospital stay (7.5 vs. 13.1), and earlier return to normal daily activities.

Discussion:
Laparoscopic surgery minimizes postoperative wound pain and encourages early mobilization and return to normal daily activities. The benefit of early discharge and return to work may outweigh the consumable cost incurred in the execution of laparoscopic procedures.

Conclusions:
Complications in both procedures are similar but laparoscopic procedure shows economic advantages for reducing postoperative hospital stay, postoperative pain, and for a good integrity of abdominal wall.
Catching ghosts with a coarse net: use and abuse of spatial sampling data in detecting synchronization
Authors: Petrovskaya Natalia , Petrovskii Sergei 
Published: February 2017

Synchronization of population dynamics in different habitats is a frequently observed phenomenon. A common mathematical tool to reveal synchronization is the (cross)correlation coefficient between time courses of values of the population size of a given species where the population size is evaluated from spatial sampling data. The corresponding sampling net or grid is often coarse, i.e. it does not resolve all details of the spatial configuration, and the evaluation error—i.e. the difference between the true value of the population size and its estimated value—can be considerable. We show that this estimation error can make the value of the correlation coefficient very inaccurate or even irrelevant. We consider several population models to show that the value of the correlation coefficient calculated on a coarse sampling grid rarely exceeds 0.5, even if the true value is close to 1, so that the synchronization is effectively lost. We also observe ‘ghost synchronization’ when the correlation coefficient calculated on a coarse sampling grid is close to 1 but in reality the dynamics are not correlated. Finally, we suggest a simple test to check the sampling grid coarseness and hence to distinguish between the true and artifactual values of the correlation coefficient.
Flexible motor adjustment of pecking with an artificially extended bill in crows but not in pigeons
Authors: Matsui Hiroshi , Izawa Ei-Ichi 
Published: February 2017

The dextrous foraging skills of primates, including humans, are underpinned by flexible vision-guided control of the arms/hands and even tools as body-part extensions. This capacity involves a visuomotor conversion process that transfers the locations of the hands/arms and a target in retinal coordinates into body coordinates to generate a reaching/grasping movement and to correct online. Similar capacities have evolved in birds, such as tool use in corvids and finches, which represents the flexible motor control of extended body parts. However, the flexibility of avian head-reaching and bill-grasping with body-part extensions remains poorly understood. This study comparatively investigated the flexibility of pecking with an artificially extended bill in crows and pigeons. Pecking performance and kinematics were examined when the bill extension was attached, and after its removal. The bill extension deteriorated pecking in pigeons in both performance and kinematics over 10 days. After the bill removal, pigeons started bill-grasping earlier, indicating motor adaptation to the bill extension. Contrastingly, pecking in crows was deteriorated transiently with the bill extension, but was recovered by adjusting pecking at closer distances, suggesting a quick adjustment to the bill extension. These results indicate flexible visuomotor control to extended body parts in crows but not in pigeons.
In vivostructures of an intact type VI secretion system revealed by electron cryotomography
Authors: Chang Yi-Wei , Rettberg Lee A. , J. Jensen Grant 
Published: February 2017

SUMMARYThe type VI secretion system (T6SS) is a versatile molecular weapon used by many bacteria against eukaryotic hosts or prokaryotic competitors. It consists of a cytoplasmic bacteriophage tail-like structure anchored in the bacterial cell envelope via a cytoplasmic baseplate and a periplasmic membrane complex. Rapid contraction of the sheath in the bacteriophage tail-like structure propels an inner tube/spike complex through the target cell envelope to deliver effectors. While structures of purified contracted sheath and purified membrane complex have been solved, because sheaths contract upon cell lysis and purification, no structure is available for the extended sheath. Structural information about the baseplate is also lacking. Here we use electron cryotomography to directly visualize intact T6SS structures insideMyxococcus xanthuscells. Using sub-tomogram averaging, we resolve the structure of the extended sheath and membrane-associated components including the baseplate. Moreover, we identify novel extracellular bacteriophage tail fiber-like antennae. These results provide new structural insights into how the extended sheath prevents premature disassembly and how this sophisticated machine may recognize targets.
Resting-state network dysfunction in Alzheimer’s disease: a systematic review and meta-analysis
Authors: Badhwar AmanPreet , Tam Angela , Dansereau Christian , Orban Pierre , Hoffstaedter Felix , Bellec Pierre 
Published: February 2017

ABSTRACTINTRODUCTIONWe performed a systematic review and meta-analysis of the Alzheimer’s disease (AD) literature to examine consistency of functional connectivity alterations in AD dementia and mild cognitive impairment (MCI), using resting-state functional magnetic resonance imaging (rsfMRI).METHODSStudies were screened using a standardized procedure. Multiresolution statistics were performed to assess the spatial consistency of findings across studies.RESULTSThirty-four studies were included (1,363 participants, average 40 per study). Consistent alterations in connectivity were found in the default-mode, salience and limbic networks in patients with AD dementia, MCI, or in both groups. We also identified a bias in the literature towards specific examination of the default-mode network.DISCUSSIONConvergent evidence across the literature supports the use of resting-state connectivity as a biomarker of AD. The locations of consistent alterations suggest that metabolically expensive hub regions in the brain might be an early target of AD.