bluuebunny/crossref_metadata_2025_split huggingface dataset:
Graves' disease in children: long‐term outcomes of medical therapy
Authors: Rabon Shona , Burton Amy M. , White Perrin C. 
Published: May 2016

SummaryBackground and objectivesManagement options are limited for the treatment of Graves' disease, and there is controversy regarding optimal treatment. We describe the demographic and biochemical characteristics of children with Graves' disease and the outcomes of its management.MethodsThis is a retrospective study reviewing medical records from 2001 to 2011 at a tertiary‐care paediatric hospital. Diagnostic criteria included elevated free T4 and total T3, suppressed TSH, and either positive thyroid‐stimulating immunoglobulin or thyroid receptor antibodies or clinical signs suggestive of Graves' disease, for example exophthalmos. Patients were treated with antithyroid drugs (ATD), radioactive iodine, or thyroidectomy. The main outcome measures were remission after medical therapy for at least 6 months and subsequent relapse.ResultsA total of 291 children met diagnostic criteria. A total of 62 were male (21%); 117 (40%) were Hispanic, 90 (31%) Caucasian, and 59 (20%) African American. Mean age (±standard deviation) at diagnosis was 12·3 ± 3·8 (range 3–18·5) years. At diagnosis, 268 patients were started on an antithyroid drug and 23 underwent thyroid ablation or thyroidectomy. Fifty‐seven (21%) children achieved remission and 16 (28%) of these patients relapsed, almost all within 16 months. Gender and ethnicity did not affect rates of remission or relapse. Of 251 patients treated with methimazole, 53 (21%) had an adverse reaction, including rash, arthralgias, elevated transaminases, or neutropenia.ConclusionsMost children with Graves' disease treated with ATD do not experience remission, but most remissions do not end in relapse. Adverse reactions to methimazole are common but generally mild.
Oxaliplatin/fluorouracil‐based adjuvant chemotherapy for locally advanced rectal cancer after neoadjuvant chemoradiotherapy and surgery: a systematic review and meta‐analysis of randomized controlled trials
Authors: Zhao L. , Liu R. , Zhang Z. , Li T. , Li F. , Liu H. , Li G. 
Published: May 2016

AbstractAimPrevious randomized controlled trials and meta‐analyses have demonstrated the ineffectiveness of fluorouracil‐based adjuvant chemotherapy for patients with rectal cancer who have undergone neoadjuvant chemoradiotherapy and subsequent surgery. The role of oxaliplatin/fluorouracil‐based adjuvant chemotherapy in such patients is unknown. We performed a meta‐analysis to evaluate the efficacy of oxaliplatin/fluorouracil‐based adjuvant chemotherapy based on a comparison with fluorouracil‐based adjuvant chemotherapy for patients with rectal cancer.MethodA literature search of MEDLINE, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov was performed to identify eligible studies. The primary end‐point of interest was disease‐free survival (DFS). The secondary end‐points were overall survival, compliance and the incidence of Grade 3 or 4 toxicity.ResultsThe literature search identified four randomized controlled trials that met the inclusion criteria for the meta‐analysis, and 2793 patients with pathological TNM or clinical TNM Stage II or III disease were included. The meta‐analysis showed that oxaliplatin/fluorouracil‐based adjuvant chemotherapy was associated with a significantly improved DFS (hazard ratio 0.85; 95% CI 0.73−0.98; P = 0.03), comparable compliance (OR 1.18; 95% CI 0.95−1.46; P = 0.13) and a higher incidence of vomiting or nausea (OR 2.47; 95% CI 1.21−5.05; P = 0.01). No significant differences were observed between the groups with respect to overall survival and the incidence of leucopaenia, anaemia, thrombocytopaenia and diarrhoea.ConclusionAdjuvant oxaliplatin/fluorouracil‐based chemotherapy can improve the DFS of patients after neoadjuvant chemoradiotherapy and radical surgery, compared with adjuvant fluorouracil‐based chemotherapy. Data of the longer‐term survival outcome are needed.
Gut microbiota in early pediatric multiple sclerosis: a case−control study
Authors: Tremlett H. , Fadrosh D. W. , Faruqi A. A. , Zhu F. , Hart J. , Roalstad S. , Graves J. , Lynch S. , Waubant E. ,   the US Network of Pediatric MS Centers
Published: May 2016

Background and purposeAlterations in the gut microbial community composition may be influential in neurological disease. Microbial community profiles were compared between early onset pediatric multiple sclerosis (MS) and control children similar for age and sex.MethodsChildren ≤18 years old within 2 years ofMSonset or controls without autoimmune disorders attending a University of California, San Francisco,USA, pediatric clinic were examined for fecal bacterial community composition and predicted function by 16S ribosomalRNAsequencing and phylogenetic reconstruction of unobserved states (PICRUSt) analysis. Associations between subject characteristics and the microbiota, including beta diversity and taxa abundance, were identified using non‐parametric tests, permutational multivariate analysis of variance and negative binomial regression.ResultsEighteen relapsing−remittingMScases and 17 controls (mean age 13 years; range 4–18) were studied. Cases had a short disease duration (mean 11 months; range 2–24) and half were immunomodulatory drug (IMD) naïve. Whilst overall gut bacterial beta diversity was not significantly related toMSstatus,IMDexposure was (Canberra,P< 0.02). However, relative to controls,MScases had a significant enrichment in relative abundance for members of theDesulfovibrionaceae(Bilophila,DesulfovibrioandChristensenellaceae) and depletion inLachnospiraceaeandRuminococcaceae(allPandq< 0.000005). Microbial genes predicted as enriched inMSversus controls included those involved in glutathione metabolism (Mann−Whitney,P= 0.017), findings that were consistent regardless ofIMDexposure.ConclusionsIn recent onset pediatricMS, perturbations in the gut microbiome composition were observed, in parallel with predicted enrichment of metabolic pathways associated with neurodegeneration. Findings were suggestive of a pro‐inflammatory milieu.
Cardiometabolic risk profile based on body mass index in American Indian children and adolescents
Authors: Wheelock K. M. , Fufaa G. D. , Nelson R. G. , Hanson R. L. , Knowler W. C. , Sinha M. 
Published: May 2016

SummaryBackgroundChildhood obesity is associated with increased cardiometabolic risk.ObjectiveTo study the relationship between body mass index (BMI) and cardiometabolic risk factors in American Indian children and adolescents.MethodsDifferences in metabolic variables by age and sex‐specific BMI percentiles (2000 Centers for Disease Control and Prevention Growth Charts) were examined in a cross‐sectional analysis of 2977 individuals across three age categories. Children with an exam in two consecutive age categories were included in a longitudinal analysis. Spearman's correlations were used to test the association of BMI percentile with anthropometric and biochemical variables.ResultsBody mass index percentile correlated with systolic (r = 0.24 to 0.38) and diastolic (r = 0.13 to 0.22) blood pressure, fasting plasma glucose (r = 0.20 to 0.33), 2‐h plasma glucose (r = 0.30 to 0.46), total cholesterol (r = 0.12 to 0.23), serum triglycerides (r = 0.40 to 0.51) and HDL cholesterol (r = −0.36 to −0.43) in each age group (5–9, 10–13 and 14–17 years). Among participants examined in multiple age categories, BMI percentile increased over time. Change in BMI percentile from one age category to the next was associated with an increase in fasting glucose, 2‐h glucose and triglycerides and a decrease in HDL cholesterol.ConclusionHigher BMI was associated with blood pressure elevation, hyperglycaemia and dyslipidaemia in American Indian children and adolescents.
Concurrent vaccination against equine influenza and equine herpesvirus – a practical approach
Authors: Gildea Sarah , Sanchez Higgins Maria Jose , Johnson Gillian , Walsh Cathal , Cullinane Ann 
Published: May 2016

BackgroundThere is a lack of information concerning concurrent administration of vaccines against equine influenza virus (EIV) and equine herpesvirus 1 and 4 (EHV‐1/4).ObjectivesThe primary objective of this study was to determine the impact of the concurrent use of EIV and EHV‐1/4 vaccines in Thoroughbred racehorses on their humoral immune response to EIV.MethodsThis study was carried out on a population of 30 horses using an inactivated whole‐virus EIV vaccine and an inactivated EHV‐1/4 vaccine. Horses were randomly allocated to vaccination group A or B. Horses in group A were vaccinated against EIV and EHV‐1/4 2 weeks apart. Horses in group B were vaccinated against EIV and EHV‐1/4 on the same day. Whole‐blood samples were collected on the day of vaccination and 2 weeks and 6 weeks post‐vaccination. Antibody levels against EIV and EHV‐1/4 were measured using the single radial haemolysis and serum neutralisation test, respectively.ResultsThe pattern of EIV antibody response post‐vaccination was similar for both groups. Highest EIV antibody levels were recorded 2 weeks post‐vaccination, and a significant decrease in antibody level was observed 4 weeks later. Horses in group B demonstrated a significantly higher EIV antibody response post‐vaccination. Overall, there was no significant difference in EHV‐1/4 antibody response between the two groups post‐vaccination.ConclusionIn this study, concurrent vaccination against EIV and EHV‐1/4 increased the response to EIV and did not compromise the humoral immune response to EHV‐1/4.
Clinical validation of the nursing diagnosis of dysfunctional family processes related to alcoholism
Authors: Mangueira Suzana de Oliveira , Lopes Marcos Venícios de Oliveira 
Published: May 2016

AbstractAimsTo evaluate the clinical validity indicators for the nursing diagnosis of dysfunctional family processes related to alcohol abuse.BackgroundAlcoholism is a chronic disease that negatively affects family relationships. Studies on the nursing diagnosis of dysfunctional family processes are scarce in the literature. This diagnosis is currently composed of 115 defining characteristics, hindering their use in practice and highlighting the need for clinical validation.DesignThis was a diagnostic accuracy study.MethodsA sample of 110 alcoholics admitted to a reference centre for alcohol treatment was assessed during the second half of 2013 for the presence or absence of the defining characteristics of the diagnosis. Operational definitions were created for each defining characteristic based on concept analysis and experts evaluated the content of these definitions. Diagnostic accuracy measures were calculated from latent class models with random effects.Results/findingsAll 89 clinical indicators were found in the sample and a set of 24 clinical indicators was identified as clinically valid for a diagnostic screening for family dysfunction from the report of alcoholics. Main clinical indicators with high specificity included sexual abuse, disturbance in academic performance in children and manipulation. The main indicators that showed high sensitivity values were distress, loss, anxiety, low self‐esteem, confusion, embarrassment, insecurity, anger, loneliness, deterioration in family relationships and disturbance in family dynamics.ConclusionEighteen clinical indicators showed a high capacity for diagnostic screening for alcoholics (high sensitivity) and six indicators can be used for confirmatory diagnosis (high specificity).
Incidence of Significant Delayed Esophageal Temperature Drop After Cryoballoon‐Based Pulmonary Vein Isolation
Authors: DEISS SEBASTIAN , METZNER ANDREAS , OUYANG FEIFAN , TILZ ROLAND R. , MATHEW SHIBU , LEMES CHRISTINE , HEEGER CHRISTIAN‐H. , MAURER TILMAN , KUCK KARL‐HEINZ , WISSNER ERIK 
Published: May 2016

Significant Delayed ET Drop After CB‐Based PV Vein IsolationBackgroundThe second‐generation cryoballoon (CB2) has demonstrated superior clinical outcome. Potential procedural complications include esophageal thermal lesions due to excessive esophageal temperature (ET). Safety cut‐offs for the ET have previously been published. A safety margin was incorporated due to a delayed esophageal temperature decline even after termination of the CB2 freeze cycle. The extent of these delayed temperature drops requires further systematic evaluation.Methods and ResultsThe study enrolled 29 patients with paroxysmal or shortstanding persistent AF who underwent CB2‐based PVI. Freeze cycle duration was 240 seconds. No bonus freeze was applied after successful PVI. The intraluminal ET was continuously measured via a transorally inserted probe (SensiTherm, St. Jude Medical, Inc.). The CB2 temperature and ET were recorded throughout the procedure using a camera setup. The mean number of freeze cycles per patient was 4.3 ± 2. A total of 147 cryoenergy applications were analyzed. A delayed decline in ET of >0.5 °C was recorded following termination of 23.1% of freeze cycles. The maximum drop in delayed ET was 6.4 °C. Excessive esophageal cooling during the freeze cycle exceeding 8.5 °C/min may result in ET ≤10 °C.ConclusionsFollowing termination of cryoenergy delivery, the ET may decline an additional 6.4 °C. Proposed ET safety cut‐offs during CB2‐based PVI need to account for a significant ET drop that may occur even after termination of the individual freeze cycle.
Internet use and online safety in adults with Williams syndrome
Authors: Lough E. , Fisher M. H. 
Published: May 2016

AbstractBackgroundIndividuals with intellectual and developmental disabilities (IDD) increasingly have access to the Internet. Whilst Internet access increases opportunities for social connection for individuals with IDD, it also may increase risk of victimisation. Adults with Williams syndrome (WS), who display an extreme pro‐social drive to engage with both familiar and unfamiliar people, might be especially vulnerable to online victimisation. This study first explores how often and why individuals with WS use the Internet and social networking sites. Next, the online vulnerability of individuals with WS is assessed through responses to hypothetical scenarios of potentially dangerous online interactions.MethodTwenty‐eight young adults with WS (mean age = 27.7 years) and their parents completed questionnaires about their Internet and social networking use and parental oversight. Participants with WS then responded to hypothetical scenarios assessing their likelihood to take social and non‐social risks online.ResultsMost participants with WS frequently use the Internet and the majority visit social networking sites every day or almost every day, with little parental supervision or oversight. Individuals with WS interact with both known and unknown individuals through social networking sites. Participants are more likely to agree to engage in socially risky behaviours compared to risky behaviours that are not social in nature when online. For example, participants were more likely to agree to meet an ‘online friend’ in person than they were to give their bank account information for winning a ‘contest’.ConclusionsIndividuals with WS, who are a socially vulnerable group in the real world, display behaviours that could also lead to victimisation online as well. As the Internet continues to become more accessible, more research is needed to increase online safety of individuals with WS and other IDDs. Implications for intervention and future research are discussed.
Development of a clinical nurse recognition scale for female intimate partner violence patients
Authors: Inoue Matsuyo , Uza Miyoko , Shinjo Masaki , Akamine Itsuko 
Published: May 2016

AbstractAimWe aimed to develop a Recognition Scale for Female Intimate Partner Violence (IPV) Patients (RS‐FIPVP); measure the levels and clarify the structure of IPV recognition among clinical nurses; and confirm the validity and reliability of the scale.MethodsA cross‐sectional, anonymous, self‐administered questionnaire was administered to clinical nurses (n = 2570) at seven clinical settings in Okinawa, Japan. As a result, 1855 valid responses were obtained and used in the analysis. The statistical analysis examined an exploratory and confirmatory factor analysis, internal consistency, and construct validity.ResultsFour factors, comprising 20 items, were extracted for IPV recognition among clinical nurses. The confirmatory factor analysis showed that the indices of fitness supported these results. The Cronbach's alpha coefficient was 0.83 for the total score and 0.71, 0.73, 0.74, and 0.71 for Factors 1, 2, 3, and 4, respectively. Four factors were extracted from the oblique factor analysis, with a cumulative variance of 50.0%: “understanding of the victim's situation”, “violence that is difficult to detect”, “patient characteristics”, and “support and coordination”. The four factors had a moderate correlation (0.27–0.47, P < 0.01) with each other, which indicated construct validity. These findings confirmed fit for the RS‐FIPVP.ConclusionsThe RS‐FIPVP, a recognition scale to measure and evaluate the recognition of female IPV patients among clinical nurses, was developed. It may be used to improve the recognition of female IPV patients in nursing continuing education and also to measure and evaluate educational interventions. The reliability and validity of the scale were verified; however, further refining, testing, and evaluation are required.
Age‐related changes in the tooth–bone interface area of acrodont dentition in the chameleon
Authors: Dosedělová Hana , Štěpánková Kateřina , Zikmund Tomáš , Lesot Herve , Kaiser Jozef , Novotný Karel , Štembírek Jan , Knotek Zdeněk , Zahradníček Oldřich , Buchtová Marcela 
Published: May 2016

AbstractChameleon teeth develop as individual structures at a distance from the developing jaw bone during the pre‐hatching period and also partially during the post‐hatching period. However, in the adult, all teeth are fused together and tightly attached to the jaw bone by mineralized attachment tissue to form one functional unit. Tooth to bone as well as tooth to tooth attachments are so firm that if injury to the oral cavity occurs, several neighbouring teeth and pieces of jaw can be broken off. We analysed age‐related changes in chameleon acrodont dentition, where ankylosis represents a physiological condition, whereas in mammals, ankylosis only occurs in a pathological context. The changes in hard‐tissue morphology and mineral composition leading to this fusion were analysed. For this purpose, the lower jaws of chameleons were investigated using X‐ray micro‐computed tomography, laser‐induced breakdown spectroscopy and microprobe analysis. For a long time, the dental pulp cavity remained connected with neighbouring teeth and also to the underlying bone marrow cavity. Then, a progressive filling of the dental pulp cavity by a mineralized matrix occurred, and a complex network of non‐mineralized channels remained. The size of these unmineralized channels progressively decreased until they completely disappeared, and the dental pulp cavity was filled by a mineralized matrix over time. Moreover, the distribution of calcium, phosphorus and magnesium showed distinct patterns in the different regions of the tooth–bone interface, with a significant progression of mineralization in dentin as well as in the supporting bone. In conclusion, tooth–bone fusion in chameleons results from an enhanced production of mineralized tissue during post‐hatching development. Uncovering the developmental processes underlying these outcomes and performing comparative studies is necessary to better understand physiological ankylosis; for that purpose, the chameleon can serve as a useful model species.
The organization of spinal motor neurons in a monotreme is consistent with a six‐region schema of the mammalian spinal cord
Authors: Mitchelle Amer , Watson Charles 
Published: May 2016

AbstractThe motor neurons in the spinal cord of an echidna (Tachyglossus aculeatus) have been mapped in Nissl‐stained sections from spinal cord segments defined by spinal nerve anatomy. A medial motor column of motor neurons is found at all spinal cord levels, and a hypaxial column is found at most levels. The organization of the motor neuron clusters in the lateral motor column of the brachial (C5 to T3) and crural (L2 to S3) limb enlargements is very similar to the pattern previously revealed by retrograde tracing in placental mammals, and the motor neuron clusters have been tentatively identified according to the muscle groups they are likely to supply. The region separating the two limb enlargements (T4 to L1) contains preganglionic motor neurons that appear to represent the spinal sympathetic outflow. Immediately caudal to the crural limb enlargement is a short column of preganglionic motor neurons (S3 to S4), which it is believed represents the pelvic parasympathetic outflow. The rostral and caudal ends of the spinal cord contain neither a lateral motor column nor a preganglionic column. Branchial motor neurons (which are believed to supply the sternomastoid and trapezius muscles) are present at the lateral margin of the ventral horn in rostral cervical segments (C2–C4). These same segments contain the phrenic nucleus, which belongs to the hypaxial column. The presence or absence of the main spinal motor neuron columns in the different regions echidna spinal cord (and also in that of other amniote vertebrates) provides a basis for dividing the spinal cord into six main regions – prebrachial, brachial, postbrachial, crural, postcrural and caudal. The considerable biological and functional significance of this subdivision pattern is supported by recent studies on spinal cord hox gene expression in chicks and mice. On the other hand, the familiar ‘segments’ of the spinal cord are defined only by the anatomy of adjacent vertebrae, and are not demarcated by intrinsic gene expression. The recognition of segments defined by vertebrae (somites) is obviously of great value in defining topography, but the emphasis on such segments obscures the underlying evolutionary reality of a spinal cord comprised of six genetically defined regions. The six‐region system can be usefully applied to the spinal cord of any amniote (and probably most anurans), independent of the number of vertebral segments in each part of the spinal column.