bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Cervical Degeneration and Global Spinal Alignment in Patients With Adult Spinal Deformity
Authors: Fujimori Takahito , Le Hai , Schairer William , Inoue Shinichi , Iwasaki Motoki , Oda Takenori , Hu Serena S. 
Published: October 2015

Objectives:
To examine the relationship between cervical degeneration and spinal alignment by comparing patients with adult spinal deformity versus the control cohort.

Summary of Background Data:
The effect of degeneration on cervical alignment has been controversial.

Methods:
Cervical and full-length spine radiographs of 57 patients with adult spinal deformity and 78 patients in the control group were reviewed. Adult spinal deformity was classified into 3 types based on the primary characteristics of the deformity: “Degenerative flatback” group, “Positive sagittal imbalance” group, and “Hyperthoracic kyphosis” group. Cervical degeneration was assessed using the cervical degeneration index scoring system.

Results:
The “Degenerative flatback” group had significantly higher total cervical degeneration index score (25±7) than the control group (16±8), the “Positive sagittal imbalance” group (18±8), and the “Hyperthoracic kyphosis” group (12±7) (P<0.01). The “Degenerative flatback” group had significantly less cervical lordosis than the other groups. This reduced amount of cervical lordosis was thought to be induced by a compensatory decrease in thoracic kyphosis. In this group, increased cervical degeneration was significantly associated with a decrease in cervical lordosis. Significantly greater compensatory increase in cervical lordosis was noted in the “Positive sagittal imbalance” group (20±15 degrees) and the “Hyperthoracic kyphosis” group (26±9 degrees) compared with the control group (11±12 degrees) (P<0.02).

Conclusions:
Flat cervical spine coexisted with cervical degeneration when compensatory hypothoracic kyphosis was induced by degenerative flatback. In other situations, cervical lordosis could increase as a compensatory reaction against sagittal imbalance or hyperthoracic kyphosis.
Abdominal Pain‐predominant Functional Gastrointestinal Disorders in Adolescent Nigerians
Authors: Udoh Ekong , Devanarayana Niranga Manjuri , Rajindrajith Shaman , Meremikwu Martin , Benninga Marc Alexander 
Published: October 2015

ABSTRACTObjectives:To determine the prevalence, pattern, and predisposing factors of abdominal pain‐predominant functional gastrointestinal disorders (AP‐FGIDs) in adolescent Nigerians.Methods:A cross‐sectional study was conducted in 2 states in the southern part of Nigeria in June 2014. Adolescents of age 10 to 18 years were recruited from 11 secondary schools using a stratified random sampling technique. A validated self‐administered questionnaire on Rome III criteria for diagnosing AP‐FGIDs and its determinants were filled by the participants in a classroom setting.Results:A total of 874 participants filled the questionnaire. Of this, 818 (93.4%) filled it properly and were included in the final analysis. The mean age of the participants was 14.6 ± 2.0 years with 409 (50.0%) being boys. AP‐FGIDs were present in 81 (9.9%) participants. Forty six (5.6%) of the study participants had irritable bowel syndrome (IBS), 21 (2.6%) functional abdominal pain, 15 (1.8%) abdominal migraine while 3 (0.4%) had functional dyspepsia. The difference in AP‐FGIDs between adolescents residing in rural and urban areas was not statistically significant (P = 0.22). Intestinal and extra‐intestinal symptoms occurred more frequently in those with AP‐FGIDs. Nausea was the only symptom independently associated with AP‐FGIDs (p = 0.015). Multiple regression analysis showed no significant association between stressful life events and AP‐FGIDs.Conclusions:AP‐FGIDs are a significant health problem in Nigerian adolescents. In addition to the intestinal symptoms, most of the affected children and others also had extraintestinal symptoms. None of the stressful life events evaluated was significantly associated with FGIDs.
Environmental Risk Factors of Pediatric‐Onset Primary Sclerosing Cholangitis and Autoimmune Hepatitis
Authors: Tenca Andrea , Färkkilä Martti , Jalanko Hannu , Vapalahti Katariina , Arola Johanna , Jaakkola Tytti , Penagini Roberto , Vapalahti Olli , Kolho Kaija‐Leena 
Published: October 2015

ABSTRACTObjectives:The aim of this population‐based observational case‐control questionnaire study was to investigate the possible role of environmental risk factors associated with pediatric‐onset autoimmune liver diseases.Methods:Seventy‐one patients with autoimmune liver diseases (<16 years) received a questionnaire with 22 items, evaluating contact with environmental factors (eg, family manners, type of housing, pets) before the diagnosis. Two age‐ and sex‐matched control groups were used: inflammatory bowel disease (IBD; n = 91) and healthy subjects (n = 716; matched also for place of residence at birth). Univariate analysis (odds ratio [OR] and 95% confidence interval) for all variables was calculated. Fisher exact test was performed to depict associations between variables and the multivariate logistic regression to test their interactions.Results:In the final analyses, the responses of 51 autoimmune liver diseases cases (n = 51/71, 72%), 59 IBD controls (n = 59/91, 65%), and 292 healthy controls (n = 292/716, 41%) were investigated. In univariate analysis only having a cat, a dog, and a cat or a dog were risk factors of autoimmune liver diseases (OR varying between 2.6–3.4); no other significant associations (eg, place of residence, number of siblings, family manners) were found. Multivariate logistic regression analyses showed that especially living with a cat in block of flats was a risk factor (OR 3.6, 1.2–10.8).Conclusions:Living in a close contact with a pet (especially a cat) was a risk factor of autoimmune liver diseases. This finding may suggest an involvement of an unidentified agent (ie, toxin/microbe) among the triggers of these diseases.
Precolectomy Therapy Does Not Alter Histologic Findings Distribution in Resected Colon in Pediatric Ulcerative Colitis
Authors: Wahbeh Ghassan T. , Lawless Margaret E. , Suskind David L. , Shaffer Michele L. , Cole Bonnie 
Published: October 2015

ABSTRACTObjectives:Medically intractable pediatric ulcerative colitis can lead to colectomy after which patients commonly receive an ileoanal pouch. Postoperative complications are more common in patients with Crohn disease, a diagnosis that may be rendered after the colectomy specimen is examined. Because most children are likely to be exposed to medications before colectomy, we sought to examine whether such exposure influences the distribution of the inflammation within the resected colon and therefore potentially raise questions about the diagnosis accuracy.Methods:We conducted a retrospective cohort study of 32 pediatric ulcerative colitis cases undergoing colectomy from 2007 to 2014 for clinical data and precolectomy treatment history. The resected colon histology was reviewed independently by 2 blinded pathologists. The acute/active inflammation was scored using the modified Riley score for 3 colonic segments (proximal, transverse, and distal colon) for each patient. Linear mixed‐effects models were used to evaluate possible association between acute/active inflammation scores at various sites and medication use.Results:Twelve cases (38%) showed decreasing acute inflammation score distally to proximally, 8 (25%) had increasing scores, and 12 cases showed no change. Patients were most commonly exposed to corticosteroids, followed by anti‐tumor necrosis factor antibodies. There was no statistically or clinically significant change in the histologic scores across the colonic segments of the resected colon in association with exposure to any specific medication or combination of medications, sex, age at diagnosis and surgery, or duration of disease.Conclusions:Precolectomy therapy does not seem to influence the distribution of inflammation within the resected colon.
Role of Vitamin D in Hospitalized Children With Lower Tract Acute Respiratory Infections
Authors: Cebey‐López Miriam , Pardo‐Seco Jacobo , Gómez‐Carballa Alberto , Martinón‐Torres Nazareth , Rivero‐Calle Irene , Justicia Antonio , Redondo Lorenzo , Martinón‐Sánchez José María , Martínez‐Padilla María del Carmen , Giménez‐Sánchez Francisco , Salas Antonio , Martinón‐Torres Federico ,   GENDRES Network
Published: October 2015

ABSTRACTBackground:Vitamin D is known to have modulatory actions in the immune system. Its influence on the severity of lower tract acute respiratory infections (LT‐ARIs) is unclear.Objectives:The aim of the present study was to evaluate the role of vitamin D on LT‐ARI in paediatric patients.Methods:Children admitted to hospital with LT‐ARI were prospectively recruited through the GENDRES network (March 2009–May 2013). The 25‐hydroxyvitamin D (25‐OHD) levels were measured by immunoassay. The severity of the illness was evaluated according to clinical scales, length of hospital stay, ventilatory requirements, and pediatric intensive care unit admission.Results:A total of 347 patients with a median (interquartile range) age of 8.4 (2.6–21.1) months were included. The mean (SD) 25‐OHD levels in our series were 27.1 (11.3) ng/mL. In this study, a cutoff value of ≥30 ng/mL was considered optimal vitamin status. Patients with 25‐OHD levels <20 ng/mL were at a higher risk of showing severe signs of respiratory difficulties (OR 5.065, 95% confidence interval 1.998–12.842; P = 0.001) than patients with normal values, and had a 117% higher risk of oxygen necessity and 217% higher risk of ventilatory requirement than those patients with normal values. An inverse correlation was found between 25‐OHD levels and the severity in the evaluated scales. 25‐OHD levels did not influence PICU admission rate or length of hospital stay.Conclusions:25‐OHD levels of children admitted because of a LT‐ARI are <30 ng/mL. Lower levels of 25‐OHD were found to be correlated with severity of the disease. The possible role of abnormal 25‐OHD levels as a facilitator or consequence of the infection needs further evaluation.
Infected Congenital Epicardial Cyst Presenting as Acute Abdomen
Authors: Dribin Timothy , Files Matthew D. , Rudzinski Erin R. , Kaplan Ron , Stone Kimberly P. 
Published: October 2015

Abstract
A previously healthy 3-year-old boy presented to the emergency department with abdominal pain, fever, and emesis. Laboratory and radiologic evaluation for causes of acute abdomen were negative; however, review of the abdominal x-ray demonstrated cardiomegaly with the subsequent diagnosis of pericardial cyst by echocardiogram and computed tomography. The patient underwent surgical decompression and attempted removal of the cystic structure revealing that the cyst originated from the epicardium. His abdominal pain and fever resolved postoperatively and he completed a 3-week course of ceftriaxone for treatment of Propionibacterium acnes infected congenital epicardial cyst. Emergency department physicians must maintain a broad differential in patients with symptoms of acute abdomen to prevent complications from serious cardiac or pulmonary diseases that present with symptoms of referred abdominal pain.
Pediatric Disseminated Lemierre Syndrome in 2 Infants
Authors: García-Salido Alberto , Unzueta-Roch José Luis , García-Teresa María Ángeles , Sirvent-Cerdá Sara , Martínez de Azagra-Garde Amelia , Casado-Flores Juan 
Published: October 2015

Abstract
The Lemierre syndrome is characterized by an oropharyngeal infection, thrombosis of the internal jugular vein, and multiple septic metastases. Fusobacterium necrophorum is a common cause of it. The incidence is 0.6 to 2.3 cases per million with a mortality rate of 4% to 18%. Its fast evolution and the possibility of severe complications require a high index of suspicion for its diagnosis. We present 2 infants with Lemierre syndrome. The younger case, a 6-month-old infant, was fully recovered. In the other side, and despite an aggressive therapy, an 18-month-old infant developed cerebral palsy. We also provide a short literature review with a focus on clinical presentation and differential diagnosis in order to initiate an early and adequate therapy.
Severe Respiratory Distress in a Neonate due to Bilateral Dacryocystoceles
Authors: Klotz Daniel , Schönlaub Jörn , Hackenberg Stephan , Wirbelauer Johannes 
Published: October 2015

Abstract
Nasal passage contributes up to 50% of total resistance in normal breathing especially in neonates who are obligatory nose breathers. Any further increase in airway resistance may lead to severe respiratory distress. Dacryocystoceles are a rare cause of nasal obstruction in neonates. We present the case of a full-term 3-day-old female infant with progressive respiratory distress due to bilateral dacryocystoceles.
A Novel Agent for Management of Agitated Delirium
Authors: Kowalski J. Michael , Kopec Kathryn T. , Lavelle Jane , Osterhoudt Kevin 
Published: October 2015

Abstract
Control of the agitated patient in the emergency department is challenging. Many options exist for chemical sedation, but most have suboptimal pharmacodynamic action, and many have undesirable adverse effects. There are reports of ketamine administration for control of agitation prehospital and in traumatically injured patients. Ketamine is a noncompetitive N-methyl-D-aspartic acid receptor antagonist, making it an effective dissociative agent. We present 5 cases of ketamine administration to manage agitated adolescent patients with underlying psychiatric disease and/or drug intoxication. Ketamine, as a dissociative agent, may be an alternative pharmacological consideration for the control of agitation in patients with undifferentiated agitated delirium.
Geographic Variation in the Use of Low-Acuity Pediatric Emergency Medical Services
Authors: Gregory Emily F. , Chamberlain James M. , Teach Stephen J. , Engstrom Ryan , Mathison David J. 
Published: October 2015

Objective
The aim of this study was to examine geographic variation in pediatric low-acuity emergency medical services (EMS) use in Washington, DC.

Methods
This cross-sectional analysis of low-acuity EMS transports evaluated arrivals at 2 emergency departments and included 93% of pediatric transports in Washington, DC, during the study period. Low-acuity classification was defined as a triage emergency severity index of 4 or 5 not resulting in transfer, admission, or death. Logistic regression compared low-acuity visits arriving via EMS with all other low-acuity visits. Home zip code represented geographic location. Covariates included patient age, sex, race/ethnicity, hour of emergency department arrival, and insurance status.

Results
There were 45,454 low-acuity visits among children aged 0 to 17 years. Of these, 3304 (7.3%) arrived via EMS. The mean age was 5.6 (±5.0) years. Most were African American (84.3%) and had Medicaid insurance (87.3%). Geographic variation predicted EMS use. Adjusted odds ratios (ORs) of using EMS varied from 1.11 to 2.54 when compared with the lowest EMS use zip code. Odds of EMS use were higher among those with public insurance (adjusted OR [adj OR], 1.71; 95% confidence interval [CI], 1.46–2.00) and those with evening and overnight arrivals (evening arrival, adj OR of 1.65 and 95% CI of 1.47–1.86; overnight arrival, adj OR of 2.98 and 95% CI of 2.43–3.65).

Conclusions
After adjusting for known covariates, residential zip code was associated with low-acuity EMS activation, stressing the importance of geographic variation in EMS use. Providing alternate means of transportation, or targeted education to certain residential areas, may decrease unnecessary EMS activation.
Benchmarking inverse statistical approaches for protein structure and design with exactly solvable models
Authors: Jacquin Hugo , Gilson Amy , Shakhnovich Eugene , Cocco Simona , Monasson Rémi 
Published: October 2015

AbstractInverse statistical approaches to determine protein structure and function from Multiple Sequence Alignments (MSA) are emerging as powerful tools in computational biology. However the underlying assumptions of the relationship between the inferred effective Potts Hamiltonian and real protein structure and energetics remain untested so far. Here we use lattice protein model (LP) to benchmark those inverse statistical approaches. We build MSA of highly stable sequences in target LP structures, and infer the effective pairwise Potts Hamiltonians from those MSA. We find that inferred Potts Hamiltonians reproduce many important aspects of ‘true’ LP structures and energetics. Careful analysis reveals that effective pairwise couplings in inferred Potts Hamiltonians depend not only on the energetics of the native structure but also on competing folds; in particular, the coupling values reflect both positive design (stabilization of native conformation) and negative design (destabilization of competing folds). In addition to providing detailed structural information, the inferred Potts models used as protein Hamiltonian for design of new sequences are able to generate with high probability completely new sequences with the desired folds, which is not possible using independent-site models. Those are remarkable results as the effective LP Hamiltonians used to generate MSA are not simple pairwise models due to the competition between the folds. Our findings elucidate the reasons of the power of inverse approaches to the modelling of proteins from sequence data, and their limitations; we show, in particular, that their success crucially depend on the accurate inference of the Potts pairwise couplings.Author SummaryInverse statistical approaches, modeling pairwise correlations between amino acids in the sequences of similar proteins across many different organisms, can successfully extract protein structure (contact) information. Here, we benchmark those statistical approaches on exactly solvable models of proteins, folding on a 3D lattice, to assess the reasons underlying their success and their limitations. We show that the inferred parameters (effective pairwise interactions) of the statistical models have clear and quantitative interpretations in terms of positive (favoring the native fold) and negative (disfavoring competing folds) protein sequence design. New sequences randomly drawn from the statistical models are likely to fold into the native structures when effective pairwise interactions are accurately inferred, a performance which cannot be achieved with independent-site models.
CRISPR system acquisition and evolution of an obligate intracellularChlamydia-related bacterium
Authors: Bertelli Claire , Cissé Ousmane , Rusconi Brigida , Kebbi-Beghdadi Carole , Croxatto Antony , Goesmann Alexander , Collyn François , Greub Gilbert 
Published: October 2015

ABSTRACTRecently, a newChlamydia-relatedorganism,Protochlamydia naegleriophilaKNic, was discovered within aNaegleriaamoeba. To decipher the mechanisms at play in the modeling of genomes from theProtochlamydiagenus, we sequencedde novothe full genome ofPr. naegleriophilacombining the advantages of two second-generation sequencing technologies. The assembled complete genome comprises a 2,885,111 bp chromosome and a 145,285 bp megaplasmid. For the first time within theChlamydialesorder, a CRISPR system, the immune system of bacteria, was discovered on the chromosome. It is composed of a small CRISPR locus comprising eight repeats and the associatedcasandcsegenes of the subtype I-E. A CRISPR locus was also found withinChlamydiasp. Diamant, anotherPr. naegleriophilastrain whose genome was recently released, suggesting that the CRISPR system was acquired by a common ancestor of these two members ofPr. naegleriophila,after the divergence fromPr. amoebophila.The plasmid encodes an F-type conjugative system similar to that found in the Pam100G genomic island ofPr. amoebophilasuggesting an acquisition of this conjugative system before the divergence of bothProtochlamydiaspecies and the integration of a putativePr. amoebophilaplasmid into its main chromosome giving rise to the Pam100G genomic island. Overall, this newPr. naegleriophilagenome sequence enables to investigate further the dynamic processes shaping the genomes ofChlamydia-relatedbacteria.
Personalisation – love it or hate it?
Authors: Needham Catherine , Glasby Jon 
Published: October 2015

Purpose
– The purpose of this paper is to reflect on five reasons why personalisation is so contested. It aims to highlight the shared themes that point to common ground between advocates and critics of personalisation.

Design/methodology/approach
– The paper draws on different academic and practitioner perspectives on personalisation, covering both advocates for and critics of the personalisation reforms.

Findings
– The paper concludes by suggesting that the development of self-directed support in Scotland has the potential to develop social care change in ways which may be palatable to both sides of the English policy debate.

Originality/value
– People who support and critique personalisation often write in ways which do not directly engage with the perspectives of the other side. Here the authors engage directly with the points of difference to explicate why such a diversity of perspectives exists, and how there is more common ground than might be assumed.
Is the FHA Creating Sustainable Homeownership?
Authors: Caplin Andrew , Cororaton Anna , Tracy Joseph 
Published: October 2015

We produce first estimates of the sustainability of homeownership for recent Federal Housing Administration (FHA) borrowers. Unfortunately, the FHA does not produce its own statistics on sustainability. Neither does it permit researchers access to its data on internal refinances. This imposes significant barriers to entry for researchers who wish to track FHA borrower performance over time. We carefully construct the required tracking data to overcome this barrier. We forecast that no more than 75% of the 2007–2009 vintages of FHA borrowers will be able to successfully exit the FHA system. Our work raises questions about FHA's role, its accounting and its accountability.
Spruce budworm feeding and oviposition are stimulated by monoterpenes in white spruce epicuticular waxes
Authors: Ennis Darragh , Despland Emma , Chen Fei , Forgione Pat , Bauce Eric 
Published: October 2015

AbstractMonoterpenes, source of the distinctive odor of conifers, are generally considered plant defensive compounds. However, they are also known to act as long‐range insect attractants, as they are volatile and permeate forest airspaces. Moreover, they are lipid soluble and can be absorbed into plant epicuticular waxes. We test their role in short‐range host plant choice by both adult females and larvae of a folivorous forest pest (Choristoneura fumiferana). We conducted laboratory assays testing the responses of Eastern spruce budworm to an artificial monoterpene mix (α‐pinene, β‐pinene, limonene, myrcene) and to white spruce (Picea glauca) epicuticular waxes in closed arenas. Ovipositing females preferred filter paper discs treated with P. glauca waxes to controls, and preferred the waxes + monoterpenes treatment to waxes alone. However, females showed no preference between the monoterpene‐treated disc and the control when presented without waxes. Feeding larvae prefered wax discs to control discs. They also consumed discs treated with realistic monoterpene concentrations and wax preferentially over wax‐only discs, but showed no preference between extremely high monoterpene concentrations and wax‐only controls. In an insect‐free assay, P. glauca epicuticular wax decreased monoterpene volatilization. These results suggest that P. glauca waxes and realistic concentrations of monoterpenes are stimulatory to both egg‐laying females and feeding larvae, and that their effects are synergistic.