bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use and Accuracy of Diagnostic Imaging by Hospital Type in Pediatric Appendicitis
Authors: Saito Jacqueline M. , Yan Yan , Evashwick Thomas W. , Warner Brad W. , Tarr Phillip I. 
Published: December 2012

OBJECTIVE:
Accurate, timely diagnosis of pediatric appendicitis minimizes unnecessary operations and treatment delays. Preoperative abdominal-pelvic computed tomography (CT) scan is sensitive and specific for appendicitis; however, concerns regarding radiation exposure in children obligate scrutiny of CT use. Here, we characterize recent preoperative imaging use and accuracy among pediatric appendectomy subjects.

METHODS:
We retrospectively reviewed children who underwent operations for presumed appendicitis at a single tertiary-care children’s hospital and examined preoperative CT and ultrasound use with subject characteristics. Preoperative imaging accuracy was compared with postoperative and histologic diagnosis as the reference standard.

RESULTS:
Most children (395/423, 93.4%) who underwent an operation for appendicitis during 2009–2010 had preoperative imaging. Final diagnoses included normal appendix (7.3%) and perforated appendicitis (23.6%). In multivariable analysis, initial evaluation at a community hospital versus the children’s hospital was associated with 4.4-fold higher odds of obtaining a preoperative CT scan (P = .002), whereas preoperative ultrasound was less likely (odds ratio 0.20; P = .003). Ultrasound and CT sensitivities for appendicitis were diminished for studies performed at community hospitals compared with the children’s hospital. Girls were 4.5-fold more likely to undergo both ultrasound and CT scans and were associated with lower ultrasound sensitivity for appendicitis.

CONCLUSIONS:
Widespread preoperative imaging did not eliminate unnecessary pediatric appendectomies. Controlling for factors potentially associated with referral bias, a CT scan was more likely to be performed in children initially evaluated at community hospitals compared with the children’s hospital. Broadly-applicable strategies to systematically maximize diagnostic accuracy for childhood appendicitis, while minimizing ionizing radiation exposure, are urgently needed.
Prevalence of Vitamin D Deficiency Among Overweight and Obese US Children
Authors: Turer Christy B. , Lin Hua , Flores Glenn 
Published: December 2012

OBJECTIVE:
Adequate vitamin D is essential for skeletal health in developing children. Although excess body weight is associated with risk of vitamin D deficiency, the national prevalence of and risk factors associated with vitamin D deficiency in overweight and obese children are unknown.

METHODS:
The prevalence of vitamin D deficiency (defined as 25-hydroxyvitamin-D &lt;20 ng/mL) was determined in a sample of 6- to 18-year-old children who were enrolled in a cross-sectional study (the 2003–2006 National Health and Nutrition Examination Survey) in which body weight and height were measured directly. Children were classified as healthy-weight, overweight, obese, or severely obese by using recommended age- and gender-specificBMI-percentile cut points. Associations between BMI-percentile classification and vitamin D deficiency were examined after adjustment for relevant confounders. Sample weights were used to generate nationally representative estimates.

RESULTS:
The prevalence of vitamin D deficiency in healthy-weight, overweight, obese, and severely obese children was 21% (20%–22%), 29% (27%–31%), 34% (32%–36%), and 49% (45%–53%), respectively. The prevalence of vitamin D deficiency in severely obese white, Latino, and African-American children was 27% (3%–51%), 52% (36%–68%), and 87% (81%–93%), respectively. Compared with healthy-weight children, overweight, obese, and severely obese children had significantly greater adjusted odds of vitamin D deficiency. Modifiable factors associated with vitamin D deficiency in overweight/obese children were identified.

CONCLUSIONS:
Vitamin D deficiency is highly prevalent in overweight and obese children. The particularly high prevalence in severely obese and minority children suggests that targeted screening and treatment guidance is needed.
Development at Age 36 Months in Children With Deformational Plagiocephaly
Authors: Collett Brent R. , Gray Kristen E. , Starr Jacqueline R. , Heike Carrie L. , Cunningham Michael L. , Speltz Matthew L. 
Published: December 2012

OBJECTIVES:Infants and toddlers with deformational plagiocephaly (DP) have been shown to score lower on developmental measures than unaffected children. To determine whether these differences persist, we examined development in 36-month-old children with and without a history of DP.METHODS:Participants included 224 children with DP and 231 children without diagnosed DP, all of who had been followed in a longitudinal study since infancy. To confirm the presence or absence of DP, pediatricians blinded to children’s case status rated 3-dimensional cranial images taken when children were 7 months old on average. The Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) was administered as a measure of child development.RESULTS:Children with DP scored lower on all scales of the BSID-III than children without DP. Differences were largest in cognition, language, and parent-reported adaptive behavior (adjusted differences = –2.9 to –4.4 standard score points) and smallest in motor development (adjusted difference = –2.7). Children in the control group who did not have previously diagnosed DP but who were later rated by pediatricians to have at least mild cranial deformation also scored lower on the BSID-III than unaffected controls.CONCLUSIONS:Preschool-aged children with a history of DP continue to receive lower developmental scores than unaffected controls. These findings do not imply that DP causes developmental problems, but DP may nonetheless serve as a marker of developmental risk. We encourage clinicians to screen children with DP for developmental concerns to facilitate early identification and intervention.
Forensic standardizations in torture and death in custody investigations
Authors: Stan Cristian Adrian 
Published: December 2012

Abstract
Torture and death in custody have incurred rapid development as juridical subject in recent years in Europe, with the implementation of the European Convention of Human Rights. Evaluation of sufferance severity, which is the consequence of pathology with chronic evolution, the predictability of decompensation of a subclinical pathology, and translating these medical information on a scale measuring the severity of detention consequences, are all challenges for the modern detention healthcare system, in which most allegations of torture are due to lack of appropriate medical treatment administered to inmates. Where ethics are concerned, the main data difficulties are addressed in ethical conflicts between officials and experts of the parties and also between experts and judiciary officials who handle cases of torture or death in detention; this is why standardization is very important in such cases both in clinical expertise and in autopsies or exhumations.

Discussions
We must improve the forensic expertise methodology, the process of collecting data with statistical purposes, and sound evaluation criteria, all in a strong connection with the need for a balanced legal framework applied in the case of civil compensations granted after death in custody, and the biunique relation between medico-legal expertise and case investigation has to be standardized.
The Ideal Approach for Working Over Onshore Wells in Very Congested Locations
Authors: Al-Dossary Abdulla F. , Al-Ghamdi Mohammed S. , Al-Haj Haider A. 
Published: December 2012

Abstract
Accessibility to wells location requiring work over is so important to ensure safe production, work environment and provides a protection to the existing assets including wells, pipelines and other production facilities. The locations of multiple wells are designed and constructed to provide enough space between wells for a rig to drill them safely and smoothly. Besides, they should accommodate future work over operations. When location has several wells with limited space in between, it is challenging to work over them with full compliance to the safety guidelines. Saudi Aramco work over team has managed successfully to work over wells in very congested location in one of north onshore fields where the spacing does not exceed a few feet. In this paper, a light will be cast on the work over campaign launched recently to work over these wells to convert them from purely vertical wells into horizontal to bring birth to them after being dead for high water production. The challenges including accessibility to well sites, site preparation, securing wells nearby, protection of environment and safe operation are all going to be addressed and discussed in details. Also, measures taken to overcome difficulties encountered especially safe rig up are presented and explained as well.
A moment of Klim
Authors: Karas Alyona 
Published: December 2012

Abstract
The present article focuses on the notion of intertextuality as put into practice on the Russian stage by the Podval generation (late 1980s). The author documents the aesthetic complexity of the stage imagery employed by this generation in an analysis of performances staged by the most important dramatist and theatre maker of Russian alternative theatre, Klim (born 1952 in Ukraine).
Image, Europe, drama
Authors: Pavlovski Mishel 
Published: December 2012

Abstract
By questioning the ways in which a supra-national European identity can be created in an environment of globalization, this article starts with the thesis that this concept faces problems which must be resolved first and foremost at the national level. By problematizing multiculturalism as a “utopian theory” which does not solve any problems at the practical level, and by viewing interculturalism as a potential danger to “smaller” cultures, this article identifies what it is that hinders the possible acceptance of the idea of a Europe without borders by analyzing plays by Goran Stefanovski. In four of his plays, Euralien, Hotel Europa, Ex-Yu, and Goce, Stefanovski criticizes Western Europe, on the one hand, for constructing a problematic Other, imposing a visa regime, and contributing to its marginalization, and the Balkans on the other, for mythologizing its nationally-romanticized narrative. The paper sheds light on the fact that the acceptance of a common (shared) European identity, a necessity which propagates itself amidst conditions of globalization, is dependent on the ways in which Europe will resolve its problems, such as the marginalization of the Other, way of thinking in binary oppositions, like old/new Europe, rich/poor Europe, and especially (talking about Balkan countries) the phrase South-East Balkan.
Accuracy of Transnasal Cannulation and Dilation of the Maxillary Ostium in Cadavers with Intact Uncinates
Authors: Brodner David , Alexander Ian , Chandler Stephen , Cutler Jeffrey , Saigal Kapil 
Published: December 2012

Background Transnasal cannulation of the natural ostium in patients with an intact uncinate process is complicated by the lack of direct visualization of the ostium. Accuracy of transnasal dilation of the maxillary ostium was evaluated for a malleable-tipped balloon device that was bent to specific angles for avoiding the fontanelle during cannulation. Methods Transnasal cannulation and dilation of 42 cadaver maxillary sinus ostia was attempted by 6 surgeons including 3 with very limited clinical experience using the study device. All physicians received procedure training including the technique to shape the balloon device into the recommended 135° maxillary configuration. Tissue dissection was prohibited. Canine fossa trephination and transantral endoscopy were used to evaluate cannulation and dilation outcomes. Physician operators were blinded to transantral images and results were documented by two observers. Results Appropriate transnasal cannulation and dilation of natural maxillary sinus ostia occurred in 92.9% (39/42) of attempts. Two failures emanated from procedural deviations. In one deviation, the bend angle was changed to 90° and the device tip did not cannulate the ostium. In the second, the device was passed through a preexisting hole in the uncinate and cannulated the natural ostium. A third failure occurred when the device was passed through the fontanelle creating a false lumen. Conclusion Using recommended procedural techniques and a malleable-tipped balloon device, newly trained and experienced physicians alike can perform uncinate-preserving transnasal cannulation and dilation of the maxillary ostium with a high rate of success.
Aeroallergen Challenge Promotes Dendritic Cell Proliferation in the Airways
Authors: Veres Tibor Z. , Voedisch Sabrina , Spies Emma , Valtonen Joona , Prenzler Frauke , Braun Armin 
Published: December 2012

Abstract
Aeroallergen provocation induces the rapid accumulation of CD11c+MHC class II (MHC II)+ dendritic cells (DCs) in the lungs, which is driven by an increased recruitment of blood-derived DC precursors. Recent data show, however, that well-differentiated DCs proliferate in situ in various tissues. This may also contribute to their allergen-induced expansion; therefore, we studied DC proliferation in the airways of mice in the steady state and after local aeroallergen provocation. Confocal whole-mount microscopy was used to visualize proliferating DCs in different microanatomical compartments of the lung. We demonstrate that in the steady state, CD11c+MHC II+ DCs proliferate in both the epithelial and subepithelial layers of the airway mucosa as well as in the lung parenchyma. A 1-h pulse of the nucleotide 5-ethynyl-2′-deoxyuridine was sufficient to label 5% of DCs in both layers of the airway mucosa. On the level of whole-lung tissue, 3–5% of both CD11b+ and CD11b− DC populations and 0.3% of CD11c+MHC IIlow lung macrophages incorporated 5-ethynyl-2′-deoxyuridine. Aeroallergen provocation caused a 3-fold increase in the frequency of locally proliferating DCs in the airway mucosa. This increase in mucosal DC proliferation was later followed by an elevation in the number of DCs. The recruitment of monocyte-derived inflammatory DCs contributed to the increasing number of DCs in the lung parenchyma, but not in the airway mucosa. We conclude that local proliferation significantly contributes to airway DC homeostasis in the steady state and that it is the major mechanism underlying the expansion of the mucosal epithelial/subepithelial DC network in allergic inflammation.
Aurintricarboxylic Acid Ameliorates Experimental Autoimmune Encephalomyelitis by Blocking Chemokine-Mediated Pathogenic Cell Migration and Infiltration
Authors: Zhang Feifei , Wei Wei , Chai Hui , Xie Xin 
Published: December 2012

Abstract
Multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis (EAE), are autoimmune diseases characterized by the immune-mediated demyelination and neurodegeneration of the CNS. Overactivation of CD4+ T cells, especially the Th1 and Th17 subpopulations, is thought to be the direct cause of this disease. Aurintricarboxylic acid (ATA), an inhibitor of protein–nucleic acid interaction, has been reported to block with the JAK/STAT signaling pathway that is critical for Th cell differentiation. In this study, we discovered that ATA treatment significantly reduces the clinical score of EAE, but it does not directly inhibit the differentiation of Th1 and Th17 cells in vitro. ATA was found to block the chemotaxis and accumulation of dendritic cells in the spleen of EAE mice before the onset of the disease and to reduce the percentage of Th1 and Th17 cells in the spleen. Further study revealed that ATA also blocks the infiltration of pathogenic T cells into the CNS and blocks the onset of passive EAE. ATA was found to inhibit the functions of many chemokine receptors. By blocking chemokine-mediated migration of dendritic cells and pathogenic T cells, ATA alleviates the pathogenesis of EAE and might be used to treat autoimmune diseases, including multiple sclerosis.
Nck Recruitment to the TCR Required for ZAP70 Activation during Thymic Development
Authors: Borroto Aldo , Arellano Irene , Dopfer Elaine P. , Prouza Marek , Suchànek Miloslav , Fuentes Manuel , Orfao Alberto , Schamel Wolfgang W. , Alarcón Balbino 
Published: December 2012

Abstract
The adaptor protein Nck is inducibly recruited through its SH3.1 domain to a proline-rich sequence (PRS) in CD3ε after TCR engagement. However, experiments with a knockin mutant bearing an 8-aa replacement of the PRS have indicated that Nck binding to the TCR is constitutive, and that it promotes the degradation of the TCR in preselection double-positive (DP) CD4+CD8+ thymocytes. To clarify these discrepancies, we have generated a new knockin mouse line (KI-PRS) bearing a conservative mutation in the PRS resulting from the replacement of the two central prolines. Thymocytes of KI-PRS mice are partly arrested at each step at which pre-TCR or TCR signaling is required. The mutation prevents the trigger-dependent inducible recruitment of endogenous Nck to the TCR but does not impair TCR degradation. However, KI-PRS preselection DP thymocytes show impaired tyrosine phosphorylation of CD3ζ, as well as impaired recruitment of ZAP70 to the TCR and impaired ZAP70 activation. Our results indicate that Nck is recruited to the TCR in an inducible manner in DP thymocytes, and that this recruitment is required for the activation of early TCR-dependent events. Differences in the extent of PRS mutation could explain the phenotypic differences in both knockin mice.
Mouse IgM Fc Receptor, FCMR, Promotes B Cell Development and Modulates Antigen-Driven Immune Responses
Authors: Choi Seung-Chul , Wang Hongsheng , Tian Linjie , Murakami Yousuke , Shin Dong-Mi , Borrego Francisco , Morse Herbert C. , Coligan John E. 
Published: December 2012

Abstract
FcR specific for pentameric IgM (FCMR) is expressed at high levels by B cells. Although circulating IgM has profound effects on responses to pathogens, autoimmunity, and B cell homeostasis, the biologic consequences of its binding to FCMR are poorly understood. We interrogated FCMR contributions to B cell function by studying mice that lack FCMR. FCMR transcripts are expressed at different levels by various B cell subsets. FCMR-deficient mice have reduced numbers of developing B cells, splenic follicular and peritoneal B-2 cells, but increased levels of peritoneal B-1a cells and autoantibodies. After immunization, germinal center B cell and plasma cell numbers are increased. FCMR-deficient B cells are sensitive to apoptosis induced by BCR ligation. Our studies demonstrate that FCMR is required for B cell differentiation and homeostasis, the prevention of autoreactive B cells, and responsiveness to antigenic challenge.
Deficiency of Annexin A1 in CD4+ T Cells Exacerbates T Cell–Dependent Inflammation
Authors: Yang Yuan H. , Song Wuqi , Deane James A. , Kao Wenping , Ooi Joshua D. , Ngo Devi , Kitching A. Richard , Morand Eric F. , Hickey Michael J. 
Published: December 2012

Abstract
Annexin A1 (AnxA1) is recognized as an endogenous anti-inflammatory molecule. However, its effects on the adaptive immune response and, in particular, on T cells remain unclear. In this study, we investigated the actions of AnxA1 in three distinct models of T cell–mediated inflammation. In contact hypersensitivity, collagen-induced arthritis, and inflammation induced by OT-II TCR transgenic T cells responding to OVA, AnxA1 deficiency significantly increased Ag-induced T cell proliferation and the resultant level of inflammation. In the contact hypersensitivity model, this was associated with increased adhesion of CD4+ T cells, CD8+ T cells, and neutrophils in the dermal microvasculature, as well as increased T cell expression of RORγt and IL-17A. In collagen-induced arthritis, deficiency of endogenous AnxA1 increased susceptibility to arthritis and Ag-specific T cell activation. Deficiency of AnxA1 also increased OVA-induced cutaneous delayed-type hypersensitivity and IFN-γ and IL-17 release. Transfer experiments using CD4+ T cells from AnxA1−/− mice demonstrated that the absence of AnxA1 solely in T cells resulted in increased inflammatory responses in wild-type recipients. Similarly, experiments using AnxA1−/− OT-II CD4+ T cells demonstrated that the absence of AnxA1 in T cells was sufficient to induce increased Ag-specific CD4+ T cell proliferation in vivo, augment T cell production of IFN-γ, IL-17, TNF, and IL-6, and increase Akt, ERK, and p38 activation. Together, these findings indicate that T cell–expressed AnxA1 functions to attenuate T cell–driven inflammatory responses via T cell–intrinsic effects on intracellular signaling, proliferation, and Th1/Th17 cytokine release.
Neutrophil Extracellular Trap–Associated Protein Activation of the NLRP3 Inflammasome Is Enhanced in Lupus Macrophages
Authors: Kahlenberg J. Michelle , Carmona-Rivera Carmelo , Smith Carolyne K. , Kaplan Mariana J. 
Published: December 2012

Abstract
Neutrophil extracellular traps (NETs) represent an important defense mechanism against microorganisms. Clearance of NETs is impaired in a subset of patients with systemic lupus erythematosus, and NETosis is increased in neutrophils and, particularly, in low-density granulocytes derived from lupus patients. NETs are toxic to the endothelium, expose immunostimulatory molecules, activate plasmacytoid dendritic cells, and may participate in organ damage through incompletely characterized pathways. To better understand the role of NETs in fostering dysregulated inflammation, we examined inflammasome activation in response to NETs or to LL-37, an antibacterial protein externalized on NETs. Both NETs and LL-37 activate caspase-1, the central enzyme of the inflammasome, in both human and murine macrophages, resulting in release of active IL-1β and IL-18. LL-37 activation of the NLRP3 inflammasome utilizes P2X7 receptor–mediated potassium efflux. NET and LL-37-mediated activation of the inflammasome is enhanced in macrophages derived from lupus patients. In turn, IL-18 is able to stimulate NETosis in human neutrophils. These results suggest that enhanced formation of NETs in lupus patients can lead to increased inflammasome activation in adjacent macrophages. This leads to release of inflammatory cytokines that further stimulate NETosis, resulting in a feed-forward inflammatory loop that could potentially lead to disease flares and/or organ damage.
CD8+ TCR Repertoire Formation Is Guided Primarily by the Peptide Component of the Antigenic Complex
Authors: Koning Dan , Costa Ana I. , Hoof Ilka , Miles John J. , Nanlohy Nening M. , Ladell Kristin , Matthews Katherine K. , Venturi Vanessa , Schellens Ingrid M. M. , Borghans Jose A. M. , Keşmir Can , Price David A. , van Baarle Debbie 
Published: December 2012

Abstract
CD8+ T cells recognize infected or dysregulated cells via the clonotypically expressed αβ TCR, which engages Ag in the form of peptide bound to MHC class I (MHC I) on the target cell surface. Previous studies have indicated that a diverse Ag-specific TCR repertoire can be beneficial to the host, yet the determinants of clonotypic diversity are poorly defined. To better understand the factors that govern TCR repertoire formation, we conducted a comprehensive clonotypic analysis of CD8+ T cell populations directed against epitopes derived from EBV and CMV. Neither pathogen source nor the restricting MHC I molecule were linked with TCR diversity; indeed, both HLA-A and HLA-B molecules were observed to interact with an overlapping repertoire of expressed TRBV genes. Peptide specificity, however, markedly impacted TCR diversity. In addition, distinct peptides sharing HLA restriction and viral origin mobilized TCR repertoires with distinct patterns of TRBV gene usage. Notably, no relationship was observed between immunodominance and TCR diversity. These findings provide new insights into the forces that shape the Ag-specific TCR repertoire in vivo and highlight a determinative role for the peptide component of the peptide–MHC I complex on the molecular frontline of CD8+ T cell–mediated immune surveillance.