bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of thymus size in healthy term neonates using sonography – A study from tertiary care hospital of Central India
Authors: Mehta S. 
Published: August 2015

OBJECTIVE: A cross-sectional study was done to assess the size of thymus in term healthy infants using sonography and to assess its variation in size, shape, location, echogenicity and echotexture for both male and female reference population. MATERIAL AND METHODS: A total of 250 term healthy neonates of either sex were subjected to thymic sonography. The shape, size in maximal anteroposterior, longitudinal, and transverse dimensions of both right and left lobes of thymus was evaluated. Their echotexture and echogenicity were determined and standards for reference population were calculated. The results were statistically evaluated. RESULTS: According to the shape; the thymus was quadrilateral in 156 neonates (62%), round in 37 (15%), bilobate in 32 (13%), and crescent shaped in 25 (10%) in transverse scan. According to the echo texture, the thymus echogenicity was homogeneous and almost similar or slightly less to that of the liver and spleen in most cases 200 [80%] and was coarse in 50 (20%). In all subjects, the echogenicity of the thymus was less than that of the thyroid gland. Variations in location of the thymus were found in 70 (28%) neonates. The range of mean AP diameter was 0.39–2.36 cm (mean 1.43 ± 0.3), that of transverse 1.4 – 4.3 cm (mean 2.16 ± 0.54) and that of thymic index 1.2–5.1 cm2 (mean 2.98 ± 0.64). CONCLUSIONS: A normative range was calculated for standard population, which can be used as a reference for comparing thymus size for both normal and diseased neonates for various immunological diseases.
Expression of cystathionine beta-synthase and histopathological observations in placentas of patients with Down syndrome
Authors: Pinilla J. Martínez , Ayala-Ramírez P. , García-Robles R. , Olaya-C M. , Bermúdez M. 
Published: August 2015

Down syndrome is the most frequent aneuploidy in live births, with an overall frequency of 1/600-700 births. The overexpression of cystathionine β-synthase is thought to participate in the presentation of some phenotypes observed in Down syndrome. OBJECTIVE: The aim of this study was to compare the expression levels of cystathionine β-synthase and histopathological observations from placentas of infants with Down syndrome and healthy newborns. MATERIALS AND METHODS: Six placentas of fetuses/infants with Down syndrome and sixteen placentas of healthy fetuses were studied. Cystathionine β-synthase mRNA and protein expression were performed by real-time PCR and immunohistochemistry, respectively. RESULTS: We observed an increase in cystathionine β-synthase mRNA expression ( p = 0.0465) and protein levels ( p = 0.009) in placentas of fetus/infants with Down syndrome compared with controls. Significantly more circinate edges ( p = 0.0007) and trophoblast inclusions ( p = 0.0037) were observed in the group with Down syndrome compared with control group. CONCLUSION: The results demonstrate overexpression of cystathionine β-synthase mRNA and protein in placentas of fetuses/infants with trisomy 21. Further histological abnormalities were found in placentas of patients with Down syndrome, suggesting an alteration in the development of placenta.
Do early postnatal body weight changes contribute to neonatal morbidities in the extremely low birth weight infants
Authors: Verma R. , Shibly S. , Fang H. , Pollack S. 
Published: August 2015

BACKGROUND: The implications of early postnatal body weight changes (Δ bw) in the morbidities related to body fluid metabolism in sick preterm infants in not well investigated. The extremely low birth weight infants (ELBW, birth weight <1000 g) have the highest incidence of such morbidities among all neonates. AIM: To determine the relationships between Δ bw and neonatal morbidities associated with body fluid metabolism in the ELBW infants. METHODS: In an observational study, the associations between daily weight changes from birth weight (DΔ bw) and oxygen dependence on postnatal day 28 (BPD28), patent ductus arteriosus (PDA), intraventricular-periventricular hemorrhage (IVH), antenatal steroid (ANS) and gestational age (GA) were evaluated. Maximum weight loss (MΔ bw) was correlated with GA, BPD28 and BPD36 (oxygen dependence on postmenstrual 36 weeks). Pearson’s correlation co-efficient and multivariate logistic regressions were performed for analysis. RESULTS: DΔ bw correlated inversely with GA on days 1–8 of life ( p <  0.01 for all, 0.06 for DOL 2). DΔ bw was associated with a lower risk of BPD28 on days 6 (OR 0.87, 95% CI 0.76–1), 10 (OR 0.86, 95% CI 0.76–0.98) and 11 (OR 0.87, 95% CI 0.77–0.99); with PDA on days 8–11 (OR ranging between 0.89 to 0.92 for the 4 days, 95% CI 0.83 to 0.99) and with IVH on day 5 (OR 0.93, 95% CI 0.86–1) after controlling for GA. DΔ bw was not identified as risk factor for the tested morbidities. ANS decreased DΔ bw on days 4 (OR 0.88, 95% CI 0.78–1) and 10 (OR 0.9, 95% CI 0.84–1). MΔ bw correlated directly with BPD28 ( r = 0.3, p = 0.004), which declined after controlling for GA ( r = 0.2, p = 0.2). CONCLUSIONS: DΔ bw is protective for PDA, BPD28 and IVH, independent of gestational age, whereas, the effects of MΔ bw on BPD are governed by maturation in ELBW infants. ANS decreases DΔ bw, which correlates inversely with GA during the first week of life.
High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy
Authors: Al Shafouri N. , Narvey M. , Srinivasan G. , Vallance J. , Hansen G. 
Published: August 2015

BACKGROUND: In neonatal hypoxic ischemic encephalopathy (HIE), hypo- and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. OBJECTIVE: To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. STUDY DESIGN: In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score <70, Bayley III Language Score <70 and Bayley III Cognitive Standard Score <70. RESULTS: The neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (–0.28 to –0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo- or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. CONCLUSIONS: Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.
Tripartite mutualism: Facilitation or trade‐offs between rhizobial and mycorrhizal symbionts of legume hosts
Authors: Ossler Julia N. , Zielinski Carissa A. , Heath Katy D. 
Published: August 2015

• Premise of the study: Multiple mutualist effects (MMEs) are common in nature, yet we lack a predictive understanding of how two mutualists on the same host will influence each other and whether these effects will be positive or negative. Leguminous plants maintain root symbioses with two nutritional mutualists: rhizobia that fix atmospheric nitrogen and arbuscular mycorrhizal fungi (AMF) that increase phosphorus uptake. Both symbionts receive plant carbon, and host genetic networks that regulate colonization are partially shared by both symbioses; whether these factors generate trade‐offs or facilitation between rhizobial and AMF symbionts of legumes is not well known.• Methods: We evaluated host allocation to each symbiont in three settings. First, in situ in a remnant prairie, then in a greenhouse experiment with multiple plant populations, and finally under manipulated rhizobium densities in the greenhouse.• Key results: In the remnant prairie, rhizobium nodule number and colonization of AMF were positively correlated, and plants with increased nodule number had higher fitness in the field, generating indirect selection on the colonization of AMF. In the greenhouse experiment, allocation to each symbiont was genetically variable among populations, with some suggestion that rhizobium and AMF colonization are positively genetically correlated. Finally, increasing the number of rhizobia in the soil decreased AMF colonization.• Conclusions: Our results suggest that trade‐offs between plant colonization by rhizobia and AMF are context dependent and might not be common under field conditions, but that physiological and/or genetic drivers couple these two symbioses in nature.
Interactions between plant size and canopy openness influence vital rates and life‐history tradeoffs in two neotropical understory herbs
Authors: Westerband Andrea C. , Horvitz Carol C. 
Published: August 2015

• Premise of the study: For tropical forest understory plants, the ability to grow, survive, and reproduce is limited by the availability of light. The extent to which reproduction incurs a survival or growth cost may change with light availability, plant size, and adaptation to shade, and may vary among similar species.• Methods: We estimated size‐specific rates of growth, survival, and reproduction (vital rates), for two neotropical understory herbs (order Zingiberales) in a premontane tropical rainforest in Costa Rica. During three annual censuses we monitored 1278 plants, measuring leaf area, number of inflorescences, and canopy openness. We fit regression models of all vital rates and evaluated them over a range of light levels. The best fitting models were selected using Akaike's Information Criterion.• Key results: All vital rates were significantly influenced by size in both species, but not always by light. Increasing light resulted in higher growth and a higher probability of reproduction in both species, but lower survival in one species. Both species grew at small sizes but shrank at larger sizes. The size at which shrinkage began differed among species and light environments. Vital rates of large individuals were more sensitive to changes in light than small individuals.• Conclusions: Increasing light does not always positively influence vital rates; the extent to which light affects vital rates depends on plant size. Differences among species in their abilities to thrive under different light conditions and thus occupy distinct niches may contribute to the maintenance of species diversity.
Long‐term shifts in the phenology of rare and endemic Rocky Mountain plants
Authors: Munson Seth M. , Sher Anna A. 
Published: August 2015

• Premise of the study: Mountainous regions support high plant productivity, diversity, and endemism, yet are highly vulnerable to climate change. Historical records and model predictions show increasing temperatures across high elevation regions including the Southern Rocky Mountains, which can have a strong influence on the performance and distribution of montane plant species. Rare plant species can be particularly vulnerable to climate change because of their limited abundance and distribution.• Methods: We tracked the phenology of rare and endemic species, which are identified as imperiled, across three different habitat types with herbarium records to determine if flowering time has changed over the last century, and if phenological change was related to shifts in climate.• Key results: We found that the flowering date of rare species has accelerated 3.1 d every decade (42 d total) since the late 1800s, with plants in sagebrush interbasins showing the strongest accelerations in phenology. High winter temperatures were associated with the acceleration of phenology in low elevation sagebrush and barren river habitats, whereas high spring temperatures explained accelerated phenology in the high elevation alpine habitat. In contrast, high spring temperatures delayed the phenology of plant species in the two low‐elevation habitats and precipitation had mixed effects depending on the season.• Conclusions: These results provide evidence for large shifts in the phenology of rare Rocky Mountain plants related to climate, which can have strong effects on plant fitness, the abundance of associated wildlife, and the future of plant conservation in mountainous regions.
Central PresbyLASIK for Hyperopia and Presbyopia Using Micro-monovision With the Technolas 217P Platform and SUPRACOR Algorithm
Authors: Saib Naïma , Abrieu-Lacaille Mélanie , Berguiga Marouen , Rambaud Camille , Froussart-Maille Françoise , Rigal-Sastourne Jean-Claude 
Published: August 2015

PURPOSE:
To analyze the refractive outcomes and satisfaction of presbyopic hyperopes treated with central presbyopicLASIK (presbyLASIK) with induced micro-monovision.

METHODS:
This retrospective study included 74 eyes of 37 patients treated with central presbyLASIK with micro-monovision using the Technolas 217P excimer laser (Technolas Perfect Vision GmbH, Munich, Germany) between June 2011 and March 2014. Study parameters included uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA), aberrometry, the central steep zone, and patient satisfaction.

RESULTS:

Median age was 54.3 ± 4 years (range: 46 to 63 years). Mean postoperative spherical equivalent refraction was 0.00 ± 0.58 diopters (D) for dominant eyes and −0.51 ± 0.54 D for non-dominant eyes. Mean binocular UDVA was 0.01 ± 0.10 logMAR (Snellen 20/20) at 6 months and −0.01 ± 0.05 logMAR (Snellen 20/19) at 1 year postoperatively. Mean binocular UNVA was 0.18 ± 0.14 logMAR (Parinaud 2) (Jaeger 1) at 6 months and 0.18 ± 0.12 logMAR (Parinaud 2) (Jaeger 1) at 1 year postoperatively. At 6 months, 79.31% of patients achieved 20/25 and could read Parinaud 2 (Jaeger 1) binocularly. At 1 year, 84.21% of patients achieved 20/25 and could read Parinaud 2 (Jaeger 1) binocularly. The mean central steep zone was 2.35 ± 1.00 D. There were significantly more negative spherical aberration and vertical coma in the central 5 mm postoperatively (
P
< .05). The re-treatment rate was 6.75%. Eighty-three percent of these patients did not need any glasses for distance and near vision.

CONCLUSIONS:
This procedure may improve functional near, intermediate, and distance vision in presbyopic patients with low and moderate hyperopia.

[
J Refract Surg.
2015;31(8):540–546.]
Outcomes of Pars Plana Vitrectomy for Patients With Vitreomacular Traction
Authors: Gonzalez Marco A. , Flynn Harry W. , Bokman Christine M. , Feuer William , Smiddy William E. 
Published: August 2015

BACKGROUND AND OBJECTIVE:
To evaluate clinical and optical coherence tomography (OCT) outcomes of pars plana vitrectomy (PPV) for patients with vitreomacular traction (VMT).

PATIENTS AND METHODS:
Noncomparative, interventional, consecutive case series from 2007 to 2014.

RESULTS:

Of the 37 study eyes, patients were grouped according to the extent of VMT evident on OCT. Group 1 (18 eyes) had intraretinal cysts on OCT. Group 2 (19 eyes) had both intraretinal cysts and subretinal fluid. Visual acuity (VA) improved at least one line or more in 76% of eyes postoperatively. Postoperative VA was not significantly different across the two groups (
P
> .36). Postoperatively, a macular hole developed in 4 eyes (10%). After reoperation, three of four eyes achieved macular hole closure.

CONCLUSIONS:
Patients with VMT achieve visual and OCT improvements after PPV. Postoperative macular hole formation is uncommon but can be successfully repaired with further surgery.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:708–714.]
Long-term Choroidal Thickness Changes After Acute Solar Retinopathy
Authors: Akay Fahrettin , Toyran Sami , Oztas Zafer , Koksal Serkan 
Published: August 2015

BACKGROUND AND OBJECTIVE:
To identify long-term changes in choroidal thickness after solar retinopathy.

PATIENTS AND METHODS:
The study included 25 eyes of 25 men with acute solar retinopathy. Ocular examination, best corrected visual acuity (BCVA), and retinal and choroidal thickness measurements obtained using spectral-domain optical coherence tomography were evaluated.

RESULTS:

The mean follow-up was 6.1 ± 0.4 months. The initial BCVA decreased in the affected eyes (
P
< .001). The mean BCVA (logMAR) improved significantly from 0.16 ± 0.06 to 0.03 ± 0.05 at 6 months (
P
< .001). There were no significant differences in the initial retinal and choroidal thicknesses between the affected and other eyes, while there was a significant decrease in the mean macular thickness and mean macular volume at 1 month and the mean choroidal thickness increased (
P
< .001).

CONCLUSION:
Significant retinal and choroidal thickness changes occurred after solar retinopathy. The changes in choroidal thickness suggest that the effects of solar retinopathy might not be limited to the retina.

[
Ophthalmic Surg Lasers Imaging Retina.
2015;46:738–742.]
Comorbidity and Health Care Resource Use Among Commercially Insured Non-Elderly Patients With Diabetic Macular Edema
Authors: Wallick Christopher J. , Hansen Ryan N. , Campbell Joanna , Kiss Szilárd , Kowalski Jonathan W. , Sullivan Sean D. 
Published: August 2015

BACKGROUND AND OBJECTIVE:
Diabetic macular edema (DME) is a leading cause of blindness for non-elderly adults; however, health care-associated burden data from this population is lacking. The authors describe health care-associated burden in non-elderly patients with DME compared to those with diabetes and no DME.

PATIENTS AND METHODS:
In this retrospective, large-cohort study examines enrollment and health care claims (2007 to 2011) from a national database of insured patients aged 18 to 63 years (mean: 51). Comorbidity and health care utilization differences between patients with DME (n = 24,326) and matched controls with diabetes but no DME (n = 122,710) were analyzed over 1 and 3 years.

RESULTS:

DME patients had significantly more baseline comorbidities, and generally developed them at a higher rate over the study. Health care resource utilization rates were significantly higher in DME patients for every category analyzed. Patients with DME averaged more than 10 health care visits more than those with diabetes but no DME (25.5 vs 14.9;
P
< .001).

CONCLUSION:
Working-age patients with DME exhibit a complicated comorbidity profile and high associated burden of health care consumption. Considering this burden is critical for managing this complex population.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:744–751.]
Surgical Management of Anterior Chamber Migration of a Dexamethasone Intravitreal Implant
Authors: Stelton Christopher R. , Townsend Justin , Peterson Luke T. , Khurana Rahul N. , Yeh Steven 
Published: August 2015

BACKGROUND AND OBJECTIVE:
Anterior chamber migration of the dexamethasone intravitreal implant (Ozurdex; Allergan, Irvine, CA) may lead to corneal edema and elevated intraocular pressure, warranting removal of the implant.

MATERIALS AND METHODS:
A 59-year-old patient with a history of prior vitrectomy, a posterior chamber intraocular lens with a disrupted posterior capsule, and a large inferior peripheral iridectomy presented with decreased vision due to corneal edema following dexamethasone intravitreal implant injection. The authors describe their technique for implant removal, which uses standard vitreoretinal instrumentation, viscoelastic, a modified Sheets glide, and angled forceps in order to avoid fragmentation of the implant and limit iatrogenic morbidity.

RESULTS:
The implant was successfully explanted. Postoperatively, the patient experienced improvement in the corneal edema, and after Descemet’s stripping endothelial keratoplasty achieved a final best corrected visual acuity of 20/60 at final 12-month follow-up.

CONCLUSION:
Patients with aphakic lens status, anterior chamber intraocular lens with a disrupted posterior capsule, posterior chamber intraocular lens and a ruptured capsule, prior vitrectomy, and large peripheral iridectomies may be susceptible to migration of dexamethasone intravitreal implants into the anterior chamber.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:756–759.]
Loss of Phosphatase and Tensin Homolog in APCs Impedes Th17-Mediated Autoimmune Encephalomyelitis
Authors: Sahin Emine , Brunner Julia S. , Kral Julia B. , Kuttke Mario , Hanzl Leslie , Datler Hannes , Paar Hannah , Neuwinger Nick , Saferding Victoria , Zinser Elisabeth , Halfmann Angela , Soukup Klara , Hainzl Eva , Lohmeyer Tobias , Niederreiter Birgit , Haider Thomas , Dohnal Alexander M. , Krönke Gerhard , Blüml Stephan , Schabbauer Gernot 
Published: August 2015

Abstract
The PI3K signaling cascade in APCs has been recognized as an essential pathway to initiate, maintain, and resolve immune responses. In this study, we demonstrate that a cell type–specific loss of the PI3K antagonist phosphatase and tensin homolog (PTEN) in myeloid cells renders APCs toward a regulatory phenotype. APCs deficient for PTEN exhibit reduced activation of p38 MAPK and reduced expression of T cell–polarizing cytokines. Furthermore, PTEN deficiency leads to upregulation of markers for alternative activation, such as Arginase 1, with concomitant downregulation of inducible NO synthase in APCs in vitro and in vivo. As a result, T cell polarization was dysfunctional in PTEN−/− APCs, in particular affecting the Th17 cell subset. Intriguingly, mice with cell type–specific deletions of PTEN-targeting APCs were protected from experimental autoimmune encephalomyelitis, which was accompanied by a pronounced reduction of IL-17– and IL-22–producing autoreactive T cells and reduced CNS influx of classically activated monocytes/macrophages. These observations support the notion that activation of the PI3K signaling cascade promotes regulatory APC properties and suppresses pathogenic T cell polarization, thereby reducing the clinical symptoms and pathology of experimental autoimmune encephalomyelitis.
Machine Learning Techniques for Prediction of Early Childhood Obesity
Authors: Mukhopadhyay S. , Carroll A. , Downs S. , Dugan T. M. 
Published: August 2015

Summary
Objectives: This paper aims to predict childhood obesity after age two, using only data collected prior to the second birthday by a clinical decision support system called CHICA.
Methods: Analyses of six different machine learning methods: RandomTree, RandomForest, J48, ID3, Naïve Bayes, and Bayes trained on CHICA data show that an accurate, sensitive model can be created.
Results: Of the methods analyzed, the ID3 model trained on the CHICA dataset proved the best overall performance with accuracy of 85% and sensitivity of 89%. Additionally, the ID3 model had a positive predictive value of 84% and a negative predictive value of 88%. The structure of the tree also gives insight into the strongest predictors of future obesity in children. Many of the strongest predictors seen in the ID3 modeling of the CHICA dataset have been independently validated in the literature as correlated with obesity, thereby supporting the validity of the model.
Conclusions: This study demonstrated that data from a production clinical decision support system can be used to build an accurate machine learning model to predict obesity in children after age two.
Citation: Dugan TM, Mukhopadhyay S, Carroll AE, Downs SM. Machine learning techniques for prediction of early childhood obesity. Appl Clin Inform 2015; 6: 506–520http://dx.doi.org/10.4338/ACI-2015-03-RA-0036