bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP‐11 DO TRAUMATIC LIFE EVENTS PREDISPOSE CHILDREN TO DEVELOP CONSTIPATION?
Authors: Rrajindrajith S. , Devanarayana N.M. , Rajapakshe N.N. , Benninga M.A. 
Published: September 2015

Background:The aetiology of functional constipation (FC) in children is not been fully understood. Exposure to physical, emotional and sexual abuse are known to predispose children to develop FC. No paediatric study has evaluated traumatic life events other than abuse as a potential predisposing factor for FC in children. We aimed to assess the association between traumatic life events and development of FC in children.Methods:We conducted a cross sectional, school based study. Children aged 13–18 years were selected from four semi‐urban schools in the Gampaha district, Sri Lanka. A validated, self‐administered questionnaires were used for collect data on functional gastrointestinal disease and traumatic life events. FC was defined using the Rome III criteria.Results:A total of1792 children were included in the analysis [males 975 (54.4%), mean age 14.4 years, SD 1.3 yearsyears]. Out of them, 138(7.7%) had FC. Prevalence of FC was significantly higher in those exposed to traumatic life events compared to controls (53.6% vs.32.9%,p < 0.0001). Traumatic life events such as parents living separately (13.4% vs. 7.12%,p = 0.038), living in a boarding house (10.1% vs. 1.6%, p = 0.049), liquor abuse by parents (14,8% vs. 6,3%, p < 0.0001), witnessing a murder (16.7% vs. 3.9%, p = 0.002), child labour (13.9%vs. 7.3%, p = 0.02) and ill‐treated by parents (27.5% vs. 7.3%, p < 0.0001) were shown to predispose children to develop FC. Parental substance abuse (12.8% vs. 7.4%), domestic violence (14.8 vs. 7.5%) were not associated with FC (p > 0.05).Conclusions:FC is associated with childhoodtraumatic experiences. This provides further insight intohow traumatic childhood events are associated withdevelopment and perpetuation of FC in children.
OP‐14 EFFECT OF TUBE‐FEEDING ON BOLUS CLEARANCE TIME IN NEUROLOGICALLY IMPAIRED CHILDREN VERSUS NORMAL CHILDREN
Authors: Tan L.N. Michelle , Liwanag Janelle M. , Quak S.H. , Aw Marion M. 
Published: September 2015

Aim:Neurologically impaired children are at increased risk of gastro‐esophageal reflux disease (GERD). Pathogenic factors that can lead to GERD include transient lower oesophageal sphincter relaxation and impaired oesophageal clearance. Previous studies had suggested that neurologically impaired children have increased bolus clearance time (BCT). The aim of our study is to determine the effect of (naso‐gastric) tube‐feeding on BCT in these children.Methods: Retrospective review of the multi‐channel intra‐luminal impedance‐pH (MII‐pH) results of the paediatric population performed from January 2012 to December 2014.Results:A total of 71 studies were performed. 7 studies were excluded from data analysis as these children had previous fundoplication which is known to alter oesophageal peristalsis. Of the 64 analysed, 33 were in neurologically impaired children and 32 were male. The median (range) age was 1.35 (0.03–18.58) years. 60 (93.75%) children were less than 5 years old at the time of the study.In our cohort, all the neurologically impaired children were tube‐fed. 41 (68.75%) of the children were tube‐fed; bolus fed (n = 30), continuous naso‐gastric (n = 7) or naso‐jejunal (n = 4). Based on the MII‐pH results, 16 children (25%) were diagnosed to have GERD. 9 of the neurologically‐impaired children had GERD while 7 of the neurologically normal children had GERD. There was no difference in the means of the “median BCT” in neurologically impaired versus normal children (10.42 (SD 4.27) vs 9.18 (SD 2.12) seconds, p = 0.144), or in those with or without GERD based on MII‐pH, regardless of underlying neurological status.Conclusions:Our data suggest that BCT in neurologically abnormal children who are tube‐fed do not appear to be longer than neurologically normal children, or associated with an increased risk of GERD. This suggests that other mechanisms have a greater role in conferring the increased risk of GERD in this population. Of note, “median BCT” values were also shorter in our population of predominantly young children of age less than 5.
OP‐15 FEATURES OF AEROPHAGIA MEASURED WITH MULTICHANNEL PH‐IMPEDANCE IN CHILDREN
Authors: Rybak Anna , Gomez Carlos Tutau , Lindley Keith , Thapar Nikhil , Mutalib Mohamed 
Published: September 2015

Introduction and Aim:Diagnosis of aerophagia is based on clinical symptoms and described in Rome III Criteria. The aim of this study was to estimate the normal and pathological values for air swallows measured with pH‐impedance in children.Material and methods:We analysed features of air swallowing in pH‐impedance for patients hospitalized in the Great Ormond Street Hospital in 2008–2014, with the clinical symptoms of aerophagia, who have met the Rome III Criteria. Children with pH‐impedance performed due to other gastrointestinal conditions (GORD, Abdominal pain, food allergy and asthma) and had normal studies comprised the control group. The exclusion criteria were: neurological, metabolic or genetic disorders, previous oesophageal surgery including fundoplication, connective tissue disorders and studies lasting less than 16 hours in durationAll studies were re analysed manually, meals were excluded from analysis. Total number of air swallows (in upright and recumbent position); mixed swallows, gastric belching and supragastric belching were counted. The results were presented as total number of episodes and as median number of episodes per hour.Results:Impedance recording of 10 patients (7 males) with clinical aerophagia and control group of10 children (7 males) were analysed. Mean age of patients was 10 years (4.5–13.5) and 7 years in control group (4.5–17 years). Mean (±SD) recording time for patients 21.3 hrs (±2.3) for control 21.2 hrs (±1.2). Total number of liquid reflux (mean ± SD) for patients 46.9 (±22.6), control 27.6 (±15.4) p = 0.028. The median of total air swallows per hour was 30.35 (IQR: 22.6 to 43.50) in patients with aerophagia and 7.33 (IQR: 5.43 to 9.9) in control group. There were significant differences in total number of air swallows, as well as in supragastric belches between the groups (p = 0.0001 and p = 0.001, respectively). Both, air swallows and gastric belches were significantly more often observed in boys (median for boys 20.92 and 1.06; for girls 7.20 and 0.34; p = 0.02 and p = 0.006, respectively).Conclusions:pH‐impedance is an important diagnostic tool in the measurement of gas and fluid movement in the oesophagus. Hereby we showed suitability of pH‐impedance in the assessment of children with clinically diagnosed aerophagia.
OP‐20 THE ASSOCIATION BETWEEN ADVERSE LIFE EVENTS AND ABDOMINAL PAIN‐PREDOMINANT FUNCTIONAL GASTROINTESTINAL DISORDERS
Authors: Devanarayana N.M. , Rajindrajith S. , Benninga M.A. 
Published: September 2015

Background:Abdominal pain‐predominant functional gastrointestinal disorders (AP‐FGIDs) are a common public health problem in children. The precise aetiology of AP‐FGIDs is far from clear. Psychological stress and all forms of child abuse are known predisposing factors to develop AP‐FGIDs. The main objective of this study is to study the association between adverse life events (ALEs) and development of AP‐FGIDs.Methods:A cross sectional, school based study was conducted in Gampaha district of Sri Lanka. All children aged 13–18 years were recruited from four randomly selected semi‐urban schools in the district after obtaining consent from parents, school administration and children themselves. A translated and validated, self‐administered questionnaire consisting of four parts was used for data collection. Part I was the Rome III questionnaire for functional gastrointestinal disorders, self‐report form for children above 10 years. Part II was a questionnaire on exposure to adverse life events. Part III was the Sinhala (the native language) version of the PedsQL, Pediatric Quality of Life Inventory 4.0 (Generic Core Scales). Part IV was the Child Somatization Inventory. The questionnaire was administered under examination setting to ensure confidentiality and privacy. Research assistant were present during filling the questionnaire for provide assistance and verifications. AP‐FGIDs were defined using the Rome III criteria.Results:A total of 1792 children were included in the analysis (males 975 [54.4%], mean age 14.4 years, SD 1.3 years years). Out of them, 305 (17.0%) had AP‐FGIDs. ALEs that showed a significant association with AP‐FGIDs include, parental substance abuse (25.1% vs. 16.0% in controls, p = 0.015) and domestic violence (28.5% vs. 16.1%, p = 0.02). Children with AP‐FGIDs exposed to ALEs have a higher somatization index compared to children not exposed to ALEs (16.9 vs. 13.4, p = 0.003), and a lower overall health‐related quality of life (HRQoL) score (81.8 vs. 85.1, p = 0.02). The scores they obtained for psycho‐social (86.4 vs. 92.4, p < 0.0001) and emotional (72.5 vs. 77.7, p = 0.03) domains of the HRQoL were also lower than that of children with no such experiences.Conclusions:Exposure to ALEs predispose children to develop AP‐FGIDs. Experience of childhood ALEs deleteriously affects the HRQoL and somatization of children with AP‐FGIDs.
OP‐23 FUNCTIONAL DYSPEPSIA IS ASSOCIATED WITH DUODENAL EOSINOPHILIA IN A PEDIATRIC COHORT
Authors: Wauters L. , Nightingale S. , Sulaiman B. , Talley N. , Walker M. 
Published: September 2015

Objectives:Functional dyspepsia (FD) is a highly prevalent gastrointestinal disorder with unknown etiology. We aimed to assess the association between dyspeptic symptoms and duodenal eosinophilia in children referred for upper endoscopy.Methods:In this retrospective cohort study, all histopathology reports of normal upper endoscopies performed at a single tertiary center between 2010 and 2014 were reviewed. FD was defined as epigastric pain or discomfort for more than 2 months with no response to acid suppressants. Controls were those with non‐erosive reflux disease, dysphagia or rumination syndrome. Duodenal biopsies were analyzed by pathologists blinded to indication. Intramucosal eosinophils were counted per mm2 on haematoxylin and eosin stained digital imaged sections using Aperio eSlide Manager. Demographics, clinical variables, family history and histologic findings were compared between cases and controls.Results:In total, 36 cases and 36 non‐matched controls were identified of which 56% and 53% were female (p = 0.81). Mean (± SD) age was higher in cases compared to controls (13.6 (± 3.1) vs. 10.5 (± 4.0) years; p = .001). Dyspeptic symptoms (epigastric pain 81% and/or upper abdominal discomfort 33%) were food‐related in 69% and nocturnal in 31% of cases. Self‐reported nausea (64% vs. 17%; p < .0001), lethargy (19% vs. 0%; p = .005) and a family history of functional gastrointestinal disorders (28% vs. 3%; p = .003) were more common in cases than controls. There was a higher but not significantly different rate of atopic history (39% vs. 25%; p = .21) and psychological co‐morbidity (53% vs. 39%; p = .24) in FD cases versus controls. Duodenal intraepithelial lymphocytes per 100 enterocytes were similar in cases and controls (median (IQR) 10 (8–13) vs. 12 (8–18); p = 0.12). Duodenal eosinophil counts per mm2 were significantly increased in cases compared to controls (151 (118–207) vs. 76 (60–106); p < 0.001).Conclusions:This study confirms recent reports of duodenal eosinophilia in FD. The high rate of atopic and psychological co‐morbidity in FD suggests multi‐factorial mechanisms and may explain why current therapeutic options aimed at symptom control are largely unsatisfactory. Duodenal eosinophilia in FD should be considered a therapeutic target.
PP‐1 BOWEL HABITS IN SRI LANKAN INFANTS AND TODDLERS, A POPULATION BASED STUDY
Authors: Walter Hannah A.W. , Hovenkamp Anne , Rajindrajit Shaman , Devanarayana Niranga M. , Benninga Marc A. 
Published: September 2015

Objective:To obtain knowledge about bowel habits in healthy population of infants and toddlers in Sri Lanka.Methods:We selected healthy children between 7 months and 5 years of age who visited vaccination and weighing clinics. To achieve data we used a self‐administered questionnaire about the child's bowel habits during the previous two months. All subjects were selected in Gampaha district, Sri Lanka. Only those without defecation disorders were used for analysis.Results:A total of 879 toddlers were eligible for analysis, (female n = 442 [50,3%], mean age 21,7 months, standard deviation [SD] 12,5 months). Of them, 595 (69,6%) defecated once a day, 20 (2,3%) had defecation >3/week and 6 (0,7%) <3/week. Stool consistency was hard or very hard in 30 (3,4%), 665 (78,9%) had smooth and soft stool and 107 (12,2%) had varying consistency. Straining and painful stool were reported in 560 (64,7%) respectively 194 (23%) of the sample, stool holding was present in 93 (10,8%) and 44 (4,9%) passed blood with the stool. No children reported fecal incontinence.Conclusions:This study provides data on normal bowel habits of Sri Lankan toddlers and infants. Bowel habits and disorders related to defecation in Sri Lankan toddlers and children differ from those living in the West probably due to dietary, genetic and environmental variations.
PP‐2 ABNORMAL PERSONALITY TRAITS IN CHILDREN WITH AEROPHAGIA
Authors: Devanarayana Niranga Manjuri , Jayawickrama Nirodha , Gulegoda Ishani Chathurika , Rajindrajith Shaman 
Published: September 2015

Objective:The main objective of this study is to study the personality types in children with aerophagia.Methods:A cross sectional survey was conducted in 8 randomly selected schools in 4 randomly selected provinces Sri Lanka. From each school, all cchildren aged 13–18 years were selected after obtaining written consent from parents, school administration and provincial education office. Assent was obtained from all children recruited. Date were collected using a self‐administered questionnaire administered under examination setting to ensure confidentiality and privacy. Questionnaire contained previously translated and validated Rome III questionnaire for functional gastrointestinal diseases (self‐administered form for children above 10 years) and childhood personality assessment questionnaire. Trained research assistants were present during filling the questionnaire to provide assistance and to verify doubts. Aerophagia was defined using the Rome III criteria. Severities of individual symptoms were recorded in 100 mm visual analogue scale.Results:A total of 1069 questionnaires were distributed and all of them were returned and included in analysis [males 508 (47.5%), mean age 15.3 years, SD 1.8 years years]. One hundred and thirty six (12.7%) fulfilled Rome III criteria for aerophagia and 933 children without aerophagia were considered as controls. Nineteen (13.8%) children with aerophagia and 71 (7.6%) controls had personality scores above the international cut‐off value (105) for abnormal personality (p = 0.01). Children with aerophagia had significantly higher scores for different personality traits than controls; including hostility and aggression (13.2 vs. 12.2 in controls, p = 0.006), negative self‐esteem (11.0 vs. 9.9, p < 0.0001), negative self‐adequacy (10.6 vs. 9.6, p = 0.001), emotional unresponsiveness (10.5 vs. 9.6, p < 0.0001), emotional instability (16.9 vs. 15.7, p < 0.001), negative world view (10.9 vs. 10.1, p = 0.02) and total personality score (92.1 vs. 87.7, p = 001). In children with aerophagia, scores obtained for severity of bloating correlated with scores obtained for hostility and aggression (r = 0.22, p = 0.02).Conclusions:Children with aerophagia has abnormal personality traits and this fact may at least partly responsible for development and perpetuation of symptoms in them.
PP‐10 CHARACTERIZATION OF ESOPHAGEAL MOTILITY IN INFANTS BORN WITH CONGENITAL DIAPHRAGMATIC HERNIA USING HIGH RESOLUTION MANOMETRY
Authors: Rayyan Maissa , Omari Taher , Allegaert Karel , Decaluwe Herbert , Nafteux Philippe , Van Veer Hans , Deprest Jan , Rommel Nathalie 
Published: September 2015

Purpose:Congenital diaphragmatic hernia (CDH) is a rare condition characterized by a congenital defect in the diaphragm. Abdominal organs are displaced into the thorax through the diaphragmatic defect, hereby causing lung hypoplasia. Survivors also present with long‐term functional gastro‐intestinal morbidity such as gastro‐esophageal reflux, esophageal dysfunction and poor nutritional status. Congenital esophageal dysmotility and surgical disruption of the esophago‐gastric junction (EGJ) may contribute to this esophageal dysfunction. The aim of this study was to characterize esophageal function in young infants born with CDH.Methods:High resolution solid state manometry was used to investigate the esophageal function in 9 postoperative infants born with CDH (6 M, median age 23 days). A total of 416 liquid swallows were analyzed (range 27–70 swallows per patient; mean 46 swallows). All data are presented as median (IQR).Results:We included 9 patients: 8 with a left diaphragmatic defect, 5 with a “liver up” defect, 4 underwent a fetal tracheal occlusion procedure because of severe lung hypoplasia, 8 needed a patch to close a large diaphragmatic defect. Across patients, length of peristaltic defects was 0.4 (0.3,0.6) cm. Distal contractile integral (DCI) was 357 (249,428) mmHg.sec.cm. Distal Latency (DL) was 4.9 (3.6,5.6) sec, whereby 5/9 patients had a DL less than 4.5 sec. EGJ resting pressure was 37 (17,60) mmHg. The integrated relaxation pressure (IRP4) was 14 (9,19) mmHg with IRP4 over 15 mmHg in 4 patients.Conclusion:We investigated the esophageal body and EGJ function in 9 patients with CDH using high resolution manometry. This pilot study shows that the distal contractile integral is reduced in all infants with CDH. This reflects weak esophageal contractile strength and supports the congenital foregut dysmotility hypothesis. Surprisingly, deglutitive relaxation pressures were increased in only 4/9 patients suggesting that EGJ outflow obstruction post hernia repair of the crural diaphragm, is only partially contributing to the esophageal motor dysfunction observed in patients with CDH.
PP‐12 EFFICACY OF A STANDARDIZED EXTRACT OF MATRICARIAE CHAMOMILLA L., MELISSA OFFICINALIS L. AND TYNDALLIZED LACTOBACILLUS ACIDOPHILUS (H122) COMPARED WITH LACTOBACILLUS REUTERI (DSM 17938) AND WITH SIMETHICONE FOR THE TREATMENT OF INFANTILE COLIC
Authors: Ummarino Dario , Martinelli Massimo , Giugliano Francesca Paola , Tortora Clelia , Valenti Simona , Pidone Caterina , De Giovanni Donatella , Rutigliano Irene , Campanozzi Angelo , Romano Claudio , Miele Erasmo , Staiano Annamaria 
Published: September 2015

Background and Aim:Infant colic is a prevalent physiological event of healthy children under 3 months of age, which can disrupt the child's home environment. Despite its benign natural history, sometimes it requires a therapeutic approach. There is limited evidence supporting the use of complementary and alternative treatments. The aim of this study was to investigate the effectiveness of a mixture of standardized extract of matricariae Chamomilla L., Melissa Officinalis L. and tyndallized Lactobacillus Acidophilus (H122) compared with Lactobacillus Reuteri (DSM 17938) and with simethicone for the treatment of infantile colic.Patients and Methods:A multicenter prospective, randomized comparative study was conducted involving 133 infants with colic, according to Rome III criteria, who were assigned at random to receive Chamomilla L., Melissa Officinalis L. and tyndallized L. Acidophilus (H122) (Group A; n = 45), L reuteri DSM 17938 (108 CFU) (Group B; n = 45) or simethicone (Group C; n = 43). Treatment was given to subjects for 21 days and they were followed for 4 weeks. Treatment success was assessed at the end of study period. Daily crying and fussing times were recorded in a structured diary, and maternal questionnaires were completed to monitor changes in infant colic symptoms and adverse events.Results: Treatment success was observed in 30 out of 45 patients (66.7%) of infants in Group A, while it was seen in 31 out of 45 patients (68.9%) of Group B and in 19 out of 43 (44.2%) of subjects of Group C (χ2: 6.8; p = 0.03). Mean daily crying time was more significantly reduced (from 211.3 ± 40 min/day to 69.6 ± 59 min/day) in the Group A and in Group B (from 201.6 ± 32.5 min/day to 58.1 ± 48.9 min/day) when compared with Group C (from 199.5 ± 32 min/day to 106 ± 56.5 min/day) (p < 0.01, p = 0.006 respectively). No significant difference was observed comparing Group A and B (p = 0.4). No adverse events were reported in any group.Conclusions:This study suggests that administration of Chamomilla L., Melissa Officinalis L. and tyndallized L. Acidophilus (H122) and L reuteri DSM 17938 are significantly more effective than simethicone in improving colic symptoms. Therefore, the use of herbal supplements may represent a new therapeutic strategy in the management of colicky infants.
Summer temperature can predict the distribution of wild yeast populations
Authors: Robinson Heather A. , Pinharanda Ana , Bensasson Douda 
Published: September 2015

AbstractThe wine yeast,Saccharomyces cerevisiae,is the best understood microbial eukaryote at the molecular and cellular level, yet its natural geographic distribution is unknown. Here we report the results of a field survey forS. cerevisiae, S. paradoxusand other budding yeast on oak trees in Europe. We show that yeast species differ in their geographic distributions, and investigated which ecological variables can predict the isolation rate ofS. paradoxus, the most abundant species. We find a positive association between trunk girth andS. paradoxusabundance suggesting that older trees harbour more yeast.S. paradoxusisolation frequency is also associated with summer temperature, showing highest isolation rates at intermediate temperatures. Using our statistical model, we estimated a range of summer temperatures at which we expect highS. paradoxusisolation rates, and show that the geographic distribution predicted by this optimum temperature range is consistent with the worldwide distribution of sites whereS. paradoxushas been isolated. Using laboratory estimates of optimal growth temperatures forS. cerevisiaerelative toS. paradoxus, we also estimated an optimum range of summer temperatures forS. cerevisiae. The geographical distribution of these optimum temperatures are consistent with the locations where wildS. cerevisiaehave been reported, and can explain why only human-associatedS. cerevisiaestrains are isolated at northernmost latitudes. Our results provide a starting point for targeted isolation ofS. cerevisiaefrom natural habitats, which could lead to a better understanding of climate associations and natural history in this important model microbe.
Parental effects and the evolution of phenotypic memory
Authors: Kuijper Bram , Johnstone Rufus A. 
Published: September 2015

AbstractDespite growing evidence for nongenetic inheritance, the ecological conditions that favor the evolution of heritable parental or grandparental effects remain poorly understood. Here, we systematically explore the evolution of parental effects in a patch-structured population with locally changing environments. When selection favors the production of a mix of offspring types, this mix differs according to the parental phenotype, implying that parental effects are favored over selection for bet-hedging in which the mixture of offspring phenotypes produced does not depend on the parental phenotype. Positive parental effects (generating a positive correlation between parental and offspring phenotype) are favored in relatively stable habitats and when different types of local environment are roughly equally abundant, and can give rise to long-term parental inheritance of phenotypes. By contrast, unstable habitats can favor negative parental effects (generating a negative correlation between parental and offspring phenotype), and under these circumstances even slight asymmetries in the abundance of local environmental states select for marked asymmetries in transmission fidelity.