Colorectal cancer screening: the surgery rates they are a-changing. A nationwide study on surgical resections in Italy

Growing evidence suggests that colorectal cancer (CRC) screening based on the fecal immunochemical test (FIT) reduces CRC incidence and surgical resection rates.

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Applications of neuromuscular ultrasound in amyotrophic lateral sclerosis

Nerve and muscle ultrasound is becoming an important ancillary investigation in the diagnosis of amyotrophic lateral sclerosis (ALS). ALS remains a clinical diagnosis without a gold standard diagnostic investigation. However, the results of supporting investigations such as electromyography (EMG) help to increase the confidence in the clinical diagnosis and eliminate potential mimicking conditions.

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Concentric or Monopolar Electrode for Jitter Determination in Orbicularis Oculi

Single fiber electromyography (SFEMG), developed by Ekstedt and Stålberg in the 1960s, is the best-recognized technique for the study of motor unit microphysiology, including the neuromuscular jitter, the propagation velocity along individual muscle fibers, and muscle fiber organization within single motor units (Ekstedt, 1964; Stålberg and Ekstedt, 1968; Sanders and Stålberg, 1996). Jitter is a measure of the time variability of single muscle fibre depolarization in a motor unit, due to temporal variability at the neuromuscular junction during successive discharges.

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Safety of intradiscal delivery of triamcinolone acetonide by a poly(esteramide) microsphere platform in a large animal model of intervertebral disc degeneration

Local corticosteroids have been used to relieve symptoms of chronic low back pain, although treatment effects have been shown to wear off relatively fast. Prolonging corticosteroid presence by controlled release from biomaterials may allow for longer pain relief while circumventing adverse effects such as high bolus dosages.

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Perioperative complications of anterior decompression with fusion versus laminoplasty for the treatment of cervical ossification of the posterior longitudinal ligament: Propensity score matching analysis using a nation-wide inpatient database

Surgical treatment of cervical ossification of the posterior longitudinal ligament (OPLL) has a high risk of various complications. Anterior decompression with fusion (ADF) and laminoplasty (LAMP) are the most representative surgical procedures. However, few studies have compared the two procedures in terms of perioperative surgical complications.

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Colorectal cancer screening: the surgery rates they are a-changing. A nationwide study on surgical resections in Italy

Growing evidence suggests that colorectal cancer (CRC) screening based on the fecal immunochemical test (FIT) reduces CRC incidence and surgical resection rates.

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Guardian Angel debuts Elite Series personal safety lighting devices for first responders

The new design is to increase the visibility of first responders as they attend to roadside incidents

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TBL1XR1 mutations in Pierpont syndrome are not restricted to the recurrent p.Tyr446Cys mutation

American Journal of Medical Genetics Part A, EarlyView.


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Disordered Society: Women in Eating Disorder Recovery Advise Policymakers on Change

Abstract

This qualitative study draws on a photo-elicitation method ("PhotoVoice") and semi-structured interviews to examine the key areas stakeholders (30 young women between the ages of 18 and 35 in eating disorder recovery) identify as meaningful venues of policy-based change. Photography and the accompanying narratives capturing personally-meaningful social, cultural, and systemic influences on recovery were shared with the research team. Photographs and interviews were examined for policy implications using thematic analysis, and six areas of improvement emerged: media, healthcare practice and access, health insurance reform, education, objectification of the female body, and mental health stigma. Implications for reform are discussed.

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Instructor, EMS - Gateway Technical College

The Instructor, EMS, will teach EMS courses at all levels and teach Paramedic classes using the Department of Health Services (DHS) curricula - assist in the delivery of all pre-hospital EMS didactic and lab skills at the Paramedic level. This position reports to the Dean, School of Protective & Human Services. Responsibilities: - Plan and teach courses which fulfill the current curriculum goals and ...

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Use of antifibrinolytics in pediatric cardiac surgery: where are we now?

Pediatric Anesthesia, Volume 0, Issue ja, -Not available-.


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What are the validity and reliability of the modified Yale Preoperative Anxiety Scale‐Short Form in children less than 2 years‐old?

Pediatric Anesthesia, Volume 0, Issue ja, -Not available-.


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A quality improvement project to reduce post‐operative adverse respiratory events and increase safety in the post‐anesthesia care unit of a pediatric institution

Pediatric Anesthesia, Volume 0, Issue ja, -Not available-.


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Postoperative behavioral changes in Chinese children undergoing hypospadias repair surgery: A prospective cohort study

Pediatric Anesthesia, Volume 0, Issue ja, -Not available-.


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Seafinding revisited: how hatchling marine turtles respond to natural lighting at a nesting beach

Abstract

Hatchling marine turtles emerge at night from underground nests on oceanic beaches and then use visual cues to crawl from the nest site to the sea ("seafinding"). However, the light wavelengths (λ's) used to accomplish this orientation have not been thoroughly documented, nor do we understand why some λ's are favored over others. We measured nocturnal radiance on the horizon at 20 nm intervals between 340 and 600 nm at two nesting beach sites and then, under laboratory conditions, determined the lowest intensities of those λ's that induced green turtle and loggerhead hatchlings to crawl toward each light source (a low positive "phototaxis threshold"). Both species were similarly sensitive and were attracted to all λ's. Radiance measures at all λ's were greater toward the seaward horizon than toward the landward horizon, providing an important orientation cue regardless of variation in lunar illumination. Previous studies document that both species detect λ's longer than those that are most attractive. We hypothesize that seafinding is a specialized response mediated by cones that are sensitive to the shorter λ's (to minimize the effects of dark noise) but such as rods, are especially sensitive to low levels of nocturnal illumination.

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A good beginning makes a good ending: association between acute pain trajectory and chronic postsurgical pain

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Longitudinal Associations of Fitness, Motor Competence, and Adiposity with Cognition

Purpose To investigate the longitudinal associations of cardiorespiratory fitness (CRF), motor competence (MC), and body fat percentage (BF%) with cognition in children. Methods Altogether 371 children (188 boys, 183 girls) aged 6–9 years at baseline participated in this 2-year follow-up study. We assessed CRF by maximal cycle ergometer test, computed the MC score from the z-scores of 50-metre shuttle run, static balance, and box and block test results, measured BF% by dual-energy X-ray absorptiometry, and assessed cognition using the Raven's Coloured Progressive Matrices (RCPM) score. The associations were studied by linear regression analysis and analysis of covariance with repeated measures. Results In boys, a higher MC score (β=-0.161, 95% CI=-0.314 to -0.009), a shorter 50-metre shuttle run test duration (β=0.152, 95% CI=0.007 to 0.296), and a higher number of cubes moved in the BBT (β=-0.161, 95% CI=-0.309 to -0.013) at baseline were associated with a smaller increase in the RCPM score during follow-up. These associations were largely explained by the RCPM score at baseline. However, boys in the highest third (mean difference=2.5, 95% CI for difference=0.66 to 4.33) and the middle third (mean difference=2.1, 95% CI for difference=0.39 to 3.82) of the MC score at baseline had a higher RCPM score over the 2-year follow-up than boys in the lowest third. CRF, MC, or adiposity were not associated with the RCPM score in girls. Changes in CRF, MC, or BF% were not associated with changes in cognition. Conclusions Higher MC at baseline predicted better cognition during the first two school years in boys but not in girls. CRF or adiposity was not associated with cognition in boys or girls. Accepted for Publication: 22 October 2018 Address correspondence to: Eero A. Haapala, PhD, Sports and Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, FI-40014 University of Jyväskylä, room VIV 247, email: eero.a.haapala@jyu.fi; telephone: +358408054210 The PANIC Study has financially been supported by Ministry of Education and Culture of Finland, Research Committee of the Kuopio University Hospital Catchment Area (State Research Funding), Finnish Innovation Fund Sitra, Social Insurance Institution of Finland, Finnish Cultural Foundation, Foundation for Paediatric Research, Diabetes Research Foundation in Finland, Finnish Foundation for Cardiovascular Research, Juho Vainio Foundation, Paavo Nurmi Foundation, Yrjö Jahnsson Foundation, and the city of Kuopio. Moreover, the PhD students and postdoctoral researchers of the PANIC Study have been supported by Program for Clinical Research and Program for Health Sciences of Doctoral School of University of Eastern Finland, Finnish Doctoral Programs in Public Health, Päivikki and Sakari Sohlberg Foundation, Paulo Foundation, Jalmari and Rauha Ahokas Foundation, Aarne and Aili Turunen Foundation, Finnish Medical Foundation, Jenny and Antti Wihuri Foundation, Kuopio Naturalists' Society, Olvi Foundation, the Aino Eerola and Orion Trusts of Finnish Medical Foundation, the Foundation for Diabetes Research, and the city of Kuopio. The work of Dr. Haapala was part of the University of Jyväskylä profiling area of multidisciplinary brain research funded by Academy of Finland. The sponsors had no role in designing the study, the collection, analysis, or interpretation of the data, the writing of the report, or the decision to submit the manuscript for publication. The authors declare that there are no conflicts of interest. The results of the present study do not constitute endorsement by ACSM. The Authors declare that the results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. © 2018 American College of Sports Medicine

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Editorial Note to Batterham and Hopkins Letter and Sainani Response

No abstract available

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The Problems with “The Problem with ‘Magnitude-based Inference’”

No abstract available

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Response

No abstract available

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Organizational principles of 3D genome architecture

Organizational principles of 3D genome architecture

Organizational principles of 3D genome architecture, Published online: 26 October 2018; doi:10.1038/s41576-018-0060-8

High-resolution studies of chromosome conformation are revealing that the 3D genome is organized into smaller structural features than was previously supposed and is primarily composed of compartmental domains and CTCF loops. In this Perspectives article Rowley and Corces describe the latest views on the organizational drivers and principles of the 3D genome, and the interplay between genome activity and organization.

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Spotlight on nucleosomes

Spotlight on nucleosomes

Spotlight on nucleosomes, Published online: 26 October 2018; doi:10.1038/s41576-018-0070-6

Two new studies in Nature provide insight into the role of nucleosomes in gene regulation. One describes the genome-wide organization of nucleosomes and the other details how transcription factor binding to DNA is affected by the presence of nucleosomes.

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Walking Speed is Correlated with the Isokinetic Muscular Strength of the Knee in Patients with Charcot-Marie-Tooth Type 1A

Charcot-Marie-Tooth disease type 1A (CMT1A) is the most common hereditary neuropathy. Affected individuals have a distal motor deficit, initially affecting the lower limbs and impairing walking performance. Isokinetic dynamometry can be used to objectively assess muscle strength of patients with neuromuscular disorders. No studies have evaluated the effect of muscle strength deficits of knee extensors and flexors on walking parameters for patients with CMT1A. The purpose of this study was to determine correlations between the isokinetic muscular strength (IMS) of knee flexors (KFs) and knee extensors (KEs) and walk parameters for patients with CMT1A. IMS of the knee was assessed on an isokinetic dynamometer (Cybex®) and walking by instrumented walkway analysis (GaitRite®). We included 33 patients (23 females, mean age 46.7±13.3 years, mean body mass index 25.7±4.6 kg/m2). We found a correlation between walking speed and IMS of KEs for the entire population and between walking speed and IMS of KEs and KFs for patients under 50 years of age. Isokinetic dynamometry can provide objective measures of knee muscle strength, which is correlated with walking speed but not cadence or step/stride length of patients with CMT. Related author: Pr Emmanuel Coudeyre, Department of Physical Medicine and Rehabilitation, Clermont-Ferrand University Hospital, Hôpital Nord, route de Chateaugay, BP 30056, 63 118 Cébazat, France, Tel: + 33 4 73 75 09 00 Fax: + 33 4 73 75 09 01, Email: ecoudeyre@chu-clermontferrand.fr Conflict of Interest: Each individual named as an author meets the uniform Requirements for Manuscripts Submitted to biomedical Journals criteria for authorship. All the authors declare do not have any conflict of interest to declare. Funding: The authors sincerely thank Clermont-Ferrand University Hospital for funding (2012). Length of manuscript: 186 words for the abstract, 1743 for the main text, 2 tables/figures and 24 references. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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A Nutritional Cause of Low Back Pain?

No abstract available

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A “BREACH” TOO FAR: EXERTIONAL RHABDOMYOLYSIS IN THE ELBOW FLEXOR MUSCLES

No abstract available

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The slow ape: High infant survival and long interbirth intervals in wild orangutans

Publication date: December 2018

Source: Journal of Human Evolution, Volume 125

Author(s): Maria A. van Noordwijk, S. Suci Utami Atmoko, Cheryl D. Knott, Noko Kuze, Helen C. Morrogh-Bernard, Felicity Oram, Caroline Schuppli, Carel P. van Schaik, Erik P. Willems

Abstract

Orangutans (Pongo spp.) are reported to have extremely slow life histories, including the longest average interbirth intervals of all mammals. Such slow life history can be viable only when unavoidable mortality is kept low. Thus, orangutans' survivorship under natural conditions is expected to be extremely high. Previous estimates of orangutan life history were based on captive individuals living under very different circumstances or on small samples from wild populations. Here, we combine birth data from seven field sites, each with demographic data collection for at least 10 years (range 12–43 years) on wild orangutans to better document their life history. Using strict criteria for data inclusion, we calculated infant survival, interbirth intervals and female age at first reproduction, across species, subspecies and islands. We found an average closed interbirth interval of 7.6 years, as well as consistently very high pre-weaning survival for males and females. Female survival of 94% until age at first birth (at around age 15 years) was higher than reported for any other mammal species under natural conditions. Similarly, annual survival among parous females is very high, but longevity remains to be estimated. Current data suggest no major life history differences between Sumatran and Bornean orangutans. The high offspring survival is remarkable, noting that modern human populations seem to have reached the same level of survival only in the 20th century. The orangutans' slow life history illustrates what can be achieved if a hominoid bauplan is exposed to low unavoidable mortality. Their high survival is likely due to their arboreal and non-gregarious lifestyle, and has allowed them to maintain viable populations, despite living in low-productivity habitats. However, their slow life history also implies that orangutans are highly vulnerable to a catastrophic population crash in the face of drastic habitat change.

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Critical evaluation of current data analysis strategies for psychophysiological measures of fear conditioning and extinction in humans

Publication date: Available online 26 October 2018

Source: International Journal of Psychophysiology

Author(s): L.J. Ney, M. Wade, A. Reynolds, D.V. Zuj, S. Dymond, A. Matthews, K.L. Felmingham

Abstract

Fear conditioning and extinction is a construct integral to understanding trauma-, stress- and anxiety-related disorders. In the laboratory, associative learning paradigms that pair aversive with neutral stimuli are used as analogues to real-life fear learning. These studies use physiological indices, such as skin conductance, to sensitively measure rates and intensity of learning and extinction. In this review, we discuss some of the potential limitations in interpreting and analysing physiological data during the acquisition or extinction of conditioned fear. We argue that the utmost attention should be paid to the development of modelling approaches of physiological data in associative learning paradigms, by illustrating the lack of replicability and interpretability of results in current methods. We also show that statistical significance may be easily achieved in this paradigm without more stringent data and data analysis reporting requirements, leaving this particular field vulnerable to misleading conclusions. This review is written so that issues and potential solutions are accessible to researchers without mathematical training. We conclude the review with some suggestions that all laboratories should be able to implement, including visualising the full data set in publications and adopting modelling, or at least regression-based, approaches.

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The transfer of fallout plutonium from paddy soil to rice: A field study in Japan

Publication date: January 2019

Source: Journal of Environmental Radioactivity, Volume 196

Author(s): Youyi Ni, Zhongtang Wang, Jian Zheng, Keiko Tagami, Qiuju Guo, Shigeo Uchida, Hirofumi Tsukada

Abstract

Reported transfer factor (TF) values of Pu from paddy soil to rice are rather scarce, despite the radiotoxicity of Pu and the irreplaceable role of rice in Asian peoples' diets. Here, we conducted a field study to investigate the transfer of global fallout Pu from paddy soil to rice grain (hulled rice) in Japan. The ²⁴⁰Pu/²³⁹Pu atomic ratios in two rice grain samples out of 16 samples were determined and the ratios corresponded well with the global fallout value. The soil-to-rice TF_Pu in 12 Japanese prefectures ranged from 4.5 × 10⁻⁶ to 1.2 × 10⁻⁴ with a geometric mean of 3.3 × 10⁻⁵. The TFs of rice obtained in this study were compatible to the TFs for the broad heading "cereals" compiled in the IAEA Technical Report Series No. 472. Weak correlations were found between the TF and the investigated soil characteristics such as soil pH and loss on ignition. Regarding the TFs for cerium (Ce) and thorium (Th) which are commonly considered as Pu analogues, we observed no significant correlations between the log(TF_Pu) and log(TF_Ce) or log(TF_Pu) and log(TF_Th). On the other hand, interestingly, a significantly positive correlation (r = 0.795, p < 0.001) was observed between log(TF_Pu) and log(TF_U). In view of the observed similarity of TF values for U and Pu from soil to rice, we thought that using the easy-to-measure TF_U to estimate TF_Pu from soil to rice might be suggested although the mechanism was unclear.

Graphical abstract

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Meteoric 10Be in aerosol filters in the city of Seville

Publication date: January 2019

Source: Journal of Environmental Radioactivity, Volume 196

Author(s): S. Padilla, J.M. López-Gutiérrez, G. Manjón, R. García-Tenorio, J.A. Galván, M. García-León

Abstract

Cosmogenic radionuclides in the one-million-year half-life range, like ¹⁰Be, find application fields in several Sciences. They are powerful tools in Geology and Geochronology, as they are very important tracers on the Earth, being utilized as chronometer. Meteoric ¹⁰Be (T_1/2 = 1.39 × 10⁶ y) associated to aerosols can be used as a tracer of atmospheric processes and specifically as indicators of the cosmogenic interactions in lower Stratosphere, upper Troposphere, the air exchange between both and deposition processes on the Earth surface. The applications of ¹⁰Be are even more relevant when combined with other radionuclides such as ²⁶Al. In order to provide new data about concentration ¹⁰Be in this type of samples, the first atmospheric air filters in Spain have been analysed. Values around 10⁴ at/m³ (atoms per cubic meter of air) for ¹⁰Be have been obtained. Due to the location and the features of the sampling site (urban area, at sea level and mid latitude), a new radiochemical procedure was designed and developed in our laboratory for the Accelerator Mass Spectrometry (AMS) measurement of ¹⁰Be in this kind of samples. The samples were measured in SARA, the 1 MV AMS system at Centro Nacional de Aceleradores (CNA).

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Application of synchrotron radiation and other techniques in analysis of radioactive microparticles emitted from the Fukushima Daiichi Nuclear Power Plant accident-A review

Publication date: January 2019

Source: Journal of Environmental Radioactivity, Volume 196

Author(s): Fei Chen, Jun Hu, Yoshio Takahashi, Masatoshi Yamada, M. Safiur Rahman, Guosheng Yang

Abstract

During the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, large amounts of radioactive materials were released into the environment. Among them, a large proportion of the radionuclides, such as Cs, entered into the environment as radioactive microparticles (RMs). In recent years, the characterization of RMs based on synchrotron radiation (SR) techniques has been reported, since their physical and chemical properties played an important role in evaluating the chemical reactions and physical changes that occurred when the nuclear material meltdowns took place. In this review, we summarize separation and measurement technologies used in studies of RMs, and we emphasize the application of SR-based techniques in the characterization of RMs. We report research progress, including information for elemental composition, isotopic distribution, radioactivity, and formation processes. Also, we compare the RMs from the FDNPP and the Chernobyl Nuclear Power Plant accidents. The SR-based technologies offer great improvement in the resolution and precision compared to conventional technologies, such as X-ray fluorescence and X-ray diffraction.

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Treating Military Service Members and Veterans in the Private Sector: Information and Resources for Clinicians

Publication date: Available online 25 October 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Alison Cogan, Larry Cervelli, Tina Dillahunt-Aspillaga, Alicia Gill Rossiter

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Organizational principles of 3D genome architecture

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Spotlight on nucleosomes

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Mitochondrial ATP Synthase Beta Subunit production rate and ATP Synthase Specific Activity are reduced in skeletal muscle of humans with obesity

Experimental Physiology, Volume 0, Issue ja, -Not available-.


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Intramuscular Hemangioma but not Adductor Muscle Strain: Ultrasound Imaging for an Adolescent with Posterior Proximal Thigh Pain

No abstract available

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Diagnostic approach to traumatic axonal injury of the optic radiation in mild traumatic brain injury: A case report

We describe a diffusion tensor tractography(DTT)-based diagnostic approach to traumatic axonal injury(TAI) of the optic radiation(OR) in a patient who showed visual field defect following mild traumatic brain injury(TBI). A 43-year-old female patient suffered head trauma during a motor vehicle accident. After the head trauma, she noticed visual disturbance. Peripheral field defects were detected in both eyes on the Humphrey visual field test. After DTT-based reconstruction of the OR, we determined the fractional anisotropy(FA) and fiber number of each whole OR. Four regions of interest(ROIs) were placed on the ORs based on DTT configuration. The right OR showed narrowing, and the left OR revealed partial tearing in the posterior portion. The fiber number of the right OR was more than two standard deviations lower than the control mean. The FA values of the ROI 2(the narrowed area of the right OR) and ROI 3(the partially torn area of the left OR) were more than two standard deviations lower than the control mean. Our results suggest that analysis of the configuration and parameters of the OR based on three-dimensionally reconstructed DTT results is useful technique in the detection of TAI of the OR in individual patients with mild TBI. Corresponding author: Han Do Lee, MS, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Mailing Address: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam, University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea, Tel: 82-53-620-4098 FAX: 82-53-620-4508 e-mail: lhd890221@hanmail.net Acknowledgement This work was supported by the Medical Research Center Program (2015R1A5A2009124) through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Compendium of physical activities strongly underestimates the oxygen cost during activities of daily living in stroke patients

Objective To measure the Metabolic Equivalent Task (MET) when performing physical activities of daily living in post-stroke individuals. Design Post-stroke individuals who were able to walk without human assistance were recruited and asked to perform the following activities of daily living: washing dishes (activity code:05041 in Ainsworth's compendium), walking at a slow pace

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Heart‐rate modulations reveal attention and consciousness interactions

Psychophysiology, EarlyView.


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Don’t look, don’t think, just do it! Toward an understanding of alpha gating in a discrete aiming task

Psychophysiology, EarlyView.


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A Systematic Review of Probiotics for Cystic Fibrosis Patients: Moving Forward

Background: Cystic fibrosis (CF) is associated with chronic respiratory disease and pancreatic insufficiency and results in the malabsorption of nutrients and intestinal inflammation. There is evidence that probiotic supplementation may impact the gastrointestinal and respiratory microbiota. This study aimed to categorize current evidence regarding the effects of supplementing with probiotics in CF patients on gastrointestinal and respiratory outcomes according to the type of intervention. Methods: The initial database search included all identified studies according to the recommendations of the Cochrane Collaboration, regardless of language, publication date or design. Studies were categorized by probiotic strain (Lactobacillus reuteri; Lactobacillus rhamnosus GG or a mix of strains); dosage (low dosage if 109 CFU); and duration of intervention (one, three, six or twelve months). Assessment of quality was performed based on the Cochrane risk of bias criteria and the Downs & Black checklist. Results: A total of 205 studies were identified; however, only nine met the criteria for inclusion. The studies were considered to have a high risk of bias, hampering the possibility of performing a meta-analysis. Eighty percent of the studies (4 of 5) reported a positive result for intestinal inflammation, and another 4 studies (4 of 5) reported a positive result for pulmonary exacerbation frequency, regardless of the treatment approach. Conclusion: The present data indicate a promising future for probiotic use in cystic fibrosis, which has an impact on exacerbations and intestinal inflammation; however, further studies of standardized therapeutic interventions are required. Address correspondence and reprint requests to Lenycia de Cassya Lopes Neri, M.Sc., Rua Albina Barbosa, 273, Aclimação São Paulo SP Brasil. CEP 01530-020 (e-mail: lenycia@gmail.com). Received 27 April, 2018 Accepted 1 October, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Financial support: None Potential conflicts of interest: None Lenycia de Cassya Lopes Neri: Conception and design of the work; acquisition, analysis, and interpretation of data for the work; Revising it critically for important intellectual content; Final approval of the version to be published; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Monica Taminato: Substantial contributions to the conception and design of the work; interpretation of data for the work; revising it critically for important intellectual content; Final approval of the version to be published; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Luiz Vicente Ribeiro Ferreira da Silva Filho: Substantial contributions to the conception and design of the work; the acquisition, analysis, or interpretation of data for the work; Revising it critically for important intellectual content; Final approval of the version to be published; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework

Pediatric feeding disorders lack a universally accepted definition. Feeding disorders require comprehensive assessment and treatment of four closely-related, complementary domains (medical, psychosocial, and feeding skill-based systems and associated nutritional complications). However, previous diagnostic paradigms have typically defined feeding disorders using the lens of a single professional discipline and fail to characterize associated functional limitations that are critical to plan appropriate interventions and improve quality of life. Using the framework of the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF), a unifying diagnostic term is proposed: "Pediatric Feeding Disorder" (PFD), defined as impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction. By incorporating associated functional limitations, the proposed diagnostic criteria for PFD should enable practitioners and researchers to better characterize the needs of heterogeneous patient populations, facilitate inclusion of all relevant disciplines in treatment planning, and promote the use of common, precise, terminology necessary to advance clinical practice, research, and health-care policy. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/OBJ4xP Address correspondence and reprint requests to Praveen Goday, MBBS, CNSC, Professor, Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Road Milwaukee, WI 53226 (e-mail: pgoday@mcw.edu). Received 6 July, 2018 Accepted 27 September, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Funding Source: This paper was possible through a grant from Comerica Bank to Feeding Matters, Inc. to enable a consensus meeting held in Phoenix, AZ on March 4-5, 2016. Financial Disclosure: Dr Goday serves as consultant to Nutricia and serves on a Data Safety and Monitoring Board for Shire Pharmaceuticals. The remaining authors have no financial relationships relevant to this article to disclose. Conflict of Interest: None of the authors have any conflicts of interest to disclose. Contributors statement: Drs. Goday, Huh, Silverman, Lukens, Dodrill, Cohen, Delaney, Mrs. Feuling, Drs. Noel, Gisel, and Phalen participated in the initial consensus work, drafted sections of the initial manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted. Drs. Kenzer, Kessler, and Browne participated in the initial consensus work, reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr. de Camargo provided input into key elements of the consensus work, reviewed and revised the manuscript, and approved the final manuscript as submitted. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Quantitative Analysis of Apparent Diffusion Coefficient for Disease Assessment in Paediatric Inflammatory Bowel Disease

Objective: To establish an apparent diffusion coefficient (ADC) cut-off value to classify active and non-active lesions in inflammatory bowel disease. Methods: We reviewed 167 paediatric Magnetic Resonance Enterographies (MRE) executed for suspected inflammatory bowel disease by using a 1.5- and 3-tesla scanner. We assessed the presence and activity of the disease by using morphologic and functional parameters such as the ADC. Each patient could have more than one examinations. Quantitative assessment of disease activity in the ADC map was measured placing 3 regions of interest in the areas of highest inflammation and the mean value was calculated, patients without sign of inflammation were assessed at two standardised site. Ileocolonoscopy, esophagogastroduodenoscopy, surgery or video-capsule endoscopy were used as standards of reference. Results: We enrolled 34 patients and 35 examinations: radiological findings of disease were identified in 29 exams and 44 lesions were detected. Six patients had negative results and ADC assessment was taken at the terminal ileum and cecum. A total of 56 bowel segments were included in the study. Image analysis revealed 39 active lesions (69.6%) and their ADC values were lower compared to the ones of non-active segments. For each scanner a cut-off value was found (sensitivity: 0.91, specificity: 0.89 for 1.5T and 0.81 for 3T). Inter-rater agreement on disease activity between ADC values and MRE results and and between ADC values and the standard of reference were very good. Conclusions: ADC can provide a scanner-based quantitative measurement of disease activity. Address correspondence and reprint requests to Alessandra Scionti, MD, Division of Diagnostic and Interventional Radiology, Department of Translational Research on New Technologies in Medicine and Surgery, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy (e-mail: alessandra86sc@gmail.com). Received 2 August, 2018 Accepted 5 October, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). The authors declare that they have no conflict of interest and that no funding was received for this work. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Biliary Atresia Relevant Human iPSCs Recapitulate Key Disease Features in a Dish

Biliary atresia (BA) is the most common cause of pediatric end-stage liver disease and the etiology is poorly understood. There is no effective therapy for BA partly due to lack of human BA models. Towards developing in vitro human models of BA, disease-specific iPSCs from 6 BA patients were generated using non-integrating episomal plasmids. In addition, to determine the functional significance of BA-susceptibility genes identified by genome wide association studies (GWAS) in biliary development, a genome-editing approach was used to create iPSCs with defined mutations in these GWAS BA loci. Using the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas9 system, isogenic iPSCs deficient in BA-associated genes (GPC1 and ADD3) were created from healthy iPSCs. Both the BA patient-iPSCs and the knockout (KO) iPSCs were studied for their in vitro biliary differentiation potential. These BA-specific iPSCs demonstrated significantly decreased formation of ductal structures, decreased expression of biliary markers including CK7, EpCAM, SOX9, CK19, AE2 and CFTR and increased fibrosis markers such as alpha SMA, Loxl2 and Collagen1 compared to controls. Both the patient- and the KO- iPSCs also showed increased yes-associated protein (YAP, a marker of bile duct proliferation/fibrosis). Collagen and YAP were reduced by treatment with the anti-fibrogenic drug pentoxifylline. In summary, these BA-specific human iPSCs showed deficiency in biliary differentiation along with increased fibrosis, the two key disease features of BA. These iPSCs can provide new human BA models for understanding the molecular basis of abnormal biliary development and opportunities to identify drugs that have therapeutic effects on BA. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/OBJ4xP Address correspondence and reprint requests to Kathleen B. Schwarz, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA (e-mail: kschwarz@jhmi.edu), Yoon-Young Jang, MD, PhD, 1550 Orleans Street, CRB2 Rm552, Baltimore, MD 21231 (e-mail: yjang3@jhmi.edu). Received 2 August, 2018 Accepted 3 October, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Author contribution: Lipeng Tian: Collection and/or assembly of data, Data analysis and interpretation Zhaohui Ye: Collection and/or assembly of data, Conception and design Kim Kafka: Collection of data, Administrative support Dylan Stewart: Provision of study material or patients Robert Anders: Provision of study material or patients Kathleen B. Schwarz: Provision of study material or patients, Conception and design, Manuscript writing Yoon-Young Jang: Data analysis and interpretation, Conception and design, Manuscript writing Financial support: Maryland Stem Cell Research Foundation, NIBIB (R01EB023812), NICHD (R03HD091264), Colleen Mitchel BA 5K; Zachary Meehan Memorial Fund for BA Research; Johns Hopkins Pediatric Liver Center, Johns Hopkins Children's Center There are no conflicts of interest. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Epidemiology of Pediatric Acute Pancreatitis in Taiwan: A Nationwide Population-Based Study

Objective: Pediatric acute pancreatitis (AP) may be different from adult AP in various respects. This study focuses on the epidemiology and medical resource use of pediatric AP in Taiwan. Methods: Patients aged 0–18 years with AP were identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases, Ninth Revision (ICD-9) code of AP 577.0. The medical resource use was measured by length of hospital stay (LOS) and hospital charges. Results: Between 2000 and 2013, a total of 2,127 inpatient cases of pediatric AP were collected, which represented a hospitalization rate of 2.83 per 100,000 population. The incidence by age had two peaks, the first peak was at age 4–5 years old, and the second one started rising from 12–13 years old until adulthood. The incidence by year increased from 2.33 to 3.07 cases per 100,000 population during the study period. The average hospital stay is steady, but the medical cost is increasing. Females have longer hospital stays, higher medical expenditures, more use of endoscopic retrograde cholangiopancreatography (ERCP) possibly due to more comorbidities with biliary tract diseases than males (p 

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Are all Breastfed Infants Equal? Clustering Metabolomics Data to Identify Predictive Risk Clusters for Childhood Obesity

Objectives: Fetal and early life represent a period of developmental plasticity during which metabolic pathways are modified by environmental and nutritional cues. Little is known on the pathways underlying this multifactorial complex. We explored whether 6 months old breastfed infants could be clustered into metabolically similar groups and that those metabotypes could be used to predict later obesity risk. Methods: Plasma samples were obtained from 183 breastfed infants aged 6-months participating in the European multicenter Childhood Obesity Project study. We measured amino acids along with polar lipid concentrations (acylcarnitines, lysophosphatidylcholines, phosphatidylcholines, sphingomyelins). We determined the metabotypes using a Bayesian agglomerative clustering method and investigated the properties of these clusters with respect to clinical, programming, and metabolic factors up to 6 years of age. Results: We identified 20 metabolite clusters comprising 1–39 children. Phosphatidylcholines predominantly influenced the clustering process. In the largest clusters (n ≥ 14), large differences existed for birth length (unadjusted P 

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