bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurodevelopmental Impairment at 1 Year of Age in Infants With Previous Invasive Group B Streptococcal Sepsis and Meningitis
Authors: Nakwa Firdose L. , Lala Sanjay G. , Madhi Shabir A. , Dangor Ziyaad 
Published: April 2020

Background:
Invasive group B streptococcal (GBS) disease causes considerable morbidity and mortality in young infants, and 18% of GBS-meningitis survivors have moderate-to-severe neurodevelopmental impairment. However, there is a paucity of data regarding neurologic impairment following GBS sepsis.

Methods:
A case–control study was undertaken in infants at 3 secondary–tertiary hospitals in Johannesburg, South Africa. Neurodevelopmental assessments were done at 1 year of age using the Denver II Developmental screening tool. A case was defined as isolation of GBS from blood or cerebrospinal fluid in infants less than 90  days of age. Three healthy controls (range: 1–6) were matched to maternal age, maternal HIV-infection status, gestational age and timing of enrollment.

Results:
Of 122 invasive GBS cases, 78 (63.9%) had sepsis and 44 (36.1%) meningitis. Twenty-two (18%) invasive GBS cases (17 of 78; 21.8% with sepsis and 5 of 44; 11.4% with meningitis) died during the course of hospitalization, and a further 2 (1.6%; 1 sepsis and 1 meningitis case) died by 1 year of age. Five (1.1%) of 449 controls died by 1 year of age. Of the 45 GBS sepsis cases and 141 matched controls followed through to 1 year of age, 11 (24.4%) cases (3 with moderate-to-severe impairment) and 10 (7.1%) controls had an abnormal Denver score with an adjusted (for gender) odds ratio of 3.51; 95% confidence interval (CI): 1.23–10.04; P = 0.019. Four (20%) of the 20 GBS meningitis cases compared with 1 (1.5%) control had neurologic impairment at 1-year of age (aOR: 8.29; 95% CI: 0.88–78.3; P = 0.065)

Conclusion:
In this setting, invasive GBS disease is associated with a high mortality. Infant survivors of invasive GBS sepsis compared with controls had 3.5-fold greater odds of neurologic impairment by 1 year of age. This corroborates the need for strategies to prevent invasive GBS disease.
Acute Childhood Viral Encephalitis in Southern Brazil
Authors: Valle Daniel Almeida do , Santos Mara Lúcia Schmitz Ferreira , Giamberardino Heloísa Ihle Garcia , Raboni Sonia Mara , Scola Rosana Herminia 
Published: April 2020

Background:
Viral meningoencephalitis is highly heterogeneous, varying by geographic location. The aim of this study was to characterize the etiology and reporting the clinical findings and outcome of viral encephalitis in children in southern Brazil.

Methods:
A cross-Sectional study was conducted at Hospital Pequeno Príncipe, Curitiba, Brazil, between January 2013 and December 2017. It included patients younger than 18 years, who fulfilled the criteria: altered mental status as a major criteria and 2 or more minor criteria (1) fever, (2) seizures, (3) focal neurologic findings, (4) central system fluid white cell count of ≥5 cells/mm3, (5) abnormal brain imaging, and/or (6) electroencephalogram abnormalities.

Results:
Viral meningoencephalitis was diagnosed in 270 children, with median age of 2 years (interquartile range: 0–4), The etiology of viral meningoencephalitis was confirmed in 47% of patients. Enterovirus (18%) was the major cause of encephalitis in Southern Brazilian children, and a high prevalence of Epstein-Barr virus (6%) was demonstrated. Most patients presented with fever (81%), followed by vomiting (50%), focal neurologic findings (46%), seizures (31%) and headache (30%). Few abnormalities were detected on electroencephalograms and brain magnetic resonance images. On discharge from hospital, symptoms resolved completely in 87% of children. Sequelae were mainly observed in patients with focal neurologic symptoms (P<0.001), presence of seizures (P<0.001) and electroencephalogram abnormalities (P=0.024).

Conclusions:
Enterovirus was the major cause of encephalitis. Etiologic agent of encephalitis seems to be influenced by the local virologic pattern. A poor outcome was identified in patients with seizures, focal neurologic findings and electroencephalogram abnormalities.
Interferon-Gamma Release Assay Testing in Children Younger Than 2 Years in a US-Based Health System
Authors: Gaensbauer James , Young Janine , Harasaki Cara , Aiona Kaylynn , Belknap Robert , Haas Michelle K. 
Published: April 2020

Background:
Use of interferon-gamma releasing assays (IGRAs) in children <2 years old may derive many of the same advantages, which have led to preference over tuberculin skin test (TST) in older children, but data are limited. Since 2011, we have tested children <2 years old with Quantiferon-TB Gold/Gold Plus (QFT)) in select clinical scenarios at Denver Health, a health system encompassing a TB clinic, refugee and immigrant screening and primary care.

Methods:
We identified patients <2 years old tested with QFT between February, 2011 and August, 2019. The primary outcome measure was incident cases of TB among tested patients. Test results and in vitro characteristics were analyzed, as were demographic, epidemiologic and clinical outcomes.

Results:
We analyzed 116 QFTs ordered in children age 7–23 months. Two were positive, 3 indeterminate, 3 failed/refused phlebotomy and the remainder (93%) were negative. Mitogen tube results were robust. Thirteen patients were TST-positive: 11 were QFT-negative, 1 QFT-positive and 1 failed phlebotomy. Eight patients received some form of TB medication, including 4 QFT-negative patients who were treated for active TB or latent TB infection based on positive TST or clinical findings. Among QFT-negative patients, including 6 TST-positive, not treated for active TB or latent TB infection, no TB disease has been identified over a median follow-up time of 2.96 years.

Conclusions:
IGRA use was not limited by barriers of phlebotomy, indeterminate result or gamma-interferon production. The risk of missing an infected but IGRA-negative patient can be reduced by treatment of select patients at higher risk. Current recommendations against IGRA use in children <2 years old could be amended to allow careful introduction, particularly among well-appearing BCG-vaccinated patients.
Characteristics and factors associated with intraocular lens tilt and decentration after cataract surgery
Authors: Chen Xiaoyun , Gu Xiaoxun , Wang Wei , Xiao Wei , Jin Guangming , Wang Lanhua , Dai Ye , Zhang Enen , Ruan Xiaoting , Liu Zhenzhen , Luo Lixia , Liu Yizhi 
Published: April 2020

Purpose:
To analyze the characteristics and factors associated with intraocular lens (IOL) tilt and decentration after uneventful phacoemulsification with IOL implantation.

Setting:
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Design:
Cross-sectional study.

Methods:
All patients underwent a general ophthalmologic examination and anterior segment photography. IOL tilt and decentration were measured with a second-generation anterior segment optical coherence tomography (Casia2). Univariate and multivariate regression analyses were performed to assess the association between IOL tilt and decentration with ocular biometric and systemic parameters, and the visual acuity.

Results:
A total of 196 eyes of 196 patients were enrolled in this study. IOLs showed a mean tilt of 4.8 degrees toward the inferotemporal direction, and the mean decentration was 0.21 mm. Both eyes presented a mirror symmetry relationship. Twenty-two eyes (11.22%) had a tilt greater than 7 degrees, and 21 eyes (10.72%) had a decentration more than 0.4 mm. Multivariate regression analysis showed previous pars plana vitrectomy (PPV) and short axial length (AL) were associated with greater IOL tilt (P = .014 and P < .001). In addition, long AL, thicker lens, and less capsulorhexis–IOL overlap were positively correlated with decentration (P < .001, P = .029, and P = .026). Corrected distance visual acuity did not directly correlate with IOL tilt and decentration (P = .417 and P = .550).

Conclusions:
PPV history and short AL were associated with greater IOL tilt, whereas longer AL, thicker lens, and overlarge capsulorhexis contribute to greater decentration. Implantation of toric and multifocal IOLs in these patients should be cautious.
Protecting the Mental Health of Small-to-Medium Enterprise Owners
Authors: Martin Angela , Kilpatrick Michelle , Scott Jenn , Cocker Fiona , Dawkins Sarah , Brough Paula , Sanderson Kristy 
Published: April 2020

Objective:
Small-medium enterprises (SMEs) are under-represented in occupational health research. Owner/managers face mental ill-health risks/exacerbating factors including financial stress and long working hours. This study assessed the effectiveness of a workplace mental health and wellbeing intervention specifically for SME owner/managers.

Methods:
Two hundred ninety seven owner/managers of SMEs were recruited and invited to complete a baseline survey assessing their mental health and wellbeing and were then randomly allocated to one of three intervention groups: (1) self-administered, (2) self-administered plus telephone, or (3) an active control condition. After a four-month intervention period they were followed up with a second survey.

Results:
Intention to treat analyses showed a significant decrease in psychological distress for both the active control and the telephone facilitated intervention groups, with the telephone group demonstrating a greater ratio of change.

Conclusion:
The provision of telephone support for self-administered interventions in this context appears warranted.
The Acute Care Confidence Survey: Examination of the Psychometric Properties and Predictors of Performance Among Students in a Large Inpatient Hospital System
Authors: Rosenfeldt Anson B. , Greenwood Kristin , Lubbeck Karoline , Brown Jennifer , Iversen Maura D. 
Published: April 2020

Introduction.
The Acute Care Confidence Survey (ACCS) was created as a measure of student self-efficacy for acute care clinical education experiences (CEEs). Initial measures of validity and reliability have been established; however, further psychometric testing is warranted to facilitate academic and clinical adaptation. This study aimed to further investigate the psychometric properties of the ACCS on a population of physical therapist students from diverse educational backgrounds. The study aims were to examine 1) the test–retest reliability of the ACCS, 2) the relationship between the ACCS and student demographic variables including previous acute care exposure, and 3) the relationship between ACCS scores and clinical performance.

Methods.
A total of 66 students completing their acute care CEE in a large hospital system were recruited. Sixty students from 14 different Doctor of Physical Therapy programs had complete data sets and were used for the final analysis. On the first day of their CEE, the students completed the ACCS along with a demographic questionnaire including items about academic preparation. Students completed the ACCS a second time within 1 week to determine the test–retest reliability. The midterm Clinical Performance Instrument (CPI) scores were used to measure the CEE performance. Descriptive statistics characterized the sample. A Pearson correlation coefficient was used to determine the test–retest reliability. The associations between ACCS scores and demographic characteristics and CPI scores were computed using Chi squared tests, t tests, and correlation coefficients.

Results.
The test–retest reliability of the ACCS was 0.83 (P < .0001). The correlation between total ACCS score and midterm CPI score was 0.32 (P < .01); low to moderate correlations were found between the mobility, instruct, and judgment subscales of the ACCS and midterm CPI scores (r = 0.26, 0.30, 0.44, respectively, P < .05). There were low but significant associations between ACCS scores and the number of previous CEEs (first, middle, and terminal; r = 0.33; P < .01), number of weeks of completed full-time CEEs (r = 0.37; P < .003), and number of acute care exposure hours (r = 0.28, P = .02). Having taken a didactic course specifically dedicated to acute care significantly impacted the judgment subscale of the ACCS (P = .005).

Discussion.
Previous exposure to the acute care setting and CEE experiences, regardless of setting, had a positive impact on the ACCS scores. The low to moderate correlations reported between the ACCS and student performance measured by the CPI indicate that self-efficacy alone may not be sufficient to predict the student performance.

Conclusion.
These data indicate that the ACCS is a reliable measure of student preparedness. Further examination on the utility of the ACCS is warranted.
The Physiological and Psychological Effects of the First Year of an Entry-Level Physical Therapist Education Program on Students
Authors: Douris Peter C. , D'Agostino Nick A. , Mathew Seena K. , Anderson Robert P. , Bauman Kevin M. , Tiangtham Sattha A. , Greco Tom , Pizow Adam , Hall Cheryl A. 
Published: April 2020

Introduction/Review of Literature.
Physical therapy students anecdotally report the adverse physiological and psychological effects of attending an entry-level physical therapist education program. Previous research on medical students has demonstrated significant negative changes in health and physical fitness during the course of medical school.

Purpose.
The purpose of this study was to quantify the changes in anthropometric parameters, fitness, exercise, stress, sleep, and quality of life in students during their first year of an entry-level physical therapist education program.

Subjects.
Thirty-eight first-year Doctor of Physical Therapy students at the New York Institute of Technology.

Methods.
The design was a prospective longitudinal cohort study. The outcome measures were assessed during the first 3 semesters of the first academic school year.

Results.
Significant changes in aerobic fitness were documented from the beginning to the end of the first year, with V̇o
2max decreasing from 40.8 to 35.5 mL/kg/min. Exercise levels decreased significantly when comparing the fall semester to the summer and winter semesters. Stress levels showed a significant increase, whereas hours of sleep, global quality of sleep, and quality of life decreased significantly, as students progressed through each semester.

Discussion and Conclusion.
The results are based on a cohort of students belonging to a single physical therapist education program and may not be broadly generalizable. These findings suggest that stress management programs and wellness resources ought to be offered while enrolled in a physical therapist education program.
Cervical Stratified Mucin-Producing Intraepithelial Lesion: A Systematic Review of Diagnosis and Management
Authors: Wolf Jennifer L. , Billingsley Caroline C. , Kendler Ady , Jackson Amanda L. 
Published: April 2020

Objectives
The aims of the study were to synthesize reported associations of stratified mucin-producing intraepithelial lesion (SMILE) of the cervix with other dysplasia lesions and immunohistochemical (IHC) stains, compare expected patterns of IHC staining to other lesions in the differential diagnosis, and assess follow-up pathology.

Methods
This systematic review includes all case reports and case series of cervical lesions consistent with SMILE based on the histologic diagnosis described in the original case series. MEDLINE, EMBASE, and Cochrane Database were searched through June 2019. Immunohistochemical analysis, concurrent lesions, and pathology on follow-up were compiled for comparison. Weighted averages of concurrent lesions were calculated.

Results
Nine case reports and case series were included, published between 2000 and 2019. Of 9 studies, 6 and 5 studies reported strong, diffuse staining of p16 and increased expression of Ki-67, respectively. Stratified mucin-producing intraepithelial lesion is associated with human papillomavirus, especially type 18. The weighted average risk of concurrent high-grade squamous intraepithelial lesion was 79% (range = 33%–93%), adenocarcinoma in situ 39% (2.9%–92%), adenocarcinoma 5% (1%–25%), and squamous cell carcinoma 6% (0%–11%). Patients underwent follow-up ranging from repeat Pap to radical hysterectomy, with pathology on follow-up infrequently and irregularly reported.

Conclusions
Stratified mucin-producing intraepithelial lesion is a rare lesion with a paucity of research on necessary cytology and IHC stains for diagnosis, but p16 and Ki-67 IHC stains can be performed to rule out benign lesions. The lesion is associated with high risk of concurrent high-grade squamous intraepithelial lesion, adenocarcinoma in situ, and invasive carcinoma, but studies on the risk of pursuing fertility-preserving management are needed.
Single-Sided Deafness—Outcomes of Three Interventions for Profound Unilateral Sensorineural Hearing Loss: A Randomized Clinical Trial
Authors: Fogels Jonas , Jönsson Radi , Sadeghi André , Flynn Mark , Flynn Traci 
Published: April 2020

Objective:
A comparison of three interventions for profound unilateral sensorineural hearing loss.

Study Design:
Prospective, crossover randomized clinical trial.

Participants:
Fifteen participants with profound unilateral sensorineural hearing loss.

Interventions:
Three potential technical interventions were compared: Bone Conduction Device on softband, Contralateral Routing of Signal (CROS), and Remote Microphone . Each intervention was randomly trialed for a period of 3 weeks, separated by a 1 week washout period.

Outcome Measures:
Speech in noise recognition test performed under four conditions (lateral noise poorer ear, lateral noise better ear, speech poorer ear, speech better ear). Standardized questionnaires (Abbreviated Profile of Hearing Aid Benefit, Bern Benefit in Single Sided Deafness Questionnaire, and Speech, Spatial, and Other Qualities 12) were used to evaluate amplification benefit at baseline and following each intervention.

Results:
The use of remote microphone provided the best results in the speech recognition in noise test. A benefit in some signal-to-noise ratios was presented of the CROS over bone conduction device on softband in the Speech Poor Ear condition. On questionnaires of benefit, participants did not rate a particular intervention as significantly better than any other. Following the study, CROS was the intervention preferred by the 8 of 15 participants (53%). The majority of participants (80%) chose to continue with an intervention rather than no treatment.

Conclusion:
The use of all interventions resulted in increased performance in speech recognition in noise and rated higher on subjective benefits in comparison with baseline. People with SSD are a heterogeneous population when considering perceived difficulties. Future research should focus on segmenting the population of SSD depending on factors such as etiology, high frequency loss in the better ear, and age of acquired loss for the poorer ear. This stratification may possibly increase the benefit for the patient in terms of more individual-based clinical routines.
Cerumenolytic Efficacy of 2.5% Sodium Bicarbonate Versus Docusate Sodium: A Randomized, Controlled Trial
Authors: Piromchai Patorn , Laohakittikul Chanticha , Khunnawongkrit Sirichoke , Srirompotong Somchai 
Published: April 2020

Objectives:
To evaluate the efficacy of 2.5% sodium bicarbonate and docusate sodium in patients with complete occlusion of the ear canal from impacted cerumen.

Study Design:
Randomized controlled trial.

Method:
We enrolled patients with unilateral complete cerumen occlusion of the ear canal that was unable to be removed using suction. Either 2.5% sodium bicarbonate or docusate sodium was applied and allowed to sit for 15 minutes. The ear canal was then cleaned under a microscope for up to 3 minutes until the tympanic membrane was completely visible. A second attempt with the same agent was performed in subjects in whom the first application was unsuccessful. The outcomes were compared between the two groups in terms of cleaning, the success rate, time taken to clean the canal, and adverse events.

Results:
There were 91 participants enrolled in this study. The mean age of the participants was 48.0 years. The patients’ demographic did not differ between the two groups. At the end of the treatment, the tympanic membrane was completely visible in 41 (91.11%) subjects treated with 2.5% sodium bicarbonate and 38 (82.61%) subjects treated with docusate sodium, with a 1.10 success ratio between the two groups (95% CI: 0.94–1.29, p = 0.23). The mean successful suctioning time was 103.61 seconds using 2.5% sodium bicarbonate and 124.13 using docusate sodium. The mean difference was 20.52 seconds (95% CI: –10.55–51.59).

Conclusion:
2.5% sodium bicarbonate demonstrated non-inferior efficacy and safety compared with docusate sodium. We recommend using this agent in clinical practice.

Trial Registration:
Clinicaltrials.in.th/TCTR20160803001.
Hearing Loss's Incidence and Impact on Employment in the United States
Authors: Tehranchi Kian , Jeyakumar Anita 
Published: April 2020

Objective:
To determine the incidence of hearing loss (HL) as well as differences in wages and labor force participation rates between individuals with and without HL.

Study Design:
Retrospective ecological study.

Patients:
1% of the US population including individuals with and without HL from the public use micro data sample (PUMS) of the 2011 to 2016 American Community Survey (ACS) was analyzed.

Main Outcome Measure:
ACS census data on individual age, self-reported hearing loss, labor force participation, and monetary earnings between 2011 and 2016.

Results:
HL incidence rates were 13.4, 0.4, 3.8, 18.1, and 117.1 per 10,000 people among 0 to 2, 3 to 17, 18 to 44, 45 to 64, and 65+ years old, respectively. HL 18 to 44, 45 to 64, and 65+ years old participated in the labor force at 86, 81, and 61% of the rate of hearing individuals. HL 18 to 44, 45 to 64, and 65+ years old earned 78, 73, and 72% of the wages earned by non-HL individuals.

Conclusions:
Calculated HL incidence and labor force participation rates were higher than previously published in literature analyzing 1991 census data. The changes may be due to the methodology used in this study but may also reflect improvements in diagnosis, access to technology, and the implementation of the Americans with Disabilities Act (ADA) of 1990.
Electrocochleography and Cochlear Implantation: A Systematic Review
Authors: Trecca Eleonora M. C. , Riggs William J. , Mattingly Jameson K. , Hiss Meghan M. , Cassano Michele , Adunka Oliver F. 
Published: April 2020

Objective:
Given the heterogeneity of papers about electrocochleography (ECochG) and cochlear implantation (CI) and the absence of a systematic review in the current literature, the aim of this work was to analyze the uses of ECochG in the different stages of CI.

Data Sources:
A search of PubMed from inception to December 8, 2019, with cross-references, was executed. Keywords were: “Cochlear Implant” OR “Cochlear Implantation” AND “Electrocochleography” OR “ECochG.” The main eligibility criteria were English-language articles, investigating the use of ECochG in the different phases of CI.

Study Selection:
Literature reviews, editorials, case reports, conference papers were excluded, as were papers in which ECochG was just sporadically executed.

Data Extraction:
The quality of the included studies was assessed using “The Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) Statement.

Data Synthesis:
A total of 95 articles were identified and 60 papers were included. The included articles covered a timeframe from 2003 to 2019. Of the 60 papers, 46 were human studies, 12 animal studies, and two involved more data sets. Eleven related to the diagnostic phase, 43 described intraoperative monitoring, and 10 were regarding follow-up testing. Hearing preservation was the most discussed topic with 25 included articles.

Conclusions and Relevance:
ECochG measurements appeared to be useful in many aspects of CI, such as hearing preservation. Our review is the first that shows the evolution of the technique and how much has been achieved from the earliest experiments to the most recent signal process refinements and device implementation in CI.