bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modulation of Individual Alpha Frequency with tACS shifts Time Perception
Authors: Mioni Giovanna , Shelp Adam , Stanfield-Wiswell Candice T , Gladhill Keri A , Bader Farah , Wiener Martin 
Published: September 2020

AbstractPrevious studies have linked brain oscillation and timing, with evidence suggesting that alpha oscillations (10 Hz) may serve as a “sample rate” for the visual system. However, direct manipulation of alpha oscillations and time perception has not yet been demonstrated. To test this, we had 18 human subjects perform a time generalization task with visual stimuli. Additionally, we had previously recorded resting-state EEG from each subject and calculated their individual alpha frequency (IAF), estimated as the peak frequency from the mean spectrum over posterior electrodes between 8 and 13 Hz. Participants first learned a standard interval (600 ms) and were then required to judge if a new set of temporal intervals were equal or different compared with that standard. After learning the standard, participants performed this task while receiving occipital transcranial Alternating Current Stimulation (tACS). Crucially, for each subject, tACS was administered at their IAF or at off-peak alpha frequencies (IAF ± 2 Hz). Results demonstrated a linear shift in the psychometric function indicating a modification of perceived duration, such that progressively “faster” alpha stimulation led to longer perceived intervals. These results provide the first evidence that direct manipulations of alpha oscillations can shift perceived time in a manner consistent with a clock speed effect.
A Systematic Review of the Efficacy and Safety of Microneedling in the Treatment of Melasma
Authors: Wu Sean Z. , Muddasani Suraj , Alam Murad 
Published: September 2020

BACKGROUND
Melasma is an acquired disorder of hyperpigmentation that is often recalcitrant to current therapies. Microneedling is used to treat scars, striae, and rhytides and has a relatively low risk of post-treatment dyspigmentation. Several studies have examined its use in melasma.

OBJECTIVE
To review the published evidence on the efficacy and safety of microneedling in the treatment of melasma.

METHODS
A systematic review was performed. A meta-analysis could not be performed because of methodological differences across studies and data heterogeneity.

RESULTS
Eight studies were included for analysis. Most studies assessed the utility of microneedling in combination with other topical therapies and detected some success. However, microneedling-mediated transdermal delivery of medications is not superior to microinjections of medications. There is less evidence supporting the use of microneedling as monotherapy. Microneedling, when used with a 1064-nm Q-switched Nd:YAG laser, may provide additional benefit, although with a risk of post-treatment dyspigmentation.

CONCLUSION
Based on low-quality evidence, microneedling may play a role in the treatment of melasma, with the mechanism of action likely being the facilitation of delivery of topical therapies to the epidermis and dermis, and one ancillary benefit of this approach being the very low risk of postinflammatory hyperpigmentation.
Protocol for development of a core outcome set for menopausal symptoms (COMMA)
Authors: Kim Bobae V. , Iliodromiti Stamatina , Christmas Monica , Bell Robin , Lensen Sarah , Hickey Martha 
Published: September 2020

Abstract

Objective:
Menopause is the natural cessation of menstruation and may be accompanied by troublesome symptoms including hot flushes and night sweats (vasomotor symptoms) and genitourinary symptoms. Randomized trials evaluating the safety and effectiveness of interventions for these symptoms have reported a wide range of outcomes and used inconsistent measures. This variation precludes comparing and combining data from different trials. To overcome this limitation, we will develop a Core Outcome Set for Menopausal Symptoms.

Methods:
We will systematically review the literature to identify the outcomes reported in the interventional trials for vasomotor and genitourinary symptoms. This list will be entered into a two-round modified Delphi survey to be completed by clinicians, researchers, and consumers (women who have experienced menopause). Participants will score outcomes on a nine-point scale from “not important” to “critically important.” Representatives from each stakeholder group will then meet to discuss the results and finalize the Core Outcome Set. Ethics approval was not required as this was considered service evaluation and development. The study is registered with the Core Outcome Measures in Effectiveness Trials Initiative (http://www.comet-initiative.org/studies/details/917).

Results:
An agreed upon set of minimum outcomes and outcome measures will facilitate combining and comparing findings from future trials of treatments for menopausal symptoms.

Conclusions:
This Core Outcome Set will better enable women and clinicians to select effective treatments, improve the quality of trial reporting, reduce research wastage, and improve care for women with troublesome menopausal symptoms.

Video Summary:

http://links.lww.com/MENO/A633.
Acupuncture ameliorated vasomotor symptoms during menopausal transition: single-blind, placebo-controlled, randomized trial to test treatment efficacy
Authors: Soares Jose M. , Branco-de-Luca Alexandre C. , da Fonseca Angela M. , Carvalho-Lopes Ceci M. , Arruda-Veiga Eduardo C. , Roa Cristiane L. , Bagnoli Vicente R. , Baracat Edmund C. 
Published: September 2020

Abstract

Objectives:
This study aimed to evaluate the effects of acupuncture on women with vasomotor symptoms during the menopausal transition with the aid of the Kupperman-Blatt Menopausal Index.

Method:
Crossover, single-blind, sham-controlled trial with 100 women randomly divided into two groups of 50 participants each: G1 and G2. During the first 24 weeks of treatment, the G1 women received acupuncture and the G2 women were given sham acupuncture. The crossover was then applied: the G1 participants were given sham acupuncture, and the G2 participants received acupuncture for 24 more weeks.

Results:
The mean score of hot flashes of the group who first experienced acupuncture (G1) was statistically higher than that of the group that started with sham acupuncture (G2, P = 0.020). Also, both groups had similar mean scores in the middle of the study (both were receiving acupuncture). During the last 6 months of the study, after crossover, the values of G2 (acupuncture) were lower than those of G1 (sham acupuncture).

Conclusions:
Acupuncture treatment may mitigate hot flashes and other climacteric symptoms during the menopausal transition.

Video Summary:
http://links.lww.com/MENO/A641.
Unnecessary bilateral salpingo-oophorectomy at the time of hysterectomy and potential for ovarian preservation
Authors: Wong Jellena , Murji Ally , Sunderji Zahra , Chow Ovina , Shapiro Jodi , Wolfman Wendy , Shirreff Lindsay 
Published: September 2020

Abstract

Objective:
To evaluate predictors of bilateral salpingo-oophorectomy at hysterectomy and determine rate of unnecessary bilateral salpingo-oophorectomy.

Methods:
Retrospective review of hysterectomies at six Ontario, Canada hospitals from July 2016 to June 2018. Data was extracted from health records coding and electronic medical records. Of patients with concurrent bilateral salpingo-oophorectomy, age, preoperative diagnoses, surgical factors (presence of endometriosis/adhesions), and surgeon training (fellowship/no fellowship) were recorded. Chi-square tests compared indicated and nonindicated bilateral salpingo-oophorectomy cases based on preoperative diagnosis. Criteria for unnecessary bilateral salpingo-oophorectomy were: age under 51 years, benign preoperative diagnosis, and absence of intraoperative endometriosis and adhesions.

Results:
Concurrent bilateral salpingo-oophorectomy occurred in 749/2,656 (28%) cases with 509/749 (68%) indicated based on preoperative diagnosis. There was interhospital variation in rate of indicated bilateral salpingo-oophorectomy based on preoperative diagnosis (45.3%–76.9%, χ2
P < 0.001). Concurrent bilateral salpingo-oophorectomy at academic centers was more likely to have preoperative indications versus those at community hospitals (70% vs 63%, OR 1.42, 95% CI 1.02–1.97, P = 0.04). BSO performed by fellowship-trained surgeons were more likely to be indicated than those performed by generalists (75% vs 63%, OR 1.76, 95% CI 1.26–2.44, P = 0.001). Of patients without preoperative indications for bilateral salpingo-oophorectomy, 105/239 (44%) were under 51 years of age, of which 59 (58%) had no intraoperative endometriosis/adhesions. Ovarian preservation may have been reasonable in 8% (59/749).

Conclusions:
Concurrent bilateral salpingo-oophorectomy performed by generalists and at community hospitals was less likely to have preoperative indications. Ovarian preservation was potentially possible for 8%.
Age at menarche and cardiovascular health: results from the NHANES 1999-2016
Authors: Zheng Yi , Wen Tony S. , Shen Yun , Hu Hui 
Published: September 2020

Abstract

Objective:
Cardiovascular disease is the leading cause of death among women. Early menarche has been associated with many cardiovascular disease risk factors, but little is known about its associations with cardiovascular health (CVH) as defined by Life's Simple 7 (LS7). We aim to examine the associations between age at menarche and CVH.

Methods:
Data were obtained from the 1999-2016 National Health and Nutrition Examinations Survey (NHANES). CVH was assessed according to LS7 (ideal CVH: > 4 ideal CVH metrics, CVH score: ranging from 0 to 14). Weighted logistic regression was used after adjusting for sociodemographic factors. The interaction between age at menarche and age was also examined.

Results:
Among the 20,447 women included, 2,292 (11.2%) had ideal CVH. After adjusting for age, race/ethnicity, education, poverty income ratio, marital status, and birth year, significantly worse CVH was observed among women with early menarche (OR: 0.70, 95% CI: 0.60-0.82), and higher odds of ideal CVH were observed among those with late menarche (OR: 1.40, 95% CI: 1.21-1.62). Consistent results were observed for CVH score. Age significantly modifies the associations between age at menarche and CVH. Late menarche was significantly associated with ideal CVH among those aged 25-34 (OR: 1.64, 95% CI: 1.27-2.11) or 35-44 (OR: 1.73, 95% CI: 1.31-2.30), while the associations for early menarche were observed only among those aged 25-34 years (OR: 0.72, 95% CI: 0.53-0.97).

Conclusions:
Our findings suggested that early menarche is associated with worse CVH, especially among young women. Further efforts are warranted to confirm these findings.

Video Summary:

http://links.lww.com/MENO/A643.
A Solution for Iterative Determination of Patient Release Instructions for Fractionated Radionuclide Therapy
Authors: Otis Garrett 
Published: September 2020

Introduction
For fractionated radionuclide therapy protocols that involve large activities administered within short periods of time, there is a lack of guidance concerning how patient release calculations should be performed.

Objectives
Present a solution for estimating the effective dose of individuals exposed to a patient undergoing fractionated radionuclide therapy; this is intended to be used for iterative determination of patient release instructions.

Methods
The effective dose of an individual in the vicinity of a patient is described by a piecewise function that is integrated over periods of time that are defined by several variables relevant to clinical planning of fractionated radionuclide therapy protocols. This solution is compared to a simpler calculation that treats all administrations as identical events.

Results
For the two compared methodologies, their equivalence for estimating effective dose depends on several variables. However, for protocols where the elimination time of the radionuclide is far smaller than the time between administrations, both methodologies produce essentially equal results.

Conclusion
The author recommends using the presented solution for iterative determination of patient release instructions if a simpler approach generates release instructions that are overly restrictive. Doing so will allow for less strict release instructions because the dose mitigation from repeated adherence to release instructions after each fraction, in addition to potential inpatient time after each fraction, will be taken into account. Lastly, a spreadsheet that incorporates the presented solution has been made freely available for download.
Clinical Detection and Recovery of Vestibular and Oculomotor Impairments Among Amateur Athletes Following Sport-Related Concussion: A Prospective, Matched-Cohort Study
Authors: Büttner Fionn , Howell David R. , Doherty Cailbhe , Blake Catherine , Ryan John , Delahunt Eamonn 
Published: September 2020

Objective:
To (1) quantify the diagnostic accuracy of the vestibular/oculomotor screening (VOMS), and (2) determine the recovery of vestibular and oculomotor impairments exhibited by concussed athletes compared with nonconcussed athletes using the VOMS.

Setting:
Clinical assessment laboratory.

Participants:
Amateur athletes who were diagnosed with sport-related concussion by emergency department physicians, and non-concussed, control athletes.

Design:
Prospective, longitudinal study.

Main Measures:
Participants were assessed 1 week following sport-related concussion, upon clearance to return-to-sporting activity, and 2 weeks following return-to-sporting activity by a study investigator who administered the VOMS. We calculated test sensitivity, specificity, and positive and negative predictive values to estimate the diagnostic accuracy of the VOMS. We performed a mixed-design analysis of variance to assess differences in VOMS symptom scores reported by concussed athletes compared with control athletes.

Results:
Fifty concussion participants and 50 control participants completed the study. The VOMS demonstrated sensitivity and specificity of 96% and 46%, respectively, and produced positive and negative predictive values of 64% and 92%, respectively. The concussion group exhibited a significantly greater symptom provocation change score from baseline than the control group for all test domains of the VOMS only in the first week following concussion.

Conclusion:
The VOMS may be most useful as a clinical screening tool to rule out, rather than confirm, the presence of sport-related concussion. The VOMS may be appropriate to inform the recovery of vestibular and oculomotor impairments exhibited by concussed individuals over time.
Clinical Utility of the Patient Health Questionnaire–Adolescent in Adolescents With Traumatic Brain Injury
Authors: Zachar-Tirado Rachel , Chen Ziqi , Donders Jacobus 
Published: September 2020

Objective:
To determine the clinical utility of the Patient Health Questionnaire–Adolescent (PHQ-A) in screening for depressive disorders in adolescents following traumatic brain injury (TBI).

Design:
Retrospective analysis of data collected as a part of routine clinical care over a period of 4 years.

Setting:
Regional rehabilitation facility.

Participants:
Adolescents (n = 101) with mild to moderate-severe TBI who were referred for an outpatient neuropsychological evaluation within 1 to 12 months postinjury.

Main Outcome Measures:
PHQ-A, PHQ-A_2 (2-item version), and Processing Speed Index (PSI) from the Wechsler scales of intelligence.

Results:
Both premorbid depressive disorder and PHQ-A scores predicted a postinjury diagnosis of depressive disorder, with a combined sensitivity of 0.91 and specificity of 0.59. PHQ-A_2 did not reach acceptable levels of sensitivity in predicting suicidal thoughts. PHQ-A scores did not add significantly to the prediction of PSI results after accounting for TBI severity.

Conclusions:
PHQ-A has clinical utility as a screening instrument for depressive disorders in outpatient adolescents with TBI when the cutoff for clinically significant concern is set at more than 4 and premorbid psychiatric history is also taken into account.
An update on the diagnosis and management of ocular sarcoidosis
Authors: Hwang De-Kuang , Sheu Shwu-Jiuan 
Published: September 2020

Purpose of review
Ocular sarcoidosis is one of the most common causes of uveitis worldwide. The diagnosis and treatment of patients with ocular sarcoidosis remains challenging in some cases. It is important for clinicians to keep up to date with new diagnostic and treatment tools for this disease.

Recent findings
The International Workshop on Ocular Sarcoidosis diagnostic criteria were first proposed in 2009 and revised in 2017. The new criteria contained two parts: ocular presentation and systemic investigation. The diagnostic value of liver enzymes was reduced in the new criteria, whereas the value placed of lymphopenia and the CD4/CD8 ratio in bronchoalveolar lavage fluid were increased. Despite not being included in the criteria, recent studies have also highlighted the diagnostic value of serum soluble interleukin-2 receptors. Recent ophthalmologic imaging also provides useful insights for the differential diagnosis.
Many new treatments for ocular sarcoidosis have been developed in recent years. The introduction of biological immunomodulatory agents for uveitis treatment represents a big improvement. Antitumor necrosis factor-alpha antibodies, including adalimumab, have been proven to be effective for treating ocular sarcoidosis. Many studies have also suggested that other biological agents could be effective and well tolerated. Newer intravitreal dexamethasone and fluocinolone implants have been developed. Patients treated with these implants have experienced good and sustained control of their intraocular inflammation.

Summary
Diagnosis and treatment options for ocular sarcoidosis have changed over time. However, challenges still exist in some difficult patients. Future studies should focus on finding more sensitive biomarkers and developing more effective immunomodulatory treatments with longer efficacy and less side effects.
Streptococcus pneumoniae Peritonitis and Enterocolitis in a Previously Healthy Female
Authors: Krause Amanda J. , Angarone Michael P. 
Published: September 2020

Abstract

Streptococcus pneumoniae rarely causes peritonitis; however, it has been associated with peritonitis in 3 major populations: in those with immunocompromising conditions, in association with gastrointestinal disease or surgery, and in previously healthy adult women from a genitourinary source. We present a case of a previously healthy 40-year-old woman who presented with symptoms of gastroenteritis. Initial workup revealed multiple dilated, thick walled, and fluid-filled loops of small bowel and S. pneumoniae bacteremia. She rapidly developed multiloculated ascites, significant peritonitis, enterocolitis, and a pelvic abscess. Polymerase chain reaction of her pelvic abscess identified S. pneumoniae. The patient was treated with multiple paracenteses, abscess drain placement, and antibacterial therapy. This case is noteworthy given the rarity of S. pneumoniae peritonitis and the severity of the patient's presentation. It is important for clinicians to be aware of the virulence of S. pneumoniae and consider this disease in a previously healthy female patient with peritonitis.
Real-World Experience Using Cefpodoxime and Cefuroxime Axetil for Urinary Tract Infections at a Large Academic Medical Center
Authors: Bao Hongkai , Jen Shin-Pung , Chen Xian Jie (Cindy) , Siegfried Justin , Pham Vinh P. , Papadopoulos John , Dubrovskaya Yanina 
Published: September 2020

Background
Cefpodoxime (CPD) and cefuroxime (CFX) are both oral cephalosporins indicated for urinary tract infection (UTI) treatment. Despite having lower renal excretion and higher risk of collateral damage compared with CFX, CPD is a third-generation cephalosporin (3GC) with broader gram-negative activity than CFX. The objective of this study was to assess the efficacy and safety of these 2 agents for UTI treatment in a real-world clinical setting.

Methods
A retrospective evaluation was conducted among adult patients who received CPD or oral CFX for UTI treatment between January 2013 and July 2018. The primary outcome was clinical cure. Secondary outcomes included rate of subsequent UTI, Clostridioides difficile infection, and detection of isolates resistant to 3GC within 90 days after treatment.

Results
A total of 747 patients were assessed for study inclusion, of which 295 patients met eligibility criteria (CPD n = 165, CFX n = 130). Clinical cure was 100% versus 98% for CPD versus CFX, P = 0.084. The rate of subsequent UTI for CPD versus CFX was 18% versus 16%, P = 0.647. There were no differences in development of Clostridioides difficile infection or 3GC resistance. After adjusting for multiple factors in multivariate analysis, chronic kidney disease and history of UTI within 180 days, but not the choice of oral cephalosporin, were independent predictors of subsequent UTI.

Conclusions
Cefpodoxime and CFX are both favorable treatment options for UTIs, with high rates of clinical cure and limited adverse effects.
Pasteurella multocida Mycotic Aortic Aneurysm in a Man After a Healed Canine Bite
Authors: Perez-Lopez Carlos Juan , Gompf Sandra G. , Cannella Anthony P. , Vega Vivian R. 
Published: September 2020

Abstract

Pasteurella multocida is most commonly associated with cat bites leading to skin and soft tissue infections, including joint and bone infections, with or without concomitant bacteremia. Mycotic aneurysm secondary to P. multocida bacteremia is a rare complication. However, because of its high morbidity and mortality, as well as the bacterium's high virulence and predilection for endothelium, this is an entity clinicians should be aware of. Because of limited data and very few reported cases in the literature, little is known regarding risk factors, clinical presentation, and treatment. All those cases presented insidiously and with nonspecific symptoms; therefore, a high degree of clinical suspicion is necessary to make the diagnosis. We present a case of an immunocompetent patient that presented with P. multocida bacteremia complicated by mycotic aneurysm of a native vessel. A review of the literature on the topic is also discussed.
Intraventricular Catheter-Associated Rothia mucilaginosa Bacteremia in a Neutropenic Patient
Authors: Li Monica , Lin Doris 
Published: September 2020

Abstract

Rothia mucilaginosa is a pleomorphic gram-positive coccobacilli found commensally in the nose and throat. Over the past several decades, it has been recognized as a rare cause of severely invasive disease in the immunocompromised. We present an uncommon case of neutropenic fever caused by R. mucilaginosa bacteremia with a recently placed Ommaya reservoir intraventricular catheter system as a potential nidus. The patient recovered after antibiotic and tbo-filgrastim therapy, as well as removal of the catheter.
Pulmonary Nocardiosis and Cryptococcosis Co-Infection in First Diagnosis of HIV Infection
Authors: Ungthammakhun Chutchawan , Nasomsong Worapong , Chueansuwan Worawong , Traipattanakul Junthima , Changpradub Dhitiwat , Wongchansom Kittisak 
Published: September 2020

Abstract
Pulmonary infections among patients with acquired immunodeficiency syndrome (AIDS) may be caused by more than 1 organism. Pulmonary nocardiosis co-infection with cryptococcosis among patients with AIDS was extremely rare and has never been reported. Here, we report a case of pulmonary co-infection with nocardiosis and cryptococcosis in a 54-year-old HIV-positive man presenting productive cough and constitutional symptoms. Bronchoalveolar lavage and lung biopsy culture were positive for Nocardia species and Cryptococcus neoformans. The patient was treated with cotrimoxazole plus ceftriaxone for Nocardia species and fluconazole for C. neoformans. Etiology of pulmonary infections among patients with AIDS may be caused by multiple organisms. Among patients with AIDS having chest radiographic abnormality, an aggressive diagnostic approach should be warranted to accurately diagnose and appropriately manage.