bluuebunny/crossref_metadata_2025_split huggingface dataset:
S188. VISUAL ATTENTION IN EARLY-ONSET SCHIZOPHRENIA AND OTHER NEURODEVELOPMENTAL DISORDERS: THE IMPACT OF SPEAKING WHILE LOOKING AT PICTURES OF SOCIAL INTERACTIONS – EVIDENCE FROM EYE TRACKING DATA
Authors: Ioannou Chara , Canu Daniela , Müller Katarina , Martin Matthias , Bender Stefan , Smyrnis Nikos , Biscaldi Monica , Fleischhaker Christian , Klein Christoph 
Published: May 2020

Abstract

Background
Visual attention in Schizophrenia (SZ) differs from that of neuro-typical controls, and scan-path abnormalities have been proposed as a robust marker of the disorder (Nishiura et al., 2007). In free viewing paradigms, a restricted area of visual exploration has been reported as a robust atypical finding in SZ participants across a variety of depicted contents (Beedie et al., 2011), and has been shown to be a highly efficient discriminator between SZ and healthy controls (Benson et al., 2012). Moreover, speaking about what one sees during the act of looking has been shown to impact visual exploration behavior (Klein et al., 2014). Finally, despite clinical and genetic-biological relationships between schizophrenia, autism and ADHD (Owen & O’Donovan, 2017) there is, to our knowledge, yet no direct comparison between these neurodevelopmental disorders using eye tracking. The “head-to-head” comparison is the primary objective of this study.

Methods
We tested four groups of adolescent and young adults, namely early-onset Schizophrenia (SZ, N=21, 15 males, mean age ± 1 standard deviation 19.7±1.7 years), Attention Deficit Hyperactivity Disorder (ADHD, N=28, 15 males, 19.9±1.4 years), Autism (ASD, N=26, 25 males, 19.7±1.9 years), and typical controls (TD, N= 29, 12 males, 19.8±1.6 years). The ocular-motor task battery comprised of different free viewing tasks including free viewing of different kinds of social interactions in static pictures whilst solely viewing versus viewing-plus speaking (in counterbalanced order). Eye movements were recorded with 1.000Hz using the EyeLink 1000+ system and analyzed with Data Viewer Eyelink Software and MATLAB (Version R2017a, Mathworks, USA). Statistical Analysis was performed in SPSS Statistics 2.3 (IBM, USA).

Results
Visual attention of SZ patients manifested significant less gaze scatter than TD whilst merely looking at the images. During looking and speaking, however, the two groups had a similar spatial scatter of fixations. Preliminary analyses indicate that participants with ADHD and ASD did not differ from TD in this measure.

Discussion
Constraint gaze scatter in visual exploration is a robust and discriminating finding in schizophrenia that has been associated with the negative symptomatology of the disorder. The present results confirm our previous findings (Klein et al., 2014) and suggest that the act of speaking may partially counteract and compensate the restricted visual scanning performed by SZ participants, thus contributing to a better understanding of Visual Attention in SZ and its differentiation from other neurodevelopmental disorders.
S196. TRANSCRANIAL MAGNETIC STIMULATION IN SCHIZOPHRENIA WITH PROMINENT NEGATIVE SYMPTOMS- A REVIEW OF THE LITERATURE
Authors: Vasiliu Octavian 
Published: May 2020

Abstract

Background
Negative symptoms in schizophrenia are associated with lower quality of life, worse functional prognosis and poorer response to the psychopharmacological treatment [1]. Many efforts have been made to find new approaches for negative symptoms, and neuromodulation techniques may represent a solution for these patients when antipsychotics have reached their limits of efficacy [2]. Transcranial magnetic stimulation (TMS) is based on the use of alternating magnetic fields to induce electrical current in the cortical areas, being mainly used for patients with treatment-resistant depression and it is considered safe and well tolerated [3].

Methods
A narrative review of data regarding the efficacy of transcranial magnetic stimulation for patients with schizophrenia with prominent negative symptoms was performed. Papers published between January 2000 and July 2019 in the main electronic databases (PubMed, Cochrane, EMBASE, CINAHL) were included in this review. The keywords used for database search were “schizophrenia” and “negative symptoms” and “transcranial magnetic stimulation” or “repetitive transcranial magnetic stimulation”.

Results
The treatment of negative symptoms in schizophrenia with high frequency TMS has been associated with favorable results in clinical trials. The targeted zones were dorsolateral prefrontal cortex, either bilaterally or only on the left side. The results varied upon the stimulation regimen, including duration, frequency, uni- versus bilaterally application etc. Two meta-analyses were identified and their results supported an effect size from 0.58 to 0.63 [2,3]. However, negative results derived from well designed clinical trials exist, which show no difference in the Positive and Negative Syndromes Scale (PANSS) - negative symptom score between rTMS and sham rTMS [4,5]. An exploratory analysis of a large-scale trial showed the impact of rTMS on different negative symptom domains confirmed no additional beneficial effect of the actove comparative to sham rTMS [5]. Also, data exist about the potential of rTMS for increasing task-related in frontal areas in patients with schizophrenia with negative predominant symptoms, which may grant further exploration of the mechanisms underlying the effects of rTMS.

Discussion
Data about the efficacy of TMS in schizophrenia with negative symptoms are controversial, because both evidence to support its efficacy and its lack of efficacy exist in clinical trials. However, meta-analyses support an important size effect which may be comparable to that of the pharmacological treatment.

References
S199. HOW TO COLLECT FREE SPEECH TO SPEECH GRAPH ANALYSIS: STANDARDIZED TIME-LIMITED PROTOCOL
Authors: Simabucuru Gabriela , Copelli Mauro , Ribeiro Sidarta , Mota Natália 
Published: May 2020

Abstract

Background
SpeechGraphs is a computational tool successfully applied to the differential diagnosis of psychosis based on the non-semantic structural analysis of speech graphs. This approach provides quantitative, fast, and low-cost measurements of clinical interest based on free speech, but its replicability needs to understand how different ways to collect speech data can impact such measurements. Stimuli or interruption on a patient’s speech can have a direct impact, especially on SpeechGraphs analysis. We developed a standard for data collection, controlling the time in order to keep the subject talking for a minimum of 30 seconds, and only stimuli the patient’s speech with general instructions. We aim to investigate specifically the impact of considering interviewers interferences marked as paragraphs in transcriptions, and the impact of a time-limited standardized protocol to avoid this bias.

Methods
Two different speech samples from a previous study were compared: 1) using free speech (N = 60, Mota 2014) or 2) using the proposed time-limited protocol (sub-sample of N = 31, Mota 2017). For both samples, we calculated connectedness attributes (such as LSC) in two in two different transcribing conditions: with and without paragraphs. The paragraphs represented the interviewer’s stimuli, and when paragraphs were deleted, we connected the subject’s speech in a unique line.

Results
Interviewer’s interferences marked by line-breaks or paragraphs had an impact on connectedness results for the freely speaking protocol (LSC Schizophrenia x Non-Schizophrenia: p = 0.0051 and without paragraph, LSC Schizophrenia x Non-Schizophrenia: p = 0.7764). The standardized protocol with a time limit was sufficient to avoid this bias: we found that there are no differences in considering or not paragraphs, with reports of 30 seconds (LSC Schizophrenia x Non-Schizophrenia: p = 0.0017 and without paragraph, LSC Schizophrenia x Non-Schizophrenia: p=0.0003)

Discussion
The standardized data collection protocol seems to be robust in comparison to not controlled methods to collect free speech, allowing the automatization of data gathering and transcriptions, preventing methodological errors in future SpeechGraphs applications.
Perspectives and reflections on teaching linear algebra
Authors: Rensaa Ragnhild Johanne , Hogstad Ninni Marie , Monaghan John 
Published: May 2020

Abstract
This paper presents ‘expert opinions’ on what should be taught in a first-year linear algebra course at university; the aim is to gain a generic picture and general guiding principles for such a course. Drawing on a Delphi method, 14 university professors—called ‘experts’ in this study—addressed the following questions: What should be on a first-year linear algebra undergraduate course for engineering and/or mathematics students? How could such courses be taught? What tools (if any) are essential to these two groups of students? The results of the investigation, these experts’ opinions, mainly concern what should be in a linear algebra course (e.g. problem-solving and applications) and what students should be able to do. The experts also emphasized that certain theoretical aspects (e.g. proofs, abstract structures, definitions and relationships) were more important to mathematics students. There was no real consensus among the experts on teaching methods or the use of digital tools, but this lack of consensus is interesting in itself. The results are discussed in relation to extant research.
Safety reassessment of cinobufotalin injection: new findings into cardiotoxicity
Authors: Li Min , Wang Xijie , Qiu Yunliang , Zhang Yizhe , Pan Xueying , Tang Naping , Chen Tao , Ruan Bing , Shao Shuming , He Liang , Li Hua , Ma Jing 
Published: May 2020

Abstract
Cinobufotalin injection, a traditional Chinese medicine preparation, successfully used for several years, might induce cardiotoxicity. The aim of the study was to evaluate the cardiotoxicity of cinobufotalin injection and the cardiotoxicity-preventive effect of sodium phenytoin in vivo. According to the 4 × 4 Latin square design, four Beagle dogs were allocated into four dose levels of 0, 0.3, 1, and 3 g/kg in treatment phases I–IV (cinobufotalin injection) and 3 g/kg in treatment phase V (cardiotoxicity antidote). The following parameters and endpoints were assessed: clinical observations, body weight, indicators of myocardial injury, and electrocardiogram (ECG) parameters. The cinobufotalin injection-related changes were observed in clinical observations (rapid breathing pattern), indicators of myocardial injury (increased cardiac troponin I, creatine kinase isoenzymes, and aspartate aminotransferase), and ECG graphics (arrhythmia) at 3 g/kg concentration in treatment phases I–IV. The cardiotoxicity of cinobufotalin injection was attenuated by sodium phenytoin in treatment phase V. The results confirmed the cardiotoxicity of cinobufotalin injection, and they might bring information about the appropriate monitoring time points and cardiotoxicity parameters in clinical practices and shed light on the treatment of cardiovascular adverse reactions.
Bloody Diarrhea Caused by Intestinal Myiasis in an Infant: A Case Report and Review of Pediatric Literature
Authors: Chen Xiu-Qi , Zhang Kang-Ling , Shan Qing-Wen 
Published: May 2020

AbstractIntestinal myiasis caused by fly larvae parasitic in gastrointestinal tract was rare reported in children. We reported an infant with bloody diarrhea caused by intestinal myiasis. A 1 year and 7 months old boy presented with the only symptom of bloody diarrhea of unknown origin. In the second week of onset, numerous moving worms were observed in the bloody stool after bowel preparation with polyethylene glycol for colonoscopy. The bloody diarrhea disappeared after 1 week of combined therapy with albendazole and metronidazole. On follow-up after 6 months, the patient remained well without bloody diarrhea. In conclusion, intestinal myiasis being a rare disease that is very challenging to diagnose, physicians should remember it when they receive cases of bloody diarrhea with non-specific symptoms without any apparent cause.
Reducing Pediatric Tracheostomy Wound Complications: An Evidence-Based Literature Review
Authors: Baker Lindsay R. , Chorney Stephen R. 
Published: May 2020

ABSTRACT

OBJECTIVE
To discuss prevention strategies that can mitigate the frequency of tracheostomy-related wound complications.

DATA SOURCES
A systematic literature review of PubMed between 2010 and 2019.

STUDY SELECTION
Full-text articles written in English language and studying human participants younger than 18 years.

DATA EXTRACTION
The primary outcome was the rate of tracheostomy-related skin complications after implementation of a given intervention. Secondary outcomes included rates of accidental decannulation or other complications.

DATA SYNTHESIS
A total of 348 studies were identified and 6 met inclusion criteria. There were 1,607 children included with interventions designed to reduce peristomal and cervical wound complications in 1,174 (73.1%). Strategies considered safe and effective included protective skin barriers, reducing prolonged pressure, and early wound identification protocols.

CONCLUSIONS
Wound complications after pediatric tracheostomy can be reduced using a multifaceted approach by providers committed to making skin care a priority.
Comparison of Silicone Sheets and Paper Tape for the Management of Postoperative Scars: A Randomized Comparative Study
Authors: Lin Ying-Sheng , Ting Pei-San , Hsu Kuei-Chang 
Published: May 2020

ABSTRACT

OBJECTIVE
To compare the effectiveness of silicone sheets and paper tape in the prevention of postoperative cesarean section scars.

METHODS
Patients undergoing horizontal cesarean section were included in this randomized controlled trial. Surgical wounds were divided into two halves. Patients randomly applied silicone sheets or paper tape to each side of their wound as assigned for 3 months. Wounds were assessed at 1, 3, 6, and 12 months after surgery. Researchers used the objective Vancouver Scar Scale (VSS) to evaluate the scars and the subjective visual analog scale (VAS) to evaluate itch, pain, and scar appearance.

RESULTS
No significant differences between the silicone sheet and paper tape groups were noted at postoperative follow-ups with respect to VSS scores. The silicone sheet group had significantly better VAS scores for scar appearance than the paper tape group at 6 (6.81 ± 1.47 vs 6.19 ± 1.62, P = .03) and 12 (6.88 ± 2.01 vs 6.2 ± 2.08, P = .04) months’ follow-up, respectively.

CONCLUSIONS
The silicone sheet group showed statistically significant differences in comparison with the paper tape group in terms of scar appearance as determined by the VAS. However, the differences were too small to be clinically meaningful.
Medial patellofemoral ligament reconstruction using a central strip of the quadriceps tendon in patients with recurrent patellar instability: a prospective case series
Authors: Fadel Mohie-Eldin , Hosni Yaser 
Published: May 2020

Background:
Patellar fractures and chondral injuries are serious complications after medial patellofemoral ligament (MPFL) reconstruction. Using a central strip from the quadriceps tendon avoids these complications. Moreover, this technique maintains an anatomical attachment of the tendon at the proximal patella at the position of the native MPFL. The quadriceps strip is biomechanically comparable to the intact MPFL, whereas the hamstring tendon graft is stiffer than the native MPFL.

Methods:
Thirty-four patients were involved in this study. Conservative treatment failed in all after an initial episode of patellar dislocation. Their mean age was 19.4 yr. The mean duration of symptoms was 14.3 mo. The mean follow-up period was 28.7 mo. Their preoperative visual analogue scale (VAS) was 5 and their preoperative Kujala score was 69.5. Mean Caton-Deschamps index was 1.1. Patella alta was found in seven patients. Thirteen patients had trochlear dysplasia. All had MPFL reconstruction using 10-cm long, 10-mm wide, 3 mm thick strip harvested from the central portion of the quadriceps tendon.

Results:
The mean VAS score was significantly reduced from 5 to 1. Mean Kujala score significantly improved from 69.5 to 94.8. The patellar tilt decreased significantly. There was no significant correlation between final Kujala scores and the presence of anatomical predisposing factor. All patients had negative patellar apprehension tests.

Conclusions:
Using a central strip of the quadriceps tendon in the reconstruction of MPFL in patients with recurrent patellar dislocation is an excellent option.

Level of Evidence:
Level IV.
Outcomes Following the Urgent Surgical Management of Displaced Femoral Neck Stress Fractures
Authors: Cochran Grant K. , Staeheli Gregory R. , Deafenbaugh Bradley K. , Kuhn Kevin M. 
Published: May 2020

Objectives:
To review the clinical course, complication rates, and mid-term functional outcomes associated with the treatment of displaced femoral neck stress fractures (FNSFs).

Design:
Retrospective Case Series.

Setting:
Military Tertiary Referral Center.

Patients:
Twenty-one operatively treated displaced FNSFs between 2002 and 2015.

Intervention:
Urgent reduction and fixation was performed. If nonunion developed, an intertrochanteric osteotomy was performed.

Main Outcome Measurements:
Nonunion, osteonecrosis (ON) of the femoral head, conversion to arthroplasty, modified Harris Hip Score, pain score, and Hip Outcome Score (HOS).

Results:
Two (9.1%) patients developed nonunion. Both united after revision with intertrochanteric osteotomy. ON developed in one patient (4.8%) who was converted to arthroplasty. Average pain score at final follow-up was 2.0 (range 0–5). Average Modified Harris Hip Score was 84 (range 54–100). Average HOS Activities of Daily Living subscale was 80.9 (range 45.6–100). Average HOS Sport subscale was 69.8 (range 27.8–100). Larger displacement on injury films correlated with lower Modified Harris Hip Scores (P = 0.048) and lower HOS Sports Subscale Single Assessment Numeric Evaluation (P = 0.023). The need for an open reduction trended toward being a risk factor for nonunion (P = 0.081).

Conclusions:
This study represents the largest series of patients undergoing urgent surgery for displaced FNSFs. Nonunion and ON is found at a similar rate to what is reported in the young traumatic literature. Pain and outcome scores compare favorably to other hip pathology in young adults. Initial injury severity is variably correlated to final outcome scores.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Association of Perioperative Computed Tomography Hounsfield Units and Failure of Femoral Neck Fracture Fixation
Authors: Lund Erik A. , Samtani Rahul , Winston Mark , Anderson Paul A. , Whiting Paul S. , O'Toole Robert V. , Hetzel Scott , Doro Christopher J. 
Published: May 2020

Objectives:
To determine whether Hounsfield units (HUs) measured on perioperative computed tomographic scans are associated with radiographic outcomes and reoperations after femoral neck fracture fixation.

Design:
Retrospective cohort study.

Setting:
Level I trauma center.

Patients:
One hundred fourteen patients age ≥18 years, who presented to a Level I trauma center, and who underwent surgical fixation of intracapsular femoral neck fracture and had perioperative computed tomographic scans and adequate follow-up.

Intervention:
None.

Main Outcome Measurements:
Screw penetration, femoral neck shortening >5 mm, and revision surgery.

Results:
A median follow-up was 23 months. An HU measurement of the femoral head was significantly associated with screw penetration and femoral neck shortening but not revision surgery. Patients with middle femoral head HU measurements <146 had 17 times (95% confidence interval: 4.32–78.9, P < 0.001) increased odds of screw penetration. Greater than 5 mm shortening was seen in patients with HUs <212.5 in the low head section by an odds ratio of 7.8 (95% confidence interval: 2.15–33.0, P = 0.014).

Conclusion:
Outcome differences regarding screw penetration and femoral neck shortening related to the HU or densities of femoral head and neck at the time of fracture are significant. These findings can help the clinician with developing a treatment plan for either arthroplasty or fixation of a femoral neck fracture based on objective bone quality measurements rather than relying on an arbitrary age recommendation.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Lumbar Artery Perforator Flap: Initial Experience with Simultaneous Bilateral Flaps for Breast Reconstruction
Authors: Haddock Nicholas T. , Teotia Sumeet S. 
Published: May 2020

Background:
The lumbar artery perforator (LAP) flap is a useful alternative for patients who are not a candidate for breast reconstruction using the deep inferior epigastric perforator flap. Due to the positioning and concerns for prolonged ischemia time, bilateral breast reconstruction using LAP flaps is frequently performed in separate stages. We present our early experience performing simultaneous LAP flaps for bilateral breast reconstruction.

Methods:
We performed a retrospective review of all patients who underwent breast reconstruction with LAP flaps from December 2018 to September 2019. Demographics, flap data, and complication data were collected. Surgical sequence is presented.

Results:
A total of 30 simultaneous bilateral breast reconstruction were performed with LAP. We experienced 1 flap loss in an undiagnosed hypercoagulable patient. The average patient age was 52.7 years, and the average body mass index was 26.9. Most patients had a surgically absent abdominal donor site (66.7%). The average operative time was 510 minutes and ischemia time was 90.3 minutes. All flaps were performed using a composite deep inferior epigastric arterial/venous graft.

Conclusions:
The LAP flap is an innovative, yet technically challenging, choice for autologous breast reconstruction. In our experience, simultaneous bilateral breast reconstruction using LAP flaps can be safely performed in a single surgical stage; however, we recommend caution and a coordinated team approach. With simultaneously performing bilateral LAP flaps, there is an inherent prolonged ischemia time and, thus, an increased possibility for vasospasm and intraoperative revisions. This experience represents the first series of bilateral LAP flaps performed simultaneously.