bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuro-ophthalmic Disease in Pediatric Glaucoma Practice
Authors: Tirpack Aubrey R. , Vanner Elizabeth A. , Sheheitli Huda , Mendoza Carlos E. , Grajewski Alana , Chang Ta C. 
Published: December 2019

Precis:Pediatric glaucoma referral to neuro-ophthalmology has a high yield for diagnosing neurological disease and neuroimaging in this cohort often uncovers intracranial abnormalities.Purpose:Multiple studies have examined the utility of neuro-ophthalmology referrals in an adult glaucoma patient population. No similar studies in the pediatric glaucoma population have been completed. An analysis of pediatric referral patterns and clinical characteristics can serve to guide future physician referrals and improve patient outcomes.Materials and Methods:A retrospective review of medical records was conducted to identify pediatric patients evaluated by both glaucoma and neuro-ophthalmology services at Bascom Palmer Eye Institute from January 2013 to August 2018. Records were reviewed for clinical examination findings, demographics, ophthalmic imaging, neuroimaging, and ultimate diagnosis.Results:A total of 59 patients, average age 10 years old, were included for analysis. The majority of patients were referred from pediatric glaucoma to neuro-ophthalmology (n=52, 88.1%). The most common reasons for referral included suspected nonglaucomatous optic neuropathy (n=14), optic disc swelling (n=7), color vision deficiency (n=6), and nonglaucomatous visual field defect (n=4). Referral to neuro-ophthalmology resulted in neuro-imaging in 22 patients (22/52, 42.3%), with 7 patients (7/52, 13.7%) having pathology on the scan. Ultimately, 38 patients (73.1%) referred to neuro-ophthalmology had an ultimate diagnosis unrelated to glaucoma. Color vision abnormality, optic nerve pallor, and/or retinal nerve fiber layer <70 µm in at least 1 eye were associated with a diagnosis unrelated to glaucoma. Of the 7 patients referred from neuro-ophthalmology to pediatric glaucoma, none were diagnosed with glaucoma or started on intraocular pressure lowering therapy.Conclusions:Patients referred from pediatric glaucoma to neuro-ophthalmology often have nonglaucomatous disease requiring subspecialty evaluation and neuroimaging. Neuroimaging in this cohort is high yield for uncovering intracranial pathology.
Predictors of Hospital-Acquired Clostridioides difficile Infection: A Systematic Review
Authors: Puro Neeraj , Joseph Reena , Zengul Ferhat D. , Cochran Kenneth J. , Camins Bernard C. , Ray Midge 
Published: December 2019

ABSTRACT

Background:

Clostridioides difficile infections (CDIs) have been identified as a major health concern due to the high morbidity, mortality, and cost of treatment. The aim of this study was to review the extant literature and identify the various patient-related, medication-related, and organizational risk factors associated with developing hospital-acquired CDIs in adult patients in the United States.

Methods:
A systematic review of four (4) online databases, including Scopus, PubMed, CINAHL, and Cochrane Library, was conducted to identify empirical studies published from 2007 to 2017 pertaining to risk factors of developing hospital-acquired CDIs.

Findings:
Thirty-eight studies (38) were included in the review. Various patient-level and medication-related risk factors were identified including advanced patient age, comorbidities, length of hospital stay, previous hospitalizations, use of probiotic medications and proton pump inhibitors. The review also identified organizational factors such as room size, academic affiliation, and geographic location to be significantly associated with hospital-acquired CDIs.

Conclusion:
Validation of the factors associated with high risk of developing hospital-acquired CDIs identified in this review can aid in the development of risk prediction models to identify patients who are at a higher risk of developing CDIs and developing quality improvement interventions that might improve patient outcomes by minimizing risk of infection.
Associations of Vestibular Tests With Penn Acoustic Neuroma Quality of Life Scores After Resection of Vestibular Schwannoma
Authors: Brown Clifford Scott , Cooper Matthew W. , Peskoe Sarah B. , Risoli Thomas , Kaylie David M. 
Published: December 2019

Objective:
Determine associations between preoperative caloric testing and video head impulse testing (vHIT) with baseline and postoperative Penn Acoustic Neuroma Quality of Life (PANQOL) scores following resection of vestibular schwannoma (VS).

Study Design:
Retrospective case series.

Setting:
Two tertiary referral hospitals.

Patients:
Adult patients with unilateral VS, preoperative calorics, vHIT, and dizziness handicap inventory (DHI) score.

Interventions:
Surgical resection of VS and postoperative surveys.

Main Outcome Measures:
PANQOL scores.

Results:
Forty-three patients were included (58.1% women) with a median age of 54 years (range, 28–82). Mean tumor size was 14.8 mm (σ=8.6), and 28 (65.1%) were right-sided. Average preoperative vHIT gain was 0.7 (σ = 0.3). Covert and overt saccades were present in 8 (25%) and 14 (42.4%) patients, respectively. Average preoperative unilateral weakness was 47% (σ = 33.2). Translabyrinthine approach was performed in 26 (60.5%) patients. No significant difference of PANQOL scores was noted at baseline or over time between patients with normal (>0.8) or abnormal (<0.8) gain. Patients with more unilateral weakness (>50%) had significantly higher baseline PANQOL scores compared with those with < 25% or 25 to 50% (p = 0.02), but had significant improvement in scores over time (p = 0.01). Higher preoperative DHI preoperatively was significantly associated with worse PANQOL scores at all timepoints (β=0.57, p = 0.0064). No differences in PANQOL scores amongst surgical approaches were observed.

Conclusion:
Preoperative vestibular testing with vHIT, calorics, DHI, and baseline PANQOL surveys may allow for patient counseling regarding postoperative quality of life over time.
Lesion Patterns and Possible Implications for Recovery in Acute Unilateral Vestibulopathy
Authors: Navari Elena , Casani Augusto Pietro 
Published: December 2019

Objective:
To assess patterns of end-organ involvement in acute unilateral vestibulopathy (AUV) and to define the recovery.

Study Design:
Retrospective chart review.

Setting:
Tertiary academic referral hospital.

Patients and Interventions:
Fifty-nine patients fulfilling clinical criteria for AUV and evaluated using the caloric vestibular test, video head impulse test, and both cervical and ocular vestibular evoked myogenic potentials, up to 10 days from symptoms onset were included.

Main Outcome Measures:
Vestibular tests and requirements for vestibular rehabilitation were analyzed.

Results:
The most affected end-organ was the horizontal canal (97%), followed by the anterior canal (83%), utricle (73%), posterior canal (46%), and saccule (44%). Nineteen (32%) patients exhibited complete receptors lesion, while 13 (22%) exhibited damage to receptors connected with the superior division of the vestibular nerve (VN). The proportion of patients who underwent vestibular rehabilitation was higher in the latter two groups (58% for both). Partial involvement of the receptors innervated by both the division of the VN, rather than by its superior division, was detected in 22 and 24% of patients, respectively. Total or partial damage to receptors innervated by the inferior VN was not found.

Conclusion:
Deeper understanding of AUV may be achieved through identification of its patterns. Slightly more than one-half of AUV cases seemed to be associated with a nerve lesion, with a worse clinical outcome. The remaining patients exhibited selective involvement of vestibular receptors, more probably consistent with an intralabyrinthine lesion pattern and experienced better spontaneous recovery.
Cerebral Venous Sinus Thrombosis After Translabyrinthine Vestibular Schwannoma—A Prospective Study and Suggested Management Paradigm
Authors: Guazzo Emily , Panizza Benedict , Lomas Andrew , Wood Martin , Amato Damien , Alalade Andrew , Gandhi Mitesh , Bowman James 
Published: December 2019

Objective:
To prospectively evaluate the incidence, risk factors and natural history of postoperative cerebral venous sinus thrombosis (pCVST) in translabyrinthine vestibular schwannoma microsurgical resection and propose a potential management paradigm.

Study Design:
Prospective, single cohort, multicenter study.

Setting:
State-wide academic tertiary referral centers.

Patients:
Fifty-four consecutive patients who underwent translabyrinthine vestibular schwannoma resection.

Main Outcome Measures:
Incidence of pCVST on postoperative imaging on Day 7, Day 28, and 12 months postoperatively. Patients and tumor characteristics, risk factors, length of stay, intraoperative parameters, complications, and follow-up were analyzed.

Results:
pCVST was demonstrated in 21 patients (38.9%) on postoperative imaging. All patients with pCVST were treated conservatively and remained asymptomatic in the immediate postoperative period and long-term follow-up. There were no instances of venous infarction, intracranial hemorrhage, or neurological deficits. A majority (61.1%) of pCVST recannalised on long-term follow up with conservative management. There was a statistical association with pCVST and surgery on the side of the non-dominant cerebral venous drainage (n = 17, 80.1%, p = 0.034). Patients with pCVST were significantly more likely to have a postoperative cerebrospinal fluid (CSF) leak (n = 5, 23.8%, p = 0.017).

Conclusion:
The incidence of pCVST following translabyrinthine vestibular schwannoma resection is much higher than previously recognized. pCVST is more likely to occur when surgery is performed on tumors situated on the side of non-dominant cerebral venous drainage. Despite the high prevalence of this iatrogenic phenomenon, all patients were asymptomatic and a majority resolved, thereby suggesting that conservative management is safe. Correlation between pCVST and increased incidence of CSF leak requires further investigation.
Mechanical Energy Dissipation Through the Ossicular Chain and Inner Ear Using Laser Doppler Vibrometer Measurement of Round Window Velocity
Authors: Ryan Matthew , Lally John , Adams Jason K. , Higgins Sophie , Ahmed Mostafa , Aden James , Esquivel Carlos , Spear Samuel A. 
Published: December 2019

Hypothesis:
Round window velocity measurements should correlate closely with vibration measurements taken at proximal points along an intact chain over a set frequency range. These round window vibration measurements should be similar to the vibration measurements taken of the ossicles if mechanical energy is conserved through the vestibular organ.

Background:
To date there has not been a study which compares vibratory velocity measurements through an intact ossicular chain to the level of the round window. This study attempted to quantify the degree of mechanical energy transmission and suspected dissipation through the ossicular chain and vestibular organ through incus, stapes, and round window velocity measurements in response to sound stimulus.

Methods:
Five thawed human temporal bones with intact ossicular chain and tympanic membrane underwent complete mastoidectomy and a facial recess approach. A laser Doppler vibrometer (LDV) was mounted on the operating microscope to measure vibration of incus, stapes, and round window in response to a sound stimulus within the external auditory canal. Sound stimulus frequencies ranged from 0.5 to 4 kHz at 90 dB SPL.

Results:
Vibration velocity was measured across the frequency range for each incus, stapes, and round window. Vibration velocity curves obtained over the frequency range were similar for each of the bones with a notable resonant frequency around 2 kHz. The incus and stapes curve amplitudes were nearly identical with similar maximum velocity and frequency at which this maximal velocity was noted. Round window vibration velocity demonstrated a unique peak velocity. Transfer function measurements of the stapes and round window demonstrated markedly similar curves. The variation in velocity between temporal bones in response to the standardized stimulus was more dramatic in the round window measurements when compared with the incus and stapes.

Conclusions:
This study supports the concept that round window transfer function is equivalent to stapes footplate transfer function when subjected to the same acoustic stimuli. This study also demonstrates that the round window is a much more difficult target to measure when using LDV technology and improvements in experimental design are required to better understand round window physiology in relation to transfer of acoustic vibratory stimulus transferred throughout the middle ear. A complete and thorough understanding of the biophysical properties of the middle and inner ear are critical for optimal ossiculoplasty outcomes and the development of future ossicular prosthetics.
Association Between Vestibular Migraine and Migraine Headache: Yet to Explore
Authors: Abouzari Mehdi , Goshtasbi Khodayar , Moshtaghi Omid , Tan Donald , Lin Harrison W. , Djalilian Hamid R. 
Published: December 2019

Objectives:
To evaluate if patients with a diagnosis of vestibular migraine (VM) by the International Classification of Headache Disorders (ICHD) criteria have meaningful differences in symptomatology and disease characteristics when compared to patients with concurrent vestibular symptoms and migraine that do not meet ICHD criteria.

Methods:
Patients who presented for the evaluation of vertigo were provided a detailed questionnaire about dizziness and migraine symptoms. Patients were assigned to either VM cohort (met ICHD criteria for VM) or migraine headache (MH) cohort (met ICHD criteria for migraine with or without aura but not VM). Disease characteristics, symptomatology, quality of life, and perceived stress score were compared between the cohorts.

Results:
The VM cohort demonstrated a shorter duration of vertigo episodes, 11 ± 22 hours versus 84 ± 146 hours in the MH cohort. In the VM cohort, 81% reported experiencing migraine headaches during episodes of vertigo, versus 61% in the MH cohort. All patients in the VM cohort reported a previous diagnosis of migraine headache, whereas 9% of the MH cohort had not been previously diagnosed by another physician. There was no difference in quality of life or perceived stress scores between the cohorts.

Conclusions:
A large proportion of vertigo patients with migrainous features do not meet the ICHD criteria for VM. The differences between cohorts represent selection bias rather than meaningful features unique to the cohorts. As such, VM and MH with vestibular symptoms may exist on a spectrum of the same disease process and may warrant the same treatment protocols.
Role of Macrophage Migration Inhibitory Factor in NLRP3 Inflammasome Expression in Otitis Media
Authors: Kariya Shin , Okano Mitsuhiro , Zhao Pengfei , Maeda Yukihide , Kataoka Yuko , Higaki Takaya , Makihara Seiichiro , Nishihira Jun , Tachibana Tomoyasu , Nishizaki Kazunori 
Published: December 2019

Hypothesis:
Macrophage migration inhibitory factor plays an important role in the expression of interleukin (IL)-1β and the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome in lipopolysaccharide-induced otitis media.

Background:
NLRP3 inflammasome and macrophage migration inhibitory factor are critical molecules mediating inflammation. However, the interaction between the NLRP3 inflammasome and macrophage migration inhibitory factor has not been fully examined.

Methods:
Wild-type mice and macrophage migration inhibitory factor gene-deficient (MIF−/−) mice received a transtympanic injection of either lipopolysaccharide or phosphate-buffered saline. The mice were sacrificed 24 hours after the injection. Concentrations of IL-1β, NLRP3, ASC (apoptosis-associated speck-like protein containing a caspase recruitment domain and a pyrin domain), and caspase-1 in the middle ear effusions were measured by enzyme-linked immunosorbent assay. Temporal bones were processed for histologic examination and immunohistochemistry.

Results:
In the immunohistochemical study using the wild-type mice, positive staining of macrophage migration inhibitory factor, NLRP3, ASC, and caspase-1 were observed in infiltrating inflammatory cells induced by lipopolysaccharide in the middle ear. The number of inflammatory cells caused by lipopolysaccharide administration decreased remarkably in the MIF−/− mice as compared with the wild-type mice. The concentrations of IL-1β, NLRP3, ASC, and caspase-1 increased in the lipopolysaccharide-treated wild-type mice. The MIF−/− mice with lipopolysaccharide had decreased levels of IL-1β, NLRP3, ASC, and caspase-1 as compared with the wild-type mice.

Conclusion:
Macrophage migration inhibitory factor has an important role in the production of IL-1β and the NLRP3 inflammasome. Controlling the inflammation by modulating macrophage migration inhibitory factor and the NLRP3 inflammasome may be a novel therapeutic strategy for otitis media.
Long-term clinical outcomes in patients with unstable angina undergoing percutaneous coronary interventions in a contemporary registry data from Poland
Authors: Piątek Łukasz , Janion-Sadowska Agnieszka , Piątek Karolina , Zandecki Łukasz , Zabojszcz Michał , Siudak Zbigniew , Sadowski Marcin 
Published: December 2019

Background
Both unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI) are still classified together in non-ST-elevation acute coronary syndromes despite the fact they substantially differ in both clinical profile and prognosis. The aim of the present study was to evaluate contemporary clinical characteristics and outcomes of unstable angina patients after percutaneous coronary intervention (PCI) in comparison with stable angina and NSTEMI in Swietokrzyskie District of Poland in years 2015–2017.

Methods
A total of 7187 patients after PCI from ORPKI Registry (38% with diagnosis of unstable angina) were included into the analysis. Impact of clinical presentation (unstable angina, stable angina, NSTEMI, STEMI) on three-year outcomes were determined.

Results
Unstable angina patients were older than stable angina but younger than NSTEMI individuals. In unstable angina group, the percentage of previous myocardial infarction (MI), PCI or coronary artery bypass grafting (CABG) was the highest among all analyzed groups. In three-year observation, the risk of death as well as MI and MACE in unstable angina after PCI was higher than stable angina angina but considerably lower than in the NSTEMI group. Multivariate analysis confirmed that prognosis in NSTEMI was substantially worse in comparison with unstable angina [relative risk (RR) 1.365, 95% confidence interval (CI): 1.126–1.655, P = 0.0015]. On the contrary in unstable angina and stable angina patients, the impact of diagnosis on mortality risk was similar (RR 1.189, 95% CI: 0.932–1.518, P = 0.1620). Parallel results were observed in respect of MI and MACE. Independent predictors of death or MACE were: age, kidney disease, hypertension, diabetes, previous stroke or previous PCI.

Conclusion
Three-year prognosis in unstable angina was considerable better in comparison with NSTEMI. On the contrary, after adjustment for baseline differences, the outcomes (death, MI, MACE) in unstable angina and stable angina patients were comparable.
Metacognitive Capacity Is Related to Self-Reported Social Functioning and May Moderate the Effects of Symptoms on Interpersonal Behavior
Authors: Fischer Melanie W. , Dimaggio Giancarlo , Hochheiser Jesse , Vohs Jenifer L. , Phalen Peter , Lysaker Paul H. 
Published: December 2019

Abstract
Impairments in metacognition or the ability to form integrated senses of self and others have been linked to deficits in laboratory-based measures of social functioning in schizophrenia. This study examined whether self-reported social functioning was related to metacognition in 88 adults in a nonacute phase of schizophrenia. Concurrent assessments were made of metacognition with the Metacognition Assessment Scale–Abbreviated, social functioning with the Social Functioning Scale, symptoms with the Positive and Negative Syndrome Scale, and neurocognition with the Wisconsin Card Sorting Task. Univariate correlations revealed that self-reported social functioning was related to metacognition. Symptom severity was linked to interpersonal relationships, and overall metacognition was found to significantly moderate that relationship such that the effects of symptoms on function grew less as metacognitive capacity was stronger, independent of the effects of neurocognition. This may suggest the potential of metacognitive interventions to titrate the negative effects of symptoms on social function.
Prostate Cancer, Use of Androgen Deprivation Therapy, and Cognitive Impairment
Authors: Alonso Quiñones Hector J. , Stish Bradley J. , Hagen Clinton , Petersen Ronald C. , Mielke Michelle M. 
Published: December 2019

Introduction:
The association of prostate cancer and androgen deprivation therapy (ADT) use with the odds of developing mild cognitive impairment (MCI) was determined in men from the population-based Mayo Clinic Study of Aging (MCSA).

Methods:
The study included 2513 men (mean age of 73.1 y) enrolled in the MCSA. A history of prostate cancer, ADT use, and length of ADT exposure before their first MCSA visit was abstracted using the Rochester Epidemiology Project medical records-linkage system. MCI was diagnosed at the baseline visit. Logistic regression was used to determine whether prostate cancer and ADT use was associated with odds of MCI.

Results:
Of the 2513 participants, 349 (13.9%) had a history of prostate cancer; among whom 99 (28.3%) were treated with ADT before MCSA enrollment. There were 382 (15.2%) with a diagnosis of MCI. In the univariate logistic regression models, prostate cancer (odds ratio, 1.50; 95% confidence interval, 1.12-2.00), and ADT exposure (odds ratio, 1.57; 95% confidence interval, 0.96-2.58) were associated with higher odds of MCI. These associations were greatly attenuated and not significant in multivariable models.

Conclusions:
Neither a diagnosis of prostate cancer nor ADT use was associated with odds of MCI in this cross-sectional population-based study.
Rapamycin rejuvenates oral health in aging mice
Authors: An Jonathan Y. , Kerns Kristopher A. , Ouellette Andrew , Robinson Laura , Morris Doug , Kaczorowski Catherine , Park So-Il , Mekvanich Title , Kang Alex , McLean Jeffrey S. , Cox Timothy C. , Kaeberlein Matt 
Published: December 2019

AbstractPeriodontal disease is an age-associated disorder clinically defined by periodontal bone loss, inflammation of the specialized tissues that surround and support the tooth, and microbiome dysbiosis. Currently, there is no therapy for reversing periodontal disease, and treatment is generally restricted to preventive measures or tooth extraction. The FDA-approved drug rapamycin slows aging and extends lifespan in multiple organisms, including mice. Here we demonstrate that short-term treatment with rapamycin rejuvenates the aged oral cavity of elderly mice, including regeneration of periodontal bone, attenuation of gingival and periodontal bone inflammation, and revertive shift of the oral microbiome toward a more youthful composition. This provides a geroscience strategy to potentially rejuvenate oral health and reverse periodontal disease in the elderly.Single Sentence SummaryShort-term treatment with rapamycin reverses periodontal bone loss, attenuates inflammation, and remodels the oral microbiome toward a more youthful state.