bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital-acquired Pneumonia and Ventilator-associated Pneumonia in Children
Authors: Ericson Jessica E. , McGuire John , Michaels Marian G. , Schwarz Adam , Frenck Robert , Deville Jaime G. , Agarwal Swati , Bressler Adam M. , Gao Jamie , Spears Tracy , Benjamin Daniel K. , Smith P. Brian , Bradley John S. ,   on behalf of the Best Pharmaceuticals for Children Act—Pediatric Trials Network Steering Committee and the Clinical Trials Transformation Initiative
Published: March 2020

Background:
Clinical trials for antibiotics designed to treat hospital-acquired and ventilator-associated bacterial pneumonias (HABP/VABP) are hampered by making these diagnoses in a way that is acceptable to the United States Food and Drug Administration and consistent with standards of care. We examined laboratory and clinical features that might improve pediatric HABP/VABP trial efficiency by identifying risk factors predisposing children to HABP/VABP and describing the epidemiology of pediatric HABP/VABP.

Methods:
We prospectively reviewed the electronic medical records of patients <18 years of age admitted to intensive and intermediate care units (ICUs) if they received qualifying respiratory support or were started on antibiotics for a lower respiratory tract infection or undifferentiated sepsis. Subjects were followed until HABP/VABP was diagnosed or they were discharged from the ICU. Clinical, laboratory and imaging data were abstracted using structured chart review. We calculated HABP/VABP incidence and used a stepwise backward selection multivariable model to identify risk factors associated with development of HABP/VABP.

Results:
A total of 862 neonates, infants and children were evaluated for development of HABP/VABP; 10% (82/800) of those receiving respiratory support and 12% (103/862) overall developed HABP/VABP. Increasing age, shorter height/length, longer ICU length of stay, aspiration risk, blood product transfusion in the prior 7 days and frequent suctioning were associated with increased odds of HABP/VABP. The use of noninvasive ventilation and gastric acid suppression were both associated with decreased odds of HABP/VABP.

Conclusions:
Food and Drug Administration-defined HABP/VABP occurred in 10%–12% of pediatric patients admitted to ICUs. Risk factors vary by age group.
Specific liver volume parameters in cirrhotic patients with peribiliary cysts
Authors: Hwang Hsuen-En , Chiu Nai-Chi , Liu Chien-An , Chou Yi-Hong , Lee Rheun-Chuan 
Published: March 2020

Background:
The presence of peribiliary cysts and morphological changes in the volumes of lobes in the livers of patients with cirrhosis are both related to the alteration of portal flow. Our study explored the relationship between these two features in patients with cirrhosis.

Methods:
We retrospectively selected 150 computed tomography (CT) images of cirrhotic livers and 105 CT images of healthy livers. The cirrhotic livers were further classified according to the presence of peribiliary cysts (peribiliary cysts group) or the absence of peribiliary cysts (control cirrhotic group). The characteristic features of liver cirrhosis, including modified caudate-right lobe ratio (mCR ratio), splenomegaly, ascites, and collateral shunts, were reviewed. Liver volume calculations included the sum of the left hepatic volume (LHV) and right hepatic volume (RHV; LHV + RHV) and the ratio of LHV to RHV (LHV/RHV).

Results:
The two groups did not differ in the presence of splenomegaly, ascites, or collateral shunts. The control cirrhotic group exhibited a significantly higher mCR ratio and LHV/RHV ratio than the peribiliary cysts group did (p < 0.001). The healthy liver group exhibited a significantly higher LHV + RHV value than either the peribiliary cysts group or the control cirrhotic group did (p < 0.001). The peribiliary cysts group and the control cirrhotic group did not differ significantly for LHV + RHV (p > 0.05).

Conclusion:
The control cirrhotic group exhibited a significantly higher mCR ratio and LHV/RHV ratio than the peribiliary cysts group did, but the two groups were similar for most measurements. Peribiliary cysts might result in reduction of portal flow, causing cirrhotic liver with peribiliary cysts with left-sided dominance not to demonstrate the typical morphological appearance of the common cirrhotic liver.
Evaluation of factors associated with the risk stratification of survivorship for stage IV squamous cell carcinoma of the oral cavity: A 10-year retrospective study
Authors: Cheng Han-Chieh , Yang Cheng-Chieh , Kao Shou-Yen , Wu Tzu-Ying , Wu Cheng-Hsien 
Published: March 2020

Background:Oral squamous cell carcinoma (OSCC) leads to thousands of deaths every year in Taiwan. Nearly 40% of OSCC patients are diagnosed with stage IV disease, which has a poor prognosis. Multimodality treatments including surgery and adjuvant therapy have been utilized, but their treatment outcomes are generally poor. In this study, we sought to identify possible clinical impact factors that may contribute to the survival of stage IV OSCC.Methods:Data for patients with malignant neoplasms of the oral cavity registered in the Cancer Registry Database of Taipei Veterans General Hospital between 2002 and 2011 were retrieved. The study patients consisted of OSCC patients with clinical stage IV disease who had undergone a surgery and adjuvant therapy. The primary endpoints were the 5-year disease-free survival (DFS) and overall survival (OS) rates. The clinicopathological characteristics of the patients were also stratified and compared.Results:A total of 191 OSCC patients were included for retrospective analysis. The different subgroups of stage IV disease presented different treatment outcomes. The 5-year OS versus DFS rates of each subgroup were as follows: T4N0: 70.9% versus 52.6%; T1-3N23: 66.1% versus 49.8%; T4N1: 49.6% versus 31.6%; and T4N23: 40.9% versus 31.0% (p< 0.01). Patients with diabetes, moderate or poor cell differentiation, perineural invasion, and extracapsular spread presented lower 5-year OS rates (hazard ratio [HR] = 1.87, 1.65, 2.42, and 2.14, respectively), and patients with perineural invasion, positive cut margin, and extracapsular spread presented lower 5-year DFS rates (HR = 1.57, 1.62, and 1.71, respectively).Conclusion:In this study, we elucidated the different survival rates of different subgroups of stage IV OSCC following the same treatment scheme. The results of the study provide clinical physicians with references by which to evaluate prognosis and determine post-operative disease monitoring timetables based upon different characteristics.
The Association Between Unit-Level Workplace Social Capital and Intention to Leave Among Employees in Health Care Settings: A Cross-Sectional Multilevel Study
Authors: Iida Mako , Watanabe Kazuhiro , Ando Emiko , Tsuno Kanami , Inoue Akiomi , Kurioka Sumiko , Kawakami Norito 
Published: March 2020

Objective:
The aim of this study was to investigate the multilevel association between workplace social capital and intention to leave among employees in health care settings in Japan.

Methods:
This study was a secondary data analysis of the cross-sectional data. A sample of 658 Japanese employees in health care settings with 17 facilities were recruited using a self-administered questionnaire. Multilevel linear regression analysis of intention to leave on unit-level workplace social capital (average score for each unit) was conducted.

Results:
Among 317 respondents from 49 units, after adjusting for demographic and work-related variables, both unit-level and individual-level workplace social capital were significantly negatively associated with intention to leave (P < 0.001).

Conclusions:
The current study found that there was a significant negative association between unit-level workplace social capital and intention to leave in the health care field.
Human Temporal Bone Study of Vestibular Histopathology in Cochlear Implant Patients With Cochlear Hydrops
Authors: Su-Velez Brooke M. , Lopez Ivan A. , Ishiyama Akira , Ishiyama Gail 
Published: March 2020

Hypothesis:
Endolymphatic hydrops (EH) associated with cochlear implantation are associated with vestibular dysfunction.

Background:
Vestibular dysfunction is a known risk after cochlear implantation (CI). CI has been shown to cause cochlear hydrops due to fibrosis surrounding the ductus reuniens. However, the association of cochlear hydrops with vestibular hydrops and the relationship to vestibular symptoms remain unknown.

Methods:
Histopathological analysis and clinical evaluation of the vestibular end organs of 17 human temporal bones (HTB)s exhibiting cochlear hydrops from 15 CI recipients.

Results:
Eight of 15 patients with cochlear hydrops due to CI had complaints of dizziness, vertigo, or imbalance following CI. In all 17 HTBs with cochlear hydrops, there was fibrosis, atrophy, or obstruction of the ductus reuniens, and all had straight electrode CI via cochleostomy. In one of the eight reporting postoperative dizziness, labyrinthitis ossificans was deemed causative. Six of the seven remaining patients had EH of both the saccule and utricle. Fifteen of 17 HTBs (88.2%) had saccular EH. In contrast, 8 of 17 HTBs (47.0%) in 7 patients had utricular EH, of which 6 patients had postoperative vertigo spells. It seems that hydrops of the utricle closely corresponds to postoperative vertigo spells and vestibular complaints.

Conclusion:
Implantation of the CI, when complicated by ductus reuniens fibrosis, may cause both cochlear hydrops and vestibular endolymphatic hydrops. Hydrops of the vestibular periphery when involving the utricle seems to be more likely associated with disabling vertigo symptoms. This study supports the round window technique of insertion rather than cochleostomy.
In Vitro Investigation of the Dependency Between Abutment Length and Implant Stability Quotient (ISQ) for Stability Measurements on Bone Anchored Hearing Implant Systems
Authors: Høgsbro Morten , Agger Andreas , Johansen Lars Vendelbo , Gaihede Michael 
Published: March 2020

Hypothesis:
The investigation aimed at measuring the relation between abutment length and Implant Stability Quotient (ISQ) for stability measurements on two types of bone-anchored hearing implant systems.

Background:
Measuring bone-anchored hearing implant stability using the ISQ has the inherent limitation that the measurement is dependent on the length of the abutment used on the implant. This dependency has not earlier been analyzed in depth. Therefore, ISQ measurements for different abutment lengths cannot be directly compared if a patient needs a change of abutment or when evaluating different patients in a scientific setting.

Methods:
The dependency of ISQ on abutment length for Cochlear BI300 (Cochlear Nordic AB, Mölnlycke, Sweden) and Ponto Wide Implant (Oticon Medical AB, Askim, Swden) was measured using a temporal bone model and a plaster model. ISQ at abutment level was compared with the corresponding ISQ at implant level and results were analyzed by multiple linear regression.

Results:
The ISQ dependency on abutment length was −3.5 ISQ/mm (95% CI: −3.7 to −3.4) (Cochlear BI300 implant) and −2.9 ISQ/mm (95% CI: −3.0 to −2.7) (Oticon Wide Implant).

Conclusion:
The dependency of ISQ on abutment length for two types of bone-anchored hearing implant systems has been established empirically. This knowledge enables clinicians to continue monitoring the ISQ for a patient after a change of abutment and enables researchers to compare ISQ between patients in a clinical study.
Long-term Hearing Preservation in Electric Acoustic Cochlear Implant Candidates
Authors: Sprinzl Georg Mathias , Schoerg Philipp , Edlinger Stefan Herwig , Magele Astrid 
Published: March 2020

Objectives:
To evaluate long-term stability and residual hearing preservation after cochlear implantation with electric acoustic stimulation (EAS).

Study Design:
Retrospective chart-analysis.

Setting:
University clinic.

Methods:
Long- and short-term hearing preservation (HP) of 18 EAS subjects (21 ears) was evaluated. Short-term was defined as follow-ups less than 12 months after surgery versus long-term outcomes longer than 12 months postsurgery.

Results:
Mean period of observation in the short-term group was 4 ± 3.0 months (range 0–7). In the long-term group the mean follow-up was 28.4 ± 15.0 months (range 12–58). Full insertion was possible in all 18 implanted subjects. In the short-term group, complete HP was achieved in 50%, partial HP in 33.3%, and minimal HP in 8.3% of the investigated subjects. One subject lost hearing completely. In the long-term group, complete HP was achieved in 50%, partial HP was observed in 40%, and minimal HP in 10% of the ears. No subject lost hearing completely. Subjects using EAS showed better word recognition scores after surgery (mean at 65 dB 55.3 ± 18.4; mean at 80 dB 68.1 ± 12.2) than subjects using electric stimulation only (mean at 65 dB 38.3 ± 18.1; mean at 80 dB 60.0 ± 16.4) with nonfunctional low-frequency hearing.

Conclusion:
The study confirms that hearing can be preserved to a large extent. As a result, most subjects benefitted from EAS. Subjects with postoperative functional low-frequency hearing showed greater benefit in word speech tests. Furthermore, the outcomes show that EAS implantation is a safe, effective, and most importantly stable treatment option (longest follow-up with 58 mo).
Will They Show? Predictors of Nonattendance for Scheduled Screening Colonoscopies at a Safety Net Hospital
Authors: O’Neil Jessica , Winter Ethan , Hemond Colin , Fass Ronnie 
Published: March 2020

Background:
Colonoscopy can reduce colorectal cancer–related mortality by up to 90% through early detection and polyp removal. Despite this, nonattendance rates for scheduled colonoscopies have been reported ranging from 4.1% to as high as 67% depending on the population studied.

Aim:
The aim of the study was to measure the nonattendance rate for scheduled screening colonoscopy at a large safety net hospital and identify predictors of nonattendance within this patient population.

Materials and Methods:
This was a population-based study of 1186 adults who were scheduled to undergo screening colonoscopy at a safety net hospital as part of their routine preventative health program. Health systems variables were assessed including procedure time and scheduling patterns as well as patient-centered variables such as socioeconomic indicators and specific comorbid diagnoses. Associations with nonattendance were examined by univariate and multivariate logistic regression.

Results:
The overall rate of nonattendance for scheduled screening colonoscopy was 33%. A multivariate model was constructed to predict nonattendance revealing that private payer status [odds ratio (OR)=0.368, 95% confidence interval (CI): 0.225, 0.602] and prior colonoscopy (OR=0.371, 95% CI: 0.209, 0.656) were associated with greater attendance rates. Chronic obstructive pulmonary disease (OR=2.034, 95% CI: 1.239, 3.341), afternoon procedure time (OR=1.807, 95% CI: 1.137, 2.871), and a greater interval time between the date the colonoscopy was ordered and the date the colonoscopy was scheduled to occur (OR=1.005, 95% CI: 1.001, 1.009) were independently associated with nonattendance when controlling for age, sex, and race.

Conclusions:
Specific predictors for scheduled screening colonoscopy nonattendance at a safety net hospital can be identified. These findings can be used to tailor community-based interventions to improve colorectal cancer screening rates.
Development and validation of a nomogram to predict the overall survival of patients with neuroblastoma
Authors: Liu Qinglin , Feng Lei , Xue Hao , Su Wandong , Li Gang 
Published: March 2020

Abstract
Neuroblastoma is the most prevalent malignancy in infants characterized by heterogeneous prognosis. It is critical to stratify the risks for patients with neuroblastoma. To stratify the risks for neuroblastoma, clinical characteristics of neuroblastoma patients were retrieved from the Therapeutically Applicable Research to Generate Effective Treatment program. All patients were randomly sampled into the development and validation sets. Cox regression was used to construct a prediction nomogram. The discrimination and calibration capacity of the nomogram was assessed. Prognostic index (PI) was calculated and tested to evaluate the performance of the nomogram. This nomogram demonstrated reasonable discrimination and calibration capacity. The nomogram derived PI exhibited acceptable accuracy in predicting the prognosis for neuroblastoma patients. The overall survival rate was significantly different between the PI discriminated high and low-risk patient subgroups. In conclusion, besides traditional staging systems, some newly defined risk factors could be involved in risk stratification for patients with neuroblastoma. Our nomogram may aid the risk stratification for neuroblastoma patients.
Comparison of the efficacy and safety of shockwave lithotripsy, retrograde intrarenal surgery, percutaneous nephrolithotomy, and minimally invasive percutaneous nephrolithotomy for lower-pole renal stones
Authors: Tsai Sheng-Han , Chung Hsiao-Jen , Tseng Ping-Tao , Wu Yi-Cheng , Tu Yu-Kang , Hsu Chih-Wei , Lei Wei-Te 
Published: March 2020

Abstract

Background:
Shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy (PCNL), and minimally invasive PCNL are currently therapeutic options for lower-pole renal stones (LPS). However, the optimal treatment for LPS remains unclear. A comprehensive evaluation of the efficacy and safety of each intervention is needed to inform clinical decision-making. This study aimed at assessing the efficacy and safety of different interventions for LPS.

Methods:
PubMed, Embase, ScienceDirect, ClinicalKey, Cochrane Library, ProQuest, Web of Science, and ClinicalTrials.gov were searched from inception to December 6th 2018. Only randomized controlled trials (RCTs) including the patients treated for LPS were included. The frequentist models of network meta-analysis were used to compare the effect sizes. The primary outcome was stone free rate, and the secondary outcomes were overall complication rate, major complication rate, retreatment rate, and auxiliary procedure rate.

Results:
This study included 13 RCTs comprising 1832 participants undergoing 6 different interventions, including RIRS, PCNL, Mini-PCNL, Micro-PCNL, SWL, and conservative observation. PCNL had the best stone free rate (odds ratio [OR] = 3.45, 95% confidence interval [CI] = 1.30–9.12), followed by Mini-PCNL (OR = 2.90, 95% CI = 1.13–7.46). Meta-regression did not find any association of the treatment effect with age, sex, and stone size. Although PCNL tended to exhibit a higher complication rate, the difference of complication rate among various interventions did not achieve a statistical significance. SWL was the less effective and associated with higher retreatment rate compared with PCNL, Mini-PNCL, and RIRS.

Conclusions:
PCNL was associated with the best stone free rate for LPS regardless of age, sex, and stone size. Each treatment achieved a similar complication rate compared with the others. Future large-scale RCTs are warranted to identify the most beneficial management for renal stones at a more complicated location.
The Influence of Screening, Misclassification, and Reporting Biases on Reported Chlamydia Case Rates Among Young Women in the United States, 2000 Through 2017
Authors: Learner Emily R. , Powers Kimberly A. , Torrone Elizabeth A. , Pence Brian W. , Fine Jason P. , Miller William C. 
Published: March 2020

Background
National chlamydia case rate trends are difficult to interpret because of biases from partial screening coverage, imperfect diagnostic tests, and underreporting. We examined the extent to which these time-varying biases could influence reported annual chlamydia case rates.

Methods
Annual reported case rates among women aged 15 through 24 years from 2000 through 2017 were obtained from the Centers for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention AtlasPlus tool. Estimates of reporting completeness, diagnostic test sensitivity and specificity, and screening coverage were derived from literature review and expert opinion. We adjusted annual reported case rates for incomplete reporting, imperfect diagnostic tests, and partial screening coverage through a series of corrections, and calculated annual adjusted case rates of correctly diagnosed chlamydia.

Results
Adjusted chlamydia case rates among young women were higher than reported case rates throughout the study period. Reported case rates increased over the study period, but adjusted rates declined from 12,900 to 7900 cases per 100,000 person-years between 2000 and 2007. After 2007, adjusted case rates declined to 7500 cases per 100,000 person-years in 2017. Bias from partial screening coverage had a larger impact on case rate magnitude and trend shape than bias from imperfect diagnostic tests or underreporting.

Conclusions
Reported chlamydia case rates may be substantially lower than true chlamydia case rates because of incomplete reporting, imperfect diagnostic tests, and partial screening coverage. Because the magnitude of these biases has declined over time, the differences between reported and adjusted case rates have narrowed, revealing a sharp decline in adjusted case rates even as reported case rates have risen. The decline in adjusted case rates suggests that the rise in reported case rates should not be interpreted strictly as increasing chlamydia incidence, as the observed rise can be explained by improvements in screening coverage, diagnostic tests, and reporting.
Ingenol Mebutate Gel 0.05% in the Treatment of Anogenital Warts: A Prospective Controlled Trial Comparing It With Topical Podophyllin Solution 25%
Authors: Shahidi Dadras Mohammad , Bizaval Zeinab , Hoormand Mahmood , Mozafari Nikoo 
Published: March 2020

Background
Anogenital warts (AGWs) are a common therapeutic challenge. All therapies are associated with burning, pain, and frustrating high rate of recurrence. The search for a new alternative continues. Recently, a diterpene ester extracted from the Euphorbia peplus plant (ingenol mebutate [IM]) has been shown to possess activity against AGWs.

Objective
This study aimed to compare and evaluate the therapeutic efficacy and safety of topical 0.05% ingenol gel with another herbal extract medication (topical 25% podophyllin solution) in treatment of AGWs.

Methods
This was a comparative single blinded nonrandomized, 2-arm trial of ingenol 0.05% gel versus podophyllin solution 25% administered up to 6 times to patients with AGWs. To evaluate the therapeutic efficacy, the complete clearance rate and recurrence rate were assessed 1 and 12 weeks after last treatment, respectively. Safety was assessed by occurrence and severity of pain and local skin reaction (LSR).

Results
Of 31 and 36 patients in the IM group and podophyllin group who completed the study, initial complete resolution was observed in 20 (64.5%) and 14 (38.9%) patients, respectively (P = 0.03). The initial clearance was faster in the IM group (2.00 ± 0.91 weeks) compared with the podophyllin group (4.21 ± 1.05 weeks, P = 0.00). After 3 months, recurrence was seen in 13 (65.0%) of 20 patients in the IM group and 6 (42.8%) of 14 in the podophyllin group (P = 0.20). The number of patients with complete resolution after 3 months was not different between the 2 groups (7/31 in the IM group and 8/36 in the podophyllin group, P = 0.97). The mean ± SD severity scores for LSR and pain in the IM group were 6.65 ± 1.76 and 6.13 ± 2.57, respectively, which was significantly higher than their scores (3.39 ± 1.57 and 2.58 ± 1.38) in the podophyllin group (P = 0.00).

Conclusion
Ingenol mebutate 0.05% gel is effective as podophyllin 25% solution in treating AGWs, with further benefit of being much more rapid. However, high recurrence rate, sever pain, and LSR limit its use.