bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Delamination Plus”: A Technique to Reduce Immediate Postoperative Diabetic Cavity Hemorrhage
Authors: Tan Shi Zhuan , Dell' aversana Orabona Giancarlo , Robins Julian J. , Kumaran Neruban , Wong Roger 
Published: May 2020

Purpose:
To investigate the effectiveness of an intraoperative surgical technique to reduce the incidence of immediate postoperative cavity hemorrhage in patients undergoing vitrectomy for complications of proliferative diabetic retinopathy.

Methods:
A single-center, prospective study of 20 consecutive patients who underwent vitrectomy for proliferative diabetic retinopathy–related complications. A standard 3-port pars plana vitrectomy with either 23 g or 25 g was performed. At the end of surgery, the infusion was switched off to create transient hypotony and endolaser photocoagulation with long-duration burns were applied to actively leaking blood vessel.

Results:
The average age was 56.2 + 12.8 years. Eleven eyes had actively bleeding vessels at the end of surgery and received endolaser photocoagulation. No patients were found to have hypotony at Day 1 postoperative. Preoperative median visual acuity was 20/1,600 improving to 20/40 at a median of 2.3 weeks post-op (range 0.4–8.5 weeks). Two eyes (10%) had a small postoperative cavity hemorrhage with 20/40 vision, which did not require further intervention.

Conclusion:
The described technique was found to be effective in reducing the incidence of postoperative cavity hemorrhage from up to 75% reported in literature to 10% in our pilot study. Further study with a larger number of patients is required.
Epidemiology of Adenovirus Infections and Outcomes of Cidofovir Treatment in Severely Ill Children
Authors: Siew Jia Xuan , Seah Xue Fen Valerie , Chew Yi Rong , Thoon Koh Cheng , Chong Chia Yin , Yung Chee Fu , Maiwald Matthias , Len Ye , Li Jiahui , Kam Kai Qian , Nadua Karen , Tanugroho Raymond , Tan Natalie Woon Hui 
Published: May 2020

Background:
An increase in human adenovirus (HAdV) infections among hospitalized children in Singapore was observed since 2013. Young age (<2 years) and significant comorbidities have been associated with severe HAdV infections which can result in significant morbidity and mortality. Cidofovir (CDV) has been used to treat severe HAdV infections despite limited data and efficacy.

Methods:
This is a retrospective, observational review of infants and children 1 month to 17 years of age with laboratory-confirmed severe HAdV infection, admitted to a pediatric tertiary care hospital in Singapore between January 2013 and September 2017. Severe infection was defined as requiring intensive care unit or high dependency care at any point during hospital admission. Clinical characteristics, potential risk factors for mortality, as well as the outcome of cases treated with CDV were examined.

Results:
A total of 1167 children were admitted for HAdV infection, of which 85 (7.3%) were severe. For severe infections, the median age was 1.5 years (interquartile range: 0.72–3.2 years). The majority had comorbidities (69.4%) and presented with pneumonia (32.9%). Genotypes HAdV-7 (29.4%) and HAdV-3 (27.0%) were the most common HAdV genotypes identified. Thirteen (15.3%) patients died. Patients who died had a higher proportion of existing neurologic comorbidity (46.2% vs. 13.9%; P = 0.014) and presentation with pneumonia (69.2% vs. 26.4%; P = 0.008) compared with survivors. Patients who presented with pneumonia had a higher risk of 30-day mortality (odds ratio 4.3, 95% confidence interval: 1.0–28.6; P < 0.05). CDV was administered to 17 (20%) children for mainly viremia (47.1%) and/or pneumonia (41.2%). Mortality rate was 41.2% for severe HAdV cases treated with CDV. A significant proportion of patients who died when compared with recovered patients presented with pneumonia (6 of 7, 85.7% vs 1 of 10, 10%; P = 0.004). All 8 patients who had viremia received CDV and survived.

Conclusions:
Mortality can be high in pediatric patients with severe HAdV infections. HAdV-7 and HAdV-3 were the most common genotypes identified in our cohort with severe HAdV infection. Pneumonia is a potential risk factor for mortality in severe HAdV infections in our cohort. Early CDV administration may be considered in patients with severe HAdV infection and existing comorbidities but more studies are required.
Changes in Measles Seroprevalence in China After the Launch of Two Provincial Supplementary Immunization Activities During 2009 to 2013
Authors: Chong Ka Chun , Rui Yan , Mohammad Kirran N. , Liu Yan , Zhou Tianyuan , Wang Maggie Haitian , Jia Katherine Min , He Hanqing 
Published: May 2020

Background:
Supplementary immunization activities (SIAs) have been demonstrated being effective in reducing measles incidence within a short period of time in China, but the effects are short-lived if there is no follow-up SIA with high routine immunization coverage.

Objectives:
To assess the change in measles seroprevalence from 2009 to 2013 after the launch of 2 large-scale SIAs within the period.

Methods:
Three population-based cross-sectional serologic surveys of measles antibodies were conducted in 2009, 2011 and 2013 in Zhejiang, a province in eastern China, with serologic samples collected from 1541, 896 and 1474 subjects, respectively. The serum levels of immunoglobulin G antibodies were measured by enzyme-linked immunosorbent assay.

Results:
We found that the seropositivity rate among infants 0–7 months of age, a group having no vaccination benefit, was below 80% throughout the study period. In addition, the seropositivity rate among adults 30–49 years of age decreased significantly from 96.0% (95% confidence interval: 93.7%–98.3%) in 2011 to 88.5% (95% confidence interval: 84.3%–92.8%) in 2013.

Conclusion:
We showed that large-scale SIAs were effective, but their effects were not long lasting. Given the drop in seropositivity among adults, their susceptibility should be carefully monitored. While older individuals could benefit from the immunization activities, children who were too young to be vaccinated still have a weak seropositivity profile and the optimal age for the administration of the first dose of vaccine should be reconsidered.
Tuberculosis Verrucosa Cutis on the Buttocks: A Case Report
Authors: Xiao Yu , Peng Shan-Shan , Zhang Lyu-Ya , Lin Jie , Hu You-Hong , Fang Mu-Ping 
Published: May 2020

Introduction:
Tuberculosis verrucosa cutis is a rare form of cutaneous tuberculosis and occurs commonly on the lower extremeties (hand, thighs and buttock). It is often missed as other cutaneous verrucosa dieases and the pathogens of cutaneous tuberculosis is difficult to find.
We showed an unusual case of tuberculosis verrucosa cutis on both buttocks.

Case presentation:
A 54 Chinese male presented with 9-year history of asymptomatic verrucous lesions on bilateral buttocks. Lesions presented a well-defined plaque, verrucous lesion and yellow pus discharge on buttocks. The skin biopsy showed pseudoepitheliomatous hyperplasia of the epidermis and dermal granulomatous inflammation composed of epithelioid histiocytes and mixed inflammatory cells. The tuberculin test and the polymerase chain reaction for Mycobacterium tuberculosis were negative, but T-spot test were positive. the treatment of antituberculosis showed favourable effect. Finally, the diagnosis of tuberculosis verrucosa cuti was made.

Discussion:
Tuberculosis verrucosa cutis is easily confused with other verrucous diseases, such as verrucous porokeratosis, discoid lupus erythematosus hypertrophicus lichen planus, chromoblastomycosis. Diagnostic therapy is usually recommended for most of these diagnoses.

Conclusion:
A diagnosis of tuberculosis verrucosa cutis should be taken correctly based on the combination of clinical manifestions, histopathological characteristics, laboratory findings and diagnostic therapy. It is vital for dermatologists to be aware of verrucous lesions since a delay in diagnosis can lead to aggravate the disease, abuse of glucocorticoids.
Lifestyle Changes and Weight Gain
Authors: Suka Machi , Yamauchi Takashi , Yanagisawa Hiroyuki 
Published: May 2020

Objective:
To examine age-dependent trends in weight and lifestyle changes in Japanese workers.

Methods:
Using annual health examination data, 60,143 eligible Japanese workers aged 20 to 59 years were examined for their 2-year changes in weight and smoking, eating, exercise, drinking, and sleep habits.

Results:
Young male workers aged 20 to 24 years showed the greatest weight gain and the highest incidence of unhealthy lifestyle habits. Multivariate analyses indicated that quitting “exercise less than two times/week,” “walking less than 60 min/d,” and “smoking everyday” contributed to weight gain to a considerable extent except in young female workers aged 20 to 24 years.

Conclusions:
Greater weight gain associated with unhealthy lifestyle changes tended to occur in early rather than middle-to-old adulthood. It is important to deliver health promotion programs targeting young male workers.
Self-Rated Health Trajectory Changes According to Employment Transition
Authors: Kang Young Joong , Kim Taeshik , Lee Dong-wook , Kang Mo-Yeol 
Published: May 2020

Objective:
To investigate the impact of employment transitions on self-rated health (SRH) trajectories.

Methods:
We used data from the Korean Labor and Income Panel Study 2003 to 2016. Employment transitions were measured using four categories: continuously non-working, continuously working, labor force exit, and labor force entry. For examination of the time trends in the likelihood of poor SRH, we calculated the annual odds ratios with those from 2003 as the reference, using generalized estimating equations.

Results:
The time trends in the likelihood of poor SRH showed a significant increasing trend in the labor force exit group, while continuously working group and labor force entry group showed significantly decreasing patterns.

Conclusions:
Labor force exit was associated with a substantial increase in prevalence of poor SRH, while labor force entry was associated with a decrease in prevalence of that.
Allergy and Lung Injury Among Rescue Workers Exposed to the World Trade Center Disaster Assessed 17 Years After Exposure to Ground Zero
Authors: Caruana Dennis L. , Huang Po Hsuan , Li Jonathan C. , Cheslack-Postava Keely , Szema Anthony M. 
Published: May 2020

Objective:
Investigate the following in rescue and cleanup workers exposed to the World Trade Center (WTC) disaster 17 years post-fallout: (1) allergic hypersensitivity; (2) spirometry; (3) impulse oscillometry; and (4) the reversibility of airway hyperresponsiveness and distal airways narrowing pre- and post-bronchodilator.

Methods:
In subjects (n = 54) referred to our clinic from the WTC Health Program for management of allergy-immunology services, environmental allergy testing, impulse oscillometry (IOS), and spirometry results were retrospectively reviewed to determine the long-term impact of exposure to the WTC fallout.

Results:
Rescue and cleanup workers exposed to the WTC fallout had a high incidence of allergic hypersensitivity and had evidence of permanent small airways dysfunction characterized by distal airways narrowing and airway hyperresponsiveness.

Conclusion:
Following exposure to the WTC disaster, the patients in our cohort developed allergic hypersensitivity and severe lung injury with only partial reversibility.
Increased Neutrophil Granulocyte and Myeloperoxidase Levels Indicate Acute Inflammation Due to the Exposure of Zinc- and Copper-Containing Welding Fumes
Authors: Reisgen Mara , Thomas Katharina , Beilmann Viktor , Markert Agnieszka , Gerhards Benjamin , Krichel Thomas , Schmidt Kathrin , Kraus Thomas , Martin Christian , Brand Peter , Krabbe Julia 
Published: May 2020

Objective:
Recent studies have shown an increase of C-reactive-protein (CRP) after exposure to zinc- and copper-containing welding fumes. The objective of this study was to determine the effects of exposure to zinc- and copper-containing welding fumes on leukocytes, their subtypes, and myeloperoxidase (MPO).

Methods:
Serum samples of male volunteers were examined after exposures to welding fumes in two settings: repeated exposure on 4 consecutive days for 6 hours and single exposures for different times (3, 4, 5 hours).

Results:
Neutrophil granulocyte and MPO levels showed increases 24 hours after single and repeated exposures for 6 hours similar to CRP increases reported in literature. Overall leukocyte levels and levels of monocytes and lymphocytes were not significantly affected.

Conclusions:
This study indicates the involvement of neutrophil granulocytes in welding fume fever additional to mediator related effects.
18F-choline PET/computed tomography and clinical parameters in the detection of significant prostate cancer in patients with increased prostate-specific antigen levels and previous negative biopsies
Authors: Jiménez Londoño Germán Andrés , García Vicente Ana Maria , Noriega Álvarez Edel , Pena Pardo Francisco José , Amo-Salas Mariano , López Guerrero Mauricio Andres , Fúnez Mayorga Federico , Soriano Castrejón Ángel Maria 
Published: May 2020

Objectives
The aim of this study is to assess the value of the 18F-choline PET/computed tomography (CT) in predicting significant prostate cancer (sPCa) in patients with persistently increased prostate-specific antigen (PSA) levels and previous negative biopsies. To study the possible predictive added value of 18F-choline PET/CT to clinical variables and biomarkers derived from PSA in detecting sPCa.

Methods
We evaluated patients who underwent 18F-choline PET/CT because of ongoing suspicion of prostate cancer (PCa) due to elevated PSA levels (4–20 ng/mL) and at least one previous negative or no conclusive prostate biopsy for PCa. Age, PSA, free PSA, free/total PSA ratio, PSA velocity, PSA doubling time, PSA density and score risk were obtained. 18F-choline PET/CT was classified as negative/positive (PET-categorical). Additionally, we subclassified 18F-choline PET/CT according to the radiotracer uptake patterns (PET-pattern). The reference standard was the histological confirmation. Accuracy of PET/CT was evaluated. Univariate and multivariate logistic regression analyses were performed for metabolic and clinical variables.

Results
A total of 78 patients were included in our study, 23 had PCa (15 with sPCa). The PET pattern showed the highest accuracy and was the most powerful predictor of sPCa. In this research, the prediction of sPCa was improved combining PET pattern and score risk.

Conclusion

18F-choline PET/CT is a potential tool for predicting sPCa in patients with persistently increased PSA levels and previous negative biopsies, and also it could improve the performance of score risk in predicting sPCa.
Detectability of small objects in PET/computed tomography phantom images with Bayesian penalised likelihood reconstruction
Authors: Macnab Margo-Rose F. , Biggans Thomas J. , Mckiddie Fergus I. , Pether Mark I. , Straiton Jack B. , Staff Roger T. 
Published: May 2020

Objectives
This study investigated the subcentimetre lesion detection gains of a Bayesian penalised likelihood reconstruction (BPLR) (Q.Clear, GE Healthcare, Milwaukee, USA) in PET/computed tomography (CT) phantom images and compares observer performance with ordered subset expectation maximisation (OSEM) reconstruction images (VUE Point HD, GE Healthcare).

Methods
Images were presented to three blinded experienced observers to identify lesions and assign confidence ratings. Responses were analysed using jackknife alternative free receiver operator characteristic (JAFROC) software. Phantom lesions (active and nonactive) were constructed using putty. Seventy nonactive and 93 (18F) active lesions, with diameters of 3, 5 or 7 mm were suspended in active backgrounds at varying contrast ratios (2:1–32:1) within an National Electrical Manufacturers Association 2012 phantom. PET/CT images were acquired with a GE Discovery 710 and reconstructed using both BPLR (penalisation coefficient 400) and high-definition attenuation corrected (HDAC) OSEM (2 iterations, 24 subsets).

Results
Small but significant (P = 0.009) visual detection gains were seen for active lesions with BPLR [weighted JAFROC figure of merit (wJAFROC FOM) = 0.77] over OSEM (FOM = 0.74). When split by subset, these improvements were significant for 5 mm and lesion to background ratio of 8:1. No significant (P = 0.514) differences were seen for the identification of nonactive lesions of any size (BPLR FOM = 0.74 and OSEM FOM = 0.73).

Conclusions
Significant detection gains were demonstrated for small active lesions with BPLR over OSEM. Coupled with the significant increase in contrast-to-noise ratio, these results support the use of BPLR in the imaging of small active (≤7 mm) lesions but show no improvement with BPLR in the identification of true negative lesions.
Comparison of Lutetium-177 tin colloid and Rhenium-188 tin colloid radiosynovectomy in chronic knee arthritis
Authors: Shamim Shamim Ahmed , Arora Geetanjali , Jha Pragati , Gupta Priyanka , Behera Abhishek , Mukherjee Anirban , Prabhu Meghna , Ansari Mohammad Tahir , Vyas Surabhi , Bal Chandrasekhar 
Published: May 2020

Objective
To assess the role of Lutetium-177(Lu-177) tin colloid for radiosynovectomy and compare it with Rhenium-188 (Re-188) tin colloid radiosynovectomy for alleviation of pain in patients with chronic inflammatory arthritis of knee.

Methods
Patients of chronic inflammatory arthritis of the knee underwent pretherapeutic evaluation in a form of knee ultrasonogram, bone scan and clinical evaluation. Fifty-seven recruited patients were allocated at random to receive either intraarticular injections of Lu-177 tin colloid or Re-188 tin colloid. Eventually, 27 patients received Re-188 tin colloid and 30 patients received Lu-177 tin colloid. The joint was then immobilized for 2 days. Response evaluation was done using knee ultrasound, bone scan and clinical findings.

Result
Of 30, 20 patients responded to radiosynovectomy in the Lu-177 tin colloid group compared to 21/27 patients in the Re-188 tin colloid group.

Conclusion
Lu-177 tin colloid is an effective alternative to Re-188 tin colloid for radiosynovectomy in patients with chronic inflammatory knee arthritis.
Fecal Amino Acid Profiles Exceed Accuracy of Serum Amino Acids in Diagnosing Pediatric Inflammatory Bowel Disease
Authors: Bosch Sofie , El Manouni el Hassani Sofia , Brizzio Brentar Marina , Ayada Ibrahim , Bakkali Abdellatif , Jansen Erwin E.W. , Struys Eduard A. , Benninga Marc A. , de Boer Nanne K.H. , de Meij Tim G.J. 
Published: May 2020

ABSTRACTIn this prospective intention‐to‐diagnose pilot study, we aimed to assess accuracy of serum and fecal amino‐acids to discriminate de novo pediatric inflammatory bowel disease (IBD) and non‐IBD children. Patients with suspected IBD were allocated the IBD (n = 11) or non‐IBD group (n = 8) following laboratory testing or endoscopy according to the revised Porto‐criteria. Fecal calprotectin levels were obtained, an additional blood and fecal sample were collected. Fecal and serum amino‐acid profiles were analyzed using high performance‐liquid chromatography. Nine fecal amino‐acids (alanine [area under the curve 0.94], citrulline [0.94], glutamine [0.89], leucine [0.98], lysine [0.89], phenylalanine [0.99], serine [0.91], tyrosine [0.96], and valine [0.95]) differed significantly between IBD and non‐IBD. In serum, no significant differences were observed. This study underlines the potential of fecal amino‐acids as novel, adjuvant noninvasive, and low‐cost biomarkers in the diagnostic work‐up of pediatric IBD detection.
Pediatric Febrile Neutropenia: Change in Etiology of Bacteremia, Empiric Choice of Therapy and Clinical Outcomes
Authors: Alali Muayad , David Michael Z. , Danziger-Isakov Lara A. , Elmuti Lena , Bhagat Palak H. , Bartlett Allison H. 
Published: May 2020

Background:
The optimal choice of initial antibiotic therapy for patients with high-risk febrile neutropenia (FN) in children is unclear and varies by the institution on the basis of local antibiograms and epidemiology of specific pathogens. The authors evaluated the appropriateness of antibiotics for the empiric treatment of FN in pediatric patients with cancer in our institution on the basis of changes in the epidemiology of organisms isolated from blood cultures (BCx).

Methods:
The authors conducted a retrospective medical record review of pediatric patients who received any oncology care (including patients with cancer and patients who had stem cell transplant) at University of Chicago Medicine Comer Children’s Hospitals (March 2009 to December 2016) with a diagnosis of FN who had at least 1 BCx obtained. They reviewed pathogens isolated from BCx and determined whether they were pathogens or contaminants using the Infectious Diseases Society of America (IDSA) guidelines and the team’s decision to treat. They investigated the microbiologic spectrum and susceptibility patterns of pathogens causing bacteremia in pediatric FN and whether the empiric therapy chosen may have affected clinical outcomes.

Results:
A total of 667 FN episodes were identified in 268 patients. BCx were negative in 497 (74.5%) and were determined to be contaminants in 27 (4%). In 143 episodes (21.5%), the BCx were positive for a pathogenic species. Polymicrobial bacteremia was identified in 25 episodes; a total of 176 pathogens were isolated. The majority of pathogens (95/176, 54%) were Gram-positive (GP), whereas 64 of 162 (36%) were Gram-negative (GN), 5 were fungal, and 4 were mycobacterial. The most common GP pathogens were viridans group streptococci (VGS) (n=34, 19.3%), coagulase-negative staphylococci (n=25, 14%), and methicillin-susceptible Staphylococcus aureus (n=12, 6.8%). Of aerobic GN bacilli, 15 (8.5%) were AmpC producers and 3 (1.7%) carried extended-spectrum beta-lactamases. There was no increase in the prevalence of multidrug-resistant GN isolates during the study period. Patients with VGS and multidrug-resistant GN bacteremia were more likely to be admitted to the pediatric intensive care unit [odds ratio (OR), 3.24; P=0.017; and OR, 2.8; P=0.07, respectively]. There were trends toward a higher prevalence of GP pathogens causing bacteremia and the emergence of VGS with decreased penicillin sensitivity. The prevalence of bacteremia with VGS was higher in acute myelogenous leukemia and neuroblastoma (OR, 2.3; P<0.01) than in patients with other solid tumors.

Conclusions:
Empiric antibiotic treatment should be tailored to patients’ risk for VGS and multidrug-resistant organisms. Individual hospitals should monitor the pathogens causing FN among patients with cancer to guide choice of empiric therapy.