bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increase Risk of Dementia in Patients With Sudden Hearing Loss: A Population-Based Cohort Study With 7-Year Follow-Up in Taiwan
Authors: Lin Ching-Chun , Lin Herng-Ching , Chiu Hung-Wen 
Published: August 2020

Objective:
To investigate the prevalence and risk of subsequent dementia in subjects with sudden hearing loss during a 7-year follow-up period through comparisons with cohorts matched by sex, age group, and year of index date.

Study Design:
A retrospective matched-cohort study.

Setting:
The Longitudinal Health Insurance Database 2000 (LHID2000) in Taiwan.

Patients:
This study included a total of 11,148 subjects, including 1,858 in the study group and 9,290 in the comparison cohort group.

Intervention(s):
None.

Main Outcome Measure(s):
We analyzed the differences in sociodemographic characteristics and comorbidities between subjects with sudden hearing loss and the comparison cohort group. Then, we estimated the risk of dementia and also plotted the survival outcomes to evaluate differences in dementia-free survival rates between the two groups.

Results:
The dementia incidence rates per 1000 person-years were 20.45 and 8.15 for the subjects with sudden hearing loss and comparison cohorts, respectively. When we adjusted for the subjects’ characteristics, the hazard ratio for dementia was 1.69 (95% confidence interval [CI] = 1.06–2.68, p < 0.01) for subjects with sudden hearing loss compared with comparison cohorts during the follow-up period, and subjects with sudden hearing loss had lower 7-year dementia-free survival rates compared with comparison cohorts by using a log-rank test. Furthermore, male subjects with sudden hearing loss had a higher risk of dementia (adjusted hazard ratio [HR] = 2.11) than did the male comparison cohorts.

Conclusions:
This study revealed a relationship between sudden hearing loss and dementia in an Asian country. The risk of dementia was higher among patients with sudden hearing loss compared with matched cohorts during the 7-year follow-up period.
Feasibility and Efficacy of Vibrant Soundbridge Short Process Coupler in Patients With Aural Atresia
Authors: Alzhrani Farid , Halawani Roa , Yousef Medhat 
Published: August 2020

Objectives:
Different options are available for hearing restoration in patients with aural atresia. Middle ear implantation with the Vibrant Soundbridge (VSB) has been used successfully in many patients with aural atresia with conductive or mixed hearing loss. The aim of the current study was to assess the safety and the efficiency of VSBs coupled to the short process of the incus in patients with aural atresia with conductive or mixed hearing loss.

Methods:
The study was a retrospective chart review conducted at a tertiary university hospital. Audiological and surgical data from six ears with aural atresia implanted with VSBs coupled to the short process of the incus were analyzed. The audiological results were compared with previously reported results obtained after the utilization of different coupling techniques.

Results:
All six atretic ears were successfully implanted using the short process coupler, and there were no major complications. Postoperative bone conduction thresholds did not differ substantially from preoperative thresholds. The respective mean preoperative pure-tone average 4, speech reception threshold, and word recognition score values were 56.7 dB, 61.7 dB, and 44%. Postoperative pure-tone average 4 thresholds (25 ± 3.5 dB) and speech reception thresholds (20.8 ± 8 dB) were significantly improved. The maximum postoperative word recognition score achieved was 100%. The audiological outcomes obtained were similar to previously reported outcomes after classic stapes placement.

Conclusion:
Coupling of the floating mass transducer to the short process of the incus in patients with aural atresia resulted in significant audiological improvements that were comparable to previously reported improvements after placement via other methods.
Variants in the Enteric Smooth Muscle Actin γ‐2 Cause Pediatric Intestinal Pseudo‐obstruction in Chinese Patients
Authors: Wei Zhiliang , Lu Lina , Zheng Youjie , Yan Weihui , Tao Yijng , Xiao Yongtao , Cai Wei , Wang Ying 
Published: August 2020

ABSTRACTObjectives:Pediatric intestinal pseudo‐obstruction (PIPO) is a severe gastrointestinal disorder occurring in children, leading to failure to thrive, malnutrition, and long‐term parenteral nutrition dependence. Enteric smooth muscle actin γ‐2 (ACTG2) variants have been reported to be related to the pathogenesis of PIPO. This study aimed to determine the presence of ACTG2 variants in Chinese PIPO patients.Methods:Whole‐exome sequencing was performed using samples from 39 recruited patients, whereas whole ACTG2 Sanger sequencing was performed using samples from 2 patients. Published data was reviewed to determine the number of pathogenic variants and the genotype related to ACTG2 variants in the Chinese population.Results:A total of 21 Chinese probands were found to carry heterozygous missense variants of ACTG2, among which 20 were de novo. Fifteen probands had p.Arg257 variants (c.770G>A and c.769C>T), and the other 2 probands had c.533G>A (p.Arg178His) and c.443G>T (p.Arg148Leu) variants. Four probands had novel variants c.337C>T (p.Pro113Ser), c.588G>C (p.Glu196Asp), c.734A>G (p.Asp245Gly), and c.553G>T (p.Asp185Tyr).Conclusions:Variants affecting codon 257 of ACTG2 protein sequence appeared to be frequent in both Chinese and Caucasian PIPO patients, whereas p.Arg178 variants were less common in Chinese patients compared with Caucasian patients. The 4 novel variants in ACTG2 were also found to be related to Chinese PIPO.
National Recommendations for Infant and Young Child Feeding in the World Health Organization European Region
Authors: Koletzko Berthold , Hirsch Nathali Lehmann , Jewell Jo Martin , Dos Santos Quenia , Breda João , Fewtrell Mary , Weber Martin W. 
Published: August 2020

ABSTRACT

Objectives:
Complementary feeding should provide a healthy diet with critical nutrients for growth and development. Information is limited on child and infant feeding recommendations within the World Health Organization (WHO) European Region.

Methods:
The WHO Regional Office for Europe and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) performed a survey of national recommendations on infant and young child nutrition aimed at national government departments of health and national paediatric experts. Questions addressed national recommendations on breast-feeding and complementary feeding.

Results:
Information was available from 48 of the 53 Member States. Forty-five of 48 countries (94%) have national recommendations on infant and young child feeding, of which 41 are endorsed by official public health authorities. Regarding introduction of complementary feeding, 25 countries (out of 34, 74%) recommend 6 months of age as the ideal age. The earliest age of introduction recommended varies from 4 to 5 months in (31/38 countries, 82%) to 6 months (6/38, 16%) and 7 months (1/38, 2.6%). The recommended meal composition varies widely; introduction of iron-rich foods (meat, fish, eggs) at the age of 6 months is recommended in 30 out of 43 countries, whereas 13 (30%) recommend later introduction.

Conclusions:
National infant feeding recommendations vary widely between studied countries and partly differ from international recommendations. Too early introduction of complementary feeding can reduce duration of exclusive breast-feeding (EBF). Too late introduction of iron-rich complementary foods might increase anemia risk and adversely affect child development. A review and further harmonization of national recommendations appears desirable.
Electronic Health Record Workstation Single Sign-on
Authors: Gellert George A. , Ramirez Ricardo , Jacobs Walter J. , Maciaz Gabriel 
Published: August 2020

OBJECTIVE
The aim of this study was to quantify the impact of electronic health record (EHR) workstation single sign-on (SSO) for nurses.

BACKGROUND
SSO was implemented in 19 hospitals for expedited EHR access.

METHODS
Login durations before and after SSO implementation were compared, and the financial value of nursing time liberated from keyboard was estimated. Stratified analyses show time liberated and financial value by staffing level and system size.

RESULTS
First-of-shift login was reduced by 5.3 seconds (15.3%) and reconnect duration was reduced by 20.4 seconds (69.9%). SSO liberated 27,962.4 hours of nursing time from keyboard login per year across 19 facilities, and 1,471.7 hours/year/facility, valued at $52,112/facility and $990,128 for 19 hospitals. Time value ranges from $201,835 per year for a 5-hospital system with 300 nurses per facility to $672,790 per year for a 10-facility system with 500 nurses per hospital.

CONCLUSIONS
Nurses gained substantial time liberated from EHR keyboard by SSO for patient care, having significant financial value for the organization.
Health Profession Students’ Awareness, Knowledge, and Confidence Regarding Preexposure Prophylaxis: Results of a National, Multidisciplinary Survey
Authors: Bunting Samuel R. , Garber Sarah S. , Goldstein Robert H. , Calabrese Sarah K. , Ritchie Timothy D. , Batteson Tamzin J. 
Published: August 2020

Background
Preexposure prophylaxis (PrEP) is a highly effective, pharmacologic method of HIV prevention. Despite its safety and efficacy, PrEP prescription remains low in those patients who are at highest risk for HIV infection. One possible reason for this may be the lack of inclusion of PrEP and HIV prevention discussions within the curricula of health professions education.

Methods
An online survey was administered to a cross-sectional sample of future prescribers (osteopathic/allopathic medical and physician assistant students), future nurses, and future pharmacists (n = 2085) in the United States between January and July 2019 to assess and compare awareness of PrEP, PrEP education, PrEP knowledge, and confidence in 2 areas related to PrEP.

Results
We show that, overall, awareness of PrEP is high among future health care providers (81.6%), with the future pharmacists reporting the greatest awareness (92.2%; P < 0.001) and more commonly reporting PrEP education (71.0%). Students had mixed knowledge of PrEP, with future pharmacists reporting the highest knowledge of PrEP. Approximately 30% of students in all disciplines reported having low confidence counseling a patient about PrEP and low confidence educating a colleague about PrEP. Knowledge of PrEP was a significant predictor of confidence counseling a patient about PrEP (P < 0.001) and educating a colleague about PrEP (P < 0.001).

Conclusions
This study identifies opportunities to improve and incorporate evidence-based strategies for educating future health care providers about PrEP for HIV prevention within health professions curricula.
Estimating the Direct Medical Outpatient Costs of Diagnosis and Treatment of Trichomoniasis Among Commercially Insured Patients in the United States, 2016 to 2018
Authors: Kumar Sagar , Chesson Harrell , Gift Thomas L. 
Published: August 2020

Abstract
We used 2016–2018 outpatient claims data to calculate direct outpatient medical costs per case of trichomoniasis in 2019 US dollars. The outpatient, drug, and total costs per treated case of trichomoniasis were $174, $39, and $213, respectively. Total costs were higher for female patients ($220) than for male patients ($158).
Restoring Immunization Services Provided by the Vaccines for Children Program in Puerto Rico After Hurricanes Irma and Maria, 2017-2019
Authors: Luna-Pinto S. Carolina , Rivera Angel , Cardona Iris , Rijo Candelaria , Alvarez Veronica , Rodriguez Jesus , Yoerg Broderick , Shapiro Craig N. , Patel Anita 
Published: August 2020

Context:
In September 2017, Hurricanes Irma and Maria impacted Puerto Rico, causing significant disruption of immunization services and vaccine losses due to widespread infrastructure and electrical grid damage and resulting cold chain failures.

Objective:
To describe posthurricane efforts undertaken to restore and strengthen immunization services provided by Puerto Rico's federally funded Vaccines for Children (VFC) Program, a network of clinics that provide vaccines to eligible children.

Design:
Historical records were reviewed to characterize Puerto Rico's prehurricane immunization system. Site visits to assess VFC clinic posthurricane operational status were conducted by the Puerto Rico Department of Health, working with the Centers for Disease Control and Prevention and other partners. Infrastructure repair and acquisition of backup generators, temperature data loggers, and replacement vaccines were carried out to restore operations.

Results:
Prior to the hurricanes, 224 VFC clinics throughout the island provided immunizations. An initial assessment 10 days after Hurricane Maria showed that only 11 (5%) of the clinics were operational. Reasons included ongoing power outages; difficulties in obtaining generator fuel; equipment or facility damage; and damaged vaccines. The VFC clinics were restored incrementally; 123 (55%) were operational by December 2017, 193 (86%) by May 2018, and 204 (91%) by May 2019. Long-term recovery activities are underway and focus on strengthening Puerto Rico's immunization system to withstand future disasters, including improving backup power systems.

Conclusion:
Through coordinated efforts of the Puerto Rico Department of Health, the Centers for Disease Control and Prevention, and other partners, the operational status of VFC clinics posthurricanes was assessed and operations restored. Emergency plans for vaccine storage and handling, which called for alternative vaccine storage locations and backup generators, were inadequate to address disasters of the magnitude of Hurricanes Irma and Maria; such plans need to consider the possibility of large-scale disasters that result in long-term power outages.
Mixed-Methods Evaluation of the Washington State Practice Transformation Support Hub
Authors: Kwan-Gett Tao Sheng , Albertson Elaine Michelle , Banks Jordan , Revere Debra , Rogers Megan , Baseman Janet , Andris Lydia , Conrad Douglas 
Published: August 2020

Purpose:
Practice transformation initiatives have the potential to promote collaborations between public health, primary care, and behavioral health, but limited empirical evidence is available on how these programs affect participating clinical practices.

Objective:
To report the findings from a mixed-methods program evaluation of the Washington Practice Transformation Support Hub (Hub), a publicly funded, multicomponent practice transformation initiative in Washington State.

Design:
We used quantitative and qualitative methods to evaluate the impact of Hub activities on participating primary care and behavioral health practices. Pre- and posttest survey data were combined with administrative program data to understand the effect of program components. Qualitative interviews contextualized findings.

Setting:
Urban and rural primary care and behavioral health practices in Washington State.

Participants:
One hundred seventy-five practices that were recruited to receive Hub coaching and facilitation from 8 coaches; of these, 13 practices and all coaches participated in key informant interviews.

Intervention:
Practice coaching and facilitation supported by an online resource portal, from January 2017 through January 2019.

Main Outcome Measures:
Self-reported progress in specific activities in 3 practice-level domains: bidirectional integration of physical and behavioral health care (care integration); alignment with community-based services for whole-person care (clinical-community linkages); and value-based payment.

Results:
Participation in Hub activities was associated with improvements in care integration and clinical-community linkages but not with progress toward value-based payment. Qualitative results indicated that practice progress was influenced by communication with practices, the culture of the practice, resource constraints (particularly in rural areas), and perceptions about sustainability.

Conclusions:
This statewide practice transformation initiative was successful in strengthening primary care and behavioral health integration and clinical-community linkages among participating practices but not value-based payment. Future practice transformation efforts may benefit from addressing barriers posed by communication, limited application of value-based payment, culture change, competing priorities, and resource limitations, particularly for rural communities.
Feasibility and Safety of Laparoscopic Treatment for Early and T3 Stage Gallbladder Cancer: A Systematic Review
Authors: Zhang Wei , Che Xu 
Published: August 2020

Background:
Effect of laparoscopic approach in the treatment of gallbladder cancer (GBC) is still controversial.

Materials and Methods:
Literature published before December 2019 was retrieved from PubMed, EMBASE, and Cochrane Library databases for a comparative study between laparoscopic group (LG) and open group (OG) for GBC. Revman 5.3 statistical software was used for analysis.

Results:
Nine comparative studies were eligible and included 654 patients, 287 were in LG and 367 were in OG. Meta-analysis showed that the operation time, estimated blood loss, drainage tube time, and hospitalization time after LG were significantly less than those in the OG [weighted mean difference (WMD)=−27.5; 95% confidence interval (CI), −36.6 to −18.4; P<0.00001; WMD=−267.56, 95% CI, −372.25 to −162.86; P<0.00001; WMD=−1.35; 95% CI, −2.26 to −0.44; P=0.004; WMD=−6.44; 95% CI,−9.07 to −3.81; P<0.00001, respectively). There was no significant difference between LG and OG in postoperative complications, mortality, lymph node dissection, R0 rate, scar recurrence, recurrence, and the 3- and 5-year overall survival (OS) rates. The 1-year OS of all patients, and the 1- and 2-year OS of patients with T3 tumors in the LG were significantly better than those in the OG [relative risk (RR)=1.11; 95% CI, 1.01 to 1.22; P=0.04; RR=1.46; 95% CI, 1.03 to 2.08, P=0.04 and RR=1.71; 95% CI, 1.02 to 2.84; P=0.04, respectively].

Conclusions:
The safety and efficacy of LG for early GBC is comparable to OG, and to some extent, it can reduce operation time, estimated blood loss, drainage tube time, and hospitalization time, and have a higher 1-year OS. Patients in T3 stage may have a longer survival by LC, however, this conclusion still needs to be validated by more high-quality clinical studies, especially prospective randomized controlled trials.
SARS-Cov-2-, HIV-1-, Ebola-neutralizing and anti-PD1 clones are predisposed
Authors: Zhang Yanfang , Xu Qingxian , Zeng Huikun , Wang Minhui , Zhang Yanxia , Lan Chunhong , Yang Xiujia , Zhu Yan , Chen Yuan , Wang Qilong , Tang Haipei , Zhang Yan , Wu Jiaqi , Wang Chengrui , Xie Wenxi , Ma Cuiyu , Guan Junjie , Guo Shixin , Chen Sen , Chang Changqing , Yang Wei , Wei Lai , Ren Jian , Yu Xueqing , Zhang Zhenhai 
Published: August 2020

AbstractAntibody repertoire refers to the totality of the superbly diversified antibodies within an individual to cope with the vast array of possible pathogens. Despite this extreme diversity, antibodies of the same clonotype, namely public clones, have been discovered among individuals. Although some public clones could be explained by antibody convergence, public clones in naïve repertoire or virus-neutralizing clones from not infected people were also discovered. All these findings indicated that public clones might not occur by random and they might exert essential functions. However, the frequencies and functions of public clones in a population have never been studied. Here, we integrated 2,449 Rep-seq datasets from 767 donors and discovered 5.07 million public clones – ~10% of the repertoire are public in population. We found 38 therapeutic clones out of 3,390 annotated public clones including anti-PD1 clones in healthy people. Moreover, we also revealed clones neutralizing SARS-CoV-2, Ebola, and HIV-1 viruses in healthy individuals. Our result demonstrated that these clones are predisposed in the human antibody repertoire and may exert critical functions during particular immunological stimuli and consequently benefit the donors. We also implemented RAPID – aRep-seqAnalysisPlatform withIntegratedDatabases, which may serve as a useful tool for others in the field.
COVID-19 among nursing staff: Settings and regional differences
Authors: Hoedl Manuela , Bauer Silvia , Eglseer Doris 
Published: August 2020

AbstractPurposeThis study was carried out to describe settings of and regional differences in the occurrence of COVID-19 among nursing staff, analysing COVID-19 symptoms, testing and diagnosis procedures.DesignWe used an online survey to conduct this cross-sectional study among nursing staff in different settings. Data collection was carried out between 12 May and 13 July 2020.MethodsThe survey included questions that allowed us to collect demographic data (e.g. age), professional qualifications (e.g. nurse, nurse aid) and data regarding the federal states and settings in which the participants worked. In additon, we asked the participants to describe their COVID-19 symptoms, if any were experienced, and the result of COVID-19 testing that they underwent. We used descriptive statistics as well as bivariate analysis methods to calculate differences.FindingsMore than 80% of the nursing staff (N = 2600) were women, nearly half of these staff members worked in the province of Styria and about three-quarters worked in hospitals. In general, nearly every sixth nurse reported experiencing COVID-19 symptoms. We found statistically significant differences between the settings and the federal provinces with regard to the COVID-19 symptoms reported, but not the test results. The highest porportion of nurses who experienced symptoms worked in lower Austria and in the primary care sector. In total, 1.6% of the participating nurses were tested for COVID-19, as well as about 1% of the nurses who worked in the nursing homes. The highest number of tests were carried out in Vienna followed by the province of Burgenland. In total, all of the nurses who underwent testing were diagnosed with COVID-19.ConclusionsOnly 1% of the nurses who worked in nursing homes were tested. This group of nurses takes care of the most vulnerable and high-risk group in Austrian society.Therefore, the nursing home staff should have the possibility to be tested even though they did not experience/report any symptoms. The highest prorportion of nurses who experienced symptoms worked in the primary care sector. In the future during a pandemic, health care staff should be comprehensively tested in all settings.Clinical RelevanceProviding insights into COVID-19 symptoms experienced by nursing staff workforce and testing for COVID-19 can help us address these aspects in future pandemics more efficiently. In addition, these insights can help to shift the perspectives from critical and acute settings to other settings, e.g. nursing homes. This is an important change in perspectives, as these nurses have worked with the most vulnerable and high-risk group during the COVID-19 pandemic. Ensuring the safety of nursing home residents and providing, high-quality nursing care and interventions can reduce hospital admission rates, decrease health care costs during such pandemics and might even reduce secondary morbidity and mortality.