bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between the time required for transfer and outcomes in patients with appendicitis
Authors: Ko Ryoung Eun , Park Se Jin , Kim Ho Seung 
Published: October 2019

Abstract
A few studies have compared patients who were directly admitted with patients who were transferred to a tertiary facility for an appendectomy. However, there have been no reports of an association between the time to transfer and outcome in patients who underwent an appendectomy. As the only tertiary military hospital in South Korea, we occasionally encountered patients who were delayed for transfer due to the military environment. We hypothesize that patients with a longer time to transfer have a worse outcome. This study aimed to evaluate the relationship between the time to transfer and the outcome of patients who underwent an appendectomy.
Patients who underwent appendectomy in the tertiary military hospital in South Korea from May 2015 to April 2017 were analyzed retrospectively. The groups were divided by the time for the transfer. Four hours was used as the cut-off point to divide the early and delayed transfer groups. Time from symptom onset to hospitalization, time from diagnosis to surgery, and time from hospitalization to surgery were also analyzed to assess the effect of time for the transfer.
A total of 449 patients were analyzed: 293 with direct admission, 110 with early transfer, and 46 with delayed transfer. The time required for transfer was more critical for delaying appendectomy than the time from hospital admission to surgery. There was no difference in outcomes among the groups. When patients were compared according to the perforation, no differences were found in time from hospitalization to surgery, time from diagnosis to surgery, and presence of transfer. Multivariate analysis showed that a greater than 72 hours delay from symptom onset to hospitalization was associated with perforation (odds ratio = 12.61; 95% confidence interval: 3.84–41.40; P < .001).
Even if a long transfer time is necessary, an appendectomy can be performed safely if patients were administered antibiotics immediately after diagnosis.
Impact of trauma designation levels on survival of drowning victims
Authors: Dakessian Alik , Bachir Rana , El Sayed Mazen 
Published: October 2019

Abstract
Drowning causes significant morbidity and mortality. Healthcare regionalization aims at improving patient outcomes. This study examines the impact of trauma center level designation on survival of drowning victims.
Retrospective cohort study utilizing the National Trauma Data Bank (NTDB) 2015. Descriptive, bivariate and multivariate analyses were conducted.
The 212 patients were included. Mean age was 33.58 (±20.02) years with 69.3% (n = 147) males. Patients were mostly taken to Level I (n = 107, 50.5%) and II (n = 81, 32.8%) centers, requiring admission (43.5% (n = 96), 23.1% (n = 49) and 8.5% (n = 18) to Intensive Care, floor, and Operating Room, respectively). Overall hospital discharge survival was 83.5% (n = 177). After adjusting for confounders, there was no significant difference in survival of patients taken to Level I compared to Level II and III centers.
This study did not identify a survival benefit for patients with drowning related injuries when taken to Level I compared to Level II or III Trauma centers. Further outcome studies are needed in organized trauma systems to improve field triage criteria for specific injury mechanisms.
Assessing the Validity of Adult‐derived Prognostic Models for Primary Sclerosing Cholangitis Outcomes in Children
Authors: Deneau Mark R. , Valentino Pamela L. , Mack Cara , Alqoaer Khaled , Amin Mansi , Amir Achiya Z. , Aumar Madeleine , Auth Marcus , Broderick Annemarie , DiGuglielmo Matthew , Draijer Laura G. , El‐Matary Wael , Ferrari Federica , Furuya Katryn N. , Gottrand Frederic , Gupta Nitika , Homan Matjaz , Jensen M.K. , Kamath Binita M. , Kim Kyung Mo , Kolho Kaija‐Leena , Koot Bart , Iorio Raffaele , Martinez Mercedes , Miloh Tamir , Mohan Parvathi , Palle Sirish , Papadopoulou Alexandra , Ricciuto Amanda , Saubermann Lawrence , Sathya Pushpa , Shteyer Eyal , Smolka Vratislav , Tanaka Atsushi , Varier Raghu , Venkat Veena , Vitola Bernadette , Woynarowski Marek , Guthery Stephen 
Published: October 2019

ABSTRACTBackground:Natural history models for primary sclerosing cholangitis (PSC) are derived from adult patient data, but have never been validated in children. It is unclear how accurate such models are for children with PSC.Methods:We utilized the pediatric PSC consortium database to assess the Revised Mayo Clinic, Amsterdam‐Oxford, and Boberg models. We calculated the risk stratum and predicted survival for each patient within each model using patient data at PSC diagnosis, and compared it with observed survival. We evaluated model fit using the c‐statistic.Results:Model fit was good at 1 year (c‐statistics 0.93, 0.87, 0.82) and fair at 10 years (0.78, 0.75, 0.69) in the Mayo, Boberg, and Amsterdam‐Oxford models, respectively. The Mayo model correctly classified most children as low risk, whereas the Amsterdam‐Oxford model incorrectly classified most as high risk. All of the models underestimated survival of patients classified as high risk. Albumin, bilirubin, AST, and platelets were most associated with outcomes. Autoimmune hepatitis was more prevalent in higher risk groups, and over‐weighting of AST in these patients accounted for the observed versus predicted survival discrepancy.Conclusions:All 3 models offered good short‐term discrimination of outcomes but only fair long‐term discrimination. None of the models account for the high prevalence of features of autoimmune hepatitis overlap in children and the associated elevated aminotransferases. A pediatric‐specific model is needed. AST, bilirubin, albumin, and platelets will be important predictors, but must be weighted to account for the unique features of PSC in children.
Neonatal Intestinal Failure Is Independently Associated With Impaired Cognitive Development Later in Childhood
Authors: Gunnar Riikka J. , Kanerva Kaisa , Salmi Silja , Häyrinen Taru , Haataja Leena , Pakarinen Mikko P. , Merras‐Salmio Laura 
Published: October 2019

ABSTRACTObjective:The impact of pediatric intestinal failure (IF) on neurodevelopment beyond infancy has not been systematically studied. Our aim was to evaluate cognitive and motor impairment and to identify risk factors for adverse outcomes among children with IF.Methods:We conducted a cross‐sectional single‐center study at the Helsinki University Children's Hospital. Patients with IF with >60 days of parental nutrition (PN) dependency aged between 3 and 16 years (n = 40) were invited to participate. The cognitive and motor skills were evaluated using validated tests: Wechsler Preschool and Primary Scale of Intelligence, 3rd edition, Wechsler Intelligence Scale for Children, 4th edition, and Movement Assessment Battery for Children, 2nd edition.Results:All the patients attending the study tests (n = 30, males = 24) were included. Their median age, gestational age, and birth weight was 7.5 (range 3–16) years, 35 (interquartile range [IQR] 28–38) weeks and 2238 (IQR 1040–3288) grams, respectively. Median duration of PN was 13 (IQR 5–37) months and 9 patients were currently on PN. Median intelligence quotient was 78 (IQR 65–91) and 10 (35%) patients had an intelligence quotient under 70 (−2 standard deviation). Significant motor impairment was detected in 10 patients (36%) and milder difficulties in 8 (28%). Adverse cognitive outcome was associated with neonatal short bowel syndrome, number of interventions under general anesthesia, and length of inpatient status, whereas adverse motor outcome was associated with prematurity.Conclusion:Clinically significant cognitive and motor impairments are alarmingly common among neonatal patients with IF. We recommend early neurodevelopmental follow‐up for all children with IF.
Parent IMPACT‐III
Authors: Cushman Grace K. , Stolz Mary Gray , Shih Sharon , Blount Ronald , Otley Anthony , Talmadge Clair , Grant Amy , Reed Bonney 
Published: October 2019

ABSTRACTObjectives:The present study aimed to validate the parent‐proxy IMPACT‐III (IMPACT‐III‐P) in a sample of youth diagnosed with inflammatory bowel disease (IBD). Parent‐proxy report measures are standard for pediatric psychosocial assessment, and the IMPACT‐III‐P will provide a more comprehensive representation of HRQOL. Reliability and validity analyses were conducted.Methods:Parents (N = 50) of youth 8 to 17 years with IBD reported on their child's HRQOL (IMPACT‐III‐P and PedsQL‐4.0) and depression (BASC‐2); youth reported on their HRQOL (child IMPACT‐III), pain interference (PROMIS Pain Interference), and disease symptoms; and physicians completed measures of disease activity.Results:Criterion validity was established as the IMPACT‐III‐P was strongly, positively associated with the PedsQL (r = 0.59, P < 0.001). Convergent validity was supported as higher IMPACT‐III‐P scores were associated with less pain interference (r = −0.41, P < 0.01) and lower depression (r = −0.41, P < 0.01). Discriminant validity was partially supported, as higher IMPACT‐III‐P scores were associated with lower child‐reported symptoms (r = −0.41, P < 0.01), but scores did not differ based on inactive, mild, or moderate/severe disease activity groups as rated by physicians. Internal consistency, parent‐child agreement, and item‐level analyses revealed strong reliability.Conclusions:The IMPACT‐III‐P demonstrated strong validity and reliability. Parents and children had similar reports of HRQOL, with parents rating child HRQOL slightly lower. Findings support the use of the IMPACT‐III‐P for youth 8 to 17 years old to use in accordance with the child IMPACT‐III to provide valuable information regarding HRQOL in youth with IBD.
Awareness and Perceived Accuracy of Undetectable = Untransmittable: A Cross-Sectional Analysis With Implications for Treatment as Prevention Among Young Men Who Have Sex With Men
Authors: Meanley Steven , Connochie Daniel , Bonett Stephen , Flores Dalmacio D. , Bauermeister José A. 
Published: October 2019

Abstract

The Undetectable = Untransmittable (U=U) campaign was launched in 2016 to simultaneously reduce human immunodeficiency virus (HIV) stigma and raise awareness about treatment as prevention. This research note assesses HIV-negative young men who have sex with men's U=U awareness and perceived accuracy to inform this population's combination HIV prevention strategies.
Provider Consensus on Candidate Protective and Risk Factors for Adverse Psychosocial Outcomes Following Discharge From a PICU: A Modified Delphi Study*
Authors: Williams Conrad S. P. , Grossoehme Daniel H. , Forbes Michael L. , Friebert Sarah 
Published: October 2019

Objectives:Pediatric palliative care promotes interdisciplinary, family-centered care when children are faced with diagnoses threatening length and/or quality of life. A significant knowledge gap remains in how to best match pediatric palliative care resources to palliate the psychosocial impact of a PICU admission. This study was designed to identify drivers of adverse post-PICU psychosocial outcomes related to social determinants of health to inform pediatric palliative care services and improve post-PICU psychosocial outcomes.Design:Modified Delphi technique to develop consensus regarding social determinants of health and clinical factors affecting post-ICU psychosocial outcomes.Setting:All Delphi rounds were via an electronically mailed survey link.Subjects:First-round participants were PICU and pediatric palliative care clinicians at the study institution. Subsequent rounds invited participants from national PICU and pediatric palliative care professional online listserves.Interventions:None.Measurements and Main Results:Consensus was defined a priori as items assigned a score greater than or equal to 4 (5-point scale) by greater than75% of respondents. One-hundred twenty-six surveys were returned and scored. Social determinants of health risk factors included child protective services involvement (91%), caregiver with intellectual disability (87%), lack of friend or family support (82%), caregiver with behavioral health diagnosis (81%), teenage caregiver (79%), transportation challenges (79%), and language/cultural barrier (76%). Clinical risk factors included new home ventilator (94%), new tracheostomy (90%), greater than or equal to 3 hospitalizations in the prior 6 months (88%), and greater than or equal to 3 hospitalizations in the prior 12 months (82%). Social determinants of health protective factors included extended family support (91%), caregivers in a committed relationship (79%), and caregiver optimism (78%). Respondents reported that pediatric palliative care services had the greatest impact on caregiver satisfaction with the healthcare system (90%) and increased family involvement with state social services programs (80%).Conclusions:Consensus on candidate risk and protective factors for post-ICU psychosocial challenges and candidate pediatric palliative care-sensitive variables were identified. Further research is needed to operationalize and optimize a screening tool based on these consensus items and test it prospectively.
Pulmonary Artery/Vein Separation Using Single-Phase Computed Tomography
Authors: Ichikawa Shota , Yamamoto Hiroyuki , Ito Osamu , Fukunaga Masaaki 
Published: October 2019

Purpose:
The purpose of this article was to verify the usefulness and feasibility of a single-phase scan for pulmonary artery/vein separation using a bolus-tracking technique and to evaluate the influence of patient characteristics on differentiation of computed tomography (CT) values between arteries and veins.

Material and Methods:
A total of 79 patients (60 male individuals and 19 female individuals, mean age 70 y) with suspected lung cancers or metastasis underwent contrast-enhanced chest CT and ultrasonic echocardiography. The CT values of the pulmonary arteries and veins were measured, and the difference in CT values was calculated. The relationships between the difference in CT values and age, weight, height, body surface area, body mass index, cardiac output, cardiac index, trigger time, trigger CT value, and pulmonary transit time were investigated using univariate linear regression analysis.

Results:
The CT values were 352.8±87.3 HU and 494.6±76.5 HU for the pulmonary arteries and veins, respectively (P<0.001). A significant but weak correlation was seen between the difference in CT values and the height (r=0.24), trigger time (r=0.35), cardiac index (r=−0.25), and pulmonary transit time (r=0.53) (P<0.05). There was no significant correlation between the difference in CT values and the remaining values.

Conclusion:
The single-phase scan protocol using a bolus-tracking technique is feasible to differentiate CT values between pulmonary arteries and veins. The influence of patient characteristics on the differentiation of CT values lacks impact. Thus, the suggested protocol may be suitable independent of these factors after further validation.
Incidence and Risk Factors of Obesity in Childhood Solid-Organ Transplant Recipients
Authors: Bondi Bianca C. , Banh Tonny M. , Vasilevska-Ristovska Jovanka , Szpindel Aliya , Chanchlani Rahul , Hebert Diane , Solomon Melinda , Dipchand Anne I. , Kim S. Joseph , Ng Vicky L. , Parekh Rulan S. 
Published: October 2019

Background.
Obesity is a significant public health concern; however, the incidence post solid-organ transplantation is not well reported.

Methods.
This study determined the incidence and risk factors of obesity among pediatric solid-organ transplant recipients (heart, lung, liver, kidney, multiorgan) at The Hospital for Sick Children (2002–2011), excluding prevalent obesity. Follow-up occurred from transplantation until development of obesity, last follow-up, or end of study. Incidence of obesity was determined overall, by baseline body mass index, and organ group. Risk factors were assessed using Cox proportional-hazards regression.

Results.
Among 410 (55% male) children, median transplant age was 8.9 (interquartile range [IQR]: 1.0-14.5) years. Median follow-up time was 3.6 (IQR: 1.5-6.4) years. Incidence of obesity was 65.2 (95% confidence interval [CI]: 52.7-80.4) per 1000 person-years. Overweight recipients had a higher incidence, 190.4 (95% CI: 114.8-315.8) per 1000 person-years, than nonoverweight recipients, 56.1 (95% CI: 44.3-71.1). Cumulative incidence of obesity 5-years posttransplant was 24.1%. Kidney relative to heart recipients had the highest risk (3.13 adjusted hazard ratio [aHR]; 95% CI: 1.53-6.40) for obesity. Lung and liver recipients had similar rates to heart recipients. Those with higher baseline body mass index (z-score; 1.72 aHR; 95% CI: 1.39-2.14), overweight status (2.63 HR; 95% CI: 1.71-4.04), and younger transplant age (y; 1.18 aHR; 95% CI: 1.12-1.25) were at highest risk of obesity. Higher cumulative steroid dosage (per 10 mg/kg) was associated with increased risk of obesity after adjustment.

Conclusions.
Among all transplanted children at The Hospital for Sick Children, 25% developed obesity within 5-years posttransplant. Kidney recipients, younger children, those overweight at transplant, and those with higher cumulative steroid use (per 10 mg/kg) were at greatest risk. Early screening and intervention for obesity are important preventative strategies.
Translation and Validation of 10/66 Dementia Diagnostic Battery in Urdu in Karachi, Pakistan
Authors: Khan Qurat ul ain , Prince Martin J. , Khalid Wardah , Zulfiqar Maryam 
Published: October 2019

Purpose:
The 10/66 dementia research group (DRG) diagnostic tool was devised to diagnose dementia in people with low education in low and middle-income countries. This study aimed to validate the 10/66 DRG tool in Urdu in Pakistan.

Methodology:
People older than or equal to 60 years were included: (1) With normal cognition: no/low education, high education, and depression; (2) People with mild and moderate dementia. The diagnostic and statistical manual IV-TR clinician diagnosis was used as the gold standard for dementia. The Clinician Dementia Rating scale was used to rate dementia severity. The geriatric mental status AGECAT stage I output was used to diagnose depression. The 10/66 battery was comprised of CSI-D (cognitive screening instrument for dementia), CERAD (consortium to establish a registry of Alzheimer disease), and animal naming test.

Result:
The sensitivity and specificity of CSI-D COG score for diagnosing dementia was 86.7% and 72.1%, for CSI-D DF score was 71.1% and 96.1%, for CERAD-10 word list delayed recall was 85.9% and 62.2% at a cut point of ≥5 words, and 70.3% and 97.7% for 10/66 diagnostic algorithm.

Conclusions:
The 10/66 DRG tool is a valid instrument for diagnosing dementia in the Urdu-speaking population, including with low education and depression, in Pakistan.
Overview of EEG Montages and Principles of Localization
Authors: Acharya Jayant N. , Acharya Vinita J. 
Published: October 2019

Summary:
Montages are logical, orderly arrangements of electroencephalographic derivations or channels that are created to display activity over the entire head and to provide lateralizing and localizing information. Most often, bipolar and referential montages are used for routine electroencephalographic recordings. Common average and Laplacian montages can also be helpful in some situations. Because each type of montage has certain strengths and limitations, the ACNS guidelines recommend the use of multiple classes of montages for each electroencephalographic recording. A variety of factors need to be considered for localization by scalp electroencephalogram, but in clinical practice, a three-step approach can be used to localize an interictal epileptiform discharge by visual inspection using a standard set of scalp electrodes and conventional montages. The ACNS guideline provides a number of standard and suggested montages, but, depending on the clinical situation, additional montages can be designed using the electrodes within the 10-20 system or by placing additional electrodes.
Montages for Noninvasive EEG Recording
Authors: Kutluay Ekrem , Kalamangalam Giridhar P. 
Published: October 2019

Summary:
Identifying the localization, distribution, and polarity of waveforms are the prime goals of clinical scalp EEG analysis. Appropriate choices of bipolar and referential montages are keys to emphasizing the diagnostic features of interest, and demand some understanding of the spatiotemporal physical behavior of the underlying neuronal generators. Several examples drawn from canonical epilepsy syndromes are used to illustrate this general message.
Investigating face and house discrimination at foveal to parafoveal locations reveals category-specific characteristics
Authors: Kreichman Olga , Bonneh Yoram , Gilaie-Dotan Sharon 
Published: October 2019

AbstractSince perceptual and neural face sensitivity is associated with a foveal bias, and neural place sensitivity is associated with a peripheral bias (integration over space), we hypothesized that face perception ability will decline more with eccentricity than place perception ability. We also hypothesized that face perception ability may show an upper visual field (UVF) bias due to the proximity of face-related regions to UVF retinotopic representations, and a left visual field (LeVF) bias due to earlier reports suggesting right hemisphere dominance for faces. Participants performed foveal and parafoveal face and house discrimination tasks for upright or inverted stimuli (≤ 4°) while their eye movements were monitored. Low-level visual tasks were also measured. The eccentricity-related accuracy reductions were evident for all categories. Through detailed analyses we found (i) a robust face inversion effect across the parafovea, while for houses an opposite effect was found, (ii) higher eccentricity-related sensitivity for face performance than for house performance (via inverted vs. upright within-category eccentricity-driven reductions), (iii) within-category but not across-category performance associations across eccentricities, and (iv) no hemifield biases. Our central to parafoveal investigations suggest that high-level vision processing may be reflected in behavioural performance.
Reconstruction of fish allergenicity from the content and structural traits of the component β-parvalbumin isoforms
Authors: Pérez-Tavarez Raquel , Carrera Mónica , Pedrosa María , Quirce Santiago , Rodriguez-Perez Rosa , Gasset María 
Published: October 2019

ABSTRACTMost fish-allergic patients have anti-β-parvalbumin (β-PV) immunoglobulin E (IgE), which cross-reacts among fish species with variable clinical effects. Although the β-PV load is considered a determinant for allergenicity, fish species express distinct β-PV isoforms with unknown pathogenic contributions. To identify the role various parameters play in allergenicity, we have takenGadus morhuaandScomber japonicusmodels, determined their β-PV isoform composition and analyzed the interaction of the IgE from fish-allergic patient sera with these different conformations. We found that each fish species contains a major and a minor isoform, with the total PV content four times higher inGadus morhuathan inScomber japonicus. The isoforms showing the best IgE recognition displayed protease-sensitive globular folds, and if forming amyloids, they were not immunoreactive. Of the isoforms displaying stable globular folds, one was not recognized by IgE under any of the conditions, and the other formed highly immunoreactive amyloids. The results showed thatGadus morhuamuscles are equipped with an isoform combination and content that ensures the IgE recognition of all PV folds, whereas the allergenic load ofScomber japonicusis under the control of proteolysis. We conclude that the consideration of isoform properties and content may improve the explanation of fish species allergenicity differences.