bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence for Altered Metabolism of Sphingosine-1-Phosphate in the Corpus Callosum of Patients with Schizophrenia
Authors: Esaki Kayoko , Balan Shabeesh , Iwayama Yoshimi , Shimamoto-Mitsuyama Chie , Hirabayashi Yoshio , Dean Brian , Yoshikawa Takeo 
Published: April 2020

AbstractThe disturbed integrity of myelin and white matter, along with dysregulation of the lipid metabolism, may be involved in schizophrenia pathophysiology. Considering the crucial role of sphingolipids in neurodevelopment, particularly in oligodendrocyte differentiation and myelination, we examined the role of sphingolipid dynamics in the pathophysiology of schizophrenia. We performed targeted mass spectrometry-based analysis of sphingolipids from the cortical area and corpus callosum of postmortem brain samples from patients with schizophrenia and controls. We observed lower sphingosine-1-phosphate (S1P) levels, specifically in the corpus callosum of patients with schizophrenia, but not in major depressive disorder or bipolar disorder, when compared with the controls. Patient data and animal studies showed that antipsychotic intake did not contribute to the lowered S1P levels. We also found that lowered S1P levels in the corpus callosum of patients with schizophrenia may stem from the upregulation of genes for S1P-degrading enzymes; higher expression of genes for S1P receptors suggested a potential compensatory mechanism for the lowered S1P levels. A higher ratio of the sum of sphingosine and ceramide to S1P, which can induce apoptosis and cell-cycle arrest, was also observed in the samples of patients with schizophrenia than in controls. These results suggest that an altered S1P metabolism may underlie the deficits in oligodendrocyte differentiation and myelin formation, leading to the structural and molecular abnormalities of white matter reported in schizophrenia. Our findings may pave the way toward a novel therapeutic strategy.
Methods to Decrease Disparities in Age of Autism Diagnosis and Treatment Access among Latinx Children
Authors: Lopez Kristina , Marroquin Jessica M , Gutierrez Courtney 
Published: April 2020

Abstract
Autism spectrum disorder (ASD) affects a substantial number of individuals and their families. Early diagnosis followed by intensive behavioral services is critical to reducing social communication deficits and behavioral challenges. Research has continually demonstrated health disparities with Latinx families that perpetuate lower ASD prevalence rates, later ASD diagnosis, and limited access to treatment compared with white children. Moreover, Latinx children who are diagnosed with ASD receive less intense and fewer treatment services. Given the number of Latinx children and those with ASD, social workers are likely to encounter the intersection throughout their careers. Thus, it is critical for social workers to have general knowledge about autism and the complexity of accessing diagnostic and treatment services. In this article, the authors review the literature on Latinx children and ASD, and identify opportunities for social workers to be innovative in their use of frameworks, theories, and practice approaches to reduce disparities in ASD diagnosis and treatment among Latinx children.
Healing Justice, Transformative Justice, and Holistic Self-Care for Social Workers
Authors: Pyles Loretta 
Published: April 2020

Abstract
A self-care movement for social workers is beginning to embrace mindfulness and other forms of wellness. However, self-care is often framed as merely an individualistic pursuit and may be a tool of managerialism, reinforcing the social and economic structures and culture that are causing burnout and moral injury in the first place. Particularly for people who are marginalized, the self-care movement may ignore historical trauma and the ways that interlocking oppressions contribute to stress, trauma, moral injury, and burnout. Drawing from the evidence base on East–West mind–body practices and informed by a transformative practice lens, healing justice is presented as a framework and set of practices of the whole self. The whole self includes the physical, emotional, mental, spiritual, social, and ecological selves. A transformative approach to healing can be supported by enhancing the capabilities of mindfulness, compassion, curiosity, critical inquiry, effort, and equanimity. The concept of the healing justice organization is introduced as an opportunity for organizational change beginning with a set of inquiries for social work organizations to attend structurally and more purposefully to collective care.
Binaural Pitch Fusion in Children With Normal Hearing, Hearing Aids, and Cochlear Implants
Authors: Hartling Curtis L. , Fowler Jennifer R. , Stark Gemaine N. , Glickman Bess , Eddolls Morgan , Oh Yonghee , Ramsey Katrina , Reiss Lina A. J. 
Published: April 2020

Objectives:
Binaural pitch fusion is the perceptual integration of stimuli that evoke different pitches between the ears into a single auditory image. Adults who use hearing aids (HAs) or cochlear implants (CIs) often experience abnormally broad binaural pitch fusion, such that sounds differing in pitch by as much as 3 to 4 octaves are fused across ears, leading to spectral averaging and speech perception interference. The main goal of this study was to measure binaural pitch fusion in children with different hearing device combinations and compare results across groups and with adults. A second goal was to examine the relationship of binaural pitch fusion to interaural pitch differences or pitch match range, a measure of sequential pitch discriminability.

Design:
Binaural pitch fusion was measured in children between the ages of 6.1 and 11.1 years with bilateral HAs (n = 9), bimodal CI (n = 10), bilateral CIs (n = 17), as well as normal-hearing (NH) children (n = 21). Depending on device combination, stimuli were pure tones or electric pulse trains delivered to individual electrodes. Fusion ranges were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus to find the range that fused with the reference stimulus. Interaural pitch match functions were measured using sequential presentation of reference and comparison stimuli, and varying the comparison stimulus to find the pitch match center and range.

Results:
Children with bilateral HAs had significantly broader binaural pitch fusion than children with NH, bimodal CI, or bilateral CIs. Children with NH and bilateral HAs, but not children with bimodal or bilateral CIs, had significantly broader fusion than adults with the same hearing status and device configuration. In children with bilateral CIs, fusion range was correlated with several variables that were also correlated with each other: pure-tone average in the second implanted ear before CI, and duration of prior bilateral HA, bimodal CI, or bilateral CI experience. No relationship was observed between fusion range and pitch match differences or range.

Conclusions:
The findings suggest that binaural pitch fusion is still developing in this age range and depends on hearing device combination but not on interaural pitch differences or discriminability.
“Nailable” External Fixation of the Tibia: A Novel Technique to Accommodate Delayed Intramedullary Nailing of the Tibia
Authors: Savage-Elliott Ian , Wu Victor J. , Nguyen Lan N. , Martin Murphy P. , Gladden Paul B. 
Published: April 2020

Summary:
External fixation is often used for temporary stabilization of the tibia in several clinical scenarios. Conventional placement of external fixation pins may impede instrumentation with intramedullary nailing, thus requiring pin removal, loss of reduction, and increased operative time during definite fixation. In this article, we describe a strategic pin placement routinely used at our institution in which we create a medially based inverted triangular construct that allows for pins to remain in place during definitive fixation.
Improving outcomes in retinal detachment: the potential role of rho-kinase inhibitors
Authors: Halász Éva , Townes-Anderson Ellen , Zarbin Marco A. 
Published: April 2020

Purpose of review
Retinal detachment initiates a series of events that lead to degenerative changes in retinal synaptic architecture as well as the well-known phenomena of gliosis and photoreceptor apoptosis. Retinal reattachment does not always result in complete visual recovery, even if the fovea is not directly involved in the detachment. Rho-kinase (ROCK) inhibitors may mitigate some of these deleterious changes including disruption of synaptic architecture, photoreceptor apoptosis, and initiation of the epithelial-mesenchymal transition that characterizes proliferative vitreoretinopathy (PVR). This review focuses on the use of ROCK inhibitors to modulate synaptic disjunction.

Recent findings
ROCK inhibition prevents retinal detachment-induced photoreceptor synaptic terminal retraction (i.e., synaptic disjunction), thereby diminishing the damage of the first synapse in the visual pathway. ROCK inhibition also reduces retinal detachment-induced photoreceptor apoptosis and suppresses PVR progression in preclinical models.

Summary
Inhibition of ROCK may help to optimize visual recovery after retinal detachment surgery or iatrogenic detachments during cell transplantation or viral subretinal injection and might play a role in reducing the risk of PVR after retinal detachment surgery.
Clinical comparison of 27-gauge and 23-gauge instruments on the outcomes of pars plana vitrectomy surgery for the treatment of vitreoretinal diseases
Authors: Charles Steve , Ho Allen C. , Dugel Pravin U. , Riemann Chris D. , Berrocal María H. , Gupta Sunil , Hamilton Cody , Abulon Dina Joy K. 
Published: April 2020

Purpose of review
To compare outcomes of 27-gauge and 23-gauge pars plana vitrectomy (PPV) for treatment of vitreoretinal diseases.

Recent findings
Sixty-eight patients undergoing microincisional PPV for treatment of vitreoretinal diseases were randomized 1 : 1 to 27-gauge or 23-gauge surgery with a 7500 cuts-per-minute vitrectomy probe. The most common reasons for vitrectomy were epiretinal membrane (49%) and vitreous hemorrhage (24%). Mean ± standard deviation (SD) changes from immediate preoperative to immediate postoperative intraocular pressure were −0.40 ± 6.60 mmHg in the 27-gauge and −3.05 ± 7.64 mmHg in the 23-gauge group (adjusted mean difference 2.42 mmHg, 95% lower confidence limit 0.64, P = 0.013), but these changes were not associated with primary reason for vitrectomy (P = 0.065). Mean ± SD conjunctival edema grades in the 27-gauge and 23-gauge groups 1 week after surgery were 0.02 ± 0.124 and 0.10 ± 0.246, respectively (least squares mean difference −0.09, 95% upper confidence limit −0.03, P = 0.004), and were 0.01 ± 0.122 and 0.12 ± 0.338, respectively, at the probe incision site. Conjunctival edema grades were similar in both groups at 1 and 3 months. Mean ± SD pain ratings on postoperative day 1 – an indicator of patient comfort – were similar in the two groups.

Summary
Smaller diameter vitrectomy instruments are associated with smaller reductions in immediate postoperative intraocular pressure.
Paradoxical Antibiotic Effect of Ampicillin
Authors: Ericson Jessica E. , Hornik Christoph P. , Greenberg Rachel G. , Clark Reese H. , Tremoulet Adriana H. , Le Jennifer , Cohen-Wolkowiez Michael , Smith P. Brian , Benjamin Daniel K. ,   on behalf of the Best Pharmaceuticals for Children Act – Pediatric Trials Network
Published: April 2020

Background:
High doses of ampicillin are often used to achieve therapeutic drug concentrations in infants. A paradoxical antibiotic effect, often called the Eagle effect, occurs when increasing concentrations of antibiotic above a threshold results in decreased efficacy. It is unknown if infants treated with ampicillin are at risk for this paradoxical effect.

Methods:
We identified infants <28 days of age with Escherichia coli, Enterococcus or Streptococcus agalactiae (group B streptococcus) bloodstream infections from 1997 to 2012 and previously included in an ampicillin pharmacokinetic (PK) modeling study. We compared the odds of death for ampicillin dose, estimated time above the minimum inhibitory concentration (T > MIC) and PK parameters using separate logistic regression models. Adjusted logistic regression and Poisson models were used to calculate the odds of prolonged bacteremia ≥3 days and the duration of bacteremia, respectively, for dose, T > MIC and multiple PK parameters.

Results:
Among 1272 infants meeting inclusion criteria, odds of death 7 or 30 days after the positive blood culture were not consistent with a paradoxical effect across any of the dosing regimens or PK parameters evaluated. The odds of prolonged bacteremia was lowest at the lowest dose category and the lowest daily dose category but not associated with the area-under-the-concentration time curve from 0 to 24 hours, or the maximum or minimum concentrations at steady state. T > MIC of ≥50% of the dosing interval was associated with decreased duration of bacteremia and odds of prolonged bacteremia.

Conclusions:
It is unlikely that a paradoxical antibiotic effect will have a clinical correlate when ampicillin is used for neonatal bacteremia. A T > MIC ≥50% decreased both duration of bacteremia and odds of prolonged bacteremia.
Respiratory Syncytial Virus Prophylaxis in Immunocompromised Children
Authors: Paes Bosco A. , Saleem Mahwesh , Li Abby , Lanctôt Krista L. , Mitchell Ian ,   for the CARESS Investigators
Published: April 2020

Background:
Immunocompromised children are at increased risk for respiratory syncytial virus (RSV) infection with associated morbidity and mortality. Prophylaxis is usually provided to these children on a case-by-case basis.

Methods:
Immunocompromised children who received ≥1 injection of palivizumab were prospectively enrolled across 32 Canadian sites, between 2005 and 2017, during the RSV season. We assessed respiratory illness hospitalization (RIH) and RSV-related hospitalization (RSVH) hazard ratios (HRs) in immunocompromised children versus infants’ prophylaxed for standard indications (SI: prematurity ≤35 weeks’ gestation, bronchopulmonary dysplasia, and congenital heart disease) and complex medical disorders (CMD). Data were analyzed using t-tests, χ2 and Cox proportional hazards adjusted for confounders.

Results:
A total of 25,003 infants were recruited; 214 immunocompromised, 4283 CMD, 20,506 SI. On average, children received 4.4 ± 1.3 injections. A total of 16,231 children were perfectly adherent (58.4% immunodeficiency, 68.9% CMD, 64.2% SI; P < 0.0005). A higher proportion of immunocompromised children were aboriginal and exposed to smoking compared with CMD and SI. Immunocompromised children also had a higher median; gestational and enrollment age and birth weight compared with CMD and SI. Immunodeficient children had a higher RIH risk compared with SI (HR = 2.4, 95% confidence interval, 1.3–4.7, P = 0.009) but were similar to CMD (HR = 1.7, 95% confidence interval, 0.9–3.4, P = 0.118). RSVH in prophylaxed, immunocompromised children was similar to CMD (HR < 0.005, P = 0.955) and SI (HR < 0.005, P = 0.953).

Conclusions:
Immunocompromised children who received palivizumab had an increased RIH hazard compared with the SI group. Similar RSVH hazard between the 3 groups suggests that immunocompromised children may benefit from palivizumab during the RSV season.
A Narrative Review of Current Challenges in the Diagnosis and Management of Bacterial Vaginosis
Authors: Muzny Christina A. , Kardas Przemyslaw 
Published: April 2020

Abstract
Despite the availability of a number of oral and intravaginal antibiotic medications for the treatment of bacterial vaginosis (BV), management of this condition remains challenging. Recurrent BV occurs in >50% of patients receiving guideline-recommended treatments. This may be due to persistence or resurgence of the BV biofilm after treatment cessation, failure to reestablish an optimal vaginal microbiome after treatment, reinfection from an untreated sexual partner, or a combination of these factors. Nonadherence to multidose BV therapies may potentially contribute to recurrent BV, although there are no published data that directly assess the role of nonadherence to poor treatment outcomes and recurrent BV. There is a need for studies of BV treatment adherence in real-world settings as well as studies to explore the relationship between treatment adherence and recurrence. This review explores challenges associated with diagnosing and treating BV, current multidose antibiotic treatment options, newer single-dose treatment options, and ways to potentially maximize treatment success for this common vaginal infection.
Needling Policy Makers and Sharpening the Debate: Do Syringe Exchange Programs Improve Health at the Population Level?
Authors: Motie Ian , Carretta Henry J. , Beitsch Leslie M. 
Published: April 2020

Context:
In the midst of the current opioid epidemic, states have selected differing legislative routes implementing pathways to ensure access to clean needles and syringes.

Objective:
To determine whether states that implemented laws supporting syringe exchange programs (SEPs) had reductions in transmission rates of hepatitis B, hepatitis C, and HIV infection compared with states without such laws.

Design and Setting:
Utilizing a longitudinal panel design, we determined the legal status of SEPs in each state for years 1983-2016. Disease transmission rates for this period were estimated via a simple Poisson regression, with transmitted cases as the dependent variable, law categories as the predictor variables, and the log of state population as the exposure. The mean number of incident cases per state-year was also calculated.

Participants:
US states were utilized as the unit of analysis.

Results:
Hepatitis B and hepatitis C mean transmission rate per 100 000 population declined in states with local ordinances/decriminalized statutes and legalized SEPs (hepatitis B: 71% and 81%, respectively, differences P < .001; hepatitis C: 8% and 38%, respectively, differences P < .001). Reductions in mean incident cases per state-year mirrored these findings. HIV infection among injection drug users yielded inconsistent results.

Conclusions:
Hepatitis B and hepatitis C transmission were reduced at the population level in states with SEP laws in a pattern reflecting the degree of legal intervention. HIV infection, based upon a smaller data set, showed a mixed impact.

Policy Implications:
The results show promise that SEPs have population-level effects on disease transmission. States lacking SEPs should reconsider current policies.
Decreasing Usage of Lights and Sirens in an Urban Environment: A Quality Improvement Project
Authors: Westley Laura , Nokes Janice , Rozenfeld Ranna A. 
Published: April 2020

Introduction:
The risk of lights and sirens use in emergency medical services has been well documented. Our critical care transport team performs over 1,800 interfacility nonemergency medical services transports annually into a dense urban environment. Historically, we have utilized lights and sirens to navigate traffic patterns. The use exceeded industry standards. This quality improvement project was undertaken to decrease the use of lights and sirens.

Methods/Results:
The baseline use of lights and sirens in 2011 was 76% en route and 73% on return to the facility. We revised the internal policy guiding the appropriate usage of lights and sirens. In 2012, without an improvement in usage, a use justification process was implemented. By 2013, the use of lights and sirens was still high en route, but had decreased to 53% on the return trip. In 2014, we added accountability measures requiring justification, with a subsequent drop in 2015 to 14% en route and 13% on return. In the following 3 years, the transport teams have sustained lights and sirens use to 20% or below.

Conclusions:
This quality improvement initiative impacted team behavior and decreased the use of lights and sirens over 5 years, with sustained improvement at or below 20%. This improvement was accomplished through ongoing evaluation, education, data gathering, and open communication. There was no negative impact on patient outcomes during this time. Lights and sirens continue to be used when indicated.
Center-level Variation in HLA-incompatible Living Donor Kidney Transplantation Outcomes
Authors: Jackson Kyle R. , Long Jane , Motter Jennifer , Bowring Mary G. , Chen Jennifer , Waldram Madeleine M. , Orandi Babak J. , Montgomery Robert A. , Stegall Mark D. , Jordan Stanley C. , Benedetti Enrico , Dunn Ty B. , Ratner Lloyd E. , Kapur Sandip , Pelletier Ronald P. , Roberts John P. , Melcher Marc L. , Singh Pooja , Sudan Debra L. , Posner Marc P. , El-Amm Jose M. , Shapiro Ron , Cooper Matthew , Verbesey Jennifer E. , Lipkowitz George S. , Rees Michael A. , Marsh Christopher L. , Sankari Bashir R. , Gerber David A. , Wellen Jason , Bozorgzadeh Adel , Gaber A. Osama , Heher Eliot , Weng Francis L. , Djamali Arjang , Helderman J. Harold , Concepcion Beatrice P. , Brayman Kenneth L. , Oberholzer Jose , Kozlowski Tomasz , Covarrubias Karina , Desai Niraj , Massie Allan B. , Segev Dorry L. , Garonzik-Wang Jacqueline 
Published: April 2020

Background.
Desensitization protocols for HLA-incompatible living donor kidney transplantation (ILDKT) vary across centers. The impact of these, as well as other practice variations, on ILDKT outcomes remains unknown.

Methods.
We sought to quantify center-level variation in mortality and graft loss following ILDKT using a 25-center cohort of 1358 ILDKT recipients with linkage to Scientific Registry of Transplant Recipients for accurate outcome ascertainment. We used multilevel Cox regression with shared frailty to determine the variation in post-ILDKT outcomes attributable to between-center differences and to identify any center-level characteristics associated with improved post-ILDKT outcomes.

Results.
After adjusting for patient-level characteristics, only 6 centers (24%) had lower mortality and 1 (4%) had higher mortality than average. Similarly, only 5 centers (20%) had higher graft loss and 2 had lower graft loss than average. Only 4.7% of the differences in mortality (P < 0.01) and 4.4% of the differences in graft loss (P < 0.01) were attributable to between-center variation. These translated to a median hazard ratio of 1.36 for mortality and 1.34 of graft loss for similar candidates at different centers. Post-ILDKT outcomes were not associated with the following center-level characteristics: ILDKT volume and transplanting a higher proportion of highly sensitized, prior transplant, preemptive, or minority candidates.

Conclusions.
Unlike most aspects of transplantation in which center-level variation and volume impact outcomes, we did not find substantial evidence for this in ILDKT. Our findings support the continued practice of ILDKT across these diverse centers.