bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-frequency Cochlear Nerve Deficit Region: Relationship With Deaf Duration and Cochlear Implantation Performance in Postlingual Deaf Adults
Authors: Kim Yehree , Lee Jee Yeon , Kwak Min Young , Park Jin Taek , Kang Woo Seok , Ahn Joong Ho , Chung Jong Woo , Park Hong Ju 
Published: February 2021

Objective:
To analyze the changes of cochlear nerve diameter and the presence of a cochlear nerve deficit at a high-frequency region and investigate their effects on cochlear implant (CI) performance in postlingual deaf adults.

Study Design:
Retrospective.

Setting:
Tertiary care academic center.

Patients:
Eighty-three postlingual deaf adults with no labyrinthine anomalies or cognitive deficits who received a CI with perimodiolar electrodes from a single manufacturer.

Main Outcomes and Measures:
We evaluated the changes of cochlear nerve diameter and the presence of a “tail sign,” defined as identifiable nerve fibers originating from the far basal turn of the cochlea, which represents the presence of cochlear nerve at a high-frequency region in magnetic resonance imaging, on monosyllabic word recognition scores.

Results:
The cochlear nerve diameter showed a positive correlation with word recognition scores (maximum diameter, R2 = 0.26, p < 0.01; minimum diameter, R2 = 0.26, p < 0.01), but a negative correlation with deaf duration. Recipients with a positive tail sign performed better (73 ± 19%) than those without (45 ± 24%, p < 0.01). A positive tail sign was more commonly found in good performers (52 of 62, 84%) than in poor performers (5 of 21, 24%, p < 0.01).

Conclusions:
Favorable outcomes could be anticipated in postlingual deaf adults with a large cochlear nerve diameter and positive tail sign. A presence of cochlear nerve at a high-frequency region may be an imaging marker for predicting good CI performance.
Prevalence of Otological Disease in Turner Syndrome: A Systematic Review
Authors: Geerardyn Alexander , Willaert Annelore , Decallonne Brigitte , Desloovere Christian , Verhaert Nicolas 
Published: February 2021

Introduction:
Girls and women with Turner syndrome (TS) present with multiple ear and hearing problems, ranging from external morphologic abnormalities to sensorineural or conductive hearing loss. The exact pathophysiology behind these otological diseases is not yet completely understood. The aim of this study is to provide a systematic review on the prevalence of otological disease in TS.

Methods:
We conducted a systematic review according to the PRISMA guidelines. A database search was performed in PubMed, Embase, Web of Science, and Cochrane library.

Results:
The prevalence of otological disease as external ear deformities (20–62%), recurrent otitis media (24–48%), and hearing loss (36–84%) is high in TS. The auditory phenotype in TS is complex and seems to be dynamic with CHL due to middle ear disease at young age and sensorineural hearing loss later in life.

Conclusion:
This systematic review of the literature confirms that otological disease is definitely part of the widely variable phenotype in Turner patients. Strong evidence is lacking on the exact prevalence numbers, emphasizing the need for more prospective data gathering. Growing insights in its pathophysiology will help in the understanding and management of hearing problems in TS across lifespan.
Effect of Statin Use on Cancer-related Mortality in Nonalcoholic Fatty Liver Disease
Authors: Hajifathalian Kaveh , Tafesh Zaid , Rosenblatt Russell , Kumar Sonal , Homan Edwin A. , Sharaiha Reem Z. , Cohen David E. , Brown Robert S. , Fortune Brett E. 
Published: February 2021

Background:
Indications for use of statins are common among patients with nonalcoholic fatty liver disease (NAFLD). Epidemiologic studies have suggested a possible association between statins and decreased risk of malignancies. We hypothesized that statin use has a protective effect on cancer mortality in patients with NAFLD.

Methods:
Participants with NAFLD in 8 rounds of National Health and Nutrition Examination Survey (NHANES) were included in this study. Mortality data were obtained by linking the NHANES data to National Death Index. NAFLD was defined using the previously validated Hepatic Steatosis Index model.

Results:
A total of 10,821 participants with NAFLD were included and 23% were statin users (n=2523). Statin use was associated with a 43% lower risk of cancer mortality [hazard ratio (HR)=0.57, 95% confidence interval (CI): 0.43-0.75, P<0.001] in multivariable analysis. Statin use under 1 year did not show a significant effect on cancer mortality (HR=0.72, 95% CI: 0.46-1.12), while statin use for 1 to 5 years decreased cancer mortality by 35% (HR=0.65, 95% CI: 0.42-0.99, P=0.46), and statin use >5 years decreased cancer mortality by 56% (HR=0.44, 95% CI: 0.29-0.66, P<0.001). Statin use was associated with a significant decrease in the risk of cancer mortality in NAFLD patients with both low and high risk of liver fibrosis (HR=0.55, 95% CI: 0.38-0.81; and HR=0.53, 95% CI: 0.31-0.89, respectively).

Conclusion:
Using a large US prospective cohort, we showed statin use is associated with a considerable decrease in cancer-related mortality among patients with NAFLD. These results are important for clinical decision making, as statin indications are prevalent among NAFLD patients, but many do not receive benefit in the event that the statin is discontinued due to liver test abnormalities.
The impact of feeding experiences during infancy on later child eating behaviours
Authors: Pang Wei Wei , McCrickerd Keri 
Published: February 2021

Purpose of review
Individual differences in appetite and eating behaviours appear early in infancy. This review synthesizes recent research investigating the impact of feeding experiences during infancy on later appetite and energy intake regulation, and appraises the consistency and longevity of any effects.

Recent findings
Three themes of early feeding experiences were identified; breastfeeding, infants’ first foods and caregivers’ feeding practices. Recent findings suggest that breastfeeding alone is unlikely to promote better regulation of food intake later in childhood. It remains unclear whether the method of first food introduction (e.g., baby-led weaning vs traditional spoon feeding), or types of food introduced (e.g. ultra-processed foods), affect later child eating self-regulation. Randomised controlled trials (RCTs) on receiving guidance for responsive feeding showed some benefits; lower child body mass index z-scores in toddlerhood, parents reported less likelihood to pressure their child to eat or use food as a reward and lower emotional eating in the child.

Summary
There is little consistent new evidence for the lasting impact of any one specific infant feeding experience on later eating self-regulation. More RCTs using observed and measured behaviours, with longer follow-ups of children's eating behaviours, and those conducted across different populations are warranted.
Incidence, risk factors, clinical characteristics and outcomes of deep venous thrombosis in patients with COVID-19 attending the Emergency Department: results of the UMC-19-S8
Authors: Jiménez Sònia , Miró Òscar , Llorens Pere , Martín-Sánchez Francisco J. , Burillo-Putze Guillermo , Piñera Pascual , Martín Alfonso , Alquézar Aitor , García-Lamberechts Eric J. , Jacob Javier , Grima María L.L. , Millán Javier , Molina Francisca , Albero Patricia B. , Cardozo Carlos , Mòdol Josep M. , Aguirre Alfons , Gaya Ruth , Adroher María , Llauger Lluís , Díaz Juan J. L. , González Nayra C. , Aragües Paula L. , Gómez Ana P. , del Castillo Juan G. 
Published: February 2021

Background and importance
A higher incidence of venous thromboembolism [both pulmonary embolism and deep vein thrombosis (DVT)] in patients with coronavirus disease 2019 (COVID-19) has been described. But little is known about the true frequency of DVT in patients who attend emergency department (ED) and are diagnosed with COVID-19.

Objective
We investigated the incidence, risk factors, clinical characteristics and outcomes of DVT in patients with COVID-19 attending the ED before hospitalization.

Methods
We retrospectively reviewed all COVID patients diagnosed with DVT in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We compared DVT-COVID-19 patients with COVID-19 without DVT patients (control group). Relative frequencies of DVT were estimated in COVID and non-COVID patients visiting the ED and annual standardized incidences were estimated for both populations. Sixty-three patient characteristics and four outcomes were compared between cases and controls.

Results
We identified 112 DVT in 74 814 patients with COVID-19 attending the ED [1.50‰; 95% confidence interval (CI), 1.23–1.80‰]. This relative frequency was similar than that observed in non-COVID patients [2109/1 388 879; 1.52‰; 95% CI, 1.45–1.69‰; odds ratio (OR) = 0.98 [0.82-1.19]. Standardized incidence of DVT was higher in COVID patients (98,38 versus 42,93/100,000/year; OR, 2.20; 95% CI, 2.03–2.38). In COVID patients, the clinical characteristics associated with a higher risk of presenting DVT were older age and having a history of venous thromboembolism, recent surgery/immobilization and hypertension; chest pain and desaturation at ED arrival and some analytical disturbances were also more frequently seen, d-dimer >5000 ng/mL being the strongest. After adjustment for age and sex, hospitalization, ICU admission and prolonged hospitalization were more frequent in cases than controls, whereas mortality was similar (OR, 1.37; 95% CI, 0.77–2.45).

Conclusions
DVT was an unusual form of COVID presentation in COVID patients but was associated with a worse prognosis.
Association of frailty on treatment outcomes among patients with suspected infection treated at emergency departments
Authors: Ishikawa Shigeto , Miyagawa Ippei , Kusanaga Masashi , Abe Toshikazu , Shiraishi Atsushi , Fujishima Seitaro , Ogura Hiroshi , Saitoh Daizoh , Kushimoto Shigeki , Shiino Yasukazu , Hifumi Toru , Otomo Yasuhiro , Okamoto Kohji , Kotani Joji , Sakamoto Yuichiro , Sasaki Junichi , Shiraishi Shin-ichiro , Takuma Kiyotsugu , Hagiwara Akiyoshi , Yamakawa Kazuma , Takeyama Naoshi , Gando Satoshi , Mayumi Toshihiko 
Published: February 2021

Background
The clinical frailty scale (CFS) score has been validated as a predictor of adverse outcomes in community-dwelling older people. Older people are at a higher risk of sepsis and have a higher mortality rate. However, the association of frailty on outcomes in patients with sepsis has not been completely examined.

Objective
This study evaluated the association between CFS and outcomes in patients with sepsis.

Design
This was a multicenter prospective cohort substudy.

Settings and participants
The study included 37 emergency departments from across Japan. The patients (age ≥16 years) were included in this study if they had suspected infection at an emergency department during December 2017–February 2018.

Outcome measure and analysis
The primary outcome was 28-day mortality, stratified by the CFS score categories. The secondary outcomes were the duration of hospital stay, number of ICU-free days (ICUFDs) and number of ventilator-free days (VFDs).

Main results
A total of 917 patients were included. The median age was 79 years. The CFS score was associated with an increased risk of 28-day mortality and with a higher likelihood of long-term hospital stay and short-term VFDs and ICUFDs. Multivariate logistic regression analysis indicated that the CFS score was a predictor of 28-day mortality [odds ratio (OR), 1.26; 95% confidence interval (CI), 1.11–1.42].

Conclusions
This study reported that in patients with suspected sepsis in the emergency department, frailty may be associated with poor prognosis and length of hospital stay.
Evaluation of HEAR score to rule-out major adverse cardiac events without troponin test in patients presenting to the emergency department with chest pain
Authors: Moumneh Thomas , Penaloza Andrea , Cismas Anda , Charpentier Sandrine , Schotté Thibault , Pernet Sabrina , Malatest Stéphanie , Prunier Fabrice , Warnant Alexandra , Mezdad Tin-Hinan , Gangloff Cédric , Soulat Louis , Douillet Delphine , Riou Jérémie , Roy Pierre-Marie 
Published: February 2021

Background and importance
Current guidelines for patients presenting to the emergency department with chest pain without ST-segment elevation myocardial infarction (non-STEMI) on electrocardiogram are based on troponin measurement. The HEART score is reportedly a reliable work-up strategy that combines clinical evaluation with troponin value. A clinical rule that could select very low-risk patients without the need for a blood test (HEAR score, being the HEART score without the troponin item) would be of great interest.

Objectives
To prospectively assess the safety of a HEAR score <2 to rule-out non-STEMI without troponin measurement. Secondary objective was to assess the safety of a sequential strategy that combines HEAR score and HEART (defined as two-step HEART strategy).

Design, settings and participants
Prospective observational study in six emergency departments. Patients with nontraumatic chest pain and no alternative diagnosis were included and followed up for 45 day. Patients were considered at low-risk if the HEAR score was <2 or, for the two-step HEART strategy, if the HEART score was <4.

Outcomes measure and analysis
The primary endpoint was the 45-day rate of major adverse cardiac events (MACE) in patients with a HEAR score <2. A HEAR score based strategy was consider safe if the rate of the primary endpoint was below 1%, with an upper margin of the 95% confidence interval (CI) below 3%.

Results
Among 1452 patients included, 1402 were analyzed and 97 (7%) had a MACE during the follow-up period. The HEAR score was <2 in 279 (20%) patients and one presented a MACE [0.4% (95% CI: 0.01–1.98)]. The two-step HEART strategy classified low-risk an additional 476 patients (34%) and one of these 476 patients had a MACE [0.3% (95% CI: 0.03–0.95)]. The two-step HEART strategy would have theoretically avoided 360 troponin measurements (19%).

Conclusions
In our prospective multicenter study, a HEAR based work-up strategy was safe, with a very low risk of MACE at 45 day. We also report that a two-step HEART-based strategy may safely allow significant reduction of troponin measurements in patients presenting to the emergency department with chest pain.
Is 18F-FDG PET/CT capable of differential diagnosis from tuberculous pleurisy from malignant mesothelioma?
Authors: Özmen Özlem , Tatci Ebru , Demiröz Ş. Mustafa , Tazeler Zuhal , Demirağ Funda 
Published: February 2021

Aim
18F-Fluorodeoxyglucose (FDG) PET/computerized tomography (CT) is a valuable method in the diagnosis of malignant pleural mesothelioma (MPM). But, some infections, particularly tuberculosis, are known to mimic cancer. We aimed to compare the FDG PET/CT findings of tuberculosis pleurisy (TP) and malignant mesothelioma and evaluate its role of differential diagnosis.

Material and method
We retrospectively reviewed the data from 85 patients (45 patients with MPM and 40 patients with TP) who underwent FDG PET/CT. All images were reevaluated and pleural thickening, maximum standardized uptake values (SUVmax), lymphatic uptake and accompanying parenchymal findings were noted.

Results
There was no significant difference in age and sex between the two groups. Pleural thickening was more prominent in the MPM group. Mean pleural thickness was 21.4 ± 18.6 mm in the MPM group and 6.8 ± 3.5 mm in the TP group (P = 0.0). Besides pleural pathology, lymph nodes involvement in the thoracic (P = 0.0) and extrathoracic area (P = 0.34) and parenchymal findings were prominent in the TP group (P = 0.0). However, there was no significant difference in pleural SUVmax values between the two groups (P = 0.61).

Conclusion
Intense pleural FDG uptake can be observed in TP like malignant mesothelioma. For the evaluation of the pleural pathologies in the tuberculosis endemic countries, it should be considered that FDG PET/CT may have false-positive results. Evaluation of increased pleural FDG uptake together with the detected parenchymal findings and lymphatic involvement may help us to make more accurate interpretation of the diagnosis.
Diagnostic utility of Ga-68 DOTA-SSTR and F-18 FDG PET/CT in the detection of culprit tumours causing osteomalacia: a systematic review and meta-analysis
Authors: Agrawal Kanhaiyalal , Padhy Biswa Mohan , Meher Bikash Ranjan , Mohanty Rashmi Ranjan 
Published: February 2021

Background
Tumour-induced osteomalacia (TIO) or oncogenic osteomalacia is a rare variant of paraneoplastic syndrome secondary to a small benign phosphaturic mesenchymal tumour that secretes phosphaturic substances. Complete tumour excision is often curative. However, the localization of these offending tumours has always remained a challenge because of their small size, slow-growing nature, and presence in atypical locations. We performed a systemic review and meta-analysis on the sensitivity and specificity of F-18 FDG PET/CT and Ga-68 DOTA-SSTR PET/CT to detect tumours causing osteomalacia.

Methods
Pub Med, SCOPUS, the Cochrane Library and Web of Science were searched for articles on F-18 FDG and Ga-68 DOTA-SSTR PET/CT in the detection of culprit tumours in TIO till September 2020. Both retrospective and prospective studies having three or more patients were included. The methodological quality of included studies was assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies-2 checklist. A random-effect model was used for the statistical pooling of sensitivity and specificity. Pooled data were presented with 95% confidence intervals (95% CI) and displayed using Forest plots. Heterogeneity was expressed using the I
2 statistic.

Results
The pooled sensitivity of Ga-68 DOTA-SSTR PET/CT in detecting the culprit tumour derived from all included studies is 86% (95% CI: 79–91%). There is moderate statistical heterogeneity among the included studies (I
2 = 72.7%). The pooled sensitivity of F-18 FDG PET/CT in detecting the offending tumour derived from all included studies is 73% (95% CI: 61–84%) with moderate statistical heterogeneity among the included studies (I
2 = 45.4%).

Conclusion
In the detection of offending tumours in TIO, Ga-68 DOTA-SSTR PET/CT has better sensitivity than F-18 FDG PET/CT and should be used as first-line imaging modality due to very high sensitivity.
Role of post-therapy 99mTc-MIBI single-photon emission computed tomography/computed tomography scan in predicting survival in patients with high-grade glioma
Authors: Roshdy Esraa , ElNaggar Maha , Atta Haisam , Kandeel Ahmed , Abdel-Wanis Mostafa , Abd Elbadee Osama Mostafa , Abdelhafez Yasser G. , Mohamed Yasser 
Published: February 2021

Objective
High-grade gliomas (HGGs) carry dismal prognosis with survival typically reported as less than a year. We explored the predictive value of qualitative and quantitative evaluations of post-treatment 99m-technetium-labelled methoxyisobutylisonitrile (99mmTc-MIBI) brain single-photon emission computed tomography-computed tomography (SPECT/CT) tumor uptake in relation to overall survival (OS) in patients with HGG.

Methods
Thirty patients with pathologically or radiologically documented high-grade glioma (HGG) were prospectively recruited for this study (24 male, 6 female; mean age 43 ± 14 years). All patients had a clinical or radiological suspicion of residual/recurrent tumor after initial therapy. 99mTc-MIBI brain SPECT/CT scanning was performed, and the scans were evaluated qualitatively on a five-point probability score (1–5, scores ≥3 considered positive for residual/recurrent tumor); and quantitively via drawing volumes of interest (VOI) on the suspected lesions and normal contralateral brain tissue. All patients were followed up for 1 year or till death.

Results
Positive visual MIBI results were associated with poor survival. Among 10 patients with negative MIBI scores, only two patients died (OS = 75%), while 11/20 patients reported positive on MIBI died, with a median survival of 9 months (OS = 14.5%; P = 0.03). All patients with active isocontour volume ≤1.96 cm3 were alive at the end of the study, compared to a median survival of 9 months and OS of 12% for patients with an isocontour volume of >1.97% (P = 0.003).

Conclusion
In patients with HGG, post-therapy brain SPECT/CT with 99mTc-MIBI can provide useful prognostic information.
Systemic manifestations – do not forget the small bowel
Authors: Chetcuti Zammit Stefania , Sidhu Reena 
Published: February 2021

Purpose of review
Systemic diseases can afflict the small bowel (SB) but be challenging to diagnose. In this review, we aim to provide a broad overview of these conditions and to summarise their management.

Recent findings
Small bowel capsule endoscopy (SBCE) is an important modality to investigate pathology in the SB. SB imaging can be complementary to SBCE for mural and extramural involvement and detection of multiorgan involvement or lymphadenopathy. Device assisted enteroscopy provides a therapeutic arm, to SBCE enabling histology and therapeutics to be carried out.

Summary
SB endoscopy is essential in the diagnosis, management and monitoring of these multi-system conditions. Collaboration across SB centres to combine experience will help to improve the management of some of these rarer SB conditions.
Insulin Resistance as a Diagnostic Criterion for Metabolically Healthy Obesity in Children
Authors: Nso‐Roca Ana Pilar , Cortés Castell Ernesto , Carratalá Marco Francisco , Sánchez Ferrer Francisco 
Published: February 2021

ABSTRACTObjectives:In recent years, a subgroup of individuals with obesity has been described as having a lower risk of metabolic and cardiovascular complications. These individuals have what is referred to as metabolically healthy obesity (MHO), which has a favorable metabolic profile and a lower probability of long‐term complications. The definition of this subtype in children is not clear. The aim of the present study was to determine whether Homeostasis Model Assessment (HOMA) above a set threshold could be the marker of metabolically unhealthy obesity (MUO) in children, or a parameter that can be used in the overall assessment. It is intended to compare the International Diabetes Federation (IDF) criteria against HOMA in the diagnosis of MUO.Methods:This observational, retrospective, cohort study included children with obesity and analyzed their metabolic state by means of blood testing and dual‐energy X‐ray absorptiometry.Results:A total of 96 patients were included, 44.8% boys and 55.2% girls, ages 6–17 years. The patients with MHO according to the HOMA criterion were younger (P = 0.001), had a lower body mass index (BMI) z score (P = 0.006), waist–height index (P = 0.009), hip–height index (P = 0.010), blood glucose (P = 0.003), insulin (P < 0.001), and lower percentages of total fat (P = 0.002), trunk fat (P = 0.001), and android fat (P = 0.009) than those with MUO. The logistic regression analysis according to IDF criteria detected an area under the receiver operating characteristic (ROC) curve of 0.659 (95% CI 0.546–0.771; P = 0.009) versus the area under the ROC curve of 0.854 (95% CI 0.777–0.931; P < 0.001) for the HOMA definition. Therefore, the determination of the metabolic state according to HOMA has greater sensitivity and specificity than the IDF criteria. The multivariate analysis in children classified according to HOMA revealed that the percentage of total fat and gynoid fat distributions and triglyceride level could be markers of a healthy or unhealthy metabolic state in children with obesity (P < 0.001).Conclusions:The use of HOMA as a single criterion was demonstrated to be an effective and simple detector of adiposity, which predicts the metabolically healthy obesity in children.