bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reward Processing in Children With Psychotic-Like Experiences
Authors: Harju-Seppänen Jasmine , Irizar Haritz , Bramon Elvira , Blakemore Sarah-Jayne , Mason Liam , Bell Vaughan 
Published: December 2021

Abstract
Alterations to striatal reward pathways have been identified in individuals with psychosis. They are hypothesized to be a key mechanism that generate psychotic symptoms through the production of aberrant attribution of motivational salience and are proposed to result from accumulated childhood adversity and genetic risk, making the striatal system hyper-responsive to stress. However, few studies have examined whether children with psychotic-like experiences (PLEs) also exhibit these alterations, limiting our understanding of how differences in reward processing relate to hallucinations and delusional ideation in childhood. Consequently, we examined whether PLEs and PLE-related distress were associated with reward-related activation in the nucleus accumbens (NAcc). The sample consisted of children (N = 6718) from the Adolescent Brain Cognitive Development (ABCD) study aged 9–10 years who had participated in the Monetary Incentive Delay (MID) task in functional MRI. We used robust mixed-effects linear regression models to investigate the relationship between PLEs and NAcc activation during the reward anticipation and reward outcome stages of the MID task. Analyses were adjusted for gender, household income, ethnicity, depressive symptoms, movement in the scanner, pubertal development, scanner ID, subject and family ID. There was no reliable association between PLEs and alterations to anticipation- or outcome-related striatal reward processing. We discuss the implications for developmental models of psychosis and suggest a developmental delay model of how PLEs may arise at this stage of development.
Evaluation of Albumin Kinetics in Critically Ill Patients With Coronavirus Disease 2019 Compared to Those With Sepsis-Induced Acute Respiratory Distress Syndrome
Authors: Su Chang , Hoffman Katherine L. , Xu Zhenxing , Sanchez Elizabeth , Siempos Ilias I. , Harrington John S. , Racanelli Alexandra C. , Plataki Maria , Wang Fei , Schenck Edward J. 
Published: December 2021

OBJECTIVES:
This report aims to characterize the kinetics of serum albumin in critically ill patients with coronavirus disease 2019 compared with critically ill patients with sepsis-induced acute respiratory distress syndrome.

DESIGN:
Retrospective analysis.

SETTING:
We analyzed two critically ill cohorts, one with coronavirus disease 2019 and another with sepsis-induced acute respiratory distress syndrome, treated in the New York Presbyterian Hospital-Weill Cornell Medical Center.

PATIENTS:
Adult patients in the coronavirus disease 2019 cohort, diagnosed through reverse transcriptase-polymerase chain reaction assays performed on nasopharyngeal swabs, were admitted from March 3, 2020, to July 10, 2020. Adult patients in the sepsis-induced acute respiratory distress syndrome cohort, defined by Sepsis III criteria receipt of invasive mechanical ventilation and a Pao
2/Fio
2 ratio less than 300 were admitted from December 12, 2006, to February 26, 2019.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We evaluated serial serum albumin levels within 30 days after ICU admission in each cohort. We then examined the albumin progression trajectories, aligned at ICU admission time to test the relationship at a similar point in disease progression, in survivors and nonsurvivors. Albumin trajectory in all critically ill coronavirus disease 2019 patients show two distinct phases: phase I (deterioration) showing rapid albumin loss and phase II (recovery) showing albumin stabilization or improvement. Meanwhile, albumin recovery predicted clinical improvement in critical coronavirus disease 2019. In addition, we found a deterioration and recovery trends in survivors in the sepsis-induced acute respiratory distress syndrome cohort but did not find such two-phase trend in nonsurvivors.

CONCLUSIONS:
The changes in albumin associated with coronavirus disease 2019 associated respiratory failure are transient compared with sepsis-associated acute respiratory distress syndrome and highlight the potential for recovery following a protracted course of severe coronavirus disease 2019.
Non-alcoholic steatohepatitis and risk of hepatocellular carcinoma
Authors: Rios Rafael S. , Zheng Kenneth I. , Zheng Ming-Hua 
Published: December 2021

Abstract
The emergence of non-alcoholic fatty liver disease (NAFLD) as the leading chronic liver disease worldwide raises some concerns. In particular, NAFLD is closely tied to sedentary lifestyle habits and associated with other metabolic diseases, such as obesity and diabetes. At the end of the disease spectrum, non-alcoholic steatohepatitis (NASH) may progress to cirrhosis and hepatocellular carcinoma (HCC), representing a serious health problem to modern society. Recently, an increasing number of HCC cases originating from this progressive disease spectrum have been identified, with different levels of severity and complications. Updating the current guidelines by placing a bigger focus on this emerging cause and highlighting some of its unique features is necessary. Since, the drivers of the disease are complex and multifactorial, in order to improve future outcomes, having a better understanding of NASH progression into HCC may be helpful. The risks that can promote disease progression and currently available management strategies employed to monitor and treat NASH-related HCC make up the bulk of this review.
Estimation of Burden of Kidney Dysfunction in HIV-Infected Pediatrics and Adolescents by Use of Urinary Neutrophil Gelatinase-Associated Lipocalin: A Single Center Experience in Kenya
Authors: Lomole Anne P. , Macharia William M. , Limbe Mary S. , Kinuthia Doris W. , Kabinga Samuel K. 
Published: December 2021

Abstract

Background:
About 75% of patients infected with human immunodeficiency virus (HIV) live in sub-Saharan Africa. In Kenya, about 1.5 million Kenyans are living with HIV, of whom almost 100,000 are children and adolescents. Highly active antiretroviral therapy (HAART) has converted HIV infection to a chronic illness with its attendant complications. Kidney disease is a common complication of HIV infection and its treatment. Kidney disease in HIV-infected persons can be asymptomatic, insidious onset and may lack specific clinical features. It can only be detected on active screening. The urine albumin-to-creatinine ratio and estimated glomerular filtration rate (eGFR) using serum creatinine are not sensitive in identification of early kidney injury. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been used as marker of early kidney injury.

Methods:
This cross-sectional study used uNGAL and serum creatinine to determine the prevalence of kidney dysfunction in HIV-infected children and adolescents with HAART at Gertrude's Children's Hospital, Nairobi, Kenya, from March 2016 to February 2017. Urine samples were assayed for uNGAL using the Bio Porto® enzyme-linked immunosorbent assay. Serum creatinine was assayed using the Jaffe reaction in the Cobas® 6000 biochemistry analyzer and eGFR calculated using the Schwartz formula. Scatter plot of eGFR against log uNGAL levles was performed by Statistical Package for Social Sciences and Pearson correlation coefficeint between log uNGAL levles and eGFR was analyzed.

Results:
Ninety-three patients were recruited. Their mean age was 11.8 ± 3.6 years and the median duration on HAART was 72.6 months. Males were 47 (50.5%). The prevalence of kidney dysfunction using uNGAL was 15.1% (95% CI 7.6%–22.5%) and 5.4% (95% CI 1.8%–12.1%) by eGFR. The mean eGFR was 131 ± 25 mL·min−1·1.73 m−2 and median uNGAL was 10 ng/mL. For every one ng/mL increase in uNGAL value above the normal value, eGFR decreases by 4.8 mL·min−1·1.73 m−2 (P = 0.038). Patients with elevated uNGAL were older when compared with those with normal uNGAL (13.5 vs. 11.5 years).

Conclusion:
Urinary NGAL picked up to three times more patients with kidney dysfunction than eGFR derived from serum creatinine. All the patients were asymptomatic. Older children and adolescents were more likely to manifest with kidney dysfunction. Further studies are necessary to evaluate if uNGAL can be utilized routinely to evaluate for early kidney disease in HIV-infected patients.
Safety of 3 Tesla Magnetic Resonance Imaging in Patients With Auditory Brainstem Implants
Authors: Wichova Helena , Peng Kevin , Ledbetter Luke , Slattery William , Brackmann Derald , Lekovic Gregory 
Published: December 2021

Objective:
To evaluate the safety of 3 Tesla (T) magnetic resonance imaging (MRI) in patients with auditory brainstem implants (ABI) with the magnet removed at implantation and report incidence of complications.

Study Design:
Retrospective chart review.

Setting:
Tertiary neurotology ambulatory practice.

Patients:
Patients with diagnosis of Neurofibromatosis, type 2 (NF2) with functional ABIs.

Intervention(s):
Observational recordings.

Main Outcome Measure(s):
Of the 89 patients meeting inclusion criteria, 7 patients underwent 3T MRI, with a total of 39 scans done. Three patients had 1 scan each, one patient had 4 scans, one patient had 5 scans, one patient had 6 scans, and one patient had 21 scans. The mean time between ABI placement and first 3 T scan was 118 ± 73 months. The most common indication for imaging was surveillance of NF2 lesions. The most frequent scans were MRI brain (25.6%), followed by MRI of cervical (15%), thoracic (15%) and lumbar (15%) spine, and MRI IAC (8%). There were no reported complications for any of the scans. No scans were interrupted due to patient discomfort. There were no device malfunctions.

Conclusions:
3 T MRIs are safe in patients with ABIs as long as the magnet is removed. It is recommended that the magnet be removed at the time of implantation in all NF2 patients, who require frequent surveillance.
Optimal Light Source Intensity Setting in Endoscopic Ear Surgery
Authors: Vachutka Jaromir , Trneckova Marketa , Salzman Richard , Kolarova Hana , Belakova Petra 
Published: December 2021

Hypothesis:
Higher light intensity settings do not yield improved image quality in endoscopic ear surgery.

Background:
Light intensity is a parameter with major impact on the quality of digital images. For ear surgery, light produces heat associated with a thermal risk to ear structures and the light source setting should be accordingly optimized.

Methods:
Several series of still images were acquired during live middle ear surgery, using cadaveric and plastic temporal bone models and with three-dimensional printed models. Images obtained under varying light intensities were compared with the image acquired at maximum intensity of a light emitting diode light source. We analyzed digital image brightness and noise using quantitative methods.

Results:
Our measurements revealed significantly decreased image brightness with light intensities set below 20% with an increase in noise at light intensities lower than 30%.

Conclusion:
The optimal light source setting corresponded to 30% intensity in our experimental set-up. Special attention should be given to those cases where faster image quality degradation is expected (dark or bloody scenes or larger cavities). The results were strongly dependent on the equipment used. The methods described in this study can serve as a general guide for determining the optimal light source setting in any specific set-up.
Early Outcomes of a New Active Transcutaneous Bone Conduction Implant in Pediatric Patients
Authors: You Peng , Choi Alexander , Drob Jennifer , Hunsaker Sabrina Marciante , Liu Yi-Chun Carol , Silva Rodrigo 
Published: December 2021

Objective:
To describe the early surgical and audiometric outcomes in pediatric patients implanted with a new active transcutaneous bone conduction implant system.

Study Design:
Retrospective case review.

Setting:
Tertiary pediatric hospital.

Patients:
Pediatric patients (18 or younger) with conductive or mixed hearing loss that completed postoperative aided testing following implantation with the Cochlear Osia system from December 2019 to December 2020.

Intervention:
Rehabilitative.

Main Outcome Measure:
Preoperative air conduction (AC), preoperative bone conduction (BC), and postoperative aided thresholds were compared. Pure-tone averages (PTA), air-bone gap (ABG), and functional gain were calculated. Surgical complications and patient satisfaction were summarized from the chart review.

Results:
Sixteen patients (20 implants) met the inclusion criteria. The average age at the time of implantation was 12.9 ± 2.4 years. The preoperative AC and BC thresholds were 64.4 dB (±11.9 dB) and 7.9 dB (±4.90 dB), respectively, with an average ABG of 56.5 dB (±12.8 dB). The average postoperative aided threshold was 21.2 dB (± 4.25 dB) with a mean functional gain of 43.1 dB (±10.2 dB). One patient developed seroma postoperatively, which was treated conservatively. No other complications were reported over a mean follow-up time of 7.1 ± 4 months. For 13 patients with previous passive bone conduction implants or devices, the Osia system was universally favored.

Conclusions:
The new active transcutaneous bone conduction system showed favorable early clinical and audiometric outcomes. Repeated processor connectivity issues represent a potential area for future device development. This is the largest pediatric case series to date.

Level of Evidence: Level 4—Retrospective Review.
Outcomes of Stapedotomy in Patients With Concomitant Otosclerosis and Superior Semicircular Canal Dehiscence: Should a Radiographic Third-Window Be a Contraindication to Stapes Surgery?
Authors: Sioshansi Pedrom C. , Drury Emily E. , Tu Nathan C. , Babu Seilesh C. , Schutt Christopher A. 
Published: December 2021

Objective:
Review surgical outcomes of stapedotomy in patients with concomitant otosclerosis and superior semicircular canal dehiscence.

Study design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Patients with otosclerosis and radiographic superior semicircular canal dehiscence undergoing stapedotomy between 2008 and 2020.

Intervention:
Stapedotomy.

Main outcome measures:
Pre- and postoperative hearing and unmasking of third-window symptoms. Hearing was measured by air conduction (AC) and bone conduction (BC) pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS). Third-window symptoms included hyperacusis, autophony, sound- or pressure-induced vertigo, imbalance, or oscillopsia.

Results:
Twenty patients with otosclerosis and radiographic superior semicircular canal dehiscence underwent stapedotomy, 13 primary and 7 revision. Mean AC PTA was 49.3 dB preoperatively and 35.6 dB postoperatively (p = 0.0077), while the ABG improved on average from 23.9 to 9.68 dB (p < 0.0001). The ABG improved to ≤10 dB in 12/20 patients (60%), and ≤20 dB in 18/20 patients (90%). There was no significant difference in BC PTA or WRS postoperatively. Two patients (10%) experienced potential transient unmasking of third-window symptoms—hyperacusis and prolonged imbalance—which both resolved. There were no other complications. There was no significant difference in audiologic outcomes or unmasking of third window symptoms between primary or revision cases.

Conclusions:
Persistent conductive hearing loss is common following stapedotomy for otosclerosis in patients with concomitant superior semicircular canal dehiscence. However, a majority of patients can achieve excellent hearing outcomes, while unmasking of third window symptoms appears to be rare. Radiographic superior semicircular canal dehiscence may not be an absolute contraindication to stapes surgery for otosclerosis.
Door to Needle Count Down
Authors: El Nahas Nevine M. , Shokri Hossam M. , Roushdy Tamer M. , Dawood Noha L. , Abushady Eman M. , Georgy Shady S. , Zaki Amr S. , Bedros Rady Y. , Aref Hany M. 
Published: December 2021

Background:
The purpose of this study is to share our experience in changing hospital strategies to achieve rapid thrombolysis in acute ischemic stroke (AIS) patients in 2 university stroke centers. Rapid reperfusion by shortening door to needle time (DTN) reduces morbidity and mortality for patients with AIS. Our aim is to evaluate the effect of applying certain logistic strategies to reduce DTN for thrombolysis and its impact on clinical outcome.

Methods:
In this retrospective registry-based observational study from the SITS-ISTR Dataset, we studied AIS patients admitted to 2 stroke centers in Ain Shams University over 3 successive years from 2016 till 2018. We analyzed change of DTN and outcome at 3 months by modified Rankin scale over these 3 years.

Results:
By the end of the 3 year period there was a 6.1% increase in number of patients receiving thrombolysis. There was a significant decrease of median DTN by 41%, and increase in percentage of patients receiving recombinant tissue plasminogen activator within a shorter DTN. Also, the number of patients with a favorable outcome (modified Rankin scale≤2) increased by 23.3%. There was insignificant difference regarding mortality rate.

Conclusion:
Applying a goal-directed corrective strategy to improve quality of service can, in a short time, reduce DTN and improve patient outcome.
Community-Based Rehabilitation Promotes the Functional Recovery of Patients After Intracerebral Hemorrhage
Authors: Qian Hong , Chen Shuangxi , Chen Yarui , Chang Yunqian , Li Yihui , Dou Shiying , Chen Qianlan , Wang Gang , Xie Ming 
Published: December 2021

Background:
Intracerebral hemorrhage (ICH), a severe disorder with the high death rate, high recurrence rate and high disability rate, affected the quality of human life. Community-based rehabilitation (CBR) helps disabled people at both community and family levels. However, the effect of CBR on the recovery of people after ICH remains unclear.

Methods:
Patients were treated with the CBR training program, subsequently, medication compliance test, clinical neural impairment measurements, functional comprehensive assessments, improved Barthel index score, and life qualities assessments were to performed at 3-month or 6-month intervention of CBR to evaluate the influence of CBR on the medication compliance, physical function and life quality of patients after ICH.

Results:
After the treatment of CBR, we observed that, the rate of medication compliance, motor function, functional comprehensive rating scale score, modified Barthel index score, and generic quality of life inventory-74 in the CBR-treated group were significantly higher than that in the control group; the neural impairment measure score in the CBR-treated group was significantly decreased in comparison to the control group.

Conclusion:
CBR increased the medication compliance, promoted the recovery of the neurological function and improved the life qualities of ICH patients.
Translating Phenomenology of Psychogenic Nonepileptic Seizures Into Nosology
Authors: Janocko Nicholas J. , Morton Matthew L. , Groover Olivia , Teagarden Diane L. , Villarreal Hannah K. , Merchant Shanaz , Ahuruonye Ndubuisi , Rodriguez-Ruiz Andres A. , Drane Daniel L. , Karakis Ioannis 
Published: December 2021

Background:
Patients with psychogenic nonepileptic seizures (PNES) can be semiologically dichotomized into those with hyperkinetic and those with paucikinetic events. The objective of this study was to compare characteristics of patients with diverse phenomenology and their caregivers to evaluate for differences that could inform about disease nosology.

Methods:
Patients and caregivers monitored at the Epilepsy Monitoring Unit completed surveys about sociodemographic and disease characteristics, treatment and health care utilization, physical and psychosocial impact, and epilepsy knowledge. Patients were classified into hyperkinetic versus paucikinetic based on their recorded events. Comparison of the 2 populations was performed using Student t test for continuous variables and Fischer exact test for categorical variables.

Results:
Forty-three patients with Epilepsy Monitoring Unit confirmed PNES and 28 caregivers were enrolled. Patients with hyperkinetic events were more commonly non-White patients and necessitated greater caregiving time. Otherwise, no statistically significant differences were seen between the 2 semiologically diverse groups of patients and caregivers in their sociodemographic (age, sex, employment, income, marital, and education) and disease (age of onset, duration, seizures frequency) characteristics, treatment (number of antiseizure medications before diagnosis, side effects) and health care utilization (emergency room visits, hospitalizations, clinic visits), physical (injuries) and psychosocial (depression, anxiety, quality of life, stigma, burden) characteristics, nor in their knowledge about seizures.

Conclusions:
Hyperkinetic events were more frequently encountered in non-White patients and required more caregiving time. Further research is required to elucidate if phenomenological dichotomy of PNES can inform about their nosological basis, and if it can guide treatment and define prognosis.
Management of Chronic Subdural Hematoma in Patients Requiring Therapeutic Anticoagulation
Authors: Neth Bryan J. , Ighodaro Eseosa T. , Brinjikji Waleed , Cloft Harry , Scharf Eugene L. 
Published: December 2021

Introduction:
A common risk factor of chronic, nontraumatic subdural hematoma (SDH) is anticoagulation therapy. Anticoagulation is generally held in patients who develop SDH, but this can lead to thromboembolic events. While prior studies have reported the clinical outcomes of patients with anticoagulation-related SDH, there remains little evidence regarding ongoing anticoagulation treatment.

Case Report:
We report the management of 2 patients who developed anticoagulation-related SDH and underwent middle meningeal artery (MMA) embolization and successful reinitiation of anticoagulation therapy. In both patients, we conservatively managed anticoagulation with heparin and/or enoxaparin as a bridge to warfarin after MMA embolization. Follow-up computed tomography head revealed interval decrease of SDH and stable neurological status.

Conclusions:
These cases provide anecdotal evidence of a challenging clinical scenario where there is a necessary indication for therapeutic anticoagulation (ie, venous sinus thrombosis or atrial appendage thrombus) and comorbid SDH. Endovascular MMA embolization may be an effective adjunct therapy for clinical scenarios in patients with SDH and an urgent indication for anticoagulation. Longer follow-up, prospective series, and future randomized clinical trials are needed to objectively assess outcomes in this clinically challenging patient population.