bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent advances in Clostridioides difficile infection epidemiology, diagnosis and treatment in children
Authors: Kociolek Larry K. , Crews Jonathan D. , Schwenk Hayden T. 
Published: July 2021

Purpose of review
The US Centers for Disease Control and Prevention (CDC) classified Clostridioides difficile as an ‘urgent’ public health threat that requires ‘urgent and aggressive action’. This call to action has led to new discoveries that have advanced C. difficile infection (CDI) epidemiology, diagnosis and treatment, albeit predominantly in adults. In 2017, the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America published clinical practice guidelines for both adults and children. At that time, recommendations in children were generally limited to relatively low-quality evidence.

Recent findings
Since publication of this guidance, there have been many advancements in the understanding of CDI in children. These include better understanding of healthcare settings as uncommon sources of C. difficile acquisition in children; risk factors for recurrent and community-associated CDI; performance of diagnostic tests in children and strategies for optimizing their use; and a more rigorous evidence base for CDI treatment in children, including the first-ever randomized controlled trial of CDI treatment in children and the largest study of fecal microbiota transplantation in children.

Summary
This review highlights the most recent salient advancements in paediatric CDI knowledge and practice that supplement published clinical guidance provided prior to these advancements.
Characterization of Phenotypes and Treatment Modalities in Patients With Treacher-Collins Syndrome
Authors: Lee Hyeok Joon , Yang Il-Hyung , Baek Seung-Hak 
Published: July 2021

Abstract
The purpose of this study was to investigate the phenotypes and treatment modalities (Tx-Mod) in patients with Treacher-Collins syndrome (TCS) using a TCS severity index (TSI). The sample consisted of 14 Korean TCS patients treated at the Department of Orthodontics, Seoul National University Dental Hospital during 1998 to 2019. The TSI was calculated by adding the scores from the number of deformity-involved midface structures (eye, ear, zygoma) and the degree of mandibular hypoplasia (Pruzansky-Kaban type, gonial angle, Sella-Nasion-B point angle). The deformity-involved midface structure, degree of mandibular hypoplasia, oral manifestations, dental phenotypes, and Tx-Mod types were investigated using descriptive statistics. The TSI classified the subjects into 2 mild, 6 moderate, and 6 severe cases. The severity of ear and zygoma deformities, degree of condylar hypoplasia (Pruzansky-Kaban type), clockwise-rotated morphology (gonial angle) and retrusive position (Sella-Nasion-B point angle) of the mandible, and frequency of oral/craniofacial cleft, openbite, congenitally missing tooth and impacted tooth showed a tendency of increase from mild to severe TCS cases. After growth observation (78.6%), diverse combinations of Tx-Mods were applied except for functional appliance therapy. Surgical procedures for eye, ear, and zygoma reconstruction were performed on all patients (100%), whereas fixed orthodontic treatment, mandibular distraction osteogenesis, and orthognathic surgery were performed on 50% of patients. Surgical procedure for hearing improvement was the most frequent Tx-Mod (78.6%). The main desires of TCS patients were to obtain the facial esthetics in the midface and to improve hearing function. The TSI might provide a primary data for individualized diagnosis and treatment planning.
A Challenging Period After Repair: Etiology and Follow-Up Rates of the Patients With Cleft Lip and Palate in Intensive Care Unit
Authors: Kara Murat , Calis Mert , Kesici Selman , Canbay Ozgur , Bayrakci Benan , Ozgur Figen 
Published: July 2021

Abstract
The perioperative period is quite challenging because of the featured anatomical and clinical properties of the babies with cleft lip and palate (CLP). Therefore follow-up in the intensive care unit (ICU) is a crucial parameter for managing these patients. Although various studies in cleft literature, limited studies have analyzed the ICU admission rate and its etiology in the cleft population. At this point, the present study aims to reveal the etiology and rate of ICU admission of babies with an orofacial cleft to contribute to taking preventive precautions.
The rate of primary CLP patients was 69.5% (937 of 1348 patients). Intensive care unit admission rate of primary CLP patients was 6.2% (n = 58). The expected and unexpected ICU admission rate was 4.8% and 1.4%, respectively. Of the patients admitted to the ICU, 53.4% (n = 31) were boys and 46.6% (n = 27) were girls. There was no statistically significant association between gender and ICU admission (P = 0.896). However, the association between cleft type and ICU follow-up was statistically significant (P < 0.001).
The findings of the present study reveal the high ICU admission rate of cleft patients within all patients admitted to ICU. Due to many unique statuses of cleft babies, attentive assessment in the preoperative period and determining the postoperative need for ICU follow-up would contribute to preventing postoperative complications.
Demographics of Positional Plagiocephaly and Brachycephaly; Risk Factors and Treatment
Authors: van Cruchten Cas , Feijen Michelle Marlena Wilhelmina , van der Hulst Rene Remmelt Willie Johan 
Published: July 2021

Abstract
In the last 3 decades, the incidence of positional cranial deformations in infants, such as positional plagiocephaly and positional brachycephaly, has increased. The deviating shape often causes parental concern for the later psychosocial wellbeing of the child. Treatment options are nonoperative, varying from positional change to helmet therapy, of which the effect has often been debated. Multiple risk factors have been associated with an increased risk on the development of these deformations. The goal of this study was to assess the impact of known risk factors on the type and severity of resulting positional cranial deformation.
Parents were asked to fill out a questionnaire regarding the presence of risk factors, such as gender, age, pregnancy duration, method of delivery and reasons for atypical deliveries, breech position, birth weight, developmental status, positional preference, family history, number of siblings, and torticollis presence. Treatment methods were documented and plagiocephalometry was used to measure the cranial proportions. All children were invited to participate in short-term follow-up. The significance of the risk factors and the effect of different kinds of therapy are discussed. Although no significant correlation was found between severity and risk factors, some risk factors could be correlated with the kind of positional cranial deformation. Of the different therapies, helmet therapy had a significant impact on the reduction of positional plagiocephaly.
Role of dietary fiber in safeguarding intestinal health after pelvic radiotherapy
Authors: Bull Cecilia , Devarakonda Sravani , Ahlin Rebecca 
Published: July 2021

Purpose of review
Damage to healthy bowel tissue during pelvic radiotherapy can produce devastating and life-long changes in bowel function. The surging interest in microbiota and its importance for our wellbeing has generated a bulk of research highlighting how the food we consume impacts bowel health and disease. Dietary fiber is known to promote bowel health, yet there is a limited number of studies on dietary fiber in connection to pelvic radiotherapy. Here, we review some of the literature on the subject and present the most recent publications in the field.

Recent findings
Advice given concerning dietary fiber intake during and after pelvic radiotherapy are inconsistent, with some clinics suggesting a decrease in intake and others an increase. Recent animal studies provide a solid support for a protective role of dietary fiber with regards to intestinal health after pelvic radiotherapy, mainly through its impact on the microbiota. No clinical study has yet provided unambiguous evidence for a similar function of dietary fiber in humans undergoing pelvic radiotherapy.

Summary
There is a lack of evidence behind the dietary advice given to cancer survivors suffering from radiation-induced bowel dysfunction, and high-quality and well powered studies with long follow-up times are needed.
Longitudinal variation in SARS-CoV-2 antibody levels and emergence of viral variants: implications for the ability of serological assays to predict immunity
Authors: Muecksch Frauke , Wise Helen , Templeton Kate , Batchelor Becky , Squires Maria , McCance Kirsty , Jarvis Lisa , Malloy Kristen , Furrie Elizabeth , Richardson Claire , MacGuire Jacqueline , Godber Ian , Burns Alana , Mavin Sally , Zhang Fengwen , Schmidt Fabian , Bieniasz Paul , Jenks Sara , Hatziioannou Theodora 
Published: July 2021

AbstractBackgroundSerological assays are being deployed to monitor antibody responses in SARS-CoV-2 convalescents and vaccine recipients. There is a need to determine whether such assays can predict immunity, as antibody levels wane and viral variants emerge.MethodsWe measured antibodies in a cohort of SARS-CoV-2 infected patients using several high-throughput serological tests and functional neutralization assays. The effects of time and spike protein sequence variation on the performance and predictive value of the various assays was assessed.FindingsNeutralizing antibody titers decreased over the first few months post-infection but stabilized thereafter, at about 30% of the level observed shortly after infection. Serological assays commonly used to measure antibodies against SARS-CoV-2 displayed a range of sensitivities that declined to varying extents over time. Quantitative measurements generated by serological assays based on the spike protein were better at predicting neutralizing antibody titers than assays based on nucleocapsid, but performance was variable and manufacturer positivity thresholds were not able to predict the presence or absence of detectable neutralizing activity. Even though there was some deterioration in correlation between serological measurements and functional neutralization activity, some assays maintained an ability to predict neutralizing titers, even against variants of concern.InterpretationThe ability of high throughput serological assays to predict neutralizing antibody titers is likely crucial for evaluation of immunity at the population scale. These data will facilitate the selection of the most suitable assays as surrogates of functional neutralizing activity and suggest that such measurements may have utility in clinical practice.
Anticoagulants and Antiplatelets in COVID-19: Impact on Survival and Thromboembolism Development
Authors: Salmon Thomas , Titley Mitchell , Noori Zaid , Crosby Mark , Sankaranarayanan Rajiv 
Published: July 2021

AbstractBackgroundHigher rates of venous and arterial thromboembolism have been noted in coronavirus disease-2019 (COVID-19). There has been limited research on the impact of anticoagulant and antiplatelet choice in COVID-19.MethodsThis was a single-centre retrospective cohort study of 933 patients with COVID-19 infection presenting between 01/02/2020 and 31/05/2020. Survival time at 90 days post-diagnosis and thromboembolism development were the measured outcomes.ResultsOf 933 total patients, mean age was 68 years and 54.4% were male. 297 (31.8%) did not survive at 90 days. A Cox proportional hazards model analysis found no statistically significant relationship between anticoagulant or antiplatelet choice and survival (p<0.05).57 (6.3%) developed thromboembolism. Antiplatelet choice was not shown to have a statistically significant relationship with thromboembolism development. Warfarin and direct oral anticoagulant (DOAC) use did not have a statistically significant impact on thromboembolism development (p<0.05). Therapeutic low-molecular-weight heparin (LMWH) use was associated with increased thromboembolism risk (Odds ratio = 14.327, 95% CI 1.904 – 107.811, p = 0.010).ConclusionsAntiplatelet choice was shown to have no impact on survival or thromboembolism development in COVID-19. Anticoagulant choice did not impact survival or thromboembolism development, aside from LMWH. Therapeutic LMWH use was associated with increased risk of thromboembolism. However, it should be noted that the sample size for patients using therapeutic LMWH was small (n=4), and there may be confounding variables affecting both LMWH use and thromboembolism development. These findings should be repeated with a larger sample of patients using therapeutic LMWH with additional adjustment for cofounding variables.
Investigating the clinical utility of biomarkers and other novel tests in younger onset neurocognitive disorders: the BeYOND study, protocol for a longitudinal clinical study in a real-world setting
Authors: Loi Samantha M , Eratne Dhamidhu , Cadwallader Claire , Ravanfar Parsa , Chadunow Carolyn , Vidaurre Lesley , Farrand Sarah , Kelso Wendy , Goh Anita MY , Watson Rosie , Evans Andrew , Walterfang Mark , Velakoulis Dennis 
Published: July 2021

ABSTRACTBackgroundYounger-onset dementia (YOD) can be challenging to diagnose due to its younger age of onset, heterogeneous aetiologies and broad range of presentations. Misdiagnosis is common with psychiatric conditions often diagnosed initially and diagnostic delay of five years is common. More information is needed to better understand and diagnose YOD, including the nature of symptom onset, progression of the disease, the relationship between cognition and functional outcomes for patients and carers, imaging changes and novel biomarkers. This paper reports on the background behind the “Investigating the clinical utility of biomarkers and other novel tests in younger-onset neurocognitive disorders”, the BeYOND study, and its methodology.MethodsBeYOND is a clinically-oriented “real-world” longitudinal study that follows younger people presenting with an onset of neuropsychiatric symptoms ≤ 65 years of age. We aim to collect information on participants’ cognition, neuroimaging, mental health, and blood and cerebrospinal fluid (CSF) biomarkers at 18-month time-points over 3 years. We also aim to collect information regarding the experience of carers and/or family of participants.ConclusionSerial assessment of symptomatology, cognition, imaging, and blood and CSF biomarkers will be correlated with eventual diagnosis to determine the usefulness of these measures in determining a confident diagnosis. In addition, repeat measurements of the mental health and well-being of the participant and that of their carers/family while they traverse their diagnostic journey will provide important information about service provision and how they can be better supported.
The rise and fall of an emerging SARS-CoV-2 variant with the spike protein mutation L452R
Authors: Mor Orna , Mandelboim Michal , Fleishon Shay , Bucris Efrat , Bar-Ilan Dana , Linial Michal , Lustig Yaniv ,   Israel National Consortium for SARS-CoV-2 sequencing, Mendelson Ella , Zuckerman Neta S. 
Published: July 2021

AbstractEmerging SARS-CoV-2 variants may threaten global vaccination efforts and awaited reduction in outbreak burden. In this study, we report a novel variant carrying the L452R mutation that emerged from a local B.1.362 lineage, B.1.362+L452R. The L452R mutation is associated with the Delta and Epsilon variants and was shown to cause increased infection and reduction in neutralization in pseudoviruses. Indeed, the B.1.362+L452R variant demonstrated a X4-fold reduction in neutralization capacity of sera from BNT162b2-vaccinated individuals compared to a wild-type strain. The variant infected 270 individuals in Israel between December 2020 and March 2021, until diminishing due to the gain in dominance of the Alpha variant in February 2021. This study demonstrates an independent, local emergence of a variant carrying a critical mutation, L452R, which may have the potential of becoming a variant of concern and emphasizes the importance of routine surveillance and detection of novel variants among efforts undertaken to prevent further disease spread.
Predictors of black fungus fear during the COVID-19 pandemic among the Bangladeshi health workers: a cross-sectional study
Authors: Hasan Md. Kamrul , Kabir Humayun , Rahman Mamunur , Roy Anjan Kumar , Akter Shimpi , Mitra Dipak Kumar 
Published: July 2021

AbstractBackgroundThe emergence of mucormycosis cases amid the COVID-19 pandemic; fear associated with mucormycosis may turn out to be a terrifying public health issue. This study aimed to assess the association between fear and insomnia status and other predictors of mucormycosis among Bangladeshi healthcare workers.MethodsFrom 25 May 2021 to 05 June 2021, a cross-sectional study was carried out among healthcare workers. A total of 422 healthcare workers participated in this study. A semi-structured online questionnaire was used for data collection during the COVID-19 pandemic, followed by convenient and snowball sampling methods. A multivariable linear regression model was fitted to assess the association between fear and insomnia status and other predictors of mucormycosis.ResultsThe results indicated that the respondents with insomnia status had a higher score of mucormycosis fear than not having insomnia (β = 3.91, 95% CI: 2.49, 5.33, p <0.001), significantly. Alongside the increased knowledge score of mucormycosis, the average score of fear increased significantly(β = 0.35, 95% CI: 0.20, 0.50, p <0.001). The gender, profession, and death of friends and family members due to COVID-19 significantly affected mucormycosis fear score increment.ConclusionsThis is the first study that focused on assessing the association between mucormycosis fear and insomnia status among the health care workers so far. These study findings recommend emphasizing the mental health aspects and ensuring support to the healthcare workers to better tackle the ongoing public health crisis.
Incidence of Severe Acute Respiratory Syndrome Coronavirus-2 infection among previously infected or vaccinated employees
Authors: Kojima N , Roshani A , Brobeck M , Baca A , Klausner JD 
Published: July 2021

AbstractIntroductionThe protective effect of previous infection versus vaccination is poorly studied. Among a clinical laboratory that has been conducting routine workforce screening since the beginning of the pandemic, we aimed to assess the relative risk of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among individuals who were SARS-CoV-2 naïve, previously infected, or vaccinated.MethodsUsing an electronic laboratory information system, employees were divided into three groups: (1) SARS-CoV-2 naïve and unvaccinated, (2) previous SARS-CoV-2 infection, and (3) vaccinated. Person-days were measured from the date of the employee first test and truncated at the end of the observation period. SARS-CoV-2 infection was defined as two positive SARS-CoV-2 PCR tests in a 30-day period. Individuals with fewer than 14 days of follow up were excluded. Incidence estimates and the 95% confidence intervals were calculated using the Poisson Exact equation. The incidence rate ratio (IRR) was used as a measure of association between groups. Analyses were performed on StataSE (StataCorp, College Station, TX).ResultsWe identified 4313, 254 and 739 employee records for groups 1, 2, and 3, respectively. The median age of employees was 29.0 years (interquartile range: 23.6, 39.9). During the observation period, 254, 0, and 4 infections were identified among groups 1, 2, and 3, respectively. Group 1 had an incidence of 25.9 per 100 person-years (95% CI: 22.8-29.3). Group 2 had an incidence of 0 per 100 person-years (95% CI: 0-5.0). Group 3 had an incidence of 1.6 per 100 person-years (95% CI: 0.04-4.2). The IRR of reinfection among those with previous infection compared to SARS-CoV-2 naïve was 0 (95% CI: 0-0.19). The IRR of those vaccinated compared to SARS-CoV-2 naïve was 0.06 (95% CI: 0.02-0.16). The IRR of those vaccinated compared to prior SARS-CoV-2 was 0 (95% CI: 0-4.98).ConclusionPrevious SARS-CoV-2 infection and vaccination for SARS-CoV-2 were associated with decreased risk for infection or re-infection with SARS-CoV-2 in a routinely screened workforce. The was no difference in the infection incidence between vaccinated individuals and individuals with previous infection. Further research is needed to determine whether our results are consistent with the emergence of new SARS-CoV-2 variants.
Migraine Disability, Pain Catastrophizing, And Headache Severity Are Associated With Evoked Pain And Targeted By Mind-Body Therapy
Authors: Krimmel Samuel R. , Keaser Michael L. , Speis Darrah , Haythornthwaite Jennifer A. , Seminowicz David A. 
Published: July 2021

AbstractMeta-analysis suggests migraine patients are no more sensitive to experimentally evoked pain than healthy controls. At the same time, studies have linked some migraine symptoms to Quantitative Sensory Testing (QST) profiles. Unfortunately, previous studies associating migraine symptoms and QST have important methodological shortcomings, stemming from inappropriate statistics, small sample sizes, and frequent use of univariate statistics for multivariate research questions. In the current study we seek to address these limitations by using a large sample of episodic migraine patients (n=103) and a multivariate analysis that associates pain ratings from many thermal intensities simultaneously with 12 clinical measures ranging from headache frequency to sleep abnormalities. We identified a single dimension of association between QST and migraine symptoms that relates to pain ratings for all stimulus intensities and a subset of migraine symptoms relating to disability (Headache Impact Trauma 6 and Brief Pain Inventory interference), catastrophizing (Pain Catastrophizing Scale), and pain severity (average headache pain, Brief Pain Inventory severity, and Short Form McGill Pain Questionnaire 2). Headache frequency, allodynia, affect, and sleep disturbances were unrelated to this dimension. Consistent with previous research, we did not observe any difference in QST ratings between migraine patients and healthy controls. Additionally, we found that the linear combination of symptoms that related to QST were modified by mind-body therapy. These results suggest that QST has a selective relationship with pain symptoms even in the absence of between-subjects differences between chronic pain patients and healthy controls.HighlightsExperimentally evoked pain ratings have been linked to migraine symptoms, though there are methodological shortcomingsWe find evoked pain ratings are related to disability, pain catastrophizing, and pain severity, but not to headache frequency, affect, nor sleep disturbancesEvoked pain and symptoms relate even in the absence of pain sensitivity differences between patients and healthy controlsMind-body therapy altered symptoms that related to evoked painExperimentally evoked pain should be used to study specific ensembles of symptoms, even when pain ratings do not differ between patients and healthy controls