bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vestibular Function in Pendred Syndrome: Intact High Frequency VOR and Saccular Hypersensitivity
Authors: West Niels Cramer , Ryberg Alexander Christian , Cayé-Thomasen Per 
Published: July 2021

Objective:
Although Pendred syndrome involves anatomical abnormalities in the vestibular system and patient-perceived dizziness, the literature on vestibular function is scarce. The objective was to evaluate objective vestibular function in patients with PS using the video head impulse test (VHIT) and the cervical vestibular evoked myogenic potential (cVEMP) test, assessing the high frequency vestibulo-ocular reflex (VOR) and the saccular function, respectively.

Methods:
Twenty-six subjects (52 ears) with Pendred Syndrome and severe-to-profound hearing loss (cochlear implant candidacy) were studied retrospectively. Main outcome measures were VHIT VOR gain, refixation saccades, cVEMP stimulus thresholds and amplitudes.

Results:
In total, 4 of 52 ears (8%) had pathological VHIT outcomes (2 ears with low VHIT gain and 2 ears with saccades). The mean VHIT gain value was 0.96 (range 0.63–2.02). No patients had complete VOR loss. CVEMP responses were present in 76% of tested ears and absent in 24%. The mean cVEMP amplitude value was 192 μV. Absence of cVEMP response was associated with the presence of VHIT saccades (p = 0.038) and advanced age (r
s = −0.34; p < 0.05). cVEMP amplitude was correlated with VHIT gain (r
s = 0.46; p < 0.001).

Conclusion:
Despite dysmorphic vestibular anatomy and severe loss of hearing, the VHIT VOR function is normal in patients with Pendred Syndrome. However, saccular function appears to be abnormally sensitive, as documented by low cVEMP thresholds and high amplitudes, which agrees with a “third window” effect secondary to the large vestibular aqueduct.
Thoracic computed tomography in the progressive fibrotic phenotype
Authors: Devaraj Anand , Milanese Gianluca , Sverzellati Nicola 
Published: July 2021

Purpose of review
To discuss rationale and methods for determining progressive lung fibrosis on thoracic computed tomography (CT) and describe limitations and challenges

Recent findings
Identifying patients with progressive lung fibrosis is important to determine optimal treatment. Serial high-resolution computed tomography is a method of determining disease progression. A number of studies are reviewed in this article, that have explored various parameters (both visual and automated) that signify progressive fibrosis on CT.

Summary
To reliably use serial CT as a marker of disease progression in fibrotic lung disease, clinicians and radiologists need to be aware of the optimal methods for identifying changes in disease extent, and understand their limitations.
Advancing organ transplantation through HIV-to-HIV transplantation
Authors: Fuller Risa , Rana Meenakshi M. 
Published: July 2021

Purpose of review
Persons living with HIV (PLWH) have a life expectancy that is nearly equivalent to the general population, and thus are facing health conditions associated with normal aging as well as long-term HIV infection. End-organ disease is associated with significant morbidity and mortality and solid organ transplantation (SOT) may be a viable option for many PLWH. We review the history and recent updates in SOT in PLWH, specifically focusing on HIV-to-HIV transplantation.

Recent findings
Following promising data out of South Africa and to expand the donor pool, the United States passed the HIV Organ Procurement Equity (HOPE) Act, allowing for HIV-to-HIV SOT. Preliminary data to date, especially in HIV-to-HIV kidney transplantation, suggest overall excellent patient and graft survival outcomes with no HIV breakthrough infection.

Summary
Preliminary HIV D+R+ SOT data to date suggest promising patient outcomes and no significant adverse events to recipients or living donors. This is an important step in expanding the donor pool and increasing opportunity for SOT in PLWH.
Urinary Cannabis Metabolite Concentrations in Cannabis Hyperemesis Syndrome
Authors: Cordova Jonathan , Biank Vincent , Black Elizabeth , Leikin Jerrold 
Published: July 2021

ABSTRACT

Objective:
Cannabis Hyperemesis Syndrome (CHS) is characterized by recurrent episodes of intractable emesis associated with heavy use of cannabis. Recognition of CHS can be problematic due to the lack of specific biomarkers, which can point the clinician to the diagnosis. We present, retrospectively, a series of adolescent/young adult patients who presented to a pediatric gastroenterology (GI) service with acute on chronic nausea and vomiting, subsequently found to have CHS with associated elevated urinary cannabis metabolite concentrations.

Methods:
We describe 15 patients referred to our pediatric GI division for intractable emesis with spot urinary cannabis metabolite carboxy-THC (THC-COOH) concentrations from January 1, 2018 through April 20, 2019. Urinary testing was performed using gas chromatography mass−spectrometry (GC−MS) in a manner consistent with Clinical Laboratory Improvement Amendments (CLIA) requirements at Mayo Clinic laboratory (Rochester, MN). The laboratory cutoffs were 3.0 ng/mL. Data was extracted via chart review and analyzed via online statistical application.

Results:
Fifteen patients (seven females, eight males) were studied with an average age of 17.7 years. All patients reported frequent cannabis use for at least 1 month and exhibited intractable, non-bilious emesis for at least 2 weeks. Twelve patients also reported weight loss. Two patients had underlying gastrointestinal disease (one with Crohn disease and one with irritable bowel syndrome). All patients had essentially normal GI workup including laboratory tests, imaging studies and endoscopies.
Fourteen of 15 patients had urinary THC-COOH concentrations >100 ng/mL, with seven individuals exhibiting levels >500 ng/mL. One patient had a urinary TCH-COOH concentration level under 100 ng/mL had not used cannabis for 2 weeks. Most other patients had used cannabis within 2 days of providing a urine sample. The Binomial test for CHS patients with urinary THC-COOH levels over 100 ng/mL was significant with a P-value of <0.0005 (one tail test).

Conclusion:
CHS is associated with an elevated urinary THC-COOH level usually exceeding 100 ng/mL, which is indicative of significant chronic cannabis exposure. In patients with a history consistent with CHS, urine THC-COOH testing may help guide the diagnostic evaluation of these patients and decrease the need for further workup.
Platelet Dysfunction Because of Amlodipine in Bone Marrow Transplant Recipient
Authors: Gözmen Salih , Gözmen Şükran Keskin 
Published: July 2021

Background:
Hypertension (HTN) is a complication of pediatric hematopoietic stem cell transplantation. We report a pediatric stem cell transplant patient who had HTN and adverse event because of amlodipine.

Observation:
Seven-year-old boy had haploidentical stem cell transplantation with post-transplant cyclophosphamide. He had complete donor chimerism at the end of one month. Amlodipine was started on day +36 for HTN. On day +41, he had petechiae. Platelet function analyzer (PFA)-100 was abnormal. After amlodipine was stopped, petechiae disappeared and PFA-100 returned to normal.

Conclusions:
Abnormal PFA-100 and the patient complaints indicated the possibility of amlodipine-induced platelet dysfunction through inhibition of calcium-mediated platelet reactions.
Application of Multiplex Polymerase Chain Reaction for Pathogen Identification and Antibiotic Use in Children With Respiratory Infections in a PICU
Authors: Yoshida Kota , Hatachi Takeshi , Okamoto Yuya , Aoki Yoshihiro , Kyogoku Miyako , Moon Miyashita Kazue , Inata Yu , Shimizu Yoshiyuki , Fujiwara Futoshi , Takeuchi Muneyuki 
Published: July 2021

OBJECTIVES:
To compare the pathogen identification rate and use of antibiotics before and after the implementation of multiplex polymerase chain reaction testing in children with respiratory infections in a PICU.

DESIGN:
Single-center, pre-post study.

SETTING:
PICU of Osaka Women’s and Children’s Hospital, Osaka, Japan.

PATIENTS:
Consecutive children with respiratory infections who were admitted to the PICU between December 2017 and November 2018 (premultiplex polymerase chain reaction period) and between March 2019 and February 2020 (postmultiplex polymerase chain reaction period).

INTERVENTIONS:
Conventional rapid antigen tests and bacterial culture tests were performed throughout the study period. Multiplex polymerase chain reaction testing using the FilmArray respiratory panel (BioFire Diagnostics, Salt Lake City, UT) was conducted to detect 17 viruses and three bacterial pathogens. During the postmultiplex polymerase chain reaction period, we did not recommend prescribing antibiotics for stable children, depending on the virus species and laboratory test results.

MEASUREMENTS AND MAIN RESULTS:
Ninety-six and 85 children were enrolled during the pre- and postmultiplex polymerase chain reaction periods, respectively. Rapid antigen tests identified pathogens in 22% of the children (n = 21) during the premultiplex polymerase chain reaction period, whereas rapid antigen tests and/or multiplex polymerase chain reaction testing identified pathogens in 67% of the children (n = 57) during the postmultiplex polymerase chain reaction period (p < 0.001). The most commonly identified pathogen using multiplex polymerase chain reaction testing was human rhino/enterovirus. Bacterial pathogens were identified in 50% of the children (n = 48) and 60% of the children (n = 51) during the pre- and postmultiplex polymerase chain reaction periods (p = 0.18). There were no differences in antibiotic use (84% vs 75%; p = 0.14), broad-spectrum antibiotic use (33% vs 34%; p = 0.91), or the duration of antibiotic use within 14 days of admission (6.0 vs 7.0 d; p = 0.45) between the pre- and postmultiplex polymerase chain reaction periods.

CONCLUSIONS:
Although the pathogen identification rate, especially for viral pathogens, increased using multiplex polymerase chain reaction testing, antibiotic use did not reduce in children with respiratory infections in the PICU. Definitive identification of bacterial pathogens and implementation of evidence-based antimicrobial stewardship programs employing multiplex polymerase chain reaction testing are warranted.
Anatomic Subunit Approach to Composite Reconstruction of Facial Gunshot Wounds
Authors: Heffern Eric , Nevil Collin , Przylecki Wojciech , Andrews Brian T. 
Published: July 2021

Abstract
With a rise in gun violence in the United States, surgeons are tasked with effectively managing penetrating facial trauma. The purpose of this study is to assess methods used for successful composite reconstruction of each anatomical facial subunit following penetrating trauma. A retrospective chart review was performed in subjects undergoing craniofacial reconstruction following penetrating trauma. Reconstructive methods were analyzed through operative reports. Subjects were categorized by anatomical subunit reconstructed (mandible, maxilla (malar complex and roof/palate), orbit, and cranium) and method of reconstruction (open reduction internal fixation only, bone graft, free flap, implant, and tissue expansion). Thirty-six subjects underwent reconstruction for penetrating facial trauma. Involved subunits include 24 mandible, 11 malar complex, 13 palate, 18 orbit, and 11 cranium. Predominate reconstruction method was open reduction internal fixation only for mandible (45.8%), bone grafting for malar complex (81.8%), implant for orbit (66.7%) and cranium (63.6%), and local tissue rearrangement for palate (84.6%). The predominate bone graft donor site was iliac for mandible (42.9%), rib for malar complex (36.3%) and orbit (40.0%), and frontal bone for cranium (42.8%). The predominate free flap was osteocutaneous for all mandible, orbit, and cranium and 7 of 10 (70.0%) palate reconstructions. Tissue expansion was used in all subunits except cranium. In conclusion, bone grafting, implants, free tissue transfer, and tissue expansion are all viable reconstruction options for penetrating trauma. There is no single approach to use, and decisions regarding definitive reconstruction method should be based upon anatomical subunit involved and the size/area of defects.
The Confusion of Determining the Landmark in the Craniofacial Soft Tissue Analyzes: Nasion or Sellion?
Authors: Bahşi Ilhan , Orhan Mustafa , Kervancioğlu Piraye 
Published: July 2021

Abstract
In the literature, most of the craniofacial anthropometric landmarks found on both bones and soft tissue have been clearly defined and widely used. However, it seems that few landmarks such as nasion are generally often set incorrectly. Therefore, in this study, it was aimed to examine the nasion and sellion in the dry bones and to review the definitions of each landmarks. A total of 41 adult skulls, whose nasofrontal region was not deformed and whose age, gender and ethnic origin were not known, were examined. It was found that nasion and sellion are at the same point in 24 of the 41 (58.54%) bones examined, and that in 17 of them (41.46%), sellion is below the nasion. In the bones where the sellion is below the nasion, the average distance between each two landmarks was determined as 4.53 ± 0.95 mm. Consequently, we think that it is not possible to determine nasion in the indirect craniofacial soft tissue analyzes, and it would be better to use sellion as a reference landmark instead of nasion.
A Comparison of Methods for Predicting Future Cognitive Status
Authors: Appiah Frank , Charnigo Richard J. 
Published: July 2021

Purpose:
The present work compares various methods for using baseline cognitive performance data to predict eventual cognitive status of longitudinal study participants at the University of Kentucky’s Alzheimer’s Disease Center.

Methods:
Cox proportional hazards models examined time to cognitive transition as predicted by risk strata derived from normal mixture modeling, latent class analysis, and a 1-SD thresholding approach. An additional comparator involved prediction directly from a numeric value for baseline cognitive performance.

Results:
A normal mixture model suggested 3 risk strata based on Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) T scores: high, intermediate, and low risk. Cox modeling of time to cognitive decline based on posterior probabilities for risk stratum membership yielded an estimated hazard ratio of 4.00 with 95% confidence interval 1.53-10.44 in comparing high risk membership to low risk; for intermediate risk membership versus low risk, the modeling yielded hazard ratio=2.29 and 95% confidence interval=0.98-5.33. Latent class analysis produced 3 groups, which did not have a clear ordering in terms of risk; however, one group exhibited appreciably greater hazard of cognitive decline. All methods for generating predictors of cognitive transition yielded statistically significant likelihood ratio statistics but modest concordance statistics.

Conclusion:
Posterior probabilities from mixture modeling allow for risk stratification that is data-driven and, in the case of CERAD T scores, modestly predictive of later cognitive decline. Incorporating other covariates may enhance predictions.
Core Imaging Library - Part I: a versatile Python framework for tomographic imaging
Authors: Jørgensen J. S. , Ametova E. , Burca G. , Fardell G. , Papoutsellis E. , Pasca E. , Thielemans K. , Turner M. , Warr R. , Lionheart W. R. B. , Withers P. J. 
Published: July 2021

We present the Core Imaging Library (CIL), an open-source Python framework for tomographic imaging with particular emphasis on reconstruction of challenging datasets. Conventional filtered back-projection reconstruction tends to be insufficient for highly noisy, incomplete, non-standard or multi-channel data arising for example in dynamic, spectral andin situtomography. CIL provides an extensive modular optimization framework for prototyping reconstruction methods including sparsity and total variation regularization, as well as tools for loading, preprocessing and visualizing tomographic data. The capabilities of CIL are demonstrated on a synchrotron example dataset and three challenging cases spanning golden-ratio neutron tomography, cone-beam X-ray laminography and positron emission tomography.This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 2’.
Enhanced diffuse optical tomographic reconstruction using concurrent ultrasound information
Authors: Di Sciacca G. , Di Sieno L. , Farina A. , Lanka P. , Venturini E. , Panizza P. , Dalla Mora A. , Pifferi A. , Taroni P. , Arridge S. R. 
Published: July 2021

Multimodal imaging is an active branch of research as it has the potential to improve common medical imaging techniques. Diffuse optical tomography (DOT) is an example of a low resolution, functional imaging modality that typically has very low resolution due to the ill-posedness of its underlying inverse problem. Combining the functional information of DOT with a high resolution structural imaging modality has been studied widely. In particular, the combination of DOT with ultrasound (US) could serve as a useful tool for clinicians for the formulation of accurate diagnosis of breast lesions. In this paper, we propose a novel method for US-guided DOT reconstruction using a portable time-domain measurement system. B-mode US imaging is used to retrieve morphological information on the probed tissues by means of a semi-automatical segmentation procedure based on active contour fitting. A two-dimensional to three-dimensional extrapolation procedure, based on the concept of distance transform, is then applied to generate a three-dimensional edge-weighting prior for the regularization of DOT. The reconstruction procedure has been tested on experimental data obtained on specifically designed dual-modality silicon phantoms. Results show a substantial quantification improvement upon the application of the implemented technique.
This article is part of the theme issue ‘Synergistic tomographic image reconstruction: part 2’.
COVID-19 vaccine hesitancy and refusal and associated factors in an adult population in Saskatchewan, Canada: Evidence from predictive modelling
Authors: Muhajarine Nazeem , Adeyinka Daniel A. , McCutcheon Jessica , Green Kathryn , Fahlman Miles , Kallio Natalie 
Published: July 2021

AbstractBackgroundA high population level of vaccination is required to control the COVID-19 pandemic, but not all Canadians are convinced of the value and safety of vaccination. Understanding more about these individuals can aid in developing strategies to increase their acceptance of a COVID-19 vaccine. The objectives of this study were to describe COVID-19 vaccine acceptance, hesitancy and refusal rates and associated factors in Saskatchewan, Canada.MethodsThis study consisted of a weighted sample of 9,252 survey responses from 7,265 Saskatchewan adults (≥18 years) between May 4, 2020 and April 3, 2021. The outcome variable was vaccine intention: vaccine acceptance, hesitancy, and refusal. The independent variables were layered into socio-demographic factors, risk of exposure to coronavirus, mitigating behaviours, and perceptions of COVID-19. Data were analyzed using multinomial logistic regression and a classification and regression tree.ResultsSeventy-six percent of the respondents indicated that they had been or were willing to be vaccinated, 13% had not yet decided, and the remaining 11% said they would not be vaccinated. Factors that increased the likelihood of vaccine refusal and hesitancy were lower education level, financial instability, Indigenous status, and not being concerned about spreading the coronavirus. Perceiving COVID-19 to be more of a threat to one’s community and believing that one had a higher risk of illness or death from COVID-19 decreased the likelihood of both vaccine refusal and hesitancy. Women and newcomers to Canada were more likely to be unsure about getting vaccinated. Respondents who did not plan to be vaccinated were less likely to wear face masks and practice physical distancing.ConclusionWhile many Canadians have voluntarily and eagerly become vaccinated already, reaching sufficient coverage of the population is likely to require targeted efforts to convince those who are resistant or unsure. Identifying and overcoming any barriers to vaccination that exist within the socio-demographic groups we found were least likely to be vaccinated is a crucial component.
Volumetric quantification of wound healing by machine learning and optical coherence tomography in adults with type 2 diabetes: the GC-SHEALD RCT
Authors: Wang Yinhai , Ajjan Ramzi , Freeman Adrian , Stewart Paul , Galdo Francesco Del , Tiganescu Ana 
Published: July 2021

AbstractType 2 diabetes mellitus is associated with impaired wound healing, which contributes substantially to patient morbidity and mortality. Glucocorticoid (stress hormone) excess is also known to delay wound repair. Optical coherence tomography (OCT) is an emerging tool for monitoring healing by “virtual biopsy”, but largely requires manual analysis, which is labour-intensive and restricts data volume processing. This limits the capability of OCT in clinical research.Using OCT data from the GC-SHEALD trial, we developed a novel machine learning algorithm for automated volumetric quantification of discrete morphological elements of wound healing (by 3mm punch biopsy) in patients with type 2 diabetes. This was able to differentiate between early / late granulation tissue, neo-epidermis and clot structural features and quantify their volumetric transition between day 2 and day 7 wounds. Using OCT, we were able to visualize differences in wound re-epithelialisation and re-modelling otherwise indistinguishable by gross wound morphology between these time points. Automated quantification of maximal early granulation tissue showed a strong correlation with corresponding (manual) GC-SHEALD data. Further, % re-epithelialisation was improved in patients treated with oral AZD4017, an inhibitor of systemic glucocorticoid-activating 11β-hydroxysteroid dehydrogenase type 1 enzyme action, with a similar trend in neo-epidermis volume.Through the combination of machine learning and OCT, we have developed a highly sensitive and reproducible method of automated volumetric quantification of wound healing. This novel approach could be further developed as a future clinical tool for the assessment of wound healing e.g. diabetic foot ulcers and pressure ulcers.Disclosure SummaryI certify that neither I nor my co-authors have a conflict of interest as described above that is relevant to the subject matter or materials included in this Work.