bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health State of Syrian Children and Their Parents in a German Refugee Camp
Authors: Nehring Ina , Schlag Eva , Qirjako Eni , Büyükyaglioglu Cigdem , Mall Volker , Sattel Heribert , Sack Martin , Henningsen Peter , Aberl Sigrid 
Published: April 2019

Abstract
More than 1 million Syrian refugees have sought asylum in Europe since 2011. Disastrous conditions in their country and an arduous flight increased the risk for the emergence of physical and mental problems, especially in children. We performed a comprehensive medical and psychological examination in 96 Syrian refugee children aged 0–14 years in a German reception camp. Parents were interviewed and answered questions on health, flight and living conditions. In the children, we found most frequently somatic and in particular dental problems, incomplete immunization state and mental disorders. Post-traumatic stress disorder (PTSD) was diagnosed in 30.2 per cent of the children. Fifty-seven per cent of the parents reported somatic complaints; most of them were neurological (e.g. headache) and sleep disorders. Syrian refugee children show a significant rate of PTSD, somatic disorders and incomplete immunization state. The separation from family members during flight and physical complaints of the parents were identified as risk factors for PTSD in the children of our study. Early combined acute and preventive health-care management for children and their parents is indicated.
Fluorescence-Based Measurement of Real-Time Kinetics of Protoporphyrin IX After 5-Aminolevulinic Acid Administration in Human In Situ Malignant Gliomas
Authors: Kaneko Sadahiro , Suero Molina Eric , Ewelt Christian , Warneke Nils , Stummer Walter 
Published: April 2019

Abstract

BACKGROUND
Five-aminolevulinic acid (5-ALA) is well established for fluorescence-guided resections of malignant gliomas by eliciting the accumulation of fluorescent protoporphyrin IX (PpIX) in tumors. Because of the assumed time point of peak fluorescence, 5-ALA is recommended to be administered 3 h before surgery. However, the actual time dependency of tumor fluorescence has not yet been evaluated in humans and may have important implications.

OBJECTIVE
To investigate the time dependency of PpIX by measuring fluorescence intensities in tumors at various time points during surgery.

METHODS
Patients received 5-ALA (20 mg/kg b.w.) 3 to 4 h before surgery. Fluorescence intensities (FI) and estimated tumor PpIX concentrations (CPPIX) were measured in the tumors over time with a hyperspectral camera. CPPIX was assessed using hyperspectral imaging and by evaluating fluorescence phantoms with known CPPIX.

RESULTS
A total of 201 samples from 68 patients were included in this study. On average, maximum values of calculated FI and CPPIX were observed between 7 and 8 h after 5-ALA administration. FI and CPPIX both reliably distinguished central strong and marginal weak fluorescence, and grade III compared to grade IV gliomas. Interestingly, marginal (weak) fluorescence was observed to peak later than strong fluorescence (8-9 vs 7-8 h).

CONCLUSION
In human in Situ brain tumor tissue, we determined fluorescence after 5-ALA administration to be maximal later than previously thought. In consequence, 5-ALA should be administered 4 to 5 h before surgery, with timing adjusted to internal logistical circumstances and factors related to approaching the tumor.
Medical Merchandising and Legal Procedure in Late Sixteenth-Century Spain: The Case of Petroleum as Imported Medicine
Authors: Bergman Ted Lars Lennart 
Published: April 2019

Summary
This article examines the historical context and particular case of Italian merchant Guido Mondones (also named as ‘Modones’) who sold petroleum as medicine in Spain in the late sixteenth century. The first two-thirds of the article uses printed sources as a way to demonstrate that this merchant was likely not disadvantaged by being a foreigner and itinerant. Nor would he have been considered a suspect for selling oil with healing properties, as it was a fully accepted practice, including among university-trained professionals. All the materials for Mondones’s particular case are archival and contained within a lawsuit from Valladolid that contains a wealth of information about the merchant’s relationship with legal and medical authorities. Through these sources, we learn that he managed to be financially successful by navigating Spain’s particular medical–legal landscape at the time and skillfully defending himself against accusations of tax evasion and selling false medicine.
Children Born to Mothers with Rash During Zika Virus Epidemic in Brazil: First 18 Months of Life
Authors: Vianna Renata Artimos de Oliveira , Lovero Kathryn Lynn , Oliveira Solange Artimos de , Fernandes Alexandre Ribeiro , Santos Teresa Cristina Sarmet dos , Lima Luiz Cláudio Santos de Souza , Carvalho Fabiana Rabe , Quintans Maria Dolores Salgado , Bueno Arnaldo Costa , Torbey Ana Flávia Malheiros , Souza Aurea Lucia Alves Azevedo Grippa de , Farias Armanda de Oliveira Pache de , Camacho Luiz Antonio Bastos , Riley Lee Woodland , Cardoso Claudete Aparecida Araújo 
Published: April 2019

AbstractObjectiveTo better understand the clinical spectrum and course of congenital Zika syndrome (CZS) during the first 18 months of life of children whose mothers had rash during pregnancy.MethodsThis longitudinal observational study evaluated the clinical progress from birth until 18 months of life of children of mothers who developed rash during or up to 3 months before gestation. Maternal rash occurred from November 2015 to May 2017. The study subjects were divided into three groups: children whose mothers tested positive by RT-qPCR for Zika virus (ZIKV) (Group 1), children whose mothers tested negative by RT-qPCR for ZIKV (Group 2), and children whose mothers did not undergo any testing for ZIKV (Group 3) but tested negative for other congenital infections.ResultsBetween April 2016 and July 2018, we studied 108 children: 43 in Group 1, 26 in Group 2 and 39 in Group 3. The majority of children were admitted into the study within 6 months of life. CZS was diagnosed in 26 children, equally distributed in Groups 1 and 3. Of 18 children with microcephaly, 6 were in Group 1 (1 postnatal) and 12 were in Group 3 (5 postnatal). Maternal rash frequency was 10 times higher during the first trimester than in the other trimesters (OR: 10.35; CI 95%: 3.52–30.41). CZS was diagnosed during the follow-up period in 14 (54%) cases. Developmental delays and motor abnormalities occurred in all children and persisted up to 18 months. Epilepsy occurred in 18 (69%) of the cases.ConclusionsInfants born of mothers exposed to ZIKV during pregnancy showed progression of developmental, motor and neurologic abnormalities even if they were born asymptomatic. Continued postnatal monitoring of such newborns is necessary to preclude disability-associated complications.
Prevalence and potential risk factors for gastrointestinal parasitic infections in children in urban Bissau, Guinea-Bissau
Authors: von Huth Sebastian , Kofoed Poul-Erik , Holmskov Uffe 
Published: April 2019

Abstract

Background
Gastrointestinal (GI) parasitic infections cause significant morbidity and mortality in tropical and subtropical countries. We aimed to investigate the prevalence of GI parasitic infections in children from Bissau, Guinea-Bissau and to identify the possible risk factors for these infections.

Methods
We performed an observational study on two comparable cohorts of children 2–15 y of age: one study covering health care–seeking children (n=748) and one study covering children from the background population (n=851). A total of 1274 faecal samples from the two cohorts were investigated for parasites by microscopy and the risk factors for infection were identified by logistic regression.

Results
Intestinal parasitic infections were found in 54.8% of health care–seeking children and 55.5% of children from the background population. Helminth infections were more common among health care–seeking children and were mainly due to hookworms. Pathogenic protozoa included Entamoeba histolytica/dispar and Giardia lamblia. The risk factors for infections included increasing age, household crowding and poor sanitation and water supply.

Conclusions
We found a high prevalence of intestinal parasites among both health care–seeking children and children from the background population. Compared with previous studies, we found a decreasing prevalence of intestinal helminths. This study further identifies potential risk factors for infections, including inadequate sanitation and water supply.
In the Eye of the Storm: Immune‐mediated Toxicities Associated With CAR‐T Cell Therapy
Authors: Garcia Borrega Jorge , Gödel Philipp , Rüger Maria Adele , Onur Özgür A. , Shimabukuro‐Vornhagen Alexander , Kochanek Matthias , Böll Boris 
Published: April 2019

AbstractThe success of chimeric antigen receptor (CAR)‐T cell therapy with impressive response rates in hematologic malignancies but also promising data in solid tumors came along with the cognition of unexpected, potentially life‐threatening immune‐mediated toxicities, namely the cytokine release syndrome (CRS) and neurotoxicity recently referred to as “immune effector cell‐associated neurotoxicity syndrome” (ICANS). These toxicities require urgent diagnostic and therapeutic interventions and targeted modulation of key cytokine pathways represents the mainstay of CRS treatment. However, as the underlying mechanisms of ICANS are not well understood, treatment options remain limited and further investigation is warranted.Importantly, after the recent market approval of 2 CAR‐T cell constructs, the application of CAR‐T cells will expand to nonacademic centers with limited experience in the management of CAR‐T cell‐associated toxicities.Here, we review the current evidence of CRS and ICANS pathophysiology, diagnostics, and treatment.
Seroprevalence of Anti-HIV-1, Anti-HIV-2, Hepatitis B Surface Antigen, and Anti-HCV in Eye Donors in a Tertiary Eye Hospital, Chennai, India, in the Past 13 years (2005–2017)
Authors: Kulandhai Lily Therese , Bhagavathi Hema , Krishnan Selvi , Krishnan Kaviyarasan , Balasubramaniyam Mahalakshmi , Madhavan Hajib Naraharirao 
Published: April 2019

Purpose:
To understand the seroprevalence of HIV, hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) in serum samples collected from eye donors between 2005 and 2017 at Sankara Nethralaya, Chennai, India.

Method:
The reports of 7136 eye donors serologically screened for antibodies to HIV-1 and HIV-2, HBsAg, and antibodies to HCV were retrospectively analyzed.

Result:
Among the 7136 serum samples screened during this study period, the serum samples of 14 donors (0.20%) were reactive to HIV-1 antibodies, 78 donors (1.09%) were positive for detection of HBsAg, and 37 donors (0.52%) were positive for HCV antibodies. Of interest, coinfections of HIV-1 and HBV, and HIV-1 and HCV were detected in 2 and 1 serum sample of the eye donors, respectively.

Conclusions:
This retrospective study indicates that there is a trend of reduction in the seropositivity for HIV, HBV, and HCV among eye donors in Chennai over the last decade.
Localization of Corneal Neovascularization Using Optical Coherence Tomography Angiography
Authors: Chan Szy Yann , Pan Chung Ting , Feng Yun 
Published: April 2019

Purpose:
This article explores the application of optical coherence tomography angiography (OCTA) in assessing corneal neovascularization (CoNV) and investigates the features of CoNV in eyes with corneal transplantation.

Methods:
A pilot, case series, observational study was conducted to enroll patients who underwent corneal transplantation including penetrating keratoplasty (PKP) and deep lamellar keratoplasty (DLKP) with or without additional keratolimbal allograft transplantation. All patients were followed with a series of ophthalmologic examinations including slit-lamp photography and were then imaged with the anterior segment OCTA.

Results:
The study included 15 eyes of 14 patients (12 men; mean age of 37.4 ± 13.3 years), of which 9 eyes had undergone PKP and 6 eyes DLKP. OCTA was able to clearly identify the features of CoNV in eyes with significant CoNV and to confirm the presence of CoNV in eyes suspected of having CoNV. Four types of CoNV (superficial, stromal, fringe, and recipient-bed CoNV) were discovered by OCTA based on their location and depth. Superficial CoNV was mainly discovered in eyes that had undergone PKP (88.9% ± 11.1%), whereas the recipient-bed CoNV, once thought to be located in the host–graft interface, was discovered to grow in the host cornea only in eyes that had undergone DLKP (83.3% ± 16.7%). Comparing the assessment by 2 masked observers revealed a kappa value of 0.94, indicating excellent agreement.

Conclusions:
OCTA can be useful to visualize CoNV, which may be valuable in assessing corneal graft rejection.
Effects of Smoking and Physical Activity on the Pulmonary Function of Young University Nursing Students in Cáceres (Spain)
Authors: RICO-MARTÍN Sergio , DE NICOLÁS-JIMÉNEZ Jorge M. , MARTÍNEZ-ÁLVAREZ Mariana , CORDOVILLA-GUARDIA Sergio , SANTANO-MOGENA Esperanza , CALDERÓN-GARCÍA Julián F. 
Published: April 2019

ABSTRACT

Background:
The simultaneous effect of physical activity (PA) and smoking on pulmonary function in young people remains unclear.

Propose:
The aim of this study was to determine the influence of smoking and PA on pulmonary function in young university students in Cáceres, Spain.

Methods:
A sample of 120 young nursing students was studied (60 smokers and 60 nonsmokers). All subjects underwent spirometry with a COPD-6 portable device, and their level of PA was quantified using the International Physical Activity Questionnaire. The influence of PA and smoking on pulmonary function was determined by comparing hypotheses.

Results:
Significant differences were observed between smokers and nonsmokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and the difference between lung age and chronological age (LA–CA) in those who practiced mild PA. In the subjects who performed moderate and vigorous PA, these differences were not noted. In the intragroup analysis, significant differences were observed in smokers in terms of percent forced expiratory volume in 1 second, percent forced expiratory volume in 6 seconds, lung age, and LA–CA; however, in the control group, differences were only observed in terms of lung age and LA–CA. These findings were confirmed in the multivariate analysis.

Conclusions/Implications for Practice:
Our findings confirmed a deterioration in pulmonary function in smokers who did not perform moderate or vigorous PA. The level of PA performed was positively related to pulmonary function in smokers, whereas in nonsmokers, improvements were only significant in LA–CA.
Reliability and Validity of a Chinese-Version Normalization Assessment Measure for Primary Caregivers of Children With Cancer
Authors: Tsai Su-Hui , Chang Nien-Tzu , Cheng Su-Fen , Lee Ya-Ling 
Published: April 2019

Background
“Normalization” refers to the process whereby a household with a chronically ill member returns to a normal life to reduce its distress. There has been no valid and reliable instrument to investigate such normalization in Taiwan.

Objective
The aims of this study were to develop and validate a Chinese version of the Normalization Assessment Measure for Caregivers of Children With Cancer (NAM-CCC).

Methods
Translation and revision of the Normalization Assessment Measure into Chinese. Psychometric testing was conducted on 241 caregivers of children with cancer who were treated at a medical center in northern Taiwan.

Results
The Cronbach’s α of the NAM-CCC (Chinese version) was .93. The construct validity was analyzed by exploratory factor analysis, and 1 factor was extracted. The known group validity indicated that the rate of normalization is higher in the follow-up stage than in the treatment stage (P < .00). The criterion-related validity of the Taiwan version of the World Health Organization Quality of Life assessment is 0.475 (P < .01). The content validity is 0.88 to 0.99.

Conclusion
The results indicate that the NAM-CCC possesses good reliability and validity when administered to caregivers of children with cancer in Taiwan.

Implications for Practice
The instrument can be used to measure normalization in the caregivers of children with cancer. In addition, it will help us understand what support these individuals require to construct normal lives.
Croup Admissions
Authors: Maalouli Walid M. , Hodges James S. 
Published: April 2019

Objective
This pilot study aims to identify potential predictors of postadmission interventions of hospitalized croup patients and derive a risk model aimed at reducing hospitalizations for croup.

Methods
Data were collected on all croup hospitalizations for patients aged 1 month to 17 years admitted through a community hospital's emergency department (ED) between 2012 and 2017. Potential predictors were obtained from the electronic medical records including demographics, vital signs, ED length of stay, preintervention and postintervention Westley Croup Score (WCS), number of racemic epinephrine nebulizations administered, time to dexamethasone administration, preexisting conditions, and additional interventions during hospitalization. Statistical analysis used the outcome “patient received racemic epinephrine after hospital admission (yes/no)” to identify characteristics of the child or ED visit associated with that outcome. Preliminary analyses using stepwise logistic regression, tree models, and random forests suggested predictors, interactions among predictors, and the form of their association with the outcome. A final analysis used logistic regression.

Results
A total of 116 croup admissions were included, of which 19 (16%) received racemic epinephrine posthospitalization. These characteristics were identified as having some predictive power: sex, preexisting conditions, and preintervention and postintervention WCS, along with the interaction between sex and postintervention WCS. Logistic regression estimated an equation describing the probability of postadmission intervention, permitting the choice among admission thresholds giving different sensitivities and specificities.

Conclusions
There appear to be promising predictors in croup patients presenting to the ED, which might help stratify risk for interventions after the ED encounter and thus reduce the number of potentially avoidable admissions.
Correlation Between Neurologic Impairment Grade and Ambulation Status in the Adult Spina Bifida Population
Authors: Tita Anne C. , Frampton John R. , Roehmer Christian , Izzo Sara E. , Houtrow Amy J. , Dicianno Brad E. 
Published: April 2019

ObjectiveThe aim of the study was to identify which neurologic impairment scales correlate with ambulation status in adults with spina bifida.DesignA retrospective chart review was performed on patients seen at the University of Pittsburgh Medical Center Adult Spina Bifida Clinic. Findings were graded using several neurologic impairment scales: two versions of the National Spina Bifida Patient Registry classification, the International Standards for Neurological Classification of Spinal Cord Injury motor level, and the Broughton Neurologic Impairment Scale. Ambulation ability was ranked using the Hoffer classification system.ResultsData collected from 409 patient records showed significant correlations between Hoffer ambulation status and all neurologic impairment scales evaluated. The strongest correlation was noted with the Broughton classification (rs= −0.771,P< 0.001). High correlations were also noted with both versions of the National Spina Bifida Patient Registry: strength 3/5 or greater (rs= −0.763,P< 0.001), and strength 1/5 or greater (rs= −0.716,P< 0.001). For the International Standards for Neurological Classification of Spinal Cord Injury motor level, only a moderate correlation was observed (rs= −0.565,P< 0.001).ConclusionsMultiple grading scales can be used to measure motor function in adult spina bifida patients. Although the Broughton classification seems to be the most highly correlated with ambulation status, the less complex National Spina Bifida Patient Registry scale is also highly correlated and may be easier to administer in busy clinic settings.To Claim CME CreditsComplete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME ObjectivesUpon completion of this article, the reader should be able to: (1) Explain the clinical significance of identifying ambulation status and maximizing ambulation potential in adults with spina bifida; (2) Describe each of the neurologic grading scales examined in this study, identifying potential shortcomings in applying them to the adult spina bifida population; and (3) Administer the National Spina Bifida Patient Registry (NSBPR) impairment scale motor assessment in a standard adult spina bifida outpatient clinic visit.LevelAdvancedAccreditationThe Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Brain Functional Connectivity in Patients With Somatic Symptom Disorder
Authors: Kim Sun Mi , Hong Ji Sun , Min Kyoung Joon , Han Doug Hyun 
Published: April 2019

ABSTRACT

Objective
The aim of the study was to evaluate whether individuals with somatic symptom disorder (SSD) display increased resting-state functional connectivity (FC) within and between the sensorimotor network (SMN), default mode network (DMN), salience network, and dorsal attention network (DAN).

Methods
Eighteen patients with SSD and 20 age- and sex-matched healthy control participants underwent resting-state functional magnetic resonance imaging. We used a seed-based correlation approach for the four brain networks.

Results
Patients with SSD had higher scores on the Somato-Sensory Amplification Scale (z = 5.22, p < .001) and Symptom Checklist-90-Revised-Somatization (z = 4.94, p < .001) and greater FC within the SMN, DMN, and salience network than healthy control participants. Patients with SSD also had increased FC between the SMN and DMN, SMN and salience network, SMN and DAN, and salience network and DAN (t = 5.10–7.47, all false discovery rate q < .05). The Somato-Sensory Amplification Scale scores correlated with FC between the SMN and salience network and between the SMN and DAN (r = .61–.82, all p < .003).

Conclusions
Based on the results of the FC analysis between the SMN and salience network, we suggest that SSD may be associated with alterations of sensory-discriminative processing of pain and other somatic symptoms, which is influenced by affective processing. Based on the results of the FC analysis of the SMN and DAN, we suggest that patients with SSD have a deficit in attention, leading to misperception of external stimuli and failure to regulate bodily functions aimed at interactions with external stimuli.