bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traumatic Stress among School-Aged Pediatric Surgery Patients and Their Parents
Authors: Ben Ari Amichai , Margalit Daniella , Udassin Raphael , Benarroch Fortu 
Published: June 2018

Introduction Since hospitalization can be a traumatic event for children, many of them may suffer from a cluster of chronic psychological and emotional difficulties called Pediatric Medical Traumatic Stress (PMTS). Although PMTS causes considerable functional impairment and psychological distress and may decrease the children's compliance with post-surgical care, awareness of this condition is low and thus not enough effort is made to prevent it. The objective of this study is to assess prospectively the prevalence and characteristics of PMTS in school-age children following hospitalization in a general pediatric surgery ward and in their parents, which has not been documented before.
Materials Patients and Methods We recruited parents of 88 children aged 6 to 13 years old, hospitalized in a pediatric surgery ward and which form a representative sample of the children of this age in the ward. Three to five months after discharge from the hospital, the parents completed questionnaires measuring symptoms of psychological distress.
Results About 26.4% of children displayed symptoms of PMTS, and 11.6% of parents suffered from posttraumatic stress disorder following their child's hospitalization. Moreover, we found a medium high positive correlation between the parents' level of distress and that of their child.
Conclusion In view of the prevalence of PMTS among school-aged children following surgical intervention, it is necessary to promote increased awareness, preventive interventions, and early identification and treatment of this condition.
G9a/GLP Complex Acts as a Bidirectional Switch to Regulate Metabotropic Glutamate Receptor-Dependent Plasticity in Hippocampal CA1 Pyramidal Neurons
Authors: Sharma Mahima , Sajikumar Sreedharan 
Published: June 2018

Abstract
Metabotropic glutamate receptor-dependent long-term depression (mGluR-LTD) is conventionally considered to be solely dependent on local protein synthesis. Given the impact of epigenetics on memory, the intriguing question is whether epigenetic regulation influences mGluR-LTD as well. G9a/GLP histone lysine methyltransferase complex is crucial for brain development and goal-directed learning as well as for drug-addiction. In this study, we analyzed whether the epigenetic regulation by G9a/GLP complex affects mGluR-LTD in CA1 hippocampal pyramidal neurons of 5–7 weeks old male Wistar rats. In hippocampal slices with intact CA1 dendritic regions, inhibition of G9a/GLP activity abolished mGluR-LTD. The inhibition of this complex upregulated the expression of plasticity proteins like PKMζ, which mediated the prevention of mGluR-LTD expression by regulating the NSF-GluA2-mediated trafficking of AMPA receptors towards the postsynaptic site. G9a/GLP inhibition during the induction of mGluR-LTD also downregulated the protein levels of phosphorylated-GluA2 and Arc. Interestingly, G9a/GLP inhibition could not impede the mGluR-LTD when the cell-body was severed. Our study highlights the role of G9a/GLP complex in intact neuronal network as a bidirectional switch; when turned on, it facilitates the expression of mGluR-LTD, and when turned off, it promotes the expression of long-term potentiation.
Combined Biomarkers Predict Acute Mortality Among Critically Ill Patients With Suspected Sepsis*
Authors: Kelly Brendan J. , Lautenbach Ebbing , Nachamkin Irving , Coffin Susan E. , Gerber Jeffrey S. , Fuchs Barry D. , Garrigan Charles , Han Xiaoyan , Bilker Warren B. , Wise Jacqueleen , Tolomeo Pam , Han Jennifer H. 
Published: June 2018

Objectives:
Sepsis is associated with high early and total in-hospital mortality. Despite recent revisions in the diagnostic criteria for sepsis that sought to improve predictive validity for mortality, it remains difficult to identify patients at greatest risk of death. We compared the utility of nine biomarkers to predict mortality in subjects with clinically suspected bacterial sepsis.

Design:
Cohort study.

Setting:
The medical and surgical ICUs at an academic medical center.

Subjects:
We enrolled 139 subjects who met two or more systemic inflammatory response syndrome (systemic inflammatory response syndrome) criteria and received new broad-spectrum antibacterial therapy.

Interventions:
We assayed nine biomarkers (α-2 macroglobulin, C-reactive protein, ferritin, fibrinogen, haptoglobin, procalcitonin, serum amyloid A, serum amyloid P, and tissue plasminogen activator) at onset of suspected sepsis and 24, 48, and 72 hours thereafter. We compared biomarkers between groups based on both 14-day and total in-hospital mortality and evaluated the predictive validity of single and paired biomarkers via area under the receiver operating characteristic curve.

Measurements and Main Results:
Fourteen-day mortality was 12.9%, and total in-hospital mortality was 29.5%. Serum amyloid P was significantly lower (4/4 timepoints) and tissue plasminogen activator significantly higher (3/4 timepoints) in the 14-day mortality group, and the same pattern held for total in-hospital mortality (Wilcoxon p ≤ 0.046 for all timepoints). Serum amyloid P and tissue plasminogen activator demonstrated the best individual predictive performance for mortality, and combinations of biomarkers including serum amyloid P and tissue plasminogen activator achieved greater predictive performance (area under the receiver operating characteristic curve > 0.76 for 14-d and 0.74 for total mortality).

Conclusions:
Combined biomarkers predict risk for 14-day and total mortality among subjects with suspected sepsis. Serum amyloid P and tissue plasminogen activator demonstrated the best discriminatory ability in this cohort.
Small Finger to Ring Finger Ray Transposition: Modern Surgical Technique and Case-based Review of the Literature
Authors: Aliotta Rachel E. , Reyes Bryan A. , Bafus Blaine T. 
Published: June 2018

Summary:
Ray transposition for central digital amputation has been performed following traumatic injury to the hand for decades. Small finger to ring finger ray transposition has been well described in the literature, with good functional and aesthetic outcomes reported. Originally described by Bunnell, the fourth metacarpal can be disarticulated and the fifth metacarpal base transposed with reconstruction of the intermetacarpal ligament allowing progressive closure between the third and fifth rays. However, osteotomy-based transpositions are utilized placing the osteotomy at the level of the metacarpal, followed by transposition and fixation of the small finger to the base of the ring finger metacarpal; or, by making an intracarpal wedge-osteotomy of the hamate with subsequent radial translocation of the entire small finger ray. Recent literature has suggested the intracarpal wedge osteotomy to be superior technically, and with less postoperative complications. However, for this somewhat uncommon reconstructive procedure, no high-level evidence exists to determine which of these techniques is truly more favorable. Here, we present an interesting case of ray amputation and transposition following an isolated fourth metacarpal traumatic firearm injury, and comprehensive modern surgical technique. Upon review of the literature, small to ring finger ray transposition has been shown to have acceptable functional and aesthetic outcomes regardless of the osteotomy technique used, and should be considered when the nature of presenting injury and the patient’s lifestyle and postoperative expectations are appropriate.
Quetiapine Excretion Into Human Breast Milk
Authors: Yazdani-Brojeni Parvaneh , Tanoshima Reo , Taguchi Nobuko , Garcia-Bournissen Facundo , Wallach Izhar , Moretti Myla E. , Verjee Zulfikarali , Ito Shinya 
Published: June 2018

Abstract

Background
Risk assessment of the use of quetiapine during breastfeeding is challenging owing to a paucity of data.

Methods
A pharmacokinetic study was conducted in lactating women who were taking quetiapine. The primary endpoint was to determine quetiapine concentration profiles in milk and estimated infant exposure levels. Multiple milk and a single blood quetiapine concentrations were determined using a highly sensitive liquid chromatography with tandem mass spectroscopy method.

Results
Nine subjects receiving fast-release quetiapine (mean dose, 41 mg/d) were analyzed at steady state. The mean milk/plasma drug concentration ratio at 2-hour postdose was 0.47 (SD, 0.50; range, 0.13–1.67). The mean milk concentration of each patient was 5.7 ng/mL (SD, 4.5; range, 1.4–13.9 ng/mL). The mean infant quetiapine dose via milk per body weight relative to weight-adjusted maternal dose was 0.16 % (SD, 0.08; range, 0.04%–0.35%).

Conclusions
Infant exposure levels to quetiapine via milk are predicted to be very small.
The Natural History and Rehabilitative Outcomes of Hearing Loss in Congenital Cytomegalovirus: A Systematic Review
Authors: Fletcher Kyle T. , Horrell Erin M. Wolf , Ayugi John , Irungu Catherine , Muthoka Maria , Creel Liza M. , Lester Cathy , Bush Matthew L. 
Published: June 2018

Objective:
The purpose of this study was to examine the literature regarding the natural history and rehabilitative outcomes of sensorineural hearing loss from congenital cytomegalovirus infections.

Data Sources and Study Eligibility Criteria:
A systematic search was performed in PubMed, PsychINFO, CINAHL, and Web of Science to identify peer-reviewed research. Eligible studies were those containing original peer-reviewed research in English addressing either the natural history or rehabilitative outcomes of sensorineural hearing loss (SNHL) in congenital cytomegalovirus (cCMV).

Study Appraisal and Synthesis Methods:
Two investigators independently reviewed all articles and extracted data. Bias was assessed using the Cochrane Collaboration's tool and the Newcastle-Ottawa Assessment Scale.

Results:
Thirty-six articles were reviewed. Universal screening identifies 0.2 to 1% of newborns with cCMV infection. SNHL ranged from 8 to 32% of infants and was more prevalent in symptomatic versus asymptomatic cases. Nine to 68% of hearing loss occurs in a late or delayed fashion. In 7 to 71% of cases hearing loss is progressive. Cochlear implantation (CI) is a viable option for patients with cCMV associated hearing loss and leads to improvements in hearing and language. There is limited literature comparing rehabilitation outcomes in cCMV and non-cCMV CI recipients.

Conclusion:
Late onset and progressive hearing loss is seen in children who develop hearing loss from cCMV. Frequent audiologic follow-up is necessary considering the natural history of cCMV hearing loss. Universal screening should be pursued due to the number of asymptomatic children, at birth, who develop late onset/delayed hearing loss. CI is an effective means of improving speech and language in this population.
Incidence of Intralabyrinthine Schwannoma: A Population-based Study Within the United States
Authors: Marinelli John P. , Lohse Christine M. , Carlson Matthew L. 
Published: June 2018

Objective:
To describe the incidence of intralabyrinthine schwannoma (ILS) utilizing the Rochester Epidemiology Project (REP), a unique medical consortium in the United States that covers a complete population of all ages in a well-defined geographic area over the past half-century.

Patients:
All patients with ILS diagnosed between January 1, 1966 and December 31, 2016 in Olmsted County, Minnesota, identified using the REP medical records-linkage system.

Main Outcome Measures:
Incidence of ILS.

Results:
Fourteen incident cases of ILS were identified in Olmsted County since 1966—a period spanning 5.9 million person-years. Over the past decade, the incidence rate of ILS was 0.81 per 100,000 person-years and 1.1 over the last 5 years. Since 1966, the cumulative incidence rate of ILS over the past 50 years was 0.26 per 100,000 person-years. The median age at diagnosis was 60 years (interquartile ranges, 39–70). Incidence increased with age: over the last 5 years, those aged 60 to 69 exhibited an incidence rate of 2.7 per 100,000 person-years and those 70+ displayed a rate of 4.1. All patients had varying levels of asymmetrical sensorineural hearing loss with 64% of patients presenting with class D hearing. Four (29%) patients had a history of sudden sensorineural hearing loss, five (36%) reported imbalance and/or vertigo, and four (29%) reported aural fullness. Three of the 14 (21%) patients had neurofibromatosis type 2.

Conclusion:
The incidence of ILS exceeds 1 per 100,000 person-years with modern diagnostic imaging. The rising incidence of ILS in recent years most likely reflects improved capacity for disease detection rather than a true increase in tumor development. Given the reputability of the REP consortium, these data suggest that ILS comprises a more common entity than previously considered.
BAHA Skin Complications in the Pediatric Population: Systematic Review With Meta-analysis
Authors: Shapiro Scott , Ramadan Jad , Cassis Adam 
Published: June 2018

Objective:
Compare the incidence of skin and surgical site complications for children undergoing percutaneous and transcutaneous bone conduction implant (pBCI and tBCI) surgery via systematic review and meta-analysis of the available data.

Data Sources:
1) Search of PubMed, Web of Science, and EBSCOhost databases from January 2012 to April 2017. 2) References of studies meeting initial criteria.

Study Selection:
Inclusion criteria were studies that involved patients less than 18 years old undergoing tBCI or pBCI surgery with a BI300 implant and reported skin complications, implant loss, and need for revision surgery. Exclusion criterion was use of a previous generation implant.

Data Extraction:
Implants used, number of patients, age, surgical technique, Holgers score, incidence of skin complication, implant loss, and reoperation. Bias assessment performed with the Newcastle–Ottawa Scale.

Data Synthesis:
Twenty-two studies (14 tBCI, 8 pBCI) met criteria. Meta-analysis was performed using a random effects model. Cochran's Q score and I2 inconsistency were used to assess for heterogeneity. Overall estimated skin complication rate for tBCIs was 6.3% versus 30% for pBCIs (p = 4 × 10−12). Implant loss was 0% for tBCIs and 5.3% for pBCIs (p = 0.004). Reoperation rate was 3.0% and 6.2% for tBCIs and pBCIs respectively (p = 0.00002).

Conclusion:
There is strong evidence to suggest that in pediatric patients, the incidence of skin complications, implant loss, and rate of reoperation are higher for pBCIs compared with tBCIs. This information should be part of any discussion about BCI surgery on a pediatric patient.
Association of fatty liver index with the risk of incident cardiovascular disease and acute myocardial infarction
Authors: Olubamwo Olubunmi O. , Virtanen Jyrki K. , Voutilainen Ari , Kauhanen Jussi , Pihlajamäki Jussi , Tuomainen Tomi-Pekka 
Published: June 2018

Background
Fatty liver disease (FLD) has been identified as constituting cardiometabolic risk. However, evidence on the association of fatty liver index (FLI) with cardiovascular disease (CVD) is largely cross-sectional, with limited evidence on the predictability of incident CVD, and specifically, acute myocardial infarction (AMI). Therefore, we aimed to investigate the prospective associations between fatty liver as estimated by FLI and incident CVD, and specifically AMI, in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort.

Patients and methods
Our patients were 1205 middle-aged men free of CVD at baseline. The associations of baseline FLI with incident CVD and incident AMI were analyzed using multivariable-adjusted Cox regression models.

Results
During a median follow-up of 17 years, a total of 690 incident cases of CVD and 269 cases of AMI were recorded through Finnish registries. For incident CVD, for the high (FLI≥60) versus the low (≤30) FLI category, the hazard ratio (HR) was 1.77 [95% confidence interval (CI): 1.46–2.14] in the minimally adjusted model. With increasing adjustment, the association was attenuated progressively. In the most adjusted model, the HR was 1.41 (95% CI: 1.10–1.79). For incident AMI, for the high FLI category, the HR was 1.65 (95% CI: 1.22–2.23) in the minimally adjusted model, but in most comprehensive models when we included metabolic factors, the HR was not significant (HR=1.136, 95% CI: 0.777–1.662).

Conclusion
FLI can predict incident CVD. However, the predictability of AMI using FLI is subject to interactions of metabolic factors. Individuals with FLI in the moderate to high category should be evaluated and monitored for subclinical or overt cardiovascular (including coronary) disease.
Cesarean Delivery Rates and Costs of Childbirth in a State Medicaid Program After Implementation of a Blended Payment Policy
Authors: Kozhimannil Katy B. , Graves Amy J. , Ecklund Alexandra M. , Shah Neel , Aggarwal Reena , Snowden Jonathan M. 
Published: June 2018

Background:
Nearly half of US births are financed by Medicaid, and one-third of births occur by cesarean delivery, at double the cost of vaginal delivery. With the goal of reducing unnecessary cesarean use and improving value, in 2009 Minnesota’s Medicaid program introduced a blended payment rate for uncomplicated births (ie, a single facility or professional services payment regardless of delivery mode).

Objective:
We evaluated the effect of the blended payment policy on cesarean use and costs for Medicaid fee-for-service births.

Methods:
We identified births in Medicaid Analytic Extract files from 3 years before and after the 2009 payment change in Minnesota and in 6 control states. We used a quarterly interrupted time series approach to assess policy-related changes in study outcomes, comparing Minnesota to control states. Outcomes included cesarean delivery, childbirth hospitalization costs, and maternal morbidity.

Results:
Minnesota’s prepolicy cesarean rate (22.8%) decreased 0.27 percentage points per quarter after the policy for a total decrease of 3.24 percentage points, compared with control states (P=0.01). The cost of childbirth hospitalizations in Minnesota dropped by $425.80 at the time of the policy. Postpolicy, childbirth hospitalization costs continued to decrease in Minnesota relative to prepolicy by $95.04 per quarter, and declined more than control states (P<0.001). There were no significant policy effects on maternal morbidity.

Conclusions:
Implementation of a single, blended payment to facilities and clinicians for uncomplicated births mitigated trends toward greater use of cesarean and rising costs of childbirth hospitalization, without adverse effects on maternal morbidity.
Adverse Events and Reinterventions Following Pancreatic Endoscopic Sphincterotomy
Authors: Dufault Darin L. , Elmunzer B. Joseph , Cotton Peter B. , Williams April , Cote Gregory A. 
Published: June 2018

Objectives
Pancreatic endoscopic sphincterotomy (PES) is an independent risk factor for short- and long-term adverse events (AEs) of endoscopic retrograde cholangiopancreatography. We sought to measure PES-specific AEs and trends in the use of PES.

Methods
This was a retrospective cohort of consecutive patients who underwent first-time PES between June 2008 and June 2015. Indications for PES were dichotomized: (1) structural pathology (chronic pancreatitis and local complications of acute pancreatitis) and (2) suspected sphincter pathology (idiopathic recurrent acute pancreatitis and sphincter of Oddi dysfunction). Rates of AEs and pancreatic orifice reinterventions were measured, with reintervention rates limited to those having a minimum of 12-month follow-up.

Results
Of 567 patients, 198 (34.9%) underwent PES for structural and 369 (65.1%) for suspected sphincter pathology. Rates of post–endoscopic retrograde cholangiopancreatography pancreatitis and unplanned hospitalization were high when PES was originally performed for suspected sphincter pathology (12.6% and 14.6%, respectively). The overall reintervention rate was 28.9% and significantly greater for sphincter (41.7%) compared with structural pathology (13.5%, P = 0.005).

Conclusions
The likelihood of reintervention after PES is high, particularly when the primary indication is suspected sphincter pathology such as idiopathic recurrent acute pancreatitis. Further prospective studies are needed to clarify if and when this maneuver confers significant benefit to patients.
An Observational Cohort Feasibility Study to Identify Microvesicle and Micro-RNA Biomarkers of Acute Kidney Injury Following Pediatric Cardiac Surgery
Authors: Sullo Nikol , Mariani Silvia , JnTala Maria , Kumar Tracy , Woźniak Marcin J. , Smallwood Dawn , Pais Paolo , Westrope Claire , Lotto Attilio , Murphy Gavin J. 
Published: June 2018

Objectives:
Micro-RNA, small noncoding RNA fragments involved in gene regulation, and microvesicles, membrane-bound particles less than 1 μm known to regulate cellular processes including responses to injury, may serve as disease-specific biomarkers of acute kidney injury. We evaluated the feasibility of measuring these signals as well as other known acute kidney injury biomarkers in a mixed pediatric cardiac surgery population.

Design:
Single center prospective cohort feasibility study.

Setting:
PICU.

Patients:
Twenty-four children (≤ 17 yr) undergoing cardiac surgery with cardiopulmonary bypass without preexisting inflammatory state, acute kidney injury, or extracorporeal life support.

Interventions:
None.

Measurements and Main Results:
Acute kidney injury was defined according to modified Kidney Diseases Improving Global Outcomes criteria. Blood and urine samples were collected preoperatively and at 6–12 and 24 hours. Microvesicles derivation was assessed using flow cytometry and NanoSight analysis. Micro-RNAs were isolated from plasma and analyzed by microarray and quantitative real-time polymerase chain reaction. Data completeness for the primary outcomes was 100%. Patients with acute kidney injury (n = 14/24) were younger, underwent longer cardiopulmonary bypass, and required greater inotrope support. Acute kidney injury subjects had different fractional content of platelets and endothelial-derived microvesicles before surgery. Platelets and endothelial microvesicles levels were higher in acute kidney injury patients. A number of micro-RNA species were differentially expressed in acute kidney injury patients. Pathway analysis of candidate target genes in the kidney suggested that the most often affected pathways were phosphatase and tensin homolog and signal transducer and activator of transcription 3 signaling.

Conclusions:
Microvesicles and micro-RNAs expression patterns in pediatric cardiac surgery patients can be measured in children and potentially serve as tools for stratification of patients at risk of acute kidney injury.
SANTA-SIM: Simulating Viral Sequence Evolution Dynamics Under Selection and Recombination
Authors: Jariani Abbas , Warth Christopher , Deforche Koen , Libin Pieter , J Drummond Alexei , Rambaut Andrew , Matsen Frederick A , Theys Kristof 
Published: June 2018

AbstractSimulations are widely used to provide expectations and predictive distributions under known conditions against which to compare empirical data. Such simulations are also invaluable for testing and comparing the behavior and power of inference methods. We describe SANTA-SIM, a software package to simulate the evolution of a population of gene sequences forwards through time. It models the underlying biological processes as discrete components: replication, recombination, point mutations, insertion-deletions, and selection under various fitness models and population size dynamics. The software is designed to be intuitive to work with for a wide range of users and executable in a cross-platform manner.