bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiologic and Molecular Study of EVs in Hospitalized Children With Severe Acute Respiratory Infection
Authors: Pellegrinelli Laura , Uceda Renteria Sara Colonia , Galli Cristina , Greco Letizia , Primache Valeria , Lunghi Giovanna , Binda Sandro , Pariani Elena 
Published: August 2019

Background
: To evaluate the enterovirus (EV)-positivity rate in respiratory samples collected from children ≤15 years hospitalized with severe acute respiratory infections (SARIs) and to describe the epidemiologic and molecular characteristics of EVs.

Methods:
Respiratory samples were collected from 2468 children hospitalized with SARI at a university and research hospital in Milan (September 1, 2014 to August 31, 2017). EV and EV-D68 RNA were detected using a commercial multiplex and a specific real-time RT-PCR assay, respectively. The EV-D68-negative samples were then characterized by partial sequencing of the VP1 gene.

Results:
EV-RNA was detected in 9% (222/2468) of SARI cases, 77% were children ≤3 years, almost 13% of whom required intensive care. EVs circulated all-year-round in 2 distinct epidemic waves (May–August and November–December). An EV-D68 outbreak, responsible for 14.8% of EV-positive-SARIs, occurred in 2016 and 5 newly emerging EV types were identified. Twenty-two EV types were detected and remarkable heterogeneity was observed in species distribution and between different pediatric age groups.

Conclusions:
This study showed that EV-positivity rate for our SARI series was 9%. The molecular detection and characterization of EVs allowed for the rapid detection of an EV-D68 outbreak and revealed the presence of emerging EV types that may pose a public health threat. The lack of routine screening and EV characterization in respiratory tract infections hampers the assessment of their epidemiologic and molecular features.
Incidence Trends, Risk Factors, Mortality and Healthcare Utilization in Congenital Syphilis-related Hospitalizations in the United States
Authors: Umapathi Krishna Kishore , Thavamani Aravind , Chotikanatis Kobkul 
Published: August 2019

Background:
Congenital syphilis (CS) is a devastating yet preventable disease affecting the fetus. Recent increase in cases of CS in the United States has been reported by Centers for Disease Control and Prevention. There is a lack of data on hospitalization trends and healthcare utilization related to CS. We sought to describe CS hospitalization trends, morbidity and mortality during 2009 through 2016 and related healthcare expenditure.

Methods:
National inpatient level data collected from Kid’s Inpatient Database and National Inpatient Sample databases from 2009 to 2016 were analyzed. CS hospitalizations were identified using International Classification of Diseases codes in age less than 1 year. Related demographics, risk factors and outcomes were calculated. Infant mortality related to CS were calculated per number of hospitalizations.

Results:
From 2009 to 2016, there were a total of 5912 CS-related hospitalizations. The overall trends in hospitalizations related to CS was up trending since 2009. African American ethnicity, public insurance/uninsured, low socioeconomic status, geographic location (South and West hospital regions), prematurity and low birth weight were significantly associated with CS and remained as independent risk factors. The mean length of stay (12.38 ± 0.10 d vs. 3.42 ± 0.1 d) and mean hospitalization charges were significantly higher in CS (P < 0.001) as compared with other hospitalized infants without CS. The total inflation-adjusted hospitalization charges have more than doubled over the years ($120,665,203 in 2016 vs. $54,290,310 in 2009). The rate of in-hospital deaths in CS hospitalization was 0.54% (32 deaths among 5912 hospitalizations).

Conclusions:
The incidence of CS hospitalization has been increasing since 2009. CS contributes to a significant healthcare utilization burden; its prevention can save a large amount of healthcare-related expenditure.
Pharmacogenomics of Cytochrome P450 of Nimodipine Metabolism After Aneurysmal Subarachnoid Hemorrhage
Authors: Peacock Sarah H. , James Courtney , Turnbull Marion T. , Cowart Jennifer B. , Reid Joel M. , Freeman W. David 
Published: August 2019

ABSTRACT

INTRODUCTION: Aneurysmal subarachnoid hemorrhage (aSAH) is a type of stroke that is life threatening with high rates of mortality, and many survivors are left with permanent neurologic deficits. Nimodipine is the treatment of choice for aSAH with the goal of reduction of delayed cerebral ischemia. It is the only evidence-based medication that has been shown to have improved outcomes for delayed cerebral ischemia; therefore, it is important for neuroscience nurses to be knowledgeable of the pharmacology and pharmacogenomics properties of this medication, including cytochrome P450 (CYP450) enzymes. METHODS AND RESULTS: This article reviews the CYP450 enzyme system including a review of the pharmacotherapy and pharmacogenomics of nimodipine for patients with aSAH illustrated with case study of a patient with abnormal drug metabolism. CONCLUSION: CYP450 enzymes can be inhibited or induced by multiple medications resulting in clinically significant differences in drug metabolism. Food and Drug Administration–approved medication nimodipine is the only medication shown to improve outcomes in patients with aSAH. Hence, it is important to have awareness of potential drug-to-drug interactions and pharmacogenomics of nimodipine when caring for critically ill patients with aSAH.
Validity and Reliability of the Turkish Version of the Amyotrophic Lateral Sclerosis Assessment Questionnaire
Authors: Alankaya Naile , Tülek Zeliha , Özakgül Aylin , Kaya Alper , Dik Aynur 
Published: August 2019

ABSTRACT

OBJECTIVE
The aim of this study was to adapt the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ), developed for the evaluation of quality of life in amyotrophic lateral sclerosis (ALS) patients, into the Turkish society.

METHODS
This methodological study was conducted in 92 ALS patients registered in 2 chapters (Istanbul and Izmir) of Turkish ALS-Motor Neuron Diseases Association. The expert opinion and forward-backward translation methods were applied for the linguistic validity of the ALSAQ (long and short versions: ALSAQ-40 and ALSAQ-5, respectively).

RESULTS
In the analysis of internal consistency, the Cronbach’s α reliability coefficient was .96 for the total scale, whereas it was between .88 and .98 for the 5 dimensions. The dimensions of the long form were correlated with the items of the short form.

CONCLUSION
The Turkish versions of the ALSAQ short and long forms are valid and reliable tools to be used in the assessment of the quality of life in ALS patients.
Delayed Tumor Growth in Vestibular Schwannoma: An Argument for Lifelong Surveillance
Authors: Macielak Robert J. , Patel Neil S. , Lees Katherine A. , Lohse Christine M. , Marinelli John P. , Link Michael J. , Carlson Matthew L. 
Published: August 2019

Objective:
Previous research has shown that tumor growth during observation of small-to-medium sized sporadic vestibular schwannomas (VSs) occurs almost exclusively within 3 to 5 years following diagnosis. This has led some to consider ending surveillance after this interval. This study seeks to characterize a cohort of patients with tumors that exhibited late growth.

Study Design:
Retrospective cohort study.

Setting:
Tertiary referral center.

Patients:
Adults with sporadic VSs who initially elected observation with serial magnetic resonance imaging (MRI) surveillance.

Intervention(s):
None.

Main Outcome Measure(s):
Linear tumor growth was measured in accordance with AAO-HNS reporting guidelines. Delayed growth was defined as growth ≥2 mm in linear diameter that was first detected 5 years or more from the initial MRI.

Results:
From a total of 361 patients, 172 experienced tumor growth during the interval of observation. Fourteen of these 172 patients (8.1%) experienced late growth occurring at 5 years or beyond. Among patients with delayed growth, the fastest growth rate after extended quiescence was 1.33 mm/yr, and the longest delay before tumor growth detection was 11.1 years. Additional treatment was recommended for six (42.9%) of the patients with delayed growth. Of 68 tumors that remained in the IAC, 11 (16.2%) demonstrated delayed growth. Of 66 tumors that presented in the CPA, 2 (3.0%) demonstrated delayed growth. Initial size was larger for tumors demonstrating early growth compared with those with delayed growth. For tumors within the IAC, those with early growth had a significantly higher median growth rate than those with delayed growth (1.40 vs. 0.45 mm/yr, p < 0.001).

Conclusions:
Delayed growth encompassed 8.1% of growing VSs and 3.9% of all observed tumors. Patients with delayed growth exhibited slower growth rates compared with those who were diagnosed with growth early in their observation course. These findings support the need for lifelong surveillance of untreated VSs given the possibility of clinically significant delayed growth. Increasing the time interval between MRI studies after 5 years is a reasonable concession to balance practicalities of cost and convenience with risk of delayed of tumor growth.
Intraoperative Electrocochleography in Patients With Menière's Disease Undergoing Endolymphatic Sac Decompression and Shunt Surgery
Authors: Mattingly Jameson K. , Zhan Kevin Y. , Hiss Meghan M. , Harris Michael S. , Dodson Edward E. , Moberly Aaron C. , Adunka Oliver F. , Riggs William J. 
Published: August 2019

Hypothesis:
Objective physiologic changes measured using electrocochleography at the round window (ECOGRW) are observable during endolymphatic sac decompression and shunt surgery (ELS).

Background:
Limited effective treatment options are available to patients with Menière's disease (MD) who have failed conservative management, experience persistent vertigo symptoms, and have substantial residual hearing. ELS is a feasible therapeutic option for these patients. However, the efficacy of this procedure has been questioned, and objective measures assessing inner ear physiologic alterations are lacking.

Methods:
ECOGRW was measured in patients with MD undergoing ELS. Stimuli consisted of tone bursts (250, 500, 1000, 2000, 4000 Hz) and 100 μs broadband clicks at various intensities (60–90 dB nHL). Cochlear microphonic (CM), summation potential (SP), compound action potential (AP), SP:AP ratio, and CM harmonic distortions were measured.

Results:
ECOGRW was completed in 18 patients. The mean SP magnitude at 500 Hz changed significantly from −7.1 μV before to −5.1 μV after ELS (p < 0.05). However, the mean SP:AP ratio in those tested (n = 13) did not significantly change after ELS. CM harmonic magnitudes remained unchanged from pre- to post-ELS (n = 12) across all frequencies.

Conclusion:
ECOGRW allows detection of acute electrophysiological changes in the cochlea. However, our results indicate only small objective changes in the low-frequency SP magnitude (500 Hz) immediately after ELS, but not in other frequencies or measures tested (CM, SP:AP, CM harmonic distortions). These results suggest minimal electrophysiological changes occur in the cochlea as a result of ELS.
Transvenous Stent-assisted Coil Embolization for Management of Dehiscent High Jugular Bulb With Tinnitus and Contralateral Hypoplastic Venous Sinuses
Authors: Oh Se-Joon , Kim Deoksoo , Lee Jae Il , Ko Jun Kyeung , Choi Sung-Won , Kong Soo-Keun , Goh Eui-Kyung , Lee Tae Hong 
Published: August 2019

Objectives:This study aimed to evaluate the safety and efficacy of transvenous stent-assisted coil embolization for dehiscent high jugular bulb (HJB) with tinnitus and contralateral hypoplastic venous sinus.Study Design:Case series with chart review.Setting:Tertiary academic medical center.Methods:From September 2008 to October 2018, a series of patients with dehiscent HJB presenting with intractable pulsatile tinnitus abated only by ipsilateral jugular vein compression were included. Patients underwent transvenous stent-assisted coil embolization for selective obstruction to the dome of the HJB due to hypoplastic contralateral transverse or sigmoid venous sinus. Technical safety and clinical efficacy were retrospectively analyzed. Clinical outcome measurements included pure-tone audiogram, tinnitus character, and tinnitus handicap inventory and evaluated based on the change during the first 6 months after the procedure.Results:Subjects included five patients with dehiscent HJB and troublesome pulsatile tinnitus who refused surgery (n = 4), or who experienced recurrence after surgical covering and reinforcement using autologous cartilage (n = 1). The mean age of the five patients (only female) was 45 years. Transvenous stent-assisted coil embolization was technically successful in all patients with symptomatic dehiscent HJB, with no procedure-related complications. Temporary postprocedural headache was observed in two patients, but resolved within 3 days. Symptoms were completely resolved in all cases. There was no recurrence or aggravation of tinnitus during follow-up period.Conclusions:Transvenous stent-assisted coil embolization for dehiscent HJB with tinnitus and contralateral hypoplastic transverse or sigmoid venous sinus could be a technically safe and clinically effective treatment strategy while preserving cranial venous drainage.
Clinical and Radiological Characteristics of Malignant Tumors Located to the Cerebellopontine Angle and/or Internal Acoustic Meatus
Authors: Eliezer Michael , Tran Hugo , Inagaki Akira , Vérillaud Benjamin , Takahashi Mariko , Marie Jean-Paul , Hautefort Charlotte , Herman Philippe , Murakami Shingo , Kania Romain 
Published: August 2019

Objective:
Metastatic lesions to the internal auditory meatus (IAM) and/or the cerebellopontine angle (CPA) are rare and may appear like a vestibular schwannoma (VS). We herein raise the issue of the diagnosis and treatment of nine malignant cases of the CPA and IAM among three referral centers in France and Japan. The aim of this study was 1) to report malignant lesions of the CPA, their diagnosis and treatment, 2) to review the literature, 3) to propose criteria of suspicion for malignant tumors of the CPA.

Methods:
Nine patients who had malignant lesions of the CPA and/or IAM for whom the final diagnosis was made by surgery, lumbar puncture, or PET scan were included. The main outcomes measured were: rapid onset of symptoms, association of cochlea-vestibular symptoms with facial palsy, and MRI analysis.

Results:
Among the nine patients with malignant tumor of the CPA, 8 of them (89%) had a facial palsy associated with cochlea-vestibular symptoms. Rapid growth of the tumor was observed in 77% (7/9) of the cases in a mean time interval of 4.6 months. The initial diagnosis evoked was VS in 44% of the cases (4/9). Atypical MRI aspect was seen in 67% of the cases (6/9) with bilateral tumors in 55% of cases (5/9).

Conclusion:
Although rare, malignant tumors of the CPA and/or IAM should be evoked in case of association of cochleovestibular symptoms and facial palsy, rapid onset and atypical MRI aspect.
Simulator-based assessment of ankle arterial systolic blood pressure measurement skills
Authors: Congnard Florian , Henni Samir , Le Duff Alain , Abraham Pierre , Pommeau Thierry , Noury-Desvaux Bénédicte 
Published: August 2019

Objective
Learning basic vascular examination is a complex process. Very few studies have focused on the ability to measure the arterial systolic blood pressure at the ankle (ASBPa). The aim of this study was to objectively assess the effects of a 1-h practical educational intervention on the ability to measure ASBPa among medical students.

Methods
A total of 27 medical students were prospectively recruited. Two evaluation sessions of ASBPa measurement skills were conducted, before (T1) and after a 1-h practical lesson (T2). To assess the learning effect associated to the simulator-based evaluation, a control group composed by nonmedical students, not involved in the practical lesson, was also tested. Objective assessments of ASBPa measurements were performed by an instrumented leg prototype.

Results
There was a nonsignificant decreasing trend measurement time after practical lesson. The average pressure determination error (ΔP) was significantly reduced: ΔPT1: 10.5 ± 13.8 mmHg vs. ΔPT2: 5.7 ± 6.0 mmHg (P = 0.002). The mean deflation rate (DR) of the cuff was significantly decreased: DRT1: 12.9 ± 9.2 mmHg/s vs. DRT2: 8.7 ± 4.6 mmHg/s (P = 0.001). The control group did not show significant changes.

Conclusion
A 1-h practical learning could improve some parameters of the ASBPa measurement among medical students, but was not sufficient to allow the measured technical factors to reach established guidelines.
The ability of pre-treatment F-18 FDG PET/CT metabolic parameters for predicting axillary lymph node and distant metastasis and overall survival
Authors: Yilmaz Burcak , Dağ Sedef , Ergul Nurhan , Çermik Tevfik Fikret 
Published: August 2019

Introduction
The current study aimed to investigate the diagnostic performance of metabolic parameters of pre-treatment F-18 fluorodeoxyglucose PET/computed tomography for predicting axillary lymph node metastases, distant metastases, and overall survival rates in breast cancer patients.

Materials and methods
One hundred thirteen breast cancer patients who underwent pre-treatment F18 [FDG] PET-computed tomography with biopsy-proven axillary lymph node status were included in the current study. In pre-treatment F18 [FDG] PET-computed tomography for primary tumour area maximum standard uptake value, metabolic tumour volume, tumour lesion glycolysis, tumour diameter and for axillary lymph nodes maximum standard uptake value-LN were recorded. Also if distant metastatic sites were observed they were verified.

Results
The median follow-up period was 43.8 months. Five-year overall survival was 98% vs. 56% in patients with tumour diameter < vs. ≥22 mm, 93% vs. 50% in patients with maximum standard uptake value-T < vs. ≥6.7, 71% vs. 70% in patients with metabolic tumour volume < vs. ≥8.31cm3, 94% vs. 49% in patients with maximum standard uptake value-LN < vs. ≥1.6, 98% vs. 48% in patients with tumour lesion glycolysis < vs. ≥19 084 g/ml × cm3, 90% vs. 30% in patients with negative or positive distant metastases in initial PET/computed tomography, respectively. Maximum standard uptake value-LN with a cut-off level of <1.6 and <5.7 had high sensitivity and specificity for predicting axillary lymph node and systemic metastasis, respectively. Additionally, tumour lesion glycolysis was the strongest independent prognostic factor for overall survival.

Conclusion
Our data shows that the combination of pre-treatment tumour lesion glycolysis and maximum standard uptake value-LN could improve risk stratification among breast cancer patients.
Dizziness in a Child With Irlen Syndrome: Differentiating Visual and Vestibular Complaints
Authors: Hoppes Carrie W. , Morrell Rebecca L. , Woelfel Laura Ward , Whitney Susan L. 
Published: August 2019

Purpose:
A case study of a 12-year-old boy with Irlen syndrome illustrates the overlapping symptoms of Irlen syndrome and vestibular-related dizziness.

Summary of Key Points:
Individuals with Irlen syndrome have eyestrain and headache, and often report visual perceptual distortions of blurring, doubling, and movement of print on the page. These symptoms can be relieved with the use of individually prescribed tinted lenses or overlays. Visually induced dizziness, also known as visual vertigo, is characterized by dizziness and/or unsteadiness that is triggered by complex, distorted, large field/moving visual stimuli. Visually induced dizziness can be effectively treated with progressive, controlled exposure to optokinetic visual stimuli. The child with Irlen syndrome had impaired balance, impaired gaze stability, and symptoms of visual vertigo. His complaint of visually induced dizziness resolved following vestibular rehabilitation.

Conclusions and Recommendations for Clinical Practice:
When an individual with Irlen syndrome complains of dizziness, ruling out a concomitant diagnosis of a central and/or peripheral vestibular disorder is warranted.

What This Adds to the Evidence:
The visual symptoms associated with Irlen syndrome can overlap with those of visually induced dizziness. This case report is the first to describe overlapping visual and vestibular complaints of dizziness in an individual with Irlen syndrome.
Neuroticism as a Predictor of Frailty in Old Age: A Genetically Informative Approach
Authors: Daníelsdóttir Hilda Björk , Jylhävä Juulia , Hägg Sara , Lu Yi , Colodro-Conde Lucía , Martin Nicholas G. , Pedersen Nancy L. , Mosing Miriam A. , Lehto Kelli 
Published: August 2019

ABSTRACT

Objective
Neuroticism is associated with poor health outcomes, but its contribution to the accumulation of health deficits in old age, that is, the frailty index, is largely unknown. We aimed to explore associations between neuroticism and frailty cross-sectionally and longitudinally, and to investigate the contribution of shared genetic influences.

Methods
Data were derived from the UK Biobank (UKB; n = 274,951), the Australian Over 50’s Study (AO50; n = 2849), and the Swedish Twin Registry (Screening Across the Lifespan of Twins Study [SALT], n = 18,960; The Swedish Adoption/Twin Study of Aging [SATSA], n = 1365). Associations between neuroticism and the frailty index were investigated using regression analysis cross-sectionally in UKB, AO50, and SATSA and longitudinally in SALT (25–29 years of follow-up) and SATSA (6 and 23 years of follow-up). The co-twin control method was applied to explore the contribution of underlying shared familial factors (SALT, SATSA, AO50). Genome-wide polygenic risk scores for neuroticism were used in all samples to further assess whether common genetic variants associated with neuroticism predict frailty.

Results
High neuroticism was consistently associated with greater frailty cross-sectionally (adjusted β [95% confidence intervals] in UKB = 0.32 [0.32–0.33]; AO50 = 0.35 [0.31–0.39]; SATSA = 0.33 [0.27–0.39]) and longitudinally up to 29 years (SALT = 0.24 [0.22–0.25]; SATSA 6 years = 0.31 [0.24–0.38]; SATSA 23 years = 0.16 [0.07–0.25]). When adjusting for underlying shared genetic and environmental factors, the neuroticism-frailty association remained significant, although decreased. Polygenic risk scores for neuroticism significantly predicted frailty in the two larger samples (meta-analyzed total β = 0.059 [0.055–0.062]).

Conclusions
Neuroticism in midlife predicts frailty in late life. Neuroticism may have a causal influence on frailty, whereas both environmental and genetic influences, including neuroticism-associated common genetic variants, contribute to this relationship.