bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Influenza Virus Related Severe Lower Respiratory Tract Infection in Children
Authors: Eşki Aykut , Öztürk Gökçen Kartal , Gülen Figen , Çiçek Candan , Demir Esen 
Published: August 2019

Background:
Influenza virus is one of the most common respiratory pathogens for all age groups and may cause seasonal outbreaks. Our aim was to identify risk groups and factors associated with severe clinical course including mortality in children with influenza-related lower respiratory tract infection (LRTI).

Methods:
We conducted a retrospective study in children hospitalized with influenza virus LRTI from 2008 to 2018. Data on demographic features, influenza type, viral coinfection, primary and secondary bacterial infections (SBIs), time of onset of antiviral treatment, comorbidities, hospitalization length, pediatric intensive care unit admission/invasive mechanical ventilation (IMV) need and mortality were collected from medical records.

Results:
There were 280 patients hospitalized with LRTI and median hospitalization length was 9 days. Congenital heart disease, neuromuscular disease, SBIs and late-onset antiviral treatment were independent risk factors for prolonged hospital stay (P < 0.05). Pediatric intensive care unit admission was present in 20.4% (57) of the patients and 17.1% (48) of all patients required IMV. SBIs, lymphopenia, neutrophilia, immunosuppression and human bocavirus coinfection were independent risk factors for IMV support (P < 0.05). Eighteen patients died and immunosuppression, lymphopenia and SBIs were independent risk factors for mortality (P < 0.05).

Conclusions:
Presence of comorbidity, SBIs, neutrophilia and lymphopenia at admission identified as risk factors for severe influenza infections including need for IMV and death. Although several studies showed that antiviral treatment reduce hospitalization, complications and mortality, there is a lack of prospective trials and patients for antiviral therapy should be carefully chosen by the clinician.
Involvement of the Cochlear Aqueduct by Jugular Paraganglioma Is Associated With Sensorineural Hearing Loss
Authors: Patel Neil S. , Link Michael J. , Driscoll Colin L. W. , Neff Brian A. , Van Gompel Jamie J. , Lane John I. , Carlson Matthew L. 
Published: August 2019

Objective:
The etiology of sensorineural hearing loss (SNHL) in patients with jugular paraganglioma (JP) whose tumors lack inner ear fistulae or vestibulocochlear nerve involvement is unknown. Recent literature has proposed that occlusion of the inferior cochlear vein may be causative. Herein, we assess the association between radiologic involvement of the cochlear aqueduct (CA) and the development of SNHL.

Study Design:
Blinded, retrospective review of imaging and audiometry.

Setting:
Tertiary center.

Patients:
Adults with JP.

Intervention(s):
None.

Main Outcome Measures:
Asymmetric SNHL was assessed continuously as the difference in bone conduction pure-tone average (BCPTA) between ears and as a categorical variable (≥15 dB difference at two consecutive frequencies, or a difference in speech discrimination score of ≥15%). Involvement of the CA was considered present if there was evidence of medial T2 fluid signal loss, contrast enhancement, or bony erosion/expansion.

Results:
Of 30 patients meeting inclusion criteria, 15 (50%) had asymmetric SNHL. CA involvement was observed in 87% of patients with asymmetric SNHL compared with 13% in those with symmetric hearing (p = 0.0001). Univariate analysis demonstrated that age, sex, and tumor volume were not associated with asymmetric SNHL. The median difference in BCPTA between ears in patients with CA involvement was 21.3 dB HL compared to 1.2 dB HL in those without CA involvement (p < 0.0001). Regression analysis demonstrates that enhancement within the CA is associated with a BCPTA difference of 19.4 dB HL (p = 0.0006).

Conclusions:
Cochlear aqueduct involvement by JP is associated with SNHL in the absence of inner ear fistula, vestibulocochlear nerve involvement, or brainstem compression. Correlation with operative findings or histopathologic evidence of tumor involvement may validate this intriguing imaging finding.
Microbiome Analysis of Cholesteatoma by Gene Sequencing
Authors: Weiss Joshua P. , Antonelli Patrick J. , Dirain Carolyn O. 
Published: August 2019

Objective:To compare the microbial flora of cholesteatoma and normal middle ears using gene-based sequencing analysis.Study Design:Controlledex vivohuman study.Setting:Academic, tertiary medical center.Subjects and Methods:Brush, swab, and tissue samples were each taken from cholesteatoma matrix and uninvolved tissue in patients with previously untreated, acquired cholesteatoma (n = 19) or middle ear mucosa from patients undergoing cochlear implantation with no history of cholesteatoma or previous middle ear surgery (control; n = 12). DNA was isolated from specimens then 16S rRNA gene sequencing was performed.Results:There was no difference in microbial yield between the sampling methods. Cholesteatoma specimens had lower relative abundance of 14 bacterial species compared with controls includingAcidovorax sp.,Bacillus sp.,Masillia sp.,Moraxella osloensis,Phenylobacterium conjunctum,Sphingomonas sp., andStaphylococcus epidermidis(allp < 0.05).Alternariasp. were present on nearly all the specimens.Alternariasp. andCladosporium herbarum(bothp ≤ 0.05) were lower in the cholesteatoma compared with control group. There was no difference in the relative abundance of any bacteria or fungi between the cholesteatoma matrix and uninvolved middle ear mucosa.Conclusions:Microbiome of cholesteatoma matrix is largely similar to adjacent mucosa. This differs from healthy ears. Further study is needed to understand if middle ear microbiome may impact cholesteatoma pathogenesis or treatment.
Pressure Transmission to the Inner Ear by Mastoid Palpation After Transmastoid Surgery for Superior Canal Dehiscence
Authors: Tanavde Ved A. , Creighton Francis X. , Ward Bryan K. , Carey John P. 
Published: August 2019

Objective:
To discuss an effect of transmastoid repair of superior semicircular canal dehiscence and its resolution using a mastoid titanium mesh plate.

Patients:
A 53-year-old woman with a history of superior canal dehiscence syndrome (SCDS) and subsequent transmastoid repair experienced dizziness and a loud, drum-like sound in her repaired ear when touching the ear. Palpating the skin over the mastoid defect reproduced the symptoms and could be observed on binocular microscopy as tympanic membrane deformation synchronous with mastoid palpation.

Intervention (s):
Surgery to place a titanium mesh cranioplasty plate over the mastoid cavity.

Main Outcome Measure (s):
Reduction in dizziness and auditory symptoms when palpating the mastoid.

Results:
In follow-up 2 months after surgery, palpation of the left mastoid no longer results in vertigo or hearing a loud sound. Hearing and vestibular function remained unchanged.

Conclusions:
Despite resolution of SCDS symptoms after transmastoid plugging and resurfacing of the superior semicircular canal involving mastoidectomy, patients can be bothered by dizziness and vertigo when pressing on the mastoid soft tissue envelope. This acts like a balloon that, when compressed, changes middle ear pressure and moves the tympanic membrane and can even cause alternobaric vertigo. This can be avoided or resolved by rigidly reconstructing the defect in the mastoid bone.
Concurrent Treatment With Intratympanic Dexamethasone for Moderate-Severe Through Severe Bell's Palsy
Authors: Inagaki Akira , Minakata Toshiya , Katsumi Sachiyo , Murakami Shingo 
Published: August 2019

Objective:
To determine whether early intervention with intratympanic steroid injection, known as concurrent intratympanic steroid therapy, is effective as a supplement to systemic steroid therapy for treating moderate-severe to severe Bell's palsy.

Design:
An open-label historical control trial.

Setting:
Tertiary referral center.

Participants:
A total of 35 Bell's palsy patients presenting with House–Brackmann grade IV or higher were treated with intratympanic steroid therapy concurrent with standard systemic treatment and compared with 108 patients treated with standard systemic therapy alone started within 7 days of onset.

Interventions:
In the concurrent intratympanic steroid therapy group, patients received both 410 mg of prednisolone (standard dose) and 1.65 mg of intratympanic dexamethasone for 10 consecutive days. Patients in the control group received the standard dose, or more, of systemic prednisolone. Both groups were additionally treated with valacyclovir.

Main Outcomes and Measures:
The primary outcome measure was restoration of a House–Brackmann score of grade I.

Results:
The rate of recovery to House–Brackmann Grade I was higher for the concurrent intratympanic steroid therapy group than for the control group (94% vs 73%, p = 0.008). The adjusted odds ratio was 5.47 (95% confidence interval: 1.18–25.21, p = 0.029).

Conclusions:
The recovery rate was higher for concurrent intratympanic steroid therapy treatment than for standard-of-care control treatment, regardless of whether steroid with lower or equivalent glucocorticoid action was administered. This result suggests that concurrent treatment with intratympanic steroid therapy is a potentially beneficial supplement to systemic steroid administration.
Non-contrast Magnetic Resonance Imaging for Diagnosis and Monitoring of Vestibular Schwannomas: A Systematic Review and Meta-analysis
Authors: Kim Do Hyun , Lee Seoungmin , Hwang Se Hwan 
Published: August 2019

Objective:
This study aimed to evaluate the diagnostic accuracy of high-resolution T2-weighted magnetic resonance imaging (T2wi) in terms of detecting vestibular schwannoma compared with gadolinium-enhanced T1-weighted MRI (GdT1wi).

Data Sources:
Five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database).

Data Selection:
Two authors independently searched five databases up to January 2019 on diagnosis of vestibular schwannomas via T2wi.

Data Extraction:
In the included studies, tumor diameters reported using T2wi were compared with those revealed by GdT1wi and correlation coefficients were calculated. Data on true-positives, true-negatives, false-positives, and false-negatives were extracted from the relevant articles. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Inter-rater agreement among different observers and intra-rater agreement among different measurements made by a single observer was assessed.

Data Synthesis:
Outcomes subjected to analysis included diagnostic accuracy (the diagnostic odds ratio); summary receiver operating characteristic curve and area under the curve values. The summary intra-class correlation coefficient was used for various random-effects models. The quality of each study was analyzed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool.

Conclusions:
T2wi performed without the use of a contrast agent is a highly accurate diagnostic and monitor tool compared with GdT1wi and also demonstrated high reliability. However, further studies are required to confirm the results of this study.
The Impact of Septoplasty Operation on Odor Threshold Score and Symptom Severity According to the Nasal Septum Deviation Classifications
Authors: Sakalli Cemal , Cayonu Melih , Tuna Evrim Unsal 
Published: August 2019

Objective:
The authors aimed to determine the changes in the odor threshold and sinonasal outcome test-22 scores of the patients after septoplasty surgery in terms of nasal septum deviation classifications.

Methods:
Forty-nine patients with nasal septum deviation, aged between 17 and 65, were included in our study. The sinonasal outcome test-22 scores questionnaire and the N-Butanol Threshold test were administered to the patients, 2 days before and 2 months after the septoplasty.

Results:
The authors’ study had 4 major findings: Odor threshold scores improved after septoplasty operation both for the narrower and the wider side of the nasal airway passage. The Vidigal classification for nasal septum deviation was best for predicting the changes for odor threshold scores after septoplasty operation. The nasal septum deviation in which the nasal septum was pushing the inferior turbinate to lateral nasal wall caused the most smell dysfunction according to the Vidigal classification. Unilateral vertical crest affecting the nasal valv area or the posterior part of the septum had the most negative effect on olfactory functions according to the Mladina classification.

Conclusion:
Septoplasty operation leads to improvement in odor threshold scores, and the Vidigal nasal septum deviation classification was best in predicting postoperative odor threshold changes.
Mental Skills in Surgery
Authors: Deshauer Siobhan , McQueen Sydney , Hammond Mobilio Melanie , Mutabdzic Dorotea , Moulton Carol-anne E. 
Published: August 2019

Objective:
The present study investigated the role of mental skills in surgery through the unique lens of current surgeons who had previously served as Olympic athletes, elite musicians, or expert military personnel.

Background:
Recent work has demonstrated great potential for mental skills training in surgery. However, as a field, we lag far behind other high-performance domains that explicitly train and practice mental skills to promote optimal performance. Surgery stands to benefit from this work. First, there is a need to identify which mental skills might be most useful in surgery and how they might be best employed.

Methods:
Using a constructivist grounded theory approach, semi-structured interviews were conducted with 17 surgeons across the United States and Canada who had previously performed at an elite level in sport, music, or the military.

Results:
Mental skills were used both to optimize performance in the moment and longitudinally. In the moment, skills were used proactively to enter an ideal performance state, and responsively to address unwanted thoughts or emotions to re-enter an acceptable performance zone. Longitudinally, participants used skills to build expertise and maintain wellness.

Conclusions:
Establishing a taxonomy for mental skills in surgery may help in the development of robust mental skills training programs to promote optimal surgeon wellness and performance.
Comparing Nipple-sparing Mastectomy to Secondary Nipple Reconstruction
Authors: Santosa Katherine B. , Qi Ji , Kim Hyungjin M. , Hamill Jennifer B. , Pusic Andrea L. , Chun Yoon Sun , Wilkins Edwin G. , Kozlow Jeffrey H. 
Published: August 2019

Objective:
The primary aim of this study was to compare patient-reported outcomes (PROs) of women who underwent immediate implant-based breast reconstruction (IBBR) after receiving either: (1) nipple-sparing mastectomy (NSM) or (2) simple mastectomy with subsequent nipple reconstruction (SNR).

Background:
The goal of post-mastectomy breast reconstruction is to restore body image and quality-of-life after mastectomy, but removal of the nipple-areolar complex may have its own negative psychosocial consequences. NSM may have increased in popularity due to its perceived oncologic safety in many women and to reports of superior aesthetic results with this technique. Despite the increased utilization of NSM, few studies have evaluated the impact of NSM on PROs and complications in women undergoing immediate IBBR.

Methods:
We performed a secondary analysis of the Mastectomy Reconstruction Outcomes Consortium study, a multicenter, prospective cohort study that recruited patients between February 2012 and July 2015. The primary aim of this study was to compare PROs as measured by BREAST-Q scores between women who underwent IBBR after NSM versus SNR. The secondary aim was to compare complication rates. Mixed-effects regression models controlled for demographic and clinical covariates.

Results:
Of the 600 women in the study, 286 (47.7%) underwent NSM. After controlling for baseline patient characteristics, we found no significant differences in satisfaction with breast, psychosocial well-being, physical well-being or sexual well-being between women undergoing NSM versus SNR. Mastectomy type was not a significant predictor of complications or reconstructive failure.

Conclusions:
Despite reports of superior aesthetics for NSM over simple mastectomy with nipple reconstruction in immediate IBBR, we found no significant differences at 2 years after reconstruction in patient satisfaction, quality-of-life, or complication rates.
Perioperative Probiotics or Synbiotics in Adults Undergoing Elective Abdominal Surgery
Authors: Chowdhury Abeed H. , Adiamah Alfred , Kushairi Anisa , Varadhan Krishna K. , Krznaric Zeljko , Kulkarni Anil D. , Neal Keith R. , Lobo Dileep N. 
Published: August 2019

Objective:
To define the impact of perioperative treatment with probiotics or synbiotics on postoperative outcome in patients undergoing abdominal surgery.

Background:
Postoperative surgical infection accounts for a third of all cases of sepsis, and is a leading cause of morbidity and mortality. Probiotics, prebiotics, and synbiotics (preparations that combine probiotics and prebiotics) are nutritional adjuncts that are emerging as novel therapeutic modalities for preventing surgical infections. However, current evidence on their effects is conflicting.

Methods:
A comprehensive search of the PubMed, Embase, and WHO Global Index Medicus electronic databases was performed to identify randomized controlled trials evaluating probiotics or synbiotics in adult patients undergoing elective colorectal, upper gastrointestinal, transplant, or hepatopancreaticobiliary surgery. Bibliographies of studies were also searched. The primary outcome measure was incidence of postoperative infectious complications. Secondary outcomes included incidence of noninfectious complications, mortality, length of hospital stay, and any treatment-related adverse events. Quantitative pooling of the data was undertaken using a random effects model.

Results:
A total of 34 randomized controlled trials reporting on 2723 participants were included. In the intervention arm, 1354 patients received prebiotic or symbiotic preparations, whereas 1369 patients in the control arm received placebo or standard care. Perioperative administration of either probiotics or synbiotics significantly reduced the risk of infectious complications following abdominal surgery [relative risk (RR) 0.56; 95% confidence interval (CI) 0.46–0.69; P < 0.00001, n = 2723, I
2 = 42%]. Synbiotics showed greater effect on postoperative infections compared with probiotics alone (synbiotics RR: 0.46; 95% CI: 0.33–0.66; P < 0.0001, n = 1399, I
2 = 53% probiotics RR: 0.65; 95% CI: 0.53–0.80; P < 0.0001, n = 1324, I
2 = 18%). Synbiotics but not probiotics also led to a reduction in total length of stay (synbiotics weighted mean difference: −3.89; 95% CI: −6.60 to −1.18 days; P = 0.005, n = 535, I
2 = 91% probiotics RR: −0.65; 95% CI: −2.03–0.72; P = 0.35, n = 294, I
2 = 65%). There were no significant differences in mortality (RR: 0.98; 95% CI: 0.54–1.80; P = 0.96, n = 1729, I
2 = 0%) or noninfectious complications between the intervention and control groups. The preparations were well tolerated with no significant adverse events reported.

Conclusions:
Probiotics and synbiotics are safe and effective nutritional adjuncts in reducing postoperative infective complications in elective abdominal surgery. The treatment effects are greatest with synbiotics.
Cardiac cachexia: the mandate to increase clinician awareness
Authors: Lena Alessia , Ebner Nicole , Coats Andrew J.S. , Anker Markus S. 
Published: August 2019

Purpose of review
Heart failure is a frequent problem in an ageing population, associated with high rates of morbidity and mortality. Today, it is important to not only treat heart failure itself but also the related comorbidities. Among them, cardiac cachexia is one of the major challenges. It is a complex multifactorial disease with a negative impact on quality of life and prognosis. Therefore, prevention, early recognition and treatment of cardiac cachexia is essential.

Recent findings
Cardiac cachexia frequently presents with skeletal as well as heart muscle depletion. Imaging-based diagnostic techniques can help to identify patients with cardiac cachexia and muscle wasting. Several blood biomarkers are available to detect metabolic changes in cardiac cachexia.

Summary
Several studies are currently ongoing to better comprehend the underlying pathophysiological mechanisms of cardiac cachexia and to find new treatments. It is essential to diagnose it as early as possible to initiate therapy.
Association between RELN polymorphisms and schizophrenia in a Han population from Northeast China
Authors: Bai Wei , Fu Yingli , Yu Xiao , Zhu Bo , Duan Ruixin , Yu Yaqin , Kou Changgui 
Published: August 2019

Objective
To explore the association between the RELN gene and schizophrenia in the overall sample and samples stratified by sex in a northeastern Chinese population.

Methods
A total of 1536 participants from Jilin Province, China, were recruited in this case-control study. Four single nucleotide polymorphisms (rs1062831, rs3808039, rs362746, and rs736707) in the RELN gene were genotyped. Binary logistic regression analysis was applied to detect associations between the genotypes of each single nucleotide polymorphism and schizophrenia. P values of no more than 0.003125 [0.05/(4 SNPs*4 different genetic models)] after Bonferroni correction were considered statistically significant.

Results
All single-nucleotide polymorphisms conformed to Hardy–Weinberg equilibrium in the control group. Logistic regression analysis revealed that after Bonferroni correction, rs362746 was associated with schizophrenia under the recessive model (P = 0.001) and codominant model (P = 0.003) in the overall group. The association between schizophrenia and RELN single-nucleotide polymorphisms was not found in a sex-specific pattern after Bonferroni correction.

Conclusion
Our study provides and supports the evidence that RELN is a candidate gene for schizophrenia. Replication studies conducted in different populations are required, and the sex-specific association of this gene with schizophrenia warrants further exploration.
Association study of the PDE4D gene and obsessive-compulsive disorder in a Chinese Han population
Authors: Huang Xing , Zhang Jinjuan , Liu Jie , Zhang Xinhua 
Published: August 2019

Objective
Multiple evidence suggests an involvement of the PDE4D in mental disorders. Therefore we investigate the association between obsessive-compulsive disorder and a polymorphism of the single nucleotide polymorphisms of PDE4D gene in the Chinese Han population.

Methods
We genotyped and performed a case-control association analysis of the PDE4D polymorphism rs1838733 in 400 obsessive-compulsive disorder patients and 459 healthy control subjects.

Results
The site conformed to Hardy–Weinberg (P > 0.05), three genotypes (AA, AG, GG) of PDE4D gene rs1838733 were detected. We demonstrated three principal results. First, there were no significant differences between the case and health controls in the genotype and allele at rs1838733 (P > 0.05). Second, there were no significant differences in the allele and genotype frequency between different genders obsessive-compulsive disorder (P > 0.05). Third, the genotype of single nucleotide polymorphism rs1838733 was associated with late-onset obsessive-compulsive disorder and female late-onset obsessive-compulsive disorder (P < 0.05).

Conclusion
The present study is the first to verify the associations of single nucleotide polymorphisms rs1838733 of the PDE4D gene with obsessive-compulsive disorder in a Chinese Han population. We found the genotype of single nucleotide polymorphism rs1838733 was associated with the occurrence of late-onset obsessive-compulsive disorder and female late-onset obsessive-compulsive disorder. Therefore, PDE4D may play a role in the pathogenesis of obsessive-compulsive disorder and may become a potential target for obsessive-compulsive disorder treatment in future research. Further studies should verify the current findings.