bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility and Challenges of a Multi-pathogen Diagnostic Platform for Characterizing Public Health Threats of Severe Acute Respiratory Infections in Six Countries
Authors: Milucky Jennifer ,   International TAC Working Group
Published: March 2018

Abstract

Background
Pneumonia causes significant morbidity and mortality worldwide. Comprehensive etiology studies of pneumonia in adults are limited; however, new diagnostics enable simultaneous detection of multiple pathogens in respiratory specimens. Characterizing the public health threat of severe acute respiratory infection (SARI) may enhance global health security. We studied potential etiologies of SARI among adults in six countries over a 12-month period using multi-pathogen diagnostics.

Methods
We enrolled SARI cases (acute onset of fever and cough, requiring hospitalization, in an adult) from Global Disease Detection sites in Bangladesh, China, Egypt, Guatemala, Kenya, and Thailand and healthy frequency-matched controls (2 controls: 5 cases) by time (onset), age group (18–49, 50–64, 65+ years), and catchment area. Demographics, clinical data, and nasopharyngeal and oropharyngeal specimens were collected from cases and controls. Specimens were tested for 16 viruses and 14 bacteria using Taqman® Array Card, which uses real-time reverse transcriptase polymerase chain reaction.

Results
We enrolled 2,388 cases and 1,135 controls from Oct 2013 through Oct 2015. Age distribution (Figure) and seasonality varied by site: enrollment peaked in summer months in Bangladesh, Thailand, and China, and in winter months in Egypt, but was stable throughout the year in Guatemala and Kenya. Case fatality rate across all study locations was 2.3% (range 0–7.0%). One or more pathogens was detected in 76% of cases and in 67% of controls; ≥2 pathogens were detected in 42% of cases and 37% of controls. Pathogens more commonly detected among cases than controls included influenza A (OR 13.3, CI 7.0–25.2; 12.8% of cases vs. 1.1% of controls), influenza B (OR: 27.0, CI 8.6–84.8; 8.1% vs. 0.3%), and respiratory syncytial virus (RSV) (OR: 9.4, CI 3.4–25.8; 4.0% vs. 0.4%).

Conclusion
In this SARI study, frequent detection of multiple pathogens in the oro- and nasopharynx of both cases and controls made etiology attribution difficult. Influenza and RSV, however, were likely to be causes of SARI. Because upper respiratory tract specimens may not accurately reflect disease in the lung, better specimens are needed to determine pneumonia etiology, particularly for bacteria.

Disclosures
All authors: No reported disclosures.
Pertussis-Associated Persistent Cough in Previously Vaccinated Children
Authors: Principi Nicola , Litt David , Terranova Leonardo , Picca Marina , Malvaso Concetta , Vitale Cettina , Fry Norman , Esposito Susanna ,   Italian Pertussis Group for Persistent Cough in Children
Published: March 2018

Abstract

Background
Persistent cough is a very distressing condition. It may be due to infectious agents, including Bodetella pertussis. In this case, associated symptoms are frequently different from typical pertussis (PT) cases and diagnosis is difficult and delayed. In this study, the role of B. pertussis infection as cause of persistent cough in school-children and adolescents and the protective role of previously administered PT vaccine doses was evaluated.

Methods
Healthy 7- to 17-year-old children with cough lasting from 2 to 8 weeks were enrolled. Excluded were the patients who had received the preschool booster (PSB) PT vaccine less than one year before the cough onset. At enrollment, a nasopharyngeal swab and an oral fluid sample were obtained to seek pertussis infection by detection of B. pertussis DNA in the nasopharynx using PCR and/or an elevated titer of anti-pertussis toxin IgG in oral fluid using an IgG antibody-capture enzyme-linked immunosorbent assay. Saliva determination of anti-PT toxin IgG was used because it acts as a surrogate for anti-PT toxin IgG serology.

Results
Among 96 patients, pertussis was diagnosed in 18 (18.7%; 95% CI 11.5–28.0). In 2 children with cough lasting 2 weeks, confirmation was based on the detection of B. pertussis; in 13 cases, with cough lasting 4–7 weeks, PT was diagnosed because there were high anti-PT IgG titers in oral fluid; and in 3 cases, with cough lasting 3 weeks, PT was diagnosed due to positivity for both tests. In 15 children, the disease occurred despite PSB administration. In 2 cases, PT diagnosis was made only 16 and19 months after booster injection, whereas in other 13 cases infection emerged after a longer period. However, in eight cases disease occurred less than 5 years after vaccine administration.

Conclusion
This study demonstrates that about 20% of persistent cough in children is due to PT. In case of persistent cough, this has to be considered to prescribe an effective therapy. Moreover, the study confirms that protection evoked by PT vaccine rapidly wanes and that schoolchildren may return to be PT susceptible after few year of the officially recommended PSB dose. If confirmed, these findings might lead to anticipate presently recommended PT vaccine dose for adolescents.

Disclosures
All authors: No reported disclosures.
Segmentation Analysis of Susceptibility to Cybercrime: Exploring Individual Differences in Information Security Awareness and Personality Factors
Authors: Hadlington Lee , Chivers Sally 
Published: March 2018

AbstractThe present article aimed to explore if susceptibility to cybercrime can be linked to information security awareness and personality factors. A total of 1,054 participants aged between 18 and 84 years took part in an online survey consisting of a recently developed segmentation analysis tool designed to explore an individual’s susceptibility to cybercrime. Alongside this, two other scales measuring information security awareness and the personality trait of impulsivity were also included. In total, 60% of the population surveyed presented as being in the higher risk categories for susceptibility to cybercrime. Furthermore, individuals in the higher risk categories for susceptibility to cybercrime also presented poorer information security awareness, as well as having higher levels of trait impulsivity. It was also noted that certain demographic factors also linked to susceptibility to cybercrime, including age and current employment status, with the unemployed and student populations being less well represented in lower risk categories. This work is seen as being critical while designing effective intervention strategies that are designed to target specific at-risk populations, as well as presenting a key tool that could be widely used by organizations to examine risk within their own specific populations.
How to predict and improve prognosis of food allergy
Authors: Dahdah Lamia , Pecora Valentina , Riccardi Carla , Fierro Vincenzo , Valluzzi Rocco , Mennini Maurizio 
Published: March 2018

Purpose of review
The prevalence of food allergy is increasing. More children are being diagnosed with food allergies, and it is taking longer to outgrow them, among those who develop tolerance. The aim of this review is to draw the profile of the persistent food allergic, so that prevention strategies can be developed and active treatment set up.

Recent findings
Many determinants are involved in food allergy prognosis: ethnicity and sex, type of food, innate immune system, eliciting dose, sensitization status and other biomarkers determination, gut microbiome composition, and the presence of comorbidities. Once identified, a persistent food allergy could be conveyed to active treatments, such as oral immunotherapy or the use of biologics, always taking into account their experimental nature.

Summary
A better understanding of prognostic factors and phenotypes of food allergy is crucial in decision-making when it comes to food allergy prevention and management. A good classification of the allergic patient allows to determine the degree of exclusion diets and the timing of the reintroduction of avoided food when possible. In the cases of persistent and severe food allergy, many promising interventions are emerging which could improve prognosis and quality of care.
An Observational Cohort Study Examining the Effect of the Duration of Skin-to-Skin Contact on the Physiological Parameters of the Neonate in a Neonatal Intensive Special Care Unit
Authors: Jones Hannah , Santamaria Nick 
Published: March 2018

Background:
Focus on skin-to-skin contact (SSC) as a family-centered care intervention in Neonatal Intensive Special Care (NISC) Units continues to increase. Previously, SSC has been shown to improve neonatal physiological stability, support brain development, and promote bonding and attachment. Limited research exists investigating SSC duration and neonatal physiological responses.

Purpose:
This study examined the relationship between SSC duration and the neonate's oxygen saturation, heart rate (HR), respiratory rate (RR), and temperature.

Method:
An observational cohort study was conducted at The Royal Women's Hospital NISC Unit in Melbourne, Australia. For each neonate participant, 1 SSC with their parent was studied (parent convenience) and neonatal physiological parameters recorded, with a bivariate correlation used to explore the relationship between the duration of SSC and the percentage of time during SSC that the neonate's physiological variables remained within a target range.

Findings:
No correlation existed between the duration of SSC and the neonatal physiological variables of oxygen saturation, HR, RR, and temperature. However, neonatal oxygen requirement was more often reduced across the duration of SSC.

Implications for Practice and Future Research:
Due to previously documented benefits to neonates physiologically from SSC, and our supportive finding that SSC reduces neonatal oxygen requirement, we believe that this study adds to the evidence to support promotion of SSC in NISC Units. The duration of SSC does not appear to negatively impact the physiological effects to the neonate. Thus, SSC should be encouraged in all NISC Units to be conducted for the length of time the parent is able. This study should be repeated with a larger sample size.
Early discharge after posterior spinal fusion for adolescent idiopathic scoliosis is possible using an optimized postoperative pathway: a case-control study
Authors: Fletcher Nicholas D. , Lazarus David E. , Bruce Robert W. , Owen Robert J. , Geddes Benjamin J. , Schmitz Michael 
Published: March 2018

Background:
Patients with adolescent idiopathic scoliosis (AIS) are typically healthy and yet hospital stay after posterior spinal fusion (PSF) remains lengthy.

Methods:
A review of patients undergoing PSF for AIS by four pediatric orthopaedic surgeons was performed. Patients were divided based on their surgery occurring before or after the implementation of an accelerated discharge pathway (AD). Patients treated prior to the AD pathway were managed using a less standardized traditional (TD) pathway.

Results:
Four surgeons performed 99 PSF for AIS using the TD pathway and 81 PSF after implementation of the AD pathway. Length of stay was 20% shorter in patients managed under the AD pathway (3.29±0.61 days vs. 4.11±0.97 days, P<0.0001) There was no difference in age, sex, preoperative main thoracic thoracolumbar curve magnitudes between groups. There was no difference in groups with regards to the use of osteotomies, number of levels fused, or total number of screws placed. Patients managed in the AD cohort had shorter surgical times (TD 4.55±0.9 hr vs. AD 4.19±1.11 hr, P=0.02) and lower estimated blood loss (TD 688±395 cc vs. AD 453±327 cc; P<0.0001). Multivariate regression analysis revealed a 0.82 day reduction in length of stay when controlling for estimated blood loss and length of surgery. There was no statistical difference between groups with regards to any complications.

Conclusions:
The use of a coordinated discharge pathway helped to reduce length of stay in patients undergoing PSF for AIS without an increase in complications. This hospital stay of 3 days represents a dramatic decrease over previously published averages.
The Development of a Machine Learning Inpatient Acute Kidney Injury Prediction Model*
Authors: Koyner Jay L. , Carey Kyle A. , Edelson Dana P. , Churpek Matthew M. 
Published: March 2018

Objectives:
To develop an acute kidney injury risk prediction model using electronic health record data for longitudinal use in hospitalized patients.

Design:
Observational cohort study.

Setting:
Tertiary, urban, academic medical center from November 2008 to January 2016.

Patients:
All adult inpatients without pre-existing renal failure at admission, defined as first serum creatinine greater than or equal to 3.0 mg/dL, International Classification of Diseases, 9th Edition, code for chronic kidney disease stage 4 or higher or having received renal replacement therapy within 48 hours of first serum creatinine measurement.

Interventions:
None.

Measurements and Main Results:
Demographics, vital signs, diagnostics, and interventions were used in a Gradient Boosting Machine algorithm to predict serum creatinine–based Kidney Disease Improving Global Outcomes stage 2 acute kidney injury, with 60% of the data used for derivation and 40% for validation. Area under the receiver operator characteristic curve (AUC) was calculated in the validation cohort, and subgroup analyses were conducted across admission serum creatinine, acute kidney injury severity, and hospital location. Among the 121,158 included patients, 17,482 (14.4%) developed any Kidney Disease Improving Global Outcomes acute kidney injury, with 4,251 (3.5%) developing stage 2. The AUC (95% CI) was 0.90 (0.90–0.90) for predicting stage 2 acute kidney injury within 24 hours and 0.87 (0.87–0.87) within 48 hours. The AUC was 0.96 (0.96–0.96) for receipt of renal replacement therapy (n = 821) in the next 48 hours. Accuracy was similar across hospital settings (ICU, wards, and emergency department) and admitting serum creatinine groupings. At a probability threshold of greater than or equal to 0.022, the algorithm had a sensitivity of 84% and a specificity of 85% for stage 2 acute kidney injury and predicted the development of stage 2 a median of 41 hours (interquartile range, 12–141 hr) prior to the development of stage 2 acute kidney injury.

Conclusions:
Readily available electronic health record data can be used to predict impending acute kidney injury prior to changes in serum creatinine with excellent accuracy across different patient locations and admission serum creatinine. Real-time use of this model would allow early interventions for those at high risk of acute kidney injury.
Informant Report of Financial Capacity for Individuals With Chronic Acquired Brain Injury: An Assessment of Informant Accuracy
Authors: Sunderaraman Preeti , Cosentino Stephanie , Lindgren Karen , James Angela , Schultheis Maria 
Published: March 2018

Objective:
Primarily, to investigate the association between informant report and objective performance on specific financial capacity (FC) tasks by adults with chronic, moderate to severe acquired brain injury, and to examine the nature of misestimates by the informants.

Design:
Cross-sectional design.

Setting:
A postacute, community-based rehabilitation center.

Participants:
Data were obtained from 22 chronic acquired brain injury (CABI) adults, mean age of 46.6 years (SD = 8.67), mean years of education of 13.45 years (SD = 2.15), with moderate to severe acquired brain injury (86% had traumatic brain injury), with a mean postinjury period of 17.14 years (SD = 9.5). Whereas the CABI adults completed the Financial Competence Assessment Inventory interview—a combination of self-report and performance-based assessment, 22 informants completed a specifically designed parallel version of the interview.

Results:
Pearson correlations and 1-sample t tests based on the discrepancy scores between informant report and CABI group's performance were used. The CABI group's performance was not associated with its informant's perceptions. One-sample t tests revealed that informants both underestimated and overestimated CABI group's performance.

Conclusions:
Results indicate lack of correspondence between self- and informant ratings. Further investigation revealed that misestimations by informants occurred in contrary directions with CABI adults' performance being inaccurately rated. These findings raise critical issues related to assuming that the informant report can be used as a “gold standard” for collecting functional data related to financial management, and the idea that obtaining objective data on financial tasks may represent a more valid method of assessing financial competency in adults with brain injury.
A Preliminary Investigation of Accelerometer-Derived Sleep and Physical Activity Following Sport-Related Concussion
Authors: Sufrinko Alicia M. , Howie Erin K. , Elbin R. J. , Collins Michael W. , Kontos Anthony P. 
Published: March 2018

Objective:Describe changes in postconcussion activity levels and sleep throughout recovery in a sample of pediatric sport-related concussion (SRC) patients, and examine the predictive value of accelerometer-derived activity and sleep on subsequent clinical outcomes at a follow-up clinic visit.Setting:Outpatient concussion clinic.Participants:Twenty athletes aged 12 to 19 years with diagnosed SRC.Methods:Prospective study including visit 1 (<72 hours postinjury) and visit 2 (6-18 days postinjury). Linear regressions used to predict scores (ie, neurocognitive, vestibular/oculomotor) at visit 2 from accelerometer-derived data collected 0 to 6 days postinjury. Linear mixed models evaluated changes in activity and sleep across recovery.Main Measures:Symptom, neurocognitive, and vestibular/oculomotor scores; sleep and activity data (Actigraph GT3x+)Results:The maximum intensity of physical activity increased (P= .009) and time in bed decreased throughout recovery (P= .026). Several physical activity metrics from 0 to 6 days postinjury were predictive of worse vestibular/oculomotor scores at visit 2 (P< .05). Metrics indicative of poor sleep 0 to 6 days postinjury were associated with worse reaction time at visit 2 (P< .05).Conclusions:This exploratory study suggests physical activity and sleep change from the acute to subacute postinjury time period in adolescent SRC patients. In our small sample, excess physical activity and poor sleep the first week postinjury may be associated with worse outcomes at follow-up in the subacute stage of recovery. This study further supported the feasibility of research utilizing wearable technology in concussion patients, and future research in a large, diverse sample of concussion patients examined at concise time intervals postinjury is needed.
ACUTE MACULAR NEURORETINOPATHY IN SUSAC SYNDROME: A NEW ASSOCIATION
Authors: Yang Yong-Sheng , Zhang Lily , Asdaghi Negar , Henry Christopher R. , Davis Janet L. 
Published: March 2018

Purpose:
To report a case of acute macular neuroretinopathy in a patient with Susac syndrome.

Methods:
Case report.

Results:
A 39-year-old male patient presented with severe headache, photopsias, and a sudden onset of hearing loss in the right ear. Fluorescein angiography of the right eye revealed multiple branch retinal artery occlusions. Clinical presentation of encephalopathy, hearing loss, and branch retinal artery occlusions, along with characteristic magnetic resonance imaging findings, led to a diagnosis of Susac syndrome. Despite aggressive immunosuppression for four months, the patient later presented with acute macular neuroretinopathy in the left eye.

Conclusion:
Acute macular neuroretinopathy and Susac is a new association of two well-defined disorders. The concurrence of both disorders supports retinal ischemia as the proximate cause of acute macular neuroretinopathy and inflammation as a potential etiology.
Corneal Cross-Linking for Pediatric Keratcoconus Review
Authors: Perez-Straziota Claudia , Gaster Ronald N. , Rabinowitz Yaron S. 
Published: March 2018

Purpose:
To comprehensively review the available published literature for cross-linking in the pediatric population.

Methods:
Review of the literature published in English in PubMed.

Results:
Two hundred ten publications were considered. One hundred fifteen were considered relevant to this review.

Conclusions:
Studies of cross-linking in pediatric patients are sparse, with relatively short follow-up times, and mostly on small groups of patients. Treatment with cross-linking halts progression of keratoconus in the pediatric population, and early treatment seems to be cost-effective compared with later penetrating keratoplasty. Long-term effects and regression rates remain unclear, and further studies are needed in this population.
Risk of Anterior Segment Complications Associated With the Live Herpes Zoster Vaccine: Evidence From a Health-Claim Database
Authors: Liu Rhuozhou Tom , Yeung Sonia N. , Carleton Bruce , Etminan Mahyar 
Published: March 2018

Purpose:
To determine the risk of developing anterior segment complications after receiving the live herpes zoster virus vaccine.

Methods:
This retrospective cohort study included a random sample of 9 million patients registered in a health-claim database in the United States between 2006 and 2016. Herpes zoster-related anterior segment diseases were identified by International Classification of Diseases ninth or tenth edition codes (an event). Patients without any event before index dates were separated into cohorts 1 and 2. Cohort 1 received the live virus vaccine on the index date. Cohort 2 was diagnosed with nonophthalmic zoster on the index date. The recurrent cohorts consisted of those who had an event 6 months or more before the index dates and were separated into cohort 3 and cohort 4 based on the same criteria as cohort 1 and 2, respectively. All cohorts were followed to the first event. Hazard ratios (HRs) of anterior segment complications after vaccine administration were determined.

Results:
There were 72,141 vaccine users and 133,604 nonusers. There were 379 events and 1032 events in cohort 1 and cohort 2, respectively. The adjusted HR was 0.89 (95% confidence interval: 0.77–1.02). Among those with recurrent disease, there were 2679 vaccine users and 9421 nonusers. There were 16 events in cohort 3, compared with 86 events in cohort 4. The adjusted HR was 0.70 (95% confidence interval: 0.40–1.23).

Conclusions:
Data from a large health-claim database suggest that the live zoster virus vaccine is not associated with a higher risk of anterior segment complications.