bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability and Validity of the Patient Health Questionnaire-9 as a Screening Tool for Poststroke Depression
Authors: Trotter Tanya L. , Denny Dawn L. , Evanson Tracy A. 
Published: May 2019

ABSTRACT

Background: Screening for poststroke depression (PSD) using a valid and reliable tool is recommended for all stroke survivors. This literature review identifies the specificity, sensitivity, and appropriateness of the 9-item Patient Health Questionnaire (PHQ-9) to screen stroke patients for PSD. Methods: Relevant databases were searched using the following selection criteria: (1) peer-reviewed primary research, (2) published from 2012 to 2018 (to evaluate the most recent research using this tool), and (3) examined the specificity and sensitivity of the PHQ-9 for screening stroke survivors for PSD. Results: Six studies, with an overall level of evidence grade of “B,” representing an overall total sample size of 930 participants (851 given a diagnosis of stroke and 49 given a diagnosis of transient ischemic attacks) met criteria for inclusion in the review. Only 2 studies reported data on all of the components necessary to determine the robustness of this tool to screen for depression in stroke survivors. Conclusion: Evidence regarding the sensitivity and specificity of the PHQ-9 to screen stroke patients for PSD is inconclusive. Additional research is needed to address the appropriateness of the PHQ-9 as a depression screening tool in this population. Clinicians should validate the results of PHQ-9 screening of ischemic stroke patients for PSD with the Structured Clinical Interview for DSM-5, the standard for diagnosing depression, before initiating treatment of PSD.
Prelingual Deaf Children Treated With Cochlear Implant: Monitoring Performance With Percentiles
Authors: Manrique Manuel , Calavia Diego , Manrique-Huarte Raquel , Zulueta-Santos Cristina , Martin Mario , Huarte Alicia 
Published: May 2019

Objectives:
To develop a percentile ranking system driven by speech recognition data obtained from different groups of patients treated with a cochlear implant to serve as a tool to monitor the progress of these patients.

Study Design:
Prospective study.

Setting:
Tertiary referral center.

Patients:
Diagnosed with a bilateral, profound sensorineural hearing loss treated with a unilateral cochlear implant.

Intervention:
Diagnostic.

Main Outcome Measure:
Six different percentiles (p) were classified taking into account the correlation between speech recognition outcome scores and age at implantation, with reference to the onset of hearing loss.

Results:
Four hundred sixteen prelingual patients were included. These subjects were divided into subgroups depending on age at implantation.
Prelingual group, from the fifth year after implantation, p50 centered on the following percentages of correct words in each subgroup: 100, 94.6, 91.4, 91.0, 79.2, and 63.1% in children implanted under 12 months, 1, 2, 3, 4 to 6, 7 to 10 years, respectively. After a 12-year follow-up, a significant negative correlation between age at implantation and speech recognition was observed in both prelinguals (Rhos=−0.578, p<0.001).

Conclusion:
A percentile system was developed to monitor the postimplant progress of prelingual deaf implanted patients, with potential applications in patient follow-up and handling circumstances that may deteriorate results.
Comparing Linear and Volumetric Vestibular Schwannoma Measurements Between T1 and T2 Magnetic Resonance Imaging Sequences
Authors: Tolisano Anthony M. , Wick Cameron C. , Hunter Jacob B. 
Published: May 2019

Objective:
To compare linear and volumetric vestibular schwannoma (VS) measurements between different magnetic resonance imaging (MRI) sequences.

Study Design:
Retrospective case series.

Setting:
Tertiary care university hospital.

Patients:
Those with VS that had at least two separate MRI studies containing both T1-weighted contrast (T1C) and high-resolution T2-weighted (HRT2) images.

Intervention:
Two neurotologists measured the greatest linear axial dimension and segmentation volumes of VS.

Main Outcome Measure:
1) Correlation between T1C and HRT2 VS linear and volumetric measurements. 2) Comparing the interpretation of VS growth between T1C and HRT2 sequences and reviewers, defined as an increase in tumor diameter of more than or equal to 2 mm or a volume increase of more than or equal to 20%.

Results:
Twenty-three patients met inclusion criteria. Imaging studies encompassed a median of 25.2 months. At the initial imaging study, inter-observer measurements between reviewers, analyzed with intraclass correlation coefficients, for T1C diameters, T1C volumes, HRT2 diameters, and HRT2 volumes were 0.983 (95% confidence interval [CI] 0.972–0.989), 0.989 (95% CI 0.982–0.993), 0.992 (95% CI 0.988–0.995), and 0.998 (95% CI 0.995–0.999), respectively. The Cohen's kappa for growth rates between T1C diameters, T1C volumes, HRT2 diameters, and HRT2 volumes was 0.564 (95% CI 0.284–0.844), 0.704 (95% CI 0.514–0.894), 0.605 (95% CI 0.319–0.891), and 0.475 (95% CI 0.242–0.708), respectively.

Conclusions:
There are significant differences in VS volume measurements when utilizing T1C versus HRT2 images. However, there is “excellent” interobserver agreement between T1C and HRT2 diameters and volumes. T1C VS volumes may be more reliable than HRT2 volumes to determine growth.
Evaluation of Intracochlear Position of a Slim Modiolar Electrode Array, by Using Different Radiological Analyses
Authors: Ramos de Miguel Ángel , Durmo Irfan , Falcón González Juan Carlos , Borkoski Barreiro Silvia , Ramos Macías Angel 
Published: May 2019

Introduction:
The radiological analysis following a cochlear implantation offers insight into the audiological outcomes of cochlear implant recipients. The wrapping factor (WF) is the most common radiological analysis measuring the modiolar position and depth of insertion of an electrode array. New measurements like the intracochlear position index (ICPI) or the homogeneity factor (HF) can offer more accurate information regarding the electrode's intracochlear position. We have also studied a new method to calculate the WF, by normalizing it with a new methodology (WFn).

Objectives:
To analyze and compare the results of the WF, ICPI, HF, and WFn obtained using a cone beam computer tomography (CBCT) with the histological analysis on temporal bone.

Material:
A perimodiolar electrode array (Nucleus Slim CI532) was inserted in three temporal bones. A perfect insertion was performed in the first temporal bone, according to the correct specifications. In the second specimen, a slightly over-inserted electrode was analyzed and in the third specimen a completely over-inserted electrode array was studied.

Method:
A CBCT was performed following the implantations and then, a histological analysis with slices perpendicular to the cochlea axis (modiolus). Each measurement was made 10 times by 10 experts (radiologist and otologist) with a total amount of 600 measurements (100 for each data, 3 CBCT and 3 histology). A t test statistical analysis was performed to compare the measurements between CBCT and histology.

Results:
It was observed that the ICPI and the HF correctly identify the three different insertions. Regarding the WF no significant difference in the two over-inserted specimens was found. The ICPI was the only measurement that shows no statistical difference between the CBCT and the histology, so it was considered the most accurate method. Finally, the WF shows a statistical difference between the CBCT and the histology in all cases, indicating the poor value of the radiological method. The WFn analysis includes the modiolar wall length in the measurement. This improves the final result as it reduces the error induced by the size of the cochlea.

Conclusion:
The ICPI and the HF provide better radiological information than the WF, regarding the intracochlear position of the electrode array. The most relevant difference is that the ICPI, HF, and WFn include modiolar and lateral wall dimensions, thereby using the diameter of the cochlear duct for the analysis.
First Experience With a New Thin Lateral Wall Electrode in Human Temporal Bones
Authors: Lenarz Thomas , Avci Ersin , Gazibegovic Dzemal , Salcher Rolf 
Published: May 2019

Introduction:
A modern cochlear implant electrode array design must combine: improved surgical ease of use, structure preservation, particularly important for pediatric application, stable position within the cochlea over time, and a meaningful balance between hearing preservation against addressing sufficient cochlear tissue to support electrical-only hearing. The aim of this study was to investigate a new lateral wall electrode array design from Advanced Bionics on human temporal bones (TBs).

Methods:
Ten fresh-frozen TBs were implanted with the SlimJ electrode array via the round window. The electrode array is 23 mm long, with a cross-section varying from 0.25 × 0.55 mm at the most apical contact to 0.6 × 0.8 mm at the proximal marker contact. To assess location of the electrode array, the TBs were postoperatively scanned using cone beam computed tomography, and histology was performed to assess intracochlear trauma (Grades 0–4).

Results:
All electrode arrays were considered easy to insert. The average insertion depth was 432 degrees measured from the round window with a range from 411 to 450 degrees azimuth. Nine out of 10 electrode arrays were inserted fully (<0.5 mm out of the cochlea), one electrode array was left 1.5 mm out of the cochlea. No translocations were observed in all 10 cochleae, slight touching of the basilar membrane at the distal portion of the array was observed in 50% of the cases.

Conclusion:
The results from the new thin lateral wall electrode array from Advanced Bionics provided consistent scala tympani locations. No translocations were observed and almost all electrode arrays were fully inserted. These results are promising and the new electrode array will be further studied in clinical practice investigating hearing preservation capabilities and speech performance.
Prognostic Factors of Long-Term Hearing Preservation in Small and Medium-Sized Vestibular Schwannomas After Microsurgery
Authors: Huo Zirong , Chen Jianqing , Wang Zhaoyan , Zhang Zhihua , Wu Hao 
Published: May 2019

Objective:The authors evaluated the long-term hearing outcomes of patients with vestibular schwannoma (VS) to explore appropriate surgical treatment.Study Design:Retrospective study.Setting:Tertiary referral center.Patients:A total of 138 patients diagnosed with small and medium-sized VS with serviceable hearing from January 2006 to December 2015.Interventions:All patients underwent microsurgery via retrosigmoid (RSA) or middle cranial fossa approach (MFA) and were followed up for over 2 years.Main Outcome Measures:Pre- and postoperative hearing, including pure tone audiometry, speech discrimination score, and auditory brainstem response (ABR), were analyzed.Results:The mean tumor size and volume were 16.6 ± 3.4 mm and 1711.8 ± 918.5 mm3, respectively. Preoperative hearing levels were Class A in 42, Class B in 67, and Class C in 29 patients. Patients with a tumor from the superior vestibular nerve (SVN) had better hearing at diagnosis. Postoperative hearing levels were Class A, B, C, and D for 28, 17, 32, and 61 patients. Hearing outcomes were significantly better in patients with normal intraoperative I wave on ABR. Hearing loss within 6 months had a positive effect on postoperative hearing. Better preoperative hearing and tumors from SVN were correlated with better postoperative hearing outcomes. Tumor size, cystic variation, or extension to the fundus of internal auditory canal had no influence on hearing preservation.Conclusions:Better preoperative hearing, shorter hearing loss period, tumors from SVN, and normal intraoperative I wave are prognostic factors for serviceable hearing. RSA and MFA are effective and safe for tumor removal and hearing preservation.
Hematopoietic stem cells: self-renewal and expansion
Authors: Li Zhenrui , He Xi C. , Li Linheng 
Published: May 2019

Hematopoietic stem cells (HSCs) are a unique population of cells with the remarkable ability to replenish themselves through self-renewal and to give rise to differentiated cell lineages. Though having been discovered more than 50 years ago, and having been widely used in bone marrow transplantation to treat blood disorders including leukemia, expansion of HSCs remains an unmet task, thus affecting its more effective usage in clinical practice.

Purpose of review
The purpose of this review article is to summarize past efforts in ex-vivo HSC expansion and to compare recent advances in expanding murine and human HSCs by targeting the N
6-methyladenosine (m6A) pathway.

Recent findings
Unlike past many efforts that mainly target single or limited pathways and often lead to lineage bias or expansion of progenitor cells or limited long-term HSCs (LT-HSCs), the blocking the degradation of m6A pathway has an advantage of stabilizing hundreds of key factors required for maintaining HSCs, thus resulting in expansion of functional LT-HSCs.

Summary
The new approach of targeting the m6A pathway has a promising application in clinical HSC-based transplantation.
The diagnosis and treatment of PCOS in adolescents: an update
Authors: Witchel Selma F. , Burghard Anne Claire , Tao Rachel H. , Oberfield Sharon E. 
Published: May 2019

Purpose of review
Polycystic ovary syndrome (PCOS) is often difficult to diagnose in adolescents. Recent recommendations and concepts regarding the diagnosis and treatment of PCOS in the adolescent girl are considered.

Recent findings
The diagnosis of PCOS in adolescents should be primarily based on clinical and biochemical signs of hyperandrogenism and presentation with irregular menses. Because of the similarity of normal pubertal development and features of PCOS, the diagnosis should be deferred until at least 2 years following menarche. For girls who do not fulfill the diagnostic criteria, the focus should be on treatment of symptoms.

Summary
PCOS is a complex, multifaceted disorder, and should be diagnosed and treated in adolescents after taking into consideration the patient's full diagnostic picture, metabolic risks, and individual concerns, to both avoid overdiagnosis but yet be able to provide early and meaningful interventions.
Pancreatic Cysts and Intraductal Papillary Mucinous Neoplasm in Autosomal Dominant Polycystic Kidney Disease
Authors: McNicholas Bairbre A. , Kotaro Yoshida , Martin William , Sharma Ayush , Kamath Patrick S. , Edwards Marie E. , Kremers Walter K. , Chari Suresh T. , Torres Vicente E. , Harris Peter C. , Takahashi Naoki , Hogan Marie C. 
Published: May 2019

Objectives
Pancreatic lesions in autosomal dominant polycystic kidney disease (ADPKD) are primarily cysts. They are increasingly recognized, with isolated reports of intraductal papillary mucinous neoplasia (IPMN).

Methods
Retrospective study to determine prevalence, number, size, and location of pancreatic abnormalities using abdominal magnetic resonance imaging (MRI) of genotyped ADPKD patients (seen February 1998 to October 2013) and compared with age- and sex-matched non-ADPKD controls. We evaluated presentation, investigation, and management of all IPMNs among individuals with ADPKD (January 1997 to December 2016).

Results
Abdominal MRIs were examined for 271 genotyped ADPKD patients. A pancreatic cyst lesion (PCL) was detected in 52 patients (19%; 95% confidence interval, 15%–23%). Thirty-seven (71%) had a solitary PCL; 15 (28%) had multiple. Pancreatic cyst lesion prevalence did not differ by genotype. Intraductal papillary mucinous neoplasia was detected in 1% of ADPKD cases. Among 12 IPMN patients (7 branch duct; 5 main duct or mixed type) monitored for about 140 months, 2 with main duct IPMNs required Whipple resection, and 1 patient died of complications from small-bowel obstruction after declining surgical intervention.

Conclusions
With MRI, PCLs were detected in 19% and IPMNs in 1% of 271 ADPKD patients with proven mutations, without difference across genotypes. Pancreatic cyst lesions were asymptomatic and remained stable in size.
Antibiotic Treatment in the First Week of Life Impacts the Growth Trajectory in the First Year of Life in Term Infants
Authors: Kamphorst Kim , Oosterloo Berthe C. , Vlieger Arine M. , Rutten Nicole B. , Bunkers Carin M. , Wit Ernst C. , van Elburg Ruurd M. 
Published: May 2019

ABSTRACTObjective:Antibiotic treatment in early life appears to increase the risk for childhood overweight and obesity. So far, the association between antibiotics administrated specifically during the first week of life and growth has not been studied. Therefore, we studied the association between growth and antibiotics, given in the first week of life and antibiotic courses later in the first year of life.Method:A prospective observational birth cohort of 436 term infants with 151 receiving broad‐spectrum antibiotics for suspected neonatal infection (AB+), and 285 healthy controls (AB−) was followed during their first year. Weight, height, and additional antibiotic courses were collected monthly. A generalized‐additive‐mixed‐effects model was used to fit the growth data. Growth curve estimation was controlled for differences in sex, gestational age, delivery mode, exclusive breast‐feeding, tobacco exposure, presence of siblings, and additional antibiotic courses.Results:Weight‐for‐age and length‐for‐age increase was lower in AB+ compared with AB− (P < 0.0001), resulting in a lower weight and length increase 6.26 kg (standard error [SE] 0.07 kg) and 25.4 cm (SE 0.27 cm) versus 6.47 kg (SE 0.06 kg) and 26.4 cm (SE 0.21 cm) (P < 0.05 and P < 0.005, respectively) in the first year of life. Approximately 30% of the children in both groups received additional antibiotic course(s) in their first year, whereafter additional weight gain of 76 g per course was observed (P = 0.0285).Conclusions:Decreased growth was observed after antibiotics in the first week of life, whereas increased growth was observed after later antibiotic course(s) in term born infants in the first year of life. Therefore, timing of antibiotics may determine the association with growth.
Prevalence and Clinical Characteristics of Unintentional Ingestion of Marijuana in Children Younger Than 6 Years in States With and Without Legalized Marijuana Laws
Authors: Leubitz Andrew , Spiller Henry A. , Jolliff Heath , Casavant Marcel 
Published: May 2019

Objective
The aim of this study was to examine the relationship between state marijuana legalization and the rates of unintentional ingestions of marijuana in children younger than 6 years.

Methods
This was a retrospective review of all marijuana ingestions in the National Poison Data System in children younger than 6 years between January 1, 2000, and July 31, 2017. Data analysis from NPDS included, age, sex, state and year of occurrence, clinical effects, therapies, health care facility utilization, and medical outcome. Population of children younger than 6 years was obtained from the US Census Bureau. Public records search provided state legal status of marijuana and year of state marijuana legalization.

Results
From 2000 through 2008, there was no significant change in the annual number or rate of ingestions of marijuana in children younger than 6 years across the United States. Following 2009, there was mean annual increase of 27% per year, rising to 742 ingestions per year or 2.98 ingestions per 100,000 population, respectively, in 2017. More than 70% of all cases occurred in states with legalized marijuana. Of all pediatric patients, 54.6% received some form of hospital-based care, of which 7.5% required critical care. Pediatric patients experienced a wide range of symptoms from drowsiness and confusion, to seizures and coma. Medical treatments ranged from hydration therapy to sedation and intubation. Poison centers safely managed 23.4% of these pediatric cases by phone, without the need for hospital evaluation.

Conclusion
There was a strong association between the legalization of marijuana and ingestions of marijuana by children younger than 6 years.
Caring for Children With Autism in an Emergency Department Setting
Authors: Mannenbach Mark S. , Passe Rebecca L. , Lovik Kimberly K. , Larson Erin M. , Laudon Sarah M. , Naeve Allyson , Bellolio M. Fernanda 
Published: May 2019

Objective
Patients with autism spectrum disorder (ASD) and other developmental delays represent a unique patient population. We described a cohort of children with ASD cared for in an emergency department (ED) setting and the specific health care resources used for their care.

Methods
This is an observational study of consecutive children (<18 years) with ASD presenting for ED care. Comparisons of interest were evaluated using Wilcoxon rank sum and χ2 tests. Odds ratios (ORs) are reported with 95% confidence intervals (CIs).

Results
There were 238 ED visits over a 9-month period among 175 children. Median age was 9 years, and 62% were male. Reasons for ED visit were medical (51%), psychiatric (18%), injury/assault/trauma (16%), neurological (11%), and procedure related (4%.)
Children with psychiatric complaints had longer lengths of stay than those with other chief complaints (P < 0.0001; OR, 5.8; CI, 2.8–11.9) and were more likely to have urine (OR, 8.5; CI, 3.9–18.3) and blood work ordered (OR, 2.5; CI, 1.2–4.9) and less likely to have x-rays ordered (OR, 0.10; CI, 0.02–0.44).
Eighteen (8%) children received sedation. None required physical restraint. A total of 30% were admitted to the hospital. Those with psychiatric complaints were more likely to be admitted (54.8% vs 24.5%; OR, 3.7; CI, 1.9–7.4) than those with other chief complaints.

Conclusions
The care for children with ASD varied with age and health care issues. There was a high prevalence of psychiatric complaints, and many of these children were boarded in the ED waiting for an inpatient psychiatric bed. Those with psychiatric complaints were more likely to have multiple tests ordered and were more likely to be admitted.