bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Early Auditory Deprivation on Working Memory and Reasoning Abilities in Verbal and Visuospatial Domains for Pediatric Cochlear Implant Recipients
Authors: Davidson Lisa S. , Geers Ann E. , Hale Sandra , Sommers Mitchell M. , Brenner Christine , Spehar Brent 
Published: June 2018

Objectives:
The overall goal of this study was to compare verbal and visuospatial working memory in children with normal hearing (NH) and with cochlear implants (CI). The main questions addressed by this study were (1) Does auditory deprivation result in global or domain-specific deficits in working memory in children with CIs compared with their NH age mates? (2) Does the potential for verbal recoding affect performance on measures of reasoning ability in children with CIs relative to their NH age mates? and (3) Is performance on verbal and visuospatial working memory tasks related to spoken receptive language level achieved by children with CIs?

Design:
A total of 54 children ranging in age from 5 to 9 years participated; 25 children with CIs and 29 children with NH. Participants were tested on both simple and complex measures of verbal and visuospatial working memory. Vocabulary was assessed with the Peabody Picture Vocabulary Test (PPVT) and reasoning abilities with two subtests of the WISC-IV (Wechsler Intelligence Scale for Children, 4th edition): Picture Concepts (verbally mediated) and Matrix Reasoning (visuospatial task). Groups were compared on all measures using analysis of variance after controlling for age and maternal education.

Results:
Children with CIs scored significantly lower than children with NH on measures of working memory, after accounting for age and maternal education. Differences between the groups were more apparent for verbal working memory compared with visuospatial working memory. For reasoning and vocabulary, the CI group scored significantly lower than the NH group for PPVT and WISC Picture Concepts but similar to NH age mates on WISC Matrix Reasoning.

Conclusions:
Results from this study suggest that children with CIs have deficits in working memory related to storing and processing verbal information in working memory. These deficits extend to receptive vocabulary and verbal reasoning and remain even after controlling for the higher maternal education level of the NH group. Their ability to store and process visuospatial information in working memory and complete reasoning tasks that minimize verbal labeling of stimuli more closely approaches performance of NH age mates.
Peer Support in Critical Care: A Systematic Review
Authors: Haines Kimberley J. , Beesley Sarah J. , Hopkins Ramona O. , McPeake Joanne , Quasim Tara , Ritchie Kathryn , Iwashyna Theodore J. 
Published: June 2018

Objectives:
Identifying solutions to improve recovery after critical illness is a pressing problem. We systematically evaluated studies of peer support as a potential intervention to improve recovery in critical care populations and synthesized elements important to peer support model design.

Data Sources:
A systematic search of Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, and Excertpa Medica Database was undertaken May 2017. Prospective Register of Systematic Reviews identification number: CRD42017070174.

Study Selection:
Two independent reviewers assessed titles and abstracts against study eligibility criteria. Studies were included where 1) patients and families had experienced critical illness and 2) patients and families had participated in a peer support intervention. Discrepancies were resolved by consensus and a third independent reviewer adjudicated as necessary.

Data Extraction:
Two independent reviewers assessed study quality with the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool, and data were synthesized according to the Preferred Reporting Items for Systematic Reviews guidelines and interventions summarized using the Template for Intervention Description and Replication Checklist.

Data Synthesis:
Two-thousand nine-hundred thirty-two studies were screened. Eight were included, comprising 192 family members and 92 patients including adults (with cardiac surgery, acute myocardial infarction, trauma), pediatrics, and neonates. The most common peer support model of the eight studies was an in-person, facilitated group for families that occurred during the patients’ ICU admission. Peer support reduced psychologic morbidity and improved social support and self-efficacy in two studies; in both cases, peer support was via an individual peer-to-peer model. In the remaining studies, it was difficult to determine the outcomes of peer support as the reporting and quality of studies was low.

Conclusions:
Peer support appeared to reduce psychologic morbidity and increase social support. The evidence for peer support in critically ill populations is limited. There is a need for well-designed and rigorously reported research into this complex intervention.
Population Pharmacokinetic Analysis of Gentamicin in Pediatric Extracorporeal Membrane Oxygenation
Authors: Moffett Brady S. , Morris Jennifer , Galati Marianne , Munoz Flor M. , Arikan Ayse Akcan 
Published: June 2018

Background:Gentamicin pharmacokinetics may be altered in pediatric patients undergoing extracorporeal membrane oxygenation (ECMO). Description of gentamicin pharmacokinetics and relevant variables can improve dosing.Methods:A retrospective population pharmacokinetic study was designed, and pediatric patients who received gentamicin while undergoing ECMO therapy over a period of 6 1/2 years were included. Data collection included the following: patient demographics, serum creatinine, albumin, hematocrit, gentamicin dosing and serum concentrations, urine output, and ECMO circuit parameters. Descriptive statistics were used to characterize the patient population. Population pharmacokinetic analysis was performed with NONMEM, and simulation was performed to identify empiric doses to achieve therapeutic serum concentrations.Results:A total of 37 patients met study criteria (75.7% male patients), with a median age of 0.17 [interquartile range (IQR) 0.12–0.82] years. Primary indications for ECMO included the following: congenital diaphragmatic hernia (n = 17), persistent pulmonary hypertension (n = 5), and septic shock (n = 4). Patients received a total of 117 gentamicin doses [median 1.8 (IQR 1.4–2.9) mg/kg/dose] and had 125 serum concentrations measured at a median of 22.8 (IQR 15.8–25.5) hours after a dose. Population pharmacokinetic analysis identified a 2-compartment model with additive error as the best fit. Covariates included the following: allometrically scaled fat-free mass on clearance, central and peripheral volume of distribution (VDcentraland VDperipheral), and intercompartmental clearance; serum creatinine on clearance; ultrafiltration rate on central volume of distribution. Simulation identified dosage of 4–5 mg/kg/dose every 24 hours for neonates and infants as an acceptable empiric dosing regimen. Children and adolescents had elevated trough concentrations when dosed according to traditional dosing methods.Conclusions:Fat-free mass should be used to dose gentamicin in pediatric ECMO patients. Serum creatinine is a marker of gentamicin clearance and should be used to adjust gentamicin dosing in pediatric ECMO patients.
Evidence for Adaptive Response in a Molecular Epidemiological Study of the Inhabitants of a High Background-radiation Area of Yangjiang, China
Authors: Su Shibiao , Zhou Shanyu , Wen Cuiju , Zou Jianming , Zhang Danying , Geng Jiwu , Yang Min , Liu Ming , Li Lichun , Wen Wei 
Published: June 2018

Abstract
Our previous studies have shown that cancer mortality in high background-radiation areas of China was lower than that in a control area, indicating the possibility of an adaptive response in high background-radiation areas. Our aim is to determine the effect of low-dose radiation on the level of DNA oxidative damage, DNA damage repair, antioxidant capacity, and apoptosis in high background-radiation area and control area populations of Guangdong through a molecular epidemiological study in order to identify adaptive response. Blood samples were collected from male residents aged 50 to 59 y in a high background-radiation area (Yangjiang) and a control area (Enping), and activities of superoxide dismutase, glutathione, catalase, total antioxidant capacity, and expression of O6‐methylguanine-DNA methyltransferase gene (MGMT), human 8‐oxoguanine DNA N-glycosylase 1 gene (hOGG1), proapoptotic genes and antiapoptotic genes, oxidative-stress-related genes, as well as concentrations of 8‐OHdG, TrxR, HSP27, and MT-COX2 were determined. The activities of antioxidative enzymes, relative mRNA expression level of DNA repair genes, antiapoptotic genes, oxidative-stress-related genes HSPB1 and MT-COX2, and the concentration of antioxidant index TrxR in the high background-radiation area population increased significantly compared to the control population (p < 0.05). The relative mRNA expression level of proapoptotic genes and the concentration of DNA oxidative damage index 8‐OHdG were significantly lower in the high background-radiation area compared to those in the control area (p < 0.05). In conclusion, under long-term, natural, high background, ionizing radiation, DNA damage-repair capacity and antioxidant capacity of inhabitants in the high background-radiation area may be enhanced. Additionally, it could induce up regulation of cell-survival gene expression and down regulation of apoptotic gene expression. It might be speculated that enhanced antioxidant and DNA repair capacity and inhibition of apoptosis might play important roles in adaptive response of low-dose radiation in high background-radiation areas.
NEGATIVE EFFECTS OF VITAL DYES AFTER UNEVENTFUL VITREOMACULAR SURGERY
Authors: Röhrig Stephan , Farecki Marie-Louise , Boden Karl T. , Haus Arno , Gutfleisch Matthias , Jung Sascha , Lommatzsch Albrecht , Szurman Peter , Januschowski Kai 
Published: June 2018

Purpose:
Vital dyes have become a clinical standard during chromovitrectomy but toxicity remains an issue. We compared the clinical outcome of one supposedly toxic vital dye (AV 17 with 5% mannitol) with a standard vital dye (MBB Dual) and performed a power analysis for future comparative studies.

Methods:
Retrospective analysis of 270 eyes after chromovitrectomy with internal limiting membrane peeling because of macular holes. Primary endpoint was loss in BCVA >2 lines and photoreceptor atrophy as seen on optical coherence tomography examination.

Results:
In 173 eyes, staining of the epiretinal membrane and extracellular matrix was performed using MBB (Group A), and in 97 using AV 17-M (Group B). The mean BCVA was not significantly different after more than 3 months and also not in the early postoperative period after surgery between Group A and Group B. The number of patients suffering from a decline in BCVA of two lines and more was not significantly higher in patients of Group B. There was not a significantly higher percentage of patients with an inner segment/outer segment defect.

Conclusion:
Our rather homogeneous study showed no significant difference between both dyes. Thousand five hundred patients would need to be examined to find a significant difference in future studies.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY CHARACTERISTICS OF POLYPOIDAL CHOROIDAL VASCULOPATHY SECONDARY TO CHRONIC CENTRAL SEROUS CHORIORETINOPATHY
Authors: Peiretti Enrico , Iovino Claudio , Sacconi Riccardo , Caminiti Giulia , Querques Giuseppe 
Published: June 2018

Purpose:
To report diagnostic capability of optical coherence tomography angiography (OCTA) in detecting polypoidal choroidal vasculopathy and its morphologic characteristics in white patients with chronic central serous chorioretinopathy.

Methods:
Retrospective consecutive series of 20 eyes (17 consecutive patients) with a diagnosis of polypoidal choroidal vasculopathy secondary to chronic central serous chorioretinopathy based on clinical and multimodal imaging were included. All patients underwent a complete ophthalmologic examination, including best-correct visual acuity, fundus autofluorescence, fluorescein and indocyanine green angiography, spectral-domain optical coherence tomography, and OCTA.

Results:
In all eyes (100%), OCTA revealed the branching vascular network as a hyperflow lesion in both choriocapillaris and outer retina layers. Segmentation of the choriocapillaris in OCTA, in correspondence of the polypoidal dilation detected at indocyanine green angiography, showed a hyperflow round structure in 75% of cases and hypoflow round structure in 15%. Two of 20 eyes (10%) had no detectable polyps on OCTA.

Conclusion:
Optical coherence tomography angiography is a noninvasive imaging modality allowing a good visualization of both branching vascular network and polyp dilations. Our findings suggest that OCTA is a useful tool in the investigation of chronic central serous chorioretinopathy complicated by polypoidal choroidal vasculopathy.
RECONSTITUTION OF THE ELLIPSOID ZONE WITH TOCILIZUMAB IN AUTOIMMUNE RETINOPATHY
Authors: Finn Avni P. , Keenan Robert T. , Jaffe Glenn J. 
Published: June 2018

Purpose:
To demonstrate improvement and stabilization of retinal findings, including recalcitrant cystoid macular edema, in a patient with nonparaneoplastic autoimmune retinopathy after treatment with tocilizumab, a humanized monoclonal antibody against soluble and membrane-bound IL-6 receptor.

Methods:
Observational case report. A 46-year-old woman was diagnosed with nonparaneoplastic autoimmune retinopathy and followed over 4 years on various immunosuppressive medications with worsening disease and recalcitrant cystoid macular edema. This report describes the rapid improvement and stabilization of her ocular disease once tocilizumab was initiated.

Results:
Tocilizumab, a monoclonal antibody against the IL-6 receptor, was initiated at a dose of 8 mg/kg every 4 weeks. Cystoid macular edema was significantly decreased after just two infusions and nearly resolved after five infusions. Ellipsoid zone and outer retinal integrity also improved on optical coherence tomography. The patient tolerated the medication with limited side effects.

Conclusion:
Long-term immunosuppression is the cornerstone of treatment for nonparaneoplastic autoimmune retinopathy, although success is highly variable. We report a case treated with tocilizumab with dramatic improvement in refractory macular edema and reconstitution of the ellipsoid zone on optical coherence tomography in a patient with nonparaneoplastic autoimmune retinopathy. This case highlights the potential role of treatment with an IL-6 inhibitor in autoimmune retinopathy though further studies are needed.
Endothelial Cell Loss in Obstetric Forceps-Related Corneal Injury: A Longitudinal Specular Microscopic Study
Authors: El Hamouly Ali , Sheung Man Fung Simon , Sami Hamza , Jiandani Dishay , Williams Sara , Mireskandari Kamiar , Ali Asim 
Published: June 2018

Purpose:
To assess the impact of ocular trauma associated with obstetric forceps delivery on the corneal endothelium in children.

Methods:
Five patients who attended the Hospital for Sick Children, Toronto, between 2013 and 2016 with a diagnosis of unilateral obstetrical forceps-related corneal injury were included. Clinical presentation, best-corrected visual acuity, corneal endothelial cell density (ECD, cells/mm2), and measures of cellular morphology were obtained.

Results:
The mean follow-up duration was 30 ± 10 months. Mean ECD in the affected eye at initial assessment was significantly lower than that of the fellow eye (2576 ± 733 vs. 3481 ± 288 cells/mm2, P = 0.02). At final follow-up, mean ECD was 3293 ± 175 and 1907 ± 524 cells/mm2 in the normal and affected eyes, respectively (P = 0.004). The mean annual rate of the ECD decrease was higher in the affected eyes than in the normal eyes (9.1% ± 4.2% vs. 2.0% ± 2.5%), although this difference was not statistically significant (P = 0.06).

Conclusions:
In children with forceps-related corneal injury, lower ECD with a higher annual decrease can be assessed with specular microscopy for risk stratification and parental counseling purposes.
Pediatric Amazonian Toxoplasmosis Caused by Atypical Strains in French Guiana, 2002–2017
Authors: Blaizot Romain , Nabet Cécile , Blanchet Denis , Martin Elise , Mercier Aurélien , Dardé Marie-Laure , Elenga Narcisse , Demar Magalie 
Published: June 2018

Background:
Amazonian toxoplasmosis is a recently described form of Toxoplasma gondii infection, characterized by severe clinical and biological features and involvement of atypical genetic strains circulating through a forest-based cycle. Though mostly reported in French Guiana since 1998, this disease is probably under-diagnosed in other areas of South America. Few data are available on its specific features in children.

Methods:
We retrospectively included all children seen in Cayenne between 2002 and 2017, diagnosed with acute toxoplasmosis due to an atypical strain. Clinical and biological features and risk factors of Amazonian toxoplasmosis were recorded.

Results:
Eleven children met the inclusion criteria. The main clinical features were fever, lymphadenopathy, hepatomegaly and splenomegaly, as reported in adults. Less expected signs such as rhinorrhea, pharyngitis and maculopapular rash were also frequent. Cutaneous signs were associated with the involvement of a genetically atypical strain. Respiratory involvement was rare but associated with respiratory distress. Outcome was always favorable. Treatment by pyrimethamine/sulfadiazine or trimethoprim/sulfamethoxazole was always justified, efficient and well tolerated. Genetic analysis suggested the involvement of wild mammals in disease transmission, and strain-dependent virulence as one of the prognostic risk factors.

Conclusions:
As in adults, pediatric Amazonian toxoplasmosis requires a systematic treatment. Symptoms such as skin rash, rhinorrhea and pharyngitis should not be mistaken for viral infections, when associated with lymphadenopathy or fever. Pediatricians working in South America should be familiar with these clinical presentations and with the different risk factors of Amazonian toxoplasmosis.
Immunologic-based Diagnosis of Latent Tuberculosis Among Children Younger Than 5 Years of Age Exposed and Unexposed to Tuberculosis in Tanzania
Authors: Said Khadija , Hella Jerry , Ruzegea Mwajabu , Solanki Rajesh , Chiryamkubi Magreth , Mhimbira Francis , Ritz Nicole , Schindler Christian , Mandalakas Anna M. , Manji Karim , Tanner Marcel , Utzinger Jürg , Fenner Lukas 
Published: June 2018

Background:
Childhood tuberculosis (TB) is acquired after exposure to an infectious TB case, often within the household. We prospectively screened children 6–59 months of age, exposed and unexposed to an infectious TB case within the same household, for latent tuberculosis infection (LTBI), in Dar es Salaam, Tanzania.

Methods:
We collected medical data and clinical specimens (to evaluate for helminths, TB and HIV coinfections) and performed physical examinations at enrollment and at 3-month and 6-month follow-up surveys. LTBI was assessed using QuantiFERON-TB Gold (QFT) at enrollment and at 3 months.

Results:
In total, 301 children had complete data records (186 with TB exposure and 115 without known TB exposure). The median age of children was 26 months (range: 6–58); 52% were females, and 4 were HIV positive. Eight children (3%) developed TB during the 6-month follow-up. We found equal proportions of children with LTBI among those with and without exposure: 20% (38/186) versus 20% (23/115) QFT-positive, and 2% (4/186) versus 4% (5/115) indeterminate QFT. QFT conversion rate was 7% (22 children) and reversion 8% (25 children). Of the TB-exposed children, 72% initiated isoniazid preventive therapy, but 61% of parents/caregivers of children with unknown TB exposure and positive QFT refused isoniazid preventive therapy.

Conclusions:
In this high burden TB setting, TB exposure from sources other than the household was equally important as household exposure. Nearly one third of eligible children did not receive isoniazid preventive therapy. Evaluation for LTBI in children remains an important strategy for controlling TB but should not be limited to children with documented TB exposure.
Evaluation of composite responder outcomes of pain intensity and physical function in neuropathic pain clinical trials: an ACTTION individual patient data analysis
Authors: Patel Kushang V. , Allen Robert , Burke Laurie , Farrar John T. , Gewandter Jennifer S. , Gilron Ian , Katz Nathaniel P. , Markman John D. , Marshall Scott F. , Resnick Malca , Rice Andrew S.C. , Rowbotham Michael C. , Smith Shannon M. , Vanhove Geertrui F. , Wasan Ajay D. , Zhang Shuyu , Dworkin Robert H. , Turk Dennis C. 
Published: June 2018

Abstract
Integrating information on physical function and pain intensity into a composite measure may provide a useful method for assessing treatment efficacy in clinical trials of chronic pain. Accordingly, we evaluated composite outcomes in trials of duloxetine, gabapentin, and pregabalin. Data on 2287 patients in 9 trials for painful diabetic peripheral neuropathy (DPN) and 1513 patients in 6 trials for postherpetic neuralgia (PHN) were analyzed. All trials assessed pain intensity on a 0 to 10 numeric rating scale and physical function with the 10-item subscale of the Short Form-36, ranging 0 to 100 with higher scores indicating better function. Correlation between change in pain intensity from baseline to posttreatment and change in physical function was small in DPN (ρ = −0.22; P < 0.001) and nonsignificant in PHN (ρ = −0.05; P = 0.08). Assay sensitivities of 10 composite outcomes were examined in a random subsample of patients enrolled in pregabalin trials for DPN and PHN. Of these, a responder outcome of ≥50% improvement in pain intensity, or a ≥20% improvement in pain intensity and ≥30% improvement in physical function was not only significantly associated with pregabalin vs placebo in the development cohorts for both pain conditions but also in the validation cohorts. Furthermore, this composite outcome was cross-validated in trials of gabapentin for PHN and duloxetine for DPN, and had slightly lower number needed to treat than a standard responder outcome of ≥50% reduction in pain intensity. In summary, this study identified a composite outcome of pain intensity and physical function that may improve the assay sensitivity of future neuropathic pain trials.