bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a Dynamic Balance System to Quantify Postural Steadiness and Stability of Individuals with Lower-Limb Amputation: A Pilot Study
Authors: Silver-Thorn M. Barbara , Kempfer Joel , Schnorenberg Alyssa J. , Slavens Brooke A. 
Published: October 2017

ABSTRACT

Introduction
Despite rehabilitation and gait training, the gait of individuals with lower-limb amputation is often asymmetric and falls and/or fear of falling are common. Clinical assessments of balance and stability include the Berg Balance Scale and the Dynamic Gait Index. Biomechanical assessments, conducted largely in research laboratories, are more objective, quantitative, and may provide greater resolution. These biomechanical measures include postural sway during both unilateral and bilateral standing tasks and the dynamic postural response to applied or volitional perturbations. The objective of this study was to investigate the utility of a dynamic balance system, a relatively new clinical tool incorporating dual force plates similar to that used in research laboratories, to assess the postural steadiness and stability of a small, diverse population of persons with lower-limb amputation. The specific aim was to investigate whether differences in balance of persons with amputation due to changes in prosthetic componentry were reflected in the resultant data.

Materials and Methods
Dynamic balance testing was conducted using the Bertec Balance Advantage–Dynamic CDP system on five adult subjects with varying levels of lower-limb amputation. Trials were conducted in both the subjects' current prosthesis and alternative prosthetic componentry after a 1-week acclimation period. Specific tasks included limits of stability, weight-bearing squats, and unilateral stance.

Results
Subjects had difficulty shifting their weight during the limits of stability task; both the maximum excursion and anteroposterior directional control varied with prosthetic componentry. Load sharing also varied with prosthetic componentry. Load sharing became more asymmetric as knee flexion increased during the weight-bearing bilateral squat tasks, with less weight supported on the prosthetic limb. Finally, the metrics for the unilateral stance task varied with prosthetic componentry.

Conclusions
The dynamic balance system tasks and related metrics demonstrated the potential to discern differences in balance in persons with amputation due to changes in prosthetic componentry. Further study is needed to investigate these parameters, their correlation with clinical measures of balance, and the effects of both prosthetic componentry and alignment.
The Etiological Relationship Between Migraine and Sudden Hearing Loss
Authors: Arslan Yildiz , Arslan İlker Burak , Aydin Huriye , Yağiz Özlem , Tokuçoğlu Figen , Çukurova İbrahim 
Published: October 2017

Objectives:
To investigate the relationship between sudden sensorineural hearing loss (SSNHL) and migraine, assess the prevalence of migraine in patients with idiopathic SSNHL, and determine a possible common vascular etiopathogenesis for migraine and SSNHL.

Study Design:
Prospective cohort study.

Setting:
Tertiary referral center.

Patients:
This study initially assessed 178 SSNHL cases obtained from the Head and Neck Surgery Clinic patient database at a tertiary hospital in Turkey between January 2011 and March 2016. Ultimately, a total of 61 idiopathic SSNHL patients participated in the present study.

İnterventions:
Diagnostic.

Main Outcome Measures:
Cases with inflammation in the middle or inner ear; a retro cochlear tumor; autoimmune, infectious, functional, metabolic, neoplastic, traumatic, toxic, or vascular causes; Meniere's disease; otosclerosis; multiple sclerosis; and/or cerebrovascular diseases were excluded.

Results:
Of the 61 idiopathic SSHNL patients, 34 were women (55.74%); and 24 (39.34%) had migraine, according to the criteria of the International Headache Society (IHS). The mean age of the migraine patients (Group 1) was 43.83 ± 13.16 years, and that of those without migraine (Group 2) was 51.05 ± 16.49 years. The groups did not significantly differ in terms of age, sex, or SSNHL recovery rates according to the Siegel criteria (p > 0.05). Ten of the migraine patients experienced visual aura, and the recovery rates of this group were higher. Additionally, the rate of total hearing loss was lower in Group 1 (n = 3, 12.5%) than in Group 2 (n = 10, 27%).

Conclusion:
SSNHL patients had a higher prevalence of migraine. Although those with migraine had higher recovery rates, the differences were not statistically significant.
Delayed complications from expanded endonasal surgery for intracranial tumors
Authors: Geltzeiler Mathew N. , Wang Eric W. 
Published: October 2017

Purpose of review
Delayed complications after endoscopic endonasal approaches to the skull base, defined as complications greater than 1 month postoperatively, are uncommon. These complications are divided into categories including sinonasal, neuroanatomic, endocrine and vascular. This review highlights the most up-to-date advancements and reviews the management of delayed complications for skull base patients.

Recent findings
Over the last 10 years, the field of endoscopic endonasal skull base surgery has expanded with new data highlighting the long-term patient outcomes. The majority of patients experience increased quality of life (QOL) after these interventions. However, delayed complications including alterations to sinonasal function, delayed encephaloceles from the bony skull base defect and resulting endocrinopathies can significantly impact patient's QOL. Awareness of these complications and their current management is valuable for endoscopic surgeons.

Summary
Endonasal approaches to the skull base are safe and well tolerated in properly selected patients. This article highlights the delayed complications that require recognition and management by skull base surgeons to ensure the best possible care for patients.
Wilson's Disease in Children
Authors: Socha Piotr , Janczyk Wojciech , Dhawan Anil , Baumann Ulrich , D'Antiga Lorenzo , Tanner Stuart , Iorio Raffaele , Vajro Pietro , Houwen Roderick , Fischler Björn , Dezsofi Antal , Hadzic Nedim , Hierro Loreto , Jahnel Jörg , McLin Valérie , Nobili Valerio , Smets Francoise , Verkade Henkjan J. , Debray Dominique 
Published: October 2017

ABSTRACTBackground:Clinical presentations of Wilson's disease (WD) in childhood ranges from asymptomatic liver disease to cirrhosis or acute liver failure, whereas neurological and psychiatric symptoms are rare. The basic diagnostic approach includes serum ceruloplasmin and 24‐hour urinary copper excretion. Final diagnosis of WD can be established using a diagnostic scoring system based on symptoms, biochemical tests assessing copper metabolism, and molecular analysis of mutations in the ATP7B gene. Pharmacological treatment is life‐long and aims at removal of copper excess by chelating agents as D‐penicillamine, trientine, or inhibition of intestinal copper absorption with zinc salts. Acute liver failure often requires liver transplantation. This publication aims to provide recommendations for diagnosis, treatment, and follow‐up of WD in children.Methods:Questions addressing the diagnosis, treatment, and follow‐up of WD in children were formulated by a core group of ESPGHAN members. A systematic literature search on WD using MEDLINE, EMBASE, Cochrane Database from 1990 to 2016 was performed focusing on prospective and retrospective studies in children. Quality of evidence was assessed according to the GRADE system. Expert opinion supported recommendations where the evidence was regarded as weak. The ESPGHAN core group and ESPGHAN Hepatology Committee members voted on each recommendation, using the nominal voting technique.
Splenic Rupture in Children With Portal Hypertension
Authors: Waisbourd‐Zinman Orith , Shah Amit , Lin Henry C. , Rand Elizabeth B. 
Published: October 2017

ABSTRACTIntroduction:Massive splenomegaly from portal hypertension (PHTN) in children raises the specter of splenic rupture; however, the incidence, etiology, and risk of rupture have not been studied, nor have existing practices to reduce risk. We therefore performed an international survey to describe the splenic rupture cases in PHTN and to describe the existing empirical practice among hepatologists.Methods:A questionnaire was constructed to elicit cases of splenic rupture and collect hepatologists’ common practices for prevention of splenic rupture. Pediatric hepatologists working in selected tertiary academic centers in the United States, Canada, and the United Kingdom were contacted.Results:Hepatologists from 30 of 35 centers who met the inclusion criteria replied to the survey. Thirteen cases of splenic rupture were described of which 11 resulted from trauma. In the opinion of the practitioners, high‐risk activities were football, hockey, and wrestling. Sixty‐one percent recommended total restriction from high‐risk activities. Seventy‐four percent stated that platelet count had no effect on this decision and 61% advised a spleen guard for certain activities.Conclusions:Splenic rupture in patients with PHTN and splenomegaly seems to be rare. The reported splenic rupture cases were mostly related to falling (and not to participation in sports). There was general agreement among hepatologists about restricting high impact sports. There was variation in recommendations regarding the use of a spleen guard. The authors recommend use of spleen guards in children with splenomegaly from PHTN for physical activities with risk of fall or blunt abdominal trauma.
Prospective Incidence of Paediatric Inflammatory Bowel Disease in New Zealand in 2015
Authors: Lopez Robert N. , Evans Helen M. , Appleton Laura , Bishop Jonathan , Chin Simon , Mouat Stephen , Gearry Richard B. , Day Andrew S. 
Published: October 2017

ABSTRACTBackground:The global incidence of paediatric inflammatory bowel disease (IBD) is increasing. Much of the evidence attesting to this has arisen from North America and Europe. There is a relative paucity of information on the epidemiology of paediatric IBD in the Southern Hemisphere. The present study aimed to document the prospectively collected incidence of paediatric IBD in New Zealand in 2015.Methods:All patients younger than 16 years of age and diagnosed with IBD in New Zealand between 1 January 2015 and 31 December 2015 were identified. Demographic and disease phenotypic details were collected and entered into a secure database. Age‐specific population data for New Zealand were obtained and national incidence rates for IBD and its subtypes were calculated.Results:The prospectively calculated incidence of paediatric IBD, Crohn disease, ulcerative colitis (UC), and IBD unclassified in New Zealand in 2015 were 5.2 (95% confidence interval 3.9–6.8), 3.5 (2.4–4.8), 1.0 (0.5–1.8), and 0.7 (0.3–1.4) per 100,000 children, respectively.Conclusions:Incidence rates of paediatric IBD in New Zealand are comparable to the highest rates published in the literature from Western Europe and North America. Ongoing prospective ascertainment of the incidence of paediatric IBD is required to better understand the environmental factors, which are accounting for this increase in disease burden.
Initial Pain Management in Pediatric Acute Pancreatitis
Authors: Grover Amit S. , Mitchell Paul D. , Manzi Shannon F. , Fox Victor L. 
Published: October 2017

ABSTRACTNearly all patients with acute pancreatitis (AP) experience some degree of abdominal pain that is severe enough to prompt medical evaluation and necessitate analgesia. Effective analgesia is a priority in caring for such patients. Despite its importance, strategies for pain management in AP have been poorly studied, particularly in the field of pediatrics. Presently, no published data examine the management of pain because of AP in children at the time of initial presentation. Management approaches are often extrapolated from adult practice and based on anecdotal experience in the absence of objective data. The aim of our study was to examine the initial provision of analgesia to children who presented to a pediatric emergency department with AP.
High Incidence of Proteinuria in Children With Chronic Intestinal Failure Under Long‐term Parenteral Nutrition
Authors: Billing Heiko , Traunspurger Anna , Sturm Ekkehard , Busch Andreas 
Published: October 2017

ABSTRACTLong‐term home parenteral nutrition (LTPN) in children with chronic intestinal failure (CIF) is associated with renal complications such as fluid and electrolyte imbalances, nephrocalcinosis, nephrolithiasis, and chronic kidney disease (CKD). The etiology of CIF‐associated nephropathy is multifactorial. The aim of this study was to evaluate renal involvement under LTPN. In this study, 50 patients with CIF, median age 4.2 years (1.4–9.3; 23 girls) were included. Kidney involvement was a frequent finding in this study. CKD was present in 30% of patients without correlation with LTPN duration. Glomerular proteinuria was found in the majority of patients (76%), an important long‐term risk factor for the progression of CKD. Increased urinary α‐1 microglobulin was significantly associated with duration (years) of LTPN and was increased in patients with CKD.
Pharmacokinetics of Sucralose and Acesulfame‐Potassium in Breast Milk Following Ingestion of Diet Soda
Authors: Rother Kristina I. , Sylvetsky Allison C. , Walter Peter J. , Garraffo H. Martin , Fields David A. 
Published: October 2017

ABSTRACTObjective:The aim of this study was to determine sucralose and acesulfame‐potassium (ace‐K) pharmacokinetics in breast milk following maternal ingestion of a diet soda.Methods:Thirty‐four exclusively breast‐feeding women (14 normal‐weight, 20 obese) consumed 12 ounces of Diet Rite Cola, sweetened with 68‐mg sucralose and 41‐mg ace‐K, before a standardized breakfast meal. Habitual non‐nutritional sweeteners intake was assessed via a diet questionnaire. Breast milk was collected from the same breast before beverage ingestion and hourly for 6 hours.Results:Owing to one mother having extremely high concentrations, peak sucralose and acesulfame‐potassium concentrations following ingestion of diet soda ranged from 4.0 to 7387.9 ng/mL (median peak 8.1 ng/mL) and 299.0 to 4764.2 ng/mL (median peak 945.3 ng/mL), respectively.Conclusions:Ace‐K and sucralose transfer into breast milk following ingestion of a diet soda. Future research should measure concentrations after repeated exposure and determine whether chronic ingestion of sucralose and acesulfame‐potassium via the breast milk has clinically relevant health consequences.
Exploring the Relationship Between Body Mass Index and Positive Symptom Severity in Persons at Clinical High Risk for Psychosis
Authors: Caravaggio Fernando , Brucato Gary , Kegeles Lawrence S. , Lehembre-Shiah Eugénie , Arndt Leigh Y. , Colibazzi Tiziano , Girgis Ragy 
Published: October 2017

Abstract
Metabolic health and positive symptom severity has been investigated in schizophrenia, but not in clinical high risk (CHR) patients. We hypothesized that greater body mass index (BMI) in CHR patients would be related to less positive symptoms. We examined this relationship in CHR patients being treated with 1) no psychotropic medications (n = 58), 2) an antipsychotic (n = 14), or 3) an antidepressant without an antipsychotic (n = 10). We found no relationship between BMI and positive symptoms in unmedicated CHR patients, the majority of whom had a narrow BMI range between 20 and 30. However, in the smaller sample of CHR patients taking an antidepressant or antipsychotic, BMI was negatively correlated with positive symptoms. Although potentially underpowered, these preliminary findings provide initial steps in elucidating the relationships between metabolic health, neurochemistry, and symptom severity in CHR patients.
Safety and Efficacy of Theta-Burst Stimulation in the Treatment of Psychiatric Disorders
Authors: Rachid Fady 
Published: October 2017

Abstract
Theta-burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation and is thought to induce more rapid and longer-lasting effects on synaptic plasticity than conventional repetitive transcranial magnetic stimulation protocols. TBS is being used as an investigational and more recently as a therapeutic tool. The purpose of this review is to describe and discuss the studies that have evaluated the safety and efficacy of this technique in the treatment of various psychiatric disorders such as depression, schizophrenia, obsessive-compulsive disorder, Tourette's disorder, nicotine and cocaine addiction, and pathological gambling. Studies have reported mild adverse effects but no cases of seizures or mania. Despite the fact that studies were heterogeneous in terms of design and results, some of them are promising mostly for treatment-resistant depression and auditory hallucinations. Future well-designed sham-controlled studies are needed to confirm the long-term safety and efficacy of TBS in the treatment of such conditions.
Self-Harm, Affective Traits, and Psychosocial Functioning in Adults With Depressive and Bipolar Disorders
Authors: Weintraub Marc J. , Van de Loo Margaret M. , Gitlin Michael J. , Miklowitz David J. 
Published: October 2017

Abstract
Self-harm refers to the purposeful destruction of bodily tissue without suicidal intention and for purposes that are not socially sanctioned. Little is known about the associations between a history of self-harm, mood symptoms, and functioning in adults with different types of mood disorders. Lifetime histories of self-harm, current mood symptoms, global functioning, and affective traits were collected on 142 adults with mood disorders. The prevalence of lifetime self-harm was higher in patients with bipolar disorder compared with patients with a unipolar depressive disorder. Self-harm was also more strongly linked to impulsivity in individuals with bipolar disorder compared with unipolar depressive disorder. Across both diagnoses, histories of self-harm were related to lower levels of current global functioning, more severe depressive symptoms, and high self-reported emotional dysregulation and neuroticism. Findings indicate that self-harm is a potent prognostic variable for symptoms, global functioning, and personality functioning in individuals with mood disorders.
Implementation of a 5-Minute Magnetic Resonance Imaging Screening Protocol for Prostate Cancer in Men With Elevated Prostate-Specific Antigen Before Biopsy
Authors: Weiss Jakob , Martirosian Petros , Notohamiprodjo Mike , Kaufmann Sascha , Othman Ahmed E. , Grosse Ulrich , Nikolaou Konstantin , Gatidis Sergios 
Published: October 2017

Purpose
The aims of this study were to establish a 5-minute magnetic resonance (MR) screening protocol for prostate cancer in men before biopsy and to evaluate effects on Prostate Imaging Reporting and Data System (PI-RADS) V2 scoring in comparison to a conventional, fully diagnostic multiparametric MR imaging (mpMRI) approach.

Materials and Methods
Fifty-two patients with elevated prostate-specific antigen levels and without prior biopsy were prospectively included in this institutional review board–approved study. In all patients, an mpMRI protocol according to the PI-RADS recommendations was acquired on a 3 T MRI system. In addition, an accelerated diffusion-weighted imaging sequence was acquired using simultaneous multislice technique (DW-EPISMS). Two readers independently evaluated the images for the presence/absence of prostate cancer according to the PI-RADS criteria and for additional findings. In a first reading session, only the screening protocol consisting of axial T2-weighted and DW-EPISMS images was made available. In a subsequent reading session, the mpMRI protocol was assessed blinded to the results of the first reading, serving as reference standard.

Results
Both readers successfully established a final diagnosis according to the PI-RADS criteria in the screening and mpMRI protocol. Mean lesion size was 1.2 cm in the screening and 1.4 cm in the mpMRI protocol (P = 0.4) with 35% (18/52) of PI-RADS IV/V lesions. Diagnostic performance of the screening protocol was excellent with a sensitivity and specificity of 100% for both readers with no significant differences in comparison to the mpMRI standard (P = 1.0). In 3 patients, suspicious lymph nodes were reported as additional finding, which were equally detectable in the screening and mpMRI protocol.

Conclusions
A 5-minute MR screening protocol for prostate cancer in men with elevated prostate-specific antigen levels before biopsy is applicable for clinical routine with similar diagnostic performance as the full diagnostic mpMRI approach.
Complications From Surgically Assisted Rapid Maxillary Expansion With HAAS and HYRAX Expanders
Authors: Pereira Max Domingues , Koga Alexandre Fukuzo , Prado Gabriela Pereira Ribeiro , Ferreira Lydia Masako 
Published: October 2017

Abstract
The current study aimed at comparing the number and type of undesired outcomes during and after the maxillary expansion performed with HYRAX and HAAS expanders. A total of 90 patients (41 males and 49 females, 45.6% and 54.4%, respectively) aged 18 to 59 (mean age of 26.1; standard deviation [SD] = 7.4) underwent subtotal Le Fort I osteotomy and pterygomaxillary disjunction following surgically assisted rapid maxillary expansion (SARME) carried out using HAAS (n = 29; 48.3% male and 51.7% female; mean age = 27: SD = 7.7) and HYRAX (n = 61; 44.3% male and 55.7% female; mean age = 26; SD = 7.2) expanders. Post-SARME dento-gingival, radiographic, and clinical undesired outcomes were evaluated. A total of 16 (17.8%) patients experienced at least 1 undesired outcome—7 (7.8%) and 9 (10.0%) in HAAS and HYRAX group, respectively. The most common undesired outcomes were radiographic asymmetric expansion—2 (2.2%) and 3 (3.3%) in HAAS and HYRAX group, respectively—followed by pain during out-of-clinic expansion 4 (4.4%) in HAAS group only—dental darkening 5 (5.5%) in HYRAX group, only, requiring root canal treatment, and local infection—2 (2.2%), 1 in each HAAS and HYRAX groups. Excepting for complications arising from the acrylic stop plate in HAAS expander, the number and severity of complications observed in the current study did not differ due to the use of HAAS and HYRAX appliances to perform maxillary expansion. Hygiene issues do not rule out the use of HAAS. The wider maxillary expansion performed, the more frequent are the cases of asymmetric expansion.
The Impact of Type-D Personality on Oral Health-Related Quality of Life in Cleft Lip and Palate Adolescents
Authors: Ajami Shabnam , Toraby Farzaneh , Shavakhi Mojgan , Eslami Neda 
Published: October 2017

AbstractThe purpose of this study was to investigate the oral health-related quality of life and type-D personality in cleft lip/palate (CLP) patients and the relationship between type-D personality and oral health-related quality of life (OHRQoL) in CLP patients. Fifty patients with CLP within age range from 8 to 15 years were chosen and asked to complete both Child Oral Health Impact Profile (COHI) and Type-D scale (DS14) questionnaire. Moreover, the participants of a control group matched with CLP patients were asked to complete the DS14 questionnaire. A significant difference between boys and girls on the subscale “emotional well-being” of COHIP (P= 0.001) and a positive significant correlation between “oral symptoms” and age (P= 0.029) were found among CLP patients. The prevalence of type-D personality was equal between clefts and nonclefts groups. However, there was a significant relationship between type-D personality and OHRQoL in CLP patients regarding mean scores of overall COHIP and its subscales (P< 0.05). This study has shown that the personality type remains unchanged among cleft patients and a meaningful relationship exists between type-D personality and OHRQoL.