bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Irrigation Solution Temperature on the Corneal Endothelial Functions in Posterior Vitrectomy: Room Temperature Versus Cooled
Authors: Yıldız Seda Çeri , Seyyar Sevim Ayça , Saygılı Oğuzhan , Kimyon Sabit , Mete Alper , Güngör Kıvanç 
Published: May 2023

Purpose:
To compare the effects of cooled and room temperature irrigation on the preoperative and early postoperative corneal endothelial parameter values in posterior vitrectomy.

Materials and Methods:
In this prospective, randomized, comparative study, 68 patients underwent a standard 3-port, 23-G posterior vitrectomy operation by a single surgeon. Cooled irrigation solution was applied to 36 patients during surgery (group 1), and room temperature irrigation solution was applied to 32 patients (group 2). The patients were also divided into four groups according to their history of noncomplicated cataract surgery (phakic or pseudophakic) and the types of tamponade used (silicone or gas). The central corneal thickness (CCT), endothelial cell density (ECD), mean cell area (MCA), hexagonal cell percent, and coefficient of variation of cell area (CV) parameter values of the groups at preoperative and postoperative 1 month were compared.

Results:
There were no statistically significant differences between the preoperative and postoperative corneal parameter values in groups 1 and 2 (P>0.05). However, it was remarkable that the percentage of preoperative–postoperative change in all the corneal parameter values was higher in group 2. When the results of the subgroup analyses of the patients who were pseudophakic and used gas tamponade (Group D) in group 2 were examined, it was determined that the negative effects were significantly higher in the postoperative values for the ECD, MCA, CV, and CCT parameters compared with the preoperative values (P<0.05).

Conclusion:
In patients with pseudophakia and gas tamponade, cooled irrigation was found to be more advantageous for corneal parameters.
Febrile Urinary Tract Infection in Infants Less Than 3 Months of Age
Authors: Lejarzegi Ainara , Fernandez-Uria Amaia , Gomez Borja , Velasco Roberto , Benito Javier , Mintegi Santiago 
Published: May 2023

Introduction:
Urinary tract infection (UTI) is the leading cause of bacterial infection in infants younger than 3 months of age with fever without a source.

Objective:
The objective of the study was to analyze the characteristics of emergency department presentations of febrile infants younger than 3 months of age with a UTI and identify risk factors for invasive bacterial infection (IBI) secondary to UTI.

Methods:
This was a secondary analysis of a prospective observational registry that includes infants younger than 3 months with fever without a source managed at a pediatric emergency department between 2003 and 2019.

Results:
Of the 2850 patients included, 592 (20.8%) were diagnosed with a UTI (524, 88.5%, for Escherichia coli). Infants with UTIs showed significant clinical differences when compared with those not diagnosed with a bacterial infection: patients with a UTI were more likely to have a history of renal/urological problems (8.3% vs. 3.5%), temperature ≥39ºC (38.3% vs. 29%) and poor feeding (13% vs. 8.7%). Yet, nearly half (285 of the 592, 48.1%) of the infants with febrile UTIs had none of these 3 risk factors. Thirty-six infants (6.1%) had a secondary IBI. We identified the following independent risk factors for secondary IBI: infants younger than 1 month of age, parent-reported irritability, procalcitonin >0.5 ng/mL, and C-reactive protein >60 mg/L.

Conclusions:
History and physical examination do not allow us to safely rule out a UTI among young febrile infants. Age, parent-reported irritability, and biomarkers are useful in identifying patients at increased risk of secondary IBI.
Clinical Epidemiology and Antimicrobial Resistance Patterns of Infections Due to Salmonella Species in Children, Houston, TX. 2016-2021: A Retrospective Study
Authors: Tabarani Christy , De La Hoz Alejandro , Wanger Audrey , Flores Anthony R. , Arias Cesar A. 
Published: May 2023

Background:
Salmonellosis continues to be a major public health issue and high rates of infection are reported among young children. The contemporary clinical epidemiology of pediatric Salmonella spp. infections in the US is not well characterized.

Methods:
We performed a retrospective observational study in a large hospital network in Houston, TX. We included all patients 18 years or younger identified as having a positive culture for Salmonella spp. from any body site during the years 2016–2021. The patient’s medical record was accessed and detailed demographic, clinical and microbiologic information were collected.

Results:
We identified a total of 110 pediatric patients with Salmonella spp. infections between 2016 and 2021. The highest frequency (69%) of infections was observed among children 0–5 years old. Bloody diarrhea was most frequently reported for children 0–1 years old. Although the highest number of salmonellosis was among infants smaller than 1 year, the percentage of bacteremia in this age group was the lowest (15%). Serotype Infantis was the most common (21%) and was less likely to cause Salmonella bacteremia. Among the Salmonella spp. isolates that had antimicrobial susceptibility performed 5 showed resistance to one or more antibiotics including 1 extensively drug-resistant S. ser. Typhi originating from Pakistan.

Conclusion:
Our findings suggest distinct clinical characteristics of Salmonella infections in the pediatric population. Consistent identification of isolates to the sub-species level along with serotyping seems critical to identify emerging lineages with increased virulence. Special consideration should be given to empiric treatment for patients who have recently returned from the Indian subcontinent.
Association Between Nasopharyngeal Colonization and Clinical Outcome in Children With Acute Otitis Media
Authors: Shaikh Nader , Hoberman Alejandro , Paradise Jack L. , Rockette Howard E. , Kurs-Lasky Marcia , Martin Judith M. 
Published: May 2023

Background:
Young children with acute otitis media (AOM) frequently exhibit nasopharyngeal colonization with either Streptococcus pneumoniae, Haemophilus influenzae or both pathogens. We aimed to determine if antibiotics could be spared or shortened in those without nasopharyngeal colonization with either pathogen.

Methods:
In 2 separate randomized clinical trials in children aged 6–23 months with stringently-diagnosed AOM, we performed bacterial cultures on nasopharyngeal specimens collected at the time of diagnosis. In the first trial, we compared the efficacy of amoxicillin/clavulanate (amox/clav) administered for 10 days vs. that of placebo, and in the second trial, we compared the efficacy of amox/clav administered for 10 days vs. 5 days. In each trial, we classified children as being colonized with both S. pneumoniae and H. influenzae, S. pneumoniae alone, H. influenzae alone, or neither pathogen, and as experiencing either clinical success or clinical failure at the end-of-therapy visit, based on previously reported a priori criteria.

Results:
We evaluated 796 children. Among children randomized to amox/clav, those colonized with either S. pneumoniae or H. influenzae or both were approximately twice as likely to experience clinical failure as children not colonized with either pathogen (odds ratio: 1.8; confidence intervals: 1.2–2.9). In contrast, among children randomized to placebo, clinical failure at the end-of-therapy visit was not associated with nasopharyngeal culture results at the time of diagnosis.

Conclusions:
Children colonized with either S. pneumoniae or H. influenzae or both have a greater chance of treatment failure than children colonized with neither pathogen.
Intravenous compounding robots in pharmacy intravenous admixture services: A systematic review
Authors: Yang Chunsong , Ni Xiaofeng , Zhang Lingli , Peng Lijuan 
Published: May 2023

Background:
There is a lack of best evidence of intravenous compounding robots for hospital decision-makers. This study aimed to conduct a systematic review of intravenous compounding robots.

Methods:
A comprehensive search of relevant professional health technology assessment websites and electronic databases was conducted from inception to February 3, 2022. Current studies related to intravenous compounding robots were included in this systematic review. Two reviewers independently screened the literature, extracted data, and assessed quality. The results were reported by qualitative description because of heterogeneity in the characteristics of the data in the included studies.

Results:
Thirty-three studies were included. Effectiveness: The robots improved production efficiency compared with usual/manual preparation; however, the intravenous preparation process requires further optimization. Additionally, robots reduced the incidence of medicine residues, preparation errors, and preparation failures. The solution properties of intravenous admixture medicines were satisfactory, and the robots also contributed to error recognition. Safety: The robots reduced product pollution and environmental pollution, but vigilance is still required to ensure that pollution stays low. The robots also reduced the incidence of health damage to technicians. Economy: The robots reduced material costs in these studies; however, whether they can reduce labor costs remains unclear. Social suitability: Technicians had a high degree of satisfaction with the robots, but few relevant studies focused on this aspect.

Conclusions:
Intravenous compounding robots have certain advantages in terms of effectiveness, safety, economy, and social adaptability.
Longitudinal follow-up of pediatric Graves’ disease in preschool children: Clinical characteristics and a case report
Authors: Yang Ju-Wen , Kao Ling-Yuh , Chuang Lan-Hsin , Chen Ho-Min 
Published: May 2023

Rationale:
Pediatric Graves’ disease at preschool age is a rare condition. Previous reports have indicated that adolescents with this disease are girls. Pediatric Graves’ ophthalmopathy in young children is rare, and long-term follow-up reports are lacking.

Patient concerns:
The patient had hyperthyroidism and bilateral proptosis for 2 years, but she was only 4 years old.

Diagnoses:
The blood test revealed hyperthyroidism and the ophthalmic examination revealed proptosis. The patient had Graves’ disease and Graves’ ophthalmopathy.

Interventions:
Initially, she was followed up in the pediatric department. Bilateral proptosis developed, and she was brought to the ophthalmology department for assistance. Orbital computed tomography revealed borderline enlargement of the extraocular muscles bilaterally. Other initial clinical findings included bilateral upper and lower eyelid trichiasis and mild punctate epithelial erosions of the cornea. She received conservative medical treatment in the ophthalmology department.

Outcomes:
Remission of hyperthyroidism was achieved 2 years after medical control. No elevated intraocular pressure, strabismus, or optic neuropathy developed during follow-up. Significant cosmetic improvement and gradual resolution of punctate epithelial erosions were found over 10 years. Finally, the patient had only mild bilateral lower trichiasis.

Lessons:
Longitudinal follow-up revealed that the ocular manifestations of proptosis and eyelid trichiasis may have good outcomes. Proptosis gradually improved as the patient grew up.
Latent infection after spinal cord stimulation device implantation for complex regional pain syndrome: A case report
Authors: Ki Yu Min , Park Hue Jung , Yi Seung Hyun , Sim Woo Seog , Lee Jin Young 
Published: May 2023

Rationale:
Spinal cord stimulation (SCS) is one of the invasive treatments of complex regional pain syndrome (CRPS). The positive effect has been observed for several years after implantation. However, infection is a common cause of SCS failure and device removal.

Patient concerns:
Here we describe a case of latent infection at the implantable generator pocket site 9 years after SCS implantation in a patient with CRPS.

Diagnoses:
A 52-year-old patient was diagnosed with type 1 CRPS. The right foot pain was intractable with standard treatments. SCS implantation was performed and SCS worked well without complication. Nine years later, the patient revisited due to pain, tenderness, and redness at the abdominal wall for 2 weeks. The right foot pain was maintained with NRS 4 for 8 years, and the stimulation stopped 1 year back. SCS infection was diagnosed.

Interventions:
The patient underwent SCS removal surgery.

Outcomes:
All SCS devices were removed successfully. The patient was discharged without any complications.

Conclusions:
While uncommon, infection after SCS implantation can occur even 9 years later. Immediate diagnosis, proper antibiotics, and surgical removal could be needed to prevent further spread of infection and better prognosis.
The Association of the Lactate-Albumin Ratio With Mortality and Multiple Organ Dysfunction in PICU Patients*
Authors: Ray Christopher C. , Pollack Murray M. , Gai Jiaxiang , Patel Anita K. 
Published: May 2023

OBJECTIVES:
To compare the relative associations of lactate, albumin, and the lactate-albumin ratio (LAR) measured early in disease course against mortality and prevalence of multiple organ dysfunction syndrome (MODS) in a general sample of critically ill pediatric patients.

DESIGN:
Retrospective analysis of the Health Facts (Cerner Corporation, Kansas City, MO) national database.

SETTING:
U.S. hospitals with PICUs.

PATIENTS:
Children admitted to the ICU (n = 648) from 2009 to 2018 who had lactate and albumin measured within 6 hours of admission.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
A total of 648 admissions were included, with an overall mortality rate of 10.8% (n = 70) and a MODS prevalence of 29.3% (n = 190). Compared with survivors, deaths had higher initial lactates (7.3 mmol/L [2.6–11.7 mmol/L] vs 1.9 mmol/L [1.2–3.1 mmol/L]; p < 0.01), lower initial albumins (3.3 g/dL [2.7–3.8 g/dL] vs 4.2 g/dL [3.7–4.7 g/dL]; p < 0.01), and higher LARs (2.2 [1.0–4.2] vs 0.5 [0.3–0.8]; p < 0.01), with similar trends in patients with MODS versus those without MODS. LAR demonstrated a higher odds ratio (OR) for death than initial lactate alone (2.34 [1.93–2.85] vs 1.29 [1.22–1.38]) and a higher OR for MODS than initial lactate alone (2.10 [1.73–2.56] vs 1.22 [1.16–1.29]). Area under the receiver operating characteristic (AUROC) curve of LAR for mortality was greater than initial lactate (0.86 vs 0.82; p < 0.01). The LAR AUROC for MODS was greater than the lactate AUROC (0.71 vs 0.66; p < 0.01). Trends of lactate, albumin, and LAR for mortality were consistent across several diagnostic subgroups (trauma, primary respiratory failure, toxicology), but not all.

CONCLUSIONS:
LAR measured early in the course of critical illness is significantly associated with mortality and development of MODS when compared with initial lactate or initial albumin alone in critically ill pediatric patients.
Surgical Outcomes of Autologous Breast Reconstruction in Low BMI Patients; Beyond the Gold Standard DIEP Flap
Authors: Haddock Nicholas T. , Mejia Martinez Valeria , Teotia Sumeet S. 
Published: May 2023

Background:
Autologous breast reconstruction provides higher satisfaction than implant-based reconstruction in women with low Body Mass Index (BMI). However, the gold standard of microvascular breast reconstruction, the Deep Inferior Epigastric Perforator (DIEP) flap, can be challenging to achieve due to the paucity of adnominal bulk in these patients. This study compares operative outcomes in women with BMIs less than 23.5 following reconstruction after one of three free flap methods: The DIEP flap, alternative flaps (I.e., lumbar artery perforator flap (LAP) or profounda artery perforator flap (PAP)), and stacked flaps.

Methods:
A retrospective study was conducted on thin patients (BMI < 23.5) who underwent autologous breast reconstruction between 2010 and 2021 by two senior authors (NTH, SST) at a single institution. One hundred and fifteen patients were divided into three reconstructive groups. Flap weights, complication rates, secondary revisions, and fat grafting in each group were then compared.

Results:
The success rate in all three groups was 100%, with only one partial flap loss in the stacked group. There was a significant difference in overall minor complications and donor complications between the three groups, with alternative flaps experiencing the most. All three groups had similar incidences of recipient breast complications, medical complications, need for secondary revisions, and amount of fat grafted.

Conclusions:
Autologous breast reconstruction in low BMI patients yields successful and durable results. This study shows that predictable results in the thin patient population can be obtained via alternate autologous methods beyond the gold standard DIEP flap.
Macrosomia is associated with overweight in childhood: a follow-back of a cohort established in the early years of the obesity epidemic
Authors: Adebile Temitayo , Orji Amarachukwu F. , Twum Felix , Zhang Jian 
Published: May 2023

Objective:
Interventions currently recommended to control and prevent obesity have not been successful. Recent research has shifted toward the transgenerational cycle of obesity. We assessed the association between fetal macrosomia and early childhood body weight.

Methods:
We conducted a follow-back study to link birth certificate data to the Third National Health and Nutrition Examination Survey (1988–1994) of 2621 United States-born singletons aged 2–6 years. Birth weight and gestational age data were collected from birth certificates. Fetal macrosomia was defined as ≥90th percentile of gestational age-race-sex-parity specific body weight distribution in 1989 vital statistics.

Results:
With 12.7% (standard error = 0.85%) of participants born macrosomic, the prevalence of obesity and overweight (BMI percentiles ≥85th in the CDC growth chart) among children was 17.8% (1.17%). When the body weight was measured against age-sex-specific height (BMI percentiles), macrosomia was significantly associated with overweight and obesity (odds ratio [OR] = 1.64, 95% confidence interval = 1.07–2.50) adjusted for family income, maternal age and marital status, race, maternal smoking during pregnancy, and breastfeeding. The association became insignificant after adjusting for postnatal lifestyle and parental body mass index (OR = 1.38 [0.84-2.26]]. When body weight was measured against age, children who were too heavy for their age were more likely to be born macrosomically (OR = 2.64 [1.66-4.22]) than their peers with healthy age-specific body weight.

Conclusion:
Fetal macrosomia was significantly associated with a doubled risk of heavy body weight in children aged 2–6 years.
Clinical Characteristics and Outcomes of Mexican Patients With Behçet’s Syndrome
Authors: Hinojosa-Azaola Andrea , Ramírez-Mulhern Isabela , Figueroa-Pariente Ana , Martín-Nares Eduardo 
Published: May 2023

Objective
The aim of this study was to describe the clinical characteristics and outcomes of Mexican patients with Behçet syndrome (BS) from a single center.

Methods
This medical records review study included patients with established BS diagnosis, followed up in a tertiary care center in Mexico City from 2000 to 2020. Demographics, clinical characteristics, laboratory and imaging studies, disease activity, damage, treatment, and outcomes were assessed and compared according to sex and with other international cohorts. Descriptive statistics were used, and differences between groups were evaluated using the χ
2 or Mann-Whitney U tests.

Results
Thirty-eight patients were included, 23 (60%) women and 15 (40%) men; the median age at BS diagnosis was 33 years (range, 24–39 years). The most frequent manifestations at diagnosis were recurrent oral and genital ulcers in 34 (89%) and 29 (76%), respectively, musculoskeletal in 21 (55%), and cutaneous in 15 (39%). The most frequent phenotype was the joint involvement. Treatment comprised prednisone in all, colchicine (24 [63%]), pentoxifylline (12 [32%]), and thalidomide (10 [26%]). During a median follow-up time of 12.5 years (range, 7–23 years), relapses were frequent (97%), severe infections were present in 5 patients (13%), and 2 patients (5%) died due to sepsis and pneumonia. Men showed a higher frequency of arterial hypertension (47% vs. 13%, p = 0.03) and thrombosis (20% vs. 0, p = 0.05), and a lower frequency of genital ulcers (40% vs. 78%, p = 0.03) than women.

Conclusions
This cohort of Mexican patients with BS showed a predominance of female sex, joint involvement phenotype, frequent relapses, and favorable outcomes. Differences in comorbidities and clinical manifestations were identified according to sex.
Single-Port Robotic Intersphincteric Resection for the Treatment of Rectal Cancer
Authors: Kim Hye Jin , Choi Gyu-Seog , Song Seung Ho , Park Jun Seok , Park Soo Yeun , Lee Sung Min , Na Dong Hee , Jeong Min Hye 
Published: May 2023

Background:
The da Vinci Single-port (SP) system is designed to facilitate single-incision robotic surgery in a narrow space. We developed a new procedure of intersphincteric resection (ISR) using the SP platform and evaluated the technical safety and feasibility of this procedure for the treatment of very low rectal cancer.

Materials and Methods:
Eleven rectal cancer patients who underwent SP robotic ISR between August 2020 and July 2021 were included. Patients’ clinical characteristics, operative and pathologic findings of the patients were retrospectively analyzed.

Results:
The median tumor height was 3 cm (range, 2–4 cm). A single docking was performed, and the median docking time was 3 min 10 sec (range, 2 min 50 sec–3 min 30 sec). The median total operation time was 210 min (range, 150–280 min), and the median time of pelvic dissection was 57 min (range, 45–68 min). All patients presented with negative distal resection margins [median 1 cm (range, 0.5–2.0 cm)], and only one patient had less than 1mm of circumferential resection margin (0.9 mm).

Conclusions:
Our initial experience suggests that SP robotic ISR is safe and feasible.
Halomonas dongshanensis sp. nov., isolated from the seawater of Dongshan Island
Authors: Lin Wen-zhen , Gong Lin-feng , Guo Ying , Liu Ru-zhen , Xu Wei , Guan Qi-yang , Guo Chi-ming , Lin Zhi-kai , Meng Hong-yan , Chen Xiao-yao 
Published: May 2023

A taxonomic study was carried out on strain yzlin-01T, isolated from Dongshan Island seawater. The bacterium was Gram-stain-negative, catalase-positive, oxidase-negative, rod-shaped, and motile by polar flagella. Growth was observed at temperatures of 10–40 °C, at salinities of 0.5–18 %, and at pH of 6–10. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain yzlin-01T belonged to the genus

Halomonas

, with the highest sequence similarity to

Halomonas malpeensis

YU-PRIM-29T (96.7 %), followed by

Halomonas johnsoniae

T68687T (96.4 %) and

Halomonas gomseomensis

M12T (96.4 %), and other species of the genus

Halomonas

(93.4–96.3 %). The ANI and digital DNA–DNA hybridization estimate values between strain yzlin-01T and the closest type strain

Halomonas malpeensis

YU-PRIM-29T were 77.44 and 21.6 %, respectively. The principal fatty acids were summed feature 8 (consisting of C18 : 1
ω7c and/or C18 : 1
ω6c; 55.7 %), C16 : 0 (20.6 %), C12 : 0 3-OH (6.8 %), summed feature 3 (consisting of C16 : 1
ω7c and/or C16 : 1
ω6c; 5.1 %). The G+C content of the chromosomal DNA was 60.0 mol %. The respiratory quinone was identified as Q-9 (100 %). Phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, aminophospholipid, and three unidentified phospholipids were present. Combined genotypic and phenotypic data suggest that strain yzlin-01T represents a novel species within the genus

Halomonas

, for which the name Halomonas dongshanensis sp. nov. is proposed, with the type strain yzlin-01T (=GDMCC 1.3202T=KCTC 92467T).