bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing of Adjunctive Azithromycin for Unscheduled Cesarean Delivery and Postdelivery Infection
Authors: Sanusi Ayodeji , Ye Yuanfan , Boggess Kim , Saade George , Longo Sherri , Clark Erin , Esplin Sean , Cleary Kirsten , Wapner Ron , Owens Michelle , Blackwell Sean , Szychowski Jeff M. , Tita Alan T. N. , Subramaniam Akila 
Published: June 2022

OBJECTIVE:
To estimate the association between timing of administration of adjunctive azithromycin for prophylaxis at unscheduled cesarean delivery and maternal infection and neonatal morbidity.

METHODS:
We conducted a secondary analysis of a randomized trial of adjunctive azithromycin prophylaxis in patients with singleton gestations who were undergoing unscheduled cesarean delivery. The primary exposure was the timing of initiation of the study drug (after skin incision or 0–30 minutes, more than 30–60 minutes, or more than 60 minutes before skin incision). The primary outcome was a composite of endometritis, wound infection, and other maternal infections occurring up to 6 weeks after cesarean delivery. Secondary outcomes included composite neonatal morbidity, neonatal intensive care unit admission for longer than 72 hours, and neonatal sepsis. The association of azithromycin with outcomes was compared within each antibiotic timing group and presented as risk ratios (RRs) with 95% CIs. A Breslow-Day homogeneity test was applied to assess differences in association by antibiotic timing.

RESULTS:
Of 2,013 participants, antibiotics were initiated after skin incision (median 3 minutes, range 0–229 minutes) in 269 (13.4%), 0–30 minutes before skin incision in 1,378 (68.5%), more than 30–60 minutes before skin incision in 270 (13.4%), and more than 60 minutes before skin incision (median 85 minutes, range 61–218 minutes) in 96 (4.8%). The RRs (95% CIs) of the infectious composite outcome for azithromycin compared with placebo were significantly lower for groups that initiated azithromycin after skin incision or within 1 hour before skin incision (after skin incision: RR 0.31, 95% CI 0.13–0.76; 0–30 minutes before: RR 0.62, 95% CI 0.44–0.89; more than 30–60 minutes before: 0.31, 95% CI 0.13–0.66). Risks were not significantly different in patients who received azithromycin more than 60 minutes before skin incision (RR 0.59, 95% CI 0.10–3.36). Results were similar when endometritis and wound infections were analyzed separately. Neonatal outcomes were not significantly different for azithromycin compared with placebo across all timing groups.

CONCLUSION:
Adjunctive azithromycin administration up to 60 minutes before or at a median of 3 minutes after skin incision was associated with reduced risks of maternal composite postoperative infection in unscheduled cesarean deliveries.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT01235546.
Postlingually Deafened Adult Cochlear Implant Users With Prolonged Recovery From Neural Adaptation at the Level of the Auditory Nerve Tend to Have Poorer Speech Perception Performance
Authors: He Shuman , Skidmore Jeffrey , Carter Brittney L. , Lemeshow Stanley , Sun Shuai 
Published: June 2022

Objective:
This study investigated the effects of two temporal response properties of the auditory nerve (i.e., neural adaptation and recovery from neural adaptation) on speech perception performance in postlingually deafened adult cochlear implant (CI) users.

Design:
Study participants included 18 postlingually deafened adults who were Cochlear Nucleus device users with a full electrode array insertion in the test ear(s). Neural adaptation and adaptation recovery of the auditory nerve (AN) were evaluated using electrophysiological measures of the electrically evoked compound action potential (eCAP). The amount of neural adaptation was quantified by the adaptation index within three time windows: 0 to 8.89 (window 1), 44.44 to 50.00 (window 2), and 94.44 to 100.00 ms (window 3). The speed of neural adaptation was estimated using a two-parameter power law function. To evaluate adaptation recovery of the AN, eCAPs to the last pulse of the 100-ms pulse train were recorded at masker-probe-intervals ranging from 1.054 to 256 ms in logarithmic steps. The amount of adaptation recovery was quantified by the adaptation recovery ratio. The time-constant of adaptation recovery was estimated using an exponential function with up to three components. Speech perception performance was evaluated by measuring consonant-nucleus-consonant (CNC) word scores presented in quiet and in speech-shaped noise at a signal-to-noise ratio (SNR) of +10 dB. One-tailed Pearson Product Moment correlation tests were used (1) to assess the associations among parameters of neural adaptation and adaptation recovery and (2) to evaluate the strength of association between these parameters and CNC word scores measured in quiet and in noise. The contributions of different parameters quantifying neural adaptation and adaptation recovery on speech perception scores were evaluated using multivariable linear regression analyses.

Results:
The Pearson Product Moment correlation coefficient demonstrated a moderate, negative correlation between the speed of adaptation recovery and CNC word scores measured in quiet and in noise. The speed of adaptation recovery accounted for 14.1% of variability in CNC word scores measured in quiet and 16.7% of variability in CNC word scores measured in noise. The correlation strengths between CNC word scores and the adaptation index, the adaptation recovery ratio and the speed of neural adaptation ranged from negligible to weak.

Conclusions:
The speed of adaptation recovery plays a more important role than other features of neural adaptation and adaptation recovery of the AN in speech perception in postlingually deafened adult CI users. Patients with prolonged adaptation recovery tend to show poorer speech perception performance.
Primary Cutaneous Malignant Perivascular Epithelioid Cell Tumor Mimicking Undifferentiated Pleomorphic Sarcoma: A Report of a Rare Entity
Authors: Neumann Neil M. , Cornelia Ding Chien-Kuang , Borgen Amanda , Corvera Carlos U. , North Jeffrey P. , Qorbani Amir , Horvai Andrew E. 
Published: June 2022

Abstract:
Primary cutaneous malignant perivascular epithelioid cell tumor (PEComa) is a rare and potentially aggressive neoplasm. In this article, we report the case of a 34-year-old man who initially presented with a 3-cm mass involving the skin and soft tissue of the right shoulder that, over 3 months, enlarged to 12 cm. Histologic examination of the mass revealed an infiltrative neoplasm with features resembling an undifferentiated pleomorphic sarcoma, including sheets of pleomorphic cells with abundant atypical mitoses and necrosis. Immunohistochemical evaluation showed features suggestive of PEComa. Next-generation sequencing revealed pathogenic homozygous deletions of TSC2 and TP53 genes and numerous large-scale copy number changes. Taken together, the findings supported malignant PEComa. This case demonstrates only the seventh example of malignant cutaneous PEComa. Although cutaneous PEComa is chiefly a benign mesenchymal neoplasm, in rare cases, it can rapidly transform into a malignant and infiltrative sarcoma, requiring prompt surgical management.
Comparison of Outcomes from Delayed Onset Bleb-related Endophthalmitis Treated with Pars Plana Vitrectomy versus Vitreous Biopsy
Authors: Islam Yasmin Florence Khodeja , Vanner Elizabeth A. , Khurshid Syed Gibran , Flynn Harry W. , Greenfield David S. 
Published: June 2022

Précis:
Bleb-related endophthalmitis is a serious complication of glaucoma filtration surgery. The current study reports similar visual and intraocular pressure outcomes in eyes treated with pars plana vitrectomy compared to vitreous biopsy and intravitreal antibiotics.

Purpose:
To investigate the isolated organisms, visual acuity (VA) and intraocular pressure (IOP) outcomes associated with delayed-onset bleb-related endophthalmitis (BRE) in eyes treated with pars plana vitrectomy (PPV) versus vitreous biopsy and injection of intravitreal antibiotics (TI).

Methods:
A retrospective chart review was conducted at the Bascom Palmer Eye Institute (Miami, Florida) and University of Florida (Gainesville, Florida) identifying patients treated for BRE with at least one month of follow-up from the inception of an electronic health record (2011 and 2014, respectively) through 2021. All patients had undergone bleb-forming glaucoma surgery at least 1 month prior to endophthalmitis diagnosis.

Results:
Thirty-nine eyes from 39 patients (33 from Bascom Palmer, 6 from University of Florida) were included. Trabeculectomy was performed in 34 of 39 eyes (87.2%). Streptococcus species (9 eyes, 23.1%) and Staphylococcus species (8 eyes, 20.5%) were the most common isolated organisms and were similar in both treatment groups (P=0.49). Baseline VA was worse in the PPV group (logMAR 2.51 vs. 2.16, P=0.04), but VA at last follow up was similar (P=0.48) in both groups. After recovery from BRE, the average intraocular pressure in the PPV group was 15.1▒mmHg on 0.9 IOP-lowering medications compared to 12.6▒mmHg on 1.2 medications in the TI group (IOP: P=0.56; medications: P=0.80). Additional glaucoma surgery was performed in 44.4% of the PPV eyes and 16.7% of the TI eyes (P=0.09).

Conclusions:
In eyes with delayed-onset BRE, isolated organisms, visual outcomes and IOP control were similar after initial PPV compared to TI.
Long-term Outcomes of Modified 360-degree Suture Trabeculotomy for Uveitic Glaucoma Compared with Primary Open Angle Glaucoma
Authors: Kijima Riki , Shinmei Yasuhiro , Chin Shinki , Kanaya Rina , Shinkai Akihiro , Ohguchi Takeshi , Namba Kenichi , Ishida Susumu 
Published: June 2022

Précis:
A Kaplan-Meier survival curve analysis showed no significant differences in success rates between UG and POAG 120 months after modified 360-degree suture trabeculotomy, which was effective for both groups in the long term.

Purpose:
To examine the outcomes of modified 360-degree suture trabeculotomy in patients with uveitic glaucoma (UG) as compared to those with primary open angle glaucoma (POAG).

Methods:
This was a retrospective, non-randomized, and comparative case series study. Modified 360-degree trabeculotomy using a 5-0 nylon suture (S-LOT) was performed on 51 eyes of 51 patients (54.4±13.4 y) with UG between October 2005 and January 2012 at Hokkaido University Hospital. Age-matched patients with POAG who underwent S-LOT during the same period were enrolled as controls. Written informed consent was obtained from all patients enrolled in the present study. Surgical success was defined as an intraocular pressure (IOP) <18 mmHg with similar or lower doses of antiglaucoma medications. Kaplan-Meier survival curves of surgical failure were analyzed and compared between UG and POAG.

Results:
The mean follow-up periods (±SD) for UG and POAG were 104.8±44.0 and 98.1±36.3 months (P=0.23), respectively. Mean pre-operative IOP in UG and POAG were 34.9±11.0 and 25.3±9.4 mmHg (P<0.001), respectively. After surgery, mean IOP in UG and POAG decreased to 12.0±4.1 and 13.8±3.2 mmHg, respectively, at 60 months, and 12.1±5.6 and 12.4±1.8 mmHg (P=0.86), respectively, at 120 months. The Kaplan-Meier survival curve analysis showed no significant differences in success rates between UG and POAG at the end of the follow-up (Log-rank test, P=0.13). Success rates in UG and POAG were 70.0 and 62.5% at 60 months, and 67.5 and 41.2% at 120 months, respectively.

Conclusion:
These results suggest that S-LOT is effective for UG and POAG alike.
Preliminary demonstration of a novel intraocular lens power calculation: the O formula
Authors: Goto So , Maeda Naoyuki , Ohnuma Kazuhiko , Lawu Tjundewo , Kawasaki Ryo , Koh Shizuka , Nishida Kohji , Noda Toru 
Published: June 2022

Purpose:
To evaluate the performance of a new formula of intraocular lens (IOL) power calculation (the O formula) based on ray tracing without commonly used parameters, including ultrasound-compatible axial length, keratometry readings, and A-constant.

Setting:
Tokyo Medical Center, Tokyo, Japan.

Design:
Retrospective consecutive case series.

Methods:
423 eyes (423 patients) implanted with a single-piece, L-loop, acrylic IOL were enrolled. All biometric data for the O formula were obtained by anterior segment swept-source optical coherence tomography (SS-OCT) and SS-OCT–based biometer. The performance of the O formula was compared with those of the Barrett Universal II (BUII) and Kane formulas at 1 month postoperatively. Statistical analysis was applied according to a heteroscedastic test with SD of prediction errors as the main parameter for formula performance.

Results:
The SD of the O formula (0.426) was statistically significantly lower than that of the BUII formula (0.464, P = .034) but not statistically significantly different from that of the Kane formula (0.433, P = .601). The percentages of patients with refractive prediction errors within ±0.50 diopter (D) and ±1.00 D of the O, BUII, and Kane formulas were 75.4% and 98.6%, 77.1% and 97.9%, and 76.6% and 98.1%, respectively.

Conclusions:
The O formula, based on ray tracing using SS-OCT–based devices, is one of the promising approaches for IOL power calculation, although additional larger scale studies are needed. It may be used as an alternative in IOL power calculation because of its independence from commonly used parameters.
Development of an Interprofessional Handoff Assessment for Doctor of Physical Therapy Students
Authors: Ronnebaum Julie , Jie Chunfa , Salazar Kristina 
Published: June 2022

Background and Purpose:
Handoff communication, especially interprofessional (IPE) handoff communication, has been shown to make up a large portion of communication errors in health care. There is variability in the way professionals are trained and deliver the pertinent patient information in handoffs, which, causes confusion, makes recall difficult, and increases the incidence of medical errors. Thus, this study aimed at assessing IPE handoffs for individuals who are trained in SBAR (Situation, Background, Assessment, and Recommendation) method of IPE communication developed by TEAM STEPPS®.

Method:
To assess IPE handoffs for those who are trained with the SBAR method, an existing tool was modified to make it more explicit to IPE handoff communication using descriptors from SBAR. Reliability and internal consistency were evaluated using videos of IPE handoffs of doctor of physical therapy (DPT) students.

Results:
Spearman rank coefficients for the revised assessment domains ranged from 0.56 to 0.86, indicating a strong correlation. The communication and content domains had the highest level of correlation. The interrater reliability of the 5 raters was 0.85, indicating high reliability.

Discussion and Conclusion:
This assessment proved to be simple and reliable to measure IPE handoff communication skills during emergent situations between DPT students and standardized nurses. Thus, this assessment can be used to assess interprofessional handoffs, develop competencies improved teamwork, and reduce medical errors.
Concurrent Validity Between the AM-PAC “6-Clicks” Basic Mobility Short Form and the WeeFIM in the Pediatric Acute Care Population
Authors: Gates Erin , Eilerman Sarah , Bican Rachel 
Published: June 2022

Purpose:
To evaluate concurrent validity between the Activity Measure for Post-Acute Care (AM-PAC) “6-clicks” basic mobility short form (BMSF) and the Functional Independence Measure for Children (WeeFIM) and the interrater reliability for the AM-PAC BMSF for pediatric patients in the acute care setting.

Methods:
In this prospective, cross-sectional study, study participants completed the AM-PAC BMSF and the mobility domains of the WeeFIM. One therapist recorded scores for each of the outcome measures, while a second blinded therapist recorded scores for the AM-PAC BMSF. Spearman correlation coefficients (r
s) were used to describe the relationships between measures, and the intraclass correlation coefficient (ICC) was used to assess interrater reliability.

Results:
n = 30 children (4-17 years of age) participated in this study. A significant, strong, and positive correlation was found between the AM-PAC BMSF and WeeFIM total scores (r
s = 0.95, P < .001) as well as between the transfer scores (r
s = 0.93, P < .001). Excellent agreement was found between raters for the AM-PAC BMSF (ICC = 0.97).

Conclusions:
The AM-PAC BMSF demonstrates strong concurrent validity compared with the WeeFIM and has an excellent interrater agreement, suggesting that it may be a valid and reliable measure to objectively quantify functional mobility for pediatric patients in the acute care setting.
Epidemiology and Natural History of Childhood-Acquired Chronic Hepatitis C: A Single-Center Long-Term Prospective Study
Authors: Stinco Mariangela , Bartolini Elisa , Veronese Piero , Rubino Chiara , Moriondo Maria , Ricci Silvia , Trapani Sandra , Azzari Chiara , Resti Massimo , Indolfi Giuseppe 
Published: June 2022

Objectives:To prospectively describe the epidemiology and long-term outcome of childhood-acquired hepatitis C virus (HCV) infection in a large cohort of children followed at a single center.Methods:All children with chronic HCV infection followed at the Liver Unit of our tertiary Hospital in Florence (Italy) from January 1, 1988, to September 30, 2021, were included in the analysis.Results:The final sample consisted of 163 children (median age at enrollment 4 years, interquartile range (IQR): 10; median age at last follow-up 14 years, IQR: 7). The median duration of follow-up was 86 months (IQR: 112). One hundred twenty-five children were vertically infected and 26 acquired the infection horizontally. Twenty-six of the 125 children who were vertically infected (20.8%) underwent spontaneous clearance of HCV RNA at a median age of 4 years (IQR: 2), whereas all the others remained persistently viremic. One patient was diagnosed with cirrhosis; 2 presented clinically detectable extrahepatic manifestations (chronic urticaria). Thirty-two children (19.6%) received antiviral therapy: 8 out of 32 (25%) were treated with pegylated-interferon alfa-2b [sustained virological response (SVR) 24 weeks after the end of treatment in 7/8]; 24 out of 32 (75%) were treated with direct-acting antivirals (SVR 12 weeks after the end of treatment in 23/24).Conclusions:The present study describes the largest cohort of children with chronic HCV infection prospectively evaluated with a long follow-up at a single center. HCV infection in children is often a chronic infection that can be cured with modern antiviral therapy. Early treatment could prevent the development of advanced liver disease.
Evaluating the Dietary Intake of Children With Esophageal Atresia: A Prospective, Controlled, Observational Study
Authors: Traini Isabelle , Chan Sin Yee , Menzies Jessica , Hughes Jennifer , Coffey Michael J. , Katz Tamarah , McKay Isabelle R. , Ooi Chee Y. , Leach Steven T. , Krishnan Usha 
Published: June 2022

Objectives:Children with esophageal atresia (EA) often have feeding difficulties and dysphagia, which may compromise their nutritional status. This study aimed to compare dietary intake between children with EA and matched healthy controls (HC) and to investigate the relationship between dietary factors, growth, dysphagia, and feeding difficulties in the EA cohort.Methods:This cross-sectional cohort study recruited children with EA and HC aged 2–17 years from a tertiary pediatric hospital in Australia. Growth parameters were measured. Dietary intake was assessed using the validated Australian Child and Adolescent Eating Survey. Dysphagia and feeding difficulties were assessed using objective questionnaires.Results:Twenty-one children with EA were matched for age and sex with 21 HC. Compared to HC, children with EA had lower meanzscores for height-for-age, but mean weight-for-age and body mass index-for-age z scores were similar. Energy intake was similar between the groups. The diet of children with EA consisted of a higher proportion of fats and lower proportion of carbohydrates compared to matched HC. Dysphagia severity in children with EA positively correlated with proportion of energy from fats and saturated fats.Conclusions:Children with EA have similar energy intake and growth parameters to HC, but their diet consists of a higher proportion of fats and lower proportion of carbohydrates compared to HC. Targeted dietary interventions and parental education are necessary.
Antibiotic Therapy for Culture-Proven Bacterial Overgrowth in Children With Intestinal Failure Results in Improved Symptoms and Growth
Authors: Culbreath Katherine , Knell Jamie , Keefe Gregory , Han Sam M. , Hong Charles R. , Riley Heather B. , Liu Enju , McAdam Alexander J. , Modi Biren P. , Jaksic Tom , Duggan Christopher P. , Carey Alexandra N. 
Published: June 2022

Objectives:
To evaluate symptoms, enteral tolerance, growth, and antibiotic regimens in pediatric intestinal failure (IF) patients after treated with antibiotic therapy for small bowel bacterial overgrowth (SBBO).

Methods:
Single-center retrospective review of children 0–18 years with IF with endoscopic cultures demonstrating >105 CFU/mL from 2010 to 2017. Symptoms, enteral tolerance, growth, and antibiotic regimens were evaluated at the time of endoscopy and 6 months later.

Results:
Of 505 patients followed in our intestinal rehabilitation program, 104 underwent upper gastrointestinal endoscopy and 78 had positive duodenal cultures. Clinical data pre- and post-endoscopy were available for 56 patients. Compared to baseline, in the 6 months following targeted antibiotic treatment, children showed significant improvement in emesis or feeding intolerance (58.9% vs 23.2%, P < 0.001), abdominal pain (16.1% vs 7.1%, P = 0.02), high stool output (42.9% vs 19.6%, P = 0.002), and gross GI bleeding (19.6% vs 3.6%, P = 0.003). Mean BMI-for-age z scores increased significantly (−0.03 ± 0.94 vs 0.27 ± 0.82, P = 0.03); however, height-for-age z scores, weight-for-age z scores, and percent of calories from enteral intake were not significantly different after therapy. Antibiotic regimens remained highly variable.

Conclusions:
Children with IF and culture-positive SBBO showed significant improvement in symptoms and BMI-for-age z scores after duodenal culture with subsequent targeted antibiotic therapy. Longer follow-up may be needed to detect improvements in linear growth and percent of calories from enteral feeds. Antibiotic regimens remain highly variable. Long-term consequences of chronic antimicrobial therapy, including antimicrobial resistance, remain unknown. Prospective studies focused on standardizing duodenal sampling technique, correlating culture and pathology data, and evaluating antibiotic resistance patterns are needed.