bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolonged Breastfeeding and the Risk of Plasmodium vivax Infection and Clinical Malaria in Early Childhood: A Birth Cohort Study
Authors: Pincelli Anaclara , Cardoso Marly A. , Malta Maíra B. , Nicolete Vanessa C. , Soares Irene S. , Castro Marcia C. , Ferreira Marcelo U. ,   on behalf of the MINA-Brazil Study Working Group
Published: June 2022

Background:
Relatively few Amazonian infants have clinical malaria diagnosed, treated and notified before their first birthday, either because they are little exposed to an infection or remain asymptomatic once infected. Here we measure the proportion of children who have experienced Plasmodium vivax infection and malaria by 2 years of age in the main transmission hotspot of Amazonian Brazil.

Methods:
We measured IgG antibodies to 3 blood-stage P. vivax antigens at the 1- and 2-year follow-up assessment of 435 participants in a population-based birth cohort. Children’s malaria case notifications were retrieved from the electronic database of the Ministry of Health. We used multiple Poisson regression models to identify predictors of serologically proven P. vivax infection and clinical vivax malaria during the first 2 years of life.

Results:
Overall, 23 [5.3%; 95% confidence interval (CI): 3.5–7.8%) children had antibodies to ≥2 antigens detected during at least one follow-up assessment, consistent with past P. vivax infection(s). Fifteen (3.4%; 95% CI: 2.1–5.6%) children had clinical vivax episodes notified during the first 2 years of life; 7 of them were seronegative. We estimate that half of the infections remained unnotified. Children born to women who experienced P. vivax infection during pregnancy were more likely to be infected and develop clinical vivax malaria, while those breast-fed for ≥12 months had their risk of being P. vivax-seropositive (which we take as evidence of blood-stage P. vivax infection during the first 2 years of life) decreased by 79.8% (95% CI: 69.3–86.7%).

Conclusion:

P. vivax infections in early childhood are underreported in the Amazon, are associated with anemia at 2 years of age, and appear to be partially prevented by prolonged breastfeeding.
Early Mobilization for a Patient With a Right Ventricular Assist Device With an Oxygenator
Authors: MacFarlane Sheena , Lee Vanessa , Simonds Adrienne H. , Alvarez Samantha , Carty Samantha , Ewers Kevin H. , Kelly Victoria R. , Linden Parker , Moskal Amanda L. 
Published: June 2022

Background:
Physical therapists and occupational therapists safely provide early mobilization (EM) to patients requiring mechanical circulatory support (MCS). Limited EM studies are available on patients with a right ventricular assist device with an oxygenator (Oxy-RVAD).

Purpose:
The case report describes the EM course and functional outcomes of EM for a patient with Oxy-RVAD with central cannulation in the intensive care unit (ICU).

Case Description:
A 40-year-old man was admitted for a spontaneous pneumothorax. His hospital course included acute deep vein thrombosis and pulmonary embolism with worsening of interstitial lung disease and cardiomyopathy, requiring emergent pulmonary thromboendarterectomy and subsequent Oxy-RVAD. A multidisciplinary team initiated EM 3 days after cannulation.

Outcomes:
The patient safely participated in 6 EM sessions, which included both physical therapy and occupational therapy, over 10 days on MCS with no major adverse events. Clinically meaningful improvements were noted on the ICU Mobility Scale score (3 points) and the John Hopkins Highest Level of Mobility (1 point). The patient received a heart-lung transplant on the 11th day of Oxy-RVAD support.

Discussion:
EM for patients on MCS with central cannulation, including those on Oxy-RVAD, is safe and feasible and can result in clinically significant functional gains. A framework for clinical decision-making regarding EM eligibility is presented.
Effects of Occupational Stress and Health Behaviors on Heart Rate Variability in Live-Fire Instructors
Authors: Shin Inchan , Kong So Yeon , Park Gwan-Jin , Shin Dong-Min , Chai Hyun-Seok , Kim Young min , Lee Ji-Han , Kim Sang-Chul 
Published: June 2022

Objectives
This study aimed to identify the association between the healthrelated characteristics and the subscales of occupational stress of live fire instructors and heart rate variability (HRV).

Methods
We conducted questionnaire survey on a general health checkup for 15 live fire instructors. Occupational stress and HRV parameters were measured to determine the association between health behavior, including smoking, drinking, exercise, and sleep-related disorders, and occupational stress of live fire instructors and HRV parameters using Spearman’s rank correlation coefficient.

Results
Smoking, insomnia, and job insecurity, a subscale of occupational stress measurement, showed negative Spearman rank correlations with HRV.

Conclusions
Insomnia, smoking, and job insecurity (due to occupational stress) among live fire instructors were associated with decreased HRV.
Video Learning of Surgical Procedures: A Randomized Comparison of Microscopic, 2- and 3-Dimensional Endoscopic Ear Surgery Techniques
Authors: Niederhauser Laura , Fink Raffael D. , Mast Fred W. , Caversaccio Marco , Anschuetz Lukas 
Published: June 2022

Background
Video learning of surgical procedures helps trainees gain an initial understanding of the complex anatomy and the surgical procedure. Because no comparative studies have yet examined which microsurgical approach to the middle ear is most suitable for video learning, the authors investigated objective and subjective outcomes for medical trainees observing microscopic, 2-dimensional (2D) endoscopic, and 3- dimensional (3D) endoscopic ear surgeries.

Methods
Sixty-two medical students (min. 3rd year) from the University Hospital of Bern watched three standardized videos of a type I tympanoplasty surgery recording, conducted with a microscope, a 2D endoscope, and a 3D endoscope, respectively. The authors measured participants’ learning outcome, eye movements, cognitive load, and subjective preferences.

Results
Of the 62 participants included in the study, 14 were male (22.58%), and mean age was 24.44 years (range: 21–29). Learning outcome was highest after watching the 3D endoscopic video (mean [SD], 59.48% [20.57%]). Differences in score were statistically significant: 2D endoscopic video (mean difference: –6.56%, 95% CI: –13.02 to –0.10%), microscopic video (mean difference: –13.82%, 95% CI: –20.27 to –7.36%). Participants showed lowest average eye fixation duration when watching the 3D endoscopic video (mean [SD], 307 ms [109 ms]), with statistically significant differences to the 2D endoscopic video (mean difference: –139 ms, 95% CI: –185 to –93 ms), and the microscopic video (mean difference: –264 ms, 95% CI: –310 to –218 ms). Participants reported lowest cognitive load for the 2D and 3D endoscopic videos. Ratings on discomfort, usability, naturalness, depth perception, and image quality were in favor of the 3D endoscopic video.

Conclusion
The 3D endoscopic technique offers many advantages for video learning in terms of knowledge gain, visual field exploration, and subjective evaluation. To optimize learning effects in trainees, the authors recommend the use of endoscopes in middle ear surgery and, if available, using 3D technology.
Wait and Scan Management of Intra-canalicular Vestibular Schwannomas: Analysis of Growth and Hearing Outcome
Authors: Saleh Essam , Piccirillo Enrico , Migliorelli Andrea , Piroli Piera , Kihlgren Caterina , Sanna Mario 
Published: June 2022

Objective
To report on the results of intracanalicular vestibular schwannomas (ICVS) that were managed by wait and scan and to analyze the possible predictors of tumor growth and hearing deterioration throughout the observation period.

Study Design
A retrospective case series.

Setting
Quaternary referral center for skull base pathologies.

Patients
Patients with sporadic ICVS managed by wait and scan.

Intervention
Serial resonance imaging (MRI) with size measurement and serial audiological evaluation.

Main Outcome Measure
Tumor growth defined as 2 mm increase of maximal tumor diameter, further treatment, and hearing preservation either maintain initial modified Sanna hearing class, or maintain initial serviceable hearing (class A/B).

Results
339 patients were enrolled. The mean follow-up was 36.5±31.7 months with a median of 24 months. Tumor growth occurred in 141 patients (40.6%) either as slow growth (SG) in 26.3% of cases or fast growth (FG) in 15.3% of cases. Intervention was performed in only 64 cases (18.8%). Out of 271 patients who underwent hearing analysis, 86 patients (33.5%) showed hearing deterioration to a lower hearing class of the modified Sanna classification. Tumor growth and older age were predictors of hearing deterioration. Of the 125 cases with initial serviceable hearing (Class A/B), 91 cases (72.8%) maintained serviceable hearing at last follow-up. Tumor growth and a worse initial pure tone average (PTA) were predictors of hearing deterioration.

Conclusions
Wait and scan management of ICVS is a viable option and only 18.8% of patients needed further treatment. Hearing tends to deteriorate over time.
Impact of Sclerotic Lesions on the Surgical Outcome of Cholesteatoma
Authors: Motegi Masaomi , Yamamoto Yutaka , Akutsu Taisuke , Kurihara Sho , Takahashi Masahiro , Sampei Sayaka , Sano Hiromi , Yamamoto Kazuhisa , Sakurai Yuika , Kojima Hiromi 
Published: June 2022

Objective
Cholesteatoma is occasionally accompanied by excessive calcification and presumably has different osteogenic dynamics compared to noncholesteatomous chronic otitis media. Cholesteatoma-related sclerotic lesions through the temporal bone can pose manipulatory difficulties, possibly leading to worse surgical outcomes or complications. Therefore, we compared surgical outcomes of cholesteatomas with and without sclerotic lesions.

Study design
Retrospective cohort study.

Setting
Tertiary academic medical center.

Patients
Consecutive ears with acquired cholesteatomas requiring primary resection between January 2009 and December 2019. The ears followed up for <1 year were excluded.

Interventions
Tympanoplasty with/without mastoidectomy.

Main Outcome Measures
Prevalence and location of sclerotic lesion, comorbid fistulae, postoperative air-bone gap, recidivism, and complications.

Results
Overall, 19 (6.4%) of 299 ears had sclerotic lesions. More than two-thirds (68.4%) of sclerotic lesions were located adjacent to the lateral semicircular canal (LSC). Among ears with sclerotic lesions adjacent to the LSC, 46.2% had a comorbid fistula in the LSC. The prevalence of labyrinth fistula was significantly greater in ears with sclerotic lesions (42.1%) than in ears without sclerotic lesions (5.0%) (p < 0.0001, Fisher’s exact test). Sensorineural hearing deterioration was significantly higher in ears with sclerotic lesions than in ears without (p = 0.0004, Fisher’s exact test). Multivariate logistic regression analysis demonstrated that the presence of sclerotic lesions was a significant prognostic factor for residual disease (odds ratio [95% confidence interval]: 6.820 [2.055–22.633], p = 0.0017).

Conclusions
Surgeons should be conscious of preoperative identification of sclerotic lesions adjacent to one of the semicircular canals, possibly leading to postoperative sensorineural hearing deterioration or residual cholesteatoma.
Round Window Electrocochleography to Low Frequency Tones in Pediatric Cochlear Implant Recipients with and Without Auditory Neuropathy Spectrum Disorder: Separating Hair Cell and Neural Contributions Using a Computational Model
Authors: Fontenot Tatyana E. , Giardina Christopher K. , Brown Kevin D. , Fitzpatrick Douglas C. 
Published: June 2022

Hypothesis
Characterize the contribution of the auditory nerve neurophonic (ANN) to electrocochleography (ECochG) of pediatric cochlear implant (CI) recipients with and without auditory nerve spectrum disorder (ANSD).

Background
ECochG is an emerging technique for predicting outcomes in CI recipients. Its utility may be increased by separating the cochlear microphonic (CM), produced by hair cells, from the ANN, the evoked potential correlate of neural phase-locking, which are mixed in the ongoing portion of the response to low frequency tone bursts.

Methods
Responses to tone bursts of different frequency and intensities were recorded from the round window of pediatric CI recipients. Separation of the CM and ANN was performed using a model of the underlying processes that lead to the shapes of the observed waveforms.

Results
Preoperative mean pure tone amplitudes of the included ANSD (n = 36) and non-ANSD subjects (n = 123), were similar (89.5 and 93.5, p = 0.1). Total of 1,024 ECochG responses to frequency and intensity series were recorded. The mean correlation (r) between the input and the modeled signals was 0.973 ± 0.056 (standard deviation). The ANN magnitudes were higher in the ANSD group (ANOVAs, F = 26.5 for frequency and 21.9 for intensity, df’s = 1, p’s < 0.001). However, its relative contribution to the overall signal was lower (ANOVAs, F = 25.8 and 12.1, df = 1, p’s < 0.001).

Conclusions
ANN was detected in low frequency ECochG responses but not high frequency responses in both ANSD and non-ANSD subjects. ANSD subjects, evidence of neural contribution in responses to low frequency stimuli was highly variable and often comparable to signals recorded in non-ANSD subjects. The computational model revealed that on average the ANN comprised a lower proportion of the overall signal than in non-ANSD subjects.
Intrahepatic triglyceride content: influence of metabolic and genetics drivers
Authors: Dearlove David J. , Hodson Leanne 
Published: June 2022

Purpose of review
Intrahepatic triglyceride (IHTG) content is determined by substrate flux to, fatty acid synthesis and partitioning within, and triglyceride disposal from the liver. Dysregulation of these processes may cause IHTG accumulation, potentially leading to nonalcoholic fatty liver disease. The aetiology of IHTG accumulation has not been fully elucidated; however, environmental factors and heritability are important. Here, we review recent evidence regarding the contribution of metabolic and genetic components of IHTG accumulation.

Recent findings
Obesity and insulin resistance are the primary metabolic drivers for IHTG accumulation. These risk factors have pronounced and seemingly overlapping effects on all processes involved in determining IHTG content. The strong and interchangeable associations between obesity, insulin resistance and IHTG make it challenging to determine their relative contributions. Genome-wide association studies have identified a growing list of single nucleotide polymorphisms associated with IHTG content and recent work has begun to elucidate their mechanistic effects. The mechanisms underlying metabolic and genetic drivers of IHTG appear to be distinct.

Summary
Both metabolic and genetic factors influence IHTG content by apparently distinct mechanisms. Further work is needed to determine metabolic and genetic interaction effects, which may lead to more personalized and potentially efficacious therapeutic interventions. The development of a comprehensive polygenic risk score for IHTG content may help facilitate this.
The effectiveness of the Congo red dot paper test in hypertensive disorders of pregnancy in women of African ancestry
Authors: Khaliq Olive P. , Phoswa Wendy N. , Moodley Jagidesa 
Published: June 2022

Introduction:
Hypertensive disorders of pregnancy such as preeclampsia is a global maternal and fetal health burden which has led to increased morbidity and mortality rates. Currently, the common diagnostic test that is used worldwide include blood pressure measurement and urine dip stick test. Another diagnostic test that is not commonly used is Congo Red Dot paper test is. Therefore, the main objective of this systematic review is to evaluate the effectiveness of the Congo Red Dot paper test in the diagnosis of pre-eclampsia.

Methods:
Article searching published from 2014 to 2021 will be done on PubMed, EMBASE, MEDLINE, Cochrane Library, Google scholar and Science direct. The eligibility of the studies will be screened in accordance to the selection criteria by 2 independent reviewers. The quality and risk of bias of eligible studies will be performed by both reviewers using the Hoy tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool in accordance to the measured outcomes. A data charting table will be used to extract background information and process the data items from each eligible study. The data will be analyzed using Review Manager 5.3 (RevMan 5.3) software.

Ethics and dissemination:
We anticipate finding a large number of studies reporting on the effectiveness of the Congo Red Dot paper test in the diagnosis pre-eclampsia. The study will be disseminated electronically and in print. It will also be presented to conferences related to hypertensive disorders of pregnancy.

Systematic review registration:
International prospective Register of Systematic Reviews (PROSERO) number: CRD42021283679.
Esophageal adenocarcinoma phenotypes and risk factors
Authors: Sawas Tarek , Katzka David A. 
Published: June 2022

Purpose of review
The incidence of esophageal adenocarcinoma (EAC) has increased significantly over the last several decades. The majority of EAC patients present without a prior history of Barrett's esophagus (BE). As a result, endoscopic surveillance has made a suboptimal impact on EAC survival. These concerns raise serious question whether the time has come to take a different direction. The aim of this article is to review evolving evidence of EAC phenotypes and risk factors.

Recent findings
A recent study has identified two phenotypes of EAC based on the presence or absence of intestinal metaplasia (IM) in the background of the tumor (BE/IM and non-BE/IM). The study found that one-half of patients with EAC have the non-BE/IM phenotype, which is associated with more aggressive behavior and worse survival. A retrospective review demonstrates that the proportion of the two phenotypes has been stable over the last decades. Similarly, the increasing incidence of EAC cannot be explained by an increased frequency of new, unique risk factors but rather by a higher prevalence of already known risk factors. Emerging data also demonstrates that, whereas reflux symptoms are an unreliable feature for screening regardless of phenotype, the absence of reflux symptoms is more common for the non-BE/IM. Differences in the degree of genomic methylation and immune response might explain the two phenotypes at a genomic level.

Summary
EAC phenotypes have implications for tumor behavior and phenotypic differences might underlie our suboptimal screening efforts. Future screening efforts should not uniformly rely on reflux symptoms as a prerequisite for screening and should consider alternatives to the current screening strategy.
Recent insights on functional heartburn and reflux hypersensitivity
Authors: Savarino Edoardo , Marabotto Elisa , Savarino Vincenzo 
Published: June 2022

Purpose of review
Rome IV experts have proposed that gastroesophageal reflux disease (GERD) should be diagnosed only in patients with abnormal esophageal acid exposure, and that reflux hypersensitivity (RH) and functional heartburn (FH) both should be considered functional conditions separate from GERD. Although past and recent evidence support that FH can be completely distinguished from GERD, the concept that RH is not GERD is highly questionable. This review attempts to provide current data on these issues.

Recent findings
Many recent investigations have provided new data on the different pathophysiological features characterizing RH and FH. Major differences have emerged from analyses of impedance-pH monitoring studies using the novel impedance metrics of baseline impedance (an index of mucosal integrity) and the rate of postreflux swallow-induced peristaltic waves (a reflection of the integrity of esophageal chemical clearance).

Summary
The better ability to interpret impedance-pH tracings together with earlier data on the different prevalence of microscopic esophagitis in RH and FH patients, and recent studies documenting poor therapeutic efficacy of pain modulators and good results of antireflux surgery for RH support recategorization of RH within the GERD world. Further research is needed to correctly phenotype patients who have heartburn without mucosal breaks, and to guide their effective management.
Racial and ethnic disparities in coronavirus disease 2019 disease incidence independent of comorbidities, among people with HIV in the United States
Authors: Bender Ignacio Rachel A. , Shapiro Adrienne E. , Nance Robin M. , Whitney Bridget M. , Delaney Joseph A.C. , Bamford Laura , Wooten Darcy , Karris Maile Y. , Mathews William C. , Kim Hyang Nina , Keruly Jeanne , Burkholder Greer , Napravnik Sonia , Mayer Kenneth H. , Jacobson Jeffrey , Saag Michael , Moore Richard D. , Eron Joseph J. , Willig Amanda L. , Christopoulos Katerina A. , Martin Jeffrey , Hunt Peter W. , Crane Heidi M. , Kitahata Mari M. , Cachay Edward R. ,   for the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS)†
Published: June 2022

Objectives:
To define the incidence of clinically detected coronavirus disease 2019 (COVID-19) in people with HIV (PWH) in the United States and evaluate how racial and ethnic disparities, comorbidities, and HIV-related factors contribute to risk of COVID-19.

Design:
Observational study within the CFAR Network of Integrated Clinical Systems cohort in seven cities during 2020.

Methods:
We calculated cumulative incidence rates of COVID-19 diagnosis among PWH in routine care by key characteristics including race/ethnicity, current and lowest CD4+ cell count, and geographic area. We evaluated risk factors for COVID-19 among PWH using relative risk regression models adjusted with disease risk scores.

Results:
Among 16 056 PWH in care, of whom 44.5% were black, 12.5% were Hispanic, with a median age of 52 years (IQR 40–59), 18% had a current CD4+ cell count less than 350 cells/μl, including 7% less than 200; 95.5% were on antiretroviral therapy (ART), and 85.6% were virologically suppressed. Overall in 2020, 649 PWH were diagnosed with COVID-19 for a rate of 4.94 cases per 100 person-years. The cumulative incidence of COVID-19 was 2.4-fold and 1.7-fold higher in Hispanic and black PWH respectively, than non-Hispanic white PWH. In adjusted analyses, factors associated with COVID-19 included female sex, Hispanic or black identity, lowest historical CD4+ cell count less than 350 cells/μl (proxy for CD4+ nadir), current low CD4+ : CD8+ ratio, diabetes, and obesity.

Conclusion:
Our results suggest that the presence of structural racial inequities above and beyond medical comorbidities increased the risk of COVID-19 among PWH. PWH with immune exhaustion as evidenced by lowest historical CD4+ cell count or current low CD4+ : CD8+ ratio had greater risk of COVID-19.