bluuebunny/crossref_metadata_2025 huggingface dataset:
Pilot Trial of Adoptive Transfer of Chimeric Antigen Receptor–transduced T Cells Targeting EGFRvIII in Patients With Glioblastoma
Authors: Goff Stephanie L. , Morgan Richard A. , Yang James C. , Sherry Richard M. , Robbins Paul F. , Restifo Nicholas P. , Feldman Steven A. , Lu Yong-Chen , Lu Lily , Zheng Zhili , Xi Liqiang , Epstein Monica , McIntyre Lori S. , Malekzadeh Parisa , Raffeld Mark , Fine Howard A. , Rosenberg Steven A.
Published: March 2019

A deletion variant of epidermal growth factor receptor (EGFRvIII) is a known driver mutation in a subset of primary and secondary glioblastoma multiforme. Adoptive transfer of genetically modified chimeric antigen receptor (CAR) lymphocytes has demonstrated efficacy in hematologic malignancies but is still early in development for solid cancers. The surface expression of the truncated extracellular ligand domain created by EGFRvIII makes it an attractive target for a CAR-based cancer treatment. Patients with recurrent glioblastoma expressing EGFRvIII were enrolled in a dose escalation phase I trial, using a third-generation CAR construct derived from a human antibody. Transduced cells were administered after lymphodepleting chemotherapy and supported posttransfer with intravenous interleukin-2. The dose escalation proceeded at half-log increments from 107 to >1010 cells. Primary endpoints were safety and progression-free survival. Eighteen patients were treated with final infusion products ranging from 6.3×106 to 2.6×1010 anti-EGFRvIII CAR+ T cells. Median progression-free survival was 1.3 months (interquartile range: 1.1–1.9), with a single outlier of 12.5 months. Two patients experienced severe hypoxia, including one treatment-related mortality after cell administration at the highest dose level. All patients developed expected transient hematologic toxicities from preparative chemotherapy. Median overall survival was 6.9 months (interquartile range: 2.8–10). Two patients survived over 1 year, and a third patient was alive at 59 months. Persistence of CAR+ cells correlated with cell dose, but there were no objective responses. Administration of anti-EGFRvIII CAR-transduced T cells did not demonstrate clinically meaningful effect in patients with glioblastoma multiforme in this phase I pilot trial.
Radio Peel—Synergism Between Nano-fractional Radiofrequency and 20% Trichloroacetic Acid Chemical Peeling
Authors: Artzi Ofir , Cohen Sarit , Verner Ines , Mehrabi Joseph N. , Naveh Hadas Prag , Shoshani Hadas , Nachlieli Tal
Published: March 2019

BACKGROUND

Microneedling fractional radiofrequency (FRF) and chemical peels are widely used for skin rejuvenation.

OBJECTIVE

The authors aimed at evaluating the efficacy and safety of FRF and trichloroacetic acid 20% (TCA20%) peel in different combinations for determining the optimal treatment protocol.

METHODS

In this prospective clinical comparison of 4 protocols (FRF alone, TCA20% alone, TCA20% before FRF [TCA→FRF], and TCA20% following FRF [FRF→TCA]), the patients underwent 3.8 ± 1.2 successive treatments of one protocol at 4- to 6-week intervals. The patients and 2 dermatologists evaluated improvement of pigmentation and dyschromia, erythema and blood vessels, laxity and wrinkling, and skin imperfections using a global aesthetic improvement scale (GAIS) and a 1 to 5 scoring system. The patients rated their satisfaction and reported adverse effects and reduced activity. Skin impedance and histological changes following the different protocols were also evaluated on 3 additional volunteers.

RESULTS

Sixty-seven patients (age range 22–80 years) were studied. TCA→FRF caused skin impedance to decrease, yielding a more superficial and less-efficient penetration of FRF energy. FRF→TCA produced more significant improvement in overall facial skin appearance (GAIS) and most evaluated skin parameters. Adverse effects and satisfaction rates were similar for all approaches.

CONCLUSION

FRF→TCA had the best synergistic effect on skin rejuvenation compared with FRF or TCA20% alone and TCA→FRF.
Efficacy and Safety of Bimatoprost 0.01% for the Treatment of Eyebrow Hypotrichosis: A Randomized, Double-Blind, Vehicle-Controlled Study
Authors: Suchonwanit Poonkiat , Chanasumon Nongsak , Sriphojanart Tueboon
Published: March 2019

BACKGROUND

Eyebrow hypotrichosis is an important dermatological problem. However, there is no standard treatment.

OBJECTIVE

To study the efficacy and safety of bimatoprost 0.01% for the treatment of eyebrow hypotrichosis.

MATERIALS AND METHODS

Although bimatoprost 0.03% has been studied previously, this is the first study to evaluate the efficacy and safety of bimatoprost 0.01% for the treatment of eyebrow hypotrichosis. A randomized, double-blinded, vehicle-controlled trial was conducted in 40 patients. All patients were randomized to receive bimatoprost 0.01% or placebo vehicle, once daily, for 6 months. The primary outcome was improvement in eyebrow density and diameter. Additional outcomes were the improvement in clinical assessments and safety evaluation.

RESULTS

Compared to the vehicle group, bimatoprost 0.01% significantly increased mean eyebrow hair density, eyebrow hair diameter, and clinical assessments (p < .001) in the drug group. Patients' satisfaction score was higher for the drug group than the vehicle group (p < .05). Adverse effects of the treatment were minimal and similar between the 2 groups.

CONCLUSION

Bimatoprost 0.01% was found to be superior to a placebo for eyebrow enhancement. Bimatoprost 0.01% can be considered effective, safe, and well-tolerated for the treatment of eyebrow hypotrichosis.
Therapeutic Drug Monitoring of Everolimus in Oncology: Evidences and Perspectives
Authors: Falkowski Sabrina , Woillard Jean-Baptiste
Published: March 2019

Everolimus is a mammalian target of rapamycin (m-TOR) inhibitor that has been approved for the treatment of hormone receptor-positive advanced breast cancer, metastatic renal cancer, and neuroendocrine tumors. Although therapeutic drug monitoring (TDM) of everolimus is well established in the transplantation field, it is not currently performed in oncology. The last consensus conference about the TDM of everolimus states that for the use of everolimus in oncology, “further studies are required to determine the clinical utility of TDM for everolimus in oncology settings.” In this review, the authors will discuss the current evidences and perspectives, based on observational studies available, in favor of the TDM of everolimus in oncology focusing on (1) the management of everolimus in routine practice, (2) the prerequisites for TDM of everolimus in oncology, (3) the pharmacodynamics (including a description of the biomarker of resistance and mutations in m-TOR), and (4) a general outlook.
Conservative management for postmenopausal women with tubo-ovarian abscess
Authors: Yagur Yael , Weitzner Omer , Man-El Gili , Schonman Ron , Klein Zvi , Fishman Ami , Beiner Mario , Kadan Yfat
Published: March 2019

Objectives:

The aim of the study was to describe the experience of one institution in management and outcome of tubo-ovarian abscess (TOA) in pre- and postmenopausal women and to reassess the optimal approach for TOA in postmenopausal women.

Methods:

A retrospective cohort study included women diagnosed with TOA between 2003 and 2017 in a tertiary referral center. TOA was diagnosed by sonography or computerized tomography and at least one of the following criteria: temperature more than 38°C, leukocytosis more than 15,000 mm3, or surgically proven disease. Women were followed up for a mean of 7.6 years (range 6 mo to 14 y). The rates of conservative management and pelvic malignancy were evaluated.

Results:

The study cohort included 144 (69.23%) women who met the inclusion criteria, of which 105 (72.92%) were premenopausal and 39 (27.08%) were postmenopausal. Univariate analysis found no differences in risk factors and disease characteristics between the two groups. Among the study sample, 22 (56.4%) postmenopausal women and 48 (45.7%) premenopausal women were treated surgically (P = 0.5). None of the premenopausal women and 1 (2.6%) postmenopausal woman were diagnosed with pelvic malignancy.

Conclusion:

In postmenopausal women with TOA, the prevalence of concurrent pelvic malignancy was 2.6%, which is higher than in the general population, but lower than that reported in the literature; 44% were conservatively managed without any apparent cases of misdiagnoses of cancer.
The effect of a randomized 12-week soy drink intervention on everyday mood in postmenopausal women
Authors: Simpson Ellen E.A. , Furlong Orlaith N. , Parr Heather J. , Hodge Stephanie J. , Slevin Mary M. , McSorley Emeir M. , McCormack Jacqueline M. , McConville Christopher , Magee Pamela J.
Published: March 2019

Objective:

Dietary soy may improve menopausal symptoms, and subsequently mediate mood. This novel study examines various doses of dietary soy drink on everyday mood stability and variability in postmenopausal women.

Methods:

Community-dwelling women (n = 101), within 7 years postmenopause, consumed daily either a low (10 mg, n = 35), medium (35 mg, n = 37), or high (60 mg, n = 29) dose of isoflavones, for 12 weeks. Menopausal symptoms and repeated measures of everyday mood (positive [PA] and negative [NA] affect) (assessed at four time points per day for 4 consecutive days, using The Positive and Negative Affect Schedule) were completed at baseline and follow-up.

Results:

The dietary soy intervention had no effect on everyday mood stability (for PA [F{2,70} = 0.95, P = 0.390] and NA [F{2,70} = 0.72, P = 0.489]) or variability (for PA [F{2,70} = 0.21, P = 0.807] and for NA [F{2,70} = 0.15, P = 0.864]), or on menopausal symptoms (for vasomotor [F{2,89} = 2.83, P = 0.064], psychological [F{2,88} = 0.63, P = 0.535], somatic [F{2,89} = 0.32, P = 0.729], and total menopausal symptoms [F{2,86} = 0.79, P = 0.458]). There were between-group differences with the medium dose reporting higher PA (low, mean 24.2, SD 6; and medium, mean 29.7, SD 6) and the low dose reporting higher NA (P = 0. 048) (low, mean 11.6, SD 2; and high, mean 10.6, SD 1) in mood scores. Psychological (baseline M = 18 and follow-up M = 16.5) and vasomotor (baseline M = 4.2 and follow-up M = 3.6) scores declined from baseline to follow-up for the overall sample.

Conclusions:

Soy isoflavones had no effect on mood at any of the doses tested. Future research should focus on the menopause transition from peri to postmenopause as there may be a window of vulnerability, with fluctuating hormones and increased symptoms which may affect mood.
Periwound Challenges Improve Patient Satisfaction in Wound Care
Authors: Wongkietkachorn Apinut , Surakunprapha Palakorn , Titapun Attapol , Wongkietkachorn Nuttapone , Wongkietkachorn Supawich
Published: March 2019

In wound care, we usually focus nearly all of our efforts on the wound area while paying little attention to the periwound area. Although the periwound area may seem unimportant, it matters to patients. A female patient was admitted with a wound at the perianal area. Wound dressing was performed using standard wet-to-dry gauzes. The patient had several small complaints including irritant contact dermatitis, skin maceration, pain during dressing change, and fecal contamination to the wound. In this case, we ended up switching to a different method of wound dressing. We went from using wet-to-dry gauzes for the primary dressing to a hydrofiber with silver dressing and from gauze and Micropore as a secondary dressing to an adhesive sodium carboxymethylcellulose foam dressing. This resolved all complaints. The patient’s satisfaction score using visual analog scale increased from 2 to 10 (out of 10 points). This example shows how even small details can make a significant difference in wound care. Because periwound care is often neglected, therapeutic algorithm that integrates major challenges in periwound care into wound healing strategies is proposed.
Identification of Cofilin-1 and Destrin as Potential Early-warning Biomarkers for Gamma Radiation in Mouse Liver Tissues
Authors: Yi Lan , Hu Nan , Mu Hongxiang , Sun Jing , Yin Jie , Dai Keren , Xu Fanghui , Yang Nanyang , Ding Dexin
Published: March 2019

Gamma radiation causes cell injury and leads to an increased risk of cancer, so it is of practical significance to identify biomarkers for gamma radiation. We used proteomic analysis to identify differentially expressed proteins in liver tissues of C57BL/6J mice treated with gamma radiation from 137Cs for 360 d. We confirmed obvious pathological changes in mouse liver tissues after irradiation. Compared with the control group, 74 proteins showed a fold change of ≥1.5 in the irradiated groups. We selected 24 proteins for bioinformatics analysis and peptide mass fingerprinting and found that 20 of the identified proteins were meaningful. These proteins were associated with tumorigenesis, tumor suppression, catalysis, cell apoptosis, cytoskeleton, metabolism, gene transcription, T-cell response, and other pathways. We confirmed that both cofilin-1 and destrin were up regulated in the irradiated groups by western blot and real-time polymerase chain reaction. Our findings indicate that cofilin-1 and destrin are sensitive to gamma radiation and may be potential biomarkers for gamma radiation. Whether these proteins are involved in radiation-induced tumorigenesis requires further investigation.
MULTIPLE LATE RECURRENCES OF MACULAR HOLE AFTER VITRECTOMY AND EPISODE OF SPONTANEOUS CLOSURE IN A SINGLE EYE
Authors: Parikh Pooja D. , Day Ghafoori Shelley
Published: March 2019

Purpose:

To report the novel finding of multiple recurrences of full-thickness macular hole in a 70-year-old woman with one episode of spontaneous closure.

Methods:

Case report of a 70-year-old woman who initially presented with a full-thickness macular hole who developed 3 subsequent recurrences of full-thickness macular hole over a duration of 4 years. Spontaneous closure was noted at the second recurrence. Institutional review board was not applicable for this case.

Results:

Combination of three recurrences of full-thickness macular hole with successful closure after vitrectomy as well as a single episode of spontaneous closure.

Conclusion:

This is a novel report in an adult patient with three recurrences of full-thickness macular hole in a previously vitrectomized eye along with an episode of spontaneous closure.
Age-Related Conjunctival P2Y2 Receptor Alterations in the Cu, Zn-Superoxide Dismutase-1 (Sod1)–Knockout Dry Eye Model Mice
Authors: Dogru Murat , Shinzawa Megumi , Kojima Takashi , Shimizu Takahiko , Tsubota Kazuo
Published: March 2019

Purpose:

To investigate the effects of aging on the conjunctival P2Y2 receptors, tear functions, and corneal epithelial status from 10 to 50 weeks in the Sod1

−/−
in comparison with the wild-type mice.

Methods:

Eight eyes of 4 Sod1

−/−
male mice and 8 eyes of 4 C57BL6 strain wild-type male mice were examined at 10 and 50 weeks in this study. Tear film breakup time (BUT) and corneal epithelial damage by fluorescein staining were evaluated. Phenol red–impregnated cotton threads were performed without topical anesthesia to measure aqueous tear quantity. Anterior segment photography was also performed at 10 and 50 weeks. Conjunctival specimens underwent immunohistochemistry stainings with anti P2Y2 antibodies. P2Y2 receptor mRNA expression in the bulbar conjunctiva was investigated by using quantitative real-time polymerase chain reaction.

Results:

The mean tear quantity and BUT scores significantly declined, and the mean fluorescein staining scores significantly increased in both strains of mice from 10 to 50 weeks. % mRNA expression for P2Y2 receptors significantly increased in both mice strains from 10 to 50 weeks.

Conclusion:

The tear stability, quantity, and ocular surface health decline with aging as evidenced by the decrease in tear BUT, tear quantity, and the increase in ocular surface staining. Conjunctival P2Y2 receptor mRNA was upregulated from 10 to 50 weeks, which we believe is a compensation for the decline of tear functions with aging.
The role of narrative in the development of children's pain memories: influences of father– and mother–child reminiscing on children's recall of pain
Authors: Noel Melanie , Pavlova Maria , Lund Tatiana , Jordan Abbie , Chorney Jill , Rasic Nivez , Brookes James , Hoy Monica , Yunker Warren K. , Graham Susan
Published: March 2019

Negatively biased memories for pain (ie, recalled pain is higher than initial report) robustly predict future pain experiences. During early childhood, parent–child reminiscing has been posited as playing a critical role in how children's memories are constructed and reconstructed; however, this has not been empirically demonstrated. This study examined the role of parent–child reminiscing about a recent painful surgery in young children's pain memory development. Participants included 112 children (Mage = 5.3 years; 60% boys) who underwent a tonsillectomy and one of their parents (34% fathers). Pain was assessed in hospital and during the recovery phase at home. Two weeks after surgery, parents and children attended a laboratory visit to participate in a structured narrative elicitation task wherein they reminisced about the surgery. Four weeks after surgery, children completed an established pain memory interview using the same previously administered scales through telephone. Narratives were coded for style (elaboration) and content (pain and emotion) based on coding schemes drawn from the developmental psychology literature. Findings revealed that a more elaborative parental reminiscing style in addition to greater use of emotional words predicted more accurate/positively biased pain memories. Greater parental use of pain words predicted more negatively biased pain memories. Although there were no sex and parent-role differences in pain memory biases, mothers and fathers differed in how they reminisced with their boys vs girls. This research underscores the importance of parent–child reminiscing in children's pain memory development and may be used to inform the development of a parent-led memory reframing intervention to improve pediatric pain management.
Endogenous pain modulation in children with functional abdominal pain disorders
Authors: Pas Roselien , Rheel Emma , Van Oosterwijck Sophie , Leysen Laurence , Van De Vijver Els , Nijs Jo , Ickmans Kelly , Meeus Mira
Published: March 2019

Functional abdominal pain disorders (FAPDs) are common among young individuals. To date, relatively little is known regarding the function of the endogenous analgesic mechanisms in this vulnerable group. Therefore, this case–control study aimed to compare conditioned pain modulation (CPM), pressure algometry, and psychosocial variables in 39 young children (aged 6-12 years) with FAPD and 36 age- and sex-matched pain-free controls. Pressure algometry was used to assess pressure pain thresholds (PPTs) at both symptomatic (umbilicus) as remote (trapezius and tibia) test sites. Conditioned pain modulation was recorded as an increase in the PPT at the trapezius test site in response to experimental conditioning pain imposed by the cold pressor task (12 ± 1°C). The assessors were blinded to the diagnoses. Parent-proxy and/or self-reported questionnaires were used to assess child's pain intensity, functional disability, pain-related fear, and parental pain catastrophizing. Compared with pain-free controls, young children with FAPD showed lower PPTs at all test sites (P < 0.05), a lower CPM response (P = 0.02), more functional disability (P < 0.001), and pain-related fear (P < 0.001). Parents of children with FAPD catastrophized more about their child's pain than parents of healthy children (P < 0.001). No sex differences were found for the experimental pain measurements (P > 0.05), nor was there a significant correlation between the child- and parent-reported questionnaires and the CPM effect (P > 0.05). In summary, young children with FAPD demonstrated secondary hyperalgesia and decreased functioning of endogenous analgesia.
Antihyperalgesic effects of Meteorin in the rat chronic constriction injury model: a replication study
Authors: Xie Jennifer Y. , Qu Chaoling , Munro Gordon , Petersen Kenneth A. , Porreca Frank
Published: March 2019

Data from preclinical research have been suggested to suffer from a lack of inherent reproducibility across laboratories. The goal of our study was to replicate findings from a previous report that demonstrated positive effects of Meteorin, a novel neurotrophic factor, in a rat model of neuropathic pain induced by chronic constriction injury (CCI). Notably, 5 to 6 intermittent subcutaneous (s.c.) injections of Meteorin had been reported to produce reversal of mechanical allodynia/thermal hyperalgesia after injury, wherein maximum efficacy of Meteorin was reached slowly and outlasted the elimination of the compound from the blood by several weeks. Here, we evaluated the efficacy of Meteorin in reversing hindpaw mechanical hyperalgesia and cold allodynia in male, Sprague-Dawley rats with CCI. Nociceptive behavior was monitored before and after CCI, and after drug treatment until day 42 after injury. Systemic administration of recombinant mouse Meteorin (0.5 and 1.8 mg/kg, s.c.) at days 10, 12, 14, 17, and 19 after CCI produced a prolonged reversal of neuropathic hypersensitivity with efficacy comparable with that obtained with gabapentin (100 mg/kg, orally). Despite some protocol deviations (eg, nociceptive endpoint, animal vendor, testing laboratory, investigator, etc.) being incurred, these did not affect study outcome. By paying careful attention to key facets of study design, using bioactive material, and confirming drug exposure, the current data have replicated the salient findings of the previous study, promoting confidence in further advancement of this novel molecule as a potential therapy for neuropathic pain.
Percutaneous Pulmonary Artery Venting via Jugular Vein While on Peripheral Extracorporeal Life Support
Authors: Loforte Antonio , Baiocchi Massimo , Dal Checco Erika , Gliozzi Gregorio , Fiorentino Mariafrancesca , Lo Coco Valeria , Martin Suarez Sofia , Marrozzini Cinzia , Biffi Mauro , Marinelli Giuseppe , Pacini Davide
Published: March 2019

Peripheral extracorporeal membrane oxygenation (ECMO) setting remains a valid option to treat cardiogenic shock (CS). We investigated a percutaneous approach to unload the left ventricle (LV) while on veno-arterial (v-a) peripheral ECMO support. Between 2017 and 2018, eight patients (three females, mean age: 49.6 years old, and five males, mean age: 58 years old, respectively) suffered refractory CS due to acute myocardial infarction (n = 4), acute myocarditis (n = 2), acute decompensation on chronic heart failure (n = 1), and primary graft failure after heart transplantation (Htx) (n = 1), respectively. After a multidisciplinary CS team discussion, it was decided to proceed with peripheral v-a ECMO placement and percutaneous LV venting via right internal jugular vein access to drain the pulmonary artery (PA), in the hybrid operating room. In a single postcardiotomy case, the PA trunk was vented centrally. Mean ECMO support time was 8.5 days. Seven (87.5%) patients were successfully weaned from ECMO and one (12.5%) successfully bridged to Htx. All patients were successfully discharged after treatment except for a single case who died due to sepsis. In case of not recommended usage of LV apical venting, the adoption of v-a peripheral ECMO support associated with percutaneous PA drainage enables the rapid onset of extracorporeal life support with an effective biventricular unloading.
Pediatric Nonceliac Gluten Sensitivity
Authors: Camhi Stephanie S. , Sangal Kajal , Kenyon Victoria , Lima Rosiane , Fasano Alessio , Leonard Maureen M.
Published: March 2019

Objective:

The aim of the study was to identify the prevalence and clinical characteristics of children with nonceliac gluten sensitivity (NCGS) presenting to a tertiary care center specialized for evaluation of gluten‐related disorders.

Methods:

The medical records of all patients aged 0 to 18 years who presented to our center over a 4‐year period (July 2013–June 2018) and consented to participate in our research registry were reviewed. Patients meeting the clinical criteria for NCGS were reviewed in detail.

Results:

Among 500 pediatric patients who volunteered to participate in the registry during the study period, we identified 26 (5.2%) with NCGS. Both gastrointestinal and extraintestinal symptoms associated with gluten ingestion were common with abdominal pain (57.7%), bloating (53.9%), rash (53.9%), diarrhea/loose stool (42.3%), and emotional/behavioral issues (42.3%) emerging as the predominant complaints. In addition, children with NCGS demonstrated a high personal history (61.5%) and family history (61.5%) of concomitant allergic/atopic disease.

Conclusions:

Even within our highly specialized population of patients with a suspected gluten‐related disorder, pediatric NCGS is relatively uncommon. The estimated prevalence and clinical features mirror those previously reported in a similarly highly selective population of adults. In the absence of celiac disease, clinical suspicion for NCGS should arise in a child with gastrointestinal and/or extraintestinal complaints alleviated with gluten removal and considered in symptomatic patients with associated allergic/atopic disease. Proper and adequate exclusion of celiac disease and other potential causes of the clinical complaints is essential to justify adoption of the gluten‐free diet according to an appropriate stringency and with dietitian supervision to avoid nutritional deficiencies.
The grape seed extract: a natural antimicrobial agent against different pathogens
Authors: Memar Mohammad Y. , Adibkia Khosro , Farajnia Safar , Kafil Hossein Samadi , Yekani Mina , Alizadeh Naser , Ghotaslou Reza
Published: March 2019

The increasing prevalence of antimicrobial-resistant microorganisms is presently known as a global challenge. An effective alternative is critical to guarantee an operative paradigm shift in the epidemic of resistance. The antimicrobial effects of grape seed extract (GSE) have been reported against a broad range of microbes. This study is an updated overview of the antimicrobial effect of GSE against different pathogens. The available reports from various studies retrieved from PubMed, Scopus, and Google Scholar databases regarding the antimicrobial effect of GSE was evaluated. The GSE is rich sources of phenolic compounds. GSE can inhibit the growth of a broad spectrum of Gram-negative and Gram-positive bacteria depended on its concentrations, phenolic content, and tested bacterial species. The GSE is more effective against Gram-positive bacteria than Gram-negative bacteria. It has also been shown to have inhibitory effects against several clinically important viruses and fungi. The antibiofilm effect of GSE also has been described in some studies. The significant side effects of GSE have not reported and it is almost safe. GSE may be a promising source for new generations of antimicrobial agents in the food industry and clinical setting.
Nurse-Led Mobility Program
Authors: Jones Renata A. , Merkle Sarah , Ruvalcaba Lynze , Ashton Pippin , Bailey Casey , Lopez Mary
Published: March 2019

Background:

Hospitalized medical-surgical patients are at risk for adverse health outcomes due to immobility. Despite well-documented consequences, low mobility is prevalent.

Local Problem:

In a 547-bed hospital, medical-surgical patients were mobilized less frequently than expected. Physical therapists were inappropriately consulted 22% of the time for routine mobility of patients. A preimplementation survey of registered nurses indicated a lack of knowledge and confidence to safely mobilize patients.

Methods:

This quality improvement project implemented a nurse-led mobility program in an effort to increase early mobilization, reduce physical therapy referrals for routine mobility, and reduce the sequelae of immobility.

Interventions:

The Bedside Mobility Assessment Tool and standardized interventions were implemented on 5 medical-surgical units.

Results:

Postimplementation, nurse-led patient mobilizations increased by 40%, inappropriate physical therapy orders decreased 14%, and no significant change in patient falls or pressure injuries was noted.

Conclusion:

A nurse-led mobility program was effective in increasing safe, early mobilization of patients and improving the culture of mobility.
Improving Attitudes and Perceptions About End-of-Life Nursing on a Hospital-Based Palliative Care Unit
Authors: Harrington Kristine J. , Affronti Mary Lou , Schneider Susan M. , Razzak Abdul Rab , Smith Thomas J.
Published: March 2019

Nurses play an integral role in high-quality patient care. Thus, their skills in providing end-of-life care should be assessed and continually enhanced. Education intended to improve end-of-life skills must address the affective/emotional component of nursing care. Evidence demonstrates that emotional engagement and resilience among health care providers are correlated with improved quality outcomes and, conversely, that burnout and stress negatively affect patient safety. Addressing the emotional needs of health care providers is critical to improving quality throughout the health care system. An evidence-based workshop was implemented among direct care staff on a hospital-based palliative care unit, with the goal of fostering emotional engagement to improve staff perceptions and attitudes about caring for patients at or near the end of life. Although perceptions about quality of death were not affected by this intervention, there was a significant improvement in attitudes about end-of-life nursing care. Qualitative feedback also reflected appreciation for small group discussions and opportunities to debrief with peers away from the unit. This intervention reflected the value of emotional engagement in educational efforts to improve end-of-life nursing care.
Developing a Measure of End-of-Life Care Nursing Knowledge for Japanese Geriatric Nurses
Authors: Okumura-Hiroshige Akemi , Fukahori Hiroki , Yoshioka Sachiko , Nishiyama Midori , Takamichi Kaori , Kuwata Miyoko
Published: March 2019

This study developed an end-of-life (EOL) care nursing knowledge scale for Japanese geriatric nurses (ELNKS-JG) to measure nurse knowledge of EOL care for older adults. It also was used to evaluate the quality of The End-of-Life Nursing Education Consortium–Japan Geriatric. Participants were 1168 nurses employed in 32 institutions across Japan. The items of our measure were developed to cover 8 important topics: principles of EOL care for older adults; pain management; symptom management; ethics of care; cultural and spiritual considerations; communication; loss, grief, and bereavement; and caring for final days. The measure included 51 items with an overall Cronbach α coefficient of 0.87 and an intraclass correlation coefficient of 0.81. Our measure, the ELNKS-JG, was confirmed to have good internal consistency, test-retest reliability, content validity, and known-groups validity. This scale’s items included knowledge about noncancerous diseases, physical changes due to aging, family care, and multidisciplinary collaboration. The ELNKS-JG comprehensively measures a nurse’s knowledge of EOL care for older adults in any EOL setting. Furthermore, this scale can evaluate educational programs aimed at improving care quality and encouraging related activities in facilities that provide EOL care.
Undergraduate Nursing Students’ Perception of End-of-Life Care Education Placement in the Nursing Curriculum
Authors: Li Jing , Smothers Angel , Fang Wei , Borland Michelle
Published: March 2019

Nursing students, who have been receiving the End-of-Life Nursing Education Consortium (ELNEC) Core training throughout their Bachelor of Science in Nursing program, have a unique perspective of the benefits of this training. In addition, they have insight as to where an online ELNEC module series specifically for undergraduate nursing students would best be integrated within the curriculum. This study used a mixed methods strategy to evaluate students’ opinions on the placement of end-of-life care education within the curriculum and their experience of having received ELNEC training previously throughout their program. Senior-level nursing student opinions on the placement of the ELNEC modules within the curriculum were equally divided, with one-third suggesting placement at the sophomore level, one-third suggesting placement at the junior level, and one-third suggesting placement at the senior level. Students also offered a recommendation for an end-of-life care simulation integration into the Bachelor of Science in Nursing curriculum. Students who have been receiving ELNEC training integrated throughout the curriculum reported feeling comfortable with providing end-of-life care after graduation. Themes extracted from students’ suggestions on improving end-of-life care education were as follows: (1) The quality and consistency of instruction needs to be enhanced, (2) palliative care education should be delivered using various methods, and (3) methods to assess education on palliative care should be improved. Students reported that ELNEC training helped them to gain insight into the key elements in palliative care, to understand the differences and similarities between palliative care and hospice, and to understand the nurse’s role in palliative care and hospice.
Impact of Sleep Disorders and Other Factors on the Quality of Life in General Population
Authors: Hallit Souheil , Hajj Aline , Sacre Hala , Al Karaki Gloria , Malaeb Diana , Kheir Nelly , Salameh Pascale , Hallit Rabih
Published: March 2019

The study objective was to assess if insomnia, along with other factors, can impact the physical and mental quality of life (QOL) of the Lebanese general population. This cross-sectional study, conducted between November 2017 and March 2018, enrolled 756 community-dwelling participants. A first linear regression, using the SF-12 PCS score as the dependent variable, showed that having a family history of insomnia problems (β = 1.107, p = 0.026) was significantly associated with higher physical QOL (higher SF-12 PCS score), whereas increased stress (β = 0.048, p = 0.015) was significantly associated with lower physical QOL. A second linear regression, using the SF-12 MCS score as dependent variable, showed that having increased age (β = −0.079, p < 0.001) was significantly associated with lower mental QOL. Despite its cross-sectional design and the modest sample size, this study adds to the evidence that insomnia, along with other factors (including sociodemographic and psychological factors), can have a detrimental impact on both physical and mental QOL of participants.
Relationships Among Parental Psychological Distress, Parental Feeding Practices, Child Diet, and Child Body Mass Index
Authors: Jang Myoungock , Brandon Debra , Vorderstrasse Allison
Published: March 2019

Background

Parents often play a main role in establishing the dietary patterns of preschool children, but there is no clear understanding about the relationship between parental psychological distress and child diet and body mass index (BMI).

Objective

The aim of this study was to examine the relationships among parental psychological distress, parental feeding practices, child diet, and child BMI in families with young children.

Methods

We conducted a mixed-methods study with families (parent–child dyad) of children aged 2–5 years. Measures included demographic data, parental general stress, parenting stress, parental sleep quality, parental depressive symptoms, social support for parents, mealtime environment, child feeding practice, child diet, and child BMI, with well-validated questionnaires completed by parents. Using structural equation models, we examined the path relationships of these factors. We also interviewed a subsample of 13 parents.

Results

A total of 256 families participated. Higher parental psychological distress was associated with higher parental unhealthy feeding practices (B = 0.31, p < .01). However, a parental unhealthy practice in feeding was not associated with child's unhealthy diet or BMI. There was no direct relationship between parental psychological distress and child BMI. Social support for parents was significantly inversely related to parental psychological distress (B = −11.59, p < .01), and the relationship between social support for parents and parental unhealthy feeding practices approached significance (B = 6.11, p = .05). A main theme from analysis of parent interview was that parent stress and fatigue influenced their feeding and food preparation.

Discussion

Parental psychological distress is a critical influential factor in parental feeding practices. This finding highlights potential foci in intervention programs to address parental psychological distress.
The Association Between Health Literacy and Breast and Cervical Cancer Screening Behaviors
Authors: Kim Kyounghae , Han Hae-Ra
Published: March 2019

Background

Health literacy has been linked to breast and cervical cancer screening, with inconsistent findings, which may result from the use of nonprobability sampling and a health literacy instrument that measures a subset of health literacy.

Objective

The aim of this study was to examine the association between health literacy and breast and cervical cancer screening using data from the Behavioral Risk Factor Surveillance System (BRFSS) that uses a nationally representative U.S. probability sample.

Methods

This cross-sectional, correlational study used national-level data from the 2016 BRFSS for women eligible for breast (N = 44,241) and cervical (N = 38,956) cancer screening per the American Cancer Society guidelines. A health literacy survey consisted of three items: oral (asking for medical advice), listening (understanding information that providers offer), and written (understanding printed health information) literacy. We extracted data regarding age, race/ethnicity, income, marital status, education, employment, insurance, and access to providers. Analyses were weighted using the complex survey design and multiple logistic regressions were used to test for the associations between health literacy and cancer screening after controlling for sociodemographic and healthcare system factors.

Results

Oral and listening literacies were contributing factors to up-to-date breast cancer screening (p = .002, p < .001, respectively). The association ceased to be significant in the presence of all three literacy items in one model. Oral and listening literacies were also associated with cervical cancer screening (p < .001, p = .005, respectively), but only oral literacy maintained significance in the presence of listening and written literacy items.

Discussion

Oral and listening literacies are contributing factors to lifetime breast cancer screening and up-to-date cervical cancer screening. Providers should create an atmosphere of effective patient–provider communication and informed decision-making by reducing health literacy demands in the medical encounter.
Effect of Outdoor Activities in Myopia Control: Meta-analysis of Clinical Studies
Authors: Deng Li , Pang Yi
Published: March 2019

SIGNIFICANCE

Our meta-analyses assess the benefit of outdoor activities on myopia onset and myopic shift among school-aged children reported in prospective intervention studies.

PURPOSE

The purpose of this study was to investigate the reduced risk of myopia development, myopic shift, and axial elongation with more outdoor activity time among school-aged children.

METHODS

A literature search was conducted using PubMed, MEDLINE, Scopus, EMBASE, VisionCite, and Cochrane Library. Five clinical trials met our selection criteria. Three outcome variables were used to assess the benefit of intervention: relative risk (RR), difference in myopic shift rate, and difference in axial elongation rate. Meta-analyses were applied to each outcome variable under the random-effects model. Children were grouped according to their initial refractive status: initial myopes, initial nonmyopes, or mixed.

RESULTS

The pooled RR indicates that there is a reduced risk of developing myopia with more hours of outdoor activities per week (RR, 0.66; 95% confidence interval [CI], 0.49 to 0.89). The overall rate of myopic shift rate was slower in the intervention group compared with the control group (0.13 diopter/y; 95% CI, 0.08 to 0.18). The axial elongation was also slower (−0.03 mm/y; 95% CI, −0.05 to −0.00). The benefit of slowing myopic shift was observed in all initially nonmyopic cohorts (three of three) and most of the initially myopic cohorts (two of three).

CONCLUSIONS

The meta-analysis results suggest that there is a slightly lower risk of myopia onset and myopic shift with more hours of outdoor activities. Future clinical trials are needed to assess its long-term effect and whether the effect varies by initial myopic status.
Optical Quality and Intraocular Scattering in the Diabetic Eye without Diabetic Retinopathy
Authors: Liu Jianting , Wang Xiaogang , Wang Jinfeng , Guo Haike
Published: March 2019

SIGNIFICANCE

This study suggests that despite having comparable best-corrected visual acuity and normal fundus appearance, objective measurements of optical quality showed that patients with diabetes but without overt retinopathy may have impaired visual function. Screening using the Optical Quality Analysis System might help identify those patients.

PURPOSE

Visual impairments are common in diabetes, but the status of the problem is unclear before the development of diabetic retinopathy. The aim of this pilot study was to investigate the optical quality and intraocular scattering in the diabetic eye without diabetic retinopathy.

METHODS

Twenty-seven patients with diabetes without diabetic retinopathy were enrolled. Twenty-seven age- and sex-matched healthy volunteers served as a control group. Optical quality parameters included modulation transfer function cutoff frequency, Strehl (two-dimensional) ratio, and Optical Quality Analysis System values at 100, 20, and 9 contrast levels. The objective scatter index was assessed using the Optical Quality Analysis System. Correlations were analyzed between the modulation transfer function cutoff, Strehl ratio, objective scatter index, and Optical Quality Analysis System value, and the age of the patient and the duration of diabetes mellitus.

RESULTS

The diabetic group exhibited lower modulation transfer function cutoff, Strehl ratio, and Optical Quality Analysis System values at 100, 20, and 9% contrast levels and higher objective scatter index than did the controls (all,P< .01). There were no associations between the optical quality parameters and age or the duration of diabetes mellitus in the diabetic participants (all,P> .05). Moderate associations were found between all parameters obtained from the Optical Quality Analysis System and age in the control group (all,P< .01).

CONCLUSIONS

This pilot study suggests that optical quality was reduced, and intraocular scattering increased in the diabetic eye without diabetic retinopathy compared with controls.
Social support buffers the negative influence of perceived injustice on pain interference in people living with HIV and chronic pain
Authors: Penn Terence M. , Trost Zina , Parker Romy , Wagner William P. , Owens Michael A. , Gonzalez Cesar E. , White Dyan M. , Merlin Jessica S. , Goodin Burel R.
Published: March 2019

Introduction:

A growing literature attests to the overwhelming prevalence of disabling chronic pain among people living with HIV (PLWH), yet very little is known about psychosocial contributors to poor chronic pain outcomes in this population. Pain-related perception of injustice may promote pain interference by hindering engagement in daily activities among individuals with chronic pain. Social support has been shown to buffer the negative impact of harmful beliefs on well-being and facilitate adjustment to chronic pain.

Objective:

This cross-sectional study tested the buffering hypothesis of social support to determine whether increasing levels of social support mitigate the negative influence of perceived injustice on pain interference.

Methods:

A total of 60 PLWH with chronic pain completed measures of perceived injustice, social support, pain severity, and interference, as well as depressive symptoms.

Results:

In a regression-based model adjusted for age, sex, depressive symptoms, and pain severity, results indicated that social support significantly moderated (ie, buffered) the association between perceived injustice and pain interference (P = 0.028). Specifically, it was found that perceived injustice was significantly associated with greater pain interference among PLWH with low levels of social support (P = 0.047), but not those with intermediate (P = 0.422) or high levels of social support (P = 0.381).

Conclusion:

Pain-related injustice perception reflects harmful beliefs regarding severity of loss consequent to chronic pain development, a sense of unfairness, and irreparability of loss. Access to a social support network may provide an adaptive means of mitigating the negative effects of perceived injustice.
Oncologic Trends, Outcomes, and Risk Factors for Locoregional Recurrence: An Analysis of Tumor-to-Nipple Distance and Critical Factors in Therapeutic Nipple-Sparing Mastectomy
Authors: Frey Jordan D. , Salibian Ara A. , Lee Jiyon , Harris Kristin , Axelrod Deborah M. , Guth Amber A. , Shapiro Richard L. , Schnabel Freya R. , Karp Nolan S. , Choi Mihye
Published: March 2019

Background:

Oncologic outcomes with nipple-sparing mastectomy continue to be established. The authors examine oncologic trends, outcomes, and risk factors, including tumor-to-nipple distance, in therapeutic nipple-sparing mastectomies.

Methods:

Demographics, outcomes, and overall trends for all nipple-sparing mastectomies performed for a therapeutic indication from 2006 to 2017 were analyzed. Oncologic outcomes were investigated with specific focus on recurrence and associated factors, including tumor-to-nipple distance.

Results:

A total of 496 therapeutic nipple-sparing mastectomies were performed, with an average follow-up time of 48.25 months. The most common tumor types were invasive carcinoma (52.4 percent) and ductal carcinoma in situ (50.4 percent). Sentinel lymph node sampling was performed in 79.8 percent of nipple-sparing mastectomies; 4.1 percent had positive frozen sentinel lymph node biopsy results, whereas 15.7 percent had positive nodal status on permanent pathologic examination. The most common pathologic cancer stage was stage IA (42.5 percent) followed by stage 0 (31.3 percent). The rate of local recurrence was 1.6 percent (n = 8), and the rate of regional recurrence was 0.6 percent (n = 3). In all, 171 nipple-sparing mastectomies had magnetic resonance imaging available with which to assess tumor-to-nipple distance. Tumor-to-nipple distance of 1 cm or less (25.0 percent versus 2.4 percent; p = 0.0031/p = 0.1129) and of 2 cm or less (8.7 percent versus 2.0 percent; p = 0.0218/p = 0.1345) trended to higher rates of locoregional recurrence. In univariate analysis, tumor-to-nipple distance of 1 cm or less was the only significant risk factor for recurrence (OR, 13.5833; p = 0.0385). No factors were significant in regression analysis.

Conclusions:

In early stage and in situ breast carcinoma, therapeutic nipple-sparing mastectomy appears oncologically safe, with a locoregional recurrence rate of 2.0 percent. Tumor-to-nipple distances of 1 cm or less and 2 cm or less trended to higher recurrence rates.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.