bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer
Authors: Arend Florian , Oechsner Markus , Weidenbächer Clara B. , Combs Stephanie E. , Borm Kai J. , Duma Marciana N. 
Published: July 2020

Background: The purpose of this study is to detect a correlation between the preradiation tumor staging and the relative volumetric regression of the primary tumor through external beam radiation therapy (EBRT). Methods: Clinical data of 32 patients with a mean age of 60±12 years treated with primary radiation therapy (RT) of cervical carcinoma were analyzed. Union Internationale Contre le Cancer (UICC) stages were T1 = 4 patients, T2 = 15 patients, T3 = 8 patients, T4 = 5 patients; N1 = 26 patients, N0 = 6 patients; and M0 = 25 patients, M1 = 7 patients. All patients received pelvic magnetic resonance imaging (MRI) before RT as well as during RT. The cervical primary tumor was delineated as gross tumor volume (ptGTV) in T2-weighted MRI sequences. We compared ptGTV reduction by stage, lymph node status, metastatic status, and grading. Results: Mean ptGTV reduction during RT was 61.4±28.9%. T1 tumors shrank by 88.2±13.4%, T2 by 67.6±28.7%, T3 by 50.8±23.6%, and T4 by 38.7±27.2%. The difference in tumor shrinkage was statistically significant between the lower T stages and the higher T stages ( p < 0.05). There was no statistical difference in the mean ptGTV before treatment in the group with lymph node metastases (LNM) (54.1±47.7 cm3) as compared to the group without LNM (76.6±52.2 cm3). Nonetheless, ptGTV shrank significantly differently: by 68.9±25.7% (N1 patients) and by 29.0±17.7% (N0 patients). No significant differences in ptGTV shrinkage were observed in M0 versus M1 and G2 versus G3 tumors. Conclusion: There is a correlation between mean ptGTV reduction during EBRT and tumor stages. Tumors with higher T stages shrank less under radiation treatment, and the ptGTV of N1 patients responded better than that of N0 patients.
Effectiveness of anxiety reduction interventions on test anxiety: A comparison of four techniques incorporating sensory modulation
Authors: Keptner Karen M , Fitzgibbon Carolyn , O’Sullivan Julie 
Published: July 2020

Introduction Anxiety is one of the most commonly diagnosed mental health disorders on post-secondary campuses, often brought on by stressors unique to the college environment. Traditional psychological approaches to manage anxiety might focus on breathing techniques and progressive muscle relaxation. However, additional techniques that use specific sensory input to reduce anxiety have not received the same attention in the literature. Method This longitudinal study compared four interventions for state anxiety (deep breathing, progressive muscle relaxation, an adapted dive reflex, and use of a weighted lap object) in a cohort of professional occupational therapy students. Results This study found that all four interventions significantly reduced state anxiety. The sensory-based interventions of adapted dive reflex and weighted lap object appeared to have a longer duration of impact than the traditional interventions of deep breathing and PMR. Conclusion These results suggest that both traditional and sensory-based approaches may be effective in reducing anxiety before a testing situation.
Clinical outcomes of once-daily darunavir in treatment-experienced patients with darunavir resistance-associated mutations through 48 weeks of treatment
Authors: Rolle Charlotte-Paige , Marquez Omar , Nguyen Vu , Hinestrosa Federico , DeJesus Edwin 
Published: July 2020

Darunavir (DRV) is approved for once-daily use in patients with no DRV resistance-associated mutations (RAMs) and twice-daily use in those with DRV RAMs. Several studies suggest that once-daily DRV retains efficacy in the setting of 1–2 DRV RAMs whereas three or more DRV RAMs are needed for DRV resistance. There are few data to support the long-term use of once-daily DRV in patients with DRV RAMs. This observational study evaluated 48-week clinical outcomes of 22 treatment-experienced patients with ≥1 DRV RAMs switched to once-daily DRV between 2014 and 2017. The primary endpoint was HIV-1 RNA <50 copies/ml at week 48. Safety parameters were analyzed throughout the study. The median age of the sample was 53 years, 18 (82%) had baseline HIV-1 RNA <50 copies/ml, and the median number of historical DRV RAMs was 2. At week 48, 20 (91%) had HIV-1 RNA < 50 copies/ml, and 2 (9%) had HIV-1 RNA of 82 and 59,637 copies/ml and reported non-adherence. No adverse drug reactions were observed through week 48. Once-daily DRV maintained virologic control in patients with ≥1 historical DRV RAMs and was safe and well-tolerated. Further data are needed to validate this as a viable treatment option in this population.
Moral distress in emergency and critical care nurses: A metaethnography
Authors: Arnold Tracey C 
Published: July 2020

Background: Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout. Objective: This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses. Method: This study used the Noblit and Hare’s approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis. Ethical considerations: Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases. Results: The synthesis of qualitative research on moral distress resulted in one central theme, “the battle within,” and five subthemes. Conclusions: The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses’ future patient care.
PrabotulinumtoxinA-xvfs for the Treatment of Moderate-to-Severe Glabellar Lines
Authors: Gadarowski Mary B. , Ghamrawi Rima I. , Taylor Sarah L. , Feldman Steven R. 
Published: July 2020

Objective PrabotulinumtoxinA-xvfs (Jeuveau), a botulinum toxin type A, was approved by the Food and Drug Administration for the temporary improvement in the appearance of moderate-to-severe glabellar lines in February 2019. This article will review phase II and III clinical trials to assess the efficacy, safety, and clinical application of this novel, aesthetic-only drug. Data sources A systematic literature review was performed using the terms “glabellar lines AND prabotulinumtoxinA” in the PubMed database. ClinicalTrials.gov was searched to identify nonpublished studies. Study Selection and Data Extraction Articles written in English between November 2019 and June 2020 discussing phase II and phase III clinical trials were evaluated. Data Synthesis By the primary efficacy end point on day 30, more patients achieved a greater than 2-point improvement on the Glabellar Line Scale (GLS) at maximum frown compared with baseline on day 0. The proportions of participants who responded to treatment with prabotulinumtoxinA were 67.5% and 70.4% versus 1.2% and 1.3% in placebo groups across 2 identical clinical trials ( P < 0.001). Patients receiving prabotulinumtoxinA experienced greater improvement in GLS at maximum frown on day 30 (87.2%) compared with onabotulinumtoxinA (82.8%) and placebo (4.2%; P < 0.001). PrabotulinumtoxinA was well tolerated across all studies. Relevance to Patient Care and Clinical Practice This review provides a detailed analysis of the safety and efficacy of prabotulinumtoxinA-xvfs and includes special considerations to help guide patients and clinicians. Conclusion PrabotulinumtoxinA is a safe and effective new addition to the repository of available treatments for the appearance of glabellar lines.
Midterm Fate of the Contralateral Foot in Charcot Arthropathy
Authors: Waibel Felix W. A. , Berli Martin C. , Gratwohl Viviane , Sairanen Kati , Kaiser Dominik , Shin Laura , Armstrong David G. , Schöni Madlaina 
Published: July 2020

Background: The contralateral foot in Charcot arthropathy or neuroarthropathy (CN) is subject to increased plantar pressure. To date, the clinical consequences of this pressure elevation are yet to be determined. The aim of this study was to evaluate ulcer and amputation rates of the contralateral foot in CN. Methods: We abstracted the medical records of 130 consecutive subjects with unilateral CN. Rates of contralateral CN development and recurrence, contralateral ulcer development, and contralateral amputations were recorded. Statistical analysis was performed to identify possible risk factors for contralateral CN and ulcer development, and contralateral amputation. Mean follow-up was 6.2 (SD 4) years. Results: After a mean of 2.5 years, 19.2% patients developed contralateral CN. Female gender was associated with contralateral CN development (odds ratio 3.13, 95% confidence interval 1.27, 7.7). Overall, 46.2% patients developed a contralateral ulcer. Among the patients who developed contralateral CN, 60% developed an ulcer. Sanders type 2 at the index foot (midfoot CN) was significantly associated with contralateral ulcer development. Ulcer-free survival (UFS) differed significantly between patients with diabetes type 1 (median UFS 5131 days) and patients with diabetes type 2 (median UFS 2158 days). A total of 25 amputations had to be performed in 22 (16.9%) patients. Three of those 22 patients (2.3%) needed major amputation. Conclusion: Almost 20% of patients developed contralateral CN. Nearly half of people with CN developed a contralateral foot ulceration. Patients with type 2 diabetes had significantly shorter UFS than patients with diabetes type 1. Every sixth patient needed an amputation, with the majority being minor amputations. The contralateral foot should be monitored closely and included in the treatment in patients with CN. Level of Evidence: Level IV, retrospective study.
Associations Between Hormonal Biomarkers and Preterm Infant Health and Development During the First 2 Years After Birth
Authors: Cho June , Chien Lung-Chang , Holditch-Davis Diane 
Published: July 2020

Background: Testosterone levels have been used to examine infant boys’ vulnerability to health and developmental problems, following the general theories of gender differences and the theory of extreme male brain of autism. Objectives: As testosterone is a representative androgen hormone and is higher in preterm than full-term infants, we used this steroid to determine if hypothalamic pituitary hormones, testosterone, and cortisol, were related to physical growth, health, and development of very-low-birthweight (VLBW, BW < 1,500 g) infants. Method: For this comparative longitudinal study, 40 VLBW infants were recruited from a neonatal intensive care unit of a tertiary medical center. Data were collected from medical record reviews, questionnaires, and assessments of infant development at 6, 12, and 24 months. We collected saliva at the three time points and measured hormones using enzyme-immunoassays. Results: General and generalized mixed models showed that a 1pg/ml increment of testosterone was related to a −0.42% decrease in body weight, a −0.18% decrease in length, and a −0.10% decrease in head circumference. Cortisol levels were not associated with any outcome variable. The interactions between testosterone and time on physical growth and socioemotional development also occurred. Discussion: Elevated testosterone levels can be a biological risk factor for poor infant growth and development. Theories about the effects of elevated prenatal testosterone could be useful in predicting health and developmental outcomes among VLBW infants. Research beyond the first 2 years will be needed as infants show more socioemotional and behavioral problems as they grow older.
Detection of serum uric acid in primary open angle glaucoma: A pilot study
Authors: Serra Rita , Coscas Florence , Pinna Antonio , Peri Marcella , Zucca Ignazio , Sellam Alexandre , Giancipoli Ermete , Boscia Francesco 
Published: July 2020

Purpose: To assess the association between the serum levels of uric acid (UA) and primary open-angle glaucoma (POAG). Methods: In this pilot study, 46 eyes of 23 patients with a clinical history of POAG and 30 eyes of 15 healthy subjects were included. All patients underwent a complete ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and gonioscopy. Visual field parameters, such as mean deviation (MD) and pattern standard deviation (PSD), and optical coherence tomography (OCT) values of the optic nerve head, including retinal nerve fiber layer (RNFL) thickness and vertical cup/disc ratio (VCDR), were noted. A blood sample was collected from each subject for serum UA measurement. Results: IOP, MD, PSD, RNFL thickness, and VCDR resulted significantly different in POAG patients, when compared with controls ( p < 0.05). POAG patients showed significantly lower levels of mean serum UA than healthy controls (4.00 ± 0.66 mg/dL vs 4.95 ± 0.86 mg/dL, respectively, p < 0.0001). Furthermore, severe POAG patients showed mean serum levels of UA lower than mild POAG patients (3.36 ± 0.70 mg/dL vs 4.22 ± 0.51 mg/dL, respectively, p = 0.01). Visual field and OCT parameters were statistically correlated with the mean serum levels of UA in POAG eyes ( p < 0.05). Conclusion: Results suggest that in POAG patients, serum UA levels may be decreased and correlated with visual field and OCT parameters worsening. Further larger multi-center prospective studies are necessary to confirm our findings and establish the role of UA in glaucoma.
Corneal optical density in Fuchs endothelial dystrophy determined by anterior segment optical coherence tomography
Authors: Wertheimer Christian M , Elhardt Carolin , Wartak Andreas , Luft Nikolaus , Kassumeh Stefan , Dirisamer Martin , Siedlecki Jakob , Vounotrypidis Efstathios , Priglinger Siegfried G , Mayer Wolfgang J 
Published: July 2020

Purpose: In this study, we propose a method to grade corneal stromal opacity using optical density measurements by anterior segment optical coherence tomography (AS-OCT) and validate the approach in Fuchs endothelial corneal dystrophy (FECD). Methods: A retrospective analysis of human corneal OCT scans was performed on 48 eyes of 32 patients with FECD and 33 control eyes of 21 patients using the Carl Zeiss Cirrus HD-OCT 5000. In addition, corneal edema in fresh rabbit cadaver eyes was artificially induced by distilled water and imaged with the Thorlabs TELESTO-II spectral domain OCT at different time points during saturation. The increase of opacity due to corneal edema was proposed to directly correlate with enhanced reflectivity sites in the OCT images, corresponding to higher optical density. The increase was determined as the image area above a statistically established gray-scale value using ImageJ and correlated with other disease characteristics. Results: Optical densities in human corneas showed significant differences between FECD patients and the control group ( p = 0.002). The increased optical densities determined in FECD corneas correlated well with other disease characteristics such as corneal pachymetry or visual acuity. Likewise, rabbit corneas showed a time dependent increase in thickness and in corneal optical density during soaking in distilled water. Conclusion: This study presents corneal optical density by AS-OCT as an objective value for corneal changes in FECD. Complementing other diagnostic tools in FECD the assessment of corneal optical density may identify progression of FECD, gauge novel therapeutic strategies and support risk and benefit analyses for corneal surgery.
High Prudent diet factor score predicts lower relapse hazard in early multiple sclerosis
Authors: Simpson-Yap Steve , Oddy Wendy H , Taylor Bruce , Lucas Robyn M , Black Lucinda J , Ponsonby Anne-Louise , Blizzard Leigh , van der Mei Ingrid , Dear Keith , Dwyer Terry , Taylor Bruce V , Broadley Simon , Kilpatrick Trevor , Williams David , Lechner-Scott Jeanette , Shaw Cameron , Chapman Caron , Coulthard Alan , Pender Michael P , Valery Patricia 
Published: July 2020

Background: Dietary patterns and their association with subsequent clinical course have not been well studied in early multiple sclerosis (MS). Objectives: To describe dietary patterns in people in 5 years following first clinical demyelination and assess associations with MS conversion and relapse. Methods: This study included baseline food frequency questionnaire dietary intake (entry to the Ausimmune Study) and 5-year follow-up; iterated principal factor analysis was applied. MS conversion and relapse risks were assessed by Cox proportional hazards models, adjusted for age, sex, study site, education, body mass index (BMI), smoking and omega-3 supplement use. Results: In cases with a first clinical diagnosis of central nervous system (CNS) demyelination, we identified three major dietary patterns, ‘Prudent’, ‘High-Vegetable’ and ‘Mixed’, explaining 43%, 37% and 24% of diet variance in dietary intake, respectively. Fruits, vegetables, fish, wholegrains and nuts loaded highly on the Prudent pattern, starchy vegetables and legumes on the High-Vegetable pattern, and meats and alcohol on the Mixed pattern. Diet factor scores were not associated with MS conversion risk. Those with baseline Prudent scores above the median had significantly lower relapse risk (adjusted hazard ratio = 0.54, 95% confidence interval (CI) 0.37, 0.81) with some evidence of a plateau effect. Conclusion: Prudent diet factor score above the median was prospectively associated with lower relapse risk in the 5 years following the first clinical demyelinating event.
Language experience of immigrant women in bilingual couples with Poles
Authors: Stępkowska Agnieszka 
Published: July 2020

Aims and objectives/purpose/research questions: The article focuses on language experiences shared by female expatriates and aims to investigate the circumstances which are related to their language acquisition and communication in the couple. The research question concerns the degree of socialization of these women into the Polish language as adult bilinguals via marriages to Poles. Design/methodology/approach: Based on my recent data from in-depth interviews, analyzed by means of qualitative methodology, I concentrate on the sociolinguistic complexity of bilingual couples in Poland. Data and analysis: I analyze excerpts of interviews produced by eight couples of immigrant women who settled down in Poland to live with Poles. I investigate these women’s talk with regard to their subjective evaluations of language repertoires resulting from their individual histories of L2 acquisition and their language ideologies reflected in communication patterns with their Polish husbands. Findings/conclusions: My data suggest that language competence relates to the communication quality in cross-lingual and intercultural couples, as subjectively assessed by the target women. I found evidence for apparent reshuffles in language repertoires, an appreciation for formal language learning and the specific hierarchy of priorities in private communication. The results reveal language attitudes which affect the dyadic communication and the sense of ethnicity among mixed couples. Originality: The article views multilingualism and immigration from a new perspective by giving the voice to women living in bilingual couples. The novelty relies on the less studied Polish context where immigrant women from different ethnic backgrounds share language experiences and life situations. Significance/implications: This is significant because the qualitative investigation of the socialization process through language helps understand and interpret linguistic phenomena in terms of the meanings brought to intercultural relationships.
Management of the Left Subclavian Artery in TEVAR for Chronic Type B Aortic Dissection
Authors: Conway Allan M. , Qato Khalil , Nhan Nguyen Tran N. , Giangola Gary , Carroccio Alfio 
Published: July 2020

Objectives: Left subclavian artery (LSA) revascularization in thoracic endovascular aortic repair (TEVAR) remains controversial. Left subclavian artery coverage without revascularization can cause stroke and death. TEVAR has gained popularity for the treatment of chronic type B aortic dissection (cTBD). Using the Vascular Quality Initiative (VQI) database, we reviewed outcomes of LSA revascularization in TEVAR for cTBD. Methods: The VQI registry identified 5683 patients treated with TEVAR from July 2010 to July 2016, including 208 repairs for cTBD. We analyzed outcomes per the Society for Vascular Surgery reporting standards. Results: Of the 208 patients, 150 (72.1%) were male with a median age of 65.0 years (interquartile range [IQR], 55.0-72.0). Median aneurysm diameter was 5.7 cm (IQR, 5.0-6.5 cm). Data on the patency of the LSA was available in 131 (63.0%) patients. Twenty-five (19.1%) had occlusion of the LSA without revascularization, while 106 (80.9%) maintained patency or had revascularization. Successful device delivery occurred in all 131 (100%) patients. Maintaining LSA patency did not affect the rate of cerebrovascular accident ( P = .16), spinal cord ischemia ( P = 1.00), or death ( P = 1.00). This was also nonsignificant when analyzing the subgroup of 98 elective cases. There was no difference in the rates of endoleak. Any intervention for the LSA (revascularization or occlusion) led to a longer procedure time (203.6 minutes vs 163.7 minutes, P = .04). Conclusions: Maintaining LSA patency during TEVAR for cTBD offers no advantage in perioperative morbidity or endoleak. Occlusion of LSA may be performed safely in this cohort and revascularization reserved for those who have anatomy that compromises perfusion to critical organs.
Multiple duplications of the superficial femoral artery – Case report and review of the literature
Authors: Kim Tanner I , Chaar Cassius Iyad Ochoa , Guzman Raul J , Fischer Uwe M 
Published: July 2020

Objectives Lower extremity arterial anatomic variations are rare, with duplication of the superficial femoral artery being an extremely uncommon variant with few prior reports in the literature. Methods/Results: We report the case of a 68-year-old male with calf claudication who underwent angiography and was found to have two separate areas of vessel duplication along the superficial femoral artery, which has not previously been described in the literature. Conclusion Although uncommon, recognition of a duplicated superficial femoral artery is important to avoid difficulties and complications that may arise during open or endovascular procedures.