bluuebunny/crossref_metadata_2025_split huggingface dataset:
Key Radiographic Parameters That Influence the Improvement of Postoperative Gastroesophageal Reflux Disease in Patients Treated Surgically for Adult Spinal Deformity With a Minimum 2-Year Follow-up
Authors: Ohba Tetsuro , Ebata Shigeto , Oba Hiroki , Oda Kotaro , Tanaka Nobuki , Koyama Kenuke , Haro Hirotaka 
Published: February 2020

Study Design.
Retrospective observational study.

Objective.
The study objectives were to: (1) determine radiographically which spinal malalignment parameters predominantly influence the risk of gastroesophageal reflux disease (GERD); (2) evaluate the outcome of GERD 2 years after surgery for adult spinal deformity (ASD); and (3) clarify key factors that influence the improvement of postoperative GERD in ASD.

Summary of Background Data.
Spinal deformity is reported to be involved in the pathology of GERD. Our previous study found that approximately 50% of patients treated surgically for ASD had GERD symptoms. However, the postoperative progress of GERD and the key factors that influence the improvement of postoperative GERD are largely unknown.

Methods.
Ninety-two patients with ASD treated with thoracolumbar corrective surgery and followed up for a minimum of 2 years were enrolled. All patients were asked to complete the Frequency Scale for Symptoms of GERD (FSSG) questionnaire preoperatively and at 1 and 2 years after surgery. GERD was diagnosed by FSSG score more than 8 points. Before, and at 1 and 2 years after surgery, full-length lateral radiographs were taken and radiographic parameters were obtained.

Results.
Patients were classified into two groups based on GERD symptoms, with 47 (51.1%) in the GERD+ group. Among parameters assessed, only thoracolumbar kyphosis (TLK) was significantly greater in the GERD+ group than in the GERD− group. The FSSG score improved significantly 1 year after surgery, but no significant difference was found between groups at 2 years. A significant correction loss of TLK was observed 2 years after surgery. There was a significant highly positive correlation between the FSSG score and TLK at 2 years after surgery.

Conclusion.
GERD improved with correction of the spinal deformity but significant correction loss of the TLK even within the fusion presumably due to subsidence or proximal junctional kyphosis resulted in a cessation of that improvement over time.

Level of Evidence: 3
Parental Use of “Cry Out” in a Community Sample During the First Year of Infant Life
Authors: Giesbrecht Gerald F. , Letourneau Nicole , Campbell Tavis , Hart Martha , Thomas Jenna C. , Tomfohr-Madsen Lianne ,   the APrON Study Team
Published: February 2020

ABSTRACT:

Objective:
The primary objective was to identify the characteristics of parents and infants and parenting practices associated with delayed responsiveness to infant crying during the first year of infant life. A secondary objective was to evaluate, in a subsample of maternal-infant pairs, the associations between delayed responsiveness to infant crying and observational measures of maternal-infant interaction and infant-maternal attachment.

Method:
This is a secondary analysis of the data from a community sample of pregnant women recruited to the Alberta Pregnancy Outcomes and Nutrition study. Mothers completed questionnaires during the first year of infant life (n = 1826), and a convenience subsample of maternal-infant pairs (n = 137) participated in laboratory assessments of maternal-infant interaction at 6 months of age and infant-maternal attachment at 20 months.

Results:
Parental use of “cry out” as a strategy to deal with a crying infant was associated with parental characteristics (being white and having a relatively higher income), infant characteristics (higher problematic behavior at 3 months and reduced problematic behavior at 12 months), sleep ecology (infants sleeping alone), and parental soothing strategies (less frequently taking the infant into the parent's bed, cuddling, or carrying the crying infant). Cry out was not associated with observational measures of maternal sensitivity or infant-maternal attachment.

Conclusion:
When used selectively and in response to the specific needs and characteristics of the infant, delayed responsiveness may reduce problematic behavior and does not harm the infant's socioemotional development.
Single-stage Composite Skin Reconstruction Using a Dermal Regeneration Template
Authors: Rudnicki Pamela A. , Purt Boonyapa , True Daniel , Siordia Hector , Lohmeier Steven , Chan Rodney K. 
Published: February 2020

Background:
Composite reconstruction with a dermal substitute followed by skin graft is sometimes used for reconstructing high-quality skin while preserving donor sites. This often necessitates 2 separate procedures, additional general anesthetic, and longer hospitalization. Concurrent use of dermal substitutes and skin graft in a single stage has been previously reported in small series. Here, we report our experience with single-stage skin reconstruction with Integra and split-thickness skin graft for coverage of wounds post burn eschar excision and post burn scar contracture release.

Methods:
This is a retrospective review of consecutive operations from 2013 to 2017 in which single-stage bilayer reconstruction (SSBR) was performed. Data were obtained from electronic medical records and perioperative photographs.

Results:
In this 5-year period, 13 surgical sites were identified in which SSBR was used in 8 subjects. Average and median graft take was 86.2% and 95%, respectively. Graft take was over 90% in 10 out of 13 cases. One case required regrafting after initial graft failure.

Conclusions:
In the appropriate setting, SSBR is a practical technique in covering wounds post burn eschar excision and post burn scar contracture release resulting in reasonable graft take. Use of noncontaminated wound beds is crucial. Although there is risk of regrafting, it is not clear whether this risk is any higher than in split-thickness skin grafting alone. This study was unable to evaluate contribution of dermal substitute to contraction, function, and mobility, nor how hypothesized improvement of skin quality compares to the original thick dermal substitute. We recommend further investigation.
Associations Between Systemic Omega-3 Fatty Acid Levels With Moderate-to-Severe Dry Eye Disease Signs and Symptoms at Baseline in the Dry Eye Assessment and Management Study
Authors: Kuklinski Eric J. , Hom Milton M. , Ying Gui-Shuang , Lin Meng C. , Chapkin Robert S. , Jones Richard , Moser Ann , Kim Ka Yeun , Maguire Maureen G. , Asbell Penny A. ,   the DREAM Study Research Group
Published: February 2020

Purpose:
Omega-3 (n-3) fatty acid supplementation is used to treat systemic inflammatory diseases, but the role of n-3 in the pathophysiology and therapy of dry eye disease (DED) is not definitive. We evaluated the relationship of systemic n-3 levels with signs and symptoms at baseline in the Dry Eye Assessment and Management (DREAM) Study.

Methods:
Blood samples from participants at baseline were analyzed for n-3 and n-6, measured as relative percentage by weight among all fatty acids in erythrocytes. Symptoms were evaluated using the Ocular Surface Disease Index. Signs including conjunctival staining, corneal staining, tear breakup time (TBUT), and Schirmer's test with anesthesia were also evaluated.

Results:
There was no correlation between the systemic n-3 levels and DED symptoms. When the associations with signs of DED were assessed, lower DHA levels were associated with higher conjunctival staining, with mean scores of 3.31, 2.96, and 2.82 for low, medium, and high levels of DHA, respectively (linear trend P=0.007). None of the other signs were associated with DHA or the other measures of n-3.

Conclusion:
Previous studies have found varying results on the role of n-3 supplementation with the signs and symptoms of DED. Among patients with DED enrolled in the DREAM Study, lower systemic n-3 levels were not associated with worse symptoms and most signs of DED.
Laser-induced Damage to Disposable Single-mirror Trabeculoplasty Lens During Selective Laser Trabeculoplasty
Authors: Mukhtar Sabrina , Shazly Tarek A. 
Published: February 2020

Purpose:
To demonstrate disposable trabeculoplasty lens damage after routine selective laser trabeculoplasty (SLT) for primary open-angle glaucoma.

Methods:
Disposable single-mirror laser lenses were used to perform SLT in 2 patients with primary open-angle glaucoma. Images of the single-use mirrors were taken before and after treatment.

Results:
One lens showed heavy focal loss of reflectivity of its mirror with SLT settings of 0.8 to 0.9 mJ × 97 shots on a patient with a lightly pigmented angle. Aiming beam splashing or loss was noted after most shots. The second lens showed much less damage with 0.6 mJ × 90 shots in a heavily pigmented angle.

Conclusion:
Although single-use Gonio lenses have gained popularity for their role in infection control and elimination of wear and tear of reusable lenses, our cases show that damage occurs to the silver mirror because of high laser fluence, interfering with proper aiming and possibly diminishing delivered energy and treatment efficacy.
What is Number of Days in Number of Times? Associations Between, and Responsiveness of, Two Sickness Presenteeism Measures
Authors: Aboagye Emmanuel , Gustafsson Klas , Jensen Irene , Hagberg Jan , Aronsson Gunnar , Marklund Staffan , Leineweber Constanze , Bergström Gunnar 
Published: February 2020

Objective:
To examine the associations between sickness presenteeism (SP) reported as number of days with SP reported as number of times and to evaluate their responsiveness.

Methods:
The study population (n = 454) consisted of employed individuals, at risk of long-term sickness absence. Correlation analyses were performed to examine associations between the two SP measures and external constructs such as work performance, general health, and registered sick leave. Both SP constructs were measured several times to examine responsiveness.

Results:
The SP measures are moderately correlated. They moderately correlated with work performance and health status measures. SP reported as number of times seems to be more sensitive than number of days in detecting changes after rehabilitation.

Conclusions:
Numerical or categorical constructs are valid sources of data on SP. However, categorized SP seems to be more responsive.
Electronic primary care to specialist referral: A pilot project to evaluate referral expedience and efficacy
Authors: Olson Ernestine , Fruh Sharon , Kleinpell Ruth 
Published: February 2020

ABSTRACT

Background:
Delayed referrals to specialists often result in increased morbidity and mortality.

Local problem:
A time delay in specialist care access of over 1 month identified a gap in efficient care provision in a rural south central United States outreach clinic within a multispecialty group affiliated with a hospital system.

Methods:
A pilot project with a mixed-methods design that compared the established referral process with direct primary provider referral to a specialist's electronic medical record (EMR) schedule. Authors conducted the study over 16 weeks using a convenience sample size of 74 patients.

Interventions:
Direct primary care nurse practitioner provider to specialist EMR schedule referral based on specialty referral needs.

Results:
All electronically referred patients were seen by specialists in less than 1 month.

Conclusions:
All electronic specialist referrals were completed more expediently than those referred by the standard process and patients reported an efficient and satisfactory process.
Clinical Profiles of DFNA11 at Diverse Stages of Development and Aging in a Large Family Identified by Linkage Analysis
Authors: Yamamoto Nobuko , Mutai Hideki , Namba Kazunori , Goto Fumiyuki , Ogawa Kaoru , Matsunaga Tatsuo 
Published: February 2020

Hypothesis:
The phenotype of DFNA11 consists of specific features at diverse developmental and age stages.

Background:
Only eight mutations have been identified for autosomal dominant non-syndromic hearing loss related to MYO7A (DFNA11), and the onset and progression of DFNA11 are poorly understood.

Methods:
After linkage analysis and following Sanger sequencing in a family suspected to have autosomal dominant hereditary hearing loss, we analyzed the audiometric and vestibular functions and their long-term changes in the subjects carrying the variant.

Results:
A reported variant of uncertain significance, NP_000251.3:p.Arg853His, in MYO7A was detected and cosegregation data of this large family provided evidence that the variant was likely pathogenic for DFNA11. Family members with the variant had no other symptoms associated with hearing loss and were confirmed to have autosomal dominant non-syndromic sensorineural hearing loss. Audiograms tended to show gently sloping configuration in childhood and flat configuration after the age of 30 years. Hearing loss at high frequencies progressed slowly, while hearing at low frequencies started to deteriorate later but progressed more rapidly. Some subjects showed partly abnormal results in the distortion products of otoacoustic emissions before the elevation of hearing thresholds. Vestibular function was within the normal range in all the subjects tested.

Conclusion:
We revealed that hearing loss at high frequencies was mainly noted in early developmental stages and that thresholds increased more rapidly in the low frequency range, resulting in changes in audiometric configuration. Deterioration of distortion product otoacoustic emissions (DPOAE) before the elevation of hearing thresholds was considered as a clinical feature of DFNA11.
Hepatic manifestations of cystic fibrosis
Authors: Dana Jeremy , Girard Muriel , Debray Dominique 
Published: February 2020

Purpose of review
Liver disease in cystic fibrosis (CF) usually develops before puberty, is often asymptomatic and slowly progressive. Multilobular cirrhosis develops in approximately 5–10% of patients by the age of 18, and is a significant contributor to the morbidity and mortality. No therapy, including ursodeoxycholic acid and cystic fibrosis transmembrane conductance regulator correctors or potentiators, has proven effective to prevent or halt the progression of liver disease towards cirrhosis and portal hypertension. This review provides the current knowledge in the epidemiology of CF liver disease and development of noninvasive tools to assess liver disease severity and progression overtime in order to optimize clinical management and therapeutic options.

Recent findings
Liver disease not only develops during childhood but also later in the lifetime of patients with CF; the incidence of cirrhosis with portal hypertension increases progressively reaching 10% by age 30. Several noninvasive tools to measure liver stiffness as an indirect measure of fibrosis are being investigated, and show promising results for the assessment of early stages of liver fibrosis and disease progression.

Summary
Identifying noninvasive biomarkers is fundamental to improving early diagnosis, monitoring disease evolution and measuring treatment effects. A prerequisite is the use of consistent definitions for CF- liver disease (LD) in clinical trials.
New systemic agents for hepatocellular carcinoma: an update 2020
Authors: von Felden Johann 
Published: February 2020

Purpose of review
Despite major therapeutic improvements in most cancer entities, hepatocellular carcinoma (HCC) has remained a dismal disease. In fact, incidence and mortality are increasing in many parts of the world, including the United States. Given that a number of systemic agents has recently been tested positive in phase 3 clinical trials, the objective of this review is to summarize the current treatment landscape for advanced HCC.

Recent findings
Following the positive SHARP trial in 2008, sorafenib has been the only systemic agent for advanced HCC for almost a decade. However, in first line, lenvatinib was tested noninferior to sorafenib, and most recently, the combination of atezolizumab with bevacizumab was tested superior to sorafenib. In second line, regorafenib, cabozantinib, and ramucirumab (the latter for patients with AFP ≥400 ng/ml) have shown prolonged overall survival compared with placebo.

Summary
Systemic treatment options for advanced HCC have substantially increased over the past years. The combination of atezolizumab and bevacizumab will likely become the new standard of care as it is the first treatment to report improved overall survival compared with sorafenib and the first, and so far only, positive phase 3 clinical trial for an immune-checkpoint inhibitor-containing regimen in advanced HCC.
Comparison of International Growth Standards for Assessing Nutritional Status in Cystic Fibrosis
Authors: Poulimeneas Dimitrios , Grammatikopoulou Maria G. , Petrocheilou Argyri , Kaditis Athanasios G. , Troupi Evgenia , Doudounakis Stavros E. , Laggas Dimitrios , Vassilakou Tonia 
Published: February 2020

ABSTRACTObjective:The aim of the study was to compare 3 international growth references and explore their differences in assessing growth in Greek school‐aged patients with cystic fibrosis (CF).Methods:Sample included 114 patients (50 boys, age 11.5 ± 3.9 years), provided care at Aghia Sofia Children's Hospital, Greece. Anthropometrics and predicted forced expiratory volume in 1 second (FEV1%) were measured. Body mass index (BMI) and height z scores were computed according to the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and International Obesity Task Force (IOTF) references. Agreement between methods was analyzed with kappa statistics, repeated‐measures analysis of variance, and Bland‐Altman analysis. The relationship between FEV1% and BMI was explored with linear regression.Results:Mean CDC BMI z score was the lowest (0.06 ± 1.08), followed by WHO (0.17 ± 1.14) and IOTF (0.35 ± 1.05) (P ≤ 0.001 for all). The CDC and WHO growth references highly agreed for most weight status strata and stunting; all other comparisons produced lower agreements. Except for CDC and IOTF BMI z scores, all other comparisons produced wide levels of agreement and proportional bias. CDC reference classified more children as attaining low or normal weight, against WHO or IOTF (P ≤ 0.001 for all). Lowest prevalence of ideal and excess weight was recorded by CDC, compared to all other standards (P ≤ 0.001 for all). All BMI z scores provided moderate associations with FEV1%.Conclusion:Large variations across weight status classification were present when employing 3 growth standards in school‐aged patients . Given than BMI z‐scores from all references provided comparable associations with pulmonary function, our data indicate that no studied reference is better than others in assessing growth in CF.
Nosocomial Infection Following Severe Traumatic Injury in Children
Authors: Sribnick Eric A. , Hensley Josey , Moore-Clingenpeel Melissa , Muszynski Jennifer A. , Thakkar Rajan K. , Hall Mark W. 
Published: February 2020

Objectives:
Nosocomial infection is a common source of morbidity in critically injured children including those with traumatic brain injury. Risk factors for nosocomial infection in this population, however, are poorly understood. We hypothesized that critically ill pediatric trauma patients with traumatic brain injury would demonstrate higher rates of nosocomial infection than those without traumatic brain injury.

Design:
Retrospective case-control study.

Setting:
PICU, single institution.

Patients:
Patients under 18 years old who were admitted to the PICU for at least 48 hours following a traumatic injury were included. Patients were admitted between September 2008 and December 2015. Patients with the following injury types were excluded: thermal injury, drowning, hanging/strangulation, acute hypoxic ischemic encephalopathy, or nonaccidental trauma. Data collected included demographics, injury information, hospital and PICU length of stay, vital signs, laboratory data, insertion and removal dates for invasive devices, surgeries performed, transfusions of blood products, and microbiology culture results. Initial Pediatric Risk of Mortality III and Pediatric Logistic Organ Dysfunction-2 scores were determined. Patients were classified as having: 1) an isolated traumatic brain injury, 2) a traumatic injury without traumatic brain injury, or 3) polytrauma with traumatic brain injury.

Interventions:
None.

Measurements and Main Results:
Two hundred three patients were included in the analyses, and 27 patients developed a nosocomial infection. Patients with polytrauma with traumatic brain injury demonstrated a significantly higher infection rate (30%) than patients with isolated traumatic brain injury (6%) or traumatic injury without traumatic brain injury (9%) (p < 0.001). This increased rate of nosocomial infection was noted on univariate analysis, on multivariable analysis, and after adjusting for other risk factors.

Conclusions:
In this single-center, retrospective analysis of critically ill pediatric trauma patients, nosocomial infections were more frequently observed in patients admitted following polytrauma with traumatic brain injury than in patients with isolated traumatic brain injury or trauma without traumatic brain injury.
Impact of Personal Protective Equipment on the Performance of Emergency Pediatric Tasks
Authors: Adler Mark D. , Krug Steven , Eiger Carmel , Good Grace L. , Kou Maybelle , Nash Mark , Henretig Fred M. , Hornik Christoph P. , Gosnell Leigh , Chen Jia-Yuh , Debski Julie , Sharma Gaurav , Siegel David , Donoghue Aaron J. ,   on behalf of the Best Pharmaceuticals for Children Act–Pediatric Trials Network
Published: February 2020

Objectives
Personal protective equipment (PPE) is worn by health care providers (HCPs) to protect against hazardous exposures. Studies of HCPs performing critical resuscitation tasks in PPE have yielded mixed results and have not evaluated performance in care of children. We evaluated the impacts of PPE on timeliness or success of emergency procedures performed by pediatric HCPs.

Methods
This prospective study was conducted at 2 tertiary children's hospitals. For session 1, HCPs (medical doctors and registered nurses) wore normal attire; for session 2, they wore full-shroud PPE garb with 2 glove types: Ebola level or chemical. During each session, they performed clinical tasks on a patient simulator: intubation, bag-valve mask ventilation, venous catheter (IV) placement, push-pull fluid bolus, and defibrillation. Differences in completion time per task were compared.

Results
There were no significant differences in medical doctor completion time across sessions. For registered nurses, there was a significant difference between baseline and PPE sessions for both defibrillation and IV placement tasks. Registered nurses were faster to defibrillate in Ebola PPE and slower when wearing chemical PPE (median difference, −3.5 vs 2 seconds, respectively; P < 0.01). Registered nurse IV placement took longer in Ebola and chemical PPE (5.5 vs 42 seconds, respectively; P < 0.01). After the PPE session, participants were significantly less likely to indicate that full-body PPE interfered with procedures, was claustrophobic, or slowed them down.

Conclusions
Personal protective equipment did not affect procedure timeliness or success on a simulated child, with the exception of IV placement. Further study is needed to investigate PPE's impact on procedures performed in a clinical care context.