bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Drug Resistance in Childhood Tuberculosis in Cape Town, South Africa
Authors: Schaaf H. Simon , Garcia-Prats Anthony J. , Draper Heather R. , Rautenbach Corné , Bosch Corné , Demers Anne-Marie , Hesseling Anneke C. , Walters Elisabetta 
Published: June 2020

Background:
We determined mycobacterial drug resistance and HIV prevalence among children with bacteriologically confirmed tuberculosis (TB) from March 2013 to February 2017. Results were compared with 5 previous 2-year surveillance studies (2003–2013).

Methods:
Prospective surveillance of all bacteriologically confirmed TB in children (0–13 years) completed at Tygerberg Hospital, Cape Town, South Africa. Drug susceptibility testing was done by GenoType MTBDRplus for isoniazid and rifampicin; ofloxacin and amikacin drug susceptibility testing was completed if rifampicin resistance was detected. Xpert MTB/RIF was routinely introduced during this period.

Results:
Six hundred sixty-two children, median age 34 months (interquartile range 14–79) had bacteriologically confirmed TB; 587 (88.7%) were culture-confirmed and 75 (11.3%) confirmed by Xpert MTB/RIF only. Of culture-confirmed cases, 509 (86.7%) were pan-susceptible, 47 (8.0%) were multidrug-resistant, 13 (2.2%) were RIF-resistant/INH-susceptible and 18 (3.1%) were INH-resistant/RIF-susceptible. Of Xpert-positive cases, 3/75 (4%), 68/75 (92%) and 4/75 (5%) were RIF-resistant, RIF-susceptible and RIF-indeterminate, respectively. Of 573 (97.6%) children tested, 74 (12.9%) were HIV positive. Compared with previous surveillance periods, RIF mono-resistance increased from 0% to 2.2% (trend test: χ2 = 7.050, P = 0.0079). HIV prevalence decreased from 29% to 10.6% (trend test: χ2 = 27.975, P < 0.0001). Of multidrug-resistant cases, 15/47 (32%) were ofloxacin resistant.

Conclusions:
The increase in RIF-resistant/INH-susceptible cases and ofloxacin resistance among multidrug-resistant TB cases in children, indicative of recent transmission, is concerning. The prevalence of multidrug-resistant TB remains high in children.
The Conceptual Structure of the Management by Nurses of the Ego Integrity of Residents of Nursing Homes
Authors: LIM Sun-Young , CHANG Sung Ok 
Published: June 2020

ABSTRACT

Background
The number of older people admitted to nursing homes has continued to rise with the recent expansion of the Republic of Korea's long-term care system. Maintaining ego integrity is a major task for older people approaching the end of life. As efforts to maintain ego integrity include the final stages of life, this concept is critically important for older people in nursing homes. This study was designed to assess issues related to ego integrity in the nursing home environment to determine how nurses should play a key role in managing this important life task.

Purpose
The management by nurses of the ego integrity of residents of nursing homes is a new phenomenon that is central to promoting long-term, quality care. This study was designed to clarify and conceptualize this management phenomenon in the context of nursing homes.

Methods
A hybrid model of concept development was used to analyze the ways in which nurses manage the ego integrity of residents of nursing homes. In the theoretical phase, a working definition of the management by nurses of residents' ego integrity is developed using a literature review. In the fieldwork phase, in-depth interviews are conducted with eight nurses from six nursing homes in Seoul and three other provinces. Finally, in the final analytical phase, the theoretical and fieldwork findings are interpreted and compared.

Results
Two components, assessment and intervention, of the approach by nurses to managing the ego integrity of residents of nursing homes were identified. Assessment incorporates 10 attributes in the following three dimensions: “identifying the extent to which residents' basic needs are being fulfilled,” “determining how residents achieve friendly relationships with others,” and “determining how each resident creates a harmonious view of his or her life.” Intervention incorporates nine attributes in the following two dimensions: “helping residents develop a positive view of life” and “helping residents make the best use of their remaining functional abilities.”

Conclusions/Implications for Practice
By managing the ego integrity of residents, nurses have a significant influence on residents' sociopsychological adaptation, especially in the challenging environment of a nursing home. This study supports that managing the ego integrity of residents of nursing homes is an important and practical component of the role played by nurses and of the aid and care they provide. Furthermore, the findings verify the effectiveness of intervention studies in examining assessment tools and developing guidelines for ego-integrity management.
Technical Report: Repeatability of Contrast Sensitivity Test in Children
Authors: Hernández-Andrés Rosa , Luque María Josefa , Serrano Miguel Ángel 
Published: June 2020

SIGNIFICANCEContrast sensitivity (CS) in children is not routinely measured in the clinical setting, although CS losses have been found in amblyopic and premature children. Thus simple visual acuity measurements do not completely assess their quality of vision. To evaluate contrast sensitivity in children, a reliable and easy test, sampling the entire spatial frequency range, is necessary.PURPOSEThis study aimed to evaluate the repeatability and normal range of the contrast sensitivity function measured using the Topcon CC-100 instrument, in children aged between 4 and 9 years, for use as a diagnostic tool.METHODSContrast sensitivity was measured in 25 children, 11 boys and 14 girls, with normal or corrected-to-normal visual acuity, normal binocular function, and stereopsis. Two measurements were performed, 3 months apart, with a Topcon CC-100 device using achromatic sinusoidal gratings of 1.5, 3, 6, 12, and 18 cycles per degree (cpd) with random orientation in a circular window with sharp edges.RESULTSThe normal range in the first visit is wider than in the second. Coefficients of variation are better for the middle-range spatial frequencies (6.6 and 7.8% at 3 and 6 cpd, respectively) and worst at 18 cpd (18.2%), with intermediate values at 1.5 cpd (11.3%) and 12 cpd (13.7%), and better for older than for younger children. No significant sex differences were found (P> .05, Mann-WhitneyUtest).CONCLUSIONSRepeatability measured by the coefficient of variation is better for the middle frequency range (3 and 6 cpd) than for low (1.5 cpd) and high frequencies (12 and 18 cpd). The variability of the differences between the first and second measurements suggests that the participants were not able to maintain a stable response criterion. The test seems to be subject to a learning effect, and the standard normality range may not be adequate for children.
Spectrum of Binocular Vision Anomalies in Keratoconus Subjects
Authors: Dandapani Sushmitha Arcot , Padmanabhan Prema , Hussaindeen Jameel Rizwana 
Published: June 2020

SIGNIFICANCE
Keratoconus (KC) is typically a bilateral asymmetric corneal condition associated with anisometropia. A detailed evaluation of binocular vision function is therefore a critical component of ocular examination in these patients for early detection and treatment of binocular vision anomalies.

PURPOSE
The purposes of this study were to measure the various parameters of binocular vision (BV) in patients with KC and to identify the factors that possibly influence them.

METHODS
This was a prospective, observational study of BV in patients with KC and with best-corrected visual acuity ≤0.4 logMAR in each eye. Age-matched, nonstrabismic normal patients served as controls. Binocular vision examination included motor assessment, accommodation parameters, and fusional vergence.

RESULTS
Binocular vision parameters of 84 KC patients were compared with those of 71 normal controls. The KC group showed statistically significant differences between fellow eyes in refractive cylinder (0.44 ± 2.1 D, P = .03), best-corrected visual acuity (0.06 ± 0.09 logMAR, P = .001), and maximum keratometry (6.64 ± 8.2D, P = .005). The control group showed no significant difference in any refractive or keratometric parameter between fellow eyes. Sixty-six (78.6%) of 84 KC patients had various combinations of BV anomalies: 48.8% had impaired stereopsis, 44% had abnormal fusional vergence, and 39.3% had accommodative infacility. Among individual parameters, all except accommodative amplitudes and negative distance fusional vergence showed statistically significant impairment compared with controls (P < .001). Median (interquartile range) stereoacuity was 70 (50 to 550) arc sec in the KC group and 40 (30 to 50) arc sec in control (P < .0001). There was a statistically significant but weak correlation between stereoacuity and positive fusional vergence for near (P = .008; Spearman coefficient, −0.28) and weak but significant negative correlation between phoria status and negative fusional vergence for near (P = .03; Spearman coefficient, −0.24).

CONCLUSIONS
A large proportion of KC patients have BV anomalies. Assessment of BV function should be included in the clinical examination of all KC patients.
Case Report: Cyclodialysis Cleft in a Case of Open-globe Injury and Role of Swept-source Anterior Segment Optical Coherence Tomography in Diagnosis
Authors: Selvan Harathy , Yadav Suresh , Gupta Viney , Gupta Shikha 
Published: June 2020

ABSTRACT

SIGNIFICANCE
Cyclodialysis clefts can potentially develop secondary to open globe injury. The swept-source anterior segment optical coherence tomography (SS-AS-OCT) may be a valuable diagnostic tool for the identification and estimation of the circumferential extent of cyclodialysis clefts. It could be considered an alternative when ultrasound biomicroscopy cannot be performed successfully.

PURPOSE
The purpose of this study was to report a case of open-globe injury associated with cyclodialysis cleft and the utility of SS-AS-OCT in its diagnosis.

CASE REPORT
A 12-year-old boy presented to the clinic because of penetrating ocular trauma to his left eye with a projectile stone. He was diagnosed with limbal perforation with uveal tissue prolapse and cataract. He underwent limbal repair with cataract extraction and posterior chamber intraocular lens implantation. However, even at the 6 weeks' post-operative period, he did not gain vision and had persistent hypotony with hypotonic maculopathy. Gonioscopy showed a 2-clock-hour superonasal cyclodialysis cleft. However, on SS-AS-OCT, it was discovered that the cleft extended along 5 clock hours, involving both superonasal and inferonasal quadrants. Recognizing the large extent of the cleft, endocyclopexy by modified sewing-machine technique was planned and performed. An IOP spike and improvement in vision were noted on the next post-operative day. The SS-AS-OCT confirmed cleft closure.

CONCLUSIONS
Although rare, cyclodialysis can occur in cases of open globe injury. The SS-AS-OCT is a useful diagnostic tool to study the circumferential extent of cyclodialysis and may unravel detachments hidden behind intact anterior ciliary body face.
Cognitive Impairment among Veterans in Outpatient Vision Rehabilitation
Authors: Whitson Heather E. , Woolson Sandra , Olsen Maren , Massof Robert , Ferguson Stephanie M. , Muir Kelly W. , Dziadul John A. , McConnell Eleanor , Stelmack Joan A. 
Published: June 2020

SIGNIFICANCE
Outpatient vision rehabilitation improves function in veterans with vision impairment, but the prevalence of cognitive impairment and the degree to which it may affect rehabilitation outcomes in the Veterans Affairs system are unknown.

PURPOSE
The purpose of this study was to determine the prevalence of cognitive impairment among veterans receiving outpatient vision rehabilitation in the Veterans Affairs system and compare the benefits of rehabilitation in veterans with and without cognitive impairment.

METHODS
We conducted cognitive assessments and a nested longitudinal cohort study in veterans with eye disorders at two outpatient rehabilitation sites. Cognition was assessed with the Modified Telephone Interview for Cognitive Status administered in person. Eligible veterans and their companions in the longitudinal study responded to questions about the veteran's function at baseline and 90 days later. Visual function was measured with the 48-item Low Vision Visual Function Questionnaire (LV-VFQ-48) and items from the Activity Inventory.

RESULTS
Of 291 veterans assessed (mean ± standard deviation age, 78.2 ± 12 years), 136 (46.7%) were cognitively intact (Modified Telephone Interview for Cognitive Status scores, ≥33), whereas 58 (19.9%) had borderline scores of 30 to 32, 82 (28.2%) had scores suggesting mild/moderate cognitive impairment (scores of 20 to 29), and 15 (5.2%) had scores suggesting severe cognitive impairment (score of <20). After 90 days, mean LV-VFQ-48 reading scores tended to improve in veterans with (n = 21) and without (n = 28) cognitive impairment. The magnitude of self-reported improvement in LV-VFQ-48 scores was greater among cognitively intact, compared with cognitively impaired, veterans (effect size, 0.56 for reading; 0.71 for visual motor). Veterans and companions reported similar 90-day reduction in difficulty with the veterans' top 3 Activity Inventory goals, regardless of cognitive status.

CONCLUSIONS
Approximately one in three veterans referred to outpatient vision rehabilitation has detectable cognitive impairment, yet many still experience functional improvements. Future research should determine best practices to accommodate challenges associated with cognitive impairment in vision rehabilitation and to track clinically meaningful outcomes.
The Effect of Cyclopentolate on Ocular Biometric Components
Authors: Hashemi Hassan , Asharlous Amir , Khabazkhoob Mehdi , Iribarren Rafael , Khosravi Ahmad , Yekta Abbasali , Emamian Mohammad Hassan , Fotouhi Akbar 
Published: June 2020

SIGNIFICANCE
It is apparent that a variety of biometric changes are caused by different types of cycloplegic eye drops. However, these effects are inconsistent and have not been reported in different refractive groups.

PURPOSE
The purpose of this study was to determine the effect of cyclopentolate 1% on ocular biometric components in different types of refractive errors in children.

METHODS
This cross-sectional study was conducted on 226 eyes of 113 schoolchildren in Shahroud, northeast Iran, with a mean ± standard deviation age of 9.20 ± 1.65 years. All participants had noncycloplegic and cycloplegic objective refraction using an autorefractometer. Cycloplegia was induced using cyclopentolate 1% eye drops. Biometric measurements were made with Allegro Biograph (WaveLight AG, Erlangen, Germany) before and after administering cycloplegic drops. Mixed-effect model regression was used to analyze the data.

RESULTS
After cycloplegia, the vitreous chamber depth (VCD) (−0.043; 95% confidence interval [CI], −0.067 to −0.019 mm), lens thickness (−0.146; 95% CI, −0.175 to −0.117 mm), axial length (−0.009; 95% CI, −0.012 to −0.006 mm), and lens power (−0.335; 95% CI, −0.463 to −0.208 D) decreased significantly, whereas the anterior chamber depth (ACD) (0.183; 95% CI, 0.164 to 0.202 mm), anterior segment length (0.036; 95% CI, 0.014 to 0.058) mm), lens central point (0.109; 95% CI, 0.094 to 0.124 mm), and pupil diameter (1.599; 95% CI, 1.482 to 1.716 mm) increased (P value for all tests, <.001). For changes in VCD and ACD, a significant interaction was observed between different types of refractive errors and cycloplegia, such that the adjusted mean change for ACD was significantly lower and for VCD was significantly higher in hyperopes compared with emmetropes. Lens center moves backward in myopes (0.17 mm) and stays the same in hyperopes under cycloplegia.

CONCLUSIONS
According to the findings of this study, cycloplegia reduces the thickness of the crystalline lens and subsequently causes an increase in the ACD. Cycloplegia-related ocular biometric changes were different by type of refractive error.
Impact of Complications After Pancreatoduodenectomy on Mortality, Organ Failure, Hospital Stay, and Readmission
Authors: Smits F. Jasmijn , Verweij Maaike E. , Daamen Lois A. , van Werkhoven C. Henri , Goense Lucas , Besselink Marc G. , Bonsing Bert A. , Busch Olivier R. , van Dam Ronald M. , van Eijck Casper H. J. , Festen Sebastiaan , Koerkamp Bas Groot , van der Harst Erwin , de Hingh Ignace H. , Kazemier Geert , Klaase Joost M. , van der Kolk Marion , Liem Mike , Luyer Misha D. P. , Meerdink Mark , Mieog J. Sven D. , Nieuwenhuijs Vincent B. , Roos Daphne , Schreinemakers Jennifer M. , Stommel Martijn W. , Wit Fennie , Zonderhuis Babs M. , de Meijer Vincent E. , van Santvoort Hjalmar C. , Molenaar I. Quintus 
Published: June 2020

Objective:
To quantify the impact of individual complications on mortality, organ failure, hospital stay, and readmission after pancreatoduodenectomy.

Summary of Background Data:
An initial complication may provoke a sequence of adverse events potentially leading to mortality after pancreatoduodenectomy. This study was conducted to aid prioritization of quality improvement initiatives.

Methods:
Data from consecutive patients undergoing pancreatoduodenectomy (2014–2017) were extracted from the Dutch Pancreatic Cancer Audit. Population attributable fractions (PAF) were calculated for the association of each complication (ie, postoperative pancreatic fistula, postpancreatectomy hemorrhage, bile leakage, delayed gastric emptying, wound infection, and pneumonia) with each unfavorable outcome [ie, in-hospital mortality, organ failure, prolonged hospital stay (>75th percentile), and unplanned readmission), whereas adjusting for confounders and other complications. The PAF represents the proportion of an outcome that could be prevented if a complication would be eliminated completely.

Results:
Overall, 2620 patients were analyzed. In-hospital mortality occurred in 95 patients (3.6%), organ failure in 198 patients (7.6%), and readmission in 427 patients (16.2%). Postoperative pancreatic fistula and postpancreatectomy hemorrhage had the greatest independent impact on mortality [PAF 25.7% (95% CI 13.4–37.9) and 32.8% (21.9–43.8), respectively] and organ failure [PAF 21.8% (95% CI 12.9–30.6) and 22.1% (15.0–29.1), respectively]. Delayed gastric emptying had the greatest independent impact on prolonged hospital stay [PAF 27.6% (95% CI 23.5–31.8)]. The impact of individual complications on unplanned readmission was smaller than 11%.

Conclusion:
Interventions focusing on postoperative pancreatic fistula and postpancreatectomy hemorrhage may have the greatest impact on in-hospital mortality and organ failure. To prevent prolonged hospital stay, initiatives should in addition focus on delayed gastric emptying.
Application of the Muse portable EEG system to aid in rapid diagnosis of stroke
Authors: Wilkinson Cassandra M. , Burrell Jennifer I. , Kuziek Jonathan W. P. , Thirunavukkarasu Sibi , Buck Brian H. , Mathewson Kyle E. 
Published: June 2020

AbstractObjectiveIn this pilot study, we investigated using portable electroencephalography (EEG) as a potential prehospital stroke diagnostic method.MethodsWe used a portable EEG system to record data from 25 participants, 16 had acute ischemic stroke events, and compared the results of age-matched controls that included stroke mimics. Delta/alpha ratio (DAR), (delta+theta)/(alpha+beta) ratio (DBATR) and pairwise-derived Brain Symmetry Index (pdBSI) were investigated, as well as accelerometer and gyroscope trends. We then made classification trees using TreeBagger to distinguish between different subgroups.ResultsDAR and DBATR showed an increase in ischemic stroke patients that correlates with stroke severity (p<0.01, partial η2 = 0.293; p<0.01, partial η2 = 0.234). pdBSI decreased in low frequencies and increased in high frequencies in patients who had a stroke (p<0.05, partial η2 = 0. 177). All quantitative EEG measures were significant between stroke patients and controls. Using classification trees, we were able to distinguish between subgroups of stroke patients and controls.ConclusionsThere are significant differences in DAR, DBATR, and pdBSI between patients with ischemic stroke when compared to controls; results relate to severity.SignificanceWith significant differences between patients with strokes and controls, we have shown the feasibility and utility for the Muse™ EEG system to aid in patient triage and diagnosis as an early detection tool.
Predator morphology affects prey consumption: evidence from an anuran population in subtropical wetlands
Authors: da Silva Camila Maria Mendonça , Dalmolin Diego Anderson , Schuck Laura Kauer , Moser Camila Fernanda , Tozetti Alexandro Marques 
Published: June 2020

AbstractMorphology and diet are key factors in the ecology of organisms, determining aspects of natural history and evolution of the species. In this work, we evaluated the diet-morphology relationship in an anuran population, measuring the influence of morphological traits on the variation in the diet of individuals ofLeptodactylus latrans. For this purpose, we collected individuals from a natural grassland habitat in southern Brazil. We analyzed the stomach content of individuals and consumed food items were classified up to the level of order. We also measured four morphological traits per individual ofL. latrans: snout-vent length, relative limb length, distance between eyes and relative mouth width. We applied Linear Mixed Effect Models to evaluate the relationship of anuran morphological traits, number of prey taxa and volume of consumed prey. We tested the hypothesis that the configuration of predator morphological traits determines both the number of taxa and the volume of consumed prey. Our results indicate that individuals ofL. latranswith larger body size consume a larger volume of prey and mouth width is directly and positively associated with the number of consumed taxa. In the same way that body size seems to define the capacity to ingest a large number of prey items, mouth width could be a limiting factor in prey selection. The capacity to consume a large prey volume could be an advantage in unpredictable environments, especially those with great daily thermal amplitudes such as the subtropical Brazilian grasslands.
Biases in demographic modelling affect our understanding of recent divergence
Authors: Momigliano Paolo , Florin Ann-Britt , Merilä Juha 
Published: June 2020

AbstractTesting among competing demographic models of divergence has become an important component of evolutionary research in model and non-model organisms. However, the effect of unaccounted demographic events on model choice and parameter estimation remains largely unexplored. Using extensive simulations, we demonstrate that under realistic divergence scenarios, failure to account for population size (Ne) changes in daughter and ancestral populations leads to strong biases in divergence time estimates as well as model choice. We illustrate these issues reconstructing the recent demographic history of North Sea and Baltic Sea turbots (Schopthalmus maximus) by testing 16 Isolation with Migration (IM) and 16 Secondary Contact (SC) scenarios, modelling changes inNeas well as the effects of linked selection and barrier loci. Failure to account for changes inNeresulted in selecting SC models with long periods of isolation and divergence times preceding the formation of the Baltic Sea. In contrast, models accounting forNechanges suggest recent (<6 kya) divergence with constant gene flow. We further show how interpreting genomic landscapes of differentiation can help discerning among competing models. For example, in the turbots data islands of differentiation show signatures of recent selective sweeps, rather than old divergence resisting secondary introgression. The results have broad implications for the study of population divergence by high-lighting the potential effects of unmodeleld changes inNeon demographic inference. Tested models should aim at representing realistic divergence scenarios for the target taxa, and extreme caution should always be exercised when interpreting results of demographic modelling.