bluuebunny/crossref_metadata_2025_split huggingface dataset:
COT-22 TIMING OF SURGERY AND BEVACIZUMAB THERAPY FOR MALIGNANT GLIOMAS
Authors: Matsubara Toshio , Mouri Genshin , Ishigaki Tomoki , Ikezawa Munenari , Suzuki Hidenori 
Published: December 2019

Abstract

BACKGROUND
The drug manufacturer recommends postponing initiation of bevacizumab for malignant gliomas at least 4 weeks later postoperatively. Malignant glioma patients with significant neurological deficits due to postoperative residual tumors are preferably needed earlier bevacizumab therapy that expecting improvement of neurological state and brain edema. There is a literature review indicating that the timing for administration of postoperative bevacizumab was at least 2 weeks. The authors assessed the safety,tolerability,efficacy for bevacizumab therapy less than 4 weeks later postoperatively.

METHODS
Six patients of malignant gliomas with residual tumors and neurological deficits were treated by bevacizumab (10mg /kg every 2 weeks) therapy 2–3 weeks later postoperatively with chemoradiotherapy. Patients included 31-year-old female with thalamic-midbrain glioblastoma (initial),11-year-old female with anaplastic ependymoma (recurrent),71-year-old female with initial cervical cord anaplastic astrocytoma (initial),88-year-old female bilateral frontal glioblastoma (initial),27-year-old female with thalamic midbrain glioblastoma (initial) and 3-year-old female with brain stem glioblastoma (initial).

RESULTS
All the patients did not experienced hemorrhage and impair wound healing. Every patient neurological state and perifocal brain edema following bevacizumab therapy demonstrated early improvement. Earlier bevacizumab therapy did not delay and cease postoperative chemoradiotherapy.

CONCLUSIONS
Initiation of bevacizumab therapy 2–3 weeks later postoperatively seems to be safe and effective for malignant glioma patients with worse neurological state due to residual tumor and perifocal edema. The optimal interval which balances the risk of complications and the risk of tumor progression should be considered.
Integrating an Adapted, Low-Intensity Program to Promote Early Childhood Development in Routine Health Visits in Rural India: A Feasibility Study
Authors: Shah Reshma , Gustafson Erika , Dhaded Sangappa , Herekar Veena , Metgud Deepa , Mastiholi Spoorthi , Kim Hajwa , Goudar Shivaprasad , Atkins Marc 
Published: December 2019

ABSTRACT:

Objective:
More than 200 million children younger than the age of 5 years fail to reach their full developmental potential in low- and middle-income countries (LMICs). The purpose of this study was to describe the feasibility of integrating a brief program to promote early childhood development within a health care setting serving a predominantly rural population in India.

Methods:
We conducted a prospective, noncomparative, mixed-methods study. An adapted parent-directed program was administered to caregivers of 2- to 6-month-old children while waiting for their health care provider. Caregivers completed baseline and 4-week follow-up surveys. Thematic analyses and generalized equation estimates were used for analyses in the following feasibility indicators: acceptability, demand, implementation and practicality, and limited efficacy testing.

Results:
Forty-seven caregivers were recruited; most were women (98%) and had equal to or less than 12 years of schooling (61%). Forty-six of 47 participants completed the follow-up at 1 month. Three administrators were trained to deliver the program over the course of 2 days. Caregivers perceived a need for the program and found the content and structure of the program useful. However, there were important suggestions for improvement, including greater visual content and dissemination to nonparental caregivers and fathers. Significant increases were seen on self-reported parenting behaviors regarding a child's caregiving environment.

Conclusion:
Our findings support the feasibility of integrating an adapted, low-intensity program in a primary care setting in India, but important adaptations and considerations will need to be addressed before effectiveness testing on a wider scale. We discussed implications for offering sustainable population-level interventions to promote early childhood development in LMICs.
Maximizing Panfacial Aesthetic Outcomes: Findings and Recommendations From the HARMONY Study
Authors: Kaminer Michael S. , Cohen Joel L. , Shamban Ava , Werschler William Philip , Shumate Garrett T. , Drinkwater Adrienne , Gallagher Conor J. 
Published: December 2019

BACKGROUND
Aesthetic medicine has evolved from targeting individual treatment areas to a global approach of panfacial rejuvenation. HARMONY was the first clinical study to systematically demonstrate positive physical and psychosocial impacts of panfacial treatment.

OBJECTIVE
Provide evidence-based guidance on treatment strategies to help maximize outcomes in patients seeking panfacial rejuvenation.

MATERIALS AND METHODS
Study sites with the lowest (n = 2) and highest (n = 2) improvements based on FACE-Q Satisfaction with Face Overall scores were analyzed to understand differences in treatment strategy that may contribute to incrementally greater patient satisfaction.

RESULTS
The highest scoring sites exhibited greater improvement in all patient-reported outcomes and investigator-assessed measures related to dermal filler treatment compared with the lowest scoring sites. The highest sites favored lateral malar augmentation and used less volume medially versus the lowest sites. In the lower face, the highest sites used greater volumes and more HYC-24L than HYC-24L+. Initial treatment volumes were more conservative at highest than lowest sites; greater volumes were used by highest sites in touch-up treatments.

CONCLUSION
Product usage trends common to the highest scoring sites (including injection volume, injection sites, and product selection) may provide guidance on best practices for a panfacial approach to aesthetic treatment to maximize patient satisfaction.
Atrial fibrillation as presenting sign of primary aldosteronism: results of the Prospective Appraisal on the Prevalence of Primary Aldosteronism in Hypertensive (PAPPHY) Study
Authors: Seccia Teresa M. , Letizia Claudio , Muiesan Maria L. , Lerco Silvia , Cesari Maurizio , Bisogni Valeria , Petramala Luigi , Maiolino Giuseppe , Volpin Roberta , Rossi Gian Paolo 
Published: December 2019

Background:
Despite hyperaldosteronism being suggested as predisposing to arrhythmias, the relationship between atrial fibrillation and primary aldosteronism remains uncertain. Therefore, we tested the hypothesis that atrial fibrillation is a presentation of primary aldosteronism in hypertensive patients with unexplained atrial fibrillation.

Design and methods:
The Prospective Appraisal on the Prevalence of Primary Aldosteronism in Hypertensive (PAPPHY) Study recruited consecutive patients with atrial fibrillation and an unambiguous diagnosis of arterial hypertension at three referral centers for hypertension.

Results:
In a cohort entailing 411 atrial fibrillation patients, we identified 18% (age 61 ± 11 years; 32% women), who showed no known cause of the arrhythmia. A thorough diagnostic work-up allowed us to identify primary aldosteronism in 73 of these patients, i.e. 42% [95% confidence interval (CI) 31.8–53.9]. Subtyping of primary aldosteronism demonstrated that surgically curable forms of primary aldosteronism accounted for 48% of the cases (95% CI 31.9–65.2). The high prevalence of primary aldosteronism was confirmed at sensitivity analyses.

Conclusion:
These results provided compelling evidence that primary aldosteronism is highly prevalent in hypertensive patients with unexplained atrial fibrillation. Accordingly, they suggest that patients with no identifiable cause of the arrhythmia should be screened for primary aldosteronism to identify those who can be cured or markedly improved with target treatment.

Clinical Trial Registration: :

https://clinicaltrials.gov, Identifier: NCT01267747.
Regulatory T-cell subset distribution in children with primary hypertension is associated with hypertension severity and hypertensive target organ damage
Authors: Gackowska Lidia , Michalkiewicz Jacek , Helmin-Basa Anna , Klosowski Maciej , Niemirska Anna , Obrycki Lukasz , Kubiszewska Izabela , Wierzbicka Aldona , Litwin Mieczyslaw 
Published: December 2019

Background:
The relationship between circulating regulatory T-cell (Tregs) subset distribution and hypertension severity in children with primary hypertension is not known. We aimed to find out if target organ damage (TOD) in children with primary hypertension is related to defects in Tregs distribution reflected by their phenotype characteristics.

Methods:
The study constituted 33 nontreated hypertensive children and 35 sex-matched and age-matched controls. Using multicolor flow cytometry technique, we assessed a distribution of the total Tregs (CD4+CD25highCD127low/−) and their subsets (CD45RA+-naive Tregs, CD45RA− memory/activated Tregs, CD45RA+CD31+ recent thymic emigrants Tregs and mature naive CD45RA+CD31− Tregs) in the whole blood.

Results:
Hypertensive children showed decreased percentage of the total Tregs, the CD45RA+-naive Tregs, the total CD31+ Tregs and the recent thymic emigrants Tregs but elevation of the CD45RA− memory/activated Treg and mature naive CD45RA+CD31− Tregs. Decreased frequency of the total Tregs, naive Tregs and CD31+-bearing Treg cell subsets (CD31+ total Tregs, CD45RA+CD31+ recent thymic emigrants Tregs) negatively correlated to TOD markers, arterial stiffness and blood pressure elevation. In contrast, increased percentage of memory Tregs and CD31− Tregs subsets positively correlated to organ damage markers, arterial stiffness and blood pressure values. These changes were independent of BMI, age, sex and hsCRP.

Conclusion:
Both diagnosis of hypertension, TOD and arterial stiffness in hypertensive children were associated with decreased population of total CD4+ Tregs, limited output of recent thymic emigrants Tregs, and increased pool of activated/memory Tregs. Hypertension was an independent predictor of the circulating Treg subsets distribution irrespective of hsCRP.
ROBOT-ASSISTED VITREORETINAL SURGERY IMPROVES SURGICAL ACCURACY COMPARED WITH MANUAL SURGERY
Authors: Forslund Jacobsen Mads , Konge Lars , Alberti Mark , la Cour Morten , Park Yoon Soo , Thomsen Ann Sofia Skou 
Published: December 2019

Purpose:
To compare manual and robot-assisted vitreoretinal surgery using a virtual-reality surgical simulator.

Methods:
Randomized controlled crossover study. Ten experienced vitreoretinal surgeons and 10 novice ophthalmic surgeons were included. The participants were randomized to start with either manual or robot-assisted surgery. Participants completed a test session consisting of three vitreoretinal modules on the Eyesi virtual-reality simulator. The automated metrics of performance supplied by the Eyesi simulator were used as outcome measures. Primary outcome measures were time with instruments inserted (seconds), instrument movement (mm), and tissue treatment (mm2).

Results:
Robot-assisted surgery was slower than manual surgery for both novices and vitreoretinal surgeons, 0.24 SD units (P = 0.024) and 0.73 SD units (P < 0.001), respectively. Robot-assisted surgery allowed for greater precision in novices and vitreoretinal surgeons, −0.96 SD units (P < 0.001) and −0.47 SD units (P < 0.001), respectively. Finally, novices using robot-assisted surgery inflicted less tissue damage when compared with that using manual surgery, −0.59 SD units (P = 0.009).

Conclusion:
At the cost of time, robot-assisted vitreoretinal surgery seems to improve precision and limit tissue damage compared with that of manual surgery. In particular, the performance of novice surgeons is enhanced with robot-assisted vitreoretinal surgery.
Force Myography across Socket Material
Authors: Curcio Brittney C. , Cirillo Nicholas V. , Wininger Michael 
Published: December 2019

ABSTRACT

Introduction
Force myography (FMG) sensors were tested for responsiveness in application to prosthetic detection when the skin's surface is obscured by socket lining materials.

Materials and Methods
FMG data were collected from 30 healthy volunteers performing repeated tasks with the upper limb (fist clench, wrist flexion) while wearing a one-ply stockinet (“Sock”), a gel prosthetic liner (“Gel”), and without material (“Null”; comparator control). Two sensors recorded activity of the flexor digitorum profundus: one sensor making contact with the skin (“Near” sensor) and the other sensor placed immediately on top of the material (“Far” sensor). In the null condition, the sensors rested on top of one another.

Results
The signal from the Near sensor was 20% to 40% more intense than that of the Far sensor; however, the waveform shape was highly concordant (ρ > 0.985 in all conditions), capturing many of the same nuances in muscle shape change. Exploratory analysis of grasp classification revealed a less than 5% false-positive rate in recognition of grasp activity.

Conclusions
We conclude that FMG shows promise as an approach for prosthetic detection in a wider variety of settings than previously thought.
Adherence to Global Initiative for Chronic Obstructive Lung Disease guidelines in the real world: current understanding, barriers, and solutions
Authors: Albitar Hasan Ahmad Hasan , Iyer Vivek N. 
Published: December 2019

Purpose of review
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) provides a comprehensive review and guidance for clinicians managing patients with chronic obstructive pulmonary disease (COPD). However, adherence to GOLD guidelines has been suboptimal over the years. The current review summarizes the current body of literature addressing the multitude of reasons for the lack of adherence to GOLD guidelines in clinical practice.

Recent findings
There continue to be several reasons for suboptimal adoption of GOLD guidelines in clinical practice. A primary and recurrent theme appears to be both delayed as well as missed diagnosis of COPD. There are several reasons for this including lack of awareness about current COPD guidelines, lack of availability as well as utilization of office spirometry and improper symptom assessment. Other issues include improper selection of proper pharmacotherapy options, misdiagnosis/mislabeling of COPD phenotypes, lack of smoking cessation counselling as well as enrollment in pulmonary rehabilitation. Potential solutions include adoption of clinical decision support systems, self-care models and careful phenotyping of COPD patients.

Summary
There are currently several barriers for the adoption of GOLD guidelines into routine clinical practice. These barriers are all amenable to systematic solutions that will increase adherence to current GOLD guidelines.
Therapeutic Advances in the Management of Smoldering Myeloma
Authors: Khan Rafiullah , Zahid Umar , Kollu Vidya , Jahan Nusrat , Ali McBride , Tricot Guido , Anwer Faiz 
Published: December 2019

Background:
The International Myeloma Working Group has defined smoldering multiple myeloma (SMM) as the presence of 10%–60% plasma cells in the bone marrow and M-protein (IgG, IgA) ≥3 g/dL without end-organ damage (an increased calcium level, renal failure, anemia, and destructive bone lesions).

Areas of Uncertainty:
Patients considered to have SMM should not have any myeloma-defining events or amyloidosis. Different risks factors classify SMM into low-, intermediate-, or high-risk categories. The rate of progression from SMM to symptomatic myeloma is ∼10% per year during the first 5 years of diagnosis. SMM requires frequent follow-up ∼every 3 months during the first 5 years as compared to monoclonal gammopathy of undermined significance, which usually requires follow-up every 6–12 months after the first year of diagnosis.

Data Sources:
A literature search was performed from electronic bibliographic databases: MEDLINE (Ovid SP/PubMed), EMBASE, the Cochrane Library (Cochrane Database of Systematic Reviews), and Cochrane Central Register of Controlled Trials and from annual meeting abstracts from inception to May 2017.

Therapeutic Advances:
This review presents the literature and available data that support or do not support early treatment of high-risk SMM (HR-SMM) and provides evidence-based recommendations for management of SMM patients. Despite emerging data recommending early treatment of HR-SMM, we predict the SMM category may disappear in the near future and patients will be diagnosed with either multiple myeloma or monoclonal gammopathy of undermined significance.

Conclusions:
Success with early therapy trials for HR-SMM is largely due to patients meeting current criteria for multiple myeloma that may have been classified as SMM and, therefore, benefitted from therapy. Based on current practices and the literature, SMM should be managed with close follow-up. Based on available data, we suggest SMM to only be treated in clinical trial settings.
A Prospective, Randomized Cross‐over Trial of 2 Low‐profile Gastrostomy Buttons to Determine Family Preference
Authors: Abdelhadi Ruba A. , Dekonenko Charlene , Dorman Robert M. , Oyetunji Tolulope A. , St. Peter Shawn D. 
Published: December 2019

ABSTRACTLow‐profile gastrostomy balloon buttons are often used in the pediatric population. We conducted a prospective, randomized crossover trial to determine family preference comparing MIC‐KEY (tube A) and MiniONE (tube B) buttons. Patients were randomized to tube A and tube B at placement. At 2 months, patients were given the opposite button. At 4 months, parents indicated their preferred button. A standardized assessment tool was used to assess gastrostomy site skin complications and device malfunction. One hundred fifty‐eight patients were randomized, 79 each to receive tube A or tube B first. Sixty‐eight with tube A and 60 with tube B completed their first follow‐up. Sixty‐five with tube A and 43 with tube B completed crossover, 69% of whom preferred tube B (P < 0.001). Including those who preferred their first button and declined to switch at 2 months, 91 of 127 (72%) kept tube B, demonstrating a strong preference for tube B.
Auditory Verbal Hallucinations in Psychosis
Authors: Mitropoulos George B. 
Published: December 2019

Abstract
Auditory verbal hallucinations (AVHs) are considered as hallmark symptoms of psychosis, more specifically of schizophrenia. A substantial body of evidence indicates that AVHs can be attributed to a disorganization of overall speech capacity in psychotic subjects. AVHs are associated with activation of cortical areas of the brain that are related to speech production and perception; “voices” in deaf patients seem to be about the message rather than the sound of it; the content of AVHs is often related to that of delusional ideas; the internal or external location of AVHs makes little diagnostic difference; AVHs are often related to the patient's subvocal speech, having identical content with that, and they have been theorized as a misattribution of inner speech (i.e., the patient's own thoughts) to external sources. The aforementioned evidence comes close to certain long-standing insights mainly of the French psychiatric (de Clérambault) and psychoanalytical (Lacan) school, according to which, 1) the outside world is perceived through normal language function, 2) a language disorder is central to schizophrenic phenomena, and 3) AVHs represent a fragmentation and autonomization of speech (thought) function in schizophrenic patients (de Clérambault: “hallucinations think”). Today, several authors agree that 1) operationalized definitions have led to an oversimplification of psychopathology, and 2) a more theoretically informed understanding and an integration of different levels of explanation of psychotic phenomena is needed. Thus, psychotic AVHs should be investigated beyond their narrow classification as disordered perceptions, in the wider context of formal thought disorder and disordered language capacity.
Psychometric Properties of an Indian Translation of the Vision-related Activity Limitation Item Bank in Cataract
Authors: Gothwal Vijaya K. , Muthineni Vani V. , Khadka Jyoti , Lamoureux Ecosse L. , Pesudovs Konrad 
Published: December 2019

SIGNIFICANCE
The Indian translated and culturally adapted version of the vision-related activity limitation (VRAL) item bank is a validated instrument to assess the difficulty in performing daily activities by cataract patients and can also be used to capture self-reported changes in ability to perform daily activities after cataract surgery.

PURPOSE
The purpose of this study was to document (a) translation, cross-cultural adaptation of VRAL item bank into an Indian language, and (b) its validation using Rasch analysis in a South Indian cataract population.

METHODS
At the first stage, a translated Indian version of VRAL item bank was produced using recommended procedures. At the second stage, Rasch analysis was performed to investigate its psychometric properties in 787 cataract patients (mean age, 58.2 years; mean ± SD visual acuity [logMAR], 1.19 ± 0.96 at baseline in eye for surgery) including comparison with the original version.

RESULTS
Post-translation equivalence of meaning was achieved, but some English phrases required cross-cultural adaptation. Subsequently, all items were appropriate for the Indian culture, and VRAL item bank demonstrated excellent measurement precision (7.39). Dimensionality assessment suggested that VRAL construct may contain other dimensions such as self-care and visual search, and mobility. Self-care and visual search formed a unidimensional measure but was highly correlated with main VRAL dimension, and the removal of its items weakened precision of the main VRAL dimension measurement. Taken together, evidence favored retaining self-care and visual search items in a larger VRAL item bank. Mobility subscale lacked adequate measurement precision, so it was not examined further; again, items were retained in VRAL scale because they strengthened its measurement properties. Majority of items (99%) did not demonstrate notable differential item functioning (>1.0 logit) by presenting visual acuity (median, 0.20 logMAR) in the better-seeing eye.

CONCLUSIONS
Items in the translated Indian VRAL item bank measure the same construct as the English version and fulfilled the psychometric requirements for use in cataract patients.