bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Typically Developing Toddlers with Hair-Pulling Behavior and Concurrent Poor Sleep Hygiene: A Case Series
Authors: Fodstad Jill C. , Greve Katherynne T. , Curtin Michelle J. , Lagges Ann M. 
Published: March 2021

ABSTRACT:

Objective:
Hair-pulling disorder is a rare condition with onset most commonly in adolescence and a well-documented association with comorbid psychiatric disorders. Minimal literature currently exists detailing the occurrence and treatment of this condition in young children, particularly less than 5 years old.

Method:
This case report describes 2 cases of children (<24 months old) with hair-pulling disorder and concurrent highly disrupted sleep. Treatment aimed at addressing sleep hygiene through parental psychoeducation and training, competing items, and faded naptime/bedtime.

Results:
In both children, sleep hygiene intervention yielded significant improvement in sleep disruption patterns and hair-pulling behavior across approximately a 3-month period that maintained at 1- and 3-month follow-ups.

Conclusion:
Identifying factors that may be related or concurrent to hair pulling in young children is vital in ensuring that treatment is individualized and effective.
Ocular Complications After Laser or Light-Based Therapy—Dangers Dermatologists Should Know
Authors: Juhasz Margit , Zachary Christopher , Cohen Joel L. 
Published: March 2021

BACKGROUND
Laser and light-based technologies have been used in the medical field for over 50 years. In dermatologic and cosmetic practice, cutaneous side effects are commonly discussed; however, ocular injury may also occur.

OBJECTIVE
To complete a systematic review of the current literature regarding ocular complications in the dermatologic field after laser and/or light-based therapies.

MATERIALS AND METHODS
A systematic review of the Medline database was performed in August 2020 using the search terms “laser or light and ocular and complication.” The inclusion criteria were articles written in English discussing ocular complications after laser or light-based therapy for dermatologic or cosmetic indications.

RESULTS
A total of 36 articles were included for review. Carbon dioxide was the most frequently used laser causing ocular damage, and the most common ophthalmologic complication was temporary ectropion. Patients described visual disturbances and pain as the most common symptoms. A large proportion of articles did not report the use of appropriate eye protection at the time of injury.

CONCLUSION
Although ocular injury post-laser or light-based procedures are rare, clinicians must be acutely aware of the signs and symptoms associated with eye damage. The informed consent process should thoroughly describe the possibility of ocular complications post-treatment, and medical practices should have appropriate emergency plans and protective equipment in place to decrease both patient and staff risk of injury.
European Multicenter Prospective Study Evaluating Long-Term Safety and Efficacy of the Polycaprolactone-Based Dermal Filler in Nasolabial Fold Correction
Authors: Moers-Carpi Marion , Christen Marie-Odile , Delmar Henry , Brun Patrick , Bodokh Isaac , Kestemont Philippe 
Published: March 2021

BACKGROUND
Age-related changes affecting facial areas can be corrected using minimally invasive dermal fillers. The use of polycaprolactone-dermal filler (PCL-filler) in aesthetics is increasing.

OBJECTIVE
To evaluate the long-term safety and efficacy of the PCL-filler, in a European, multicenter, prospective study.

MATERIALS AND METHODS
Subjects (n = 90) with moderate/severe nasolabial folds (Wrinkle Severity Rating Scale [WSRS]: 3 to 4) were treated on Day 0 with a single injection of similar volume on each side; safety and efficacy assessments were performed over an 18-month period. In 1 of the 3 study centers, safety was evaluated at 30 months.

RESULTS
At Month 12 (M12; primary endpoint), 84% of subjects showed a ≥1-point improvement on the WSRS (M6: 92%; M18: 64%). From the investigator/subject's evaluation, from Day 7 to M12, Global Aesthetic Improvement was reported for >90% of subjects, with the effect maintained for up to 18 months in >80% of patients. Subjects/investigators reported high satisfaction and skin quality improvement. Most of the immediate injection-site reactions disappeared after 2 to 4 days. No severe or unexpected adverse events were reported.

CONCLUSION
This study demonstrated the long-term safety and efficacy of the PCL-filler, with safety confirmed for up to 30 months.
Fractional Erbium-Doped Yttrium Aluminum Garnet Laser in the Treatment of Primary Cutaneous Amyloidosis
Authors: Fawzy Marwa M. , Kamel Marwa M. , El Maadawi Zeinab , Abdel Hady Rehab , Osman Mai Abdelraouf 
Published: March 2021

BACKGROUND
Although various treatments are currently available for primary cutaneous amyloidosis (PCA), there is no entirely satisfactory treatment. Recently, fractional ablative lasers are claimed to have therapeutic effects for PCA.

OBJECTIVE
To evaluate the efficacy and safety of fractional Er:YAG laser for the treatment of PCA.

METHODS AND MATERIALS
Ten patients with macular and lichen amyloidosis received 4 treatment sessions with 4-week intervals. The outcome was assessed clinically (degree of pigmentation, rippling, lichenification, and itching) through photographs and histologically (amount of amyloid, melanin, epidermal thickness, and depth of rete ridges) through biopsy specimens stained with hematoxylin–eosin, Congo red, and Fontana–Masson stain. Patients were followed up for 3 months after the final treatment.

RESULTS
At 3-month follow-up, fractional Er:YAG laser exhibited a significant clinical and histological improvement. Patient satisfaction concurred with physicians' evaluations. Recurrence was detected in 1 patient.

CONCLUSION
In light of the authors' findings, fractional Er:YAG laser offered a great clinical and histological efficacy with excellent safety profile. Careful laser selection based on making a compromise between efficacies and safeties may improve outcome.
Tectonic Mini-DSAEK Facilitates Closure of Corneal Perforation in Eyes With Healthy Endothelium
Authors: Seifelnasr Mohamed , Roberts Harry W. , Moledina Malik , Myerscough James 
Published: March 2021

Purpose:
The purpose of this study was to report a surgical technique for closure of a traumatic corneal perforation in a patient with healthy endothelium.

Methods:
A 69-year-old male patient presented to Southend University Hospital with a 2.5 mm round temporal corneal perforation caused by a metallic foreign body from an industrial accident. Best-corrected visual acuity at presentation was 6/36. The patient received a tectonic small diameter Descemet stripping automated endothelial keratoplasty (mini-DSAEK) to close the perforation. The patient subsequently developed traumatic cataract and underwent cataract surgery 8 months later. Clinical outcomes at 1 week, 1 month, 3 months, 6 months, and 9 months were evaluated. The primary outcomes of interest were successful sustained closure of the perforation and surgical complications, with secondary outcomes of best-spectacle corrected visual acuity (BSCVA, Snellen) and keratometric astigmatism (KA, Pentacam).

Results:
The anterior chamber was reformed by the graft, restoring the globe's mechanical integrity. The bare stroma reepithelized by 1 week. Neither intraoperative nor postoperative surgical complications were reported. The anterior chamber remained deep and formed during subsequent follow-ups through 9 months. At the 9-month follow-up, final best spectacle-corrected visual acuity was 6/6-1 (Snellen fraction). Keratometric astigmatism was 1.1 diopters.

Conclusions:
Tectonic mini-Descemet stripping automated endothelial keratoplasty is a safe technique in the management of corneal perforations too large for tissue adhesives, with a low astigmatic profile and rapid visual recovery.
Effects of Vectored Thermal Pulsation on Objective Tear Film Measures
Authors: Fallah Shamis , Loer Christopher J. 
Published: March 2021

Purpose:
To assess the effect of vectored thermal pulsation treatment for meibomian gland dysfunction on objective measures of lipid layer thickness (LLT) and tear osmolarity.

Methods:
One hundred patients with meibomian gland dysfunction diagnosis were recruited to participate. At their initial visit, baseline study parameters were recorded, and vectored thermal pulsation treatment was administered. At the 2- to 3-month follow-up visit, the study parameters were reevaluated. Subjective symptoms were evaluated using the Ocular Surface Disease Index questionnaire. LLT was measured using an ocular surface interferometer. Tear osmolarity was calculated using impedance measurement of tear fluid collected from the eyelid margin.

Results:
Ninety-six patients (192 eyes) completed the follow-up. Mean improvement in Ocular Surface Disease Index was 5.6 points (95% confidence interval [CI], −9.0 to −2.1, P = 0.002). There was no significant change in tear osmolarity (mean change −1.6 mOsm/L, 95% CI, −4.7 to +1.3 mOsm/L, P = 0.3). There was no significant change in LLT (mean change −4.3 nm, 95% CI, −9.1 to +0.5 nm, P = 0.08).

Conclusions:
The hypothesis that vectored thermal pulsation treatment would decrease tear osmolarity and increase LLT was not substantiated. Although we detected significant improvement in subjective symptoms, the improvement was smaller than the improvements reported in previous studies. Our results suggest that the current understanding of the effects of vectored thermal pulsation treatment is incomplete.
Trifocal intraocular lens implantation in eyes with previous corneal refractive surgery for myopia and hyperopia
Authors: Cobo-Soriano Rosario , Ortega-Usobiaga Julio , Rodríguez-Gutiérrez Beatriz , Tejerina Víctor , Llovet Fernando , Casco Bruno , Baviera Julio 
Published: March 2021

Purpose:
To evaluate the visual and refractive outcomes of trifocal intraocular lens (IOL) implantation in eyes previously treated with myopic and hyperopic corneal refractive laser surgery.

Setting:
Clinica Baviera-AIER-Eye group, Spain.

Design:
Retrospective comparative case series.

Methods:
The series was divided into 2 groups according to the type of corneal laser refraction (myopic and hyperopic). The main visual and refractive outcome measures included corrected distance visual acuity (CDVA) and uncorrected distance and near visual acuity, safety, efficacy, and predictability. The secondary outcome measures were percentage of enhancement and Nd:YAG capsulotomy and influence of prelaser magnitude of myopia and hyperopia on the outcome of trifocal IOL implantation.

Results:
The sample comprised 868 eyes (543 patients): myopic, n = 319 eyes (36.7%); and hyperopic, n = 549 eyes (63.2%). Three months postoperatively, visual outcomes were poorer in the hyperopic group than those in the myopic group for mean CDVA (0.06 ± 0.05 vs 0.04 ± 0.04, P < .01) and safety (21% vs 12% of CDVA line loss, P < .05) outcomes. However, precision outcomes were worse in the myopic group than those in the hyperopic group, with a mean spherical equivalent of −0.38 ± 0.3 vs −0.17 ± 0.3 (P < .01). Stratification by magnitude of primary laser treatment revealed poorer visual and safety results in the high hyperopia subgroup (>+3.0 diopters [D]) and poorer precision in the high myopia subgroup (<−5.0 D).

Conclusions:
Trifocal IOL implantation after photorefractive surgery in eyes previously treated with myopic ablation achieved good visual outcomes but less predictability in the high myopia subgroup. However, eyes with a previous hyperopic corneal ablation achieved excellent precision but worse visual and safety outcomes in the high hyperopia subgroup.
Identifying Prosthetic Capabilities That Define Functionality of Individuals With Amputation
Authors: Bell Elizabeth M. , Carrignan Jessica , Collier Douglas Kurt , Yang Ji Seung , Shim Jae Kun 
Published: March 2021

ABSTRACT

Introduction
Although the physical abilities associated with activity, exercise, and fitness within the general population of individuals without disabilities have been well established, it is unclear if these abilities define the physical function of individuals with lower-limb amputations (LLAs) who use a prosthesis. A multidimensional definition of the physical function of people with LLA must consider what abilities are necessary and relevant.

Objectives
This literature review aimed to identify common abilities used to evaluate the physical function of people with LLA. A secondary aim was to evaluate if each identified ability had been indirectly addressed by existing questionnaires and performance-based tests.

Study Design
Literature Review.

Methods
Ten common physical abilities associated with measuring the physical function of LLA were identified through literature review. These identified abilities were used to assess what aspects had been indirectly addressed by existing questionnaires and performance-based evaluations of LLA physical function.

Results and Conclusions
Abilities identified through literature review included agility, balance, comfort, endurance, flexibility, load, maneuverability, power, strength, and symmetry. These 10 abilities are important and commonly used as outcome measures associated with the physical function of people with LLA. Although each ability was addressed by multiple assessments, no assessment addressed all 10 identified abilities. The Prosthetic Limb Users Survey of Mobility, Prosthetic Profile of the Amputee, Rivermead Mobility Index, and the Amputee Mobility Predictor addressed most (8–9 of 10) of the identified abilities. There were clear differences and gaps in the abilities addressed by current assessments, possibly because they rely on an incomplete definition of what is required for LLA physical function. We propose that these 10 abilities are unique and underlie the definition of LLA physical function. However, future work must assess the validity of this proposed framework.

Clinical Relevance
A multidimensional definition of LLA physical function is necessary to enable more appropriate prosthetic design, prescription, and use. Promoting greater mobility and physical activity levels within this population will improve health of people with LLA.
Effect of Transtibial Prosthesis Mass Alteration on Metabolic Activity and Outcomes
Authors: Seth Mayank , Warren Kelly A. , Lamberg Eric M. 
Published: March 2021

ABSTRACT

Introduction
The loss of a lower limb is a traumatic life-changing event. It imposes restrictions on an individual's mobility and adversely affects his/her personal and social life. The gait of an individual with transtibial amputation (TTA) is less efficient, as evidenced by the higher metabolic cost during walking compared with individuals without amputation. The mass of a prosthetic leg may influence the metabolic cost of the user and potentially impact his/her activity. Currently, however, limited evidence is available on transtibial prosthesis mass. Hence, the purpose of this study was to explore the effects of prosthesis mass alterations on metabolic cost, function, satisfaction, and health-related quality of life of individuals with TTA after 7 days of acclimation.

Materials and Methods
A repeated-measures study involving three testing sessions (each 1 week apart) was conducted, during which three load conditions were examined. At the end of the first two sessions, participant's prosthesis mass was increased by adding either 30% (light load) or 50% (heavy load) of the total mass difference between both legs to a proximal location on the prosthesis. Data collection during each session comprised a 6-minute walk test (during which metabolic activity was also acquired) and completion of questionnaires from the Orthotics and Prosthetics Users' Survey.

Results
Increasing prosthesis mass with the light and heavy load conditions did not significantly increase the net metabolic cost and walking economy of the participants. Participant function (performance and self-reported) and satisfaction were not significantly affected by the mass increase. However, while using the light load condition, participants reported a significant improved health-related quality of life.

Conclusions
Increasing prosthesis mass did not result in the worsening of metabolic activity and other selected outcomes among people with TTA.
Development of postgraduate training in critical care medicine for nurse practitioners and physician assistants
Authors: Zhou Christine Y. , Pathak Vikas 
Published: March 2021

ABSTRACT
Nurse practitioners (NPs) and physician assistants (PA) are increasingly providing care to the critically ill patients in the intensive care unit. We structured a 4-month training program for our existing NPs and PAs and assessed their knowledge and skill pre and post training. The program was composed of blended didactic in critical care medicine topics, critical care simulations in simulation laboratory, and supervised critical care procedures. Formal knowledge and skill assessments were performed before and after the program to assess success in meeting predefined learning objectives. The mean preintervention medical knowledge assessment score was 3.37 ± 0.56 SD, which significantly improved to 3.86 ± 0.46 SD (p < .00001). For clinical skills for critical care procedures, the mean preintervention score was 3.10 ± 0.86 SD, which improved to 3.61 ± 0.92 SD (p < .00001). The overall knowledge (including medical knowledge and clinical skills) improved from mean 3.30 ± 0.86 SD to 3.80 ± 0.42 SD. The improvement was seen regardless of the duration of experience in critical care medicine. We concluded that structured didactics with supervised procedural training along with dedicated training in simulation laboratories, even for a short period, improves the overall knowledge and clinical skills required to work in a critical care setting.
Associations of Habitual Dietary Intake With Fecal Short-Chain Fatty Acids and Bowel Functions in Irritable Bowel Syndrome
Authors: Calderon Gerardo , Patel Chirag , Camilleri Michael , James-Stevenson Toyia , Bohm Matthew , Siwiec Robert , Rogers Nicholas , Wo John , Lockett Carolyn , Gupta Anita , Xu Huiping , Shin Andrea 
Published: March 2021

Background & Goals:
Diet may contribute to symptoms of irritable bowel syndrome (IBS) and luminal production of putative IBS biomarkers including short-chain fatty acids (SCFAs). Study aims were to to assess relationships of habitual fiber or starch intake with fecal SCFAs in patients with IBS and healthy volunteers (HVs).

Study:
In 18 HVs and 30 patients with IBS (13 constipation-predominant [IBS-C] and 17 diarrhea-predominant [IBS-D]), habitual diet using a food frequency questionnaire; bowel functions using a validated bowel diary; and fecal SCFAs by HPLC-mass spectrometry were assessed. Associations of fiber and starch with SCFAs were analyzed using Spearman (r

s
) and Pearson (R) correlations. Relationships between other dietary endpoints, SCFAs, and bowel functions were explored.

Results:
Habitual fiber or starch intakes were not significantly correlated with SCFAs or bowel functions in all participants or HVs nor with SCFAs in IBS. Starch was negatively correlated (R=−0.53; P=0.04) with complete evacuation in IBS-D. Fiber (r

s
=0.65; P=0.02) and starch (r

s
=0.56; P=0.05) were correlated with ease of passage in IBS-C. Stool form, frequency, and ease of passage were positively correlated with total SCFAs (all P<0.05), acetate (all P<0.01), propionate (all P<0.05), and butyrate (form P=0.01; ease of passage P=0.05) among all participants, but not in IBS. Complete evacuation was negatively correlated with propionate (R=−0.34; P=0.04) in all participants. Total (P=0.04) and individual SCFAs (all P<0.05) were positively correlated with stool form in HVs.

Conclusions:
Habitual fiber and starch intake does not influence fecal SCFAs but may influence bowel functions in IBS. Fecal SCFAs correlate with bowel functions among all participants including HVs.
Photodynamic Therapy (PDT), Radiofrequency Ablation (RFA) With Biliary Stents in Palliative Treatment of Unresectable Extrahepatic Cholangiocarcinoma
Authors: Mohan Babu P. , Chandan Saurabh , Khan Shahab R. , Kassab Lena L. , Ponnada Suresh , Artifon Everson L.A. , Otoch Jose P. , McDonough Stephanie , Adler Douglas G. 
Published: March 2021

Background and Aim:
Extrahepatic unresectable cholangiocarcinoma carries a dismal prognosis. In addition to biliary drainage by stent placement; photodynamic therapy (PDT) and radiofrequency ablation (RFA) have been tried to prolong survival. In this meta-analysis, we appraise the current known data on the use of PDT, RFA in the palliative treatment of extrahepatic unresectable cholangiocarcinoma.

Methods:
We searched multiple databases from inception through July 2020 to identify studies that reported on PDT and RFA. Pooled rates of survival, stent patency, 30-, 90-day mortality, and adverse events were calculated. Study heterogeneity was assessed using I
2% and 95% prediction interval.

Results:
A total of 55 studies (2146 patients) were included. A total of 1149 patients underwent treatment with PDT (33 studies), 545 with RFA (22 studies), and 452 patients with stent-only strategy. The pooled survival rate with PDT, RFA, and stent-only groups was 11.9 [95% confidence interval (CI): 10.7-13.1] months, 8.1 (95% CI: 6.4-9.9) months, and 6.7 (95% CI: 4.9-8.4) months, respectively. The pooled time of stent patency with PDT, RFA, and stent-only groups was 6.1 (95% CI: 4.2-8) months, 5.5 (95% CI: 4.2-6.7) months, and 4.7 (95% CI: 2.6-6.7) months, respectively. The pooled rate of 30-day mortality with PDT was 3.3% (95% CI: 1.6%-6.7%), with RFA was 7% (95% CI: 4.1%-11.7%) and with stent-only was 4.9% (95% CI: 1.7%-13.1%). The pooled rate of 90-day mortality with PDT was 10.4% (95% CI: 5.4%-19.2%) and with RFA was 16.3% (95% CI: 8.7%-28.6%).

Conclusion:
PDT seemed to demonstrate better overall survival and 30-day mortality rates than RFA and/or stent-only palliation.
Association Between Chronic Hepatitis C Virus Infection and Esophageal Cancer
Authors: Ponvilawan Ben , Rittiphairoj Thanitsara , Charoenngam Nipith , Rujirachun Pongprueth , Wattanachayakul Phuuwadith , Tornsatitkul Surapa , Ungprasert Patompong 
Published: March 2021

Background:
Chronic hepatitis C virus (HCV) infection is associated with increased risk of hepatobiliary tract cancer. However, whether chronic HCV infection is also associated with elevated risk of other types of cancer is still unknown. This systematic review and meta-analysis was conducted in order to investigate whether chronic HCV infection is positively associated with esophageal cancer.

Methods:
A systematic review was conducted using Embase and MEDLINE databases from inception to November 2019, with a search strategy that comprised the terms for “hepatitis C virus” and “cancer.” Eligible studies were cohort studies consisting of patients with chronic HCV infection and comparators without HCV infection, and followed them for incident esophageal cancer. Hazard risk ratio, incidence rate ratio, relative risk or standardized incidence ratio of this association were extracted from each eligible study along with their 95% confidence intervals and were combined to calculate the pooled effect estimate using the random effect, generic inverse variance method.

Results:
A total of 20,459 articles were identified using this search strategy. After 2 rounds of independent review, 7 studies satisfied the inclusion criteria and were included in the meta-analysis. Chronic HCV infection was significantly associated with a higher incidence of esophageal cancer with the pooled relative risk of 1.61 (95% confidence interval: 1.19-2.17; I
2=39%). The funnel plot was relatively symmetric which was not suggestive of publication bias.

Conclusion:
This systematic review and meta-analysis demonstrated that there is a modest association between chronic HCV and incident esophageal cancer. However, more studies are needed to investigate the causality of this association.