bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Care for School-Aged Youth With Cleft
Authors: Ruff Ryan Richard , Crerand Canice E. , Sischo Lacey , Peshansky Alexandre , Sarwer David B. , Kirschner Richard E. , Broder Hillary L. 
Published: March 2018

Objective: To explore factors related to completion of surgery recommendations among children with cleft lip and palate (CLP) or cleft palate only (CPO). Design: Multicenter prospective longitudinal cohort study (2009-2015). Setting: Six cleft centers in the United States. Patients/Participants: A diverse sample of 1186 youth aged 7.5 to 18.5 years with CLP or CPO and a caregiver. Results: Data were collected from child–caregiver dyads at baseline and up to 3 follow-up visits. Of the 765 surgeries recommended during the study period, 83 were postponed and 597 were completed; this represents a completion rate of 78%. There were multiple reasons identified by patients for why the remaining 85 recommended surgeries were not completed. Children with nonprivate insurance were more likely to postpone recommended surgeries. Hispanic/Latino and Asian children had fewer surgeries compared to whites/Caucasians. Greater severity in rated speech differences was associated with more surgeries. Among participants who had completed all recommended surgeries, providers rated over 86% as having normal or mildly different facial appearance and 83% as having a normal or mild speech intelligibility rating. Similarly, caregivers rated 80% of facial appearance and 78% of speech positively. Approximately 25% of children had an additional surgical recommendation at the end of the study. Conclusions: The majority of surgical recommendations were completed with positive outcomes in facial appearance and speech intelligibility by provider and caregiver ratings. Several factors contributed to surgical recommendations not being completed and the results underscore the importance of examining socioeconomic and demographic disparities in surgical care.
Single-pass four-throw pupilloplasty for Urrets-Zavalia syndrome
Authors: Narang Priya , Agarwal Amar , Ashok Kumar Dhivya 
Published: March 2018

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.
Pars plana vitrectomy with silicone oil tamponade for primary and secondary macular hole closure: Is it still a useful procedure?
Authors: Pieczynski Janusz , Kuklo Patrycja , Grzybowski Andrzej 
Published: March 2018

Purpose: To evaluate usefulness of posterior vitrectomy with silicone oil tamponade for primary and secondary macular hole closure. Methods: We searched for publications on the surgical treatment of full-thickness idiopathic and recurrent macular hole. We divided reports into two groups: primary macular hole repair and recurrent macular hole repair with silicone oil tamponade. Results: In primary macular hole treatment, different authors confirmed effectiveness of silicone oil tamponade. They suggest that the most important factor for successful outcome was completeness of vitreous cavity filling with oil. Complications after this method were comparable to those after gas tamponade. However, even if good anatomical results are achieved in secondary macular hole closure, visual acuity is sometimes less rewarding. Conclusion: There are reports on good efficacy of silicone oil tamponade for primary and recurrent macular hole closure. Anatomical closure and visual acuity rates in pars plana vitrectomy with silicone oil and with gas filling are comparable. Gas tamponade seems to be safer and needs no more surgery. Postoperative complications in both methods are similar, but all patients with silicone oil filling need to undergo a reoperation to have the silicone removed. There are also other surgical techniques for primary macular hole closure as well as for unsuccessful primary macular hole procedures. We think that primary macular hole closure should be performed with gas tamponade, supported with different adjuvants, as a method of choice. Silicone oil tamponade could be still an alternative in cases, when there are no more efficient techniques or possibilities to treat with success recurrent macular hole.
Structured physical assessment of arteriovenous fistulae in haemodialysis access surveillance: A missed opportunity?
Authors: Jackson Victoria E , Hurst Helen , Mitra Sandip 
Published: March 2018

Introduction: Arteriovenous fistulae remain the gold standard of vascular access in haemodialysis. There is currently no consensus on standardised methods of monitoring arteriovenous fistulae. Assessment techniques and practice remain widely variable. The purpose of this study is to determine whether existing evidence supports physical assessment as an effective tool and a good predictor of arteriovenous fistulae dysfunction to allow for timely intervention and improve outcomes. Methods: A literature search was performed using CINAHL, PubMed, Medline and BNI databases and relevant search terms. Studies included were peer-reviewed, published after 2008, in English and related to arteriovenous fistulae only. Six key papers were identified and critically analysed for validity and relevance, in relation to outcomes, assessor experience, training duration and nurses’ ability to perform physical assessment. Results: Physical assessment has been shown to be effective in detecting arteriovenous fistulae dysfunction and comparable to technology-based surveillance. Physical assessment techniques generally adopt a ‘look, listen and feel’ approach to identify arteriovenous fistulae dysfunction that includes stenosis, thrombosis, ischaemia and infections. Physical assessment is a skill that can be taught with studies showing that skill-specific training is more effective than experience alone. Cost-effectiveness analysis is lacking. Conclusion: The analysis of evidence demonstrates that physical assessment of arteriovenous fistulae is an effective method of detecting arteriovenous fistulae dysfunction and is a skill that can be taught. A structured physical assessment and its implementation may be significant in routine care, but research into the most effective physical assessment techniques and its impact on clinical practice in haemodialysis is required.
Some wheres and whys in bilingual codeswitching: Directionality, motivation and locus of codeswitching in Russian-Hebrew bilingual children
Authors: Raichlin Rina , Walters Joel , Altman Carmit 
Published: March 2018

Aims and objectives: Differences in directionality, motivations and locus of codeswitching have been reported for children’s codeswitching, but these constructs have not been subjected to experimental study in order to examine how they may interact. This study investigated these variables in bilingual preschool children’s codeswitching. Methodology: Thirty-two Russian-Hebrew bilingual children (mean age 6;3) performed two tasks: Retelling of narratives manipulated for setting/topic and listener and Conversation with a bilingual adult. Retelling conditions included a Russian story retold to a Hebrew-speaking puppet, a Hebrew story retold to a Russian speaking puppet and a Mixed language story retold to a bilingual puppet. The Conversation task involved responses to questions in Russian, Hebrew and codeswitched speech about holidays and activities at home and in preschool. Data and Analysis: All children’s speech was audio recorded and transcribed using CHILDES conventions for data transcription. Codeswitched utterances were coded for the following: Directionality (Hebrew-to-Russian/Russian-to-Hebrew); Motivation (psycholinguistic/sociopragmatic); and Locus (intra-utterance/cross-speaker). Results: Overall children produced more codeswitching from Russian to Hebrew and did so more for psycholinguistic motivations (to maintain fluency or to overcome difficulties in lexical access). Originality: High rates of codeswitching occurred in this study, ranging from 15% to 22% for Conversation and Retelling, respectively (calculated as codeswitched instances per utterance). This high rate may be attributed to the experimental nature of the tasks, which intended to elicit codeswitching in children’s speech. Significance: Drawing from Green and Wei’s processing model, findings regarding directionality and motivation are discussed in terms of connectivity and activation.
Construction, Expression, and Characterization of rSEA-EGF and In Vitro Evaluation of its Antitumor Activity Against Nasopharyngeal Cancer
Authors: Liu Xueting , Zeng Liping , Zhao Zhongqiu , Xie Yang , Wang Shan , Zhang Junyan , He Ying , Zou Zehong , Zhang Jianguo , Tao Ailin 
Published: March 2018

Staphylococcal enterotoxin A is well known as a superantigen and able to be used for cancer immunotherapy. In this study, recombinant Staphylococcal enterotoxin A was genetically conjugated to epidermal growth factor to produce a chimeric protein recombinant Staphylococcal enterotoxin A–epidermal growth factor expressed in Escherichia coli. The recombinant Staphylococcal enterotoxin A–epidermal growth factor protein was purified using Strep-Tactin affinity chromatography and Endotoxin Removal Resin and identified by sodium dodecyl sulfate-polyacrylamide gel electropheresis and liquid chromatography-tandem mass spectrometry analysis. Furthermore, in vitro experiments showed purified recombinant Staphylococcal enterotoxin A–epidermal growth factor could successfully bind to the human nasopharyngeal carcinoma cell line CNE2, significantly promote the proliferation of human peripheral blood mononuclear cells, and enhance the secretion of several cytokines that have broad antitumor activities, such as interferon-γ, tumor necrosis factor-α, and interleukin-2 . Importantly, recombinant Staphylococcal enterotoxin A–epidermal growth factor significantly inhibited proliferation of CNE2 cells and promoted apoptosis in CNE2 cells when cocultured with peripheral blood mononuclear cells. Finally, both the binding of recombinant Staphylococcal enterotoxin A–epidermal growth factor and the toxicity of recombinant Staphylococcal enterotoxin A–epidermal growth factor-activated peripheral blood mononuclear cells were demonstrated as specific and only effective on high epidermal growth factor receptor-expressing cell lines. In all, our work suggests that recombinant Staphylococcal enterotoxin A–epidermal growth factor serves as a promising novel immunotherapeutic agent. More in vivo and in vitro studies are needed to verify its antitumor potency, as well as investigate the underlying mechanisms in cancer immunotherapy.
Current best practice management of interstitial cystitis/bladder pain syndrome
Authors: Han Esther , Nguyen Laura , Sirls Larry , Peters Kenneth 
Published: March 2018

Introduction: Over the last 100 years, the terminology and diagnosis criteria for interstitial cystitis have evolved. Many therapeutic options have changed, but others have endured. This article will review the idea of separating ‘classic’ Hunner lesion interstitial cystitis (HL IC) from non-Hunner lesion interstitial cystitis and bladder pain syndrome (N-HL IC/BPS) and their respective treatment algorithms. Methods/Results: A literature search was performed to identify articles and research on HL IC and N-HL IC/BPS including definitions, etiological theories, and treatments. This article is an overview of the existing literature. We also offer insight into how HL IC and N-HL IC/BPS are approached at our tertiary referral center. Additionally, American Urological Association guidelines have been integrated and newer treatment modalities and research will be introduced at the conclusion. Conclusion: The AUA guidelines have mapped out a stepwise fashion to treat IC/BPS; at our institution we separate patients with HL IC from those with N-HL IC/BPS prior to them entering a treatment pathway. We identify the rarer patient with HL as having classic ‘IC’; this cystoscopic finding is critical in guiding treatment. We believe HL IC is a distinct disease from N-HL IC/BPS and therapy should focus on the bladder. The vast majority of patients with N-HL IC/BPS need management of their pelvic floor muscles as the primary therapy, complemented by bladder-directed therapies as needed as well as a multidisciplinary team to manage a variety of other regional/systemic symptoms. Ongoing research into IC/BPS will help us better understand the pathophysiology and phenotypes of this complex disease while exciting and novel research studies are developing promising treatments.
Correlating the King-Devick Test With Vestibular/Ocular Motor Screening in Adolescent Patients With Concussion: A Pilot Study
Authors: Russell-Giller Shira , Toto Diana , Heitzman Mike , Naematullah Mustafa , Shumko John 
Published: March 2018

Background: The King-Devick (K-D) test is a rapid number-naming task that has been well validated as a sensitive sideline performance measure for concussion detection. Patients with concussion take significantly longer to complete the K-D test than healthy controls. Previous research suggests that ocular motor deficits, specifically saccadic abnormalities, may be an underlying factor for the prolonged time. However, these findings have not been studied at length. Hypothesis: K-D testing time of concussed adolescents at the initial clinical concussion visit will positively correlate with vestibular/ocular motor screening (VOMS) total scores. Study Design: Case series. Level of Evidence: Level 3. Methods: A total of 71 patient charts were retrospectively analyzed between October 1, 2016, and January 31, 2017. Included charts consisted of patients between the ages of 10 and 18 years with a diagnosis of concussion and who had completed K-D testing and VOMS assessment at the initial physician visit. Univariate correlation between K-D testing time and the 7 VOMS items was assessed using Pearson correlation coefficients. Results: K-D testing time strongly correlated with all 7 VOMS items ( r(69) = 0.325-0.585, P < 0.01). In a linear regression model that accounted for each VOMS item, the convergence (near point) item and the visual motion sensitivity item significantly predicted K-D testing time (β = 0.387, t(63) = 2.81, P < 0.01 and β = 0.375, t(63) = 2.35, P = 0.02, respectively). Additionally, 37.5% of the 24 patients with worsening symptoms after K-D testing freely reported increased visual problems. Conclusion: Our study suggests that prolonged K-D testing times in adolescents with concussion may be related to subtypes of vestibular/ocular motor impairment that extend beyond saccadic abnormalities. Clinical Relevance: Poor K-D testing performance of adolescents with concussion may indicate a range of vestibular/ocular motor deficits that need to be further identified and addressed to maximize recovery.
Quantitative T2 Mapping Shows Increased Degeneration in Adjacent Intervertebral Discs Following Kyphoplasty
Authors: Pachowsky Milena L. , Kleyer Arnd , Wegener Lisa , Langenbach Andreas , Simon David , Janka Rolf , May Matthias , Welsch Goetz H. 
Published: March 2018

Objective A minimally invasive treatment of osteoporotic and nonosteoporotic thoracic and lumbar spine fractures is cement augmentation (kyphoplasty). Little is known about the impact on adjacent intervertebral discs. A quantitative magnetic resonance imaging (MRI) approach in addition to morphological MRI is desirable to evaluate changes in the intervertebral disc. Our study aims to evaluate the feasibility of T2 mapping for the detection of subtle changes in the intervertebral discs in spines after kyphoplasty. Design Intervertebral discs were assessed by quantitative MRI (3.0 T) using T2 relaxation time mapping. Region of interest (ROI; 6 per disc) analyses were performed. The ROIs at the anterior and posterior edges were interpreted as annulus fibrosus (AF). The 2 very inner zones were regarded as nucleus pulposus (NP) and the regions in between as intermediate transition zone. We compared T2 relaxation time values of intervertebral discs adjacent to the vertebrae after kyphoplasty with those nonadjacent to vertebrae after kyphoplasty, especially in the NP. Results The analysis of the ROIs showed that the intervertebral discs of the adjacent vertebral segments are associated with reduced T2 values compared to those that are nonadjacent to the affected vertebrae. Conclusion This study is to our knowledge the first investigation of intervertebral discs after kyphoplasty by quantitative MRI. Quantitative T2 mapping shows increased degeneration in adjacent intervertebral discs following kyphoplasty. Besides its contribution to a broader knowledge of postoperative changes after kyphoplasty, our findings may help to improve differentiation between healthy and degenerated intervertebral discs using these techniques.
Role of high-risk human papillomavirus in the etiology of oral and oropharyngeal cancers in Thailand: A case–control study
Authors: Chotipanich Adit , Siriarechakul Surattaya , Mungkung On-ong 
Published: March 2018

Background: Among developing countries, Thailand shows no increase in the incidence of human papillomavirus–driven oropharyngeal cancer. The causal role of human papillomavirus infection in this pathology has not been researched thoroughly. Methods: A hospital-based, case–control study was performed which included 104 patients with newly diagnosed oral and oropharyngeal squamous cell carcinomas and 104 individuals without cancer. The Cervista high-risk human papillomavirus and 16/18 assays were used to detect human papillomavirus. Odds ratios were used to assess the association between high-risk genotypes of human papillomavirus and the cancers. Results: High-risk human papillomavirus was detected in 4 of 52 (7.7%) oral cancer cases, 6 of 52 (11.5%) oropharyngeal cancer cases, and 1 of 104 (0.96%) control subjects. Of 104 cancer patients in the study, 83 were smokers. High-risk human papillomavirus was significantly associated with oropharyngeal cancer (odds ratio = 13.44, 95% confidence interval = 1.6–114.8) but was nonsignificantly associated with oral cancer (odds ratio = 8.58, 95% confidence interval = 0.9–78.9). However, after adjustment for smoking, high-risk human papillomavirus was determined to be nonsignificantly associated with oropharyngeal cancer (adjusted odds ratio = 5.83, 95% confidence interval = 0.8–43.5). Conclusion: Although low human papillomavirus prevalence was observed, the rate of high-risk human papillomavirus infection in the cancer group was still higher than that in the control group. Smoking may have an influence on the etiology of human papillomavirus–related cancers. However, the study is underpowered to clarify the role of human papillomavirus as the independent risk factor for oral and oropharyngeal cancers in the Thai population.
An Examination of the Application of the Kidney Donor Risk Index in British Columbia
Authors: Rose Caren , Sun Yvonne , Ferre Ed , Gill John , Landsberg David , Gill Jagbir 
Published: March 2018

Background: The Kidney Donor Risk Index (KDRI) is a continuous measure of deceased donor kidney transplant failure risk that was derived in US patients based on 10 donor characteristics. In the United States, the KDRI is utilized to guide organ allocation and to inform clinical decisions regarding organ acceptance. Objective: To examine the application of the US-derived KDRI in a large Canadian province. Patients: All deceased donor kidney-only transplant recipients in British Columbia (BC) between 2005 and 2014. Methods: We examined the predictive performance of KDRI in BC transplant recipients and compared the overall performance of KDRI with donor age alone in predicting transplant failure (from all causes including death). Results: Donors in BC (N = 785) were older but included no black donors and few Hepatitis C virus (HCV)-positive donors compared with the original derivation cohort of the KDRI in the United States. The KDRI was moderately predictive of transplant failure ( c statistic, 0.63) and had similar predictive performance to donor age alone ( c statistic, 0.64). Conclusion: Our findings suggest that the US-derived KDRI does not improve the prediction of kidney transplant failure compared with donor age alone in a Canadian cohort and highlight the need to determine the applicability of KDRI in different regions.
Predictors of Poor Outcomes in Pediatric Venoarterial Extracorporeal Membrane Oxygenation
Authors: Mistry Maanasi S. , Trucco Sara M. , Maul Timothy , Sharma Mahesh S. , Wang Li , West Shawn 
Published: March 2018

Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides respiratory and hemodynamic support to pediatric patients in severe cardiac failure. We aim to identify risk factors associated with poorer outcomes in this population. Methods: A retrospective chart review was conducted of pediatric patients requiring VA-ECMO support for cardiac indications at our institution from 2004 to 2015. Data were collected on demographics, indication, markers of cardiac output, ventricular assist device (VAD) insertion, heart transplantation, or left atrial (LA) decompression. Univariate Cox proportional hazards models were used to calculate hazard ratios (HRs) for variables associated with the composite primary outcome of transplant-free survival (TFS). Results: Of the 68 reviewed patients, 65% were male, 84% were white, 38% had a prior surgery, 13% had a prior transplant, 10% had a prior ECMO support, and 87.5% required vasoactive support within six hours of cannulation. The ECMO indications included congenital heart disease repaired >30 days prior (12%), cardiomyopathy (41%), posttransplant rejection (7%), and cardiorespiratory failure (40%). The TFS was 54.5% at discharge and 47.7% at one year. Predictors of transplant and/or death include epinephrine use (hazard ratio [HR] = 2.269, P = .041), elevated lactate (HR = 1.081, P = 0005), and elevated creatinine (HR = 1.081, P = .005) within six hours prior to cannulation. Sixteen (23.6%) patients underwent LA decompression. Placement of VAD occurred in 16 (23.5%) patients, for which nonwhite race (HR = 2.94, P = .034) and prior ECMO (HR = 3.42, P = .053) were the only identified risk factors. Conclusions: Need for VA-ECMO for cardiac support carries high inpatient morbidity and mortality. Epinephrine use and elevated lactate and creatinine were associated with especially poor outcomes. Patients who survived to discharge had good short-term follow-up results.