bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of 1,550-nm Erbium-Glass Fractional Laser Treatment and Its Effect on the Expression of Insulin-Like Growth Factor 1 and Wnt/β-Catenin in Androgenetic Alopecia
Authors: Meephansan Jitlada , Ungpraphakorn Nawaporn , Ponnikorn Saranyoo , Suchonwanit Poonkiat , Poovorawan Yong 
Published: August 2018

BACKGROUND
A new treatment for androgenetic alopecia (AGA) is a 1,550-nm erbium-glass (Er:Glass) fractional laser. The wound healing process associated with this treatment is believed to be due to the stimulation of hair regrowth. Both the Wingless-related integration site (Wnt) proteins and insulin-like growth factor 1 (IGF-1) are important molecules that promote new hair growth.

OBJECTIVE
The aim of this study was to evaluate the efficacy of 1,550-nm Er:Glass fractional laser treatment and determine the gene expression of IGF-1 and Wnt/β-catenin in patients with AGA.

METHODS
Twenty-three patients with AGA were enrolled. They received 12 treatments at 2-week intervals. A scalp biopsy was performed to evaluate mRNA levels of Wnt10A and IGF-1. Histopathologic samples were collected.

RESULTS
Significant increases in hair count and shaft diameter that occurred from Month 4 until the end of the study were observed. Histological results showed increases in the follicular unit, anagen hair count, and the anagen:telogen ratio. No up-regulation of Wnt10A and IGF-1 mRNA was observed.

CONCLUSION
The 1,550-nm Er:Glass fractional laser treatment can increase hair density and shaft diameter in patients with AGA. The mechanisms by which 1,550-nm Er:Glass laser treatment induces new hair growth may not be limited to Wnt10A/β-catenin or IGF-1 expression.
Vasa previa: prenatal diagnosis and management
Authors: Melcer Yaakov , Maymon Ron , Jauniaux Eric 
Published: August 2018

Purpose of reviewVasa previa is a rare disorder of placentation associated with a high rate of perinatal morbidity and mortality when undetected before delivery. We have evaluated the recent evidence for prenatal diagnosis and management of vasa previa.Recent findingsAround 85% of cases of vasa previa have one or more identifiable risk factors including in-vitro fertilization, multiple gestations, bilobed, succenturiate or low-lying placentas, and velamentous cord insertion. The development of standardized prenatal targeted scanning protocols may improve perinatal outcomes. There is no clear consensus on the optimal surveillance strategy including the need for hospitalization, timing of corticosteroids administration and the value of transvaginal cervical length measurements. Outpatient management is possible if there is no evidence of cervical shortening on ultrasound and there are no symptoms of bleeding or uterine contractions. Recent national guidelines and expert reviews have recommended scheduled cesarean section of all asymptomatic women presenting with vasa previa between 34 and 36 weeks’ gestation.SummaryPrenatal diagnosis of vasa previa is pivotal to prevent intrapartum fetal death. Although there is insufficient evidence to support the universal mid-gestation ultrasound screening for vasa previa, recent evidence indicates the need for standardized prenatal targeted screening protocols of pregnancies at high-risk of vasa previa.
Obesity and abnormal glucose tolerance in the offspring of mothers with diabetes
Authors: Kawasaki Maki , Arata Naoko , Ogawa Yoshihiro 
Published: August 2018

Purpose of review
Type 2 diabetes and obesity during childhood, puberty, and adulthood have become more common. This trend presents a global problem in terms of public health and health economics. Associations between intrauterine exposure to hyperglycemia, obesity, and abnormal glucose tolerance (AGT) in offspring have been reported in populations at high risk of diabetes such as Pima Indians, but these associations have not been established in other groups. In this review, we summarize the evidence on obesity and AGT in the offspring of mothers with diabetes.

Recent findings
Although there are many reports indicating that the incidence of obesity or overweight is higher in the offspring of mothers with gestational diabetes, there is no consensus on whether maternal prepregnancy obesity has a larger impact than intrauterine exposure to hyperglycemia. While the risk of AGT or type 2 diabetes in the offspring of mothers with gestational diabetes is thought to increase after puberty, the incidence of AGT is elevated by the age of 7 years in the offspring of mothers with untreated gestational diabetes. Maternal gestational diabetes is a risk factor for AGT or type 2 diabetes independent of maternal prepregnancy BMI. When the offspring of women who had gestational diabetes and received therapeutic intervention in two randomized controlled studies were followed, the prevalence of obesity and impaired fasting glucose was lower in some 7-year-old girls, but the effect of maternal intervention was limited. The risk of obesity or overweight is higher in the offspring of mothers with type 1 diabetes, even after adjustment for maternal prepregnancy BMI. The risk of type 2 diabetes in such offspring is also higher. Although the offspring of mothers with type 2 diabetes are likely to be at high risk for type 2 diabetes, there are only limited reports supporting this hypothesis.

Summary
Intrauterine exposure to hyperglycemia is associated with obesity and AGT among offspring. The present review suggests that these associations might depend on the type of maternal diabetes, that is, the timing and degree of exposure to hyperglycemia. There are only a small number of studies on the effect of therapeutic interventions for maternal diabetes on metabolism in the offspring.
Gingival Recession and Localized Aggressive Periodontitis Among HIV-infected Children and Adolescents Receiving Antiretroviral Therapy
Authors: Blignaut Elaine , Rossouw Theresa M. , Becker Piet J. , Mavuso Diana S. , Feucht Ute D. 
Published: August 2018

Background:
Limited information is available on gingival recession or localized aggressive periodontitis among HIV-infected children and adolescents. This study reports on the prevalence of these conditions among children and adolescents receiving antiretroviral therapy (ART).

Methods:
A cross-sectional study on HIV-infected children and adolescents attending a Pediatric HIV clinic in Gauteng, South Africa, between January 2013 and June 2016. Patients received an oral examination and oral hygiene instructions, irrespective of oral- or dental-related complaints. Hard and soft tissue pathology was managed and recorded, together with relevant demographic and clinical data. Statistical analysis was performed in Stata 14 with P < 0.05 as significant.

Results:
A total of 554 children and adolescents 5–19 years of age (median age: 12.2 years; interquartile range: 10.3–14.9) were included, of whom 78 (14.1%) presented with gingival recession on permanent mandibular incisors and/or localized aggressive periodontitis of molar teeth. Multivariable logistic regression revealed that patients with gingival recession and aggressive periodontitis had a significantly shorter duration of ART and were more likely to have suboptimal HIV control (CD4 count ≤500 cells/µL and/or HIV viral load ≥50 copies/mL) and be on advanced ART regimens after virologic failure on first- and second-line treatment.

Conclusions:
The results emphasize the importance of oral health care among HIV-infected children and adolescents from the onset, to prevent and manage conditions that could result in tooth loss and permanent disfigurement. This is of particular importance in the presence of virologic failure and immunosuppression.
Immediate and Short-Term Effects of Short- and Long-Duration Isometric Contractions in Patellar Tendinopathy
Authors: Pearson Stephen J. , Stadler Sarah , Menz Hylton , Morrissey Dylan , Scott Isabelle , Munteanu Shannon , Malliaras Peter 
Published: August 2018

Objectives:
Isometric muscle contractions are used in the management of patellar tendinopathy to manage pain and improve function. Little is known about whether long- or short-duration contractions are optimal to improve pain. This study examined the immediate and short-term (4 weeks) effects of long- and short-duration isometric contraction on patellar tendon pain, and tendon adaptation.

Design:
Repeated measures within groups.

Setting:
Clinical primary care.

Patients:
Participants (n = 16, males) with patellar tendinopathy.

Intervention:
Short-duration (24 sets of 10 seconds) or long-duration (6 sets of 40 seconds) isometric knee extension loading (85% maximal voluntary contraction), for 4 weeks.

Main Outcome Measure:
Immediate change in pain with single-leg decline squat (SLDS) and hop, as well as change in pain and tendon adaptation [within-session anterior–posterior (AP) strain] were assessed over 4 weeks.

Results:
Pain was significantly reduced after isometric loading on both SLDS (P < 0.01) and hop tests (P < 0.01). Pain and quadriceps function improved over the 4 weeks (P < 0.05). There was significant AP strain at each measurement occasion (P < 0.01). Although transverse strain increased across the training period from ∼14% to 22%, this was not significant (P = 0.08).

Conclusions:
This is the first study to show that short-duration isometric contractions are as effective as longer duration contractions for relieving patellar tendon pain when total time under tension is equalized. This finding provides clinicians with greater options in prescription of isometric loading and may be particularly useful among patients who do not tolerate longer duration contractions. The trend for tendon adaptation over the short 4-week study period warrants further investigation.
Effectiveness of an Exercise-Based Active Rehabilitation Intervention for Youth Who Are Slow to Recover After Concussion
Authors: Gauvin-Lepage Jérôme , Friedman Debbie , Grilli Lisa , Sufrategui Maria , De Matteo Carol , Iverson Grant L. , Gagnon Isabelle 
Published: August 2018

Objective:(1) To determine the impact of providing participants aged 8 to 17 years who are slow to recover after a concussion with a well-developed active rehabilitation intervention (ARI), compared with receiving standard care alone, on postconcussion symptoms (PCS) at 2 and 6 weeks after the initiation of ARI; and (2) to investigate functional recovery 6 weeks after initiation of ARI.Design:A multicenter prospective quasi-experimental control group design.Setting:Tertiary care pediatric trauma center and community health care providers.Participants:Forty-nine youth were enrolled (experimental n = 36; control n = 13).Procedures:Participants were assessed on 3 different occasions: (1) initial visit (baseline); (2) 2 weeks; and (3) 6 weeks after enrollment.Main Outcome Measures:Child- and parent-reported PCS were obtained by the PCS Inventory Scale (primary outcome). Secondary outcomes included: (1) mood and anxiety; (2) quality of life; (3) energy level; (4) coordination and balance; (5) neurocognition; (6) parental anxiety; and (7) satisfaction with intervention.Results:Both groups reported decrease of PCS over time (child:P= 0.01; parent:P= 0.03). Children in the experimental group presented higher quality of life (P= 0.04) and less anger (P= 0.02). A trend toward significance was observed for better tandem gait (P= 0.07) and for less general fatigue on self-reported PCS (P= 0.09) in the experimental group.Conclusions:Active rehabilitation intervention does not affect the PCS beyond the usual management, but it increases their quality of life, decreases anger, and potentially increases energy level and balance.
Can Ultrasound Identify Paradoxical Vocal Fold Movement? A Pilot Study
Authors: Finnoff Jonathan T. , Orbelo Diana M. , Ekbom Dale C. 
Published: August 2018

Objective:
Vocal cord dysfunction (VCD) is characterized by paradoxical vocal fold movement (PVFM) during inspiration. The aim of this study was to determine whether ultrasound could accurately differentiate between normal and PVFM during respirations in a resting state.

Design:
Prospective, single-subject design.

Setting:
Academic medical center.

Patients:
A speech-language pathologist who was able to volitionally alternate between normal and PVFM when breathing at rest was recruited to participate in the study.

Interventions:
The subject was instructed to randomly alternate between normal and PVFM 20 times (10 times each). A single investigator imaged the vocal folds using ultrasound and reported when the subject alternated between the 2 respiratory states.

Main Outcome Measures:
The subject recorded when they changed between the 2 respiratory states, whether the investigator identified with the change occurred, and if the correct respiratory state was identified.

Results:
The investigator recognized when the subject changed respiratory states and correctly identified the new respiratory state 100% of the time.

Conclusions:
The findings of the current study were promising and suggest that ultrasound may have utility in the diagnosis of VCD. However, because of the preliminary nature of these results, further research is required before recommending its clinical implementation.
Narrow Band Imaging for Surveillance in Inflammatory Bowel Disease
Authors: Lv Xiu-He , Wang Bo-Ling , Cao Guo-Wu 
Published: August 2018

Background:
The role of narrow band imaging (NBI) for surveillance colonoscopy in patients with inflammatory bowel disease (IBD) is debatable. We aim to compare NBI versus other endoscopic techniques in surveillance of IBD basing on current evidences.

Methods:
A systematic search of PubMed, Embase, and the Cochrane Library databases was conducted for relevant studies. To assess the detection efficacy, we estimated risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes. To assess the differentiation efficacy, we estimated sensitivity and specificity of NBI with reference to histology. All outcome variables were pooled using a random-effects model. Heterogeneity was tested by the Q statistic and I
2 statistic.

Results:
A total of 10 studies involving 938 participants were included. Statistically significant differences were not found in the likelihood of detecting patients with dysplastic lesions [RR, 1.11; 95% confidence interval (CI), 0.83-1.48] nor in the likelihood of detecting dysplastic lesions by targeted biopsies (RR, 0.76; 95% CI, 0.51-1.12) between NBI and other techniques, and there was also no difference in the likelihood of detecting dysplastic subtypes. NBI required shorter procedural time compared with other techniques (MD, −10.23; 95% CI, −11.53 to −8.92). The sensitivity and specificity of NBI to differentiate neoplastic lesions from non-neoplastic lesions were 0.64 (95% CI, 0.50-0.77) and 0.74 (95% CI, 0.69-0.79), respectively, and the area under the curve (AUC) was 0.7626.

Conclusions:
Although a shorter procedural time is needed, the clinical application of NBI for both dysplasia detection and neoplasia differentiation in IBD is not superior to other endoscopic techniques.
Chronic rejection in vascularized composite allotransplantation
Authors: Morelon Emmanuel , Petruzzo Palmina , Kanitakis Jean 
Published: August 2018

Purpose of reviewVascularized composite allografts (VCA), which restore severely damaged body parts that cannot be repaired with conventional surgical techniques, often undergo acute skin rejection episodes in the early postgraft period. Although the risk of human VCA to be affected by chronic rejection was initially unknown, such cases were recently observed.Recent findingsChronic rejection targets preferentially the skin (dermal sclerosis, adnexal atrophy, necrosis) and vessels (graft vasculopathy) and may cause graft dysfunction, often resulting in ischemic graft loss. Both immune (cell-mediated and antibody-mediated) and nonimmune mechanisms seem to be involved. The early diagnosis and management of chronic rejection are challenging. Changes of chronic rejection may be seen macroscopically on the skin and can be confirmed with skin and deep tissue biopsies. New noninvasive imaging techniques, which allow visualization of the allograft vasculature, seem promising for the noninvasive detection of graft vasculopathy.SummaryAlthough some features of chronic rejection of VCA start to be known, several important questions remain to be answered, concerning namely the proper definition of chronic rejection, precise diagnostic criteria, better understanding of triggering factors and pathogenetic mechanisms involved and, most importantly, adequate treatment. Ideally, chronic rejection should be prevented in the future by efficient tolerance-inducing protocols.
Bronchoscopy and Bronchoalveolar Lavage in the Diagnosis and Management of Pulmonary Infections in Immunocompromised Children
Authors: Rizik Suha , Hakim Fahed , Bentur Lea , Arad-Cohen Nira , Kassis Imad 
Published: August 2018

Background:
Immunocompromised children are at high risk of rapid deterioration and of developing life-threatening pulmonary infections. Etiologies in this setting are diverse, including those that are infectious and noninfectious, and many etiologies may coexist. Accurate diagnosis is required for the rational use of medications. Fiberoptic bronchoscopy (FOB) with bronchoalveolar lavage (BAL) can identify infectious causes in this population.

Objectives:
The aims of this study were to evaluate diagnostic rate, safety, and changes in treatment following FOB with BAL, when applied with advanced laboratory diagnostic techniques.

Patients and methods:
We reviewed the records of children who underwent FOB with BAL during the period spanning from 2006 to 2014 in the Hematology-Oncology Department. BAL samples were processed in microbiology, virology, cytology, and molecular laboratories.

Results:
Antimicrobials were initiated in 91 of 117 children. BAL yielded an infectious etiology in 55 episodes. Management was altered in 74 patients following a positive (40/55) or a negative (30/54) result (4 patients had missing data). No severe complications associated with the procedures occurred.

Conclusions:
Most immunocompromised patients with pulmonary manifestations are treated empirically with multiple medications. Evaluation FOB/BAL is a useful diagnostic tool, and seems to have changed the course of therapy in more than half of patients, by initiation or cessation of treatment. FOB/BAL is a safe diagnostic tool for the evaluation of pulmonary manifestations in this setting.
Relationship of Staff Information Sharing and Advice Networks to Patient Safety Outcomes
Authors: Brewer Barbara B. , Carley Kathleen M. , Benham-Hutchins Marge M. , Effken Judith A. , Reminga Jeffrey , Kowalchuck Michael 
Published: August 2018

OBJECTIVE
The aim of this study was to compare information sharing and advice networks' relationships with patient safety outcomes.

BACKGROUND
Communication contributes to medical errors, but rarely is it clear what elements of communication are key.

METHODS
We investigated relationships of information-sharing and advice networks to patient safety outcomes in 24 patient care units from 3 hospitals over 7 months. Web-based questionnaires completed via Android tablets provided data to create 2 networks using ORA, a social network analysis application. Each hospital provided nurse-sensitive patient safety outcomes.

RESULTS
In both networks, medication errors correlated positively with node count and average distance and negatively with clustering coefficient. Density and weighted density negatively correlated with medication errors and falls in both networks. Eigenvector and total degree centrality correlated negatively with both safety outcomes, whereas betweenness centrality positively related to falls in the information-sharing network.

CONCLUSION
Technology-enabled social network analysis data collection is feasible and can provide managers actionable system-level information.
A Qualitative Study of Specialized Clinical Nurses’ Perceptions of Good Care in Practice
Authors: Valizadeh Leila , Zamanzadeh Vahid , Rassouli Maryam , Ghahramanian Akram , M. Archibald Mandy , Asghari Elnaz 
Published: August 2018

Purpose/Aims:
The aim of this study was to explore specialized clinical nurses’ (SCNs’) perceptions of “good care” through descriptions of actual care experiences.

Design:
We used a qualitative design with a conventional content analysis approach.

Methods:
We conducted semistructured interviews with 24 SCNs. These nurses have passed specialized clinical courses, are master’s or bachelor’s degree prepared, have additional course work beyond the bachelor degree, and practice with an expanded scope of responsibility. The participants were purposively sampled from general and specialty hospitals, and 6 field notes were collected.

Results:
We identified 3 overarching themes to classify the findings: patient-centered care, knowledge-based care, and skillful practice. Participants regarded these 3 components as interdependent and related, which we conceptualize as 3 sides of an equilateral triangle termed the Good Care Triangle.

Conclusions:
The Good Care Triangle provides a heuristic approach to consider professional standards from the perspectives of SCNs and provides needed insight into SCNs’ perspectives on the fundamental yet underexplored concept of good care. Clinical leaders can consider how the 3 themes identified are reflected and enacted in the care practices of SCNs. Future research could examine the utility of the Good Care Triangle in guiding nursing education and evaluating SCNs’ perspectives of the care that they are providing.
When Family Matters Most: A Test of the Association Between Sexual Minority Identity Disclosure Context and Diurnal Cortisol in Sexual Minority Young Adults
Authors: Manigault Andrew W. , Figueroa Wilson S. , Hollenbeck Cari R. , Mendlein Anna E. , Woody Alex , Hamilton Katrina R. , Scanlin Matt C. , Johnson Ryan C. , Zoccola Peggy M. 
Published: August 2018

ABSTRACT

Objective
Revealing one's sexual identity to others is a complex process marked by a shift in the types of stressors faced by sexual minority young adults. Such stressors influence the secretion of health-relevant hormones, including cortisol, yet how dimensions of disclosure (i.e., the degree and context) influence neuroendocrine functioning remains poorly understood. The current study examined the association between disclosure context (disclosure to family members, friends/co-workers/acquaintances, and members of religious groups) and diurnal cortisol while allowing disclosure to vary in degree (i.e., how much is disclosed).

Methods
One hundred twenty-one sexual minority young adults (aged 18–35 years, 54.5% female, free of major psychiatric/endocrine disorders) completed an initial survey that assessed the degree and context of sexual minority identity disclosure. A randomly selected subset (n = 58) also provided salivary cortisol samples at wake, 45 minutes after wake, 12 hours after wake, and at bedtime for 1 week.

Results
Greater total disclosure and greater disclosure to family members were associated with reduced cortisol output, defined as Area Under the Curve relative to ground (AUCg; F(1,230) = 5.95, p = .015, and F(1,231) = 10.90, p = .001, respectively). Disclosure to co-workers, friends, acquaintances, or religious groups was unrelated to cortisol AUCg. All disclosure contexts tested were unrelated to the shape of diurnal cortisol slopes (including the cortisol awakening response).

Conclusions
Disclosure to family members uniquely predicted cortisol AUCg. Therefore, these results suggest that effects of disclosure on diurnal cortisol and its associated health outcomes may occur in the context of familial relationships.