bluuebunny/crossref_metadata_2025_split huggingface dataset:
Common misdiagnoses and prevalence of dermatological disorders at a pediatric tertiary care center
Authors: Onsoi Witchuwan , Chaiyarit Jitjira , Techasatian Leelawadee 
Published: September 2019

Objectives Dermatological disorders are common in general pediatric practice. This study aimed to examine common skin problems and the manner in which they tend to be misdiagnosed. Methods A cross-sectional study was conducted from January 2015 to December 2016 using medical record data from the Pediatric Dermatological Outpatient Unit at Khon Kaen University, Faculty of Medicine. Results A total of 1551 visits by 769 patients were documented during the study period. A total of 114 presenting diseases were recorded. The most common skin disease in the study population was dermatitis (unspecified) (88/769, 11.4%), followed by atopic dermatitis (76/769, 9.8%) and infantile hemangioma (72/769, 9.3%). There was a total of 55 (48.2%) misdiagnosed diseases. Some unique cutaneous diseases were undiagnosed because of their rarity. However, the percentages of common cutaneous diseases, such as tinea capitis and molluscum contagiosum, which had been misdiagnosed, were also high (62.50% [95% confidence interval = 24.49–91.48] and 71.43% [95% confidence interval = 29.04–96.33], respectively). Conclusion A large percentage of misdiagnoses of common cutaneous diseases may be due to general pediatricians being undereducated in the field of dermatology. Accurate recognition and appropriate management of these conditions should be emphasized for educating general pediatricians in the future.
Genetic and sex hormone analysis of infertile men
Authors: Xie Xiaolei , Guo Xiaoyan , Li Fuguang , Tan Weihe , Yin Weiguo , Chen Runqinag 
Published: September 2019

Objective Genetic defects and endocrine-related factors are the leading causes of male infertility. This study was performed to analyze the genetic characteristics and sex hormone levels in different types of male infertility. Methods A total of 423 men with infertility underwent genetic and sex hormone analysis at The Sixth Affiliated Hospital of Guangzhou Medical University. Results The incidences of abnormal karyotypes in patients with male infertility, azoospermia, and oligoasthenozoospermia were 6.94%, 22.40%, 15.09%, respectively. Among men with azoospermia, Klinefelter syndrome (47,XXY) was identified in 60.71% (17/28) of those with abnormal karyotypes. Additionally, the levels of follicle-stimulating hormone and human luteinizing hormone were significantly higher in men with azoospermia showing abnormal karyotypes than in men of the other study groups. The serum testosterone level in men with azoospermia showing abnormal karyotypes was lower than that in men of the other study groups. Conclusions Azoospermia is closely associated with chromosome abnormalities. The levels of testosterone, human luteinizing hormone, and follicle-stimulating hormone in men with azoospermia showing abnormal karyotypes provide a clinical reference for genetic counseling and assisted reproduction.
Occupational therapy-led pulmonary rehabilitation: A practice analysis
Authors: Easthaugh Susan , Bradley Gemma , Peel Lorna , Donnelly Joanna 
Published: September 2019

Statement of context: Pulmonary rehabilitation is accepted as an essential strategy for the management of respiratory disease. However, there is wide variation in models of service delivery, and evidence to understand which elements are most effective is less clear. This analysis outlines key elements of an occupational therapy-led pulmonary rehabilitation programme. Critical reflection on practice: It is proposed that the core focus on occupation and the unique skills and reasoning of occupational therapists contribute to positive outcomes for service users. Implications for practice: Occupational therapists are ideally placed to lead and develop pulmonary rehabilitation programmes. As there is genuine uncertainty about which elements are most effective, this analysis should encourage further evaluation and research.
The Danger of a “Geyser Disease” Effect: Structural Fragility of the Tourism-Led Recovery in Iceland
Authors: Macheda Francesco , Nadalini Roberto 
Published: September 2019

The fall of the Icelandic economy in 2008 highlighted the destructive effects of unbridled markets. Yet, in recent years Iceland’s annual growth rates have been significantly higher than those of the overwhelming majority of advanced capitalist countries. The aim of this article is to delve into the fragile foundations that the current Icelandic economic boom rests on. We argue that the impressive appreciation of the Icelandic króna, triggered by the rapid expansion of tourism, has made the rapid absorption of unemployment compatible with price stability during the recovery period. By restricting sources of international competitiveness, however, this tourism-led recovery strategy will render the current level of unemployment and real wages inconsistent with internal and external equilibrium in the long run. JEL classification: E24, F31, J24, O33, B51
Nasalance-Based Preclassification of Oral–Nasal Balance Disorders Results in Higher Agreement of Expert Listeners’ Auditory-Perceptual Assessments: Results of a Retrospective Listening Study
Authors: de Boer Gillian , Marino Viviane Christina de Castro , Dutka Jeniffer de Cassia Rillo , Pegoraro-Krook Maria Inês , Bressmann Tim 
Published: September 2019

Objective: Reliable perceptual and instrumental assessment of oral–nasal balance disorders is a persistent problem in speech-language pathology. The goal of the study was to evaluate whether nasalance-based preclassification of oral–nasal balance disorders improves listener agreement. Design: Retrospective listening study. Setting: Tertiary university hospital. Participants: Fifty-four randomly selected recordings of patients with repaired unilateral cleft lip and palate (UCLP). Three experienced speech-language pathologists participated as expert listeners. Interventions: Two listening experiments were based on nasalance scores and audio recordings of speakers with repaired UCLP. The speakers were preclassified as normal, hypernasal, hyponasal, or mixed based on their nasalance scores. Initially, the listeners determined the diagnostic category of the oral–nasal balance for 62 audio recordings (8 repeats). Six months later, they listened to 38 of the recordings (6 repeats) along with a spreadsheet indicating the nasalance-based categories for the oral–nasal balance. The listeners confirmed, or rejected and corrected, the nasalance-based preclassification. Main Outcome Measures: Intralistener, interlistener agreement, and agreement between listener categories and nasalance-based oral–nasal balance categories. Results: In the first study, the agreement between the listeners’ diagnostic category and the nasalance-based category was 45.1% and the interlistener agreement was 36.7%. In the second study, the agreement between the listeners’ category and the nasalance-based category was 67.1% (75% agreement for the correct nasalance-based categories and 41.7% for the misclassifications), and the interlistener agreement was 85.4%. Conclusions: Preclassification of oral–nasal balance disorders based on nasalance scores may help listeners achieve better diagnostic accuracy and higher agreement.
Vitreomacular interface alterations following peripheral laser retinopexy: Interface changes after laser
Authors: Tosi Gian Marco , Bacci Tommaso , Tarantello Antonio , Marigliani Davide , Calmanti Giacomo , Polito Maria Sole , Neri Giovanni , Fusco Fiorella , Cevenini Gabriele , Virgili Gianni 
Published: September 2019

Aim: To demonstrate the morphological outcomes of macular hole following prophylactic peripheral laser retinopexy (PPLR). Methods: Our retrospective case-control analysis included 92 eyes, 55 in the laser group and 37 in the non-laser group. Fifty-five patients were subjected to prophylactic peripheral laser retinopexy in preparation for pars plana vitrectomy for macular hole, with and without vitreomacular adhesion (laser group). Before and after prophylactic peripheral laser retinopexy, we evaluated any changes in vitreomacular anatomy by optical coherence tomography. Optical coherence tomography changes were also analyzed in the visits preceding pars plana vitrectomy in 37 macular hole eyes not subjected to prophylactic peripheral laser retinopexy (non-laser group). Results: In the laser group, 7 out of 55 eyes (12.7%) showed macular hole closure (6 out of 18 macular hole eyes with vitreomacular adhesion (33.3%) and 1 out of 37 eyes without vitreomacular adhesion (2.7%)), while no patients showed macular hole closure in the non-laser group (p < 0.05). The mean width of the seven closed macular hole was 191.4 µm (range: 59–282 µm). In all except one of the six macular hole eyes with vitreomacular adhesion, the macular hole closed without vitreomacular adhesion release. In our analysis of the patient subgroup with vitreomacular adhesion, we observed a release of vitreomacular adhesion in 3 out of 18 eyes (16.6%) in the laser group and in 1 out of 13 eyes (7.6%) in the non-laser group (p > 0.05). Conclusion: These findings support a possible beneficial role for prophylactic peripheral laser retinopexy in selected individuals with macular hole.
Microincision cataract surgery with implantation of a bitoric intraocular lens using an enhanced program for intraocular lens power calculation
Authors: Lesieur Gilles 
Published: September 2019

Purpose: To evaluate the potential benefit of a new version of an online toric intraocular lens calculator in eyes implanted with a bitoric intraocular lens. Patients and methods: Retrospective observational comparative study in patients that underwent cataract surgery with implantation of the bitoric intraocular lens AT TORBI 709M (Carl Zeiss Meditec AG, Jena, Germany). Visual and refractive outcomes were evaluated at 1 month after surgery. The selection of the toric intraocular lens power was performed with the software Z CALC 2.0 (Carl Zeiss Meditec AG). The absolute refractive prediction errors for the spherical equivalent and cylinder were calculated and compared with the values that would have been obtained using version 1.5 of the same software. Results: A total of 393 eyes of 276 patients were evaluated. Mean postoperative sphere and cylinder were +0.03 ± 0.54 and −0.19 ± 0.30 D, respectively. A total of 95.67%, 98.22%, and 95.17% of eyes had a postoperative sphere, cylinder, and spherical equivalent within ±1.00 D, respectively. Mean absolute refractive prediction error for spherical equivalent was 0.34 ± 0.27 D with the two versions of the Z CALC software. In contrast, a significantly higher absolute refractive prediction error value for the cylinder was found with Z CALC 1.5 compared to version 2.0 (0.35 ± 0.32 vs 0.28 ± 0.30 D, p < 0.001). The absolute refractive prediction error for cylinder was ⩽0.25 D in 62.3% and 47.5% when using the versions 2.0 and 1.5, respectively. Conclusion: The use of an optimized software for toric intraocular lens power calculation, considering the contribution of posterior corneal astigmatism, improved the astigmatic outcome with a bitoric intraocular lens.
Pivotal response treatment: A study into the relationship between therapist characteristics and fidelity of implementation
Authors: Verschuur Rianne , Huskens Bibi , Korzilius Hubert , Bakker Leonhard , Snijder Michelle , Didden Robert 
Published: September 2019

In this study, we investigated the relationship between fidelity of pivotal response treatment implementation and therapist characteristics, such as therapist personality, therapist–child relationship, therapist attitude toward evidence-based practices, and therapist experience. We also explored whether child age and autism symptom severity were related to pivotal response treatment fidelity. Participants were 41 level III certified pivotal response treatment therapists who recorded three 10-min pivotal response treatment sessions and completed four questionnaires to measure therapist characteristics. Results indicated that therapists’ attitude toward evidence-based practices, specifically openness to innovation, and therapists’ experience with pivotal response treatment significantly predicted fidelity of pivotal response treatment implementation. Cross-validation methods largely confirmed these findings. Therapist personality, therapist–child relationship, and child characteristics were not significantly related to pivotal response treatment fidelity. Implications for clinical practice and directions for future research are discussed.Lay abstractPivotal response treatment is a naturalistic behavioral intervention that teaches pivotal skills to children with autism spectrum disorder to produce widespread gains in other skills. Although most children with autism spectrum disorder benefit from pivotal response treatment, intervention outcomes vary considerably among children. Fidelity of intervention implementation (i.e. the extent to which an intervention is implemented as intended) may affect intervention outcomes. In this study, we studied the relationship between fidelity of pivotal response treatment implementation and therapist characteristics, such as therapist personality, therapist–child relationship, therapist attitude toward evidence-based practices, and therapist experience. We also explored whether a child’s age and autism symptom severity were related to pivotal response treatment fidelity. Participants were 41 pivotal response treatment therapists who videotaped three pivotal response treatment sessions and completed four questionnaires to measure therapist characteristics. This study found that therapists’ openness to innovation and their experience with pivotal response treatment predicted fidelity of implementation. Therapist personality, therapist–child relationship, and child characteristics were not related to pivotal response treatment fidelity. The results of this study emphasize that it is important (1) to target therapists’ attitudes toward innovation prior to or during training in pivotal response treatment and (2) to provide therapists with ongoing supervision and feedback after training to increase fidelity of implementation and thus to improve intervention outcomes for children with autism spectrum disorder.
Patient-reported Outcome in Surgically Treated Pelvic Ring Injuries at 5 Years Post-surgery
Authors: Hernefalk B. , Eriksson N. , Larsson S. , Borg T. 
Published: September 2019

Background and Aims: Long-term prospective data on patient-reported outcome after surgical treatment of pelvic ring injuries are scarce. This study aimed at describing results at 5 years post-surgery using validated outcome measures. Patients and Methods: Patients admitted for surgical treatment of pelvic ring injuries were prospectively included and asked to report their outcome at 1, 2 and 5 years post-surgery using two patient-reported outcome measures: the generic Short-Form 36 and the condition-specific pelvic discomfort index. Data were evaluated using mixed-effects linear models. Results: There were 108 patients (68 males and 40 females), mean age 38 years. Injury type according to the AO/OTA-classification was B-type in 68 patients and C-type in 40 patients. No domain of the Short-Form 36 reached norm values at 5 years post-surgery. Females reported a worse outcome than males concerning general health ( p < 0.01) at 5 years. Recovery of physical function ( p < 0.01), mental health ( p = 0.04), and pain ( p = 0.01) was observed for males at 5 years compared to earlier assessments, while females on the contrary described more pain at this time-point ( p = 0.03). Mean pelvic discomfort index at 5 years was 27, indicating moderate residual pelvic discomfort overall. Males reported less pelvic discomfort than females at 5 years ( p = 0.02) and improved when compared to results at 2 years ( p = 0.02), while females did not. Influence of age, fracture type, and presence of associated injuries on patient-reported outcome was limited. Conclusion: Surgically treated pelvic ring injuries are associated with long-standing negative effects on patient-reported outcome. Males report a better outcome than females at 5 years post-surgery.
CNDP2 Acts as an Activator for Human Ovarian Cancer Growth and Metastasis via the PI3K/AKT Pathway
Authors: Zhang Li Q. , Yang Hua Q. , Yang Su Q. , Wang Ying , Chen Xian J. , Lu Hong S. , Zhao Ling P. 
Published: September 2019

Introduction: The mechanism of tumorigenesis and metastasis of ovarian cancer has not yet been elucidated. This study aimed to investigate the role and molecular mechanism of cytosolic nonspecific dipeptidase 2 in tumorigenesis and metastasis. Methods: Cytosolic nonspecific dipeptidase 2 expression in human ovarian cancer tissues and cell lines was assessed with methyl thiazolyl tetrazolium (MTT), clone formation, and transwell assays performed to evaluate the ability of ovarian cancer cells to proliferate and migrate. Nude mice tumor formation experiments were also performed by subcutaneously injecting cells with stable cytosolic nonspecific dipeptidase 2 knockdown and control SKOV3 cells into BALB/c female nude mice to detect changes in PI3K/AKT pathway-related proteins by Western blotting. Results: Cytosolic nonspecific dipeptidase 2 was highly expressed in human ovarian cancer tissues, with its expression associated with pathological data, including ovarian cancer metastasis. A cytosolic nonspecific dipeptidase 2 stable knockdown or ectopic expression ovarian cancer cell model was established and demonstrated that cytosolic nonspecific dipeptidase 2 could promote the proliferation of ovarian cancer cells. Transwell cell migration and invasion assays confirmed that cytosolic nonspecific dipeptidase 2 enhanced cell metastasis in ovarian cancer. Furthermore, in vivo xenograft experiments demonstrated that cytosolic nonspecific dipeptidase 2 can promote the development and progression of ovarian cancer, increasing the expression of phosphorylated PI3K and AKT. Conclusions: Cytosolic nonspecific dipeptidase 2 promotes the occurrence and development of ovarian cancer through the PI3K/AKT signaling pathway.
Mexican American Parental Knowledge and Perceptions of Childhood Obesity: An Integrative Review
Authors: Confiac Nathalie , Turk Melanie T. , Zoucha Rick , McFarland Marilyn 
Published: September 2019

Introduction: For the past two decades, childhood obesity has remained a national public health concern, particularly among Hispanic populations. Multiple cross-sectoral obesity prevention strategies have been implemented yet remain unsuccessful in generating sustainable lifestyle changes. Method: The purpose of this integrative review, using the Whittemore and Knafl method, was to examine the literature from 2009 to 2018 regarding Mexican American parental knowledge and perceptions of childhood obesity. The CINAHL, PubMed, PsycINFO, and ERIC databases were used to search the literature, and 13 peer-reviewed articles met the inclusion criteria. Results: Three main themes emerged from the literature synthesis: (1) parental misperception of child body weight and size, (2) influence of cultural health and growth beliefs on parental perception of child weight, and (3) parental perspectives of causes and consequences of childhood obesity and how to address it. However, cultural variations in parental perceptions were found; therefore, attempts to generalize Mexican Americans’ cultural practices should be avoided. Conclusion: Studies using qualitative approaches are needed to gain deeper insights about Mexican American culture regarding children’s health as it relates to body weight, the roles of different family members in the Mexican American childrearing tradition, and the impact of their associated health beliefs.
Efficacy of inhaled ciprofloxacin agents for the treatment of bronchiectasis: a systematic review and meta-analysis of randomized controlled trials
Authors: Lim Jeong Uk , Hong Seung Wook , Ko Jae-Hoon 
Published: September 2019

Background: The efficacy of inhaled ciprofloxacin agents in the treatment of patients with bronchiectasis is controversial. The objective of the study was to review systematically the efficacy of inhaled ciprofloxacin agents in patients with bronchiectasis. Methods: We searched PubMed, EMBASE, and Cochrane Library databases for randomized controlled trials (RCTs) evaluating inhaled ciprofloxacin agents among patients with bronchiectasis. Data were pooled using a meta-analysis technique. Results: Two phase II and four phase III RCTs were included with a total of 1685 patients. Treatment durations of phase III studies were 48 weeks, while those of phase II studies were shorter. Pooled analysis of overall studies exhibited a statistically significant benefit of inhaled ciprofloxacin agents in three exacerbation outcome measures, including time to first exacerbation (hazard ratio 0.74, 95% confidence interval [CI] 0.63–0.86, I2 23%), exacerbation frequency (risk ratio [RR] 0.73, 95% CI 0.61–0.86, I2 42%), and exacerbation proportion (RR 0.85, 95% CI 0.76–0.96, I2 25%) without significant heterogeneity. Outcomes evaluating pulmonary function, quality of life, and adverse events were not significantly different between the two groups. Although eradication of respiratory pathogens was more frequently observed, the emergence of ciprofloxacin resistance was also significantly higher in the ciprofloxacin group. Conclusions: A meta-analysis of RCTs of inhaled ciprofloxacin agents showed clinical benefit in terms of pulmonary exacerbations in patients with bronchiectasis. Since a significant increase of resistance was also noticed, clinical trials with a longer study period are required for a conclusive assessment. The reviews of this paper are available via the supplemental material section.
Usage of Hydrocolloid-Based Plasters in Patients Who Have Developed Allergic Contact Dermatitis to Isobornyl Acrylate While Using Continuous Glucose Monitoring Systems
Authors: Kamann Stefanie , Heinemann Lutz , Oppel Eva 
Published: September 2019

Background: Continuous glucose monitoring (CGM) systems replace more and more capillary self-monitoring of blood glucose by patients with diabetes. However, at least a subset of patients experience adverse skin reactions such as severe allergic contact dermatitis (ACD) after prolonged usage of CGM systems. A major allergen isobornyl acrylate (IBOA) has been identified recently. Objectives: After developing an ACD, patients have difficulties in continuing the usage of their CGM system (and also of, eg, certain patch pumps). Most of such patients look for possibilities to continue the usage of, eg, a CGM system that requires intermittent scanning (iscCGM, Freestyle Libre). Patients and Methods: Eight patients with a known ACD were supplied with different hydrocolloid-based plasters ( n = 5 with Hansaplast blister plaster, n = 2 with Cutimed Hydro B from BSN, and n = 1 with Stomahesive baseplate from Convatec). They attached these plasters to their skin underneath their iscCGM system. Results: All patients were able to continue the usage of this iscCGM system when using such plasters. Conclusion: Patients with ACD benefit from the usage of such plasters; however, some limitations have to be acknowledged.