bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Methotrexate-Associated Lymphoproliferative Disorder (Lymphomatoid Granulomatosis) of the Skin
Authors: Nishida Haruto , Oyama Yuzo , Kusaba Takahiro , Kadowaki Hiroko , Arakane Motoki , Yokoyama Shigeo , Hatano Yutaka , Daa Tsutomu 
Published: May 2019

Abstract:
Iatrogenic lymphoproliferative disorder (LPD) can develop in patients treated with immunosuppressive drugs for autoimmune or other inflammatory diseases. Here, we report a case of lymphomatoid granulomatosis of the skin that occurred as a methotrexate (MTX)-associated LPD. We also review the relevant literature. A 73-year-old woman presented to our department with an approximately 10-year history of MTX therapy for rheumatoid arthritis. Three months earlier, she noticed a small nodule in her right upper arm. It gradually enlarged, and the center began to decay. Grossly, the lesion was 40 × 40 mm in size with ulceration, and the surrounding skin presented dark red erythema. A biopsy specimen was taken for definitive diagnosis. Histologically, infiltrating growth of medium-to-large atypical lymphocytes was observed underneath the ulceration and was accompanied by small reactive lymphocytes. The atypical lymphocytes demonstrated a tendency to infiltrate the vessels, which showed an angiocentric pattern. Immunohistochemistry revealed that the atypical lymphoid cells were positive for CD79a, CD20, and CD30. In addition, in situ hybridization for Epstein–Barr virus (EBV) revealed expression of EBV-encoded small RNAs. The patient was diagnosed with MTX-associated LPD (lymphomatoid granulomatosis), owing to her history of MTX treatment, the expression of the atypical lymphocytes for B-cell markers and EBV-encoded small RNA, and the angiocentric infiltrating pattern. The lesion reportedly disappeared after withdrawal of MTX.
Telomere length and socioeconomic status at neighborhood and individual levels among 80,000 adults in the Genetic Epidemiology Research on Adult Health and Aging cohort
Authors: Alexeeff Stacey E. , Schaefer Catherine A. , Kvale Mark N. , Shan Jun , Blackburn Elizabeth H. , Risch Neil , Ranatunga Dilrini K. , Jorgenson Eric , Hoffmann Thomas J. , Sakoda Lori C. , Quesenberry Charles P. , Van Den Eeden Stephen K. 
Published: May 2019

Background:
Telomere length (TL) may serve as a biologic marker of aging. We examined neighborhood and individual-level socioeconomic status (SES) in relation to TL.

Methods:
The study included 84,996 non-Hispanic white subjects from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort, part of the Research Program on Genes, Environment and Health. Relative TL (T/S) was log2 transformed to improve normality and standardized to have mean 0 and variance 1. Neighborhood SES was measured using the Neighborhood Deprivation Index (NDI), and individual SES was measured by self-reported education level. We fit linear regression models of TL on age, sex, smoking, body mass index, comorbidities, NDI, and education level. We tested for differences in the associations by sex and nonlinearity in the association of NDI with TL.

Results:
Each SD increase in NDI was associated with a decrease of 0.0192 in standardized TL, 95% confidence interval (CI) = −0.0306, −0.0078. There was no evidence of nonlinearity in the association of NDI with TL. We further found that less than high school education was associated with a decrease of 0.1371 in standardized TL, 95% CI = −0.1919, −0.0823 as compared to a college education. There were no differences in the associations by sex.

Conclusions:
We found evidence that both lower neighborhood SES and lower individual-level SES are associated with shorter TL among non-Hispanic whites. Our findings suggest that socioeconomic factors may influence aging by contributing to shorter TL.
Sleep and female reproduction
Authors: Willis Sydney Kaye , Hatch Elizabeth Elliott , Wise Lauren Anne 
Published: May 2019

Purpose of review
Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect circadian rhythms, which in turn may affect female reproduction. The objective of this review is to evaluate recent literature on the association between sleep disturbances and female reproduction.

Recent findings
There is accumulating evidence that sleep quality and duration are important for female reproduction, but epidemiologic research is limited. Recent studies provide suggestive evidence that sleep disorders are associated with increased menstrual irregularity, subfertility/infertility, and poor pregnancy and birth outcomes. Mechanisms underlying these associations are likely to be multifactorial and complex. In addition to genetics, circadian disruption may impact reproductive outcomes through dysregulation of the hypothalamic-pituitary-adrenal axis, insulin resistance, oxidative stress, and systemic inflammation. Recommendations for future studies include: use of prospective study designs; assessment of populations not already experiencing reproductive disorders; more detailed and accurate assessments of sleep such as validated self-reported measures or objective sleep measures (e.g. actigraphy); comprehensive assessment of potential confounders and mediators; and elucidation of biologic mechanisms.

Summary
There is a growing body of literature showing evidence that sleep disturbances influence female reproduction, although further epidemiologic research is needed.
Harvesting Split-thickness Skin from the Scalp Using a Scalpel
Authors: Maruyama Seiichi 
Published: May 2019

Background:
Split-thickness skin grafts (STSGs) from the scalp may be an attractive option for patients who do not want scars on their limbs or trunk. However, not all institutions have the equipment typically used to perform STSGs.

Methods:
Between January 2015 and June 2017, STSGs were harvested with a No. 15 blade under local anesthesia from the scalps of 4 patients and grafted on small skin defects from facial trauma, a tattoo, and scarring, and on a large defect from burns. Epithelialization of the donor sites and graft take, secondary contraction, and color and texture match of the recipient sites were observed. Thickness of the harvested skin was confirmed by histopathologic examination.

Results:
Mean patient age was 39.8 years; 2 patients were male. Epithelialization of the donor sites took a mean of 8.75 days. No hypertrophic scarring or alopecia was observed. Good graft take and relatively good color and texture match of the recipient site were achieved. Mild secondary contraction was noted in 2 cases. Histopathologic examination showed no damage to the hair follicles. The thickness of the harvested skin varied from 0.3 to 0.7 mm.

Conclusions:
Using the scalpel technique, surgeons can perform STSGs with only several blades, minimizing surgical costs. The hair follicles remain intact because the thickness of the graft skin is <1 mm. Epithelialization of the donor site is quick, and there is no visible wound on the limb or trunk. It is especially useful to cover small defects.
The Mini-Balance Evaluation System Test Can Predict Falls in Clinically Stable Outpatients With COPD
Authors: Pereira Ana Carolina A. C. , Xavier Rafaella F. , Lopes Aline C. , da Silva Cibele C. B. M. , Oliveira Cristino C. , Fernandes Frederico L. A. , Stelmach Rafael , Carvalho Celso R. F. 
Published: May 2019

Purpose:
This study evaluated the accuracy of the Mini-Balance Evaluation System Test (Mini-BESTest) for predicting falls in patients with chronic obstructive pulmonary disease (COPD) and investigated whether postural balance is a risk factor for falls.

Methods:
Postural balance was evaluated by the Mini-BESTest at baseline, and the incidence of falls over a 12-mo period was prospectively measured by a self-reported falls diary and confirmed by telephone calls. A discriminative power analysis was performed using receiver operating characteristic (ROC) curve and logistic regression analysis.

Results:
Sixty-seven outpatients with COPD (mean age ± SD = 67 ± 9.3 yr) were included. Twenty-five patients (37.3%) experienced ⩾1 fall, and 28.2% of the falls resulted in injuries. The Mini-BESTest predicted falls in patients with COPD at the 6- and 12-mo follow-ups with a cut-off score of 22.5 (area under the curve = 0.85 and 0.87) with good sensitivity and specificity (85.7% and 66.7%; 84% and 73.8%, respectively). Higher scores on the Mini-BESTest were associated with a lower risk of falls at 12 mo (OR = 0.50; 95% CI, 0.36–0.70; P < .001).

Conclusions:
Postural balance assessed by the Mini-BESTest is a good predictor of falls in patients with COPD. Our results imply that impaired balance contributes to the risk of falling and that balance training and fall prevention programs may be required for this population.
Postdeployment Polytrauma Diagnoses Among Soldiers and Veterans Using the Veterans Health Affairs Polytrauma System of Care and Receipt of Opioids, Nonpharmacologic, and Mental Health Treatments
Authors: Adams Rachel Sayko , Larson Mary Jo , Meerwijk Esther L. , Williams Thomas V. , Harris Alex H. S. 
Published: May 2019

Objectives:
To determine the proportion of Army soldiers who utilized care in the Veterans Health Administration (VHA) Polytrauma System of Care (PSC) within the postdeployment year and to describe prevalence of polytrauma diagnoses, and receipt of opioids, nonpharmacologic treatments (NPTs), and mental health treatments in the VHA during the year following first PSC utilization.

Setting:
VHA's 4-tiered integrated PSC network of specialized rehabilitation services for military members and veterans with polytrauma.

Participants:
Soldiers and veterans who used the PSC during the postdeployment year after an Afghanistan or Iraq deployment ending in fiscal years 2008-2011.

Design:
Population-based cohort study.

Main Measures:
Prevalence of polytrauma diagnoses (ie, traumatic brain injury [TBI], posttraumatic stress disorder [PTSD], and chronic pain [CP]), VHA utilization rates of opioid prescriptions, NPT, and specialty mental health treatment within 1 year of PSC utilization.

Results:
In total, 2.6% of the sample (n = 16 590) used the PSC during the postdeployment year. Among PSC users, CP (76.5%), PTSD (53.1%), and TBI (48.6%) were common and more frequently found together than in isolation; 26.6% filled an opioid prescription, 35.5% received at least 1 NPT, and 83.8% received specialty mental health treatment in the VHA within 1 year of PSC utilization.

Conclusion:
CP was the most common polytrauma condition among PSC users, highlighting the importance of incorporating interdisciplinary pain management approaches within the PSC, with an effort to reduce reliance on long-term opioid therapy and improve rehabilitation.
Developing a Therapeutic Approach Toward Active Engagement for Veterans With Mild Traumatic Brain Injury
Authors: Tapia Rebecca , Garg Deep , Eapen Blessen 
Published: May 2019

Background:
Treatment of chronic mild traumatic brain injury (mTBI) or postdeployment syndrome can be challenging to frontline providers who care for our nation's war heroes. There is ample guidance available for symptom-based interventions, but relatively little information regarding the structure and language of the clinical encounter. Dynamic patient education centered upon relatable language, accessible analogies, and brain health can move the visit beyond historical diagnostics into a shared understanding of postdeployment barriers to reintegration.

Objective:
We aim to describe a practical, education-based clinical approach for chronic mTBI or postdeployment syndrome (mTBI/PDS). The foundation of this method is gathering the veteran's narrative, validating and normalizing his or her experience, highlighting neurobehavioral changes from combat that may represent barriers to full community reintegration, and transitioning to an emphasis on overall brain health.

Conclusion:
The chronic mTBI or PDS clinical encounter can be enhanced by empowering the patient with relatable terms and concepts to describe his or her reintegration challenges and emphasizing factors of brain health. This approach can provide the patient with a base of understanding regarding his or her current symptoms, promote focus on factors for cognitive health, and orient the clinical encounter toward improved community reintegration and long-term cognitive wellness.
Is Performing Femtosecond Laser–Assisted In Situ Keratomileusis on the Day of the Initial Consultation Visit Safe, Predictable and Efficacious?
Authors: Gershoni Assaf , Mimouni Michael , Reitblat Olga , Livny Eitan , Ehrlich Rita , Bahar Irit 
Published: May 2019

Objectives:
Our aim is to evaluate the safety, efficacy, predictability, and clinical outcome of femtosecond laser–assisted in situ keratomileusis (FS-LASIK) procedures performed on the day of the initial consultation relative to procedures performed at subsequent visits.

Methods:
A retrospective cohort study design was used. The study group included patients with myopia of different severities who were treated with FS-LASIK in 2013 through 2014 in an optical outpatient clinic of a large private medical service. Inclusion criteria were at least 18 years of age, a stable refraction for 12 months, no history of autoimmune disease, ocular surgery, or eye disease, and complete medical records. Background, clinical, and outcome data were collected from the patient files.

Results:
Femtosecond laser–assisted in situ keratomileusis was performed in 80 patients (160 eyes) at the first visit and 361 patients (719 eyes) at a subsequent visit. The mean±SD spherical equivalent (SE) refraction before surgery was −3.74±2.03 D in the first-visit group and −3.73±1.87 D in the subsequent-visit group (P=0.99). Efficacy index values were 0.97±0.15 in the first-visit group and 0.98±0.13 in the subsequent-visit group (P=0.92), and corresponding safety index values were 0.99±0.15 and 0.99±0.12 (P=0.81). The final SE measured −0.09±0.58 D in the first-visit group and −0.19±0.55 D in the subsequent-visit group (P=0.05). Types and rates of complications were similar in the two groups.

Conclusions:
There is no significant difference in the results of refractive surgery with FS-LASIK between procedures performed at the initial or subsequent visits. In both conditions, FS-LASIK surgery is associated with excellent safety, efficacy, and predictability profiles.
Central and Peripheral Corneal Endothelial Cell Analysis With Slit-Scanning Wide-Field Contact Specular Microscopy: Agreement With Noncontact Specular Microscopy
Authors: Lee Jinhee , Mori Yosai , Ogata Miyuki , Minami Keiichiro , Miyata Kazunori 
Published: May 2019

Purpose:
The prospective case series aimed to examine the agreement between the use of a slit-scanning contact specular microscope and a noncontact specular microscope in corneal endothelial cell (CEC) analysis and to evaluate the differences between the central and peripheral regions in normal corneas.

Methods:
After confirming normal corneal endothelium with slit-lamp microscopy, CEC images of 56 eyes of 56 cataractous patients were analyzed in the central and 4 peripheral regions using a slit-scanning contact specular microscope. A noncontact specular microscope was used for the analysis in the central region. The endothelial cell density (ECD), the percentage of hexagonal shape cells (HEX), and the coefficient of variation (CV) in the central region were compared. Differences between central and peripheral CECs were also evaluated.

Results:
The mean ECD was 2778 cell/mm2 and was not different from the results using the noncontact specular microscope (2736 cell/mm2, P = 0.051). There was a significant correlation (P < 0.001, R2 = 0.72). The analysis of HEX resulted in larger values with the slit-scanning contact microscope (53.13% vs. 48.89%, P < 0.001), whereas there was no difference in the CV (38.48 vs. 38.04, P = 0.56). On comparing the central and peripheral regions, there was no significant difference in the ECD, whereas significant differences were found in the superior region in the HEX and CV (P < 0.001) and in the nasal region in CV (P = 0.023).

Conclusions:
The analysis of ECD with the use of the slit-scanning contact specular microscope did not differ from the noncontact specular microscope, and the results demonstrated no difference between the central and peripheral ECD.
Comparison of Descemet Stripping Automated Endothelial Keratoplasty and Descemet Membrane Endothelial Keratoplasty in the Treatment of Failed Penetrating Keratoplasty
Authors: Einan-Lifshitz Adi , Mednick Zale , Belkin Avner , Sorkin Nir , Alshaker Sara , Boutin Tanguy , Chan Clara C. , Rootman David S. 
Published: May 2019

Purpose:
To compare the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) with Descemet membrane endothelial keratoplasty (DMEK) for the treatment of failed penetrating keratoplasty (PKP).

Methods:
This is a retrospective chart review of patients with failed PKP who underwent DMEK or DSAEK. The median follow-up time for both groups was 28 months (range 6–116 months). Data collection included demographic characteristics, number of previous corneal transplants, previous glaucoma surgeries, best-corrected visual acuity, endothelial cell density, graft detachment and rebubble rate, rejection episodes, and graft failure.

Results:
Twenty-eight eyes in the DMEK group and 24 eyes in the DSAEK group were included in the analysis. Forty-three percent of eyes in the DMEK group and 50% of eyes in the DSAEK group had to be regrafted because of failure (P = 0.80). The most common reason for failure was persistent graft detachment (58%) in the DMEK group and secondary failure (58%) in the DSAEK group; hence, the time between endothelial keratoplasty and graft failure differed significantly between the groups (P = 0.02). Six eyes (21%) in the DMEK group and 7 eyes (29%) in the DSAEK group developed graft rejection (P = 0.39). Rejection was the cause of failure in 67% and 71% in the DMEK and DSAEK groups, respectively. The best-corrected visual acuity 6 months after surgery was better in the DMEK group compared with the DSAEK group (P = 0.051).

Conclusions:
Both DSAEK and DMEK have a role in treating PKP failure. Primary failure due to persistent graft detachment was significantly higher in the DMEK group, although the overall failure rate in the medium term was similar.
Anterior Segment Optical Coherence Tomography Images in Microsporidial Keratoconjunctivitis
Authors: Thanathanee Onsiri , Laohapitakvorn Suparat , Anutarapongpan Orapin , Suwan-apichon Olan , Bhoomibunchoo Chavakij 
Published: May 2019

Purpose:
To describe the findings of anterior segment optical coherence tomography (AS-OCT) in patients with microsporidial keratoconjunctivitis.

Methods:
The observational study included 13 eyes from 13 patients. Slit-lamp photography and AS-OCT were performed using the Swept source OCT before corneal scraping. All cases were positive for Gram-chromotrope (modified trichrome) staining for Microsporidia spp.

Results:
Three significant AS-OCT findings were observed. First, hyperreflective dots were limited to the epithelial layers of the cornea, and second, there were no extensions into the stromal layer in all cases. Last, hyperreflective dots slightly raised above the epithelial surface were observed in most cases (12/13%, 92.3%).

Conclusions:
AS-OCT represents an alternative, noninvasive tool to diagnose microsporidial keratoconjunctivitis, especially if corneal scraping is not possible.
Safety, Tolerability and Immunogenicity of an MF59-adjuvanted, Cell Culture-derived, A/H5N1, Subunit Influenza Virus Vaccine: Results From a Dose-finding Clinical Trial in Healthy Pediatric Subjects
Authors: Chanthavanich Pornthep , Anderson Edwin , Kerdpanich Phirangkul , Bulitta Michael , Kanesa-thasan Niranjan , Hohenboken Matthew 
Published: May 2019

Background:
A/H5N1 influenza virus has significant pandemic potential, and vaccination is the main prophylactic measure. This phase 2, randomized, observer-blind, multicenter study evaluated the safety and immunogenicity of two MF59-adjuvanted, cell culture-derived H5N1 (aH5N1c) vaccine formulations in healthy pediatric subjects 6 months to 17 years old.

Methods:
Subjects (N = 662) received 2 aH5N1c doses 3 weeks apart, containing either 7.5 μg (full dose) or 3.75 μg (half dose) hemagglutinin antigen per dose. Local reactions and adverse events (AEs) were assessed by age. Antibody responses were measured by hemagglutination inhibition assay and assessed as geometric mean titers, geometric mean ratios (GMRs) and percentages of subjects achieving titers ≥1:40 and seroconversion (NCT01776554).

Results:
No vaccine-related serious AEs occurred. Incidence of solicited local reactions and systemic AEs were similar across vaccine groups. Tenderness and irritability in <6-year olds, and injection site pain, myalgia and fatigue in 6–17-year olds were the most commonly reported reactions in both full- and half-dose recipients. Frequencies of AEs were lower after the second dose than the first dose in all vaccine and age groups. Three weeks after the administration of a second dose, both full- and half-dose formulations met the Center for Biologics Evaluation Research and Review (United States) and Committee for Medicinal Products for Human Use (EU) licensure criteria for titers ≥1:40 (full dose 96% subjects; half dose 86%), seroconversion (full dose 96% subjects; half dose 86%), and GMR (full dose GMR 262; half dose 84). Antibody responses were highest in 6–35-month olds.

Conclusions:
In pediatric subjects, both aH5N1c vaccine formulations were well tolerated and highly immunogenic, meeting both US and EU licensure criteria for pandemic influenza vaccines.
The Praxis of Physical Therapy
Authors: Smith James M. 
Published: May 2019

In neurorehabilitation, praxis embodies establishing a goal, planning, taking action, analyzing the impact of the action, revising the plan, and reacting accordingly until the desired outcome is achieved. That is an apt metaphor for physical therapy, whether planning a single intervention for a patient, establishing a plan of care, or managing the trajectory of a career.
Through reflections on goals, plans, and actions, this lecture presents challenges to physical therapists and physical therapist assistants to achieve praxis when providing rehabilitation and wellness services. Through reflections on the needs of patients and clients, this lecture proposes the value of the unique identity and services that are acute care physical therapy. Central to these themes, this lecture provides the challenge to embrace the honor that comes with being an acute care physical therapist and a physical therapist assistant.
Generation and characterization of Men1 mutant mouse models for studying MEN1 disease
Authors: Luo Ya-kun , Ziki Razan A. , Zhang Chang X. 
Published: May 2019

Abstract
Patients with multiple endocrine neoplasia type 1 (MEN1) mutations are predisposed to MEN1 syndrome affecting various endocrine cell lineages. Following its identification in the late 1990s, laboratories around the world, including our own, used gene-targeting approaches in murine models to study the MEN1 gene and its related diseases. Subsequently, this field of research witnessed an upsurge in the use of Men1 mutant mouse models to dissect MEN1 functions. These studies led to unraveling the natural history of MEN disease, and highlighted cellular and molecular mechanisms underlying the development of the disease. In this review, we present the currently available data concerning the generation and characterization of Men1 mutant mouse models in connection with MEN1 syndrome.