bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Iridocorneal Angle and Anterior Chamber Structure in Eyes With Anatomically Narrow Angles: Laser Iridotomy Versus Pilocarpine
Authors: Mogil Rachel S. , Khezri Nicole , Ren Ruojin , Adleyba Olga , Abumasmah Ramiz , Ghassibi Mark P. , Chien Jason L. , Pearlstein Adam , Patthanathamrongkasem Thipnapa , Liebmann Jeffrey M. , Ritch Robert , Park Sung chul 
Published: September 2018

Purpose:To compare the effects of laser iridotomy (LI) and pilocarpine on iridocorneal angle and anterior chamber structure in anatomically narrow angles (ANAs).Materials and Methods:Temporal LI was performed 90 minutes after 2% pilocarpine administration in patients with occludable ANA. Swept-source optical coherence tomography B-scans of the anterior segment were obtained at baseline, 60 minutes after 2% pilocarpine administration, and 1 week after LI. Angle-opening distance (AOD), trabecular-iris surface area (TISA), and angle recess area (ARA) were measured at the temporal, superior, nasal, and inferior quadrants. Anterior chamber depth (ACD) and lens vault (LV) were also measured. AOD, TISA, ARA, ACD, and LV were compared among 3 time points: at baseline, 60 minutes after 2% pilocarpine administration, and 1 week after LI.Results:Twenty-four eyes (24 patients; mean age, 55 y) were included. In all 4 quadrants and globally, AOD, TISA, and ARA increased from baseline after pilocarpine and after LI (allP<0.010). The increase in AOD, TISA, and ARA was greater after LI than after pilocarpine globally and in the temporal and superior quadrants (allP<0.040). ACD decreased and LV increased from baseline after pilocarpine (bothP<0.001). Postpilocarpine anterior chambers were shallower with higher LV than post-LI (bothP<0.016).Conclusion:LI is more effective than pilocarpine in widening the iridocorneal angle without significant shallowing the anterior chamber in eyes with ANA.
Human Parechovirus 3 in Infants: Expanding Our Knowledge of Adverse Outcomes
Authors: Joseph Lindsay , May Meryta , Thomas Marion , Smerdon Carla , Tozer Sarah , Bialasiewicz Seweryn , McKenna Ronan , Sargent Philip , Kynaston Anne , Heney Claire , Clark Julia E. 
Published: September 2018

Background:
Human parechovirus particularly genotype 3 (HPeV3) is an emerging infection affecting predominantly young infants. The potential for neurologic sequelae in a vulnerable subset is increasingly apparent. A review of 2 epidemics of human parechovirus (HpeV) infection in 2013 and in 2015 in Queensland, Australia, was undertaken, with an emphasis on identifying adverse neurodevelopmental outcome.

Methods:
All hospitalized cases with laboratory-confirmed HPeV infection between October 2013 June 2016 were identified. Clinical, demographic, laboratory and imaging data were collected and correlated with reported developmental outcome.

Results:
Laboratory-confirmed HPeV infections were identified in 202 patients across 25 hospitals; 86.6% (n = 175) were younger than 3 months 16.3% (n = 33) received intensive care admission. Of 142 cerebrospinal fluid samples which were HPeV polymerase chain reaction positive, all 89 isolates successfully genotyped were HPeV3. Clinical information was available for 145 children; 53.1% (n = 77) had follow-up from a pediatrician, of whom 14% (n = 11) had neurodevelopmental sequelae, ranging from hypotonia and gross motor delay to spastic quadriplegic cerebral palsy and cortical visual impairment. Of 15 children with initially abnormal brain magnetic resonance imaging, 47% (n = 7) had neurodevelopmental concerns, the remainder had normal development at follow-up between 6 and 15 months of age.

Conclusions:
This is the largest cohort of HPeV3 cases with clinical data and pediatrician-assessed neurodevelopmental follow-up to date. Developmental concerns were identified in 11 children at early follow-up. Abnormal magnetic resonance imaging during acute infection did not specifically predict poor neurodevelopmental in short-term follow-up. Continued follow-up of infants and further imaging correlation is needed to explore predictors of long-term morbidity.
Rate of Recurrence of Adverse Events Following Immunization
Authors: Zafack Joseline G. , Toth Eveline , Landry Monique , Drolet Jean-Philippe , Top Karina A. , De Serres Gaston 
Published: September 2018

Background:
While adverse events following immunization (AEFI) are frequent, there are limited data on the safety of reimmunizing patients who had a prior AEFI. Our objective was to estimate the rate and severity of AEFI recurrences.

Methods:
We analyzed data from the AEFI passive surveillance system in Quebec, Canada, that collects information on reimmunization of patients who had a prior AEFI. Patients with an initial AEFI reported to the surveillance system between 1998 and 2016 were included. Rate of AEFI recurrence was calculated as number of patients with recurrence/total number of patients reimmunized.

Results:
Overall, 1350 patients were reimmunized, of which 59% were 2 years of age or younger. The AEFI recurred in 16% (215/1350) of patients, of whom 18% (42/215) rated the recurrence as more severe than the initial AEFI. Large local reactions extending beyond the nearest joint and lasting 4 days or more had the highest recurrence rate (67%, 6/9). Patients with hypotonic hyporesponsive episodes had the lowest rate of recurrence (2%, 1/50). Allergic-like events recurred in 12% (76/659) of patients, but none developed anaphylaxis. Of 33 patients with seizures following measles mumps rubella with/without varicella vaccine, none had a recurrence. Compared with patients with nonserious AEFIs, those with serious AEFIs were less often reimmunized (60% versus 80%; rate ratio: 0.8; 95% confidence interval: 0.66–0.86).

Conclusions:
Most patients with a history of mild or moderate AEFI can be safely reimmunized. Additional studies are needed in patients with serious AEFIs who are less likely to be reimmunized.
The Effectiveness of Ledipasvir/Sofosbuvir in Youth With Genotype 4 Hepatitis C Virus
Authors: Fouad Hanan Mina , Ahmed Mohamed Amal , Sabry Magda , Abdel Aziz Hossam , Eysa Basem , Rabea Mohamed 
Published: September 2018

Background:
Licensure of ledipasvir/sofosbuvir for chronic hepatitis C virus (HCV) infection in adolescents was based on clinical trials on patients mainly with genotype 1. We aimed to evaluate the effectiveness and short-term safety of this newly approved antiviral in adolescents with HCV genotype 4.

Methods:
This was a study of 51 HCV-infected adolescents, who received the adult dose of ledipasvir/sofosbuvir, once daily for 12 weeks, and were followed-up for 12 weeks post-treatment. Laboratory tests, quantitation of HCV RNA, HCV genotyping, IL-28rs gene polymorphism and transient elastography were performed at baseline. Follow-up visits were done for blood testing and adverse events recording.

Results:
The mean age was 14.7 ± 1.5 years (11–17.5), with a male to female ratio of 1.7:1. All patients were genotype 4a, and 76.5% had the CC IL-28 gene polymorphism. About 50% gave a history of HCV-infected mother, and 31% were treatment-experienced. Liver stiffness was F0 in 72.5%, F0–F1 in 13.7% and F1–F2 in 13.7%. Adverse events were mainly abdominal pain in 72.5%, headache in 64.7% and diarrhea in 53% of patients; these were mild. A reversible increase in creatinine level with a concomitant decline in estimated glomerular filtration rate was observed in the first month of treatment. By the end of week 12, a significant decline in liver enzymes was observed. All patients achieved an early, end of treatment, and a sustained virologic response.

Conclusions:
Adolescent patients with genotype 4 chronic HCV infection achieved a good response rate with good ontreatment tolerability for ledipasvir/sofosbuvir therapy.
Priority Needs for Conducting Pandemic-relevant Clinical Research With Children in Europe
Authors: Gal Micaela , Gobat Nina , Francis Nicholas A. , Hood Kerenza , Butler Christopher C. , Bielicki Julia , Fraaij Pieter L. , Sharland Mike , Jarvis Jessica , van Rossum Annemarie M. C. , Heikkinen Terho , Martinon-Torres Federico , Herberg Jethro , Watkins Angela , Webb Steve A. R. , Moore Ronnie , Sukumar Prasanth , Nichol Alistair 
Published: September 2018

Background:
Infectious disease (ID) pandemics pose a considerable global threat and can disproportionately affect vulnerable populations including children. Pediatric clinical research in pandemics is essential to improve children’s healthcare and minimize risks of harm by interventions that lack an adequate evidence base for this population. The unique features of ID pandemics require consideration of special processes to facilitate clinical research. We aimed to obtain consensus on pediatric clinician-researchers’ perceptions of the priorities to feasibly conduct clinical pediatric pandemic research in Europe.

Methods:
Mixed method study in 2 stages, recruiting pediatric clinician-researchers with experience of conducting pediatric ID research in clinical settings in Europe. Stage 1 was an expert stakeholder workshop and interviews. Discussions focused on participant’s experience of conducting pediatric ID research and processes to facilitate pandemic research. Information informed stage 2, an online consensus survey to identify pediatric inician-researchers priorities to enable ID pandemic research.

Results:
Twenty-three pediatric clinician-researchers attended the workshop and 39 completed the survey. Priorities were primarily focused on structural and operational requirements of research design and regulation: (1) clarity within the European Clinical Trials Directive for pediatric pandemic research; (2) simplified regulatory processes for research involving clinical samples and data; and (3) improved relationships between regulatory bodies and researchers.

Conclusions:
Results suggest that changes need to be made to the current regulatory environment to facilitate and improve pediatric research in the pandemic context. These findings can provide expert evidence to research policy decision-makers and regulators and to develop a strategy to lobby for change.
Physical Therapy for an Adult Male Presenting With Torsion Dystonia Postcardiac Arrest: Posture Is Key
Authors: Hodgdon Andrew 
Published: September 2018

Introduction:
Patients suffering from cardiac arrest followed by anoxic brain injury have improved survival rates and often have debilitating neurologic and functional consequences. There is currently limited guidance in the literature for physical therapists treating adult patients in the acute care setting with presentations that can include dystonia.

Case Description:
This case report describes acute hospital physical therapy for a young adult after cardiac arrest. Physical therapy examination was initially limited secondary to severe torsion dystonia. A supported seating intervention was key in managing the dystonia and allowing for functional gains.

Outcomes:
Physical therapy treatments were successful in advancing the patient's functional status following investigation of historical treatment approaches, with subsequent application of an evidence-based intervention.

Discussion:
This case report highlights fundamental physical therapy requisite to establish a static sitting position when faced with opisthotonic posture as well as general torsion, postural distortions and dystonia. In addition, the study emphasizes the role of physical therapists as team members in the acute hospital setting.
Loading in an Upright Tilting Hospital Bed Elicits Minimal Muscle Activation in Healthy Adults
Authors: Mayer Kirby P. , Uhl Timothy L. , Morris Peter E. , Dupont-Versteegden Esther E. 
Published: September 2018

Purpose:
Upright tilting hospital beds (THB) are used during early rehabilitation of critically ill patients. Tilting patients in a THB to achieve weight-bearing or loading is purported to mitigate the response of prolonged immobility associated with critical illness. The primary aim of this study is to determine the level of muscle activation during loading in a THB and secondarily to assess whether safety straps influence the level of muscle activation.

Methods:
Quasi-experimental design in a musculoskeletal laboratory. Nineteen healthy community-dwelling adults with no prior neuromuscular disorder were included. Two groups, 10 subjects with straps-on and 9 subjects with straps-off, were tilted in a THB through 9 intervals of 10° (0°-80°). Muscle activation was recorded using surface electromyography in tibialis anterior, rectus femoris, gluteus medius, and lumbar erector spinae muscles. Raw and electromyography-normalized data were analyzed across angles and conditions. Loading (weight-bearing) was recorded using the THB footplate scale.

Results:
Electromyographic activity in the tibialis anterior, rectus femoris, gluteus medius, and lumbar erector spinae muscles was minimal as the angle of tilt and loading increased. No statistically significant increases compared with supine rest were observed, except rectus femoris muscle activation at 60° in the groups without straps (P = .023). Similarly, only muscle activation in the rectus femoris was higher in the group without straps from angles 40° to 80° than in the group with straps.

Conclusion:
Relaxed, gravity-facilitated loading in a THB elicits minimal muscle activation in healthy subjects and, therefore, passive loading's usefulness for enhancing muscle strength is questioned. Removal of safety straps did lead to increased muscle activation in the rectus femoris; this concept should be explored further to understand whether location of the straps, tightness of the straps, and/or the angle of the hip and knee joints during loading could hamper muscle activation.
Acute Rehabilitation of a 27-Year-Old Man With Failure to Thrive
Authors: Terrill Joseph , Roos Jennifer , Zarrinkhameh Leslie 
Published: September 2018

Background and Purpose:
Failure to thrive is a complex medical diagnosis that does not describe a single disease process, but rather a variety of symptoms associated with one or more possible underlying diseases or conditions. It is a diagnosis that is not well-documented outside pediatric or geriatric populations. The purpose of this case report is to present the physical therapy examination and treatment of a 27-year-old Hispanic man with a diagnosis of failure to thrive, a history of superior mesenteric artery syndrome, chronic malnutrition, type 1 diabetes mellitus, and osteopenia.

Case Description:
A 27-year-old Hispanic man, BMI of 12, admitted to the hospital for acute hypothermia, urinary tract infection, generalized weakness, hypotension, and failure to thrive. The complexity of his medical condition required nearly 2 weeks to stabilize general health prior to initiating physical therapy services. Personal and environmental factors contributed to progressive decline in physical activity prior to this hospital admission and led to increased dependence and support.

Outcomes:
Blood pressure increased by 18 mm Hg systolic and 20 mm Hg diastolic and stabilized within normal range; 5 repetitions in the 30-second sit-to-stand; functional balance composite score of 35 seconds; 20% reduction in subjective Numeric Pain Rating Scale; supervised bed mobility; maximum assistance stand-pivot transfer; and family to support caregiver needs upon return home. The patient was discharged home with recommendation for continued services through home health care referral.

Discussion:
Evidence-based literature regarding failure to thrive in the young adult or middle-aged adult population is limited. Therefore, the physical therapy plan of care necessitates the application of interventions shown to be effective in addressing the physical structure and function limitation upon examination generally applied to the geriatric and/or pediatric population. Clinical decision-making focused on improving physical activity and participation are imperative across clinical settings. Manual therapy interventions applied in this case may prove beneficial in the acute care setting to maximize muscle activation within available range of motion elicited through patterns of functional movements emphasizing existing abilities.
Expression of Psoriasin in Human Papillomavirus–Induced Cervical High-Grade Squamous Intraepithelial Lesions
Authors: Alvendal Cathrin , Kamolvit Witchuda , Wagner Siegfried , Brauner Annelie , Bohm-Starke Nina 
Published: September 2018

Objectives
Persistent infection with human papillomavirus causes cervical high-grade squamous intraepithelial lesions (HSILs). The role of antimicrobial peptides (AMPs) in premalignant and malignant transformation is not fully understood. In this study, we examined the expression of human β-defensin 1 (HBD-1), HBD-2, HBD-3, LL37, psoriasin, and interleukin 8 (IL-8) in women with HSIL before and 6 months after surgery.

Materials and Methods
Biopsies and secretion samples from the cervical canal were collected from 19 patients with HSIL and 14 healthy controls. The mRNA expression of HBD-1, HBD-2, HBD-3, LL37, psoriasin, and IL-8 was analyzed before and 6 months after surgery excision using reverse transcriptase real time polymerase chain reaction. For protein analyses, ELISA and immunohistochemistry were used for psoriasin and ELISA for IL-8.

Results
The mRNA expression of psoriasin was lower in patients before treatment compared with healthy controls (p = .05). After surgery, when the infection was cleared, psoriasin increased on mRNA (p = .04) and protein (p = .03) levels compared with before treatment. Immunostaining for psoriasin after treatment was prominent and localized in the cytoplasm of the epithelial cells. After treatment, IL-8 mRNA was reduced compared with before treatment (p = .05), but not on the protein level. No changes in mRNA expression of the other AMPs analyzed were observed in pretreatment and posttreatment samples.

Conclusions
In this study of AMP expression in human papillomavirus–induced HSIL, we observed lower psoriasin levels before surgery compared with after treatment, when both mRNA and protein levels were similar to healthy controls. Interleukin 8, on the other hand, was increased before treatment, indicating an inflammatory response.
Individual and Geospatial Characteristics Associated With Use and Nonuse of the Fecal Immunochemical Test (FIT) for Colorectal Cancer Screening in an Urban Minority Population
Authors: Ramai Daryl , Etienne Denzil , Ayide Gloria , Fields Paul J. , Reddy Madhavi 
Published: September 2018

Purpose:
Initiatives by the Centers for Disease Control and Prevention as well as the National Colorectal Cancer Roundtable aim to increase the rate of colorectal cancer (CRC) screening. We assess individual and geographic characteristics associated fecal immunochemical test (FIT) CRC screening over 3 years.

Methods:
This is a retrospective study of 1500 FIT kits which were mailed or opportunistically handed to eligible participants in Brooklyn, New York from January 2014 to December 2016. Eligibility criteria included increased risk for colon cancer, uninsured or underinsured, and a minimum age of 50 years to warrant CRC screening. We looked at the association of individual demographic characteristics and FIT screening by logistic regression using SPPS version 23 software. In addition, using ArcGIS, we coded patients address and layered census tract population information to find associations.

Results:
In total, 1367 Cancer Services Participants met our study criteria. The study sample was predominantly female (95.2%) and minority (46% African American, 24.7% Hispanic, 17.3% Caucasian, 11.4% Asian) and on average 59 years old (SD, 5.7). A large majority (73%) had household incomes below $20,000/year. Approximately half (49.9%) of all Cancer Services Participants returned their FIT kit. In participants who did not return their FIT kit, the majority were African American (41%), followed by Hispanics (26.5%), Caucasians (20.6%), and Asians (11.8%). Multivariable logistic regression showed that a screening history of prior colonoscopy or FIT, gender, ethnicity, and educational attainment were significantly associated with FIT CRC screening uptake (P<0.05). Geospatial mapping showed clusters of low screening uptake in areas of high poverty. Hot-spot analysis identified areas of significant vulnerability.

Conclusions:
FIT uptake remains suboptimal. Individual predictors as well as area poverty is associated with low screening uptake. Geospatial mapping is an effective tool for evaluating CRC screening uptake.
Randomized controlled trial of polyethylene glycol versus lactulose for the treatment of overt hepatic encephalopathy
Authors: Shehata Hala H. , Elfert Asem A. , Abdin Amany A. , Soliman Samah M. , Elkhouly Reham A. , Hawash Nehad I. , Soliman Hanan H. 
Published: September 2018

Background
Overt hepatic encephalopathy (HE) is a frequent complication of cirrhosis and one of the most debilitating manifestations that necessitates hospitalization. Although many treatment modalities are being investigated, none of them are satisfactory. So, newer treatment modalities have to be tried.

Objective
To evaluate the safety and efficacy of polyethylene glycol (PEG) versus lactulose in the management of HE.

Patients and methods
This clinical trial included 100 patients with post-hepatitis C cirrhosis who were admitted with HE. Patients were randomized into two equal groups: group I patients received lactulose and group II patients received PEG. The clinico-epidemiological characteristics of patients, Child–Pugh score, and HE scoring algorithm were registered before and 24 h after administration of the drug. Moreover, any suspected adverse effects were recorded.

Results
All 100 patients received treatment. Three patients died within 24 h of admission and did not complete the follow-up period. According to intention-to-treat approach, they were considered as treatment failure. On analysis, 36/50 (72%) patients improved one grade or more in HE scoring algorithm score after 24 h of lactulose therapy versus 47/50 (94%) of those on PEG therapy (P<0.05). The time needed for resolution of HE and length of hospital stay were significantly lower in PEG group versus lactulose group (P<0.001). Both therapies were tolerated, and no significant adverse events were reported.

Conclusion
Both lactulose and PEG were safe and effective in the treatment of HE. PEG significantly decreased the time needed for resolution of HE and significantly shortened the hospital stay.