bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of the Boston Type I Keratoprosthesis as the Primary Penetrating Corneal Procedure
Authors: Driver Todd H. , Aravena Carolina , Duong Huong N.V. , Christenbury Joseph G. , Yu Fei , Basak Samar K. , Aldave Anthony J. 
Published: August 2018

Purpose:
To report the outcomes of the Boston type I keratoprosthesis (KPro) as the primary penetrating corneal procedure.

Methods:
In this retrospective review of all KPro procedures performed by 2 surgeons from May 1, 2004, to December 31, 2015, indications and outcomes were compared between KPros performed as the primary keratoplasty procedure (primary KPro) versus after failed keratoplasty (previous keratoplasty).

Results:
A total of 262 KPros were implanted in 231 eyes, including 67 primary KPro procedures. The most common indications for primary KPros were corneal scarring/vascularization (43%), Stevens–Johnson syndrome (22%), and chemical/thermal injury (22%). Although preoperative corrected distance visual acuity (CDVA) was similar in the 2 groups (P = 0.36), a significantly higher proportion of the eyes in the primary KPro group had a CDVA ≥ 20/200 each of the first 4 years after surgery (all P ≤ 0.023). The most common postoperative complications in the primary KPro and previous keratoplasty groups were retroprosthetic membrane (40% vs. 51%, P = 0.15), persistent epithelial defect (37% vs. 24%, P = 0.05), and elevated intraocular pressure, which was the only complication significantly more common in either group (31% vs. 18%, P = 0.03). No difference in KPro retention was observed between the 2 groups (P = 0.63).

Conclusions:
In the setting of preexisting ocular comorbidities in which PK is associated with poor outcomes and KPros have been associated with an increased incidence of postoperative complications, primary KPro is associated with significantly greater % of eyes with CDVA ≥ 20/200 in the first 4 years. However, given a significantly higher incidence of postoperative intraocular pressure elevation in these eyes, longer follow-up is needed to determine whether the difference in CDVA is maintained.
Effects of manipulating the interstimulus interval on heat-evoked temporal summation of second pain across the age span
Authors: Riley Joseph L. , Cruz-Almeida Yenisel , Staud Roland , Fillingim Roger B. 
Published: August 2018

Abstract
This study examined the effects of interstimulus interval (ISI) on heat-evoked temporal summation of second pain (TSSP) and tested whether greatest maintenance of TSSP would occur at longer ISIs in older adults. Several lines of evidence support that TSSP is associated with central sensitization and is centrally mediated. The participants were 198 community-dwelling adults divided into 3 age cohorts (18-39, 40-59, and 60-78 years of age). Six TSSP trials used a train of 10 contacts with a preheated probe that made repetitive contact with the volar forearm. Participants completed 2 trials at each ISI of 2.5, 3.5, and 4.5 seconds. The intraclass correlations for each pair of trials support the reliability of the current methodology. Temporal summation of second pain scores declined in a time-dependent manner across ISI. In addition, greater maintenance of TSSP at longer ISIs was observed in middle-aged and older age groups compared with the younger cohort. Significant associations were found between TSSP and measures of recent pain. Greater summation at longer ISIs in older adults would suggest slower decay of excitability in spinal neurons and infer increased risk for central sensitization with advancing age.
The NOD2 signaling in peripheral macrophages contributes to neuropathic pain development
Authors: Santa-Cecília Flávia V. , Ferreira David W. , Guimaraes Rafaela M. , Cecilio Nerry T. , Fonseca Miriam M. , Lopes Alexandre H. , Davoli-Ferreira Marcela , Kusuda Ricardo , Souza Guilherme R. , Nachbur Ueli , Alves-Filho José C. , Teixeira Mauro M. , Zamboni Dario S. , Cunha Fernando Q. , Cunha Thiago M. 
Published: August 2018

Abstract
Neuropathic pain is one of the most important types of chronic pain. It is caused by neuronal damage. Clinical and experimental studies suggest a critical role for neuroimmune interactions in the development of neuropathic pain. In this article, we have shown that the cytoplasmic receptor Nod-like receptor-2, NOD2, and its adaptor-signaling molecule RIPK2 participate in the development of neuropathic pain after peripheral nerve injury (spared nerve injury model). The activation of NOD2 signaling in peripheral macrophage mediates the development of neuropathic pain through the production of pronociceptive cytokines (tumor necrosis factor and IL-1β). This study found that peripheral nerve injury promoted a systemic increase in the NOD2 ligand. These results highlight a previously undetermined role for NOD2 signaling in the development of neuropathic pain, suggesting a new potential target for preventing neuropathic pain.
Betulinic acid, derived from the desert lavender Hyptis emoryi, attenuates paclitaxel-, HIV-, and nerve injury–associated peripheral sensory neuropathy via block of N- and T-type calcium channels
Authors: Bellampalli Shreya S. , Ji Yingshi , Moutal Aubin , Cai Song , Wijeratne E.M. Kithsiri , Gandini Maria A. , Yu Jie , Chefdeville Aude , Dorame Angie , Chew Lindsey A. , Madura Cynthia L. , Luo Shizhen , Molnar Gabriella , Khanna May , Streicher John M. , Zamponi Gerald W. , Gunatilaka A.A. Leslie , Khanna Rajesh 
Published: August 2018

Abstract
The Federal Pain Research Strategy recommended development of nonopioid analgesics as a top priority in its strategic plan to address the significant public health crisis and individual burden of chronic pain faced by >100 million Americans. Motivated by this challenge, a natural product extracts library was screened and identified a plant extract that targets activity of voltage-gated calcium channels. This profile is of interest as a potential treatment for neuropathic pain. The active extract derived from the desert lavender plant native to southwestern United States, when subjected to bioassay-guided fractionation, afforded 3 compounds identified as pentacyclic triterpenoids, betulinic acid (BA), oleanolic acid, and ursolic acid. Betulinic acid inhibited depolarization-evoked calcium influx in dorsal root ganglion (DRG) neurons predominantly through targeting low-voltage–gated (Cav3 or T-type) and CaV2.2 (N-type) calcium channels. Voltage-clamp electrophysiology experiments revealed a reduction of Ca2+, but not Na+, currents in sensory neurons after BA exposure. Betulinic acid inhibited spontaneous excitatory postsynaptic currents and depolarization-evoked release of calcitonin gene–related peptide from lumbar spinal cord slices. Notably, BA did not engage human mu, delta, or kappa opioid receptors. Intrathecal administration of BA reversed mechanical allodynia in rat models of chemotherapy-induced peripheral neuropathy and HIV-associated peripheral sensory neuropathy as well as a mouse model of partial sciatic nerve ligation without effects on locomotion. The broad-spectrum biological and medicinal properties reported, including anti-HIV and anticancer activities of BA and its derivatives, position this plant-derived small molecule natural product as a potential nonopioid therapy for management of chronic pain.
Objective Assessment of Postural Control After Lower-Limb Amputation: A Pilot Study
Authors: Overgaard Michael , Gehlert Trine Friis , Pedersen Line Kjeldgaard , Nordbye-Nielsen Kirsten 
Published: August 2018

ABSTRACT

Introduction
Postural control might be impaired after lower-limb amputation (LLA) and contributes to a high incidence of falling in individuals with LLAs with the risk of an injury occurring. There is no agreement on which objective assessment method is most appropriate for quantifying postural control during rehabilitation. Attention should be pointed to which test is most accurate at detecting a change in postural control after a given intervention. The objective of this quantitative prospective cohort pilot study was to compare four balance tests to determine their feasibility in detecting a change in postural control in persons with LLA (transtibial and transfemoral) during rehabilitation and prosthesis fitting.

Methods
Four different balance tests were used as primary outcomes before and after a 4-week rehabilitation program (n = 5). The tests used were Berg Balance Scale (BBS), Timed Up and Go (TUG), and force plate measurements in standing and seated position (FPMstand + seat). Secondary outcome was quality of life assessed by the EuroQol, 5 dimensions, 5 levels (EQ-5D-5L) questionnaire.

Results
All participants improved in BBS, TUG, and FPMstand. FPMseat showed varying results. The EQ-5D-5L questionnaire showed a slight improvement in quality of life in accordance with the changes in primary outcome measures.

Conclusions
A change in postural control during rehabilitation and prosthesis fitting in individuals with LLAs may be assessed by BBS, TUG, and FPMstand. A criterion standard for quantifying postural control is lacking. Hence, a combination of tests to measure and detect a change in postural control can be used. Present pilot study finds that BBS, TUG, and FPMstand may be measurements used for assessment of changes in postural control in the rehabilitation of individuals with LLAs.
The Cost of ICU Delirium and Coma in the Intensive Care Unit Patient
Authors: Vasilevskis Eduard E. , Chandrasekhar Rameela , Holtze Colin H. , Graves John , Speroff Theodore , Girard Timothy D. , Patel Mayur B. , Hughes Christopher G. , Cao Aize , Pandharipande Pratik P. , Ely E. Wesley 
Published: August 2018

Rationale:
Intensive care unit (ICU) delirium is highly prevalent and a potentially avoidable hospital complication. The current cost of ICU delirium is unknown.

Objectives:
To specify the association between the daily occurrence of delirium in the ICU with costs of ICU care accounting for time-varying illness severity and death.

Research Design:
We performed a prospective cohort study within medical and surgical ICUs in a large academic medical center.

Subjects:
We analyzed critically ill patients (N=479) with respiratory failure and/or shock.

Measures:
Covariates included baseline factors (age, insurance, cognitive impairment, comorbidities, Acute Physiology and Chronic Health Evaluation II Score) and time-varying factors (sequential organ failure assessment score, mechanical ventilation, and severe sepsis). The primary analysis used a novel 3-stage regression method: first, estimation of the cumulative cost of delirium over 30 ICU days and then costs separated into those attributable to increased resource utilization among survivors and those that were avoided on the account of delirium’s association with early mortality in the ICU.

Results:
The patient-level 30-day cumulative cost of ICU delirium attributable to increased resource utilization was $17,838 (95% confidence interval, $11,132–$23,497). A combination of professional, dialysis, and bed costs accounted for the largest percentage of the incremental costs associated with ICU delirium. The 30-day cumulative incremental costs of ICU delirium that were avoided due to delirium-associated early mortality was $4654 (95% confidence interval, $2056–7869).

Conclusions:
Delirium is associated with substantial costs after accounting for time-varying illness severity and could be 20% higher (∼$22,500) if not for its association with early ICU mortality.
Enteric Virome and Bacterial Microbiota in Children With Ulcerative Colitis and Crohn Disease
Authors: Fernandes Melissa A. , Verstraete Sofia G. , Phan Tung G. , Deng Xutao , Stekol Emily , LaMere Brandon , Lynch Susan V. , Heyman Melvin B. , Delwart Eric 
Published: August 2018

ABSTRACTObjectives:We examined the fecal virome and bacterial community composition of children with Crohn disease (CD), ulcerative colitis (UC), and healthy controls to test the hypothesis that unique patterns of viral organisms and/or presence of bacterial pathogens may be identified that could contribute to the pathogenesis of pediatric inflammatory bowel disease (IBD).Methods:Fecal samples from 24 children (mean 12.2 years) with CD (n = 7) or UC (n = 5) and similar aged controls (n = 12) were processed to determine individual viromes. Viral sequences were identified through translated protein sequence similarity search. Bacterial microbiota were determined by sequencing of the V4 region of the 16S rRNA gene.Results:Only a few human viruses were detected, so virome analyses focused on bacterial viruses. The relative abundance of Caudovirales was greater than that of Microviridae phages in both IBD and healthy controls. Caudovirales phages were more abundant in CD (mean 80.8%) than UC (48.8%) (P = 0.05) but not controls. The richness of viral strains in Microviridae but not Caudovirales was higher in controls than CD (P = 0.05) but not UC cases. No other measure of phage abundance, richness, or Shannon diversity showed significant difference between the 2 IBD and control groups. Bacterial microbiota analysis revealed that IBD diagnosis, albumin, hemoglobin, erythrocyte sedimentation rate, and probiotic supplementation correlated to the composition of gut bacterial microbiota.Conclusions:Minor patterns in gut virome and bacterial community composition distinguish pediatric IBD patients from healthy controls. Probiotics are associated with bacterial microbiota composition. These exploratory results need confirmation in larger studies.
Wall-eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) in a Patient With Idiopathic Intracranial Hypertension
Authors: Keereman Vincent , Platteau Elise , Crevits Luc , Algoed Luc 
Published: August 2018

Introduction:
Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is a variant syndrome of internuclear ophthalmoplegia, consisting of primary gaze exotropia, adduction impairment, nystagmus of the abducting eye, and vertical gaze-evoked nystagmus. It seems to be most frequently associated with multiple sclerosis, although other etiologies such as brainstem ischemia or hydrocephalus have also been described.

Case Report:
We report the case of a 25-year-old woman who presented with subacute progressive oculomotor disturbances, resulting in the development of a WEBINO over a few days. Fundoscopy showed papilledema first in the right and afterwards also in the left eye. Brain magnetic resonance imaging was normal. Lumbar puncture demonstrated an opening pressure of 38 cm H2O, without pleiocytosis and with normal protein. As no other cause of intracranial hypertension could be identified by imaging or extensive biochemical testing, the patient was treated with acetazolamide for idiopathic intracranial hypertension. As there was further progression despite increase of acetazolamide dosing, more aggressive therapy was pursued, and a ventriculoperitoneal shunt was placed by our neurosurgeons. Clinical follow-up showed progressive recovery of normal oculomotor function and disappearance of papilledema over the course of 6 weeks.

Conclusions:
To our knowledge this is the first case description of a patient with WEBINO and idiopathic intracranial hypertension. The diagnosis is supported by the very high opening pressure, the absence of neuroimaging abnormalities, the papilledema, and the response to ventriculoperitoneal drainage.
Preventing Congenital Syphilis—Opportunities Identified by Congenital Syphilis Case Review Boards
Authors: Rahman Mohammad Mamun-ur , Hoover Ashley , Johnson Chaquetta , Peterman Thomas A. 
Published: August 2018

Background
Louisiana has had the highest rates of congenital syphilis (CS) in the nation since 2012. Congenital syphilis case review boards were established statewide in 2016 to study CS cases and identify interventions.

Methods
We summarized the findings of CS review boards, assessed which cases were preventable by prenatal care providers, reviewed recommended interventions, and assessed subsequent improvement in provider practices.

Results
All 79 CS cases reported from January 2016 to July 2017 were reviewed by boards during August 2016 to August 2017. Twenty-six (33%) cases that could have been prevented by prenatal care providers had: lack of rescreening at 28 to 32 weeks (n = 15), lack of any screening (n = 5), treatment delay (n = 4), or incorrect interpretation of test results (n = 2). Twenty-one (27%) cases were possibly preventable by providers including: mother did not return for follow-up and treatment (n = 19), late third trimester reactive test with premature delivery (n = 1), or incomplete treatment and lack of follow-up by health department staff (n = 1). Thirty-two (40%) cases that were unlikely to be prevented by providers had: nonreactive test at 28–32 weeks then reactive test <30 days before delivery (n = 10), no prenatal care (n = 9), mother adequately treated, case by infant criteria (n = 8), first/second trimester nonreactive, reactive at preterm delivery (n = 4), or mother adequately treated, reinfected before delivery (n = 1). Providers were advised to adhere to CDC recommended syphilis screening and treatment protocols and rapidly report pregnant women with syphilis. Many providers changed their procedures.

Conclusions
Congenital syphilis case review boards identified practices with inadequate screening, treatment, or reporting. Sharing these findings with providers changed practices and may prevent future cases.
Feasibility of Telerehabilitation for Low Vision: Satisfaction Ratings by Providers and Patients
Authors: Bittner Ava Katherine , Yoshinaga Patrick , Bowers Angie , Shepherd John D. , Succar Tony , Ross Nicole C. 
Published: August 2018

SIGNIFICANCEThis pilot study demonstrated feasibility and acceptability of telerehabilitation between a provider in-office and a low vision patient at home as an approach to provide follow-up care to improve reading ability with magnification devices and that would help overcome barriers related to transportation and paucity of providers.PURPOSEA recent systematic review found no publications with results on the topic of telerehabilitation for low vision. Our goal was to perform the initial steps to develop, administer, refine, and evaluate components required to deliver follow-up low vision telerehabilitation services.METHODSThree low vision providers (ophthalmic technician or optometrist) conducted telerehabilitation sessions from their office with 10 visually impaired older adults in their homes, who recently received a handheld magnification device for reading and self-reported difficulty with returning for follow-up training at their provider's office. All except one participant had never used videoconferencing before our study, and three had never used the Internet. Participants and providers rated the use of loaner hardware devices (i.e., tablets, MiFi mobile hotspot) and Health Insurance Portability and Accountability Act–compliant, secure videoconference services during telerehabilitation sessions at which participants read MNREAD cards and received feedback on magnifier use.RESULTSProviders reported little to no difficulty with evaluating participants' reading speed, reading accuracy, and working distance with their magnifier. Both providers and participants rated video quality as excellent to good. Audio quality ratings were variable, generally related to signal strength or technical issues during some sessions. All participants agreed that they were satisfied and comfortable receiving telerehabilitation and evaluation via videoconferencing. Eight of 10 reported that their magnifier use improved after telerehabilitation. All except one reported that they were very interested in receiving telerehabilitation services again if their visual needs change.CONCLUSIONSPositive feedback from both participants and providers in this pilot study supports the feasibility, acceptability, and potential value of low vision telerehabilitation.
Subjective and Objective Measures of Daytime Activity and Sleep Disturbance in Retinitis Pigmentosa
Authors: Bittner Ava Katherine , Haythornthwaite Jennifer A. , Patel Chandni , Smith Michael T. 
Published: August 2018

SIGNIFICANCE
Objectively measured limitations in daytime activity levels appear to be inextricably linked with sleep disturbances in retinitis pigmentosa (RP) patients, as well as associated with unemployment status and central vision loss. Innovative interventional strategies should be developed to help improve these issues and overall quality of life for RP patients.

PURPOSE
Novel sensor devices are emerging as valuable tools to objectively assess behavior. We used validated measures of wrist accelerometry to determine relationships between sleep, vision, and physical activity in RP subjects.

METHODS
For one week, 33 RP adults wore a wrist Actiwatch to detect movement during the day (average total activity counts) and disturbed sleep at night. They completed Early Treatment Diabetic Retinopathy Study visual acuity testing, Pelli-Robson contrast sensitivity, Goldmann V4e visual fields, and sleep diaries and validated questionnaires to assess their sleep and general health.

RESULTS
Greater wake after sleep onset time measured with actigraphy (i.e., sleep disruption) (P = .01), loss of visual acuity (P = .009), and nonemployment/student status (P = .002) were all significant predictors of reduced daytime average total activity counts in a multiple linear regression model, after adjusting for contrast sensitivity as a cooperative suppressor variable (P = .01) (R
2 = 0.54). Fragmentation measured with actigraphy (i.e., restlessness during sleep) (P = .07) and decreased sleep quality ratings reported upon awakening by the participants in a sleep diary (P = .06) were each marginally associated with reduced daytime average total activity counts, whereas nonemployment/student status, reduced visual acuity, and contrast sensitivity were still significant predictors. Objective and subjective measures of sleep or daytime activity were not statistically significantly correlated (P > .05).

CONCLUSIONS
We find nonemployment/student status and sleep disturbances appear to be related to reduced daytime activity levels in adults with central vision loss due to RP. These findings underscore the importance of developing and evaluating interventions to help RP patients maintain engagement in productive activities and improve their disturbed sleep.