bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Are the Effects of the Maternal Voice on Preterm Infants in the NICU?
Authors: Williamson Selena , McGrath Jacqueline M. 
Published: July 2019

Background/Significance:Premature infants often experience extended stays in the neonatal intensive care unit (NICU) as opposed to home with parents. This prolonged separation creates a strain for both parents and infants, decreasing attachment and parental caregiving. One strategy to combat this shared stress is increasing parental participation, particularly through the use of their voices whether parents are present or not.Purpose:This Evidence-Based Practice Brief column explores the connection between mother and child, specifically the effects of maternal voice on infant autonomic stability, weight gain, and behavioral states.Methods:A systematic search of CINAHL, PubMed, and PsycInfo was used to identify studies involving the use of maternal voice intervention with preterm infants in the NICU.Results:Fifteen studies were identified. Three intervention categories emerged: (1) live maternal speech, (2) recorded maternal speech (subcategories included whether intervention content was prescribed or not), and (3) recorded maternal speech that was combined with biological maternal sounds (heart rate). Within each category, studies were organized chronologically to reflect how knowledge has changed overtime.Implications for Practice:Maternal voice has physiological as well as behavioral and emotional effect on preterm infants. Several studies found that maternal voice increased autonomic stability improving (heart rate and respirations) as well as weight gain. No negative effects were identified. Given these findings, incorporating different types of maternal voice into routine care by the bedside nurse can assist the mother in feeling more involved in her infant's care without seemingly being a distraction or obstacle to providers.Implications for Research:A major limitation for generalizability was sample size; more research is needed with larger sample sizes replicating interventions types to discern best outcomes.Video Abstractavailable at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=31&autoPlay=true.
Biomechanical Analysis of Instability in Rotational Distal Fibula Fractures (OTA/AO 44-B1) With an Intact Deltoid Ligament
Authors: Hempen Eric , Butler Bennet , Barbosa Mauricio , Muriuki Muturi , Havey Robert , Kadakia Anish 
Published: July 2019

Objectives:
To biomechanically analyze instability in supination external rotation (SER) II/III patterns.

Methods:
Nineteen cadaver legs were tested in a mechanical jig. One, 2, 3, and 4 Nm of external rotation were applied to intact ankles, SER II injuries, and SER III injuries. The talar position relative to the tibia was recorded using 3D motion tracking. Change from the unloaded state in each condition and the torque level was calculated. Results were analyzed using analysis of variance with post hoc paired t tests.

Results:
SER II showed statistically significant differences from the intact state with coronal translation (2, 3, and 4 Nm), sagittal translation (1 and 2 Nm), axial rotation (1, 2, 3, and 4 Nm), and coronal rotation (3 and 4 Nm). SER III showed statistically significant differences from the intact state with coronal translation (2, 3, and 4 Nm), sagittal translation (1, 2, and 3 Nm), axial rotation (1, 2, 3, and 4 Nm), and coronal rotation (3 and 4 Nm). SER II and SER III differed significantly from each other with coronal translation (1, 2, and 3 Nm), axial rotation (2, 3, and 4 Nm), and coronal rotation (1, 3, and 4 Nm).

Conclusion:
Instability in SER injuries has only been described with coronal translation and suggests that deltoid rupture is necessary. Our data demonstrate instability in SER II/III in sagittal translation and axial rotation as well as subtle instability in coronal translation. The clinical impact is unclear, but better understanding of long-term sequelae of this instability is needed.
Approaches for vulnerable and frail older patients with diffuse large B-cell lymphomas
Authors: Soubeyran Pierre-Louis , Cordoba Raul 
Published: July 2019

Purpose of review
The current review will outline recent data which may improve management of older patients with aggressive lymphoma through comanagement by hematologists and geriatricians.

Recent findings
Many recent data show that determinants of prognosis differ in older patients with an increased importance of nonlymphoma-related parameters. As a consequence, geriatric assessment parameters are predictive of the outcome in these patients. Data from clinical trials allow for standardization of chemotherapy in diffuse large B-cell lymphoma even in older fit patients. Yet data are missing in vulnerable and frail patients. Recent results show that anthracyclines appear essential also in vulnerable patients although precautions should be considered. Geriatric intervention will be the next step but its potential value remains to be demonstrated.

Summary
Although aggressive lymphoma therapy is well standardized, management of vulnerable and frail patients remains complicated because of the accumulation of comorbidities and geriatric syndromes and because they are excluded from clinical trials. Comanagement with hematologists and geriatricians may be the solution to improve outcome but organization of care should reinvented.
Clinical Utility of a Blood-based Protein Assay on Diagnostic Colonoscopy Referrals for Elevated-risk Colorectal Cancer Patients in Primary Care
Authors: Peabody John , Rahim Arshad , Wilcox Bruce , McGehee Carrie , Estigarribia Erwin , Paculdo David , Arzadon Aislinn , Fugaro Steven , Tran Mary , Spitzer Gary 
Published: July 2019

Background:
Colonoscopies are effective in finding early stage colorectal cancer (CRC), which when found in a timely manner, dramatically improve survival rates. A significant number of at-risk patients are still not screened. We investigated the utility of a blood-based protein assay to assess for CRC in patients with elevated risk on the quality of preventive care delivered by board-certified primary care physicians (PCPs) in the United States.

Methods:
We report on the results of a 3-part, longitudinal, randomized controlled trial. Part 1 assessed physicians’ ability to identify simulated patients at risk for CRC and found PCPs missed colonoscopy referrals for high-risk patients ~40% of the time. Part 2 randomized PCPs into control and intervention arms and demonstrated that a novel blood-based protein assay increased referral rates for a diagnostic colonoscopy when caring for simulated patients. Part 3, reported herein, compares real-world colonoscopy rates of actual patients cared for by control versus intervention physicians. Part 3 was executed to confirm whether the use of the assay demonstrated the same utility in their real world, high-risk patients as found in part 2 using simulated patients.

Results:
In the simulations, physicians with access to the assay were significantly more likely to order diagnostic colonoscopies. Similarly, in real-world practice, patients were also more likely to be referred for a diagnostic colonoscopy (odds ratio, 4.57; 95% confidence interval, 1.19-17.57).

Conclusions:
An increase in CRC risk, as indicated by the assay in simulated and real-life patients, was associated with a higher likelihood of appropriate patients being referred to diagnostic colonoscopy.
The Impact of Serum Glucose in the Treatment of Locoregionally Advanced Pancreatic Cancer
Authors: Iarrobino Nick A. , Gill Beant S. , Klement Rainer J. , Bernard Mark E. , Champ Colin E. 
Published: July 2019

Introduction:
Studies have consistently identified an increased risk of pancreatic cancer in diabetics, yet the role hyperglycemia may play in predicting prognosis is less clear. This work aims to evaluate the impact of glycemic state and antidiabetics on outcomes after systemic and local treatment for locoregionally advanced pancreatic cancer.

Materials and Methods:
This retrospective study consisted of 303 patients with newly diagnosed advanced-stage pancreatic cancer treated from 2004 to 2014. Kaplan-Meier survival analysis method was used to estimate time to event for overall survival, distant metastasis, and locoregional control. Blood glucose values (n=8599) were assessed both as continuous and categorical variables in univariate and multivariable Cox proportional hazard regression models to estimate hazard ratios (HRs) and identify independent prognostic factors. A 6-month conditional landmark analysis excluding patients with <6 months follow-up or survival was conducted.

Results:
Median follow-up and survival was 18.1 and 18.4 months, respectively. On univariate analysis, maximum pretreatment glucose value was associated with reduced overall survival (HR 1.005, P=0.023) and locoregional control (HR 1.001, P=0.001). A pretreatment glucose value ≥200 mg/dL was associated with increased mortality in multivariable analysis (adjusted HR 1.01, P=0.015). After conditional analysis, glucose ≥200 mg/dL before local treatment was associated with reduced overall survival (adjusted HR 1.562; 95% confidence interval [CI], 1.16-2.11; P=0.003).

Conclusions:
Elevated blood glucose before treatment of locoregionally advanced pancreatic cancer was associated with poorer outcomes. These findings should be incorporated in future clinical trial design.
An Albumin-Bilirubin (ALBI) Grade–based Prognostic Model For Patients With Hepatocellular Carcinoma Within Milan Criteria
Authors: Ho Shu-Yein , Liu Po-Hong , Hsu Chia-Yang , Hsia Cheng-Yuan , Su Chien-Wei , Huang Yi-Hsiang , Lei Hao-Jan , He Yi-Jhen , Hou Ming-Chih , Huo Teh-Ia 
Published: July 2019

Objective:The Milan criteria are recommended as the major reference for liver transplantation in patients with small hepatocellular carcinoma (HCC). However, alternative anticancer treatments are often utilized due to severe donor organ shortage. This study aimed to develop and validate an albumin-bilirubin (ALBI) grade–based prognostic model to stratify survival in patients within Milan criteria undergoing nontransplant therapy.Patients and Methods:A total of 1655 patients were assigned into the derivation and validation cohort according to treatment modalities. Multivariate analysis was used to identify independent predictors of survival in the derivation cohort. An ALBI-based model was evaluated in the validation cohort.Results:In the Cox multivariate model, age 65 years or older (hazard ratio [HR]=1.576,P<0.001), serum α-fetoprotein (AFP) level >100 ng/mL (HR=1.671,P<0.001), ascites (HR=1.808,P<0.001), performance status 1 to 4 (HR=1.738,P<0.001), ALBI grade 2 (HR=1.827,P<0.001), and ALBI grade 3 (HR=3.589,P<0.001) were independent predictors of poor survival in the derivation cohort. An ALBI-based prognostic model with a total of 0 to 6 points was derived with the sum of 5 variables: 1 point each for age 65 years or older, AFP >100 ng/mL, presence of ascites, performance status 1 to 4, and ALBI grade 2, and 2 points for ALBI grade 3. This model can accurately predict long-term outcome in the validation cohort (P<0.001) and discriminate survival in patients stratified by curative and noncurative treatments (bothP<0.001).Conclusion:The proposed ALBI grade–based model is feasible in predicting survival in HCC patients within the Milan criteria, and helps identify high-risk patients who need timely liver transplantation.
PD-L1 Detection—Pearls and Pitfalls Associated With Current Methodologies Focusing on Entities Relevant to Dermatopathology
Authors: Oh Kei Shing , Mahalingam Meera 
Published: July 2019

Abstract:PD-L1 is a transmembrane glycoprotein with an extracellular as well as an intracellular cytoplasmic domain. Physiologically, it plays a pivotal role in regulating T-cell activation and tolerance. Many tumor cells have exploited this regulatory mechanism by overexpressing PD-L1 in an effort to escape immunologic surveillance. In this review, we parse the literature regarding the prognostic value of tumoral PD-L1 expression before discussing the various methodologies as well as the pearls and pitfalls associated with each for predicting response to anti–PD-1/PD-L1 therapies. Special attention is given to cutaneous entities in which PD-L1 expression has been documented with an emphasis on cutaneous malignancies that have seen the broadest applications of anti–PD-L1/PD-1 therapies. Currently, immunohistochemistry is the method that is most commonly used for detection of PD-L1. However, with the wide array of immunohistochemistry protocols and staining platforms available in the market, there seems to be different cutoffs not just for different entities but also for the same entity. This review is an attempt to address the need for standardization and validation of existing protocols for PD-L1 detection.
ANTERIOR MIGRATION OF INTRAVITREAL FLUOCINOLONE ACETONIDE IMPLANTS: A CASE REPORT
Authors: Gunzenhauser Robert C. , Greven Margaret A. , John Vishak J. 
Published: July 2019

Background/Purpose:
To describe management of anterior migration of a fluocinolone acetonide(FAc) intravitreal implant.

Methods:
A retrospective case report. A 61-year-old man with diabetic macular edema and prior vitrectomy had anterior migration of a FAc implant. Anterior segment photos and optical coherence tomography were performed.

Results:
Approximately 3 months after FAc implant was administered, it was noted to have migrated into the anterior chamber. Vision, intraocular pressure, and optical coherence tomography imaging initially remained stable, and no evidence of detectable corneal edema developed in 30 months of follow-up. However, at 36 months of follow-up, after second FAc implant injection, mild corneal edema developed,suspected to be related to the migrating implants.

Conclusion:
Anterior migration of a FAc implant may lead to less rapid and severe corneal decompensation compared with other steroid implants. Despite this, delayed corneal edema may occur. Careful monitoring of the cornea and intraocular pressure is recommended in cases of anterior FAc migration.
CYTOMEGALOVIRUS RETINITIS AFTER AN INTRAVITREAL DEXAMETHASONE IMPLANT IN AN IMMUNOCOMPETENT PATIENT
Authors: Witmer Matthew T. , Connolly Brian P. 
Published: July 2019

Purpose:
To present the case of a 71-year-old woman who developed cytomegalovirus retinitis after the administration of an intravitreal dexamethasone implant in an immunocompetent patient.

Methods:
Retrospective case report.

Patients:
Single patient with a diagnosis of cytomegalovirus retinitis associated with the intravitreal dexamethasone implant.

Results:
The patient developed cytomegalovirus retinitis three months after an intravitreal injection of a dexamethasone implant for macular edema. The patient had no history of poor immune function and was not taking immunosuppressive medications.

Conclusion:
Cytomegalovirus retinitis has been associated with local steroid therapy. This has been described in both immunocompromised and immunocompetent patients. The intravitreal dexamethasone implant may cause local immunosuppression and result in cytomegalovirus retinitis in immunocompetent patients.
Comparison of Corneal Power and Corneal Astigmatism of Different Diameter Zones Centered on the Pupil and Corneal Apex Using Scheimpflug Tomography
Authors: Dong Jing , Zhang Yaqin , Zhou Jing , Zhang Suhua , Sun Bin , Tang Maolong , Wang Xiaogang 
Published: July 2019

Purpose:
Using Scheimpflug tomography to investigate the difference in corneal power and corneal astigmatism between 3- and 4-mm diameter zones centered on the pupil and corneal apex.

Methods:
A total of 90 eyes were included in this study. Axial keratometry, total refractive power, and true net power centered on the pupil and corneal apex in 3- and 4-mm diameter zones were assessed. The paired sample t test and independent sample t test were used for data comparison.

Results:
For corneal power and corneal astigmatism for the 3- and 4-mm diameter zones, the flat K values of axial keratometry, total refractive power, and true net power centered on the pupil (3-mm: 43.99 ± 1.69 D, 43.12 ± 1.71 D, 42.53 ± 1.67 D; 4-mm: 44.04 ± 1.67 D, 43.38 ± 1.71 D, 42.61 ± 1.65 D) were significantly higher than those centered on the apex (3-mm: 43.93 ± 1.69 D, 43.05 ± 1.71 D, 42.46 ± 1.67 D; 4-mm: 44.01 ± 1.67 D, 43.34 ± 1.69 D, 42.58 ± 1.65 D; all P < 0.02). However, the steep K and astigmatism magnitude values centered on the pupil (3-mm: 45.71 ± 1.73 D, 45.01 ± 1.73 D, 44.38 ± 1.69 D; 1.72 ± 0.83 D, 1.89 ± 0.86 D, 1.85 ± 0.84 D; 4-mm: 45.78 ± 1.73 D, 45.28 ± 1.74 D, 44.45 ± 1.68 D; 1.73 ± 0.84 D, 1.90 ± 0.85 D, 1.84 ± 0.85 D) were lower than those centered on the apex (3-mm: 45.81 ± 1.74 D, 45.10 ± 1.72 D, 44.50 ± 1.70 D; 1.88 ± 0.90 D, 2.05 ± 0.90 D, 2.04 ± 0.90 D; 4-mm: 45.85 ± 1.73 D, 45.34 ± 1.73 D, 44.51 ± 1.69 D; 1.83 ± 0.88 D, 2.00 ± 0.90 D, 1.93 ± 0.86 D; all P < 0.01). Compared with the 3-mm diameter zone, the corresponding 4-mm diameter zone showed higher corneal power centered on both pupil and corneal apex.

Conclusions:
The difference in corneal power and corneal astigmatism, measured at 3 and 4 mm, centered on the pupil and the corneal apex should be noted in corneal refractive surgery and toric intraocular lens calculation.
Indications and Techniques of Pediatric Keratoplasty in Eastern China From 2008 to 2017
Authors: Zhao Songjiao , Le Qihua , Yao Wang , Xu Jianjiang 
Published: July 2019

Purpose:
To explore the transition of indications and surgical techniques of pediatric keratoplasty in Eastern China in the past 10 years.

Methods:
Medical charts of 1026 pediatric patients (1059 eyes) who underwent keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2008 to 2017 were retrospectively reviewed. The indications for keratoplasty and the surgical techniques were collected and analyzed.

Results:
A total of 634 infants (≤3 years) (661 eyes), 207 toddlers and older children (4–12 years) (211 eyes), and 185 adolescents (13–18 years) (187 eyes) were included. The median age at the time of surgery was 2 years. The surgical indications were composed of congenital abnormalities (74.6%), acquired nontraumatic diseases (16.5%), acquired traumatic diseases (3.6%), and regraft (5.3%). Only congenital abnormality had a significant growing trend during this decade (P = 0.023). Keratoconus (67.2%) exceeded infectious keratitis (14.9%) and was the most common acquired nontraumatic cause in our study. The annual number of pediatric keratoplasties increased significantly from 40 cases in 2008 to 190 cases in 2017 (P < 0.001). Although penetrating keratoplasty was performed in 414 eyes (39.1%), its application in the treatment of keratoconus decreased significantly during this decade (P = 0.04). By contrast, deep anterior lamellar keratoplasty showed an increasing trend because of its popularization in the treatment of keratoconus (P = 0.003).

Conclusions:
Congenital abnormalities have replaced infectious keratitis and have been the leading indications of pediatric keratoplasty in the past 10 years. Although the using of penetrating keratoplasty was still the predominant procedure to treat pediatric corneal pathologies, the adoption of deep anterior lamellar keratoplasty showed a significant increasing trend during the past decade.
Longitudinal Analysis of Bruch Membrane Opening Morphometry in Myopic Glaucoma
Authors: Bhalla Mahadev , Heisler Morgan , Han Sherry X. , Sarunic Marinko V. , Beg Mirza F. , Mackenzie Paul J. , Lee Sieun 
Published: July 2019

Précis:
The Bruch membrane opening (BMO) was posteriorly bowed and the degree of nonplanarity increased in stable and progressive glaucoma subjects. BMO became more posterior relative to the Bruch membrane (BM) in control and both stable and progressive glaucoma subjects.

Purpose:
To investigate longitudinal changes in morphologic characteristics of the BMO in control and glaucomatous subjects.

Materials and Methods:
A total of 53 myopic eyes (17 control, 6 suspect, 20 stable glaucoma, and 10 progressing glaucoma) were followed for an average of 4.2±1.4 years and imaged at the baseline and 2 follow-up appointments using a 1060 nm swept-source optical coherence tomography system. BM and BMO were segmented, and 4 morphometric BMO parameters (area, ellipse ratio, nonplanarity, and depth) were measured.

Results:
There were no significant changes in BMO area or ellipse ratio for all groups. BMO nonplanarity was shown to increase in the glaucoma groups. BMO depth relative to BM increased in all groups except the suspects (control: 8.1 µm/y, P=0.0001; stable glaucoma: 3.5 µm/y, P=0.0001; progressing glaucoma: 14.0 µm/y, P=0.0026). In linear mixed-model analysis, axial length was positively associated with BMO area in all groups except for progressing glaucoma, and with BMO nonplanarity in stable glaucoma. It was not a significant factor to the slopes of the BMO parameters in the ANCOVA analysis of slopes.

Conclusions:
Longitudinally, BMO increased in nonplanarity in the glaucoma eyes, and its axial position relative to BM became more posterior in both control and glaucoma eyes.
Perceptual and motor responses directly and indirectly mediate the effects of noxious stimuli on autonomic responses
Authors: Tiemann Laura , Hohn Vanessa D. , Ta Dinh Son , May Elisabeth S. , Nickel Moritz M. , Heitmann Henrik , Ploner Markus 
Published: July 2019

Abstract
Autonomic responses are an essential component of pain. They serve its adaptive function by regulating homeostasis and providing resources for protective and recuperative responses to noxious stimuli. To be adaptive and flexible, autonomic responses are not only determined by noxious stimulus characteristics, but likely also shaped by perceptual and motor responses to noxious stimuli. However, it is not fully known how noxious stimulus characteristics, perceptual responses, and motor responses interact in shaping autonomic responses. To address this question, we collected perceptual, motor, and autonomic responses to brief noxious laser stimuli of different intensities in 47 healthy human participants. Multilevel 2-path mediation analyses revealed that perceptual, but not motor responses mediated the translation of noxious stimuli into autonomic responses. Multilevel 3-path mediation analyses further specified that motor responses indirectly related to autonomic responses through their close association with perceptual responses. These findings confirm that autonomic responses are not only a reflexive reaction to noxious stimuli, but directly and indirectly shaped by perceptual and motor responses, respectively. These effects of motor and perceptual processes on autonomic responses likely allow for the integration of contextual processes into protective and regulatory autonomic responses, aiding adaptive and flexible coping with threat.