bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of Real-world Functional Tasks Using an Updated Oral Electronic Vision Device in Persons Blinded by Trauma
Authors: Grant Patricia , Maeng Meesa , Arango Tiffany , Hogle Rich , Szlyk Janet , Seiple William 
Published: August 2018

SIGNIFICANCE
There is an immediate need for noninvasive therapies to improve the functional abilities of persons blinded by traumatic injury. The BrainPort Vision Pro, an updated hands-free oral electronic vision device, enables perception of visual information using the tongue as a substitute for the eye.

PURPOSE
The purpose of this study was to evaluate the impact of the BrainPort Vision Pro on real-world functional task performance in persons who are profoundly blind (light perception or worse) due to traumatic injury (ocular or cortical).

METHODS
This was a prospective, within-subjects, repeated-measures study. Participants received ten hours of device training and were required to use the device independently for 1 year. Functional performance measures of object identification, orientation and mobility, word identification, and environmental awareness were assessed at baseline, post-device training, and quarterly throughout the year.

RESULTS
Seventeen profoundly blind adults were enrolled in the study. No clinically significant device-related adverse events were reported, demonstrating minimal risks associated with the BrainPort Vision Pro. None of the participants could successfully perform any of the functional tasks at baseline, without the device. After 1 year of independent device use, all participants could identify objects, and 41% identified words beyond chance level while using the device. Forty-one percent of participants could locate a sign, 94% followed a line without veering off, 71% avoided obstacles, 71% walked through a doorway without collision, 100% of participants recognized a door, and 71% identified a window.

CONCLUSIONS
Results demonstrate significant improvements in real-world functional task performance in skill areas important to everyday life. The BrainPort Vision Pro offers a nonsurgical method for improving visual function in persons blinded by trauma. The device can enhance independence and support the successful integration of profoundly blind persons, including veterans and returning service members, into community life.
Comparing Haptic Pattern Matching on Tablets and Phones: Large Screens Are Not Necessarily Better
Authors: Tennison Jennifer L. , Carril Zachary S. , Giudice Nicholas A. , Gorlewicz Jenna L. 
Published: August 2018

SIGNIFICANCE
Touchscreen-based, multimodal graphics represent an area of increasing research in digital access for individuals with blindness or visual impairments; yet, little empirical research on the effects of screen size on graphical exploration exists. This work probes if and when more screen area is necessary in supporting a pattern-matching task.

PURPOSE
Larger touchscreens are thought to have distinct benefit over smaller touchscreens for the amount of space available to convey graphical information nonvisually. The current study investigates two questions: (1) Do screen size and grid density impact a user's accuracy on pattern-matching tasks? (2) Do screen size and grid density impact a user's time on task?

METHODS
Fourteen blind and visually impaired individuals were given a pattern-matching task to complete on either a 10.5-in tablet or a 5.1-in phone. The patterns consisted of five vibrating targets imposed on sonified grids that varied in density (higher density = more grid squares). At test, participants compared the touchscreen pattern with a group of physical, embossed patterns and selected the matching pattern. Participants were evaluated on time exploring the pattern on the device and their pattern-matching accuracy. Multiple and logistic regressions were performed on the data.

RESULTS
Device size, grid density, and age had no statistically significant effects on the model of pattern-matching accuracy. However, device size, grid density, and age had significant effects on the model for grid exploration. Using the phone, exploring low-density grids, and being older were indicative of faster exploration time.

CONCLUSIONS
A trade-off of time and accuracy exists between devices that seems to be task dependent. Users may find a tablet most useful in situations where the accuracy of graphic interpretation is important and is not limited by time. Smaller screen sizes afforded comparable accuracy performance to tablets and were faster to explore overall.
Peripheral Prisms Improve Obstacle Detection during Simulated Walking for Patients with Left Hemispatial Neglect and Hemianopia
Authors: Houston Kevin E. , Bowers Alex R. , Peli Eli , Woods Russell L. 
Published: August 2018

SIGNIFICANCE
The first report on the use of peripheral prisms (p-prisms) for patients with left neglect and homonymous visual field defects (HVFDs).

PURPOSE
The purpose of this study was to investigate if patients with left hemispatial neglect and HVFDs benefit from p-prisms to expand the visual field and improve obstacle detection.

METHODS
Patients (24 with HVFDs, 10 of whom had left neglect) viewed an animated, virtual, shopping mall corridor and reported if they would have collided with a human obstacle that appeared at various offsets up to 13.5° from their simulated walking path. There were 40 obstacle presentations on each side, with and without p-prisms. No training with p-prisms was provided, and gaze was fixed at the center of expansion.

RESULTS
Detection on the side of the HVFD improved significantly with p-prisms in both groups, from 26 to 92% in the left-neglect group and 43 to 98% in the non-neglect group (both P < .001). There was a tendency for greater improvement in the neglect patients with p-prisms. For collision judgments, both groups exhibited a large increase in perceived collisions on the side of the HVFD with the prisms (P < .001), with no difference between the groups (P = .93). Increased perceived collisions represent a wider perceived safety margin on the side of the HVFD.

CONCLUSIONS
Within the controlled conditions of this simulated, collision judgment task, patients with left neglect responded well to initial application of p-prisms exhibiting improved detection and wider safety margins on the side of the HVFD that did not differ from non-neglect patients. Further study of p-prisms for neglect patients in free-gaze conditions after extended wear and in real-world mobility tasks is clearly warranted.
Recommendations on RBC Transfusions in Critically Ill Children With Acute Respiratory Failure From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative
Authors: Demaret Pierre , Emeriaud Guillaume , Hassan Nabil E. , Kneyber Martin C. J. , Valentine Stacey L. , Bateman Scot T. , Tucci Marisa 
Published: August 2018

Objectives:To present the recommendations and supporting literature for RBC transfusions in critically ill children with bleeding developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.Design:Consensus conference series of international, multidisciplinary experts in RBC transfusion management of critically ill children.Methods:The panel of 38 experts developed evidence-based and, when evidence was lacking, expert-based clinical recommendations as well as research priorities for RBC transfusions in critically ill children. The respiratory subgroup included six experts. Electronic searches were conducted using PubMed, EMBASE, and Cochrane Library databases from 1980 to May 2017. Agreement was obtained using the Research and Development/UCLA Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method.Results:Transfusion and Anemia Expertise Initiative experts developed seven recommendations focused on children with acute respiratory failure. All recommendations reached agreement (> 80%). Transfusion of RBCs in children with respiratory failure with an hemoglobin level less than 5 g/dL was strongly recommended. It was strongly recommended that RBCs not be systematically administered to children with respiratory failure who are hemodynamically stable and who have a hemoglobin level greater than or equal to 7 g/dL. Experts could not make a recommendation for children with hemodynamic instability, with severe hypoxemia and/or with an hemoglobin level between 5 and 7 g/dL. Specific RBC transfusion strategies using physiologic-based metrics and biomarkers could not be elaborated.Conclusions:The Transfusion and Anemia Expertise Initiative Consensus Conference developed specific recommendations regarding RBC transfusion management in critically ill children with respiratory failure, as well as recommendations to guide future research. Clinical recommendations emphasize relevant hemoglobin thresholds. Research recommendations emphasize the need to identify appropriate physiologic thresholds, suggest a better understanding of alternatives to RBC transfusion, and identify the need for better evidence on hemoglobin thresholds that might be used in specific subpopulations of critically ill children.
Confluent Retropharyngeal, Lateral Pharyngeal, and Peritonsilar MRSA Abscess in an Infant
Authors: Alansari Khalid , Sheikh Rashid , Sheehan Patrick Z. , Joseph Viju , Hoffman Robert J 
Published: August 2018

AbstractNeck abscesses such as retropharyngeal, peritonsilar, and lateral pharyngeal are well described, typically cause a characteristic illness, and have a known epidemiology. We present a rare occurrence of case of confluent, mixed retropharyngeal, lateral pharyngeal, and peritonsilar abscess in a 9-month-old female infant. The symptoms at presentation were very mild and not expected in association with this extensive an abscess. The causative organism was methicillin-resistantStaphylococcus aureus.
Asthma-Related Educational Needs of Families With Children With Asthma in an Urban Pediatric Emergency Department
Authors: Kwok Maria Y. , Pusic Martin V. , Cabrera Keven I. , York Deborah V. , Lee June , Evans David 
Published: August 2018

Objective
The aim of this study was to identify the educational needs of inner-city children with persistent asthma and their caregivers who utilize the emergency department (ED) for asthma care as well as determine their guideline adherence, factors associated with ED use, and comfort with computers.

Methods
Cross-sectional survey of children aged 2 to 18 years with previous diagnosis of asthma presenting with asthma-related complaints or acute asthma exacerbations to an urban pediatric ED. Data on demographics, families' response to acute asthma, approach to asthma prevention, access to care, educational topics of interest, and sources of health information were collected.

Results
Of approximately 1500 asthma-related visits, 218 caregivers were approached, and 200 completed the survey. In the past 12 months, 31% had experienced at least 1 asthma-related hospitalization, and 55.5% had had at least 3 ED visits. Although 184 (92.9%) of 198 caregivers were able to identify a primary physician, 37% reported they were more likely to take their child to the ED in response to acute asthma during the day as opposed to their physician (17%). Approximately half of patients were not on any preventive medication, with 57% not having had received an Asthma Action Plan. Caregivers expressed the most interest in learning about long-term controller medications (44.2%), use of metered dose inhalers or nebulizers (44.2%), and trigger avoidance (35.2%). Most caregivers (approximately 68%) reported ease of use with computers and the Internet.

Conclusion
There was discordance between caregivers' reports of primary care provider teaching on asthma management and the use of the controller medications and possession of the Asthma Action Plans for persistent asthma. Education could focus on caregiver concerns of the safety and benefits of the controller medications.
Usability of Transthoracic Shear Wave Elastography in Differentiation of Subpleural Solid Masses
Authors: Ozgokce Mesut , Yavuz Alpaslan , Akbudak Ibrahim , Durmaz Fatma , Uney Ibrahim , Aydin Yener , Yildiz Hanifi , Batur Abdussamet , Arslan Harun , Dundar Ilyas 
Published: August 2018

Abstract
In this study, the effectiveness of transthoracic ultrasound elastography in the benign and malign distinction of subpleural/pleural solid lesions was investigated.Between July 2015 and December 2016, 33 consecutive patients with subpleural solid lesions detected via computed tomography (CT) of the thorax were identified and prospectively included in this study. The average for each lesion's shear wave velocity (SWV) value was detected, and benign and malignant lesions' SWV values are statistically compared. The CT and pathology results were used as a reference to compare these values. A receiver operating characteristic analysis was used to determine the cutoff value for benign/malignant neoplasms.The 33 patients (10 female, 23 male) included in the study had a mean age of 56.2 ± 15.40 years (range, 17–84 years), and the mean SWV value of the lesions in 13 (39%) cases evaluated benign after a CT scan, histopathological examination, or both 2.18 ± 0.49 m/s. The mean SWV value of the lesions which were histopathologically diagnosed as malign in 23 (61%) cases was 3.50 ± 0.69 m/s. (P < 0.001). When the cutoff value was set as 2.47 m/s for the SVW value, sensitivity and specificity were determined to be 97.7%.The present study has shown that transthoracic ultrasound shear wave elastography can be an effective radiological examination method in the benign and malign differentiation of subpleural lesions and has the potential for use in the routine clinical application of transthoracic ultrasound elastography, a noninvasive method for evaluating the malignancy potentials of such lesions.
Translabial Ultrasound in Midurethral Sling (Mesh) Visualization and Erosion Detection in Women With Stress Urinary Incontinence
Authors: Viragh Karoly A. , Cohen Seth A. , Raz Shlomo , Lo Jocelyn , Raman Steven S. 
Published: August 2018

Abstract
Sling erosion is a significant complication of midurethral sling (mesh) placement for stress urinary incontinence, a common pelvic floor disorder. The goal of this retrospective case-control pilot study was to evaluate the performance of translabial ultrasound (TLUS) and magnetic resonance imaging in diagnosing mesh erosion. Therefore, women who underwent surgery in the setting of prior failed midurethral sling for stress urinary incontinence were identified from the hospital database. The case subcohort comprised all women with intraoperatively documented erosion, and the control subcohort comprised an equal number of randomly selected patients without erosion. The data consisted of selected clinical parameters, the presence of erosion at surgery (reference standard) and at cystourethroscopy, and dual-reader preoperative TLUS consensus interpretation for mesh location (intraluminal, mural, and extramural) and erosion (defined as intraluminal or mural mesh location). Odds ratios were calculated for the selected clinical parameters. Of the 198 women identified, 15 (8%) had mesh erosion at surgery into the lower urinary tract. The sensitivity, specificity, and accuracy of TLUS and cystourethroscopy in detecting erosion in the combined group of cases and controls (30 women) were 93%, 88%, and 90%, as well as 67%, 100%, and 83%, respectively (TLUS Cohen κ = 0.85). Thus, TLUS may be a good diagnostic tool in diagnosing mesh erosion. Only 7 of 30 women had pelvic magnetic resonance examination, and mesh fragments were not visualized. Case-control comparison of the selected clinical parameters was not statistically significant.
Three Skulls Dating from the French Revolutionary Years Diagnosed with Tinea Capitis: A Paleopathologic Approach
Authors: Tourreil Virginie , Giran Guillaume , Benmoussa Nadia , Paternoster Giovanna , Conan Patrick , Charlier Philippe , Khonsari Roman Hossein 
Published: August 2018

AbstractThe Musée Dupuytren was a Parisian pathology museum established in 1835. This museum hosted 3 skulls with severe craniofacial lesions initially tagged as aggressive forms of tinea capitis. The aim of this study was to investigate these specimens and discuss the initial diagnosis. Historical investigations were conducted based on the biographic data from the tags of the 3 skulls and entries on the catalog of the museum. Age was determined using dentition and the patency of cranial base synchondroses. The computed tomography scans were performed using standard medical devices. The 3 skulls were from the late 18th to early 19th century. Skull № 1 was a 5-year-old child and presented with microcephaly and extensive vault osteolysis compatible with an aggressive benign lesion, a malignant tumor, or a chronic infection. Skull № 2 was a 12- to 18-year-old teenager and presented with symmetrical porotic hyperostosis compatible with undernutrition and various hematologic conditions causing prolonged anemia, but also with chronic inflammation and/or infection. Skull № 3 was also from a 12- to 18-year-old teenager and presented with focal temporal osteolysis compatible with an aggressive benign or a low-grade malignant temporal soft-tissue lesion or with chronic infection. These skulls contribute to the understanding of the concept of tinea in the 19th century. They are furthermore windows on the sanitary and social conditions in Paris in the years following the French revolution and during the Napoleonian wars.
Impact of Reduced Preincision Antibiotic Infusion Time on Surgical Site Infection Rates
Authors: Malhotra Neil R. , Piazza Matthew , Demoor Rebecca , McClintock Scott D. , Hamilton Keith , Sharma Nikhil , Osiemo Benjamin , Berger Ian , Hossain Erik , Borovskiy Yuliya , Maloney Eileen , Smith Lachlan J. , Grady Michael Sean 
Published: August 2018

Objective:
Our objective was to determine the impact of total preincision infusion time on surgical site infections (SSIs) and establish an optimal time threshold for subsequent prospective study.

Background:
SSIs remain a major cause of morbidity. Although regulated, the total time of infusion of preincision antibiotics varies widely. Impact of infusion time on SSI risk is poorly understood.

Methods:
All consecutive patients (n = 46,791) undergoing inpatient surgical intervention were retrospectively enrolled (2014–2015) and monitored for 1 year. Primary outcomes: the presence of SSI infection as predicted by reduced preoperative antibiotic infusion time. Secondary outcomes: preintervention compliance, the impact of a quality improvement algorithm to optimize infusion time compliance. Multivariate logistic regression of the retrospective cohort demonstrated predictors of infection. Receiver-operating characteristic analysis demonstrated the timing threshold predictive of infection. Cost impact of avoidable infections was analyzed.

Results:
Only 36.1% of patients received preincision infusion of vancomycin in compliance with national and institutional standards (60–120 min). Cephalosporin infusion times were 53 times more likely to be compliant [odds ratio (OR) 53.33, P < 0.001]. Vancomycin infusion times that were not compliant with national standards (less than standard 60–120 min) did not predict infection. However, significantly noncompliant, reduced preincision infusion time, significantly predicted SSI (<24.6 min infusion, AUC = 0.762). Vancomycin infusion, initiated too close to surgical incision, predicted increased SSI (OR = 4.281, P < 0.001). Implementation of an algorithm to improve infusion time, but not powered to demonstrate infection /reduction, improved vancomycin infusion start time (257% improvement, P < 0.001) and eliminated high-risk infusions (sub-24.6 min).

Conclusions:
Initially, vancomycin infusion rarely met national guidelines; however, minimal compliance breach was not associated with SSI implications. The retrospective data here suggest a critical infusion time for infection reduction (24.6 min before incision). Prospective implementation of an algorithm led to 100% compliance. These data suggest that vancomycin administration timing should be studied prospectively.
Neural Representations of Faces are Tuned to Eye Movements
Authors: Stacchi Lisa , Ramon Meike , Lao Junpeng , Caldara Roberto 
Published: August 2018

ABSTRACTEye movements provide a functional signature of how human vision is achieved. Many recent studies have reported idiosyncratic visual sampling strategies during face recognition. Whether these inter-individual differences are mirrored by idiosyncratic neural responses has not been investigated yet. Here, we tracked observers’ eye movements during face recognition; additionally, we obtained an objective index of neural face discrimination through EEG that was recorded while subjects fixated different facial information.Across all observers, we found that those facial features that were fixated longer during face recognition elicited stronger neural face discrimination responses. This relationship occurred independently of inter-individual differences in fixation biases. Our data show that eye movements play a functional role during face processing by providing the neural system with information that is diagnostic to a specific observer. The effective processing of face identity involves idiosyncratic, rather than universal representations.
Methodologic Issues in Doubly Labeled Water Measurements of Energy Expenditure During Very Low-Carbohydrate Diets
Authors: Hall Kevin D. , Guo Juen , Chen Kong Y. , Leibel Rudolph L. , Reitman Marc L. , Rosenbaum Michael , Smith Steven R. , Ravussin Eric 
Published: August 2018

AbstractBackgroundVery low-carbohydrate diets have been reported to substantially increase human energy expenditure as measured by doubly labeled water (DLW) but not by respiratory chambers. Do the DLW data reflect true physiological differences that are undetected by respiratory chambers? Alternatively, are the apparent DLW energy expenditure a consequence of failure to fully account for respiratory quotient (RQ) differences between diets?ObjectiveTo examine energy expenditure differences between diets varying drastically in carbohydrate and to quantitatively compare DLW data with respiratory chamber and body composition measurements within an energy balance framework.DesignDLW measurements were obtained during the final two weeks of month-long baseline (BD; 50% carbohydrate, 35% fat, 15% protein) and isocaloric ketogenic diets (KD; 5% carbohydrate, 80% fat, 15% protein) in 17 men with BMI 25-35 kg/m2. Subjects resided 2d/week in respiratory chambers to measure energy expenditure (EEchamber). DLW expenditure was calculated using chamber-determined respiratory quotients (RQ) either unadjusted (EEDLW) or adjusted (EEDLWΔRQ) for net energy imbalance using diet-specific coefficients. Accelerometers measured physical activity. Body composition changes were measured by dual-energy X-ray absorptiometry which were combined with energy intake measurements to calculate energy expenditure by balance (EEbal).ResultsAfter transitioning from BD to KD, neither EEchamber nor EEbal were significantly changed (∆EEchamber=24±30 kcal/d; p=0.43 and ∆EEbal=-141±118 kcal/d; p=0.25). Similarly, physical activity (−5.1±4.8%; p=0.3) and exercise efficiency (−1.6±2.4%; p=0.52) were not significantly changed. However, EEDLW was 209±83 kcal/d higher during the KD (p=0.023) but was not significantly increased when adjusted for energy balance (EEDLWΔRQ =139±89 kcal/d; p=0.14). After removing 2 outliers whose EEDLW were incompatible with other data, EEDLW and EEDLW∆RQ were marginally increased during the KD by 126±62 kcal/d (p=0.063) and 46±65 kcal/d (p=0.49), respectively.ConclusionsDLW calculations failing to account for diet-specific energy imbalance effects on RQ erroneously suggest that very low carbohydrate diets substantially increase energy expenditure.