bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Retrospective Study of 199 Xen45 Stent Implantations From 2014 to 2016
Authors: Heidinger Astrid , Schwab Christoph , Lindner Ewald , Riedl Regina , Mossböck Georg 
Published: November 2018

Purpose:
The aim of this study is to determine the postoperative course after Xen45 Gel Stent implantation at the Medical University of Graz from 2014-2016.

Methods:
Single-center, retrospective study. All patients with Xen implantation between 2014 and 2016 were included. Clinical records and reports received from supervising ophthalmologists were used for evaluations. Investigated parameters were intraocular pressure (IOP), the number of medications, visual acuity, and the number of previous operations, IOP-follow-up, intraoperative and postoperative complications, the rate of interventions (needling), and additionally performed surgeries.

Results:
Xen was implanted in 199 eyes of 160 patients. Mean preoperative IOP was 22.8±6.9 mm Hg on 2.9±1.0 IOP-lowering medication. After 12 months follow-up, mean IOP was 17.1±5.9 mm Hg (n=89, P<0.0001; mean reduction of 22.7%) on 1.8±1.4 (n=87; P<0.0001) IOP-lowering medications. There were no intraoperative complications and in two cases (1.0%) severe postoperative adverse events occurred (aqueous misdirection and late-onset endophthalmitis). Postoperative needling was indicated in 44 cases (22.1%), while in 28 cases (14.1%) an additional glaucoma surgery was performed.

Conclusions:
Our results indicate that Xen implantation is an effective surgical intervention leading to a significant reduction of IOP and number of medications with a low rate of complications. An attentive postoperative management seems to be mandatory.
Adult-onset Buphthalmos in Down Syndrome
Authors: Faria-e-Sousa Sidney J. , Marques Alexandre G. , Vieira Juliana , Antunes-Foschini Rosalia 
Published: November 2018

Purpose:
To report a peculiar case of adult-onset buphthalmos.

Methods:
Review of the medical record of a 24-year-old patient with Down syndrome who developed buphthalmos in the left eye after corneal transplantation for keratoconus.

Results:
In the next 2 years after surgery, the operated eye evolved with chronic anterior uveitis that led to progressive peripheral synechiae, oscillating intraocular pressure, cataract, graft failure, and buphthalmos.

Conclusions:
The finding of buphthalmos of adult-onset in Down syndrome raises important issues concerning the classification of this eye condition and the responsibility for detecting and monitoring eyes with glaucoma in individuals with chromosome 21 trisomy.
Maternal Perinatal HIV Infection Is Associated With Increased Infectious Morbidity in HIV-exposed Uninfected Infants
Authors: Powis Kathleen M. , Slogrove Amy L. , Okorafor Ibeawuchi , Millen Lily , Posada Roberto , Childs Jocelyn , Abrams Elaine J. , Sperling Rhoda S. , Jao Jennifer 
Published: November 2018

Background:
The aging population of females with perinatally-acquired HIV (PHIV) are having their own children. HIV-exposed uninfected infants (HEU-N) born to women living with non-perinatally-acquired HIV (NPHIV) experience higher infectious morbidity compared with HIV-unexposed infants (HUU). Little is known about the infectious morbidity risk of HIV-exposed uninfected infants (HEU-P) born to PHIV women.

Methods:
We evaluated prevalence of infectious cause hospitalizations (ICH) during the first year of life among HEU-P, HEU-N and HUU infants in a United States (U.S) tertiary care center. Maternal HIV status was categorized as PHIV vs. NPHIV vs. HIV-uninfected. Generalized Estimating Equation models were fit to evaluate the association between maternal HIV status and infant ICH.

Results:
ICH was evaluated among 205 infants, 28 HEU-P infants, 112 HEU-N infants, and 65 HUU infants. PHIV women were younger compared with NPHIV and HIV-uninfected women (median age 22 years vs. 29 and 23 respectively, p<0.01). Overall, 21% of HEU-P, 4% of HEU-N and 12% of HUU infants experienced at least one ICH event (p<0.01) in the first year of life. After adjusting for confounders, HEU-P infants were at increased ICH risk compared with HEU-N infants [adjusted odds ratio (aOR)=7.45, 95% Confidence Interval (CI):1.58-35.04]. In sub-group analysis of HEU infants, excluding HUU infants, this relationship persisted after adjustment for maternal CD4 and HIV RNA level (aOR=10.24, 95% CI:1.66-63.31)

Conclusions:
In a small U.S. cohort, HEU-P infants experienced increased ICH risk. Differences in intrauterine environments, social factors, or access to care may be important factors to assess in future larger studies.
Manual therapy prevents onset of nociceptor activity, sensorimotor dysfunction, and neural fibrosis induced by a volitional repetitive task
Authors: Bove Geoffrey M. , Delany Sean P. , Hobson Lucas , Cruz Geneva E. , Harris Michele Y. , Amin Mamta , Chapelle Susan L. , Barbe Mary F. 
Published: November 2018

AbstractPainful and disabling musculoskeletal disorders remain prevalent. In rats trained to perform repetitive tasks leading to signs and dysfunction similar to those in humans, we tested whether manual therapy would prevent the development of the pathologies and symptoms. We collected behavioral, electrophysiological, and histological data from control rats, rats that trained for 5 weeks before performing a high-repetition high-force (HRHF) task for 3 weeks untreated, and trained rats that performed the task for 3 weeks while being treated 3x/week using modeled manual therapy (MMT) to the forearm (HRHF + MMT). The MMT included bilateral mobilization, skin rolling, and long axis stretching of the entire upper limb. High-repetition high-force rats showed decreased performance of the operant HRHF task and increased discomfort-related behaviors, starting after training. HRHF + MMT rats showed improved task performance and decreased discomfort-related behaviors compared with untreated HRHF rats. Subsets of rats were assayed for presence or absence of ongoing activity in C neurons and slow Aδ neurons in their median nerves. Neurons from HRHF rats had a heightened proportion of ongoing activity and altered conduction velocities compared with control and MMT-treated rats. Median nerve branches in HRHF rats contained increased numbers of CD68+macrophages and degraded myelin basic protein, and showed increased extraneural collagen deposition, compared with the other groups. We conclude that the performance of the task for 3 weeks leads to increased ongoing activity in nociceptors, in parallel with behavioral and histological signs of neuritis and nerve injury, and that these pathophysiologies are largely prevented by MMT.
Heart Failure Care Dyadic Typology
Authors: Buck Harleah G. , Hupcey Judith , Juárez-Vela Raul , Vellone Ercole , Riegel Barbara 
Published: November 2018

Background
Heart failure (HF) dyadic self-care science is advancing rapidly, as evidenced by recent theoretical work, literature reviews, and multiple empiric studies. Typologies, once considered archaic, are now viewed as person-oriented classification systems that allow a whole-system view of information patterns. This whole-system view is particularly needed to understand complex tasks like dyadic HF self-care.

Purpose
The purpose of this article is to review the initial conceptualization of an HF care dyadic typology and the present advances in our thinking and suggest future directions for this clinically relevant classification system.

Conclusions
Development and testing of the typology across 5 studies resulted in a well-characterized, pragmatic and parsimonious, person-oriented classification system for understanding how patients and informal caregivers conduct patients' HF self-care at home. The 4 types are characterized as 2 individually oriented types—type I, patient oriented; type II, caregiver oriented; and 2 relationally oriented types—type III, collaboratively oriented; and type IV, incongruently oriented. We have devised a single-item measure of typology group that can be assessed in the clinical setting. Once this information is ascertained, the clinician can personalize the plan of care to the realities of the dyad.

Implications
Dyads that disagree on who is responsible for self-care may forego or delay action, resulting in self-care failures with subsequent HF advancement, hospitalization, and mortality. As the HF dyadic self-care science has advanced, we have come to appreciate the complexity that arises when 2 individuals work together on 1 complex task—HF self-care.
Filling the Gaps: Predicting Physician Assistant Students' Interest in Practicing in Medically Underserved Areas
Authors: Yuen Cynthia X. , Lessard Donovan 
Published: November 2018

Purpose
Physician assistants (PAs) are well situated to provide much-needed care in medically underserved areas (MUAs). Therefore, it is critical to understand the factors that make PA students want to practice in MUAs. The current study investigated how 3 student characteristics—underrepresented minority (URM) status, geographic origin, and family socioeconomic status—were associated with PA students' interest in practicing in MUAs after graduation.

Methods
Upon their matriculation in 2016, 4329 PA students provided key demographic information (ie, gender, age, race, ethnicity, geographic origin, and an indicator of family socioeconomic status) and reported their interest in working in an MUA after graduation. Multiple linear regression was used to predict students' level of interest in practicing in an MUA, and multiple logistic regression was used to predict students' likelihood of expressing interest in practicing in an MUA. All analyses controlled for students' gender and age at matriculation.

Results
All 3 student characteristics were independently associated with interest in practicing in an MUA, such that URM students, students from rural backgrounds, and less affluent students expressed greater interest in practicing in an MUA after graduation compared with their non-URM, suburban, and more affluent counterparts.

Conclusion
Demographic commonalities may drive PA students' interest in practicing in an MUA after graduation.
The Effects of Lycra Arm Sleeve on Glenohumeral Subluxation in Poststroke Hemiplegia—A Preliminary Study
Authors: Kumar Praveen 
Published: November 2018

ABSTRACT

Introduction
The primary aim of this preliminary prospective cross-sectional study was to assess the effects of Lycra arm sleeves on the glenohumeral subluxation (acromiongreater tuberosity distance) in people with poststroke hemiplegia. A secondary aim was to explore patients' perceptions regarding the practicality of applying the Lycra arm sleeve. The setting was community care in South West England. Participants were patients with chronic stroke (n = 5; 2 men, 3 women; mean ± SD age, 51 ± 8 years) with one-sided weakness.

Materials and Methods
Patients were instructed to wear the Lycra arm sleeve for 7 hrs a day for 7 consecutive days. Ultrasound measurements of acromion greater tuberosity (AGT) distance, numerical rating scale for pain, and upper-limb function using the Motor Assessment Scale were recorded before and immediately after application of the sleeve on day 1 and day 8. A questionnaire was completed by patients on day 8 to explore perceptions.

Results
Analysis of the data using an analysis of variance for a 2 × 2 fully repeated measure design suggests that 1) there is no significant mean difference in AGT distance between day 1 and day 8 (F(1,4) = 1.28, MSE = 0.014, P = 0.322) 2); there is a significant mean difference in AGT distance due to wearing of sleeve (F(1,4) = 19.258, MSE = 0.011, P = 0.012); and 3) the change in AGT distance on day 1 due to wearing of sleeve is not statistically different from the change on day 8 (F(1,4) = 0.537, MSE = 0.008, P = 0.504). Three patients experienced decreased pain, and one patient showed improvement in the upper-limb function score. The mean time the Lycra arm sleeve was worn each day was 6.7 hrs. Three patients found the sleeve easy to wear and 4 patients found the sleeve beneficial.

Conclusions
Trends toward reduction in mean AGT distance suggest Lycra arm sleeves may be beneficial in glenohumeral subluxation (GHS) management. Further research is required to establish their effectiveness in acute and chronic settings using a well-designed fully powered randomized controlled trial.
What Do Parents Need to Know About Concussion? Developing Consensus Using the Delphi Method
Authors: Kroshus Emily , Chrisman Sara P. D. , Harmon Kimberly G. , Herring Stanley A. , Broglio Steven P. , Master Christina L. , McGill Catherine A. , Putukian Margot , Register-Mihalik Johna K. , Rivara Frederick P. ,   for the National Delphi Panel on Sports Concussion Knowledge
Published: November 2018

Objective:
Many schools and sports leagues provide preseason concussion education to parents/guardians, and in some jurisdictions, it is required for interscholastic sports participation. However, directives about content are absent or vague. The purpose of this study was to obtain expert consensus about what parents/guardians need to know to about concussion.

Design:
A modified Delphi process with nationally recognized expert panel members was used to obtain consensus about parent/guardian behaviors relevant to concussion prevention, identification, and management and knowledge domains relevant to performance of those behaviors.

Results:
Sixteen parent/guardian behaviors and 24 knowledge domains were identified. However, consensus was not achieved regarding whether it is realistic to expect parents/guardians to perform approximately one-third of the behaviors that experts agreed mattered. This variability may reflect underlying uncertainty about the capacities of some parents/guardians to put knowledge into action or the belief that there are other barriers to action. Furthermore, for most knowledge domains, there was a lack of agreement about whether or not there could be a “correct” answer on the basis of current scientific knowledge.

Conclusions:
These findings raise practical and ethical questions: how can we expect parents/guardians to help prevent, identify, or manage concussion if they cannot have all the information required to engage in these behaviors due to lack of scientific consensus? This issue is not unique to concussion. Best practices for risk communication and shared decision-making can inform how we think about educating parents/guardians about concussion inside and outside of the health care setting.
Salvianolate injection in the treatment of acute cerebral infarction
Authors: NanZhu Yang , AiChun Ju , Xin Li , XiangHua Yun 
Published: November 2018

Abstract
To evaluate the effectiveness and safety of Salvianolate injection (SI) in the treatment of acute cerebral infarction (ACI).
We electronically searched databases including PubMed, The Cochrane Library, EMBASE, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, and WanFang Data to collect randomized controlled trials (RCTs) focused on SI treating ACI up to August 2017. Two reviewers independently screened literatures, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.
A total of 39 RCTs involving 4516 patients were included. The results of meta-analysis showed that compared with the Western medicine (WM) therapies group [experimental group (EG)], the total effective rate of SI + WM [control group (CG)] was higher (relative risk = 1.29, 95% CI: 1.24–1.35, P < .00001) in 21 RCTs; SI could improve movement function evaluation scores, including National Institute of Health Stroke Scale, Barthel Index, activities of daily living (P < .00001). There was no significant difference in modified Rankin Scale scores between the 2 groups (P = .008) EG was better than CG in improving Montreal Cognitive Assessment scores (P = .001) and Mini-Mental State Examination scores (P < .00001). SI could improved not only the hemorheology indexes, including plasma viscosity, whole blood high-shear viscosity, whole blood low-shear viscosity, fibrinogen (P < .00001), but also high-sensitivity C-reactive protein and C-reactive protein. EG could achieve a better effect on improving the neural deficit scores (P < .00001). There was no significant difference about adverse drug reactions/adverse drug events between the EG and CG (P = .73).
Salvianolate can promote recovery of the motor and cognitive function of patients with ACI. However, due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.
Sotos syndrome
Authors: Kamal Naglaa M. , Althobiti Jwaher M. , Alsaedi Abdulaziz , Bakkar Ayman , Alkaabi Tahani 
Published: November 2018

Abstract

Rationale:
Sotos syndrome is a rare genetic disorder characterized by rapid growth during infancy and childhood; ≥2 SD for height and head circumference; distinctive facial appearance and developmental delay.
Ten clinically diagnosed cases have been reported from Saudi Arabia; none of them was genetically confirmed.

Patient concerns:
A male Saudi patient, who had a birth length and head circumference above 97th centile, presented with abnormal rapid growth, delayed motor and mental milestones, aggressive behavior, obsession to close doors, nail biting, defective attention, and hyperactivity.

Diagnoses:
Sotos syndrome was suspected

Interventions:
Molecular genetic analysis for NSD1 gene was carried for the patient.

Outcomes:
A novel heterozygous deletion of all exons 1 to 23 of the NSD1 gene was detected. Genetic counseling was carried for the family with extended genetic testing for the parents and his siblings with normal results.

Lessons:
Despite its worldwide distribution, Sotos syndrome may be under-reported. Besides its characteristic clinical picture, molecular genetic testing is also extremely recommended.
A meta-analysis and systematic review of percutaneous catheter drainage in treating infected pancreatitis necrosis
Authors: Zhang Zhi-Hua , Ding Yi-Xuan , Wu Yu-Duo , Gao Chong-Chong , Li Fei 
Published: November 2018

Abstract

Background:
In the current meta-analysis, we focus on the exploration of percutaneous catheter drainage (PCD) in terms of its overall safety as well as efficacy in the treatment of infected pancreatitis necrosis based on qualified studies.

Methods:
The following electronic databases were searched to identify eligible studies through the use of index words updated to May 2018: PubMed, Cochrane, and Embase. Relative risk (RR) or mean difference (MD) along with 95% confidence interval (95% CI) were utilized for the main outcomes.

Results:
A total of 622 patients in the PCD group and 650 patients in the control group from 13 studies were included in the present meta-analysis. The aggregated results indicated that the incidence of bleeding was decreased significantly (RR: 0.42, 95% CI: 0.25–0.70) in the PCD group as compared with the control group. In addition, PCD decreased the mortality (RR: 0.76, 95% CI: 0.41–1.42), hospital duration (SMD: −0.22, 95% CI: −0.77 to –0.33), duration in intensive care unit (ICU) (SMD: −0.13, 95% CI: −0.30 to –0.04), pancreatic fistula (RR: 0.73, 95% CI: 0.46–1.17), and organ failure (RR: 0.91, 95% CI: 0.45–1.82) in comparison with the control group, but without statistical significance.

Conclusion:
Our findings provide evidence for the treatment effect of PCD in the decrease of bleeding, mortality, duration in hospital and ICU, pancreatic fistula, organ failure as compared with the surgical treatment. In conclusion, further studies based on high-quality RCTs with larger sample size and long-term follow-ups are warranted for the confirmation of PCD efficacy in treating infected pancreatitis necrosis.
Is dynamic locking plate superior than other implants for intracapsular hip fracture
Authors: Li Tao , Zhang Qing-song 
Published: November 2018

Abstract

Background:
We studied the safety and efficacy of dynamic locking plate vs. other implants (cannulated cancellous screws [CCS] or sliding hip screw [SHS]) in patients undergoing intracapsular hip fracture (ICHF).

Methods:
We searched Pubmed, Embase, Web of Science, Cochrane library and Google database from inception to March 25, 2018. We selected any studies comparing dynamic locking plate for treatment ICHF. Non-union rate, osteonecrosis rate, cutout rate, revision rate, the replacement rate, and Harris hip scores were the outcomes. Stata 12.0 was used for meta-analysis.

Results:
Four studies involving 419 patients (143 patients in the dynamic locking plate group and 276 patients in the other implants group) were finally included. Compared with CCS or SHS, dynamic locking plate was associated with a reduction of nonunion rate, revision rate, replacement rate (P <.05). Furthermore, dynamic locking plate was also associated with an increase of the Harris hip scores (P <.05). There was no significant difference between the osteonecrosis rate and cutout rate (P >.05).

Conclusions:
Current meta-analysis revealed that dynamic locking plate has a benefit role in improving postoperative clinical outcome than CCS or SHS in ICHF patients. Further high quality and large-scale randomized controlled trials (RCTs) are needed to further identify the efficacy of dynamic locking plate for ICHF.
Impact of a change in duration of prophylactic antibiotics on infectious complications after radical cystectomy with a neobladder
Authors: Kim Chung-Jong , Kim Kwang Hyun , Song Wan , Lee Dong Hyeon , Choi Hee Jung 
Published: November 2018

Abstract
A profound number of prophylactic antibiotics are used after radical cystectomy with an ileal orthotopic neobladder (RCIONB) despite a negative effect of infection control. We investigated the impact of short-term prophylactic antibiotic use on infectious complications after RCIONB.
We retrospectively reviewed data from 287 patients who underwent RCIONB for bladder cancer between 2012 and 2016 at a tertiary hospital. The patients were divided into 2 groups according to the pattern of prophylactic antibiotics (185 patients in a long-term group, 25-day use of 3-staged multiple antibiotics versus 102 patients in a short-term group, 24-hour use of cefotetan). The onset of complications, including bacteriuria, febrile urinary tract infection (FU), and bacteremia, and the microorganisms responsible for infections were compared between the groups. Of all 287 patients, bacteriuria, FU, and bacteremia were identified in 177 (61.7%), 85 (29.6%), and 18 (6.3%) patients, respectively. Bacteriuria was identified more frequently in the short-term group (49.2% vs 84.3%, P <.001). However, the rates of FU within 60 days of surgery were similar in both groups (28.6% vs 28.4%, P = .969). The rate of FU was not significantly different between the 2 groups. There was no significant difference in the rate of patients with bacteremia (5.4% vs 7.8%, P = .415). The most frequent microorganisms seen in bacteriuria were Enterococcus faecium and Enterococcus faecalis, in the long-term and short-term group, respectively. Antibiotic-resistant Enterococcus species were more frequently present in the long-term group.
Short-term use of prophylactic antibiotics is effective for preventing urinary tract infections after RCIONB and decreasing colonization with multi-drug-resistant organisms.