bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Two Techniques to Measure Optic Nerve Sheath Diameter in Patients at Risk for Increased Intracranial Pressure
Authors: Agrawal Ashish , Cheng Roger , Tang Julin , Madhok Debbie Y. 
Published: March 2019

Objectives:
Intracranial pressure over 20 mm Hg is associated with poor neurologic prognosis, but measuring intracranial pressure directly requires an invasive procedure. Dilation of the optic nerve sheath on axial ultrasound of the eye has been correlated with elevated intracranial pressure, but optimal cutoffs have been inconsistent possibly related to the measurement technique. A coronal technique has been studied on healthy volunteers but not on patients with high intracranial pressure. We compared two measurement techniques (axial and coronal) in patients with suspected high intracranial pressure due to trauma, bleeding, tumor, or infection.

Design:
Prospective blinded observational study.

Setting:
Two tertiary referral center ICUs.

Patients:
Twenty adults admitted to the ICU at risk for increased intracranial pressure expected to receive invasive intracranial monitoring.

Interventions:
Ultrasound measurements of the optic nerve sheath in axial and coronal views either averaged between eyes or the highest in either eye.

Measurements and Main Results:
Coronal measurements showed less variability between each eye than axial measurements (mean difference 0.5 mm vs 1 mm; p = 0.03) and were associated with high intracranial pressure at first measurement and over 24 hours (area under the receiver operating characteristic range 0.7–0.8). Mean and highest axial measurements showed improved association with first (area under the receiver operating characteristic 0.87–0.94) and highest intracranial pressure measurement (area under the receiver operating characteristic 0.89–0.96) within 24 hours. A cutoff of highest axial measurement in either eye greater than 6.2 mm or mean axial measurement between eyes of 5.6 mm had a sensitivity of 100% in predicting high intracranial pressure over the following 24 hours.

Conclusions:
The highest axial measurement of optic nerve sheath diameter in either eye is the most predictive of patients with high intracranial pressure in our population. This comparison of measurement techniques has not previously been described and should be further explored to set test cutoffs for ultrasound of the optic nerve sheath diameter.
NOVEL APPROACH TO SCLERAL FIXATION OF A REPER INTRAOCULAR LENS AND ARTIFICIAL IRIS COMPLEX FOLLOWING PARS PLANA LENSECTOMY AND VITRECTOMY FOR ECTOPIA LENTIS AND CATARACT IN A PATIENT WITH ANIRIDIA AND NYSTAGMUS
Authors: Jiang Shangjun , Baig Kashif , Kalevar Ananda , Choudhry Netan , Gupta R. Rishi 
Published: March 2019

Purpose:
Prosthetic iris devices have recently been used to improve cosmesis and reduce glare in aniridia. There is currently no consensus on which prosthetic iris device or which surgical approach is preferred for managing large iris defects.

Methods:
A novel surgical approach with Gore-Tex polytetrafluoroethylene sutures was used to achieve scleral fixation of an intraocular lens and artificial iris complex in a 19-year-old Caucasian female patient with aniridia, nystagmus, cataracts, and ectopia lentis.

Results:
Six weeks postoperatively, the intraocular lens–artificial iris complex remained well centered, and the vision in the left eye improved from 20/400 to 20/70. Two years after prosthetic iris device implantation, there have been no complications.

Conclusion:
This case demonstrates a promising proof-of-concept for long-term management of complicated aniridia cases using an intraocular lens and artificial iris complex prosthetic iris devices. Gore-Tex sutures may be preferable to conventional polypropylene sutures because of their improved durability.
Frequencies of 4 Distinct Patterns of Glaucomatous Disc Appearance and Their Clinical Associations in Japanese Population-based Studies
Authors: Iwase Aiko , Araie Makoto , Kuwayama Yasuaki , Murata Hiroshi , Yamamoto Tetsuya 
Published: March 2019

Purpose:
To study the frequencies and factors associated with 4 disc patterns in primary open-angle glaucoma (POAG) identified in population-based studies: focal glaucomatous (FG type), generalized enlargement of cup (GE type), myopic glaucomatous (MG type), and senile sclerotic glaucomatous (SS type) patterns.

Subjects:
In total, 270 disc photographs of acceptable quality were extracted from the records of 270 definitive POAG cases diagnosed according to the International Society of Geographical and Epidemiological Ophthalmology Criteria in 2 Japanese population-based glaucoma surveys. One randomly chosen eye from the bilateral POAG cases was included.

Results:
Using a method of κ coefficient of reproducibility of classification of 0.80 according to a preliminary study, 143 discs were classified as FG, GE, MG, or SS types with respective frequencies of 57% (95% confidence interval [CI], 48-66), 33% (95% CI, 25-42), 7% (95% CI, 3-13), and 3% (95% CI, 0-7), and 127 discs as the miscellaneous type. Multinomial logistic regression analysis showed that the MG type was associated (P=0.052, 0.025, 0.019, and 0.018) with younger age, lower body mass index (BMI), and greater disc area and ovality, and the GE type was associated (P<0.001, 0.036, and 0.056) with greater disc area, corneal radius, and hyperopic refraction than the FG type.

Conclusions:
The FG type occurs most frequently in Japanese POAG followed by the GE type. The MG and SS types occurred much less often than previously reported in Japanese. Associations with age, BMI, disc area and ovality, refraction, and corneal radius differed among the FG, GE, and MG types.
The Effect of Cochlear Coverage on Auditory and Speech Performance in Cochlear Implant Patients
Authors: Doubi Aseel , Almuhawas Fida , Alzhrani Farid , Doubi Motaz , Aljutaili Hamad , Hagr Abdulrahman 
Published: March 2019

Objective:
To determine the effect of cochlear coverage on audiological and speech parameters in patients with cochlear implants. Previous work has investigated the effect of tailoring electrode size to a cochlear implant recipient's individual cochlear duct length (CDL). However, no clear relationship has been found between speech development and the extent of electrode insertion, and the benefits of apical stimulation are not yet clear.

Methodology:
In this retrospective study, we assessed the effect of cochlear coverage on audiological and speech performance. Participants were prelingually deaf children who received cochlear implants between June 2013 and December 2014 under the care of a single cochlear implant surgeon. Cochlear coverage was estimated for each ear according to electrode type, depth of insertion, and the number of active electrodes. Electrode type and length were determined by the individual's CDL, measured by computed tomography (CT), and full insertion was documented intraoperatively. The number of active electrodes was recorded using intraoperative audiological response telemetry. Audiological assessments were obtained 6 months and 1 year postoperatively. Results of the categories of auditory performance-II and speech intelligibility rating scales were obtained after 3 years. Patients were divided into two groups based on their cochlear coverage and their audiological and speech outcomes were compared.

Results:
Of the 97 children recruited, 47 were girls. Temporal bone CT scans showed the right and left mean CDLs among girls were 27.7 and 27.9 mm, respectively, and 29.2 mm for both ears in boys. For each sex, the right and left CDLs did not differ significantly (p = 0.07). Twenty patients were lost to follow-up, leaving 77 patients (120 ears), which were divided into groups according to cochlear coverage (complete vs. incomplete). Significant between-group differences were not found in assessments of audiology, categories of auditory performances, or speech intelligibility ratings after 3 years.

Conclusion:
Audiological parameters do not differ according to the degree of cochlear coverage, specifically for low-frequency tones. Speech parameters are also comparable. Therefore, complete cochlear coverage does not appear to provide significant benefit over incomplete coverage for prelingually deaf cochlear implant recipients.
Multiplication product of Model for End-stage Liver Disease and Donor Risk Index as predictive models of survival after liver transplantation
Authors: Khalaileh Abed , Khoury Tawfik , Harkrosh Subhi , Nowotny Yakob , Massarwa Mohamad , Safadi Rifaat , Mor Eytan , Nakache Richard , Abu Gazala Samir , Merhav Hadar 
Published: March 2019

Background
Liver transplantation (LT) is the treatment of choice for most end-stage liver diseases. This treatment increases survival rates and improves quality of life. Because of the shortage of organ donors, as opposed to waiting patients, the need to optimize the matching of donors to recipients for maximum utility is crucial.

Aim
The aim of this study was to examine a predictive model based on the combination of donor and recipient risk factors using the liver Donor Risk Index (DRI) and recipient Model of End-stage Liver Disease (MELD) to predict patients’ survival following LT.

Patients and methods
The charts of 289 adult primary LT patients, who had undergone transplantation in Israel between 2010 and 2015, were studied retrospectively using prospectively gathered data.

Results
Two variables, DRI and MELD, were found to significantly affect post-transplant patient survival. DRI negatively affected survival in a continuous fashion, whereas MELD had a significantly negative effect only at MELD more than 30. Both female sex and the presence of hepatocellular carcinoma were associated with increased patient survival.

Conclusion
According to our findings, the model described here is a novel prediction tool for the success of orthotopic LT and can thus be considered in liver allocation.
Charting Cognitive Growth of Nursing Students Using Linguistic Software
Authors: DeBlieck Conni J. , Summers Linda C. , Saiki Lori S. , Kuchler Elizabeth , Noe Shelly , Lynch Stephanie , Reinhardt Anita C. , Keller Teresa 
Published: March 2019

Background
Students' word choice when writing in a reflective journal may reveal their emotional development, sense of belonging, cognitive processing, and ability to appraise their own growth and understanding. New linguistic analysis software can scan and categorize these journals for the use of pronouns, positive and negative emotions, and cognitive keywords.

Methods
A retrospective study design evaluated student journaling from a psychiatric clinical course. Journal entries from weeks 1 and 12 were compared by z-score analysis.

Findings
Significant increases were found in the use of “we” (P = .001), positive emotions (P < .001), inclusion words (P < .001), and insight words (P = .004), whereas the use of cause and self-discrepancy words were not significantly different.

Conclusion
Identification of learning as expressed in words could have an impact on how student assignments are designed by including the use of the Linguistic Inquiry and Word Count software to assess changes in student cognition.
A Qualitative Analysis of Outpatient Medication Use in Community Settings: Observed Safety Vulnerabilities and Recommendations for Improved Patient Safety
Authors: Lyson Helena C. , Sharma Anjana E. , Cherian Roy , Patterson Emily S. , McDonald Kathryn M. , Lee Shin-Yu , Sarkar Urmimala 
Published: March 2019

Objective
The aim of the study was to analyze diverse patients’ experiences throughout the medication use process to inform the development of overarching interventions that support safe medication use in community settings.

Methods
Using a qualitative observational approach, we conducted approximately 18 hours of direct observation of the medication use process across multiple settings for a sample of vulnerable, high-risk patients. Observers recorded detailed field notes during the observations. To enrich the observational findings, we also conducted six semistructured interviews with medication safety experts representing a diversity of perspectives. Barriers and facilitators to safe medication use were identified based on inductive coding of the data.

Results
A variety of safety vulnerabilities plague all stages of the medication use process and many of the well-established evidence-based interventions aimed at improving the safety of medication use at key stages of the process have not been widely implemented in community settings observed in this study. Key safety vulnerabilities identified include: limited English proficiency, low health literacy, lack of clinician continuity, incomplete medication reconciliation and counseling, unsafe medication storage and disposal habits, and conflicting healthcare agendas with caregivers.

Conclusions
Our findings underscore a need for overarching, comprehensive interventions that span the entire process of medication use, including integrated communication systems between clinicians, pharmacies, and patients, and a “patient navigator” program that assists patients in navigating the entire medication-taking process. Collective ownership of the medication management system and mutual motivation for devising collaborative solutions is needed among key sectors.
Is Physician Mentorship Associated With the Occurrence of Adverse Patient Safety Events?
Authors: Harrison Reema , Sharma Anurag , Lawton Rebecca , Stewart Kevin 
Published: March 2019

Background
Mentorship has been identified as a beneficial practice for doctors and key aspect of continuing professional development, associated with a number of potential clinical and nonclinical gains. The likely contribution of mentorship to enhancing patient safety is acknowledged, but there is a dearth of empirical studies that attempt to make associations between the impact of mentorship for physicians on patient safety outcomes. This article begins to fill this gap by exploring whether a physician with a mentor reports having fewer near-misses or adverse events, compared with a physician with no mentor.

Methods
An online survey was administered to fellows and members of the Royal College of Physicians London using their membership database in April 2013. Adverse events and near misses are modeled as two separate binary variables using a logit regression framework with “having a mentor” being the main covariate. The marginal effect of this covariate captures the effect of mentorship on adverse events.

Results
A total of 1755 doctors (37% female) responded who represented all internal medical specialties. Our results show that compared with physicians with no mentor, the probability of getting involved in an adverse event or near miss is reduced by 12.69% (95% confidence interval = −17.41 to −7.98) and 11.12% (95% confidence interval = −15.84 to −6.41) for physicians with a mentor.

Conclusions
Having a mentor may contribute toward minimizing preventable harm to patients, which is a priority for health systems internationally, but longer-term studies of mentorship are necessary to determine the aspects of mentorship that are particularly important for enhancing patient safety outcomes.
Ecstasy Abuse and Its Effects on the Oral Mucosa
Authors: Biancardi Mariel Ruivo , Silveira Heitor Albergoni da , Fernandes Darcy , Almeida Luciana Yamamoto de , Ortega Rose Mara , León Jorge Esquiche , Bufalino Andreia 
Published: March 2019

Abstract
Ecstasy is an illicit drug that has been increasingly abused by young people. This synthetic drug has both stimulant and hallucinogenic effects and is usually consumed in a tablet. The side effects of ecstasy use include nausea, muscle cramping, fever, and symptoms mostly linked to muscular tension including jaw pain, facial pain, and headaches. There are few studies assessing the ecstasy effects on the oral mucosa, both clinically and histopathologically. The authors report 2 young women (22- and 27-year-old) who presented multifocal oral erosions and ulcerations. The lesions were painful and covered by a yellow-white pseudomembrane with a bright erythematous halo. By microscopy, it was observed superficial ulceration surrounded by acanthotic squamous epithelium with marked spongiosis, interstitial edema within the corion and perivascular lyphoid infiltrate, suggesting drug-induced oral mucositis. In conclusion, ecstasy use may be associated with the development of oral ulcers, which should be considered in the differential diagnosis when assessing multifocal oral ulcerations, especially in young people.
Filling in the Details: A Review of Lipofilling of Radiated Tissues in the Head and Neck
Authors: Hammond Sarah E. , Samuels Stuart , Thaller Seth 
Published: March 2019

Abstract
Adipose tissue is considered by many to be an ideal filler. Fat is the model filler in that it is biocompatible, autologous tissue which typically incorporates into the host tissue with minimal complications. Along with the increasing use of fat as a soft tissue filler has come a growing interest in the development of standardized technical protocols and indications for lipofiller use. In this review, we will examine the current literature regarding lipofilling techniques, explore the potential benefits of fat grafting in radiated tissue, and discuss recent scientific advancements to optimize fat graft survival and outcomes.
A comprehensive map of the dendritic cell transcriptional network engaged upon innate sensing of HIV
Authors: Johnson Jarrod S. , Veaux Nicholas De , Rives Alexander W. , Lahaye Xavier , Lucas Sasha Y. , Pérot Brieuc , Luka Marine , Amon Lynn M. , Watters Aaron , Aderem Alan , Manel Nicolas , Littman Dan R. , Bonneau Richard , Ménager Mickaël M. 
Published: March 2019

SummaryTranscriptional programming of the innate immune response is pivotal for host protection. However, the transcriptional mechanisms that link pathogen sensing with innate activation remain poorly understood. During infection with HIV-1, human dendritic cells (DCs) can detect the virus through an innate sensing pathway leading to antiviral interferon and DC maturation. Here, we developed an iterative experimental and computational approach to map the innate response circuitry during HIV-1 infection. By integrating genome-wide chromatin accessibility with expression kinetics, we inferred a gene regulatory network that links 542 transcription factors with 21,862 target genes. We observed that an interferon response is required, yet insufficient to drive DC maturation, and identified PRDM1 and RARA as essential regulators of the interferon response and DC maturation, respectively. Our work provides a resource for interrogation of regulators of HIV replication and innate immunity, highlighting complexity and cooperativity in the regulatory circuit controlling the DC response to infection.Graphical Abstract
Ultrasound Imaging of Gene Expression in Mammalian Cells
Authors: Farhadi Arash , Ho Gabrielle H. , Sawyer Daniel P. , Bourdeau Raymond W. , Shapiro Mikhail G. 
Published: March 2019

ABSTRACTThe study of cellular processes occurring inside intact organisms and the development of cell-based diagnostic and therapeutic agents requires methods to visualize cellular functions such as gene expression in deep tissues. Ultrasound is a widely used biomedical technology enabling deep-tissue imaging with high spatial and temporal resolution. However, no genetically encoded molecular reporters are available to connect ultrasound contrast to gene expression in mammalian cells. To address this limitation, we introduce the first mammalian acoustic reporter genes. Starting with an eleven-gene polycistronic gene cluster derived from bacteria, we engineered a eukaryotic genetic program whose introduction into mammalian cells results in the expression of a unique class of intracellular air-filled protein nanostructures called gas vesicles. The scattering of ultrasound by these nanostructures allows mammalian cells to be visualized at volumetric densities below 0.5%, enables the monitoring of dynamic circuit-driven gene expression, and permits high-resolution imaging of gene expression in living animals. These mammalian acoustic reporter genes enable previously impossible approaches to monitoring the location, viability and function of mammalian cellsin vivo.
A simple model of a quadruped discovers single-foot walking and trotting as energy optimal strategies
Authors: Polet Delyle T. , Bertram John E. A. 
Published: March 2019

AbstractIt is widely held that quadrupeds choose steady gaits that minimize their energetic cost of transport, but it is difficult to explore the entire range of possible footfall sequences empirically. We present a simple model of a quadruped that can spontaneously produce any of the 2300+ planar footfall sequences available to quadrupeds. Through trajectory optimization of a work and force-rate cost, and a large sample of random initial guesses, we provide stronger evidence towards the global optimality of symmetrical four-beat walking at low speeds and two beat running (trotting) at intermediate speeds. Using input parameters based on measurements in dogs (Canis lupus familiaris), the model predicts the correct phase offset in walking and a realistic walk-trot transition speed. It also spontaneously reproduces the double-hump ground reaction force profile observed in walking, and the smooth single-hump profile observed in trotting, despite the model’s lack of springs. However, the model incorrectly predicts duty factor at the slowest speeds, and does not choose galloping as globally optimal at high speeds. These limitations might point to missing levels of complexity that could be added to future quadrupedal models, but the present results suggest that massive legs, elastic components, head-neck oscillations and even multi-linked legs are not critical determiners for the optimality of natural quadrupedal walking and trotting.Author summaryWhy do quadrupedal mammals move in consistent ways, when so many options are available? We tackled this problem by determining energetically-optimal gaits using a simple computational model of a four-legged animal. The model can use virtually any pattern of movement (physics-permitting!) but selects natural movement strategies as energetically optimal. The similarities between the computer-based predictions and natural animal movement are striking, and suggest mammals utilize movement strategies that optimize energy use when they move.
LNISKS: Reference-free mutation identification for large and complex crop genomes
Authors: Suchecki Radosław , Sandhu Ajay , Deschamps Stéphane , Llaca Victor , Wolters Petra , Watson-Haigh Nathan S. , Pallotta Margaret , Whitford Ryan , Baumann Ute 
Published: March 2019

AbstractMutation discovery is often key to the identification of genes responsible for major phenotypic traits. In the context of bulked segregant analysis, common reference-based computational approaches are not always suitable as they rely on a genome assembly which may be incomplete or highly divergent from the studied accession. Reference-free methods based on short sequences of lengthk(k-mers), such as NIKS, exploit redundancy of information across pools of recombinant genomes. Building on concepts from NIKS we introduce LNISKS, a mutation discovery method which is suited for large and repetitive crop genomes. In our experiments, it rapidly and with high confidence, identified mutations from over 700 Gbp of bread wheat genomic sequence data. LNISKS is publicly available athttps://github.com/rsuchecki/LNISKS.