bluuebunny/crossref_metadata_2025_split huggingface dataset:
Balance ability and posture in postmenopausal women with chronic pelvic pain
Authors: Fuentes-Márquez Pedro , Rodríguez-Torres Janet R. , Valenza Marie C. , Ortíz-Rubio Araceli , Ariza-Mateos María J. , Cabrera-Martos Irene 
Published: April 2018

Abstract

Objective:
The aim of the present study was to analyze balance ability and posture in postmenopausal women with chronic pelvic pain (CPP).

Methods:
This study includes a sample of 48 women with CPP recruited from the Gynecology Service of Virgen de las Nieves and San Cecilio Hospitals in Granada (Spain) and 48 healthy control women matched with respect to age and anthropometric characteristics. Outcome variables collected included: balance ability (Mini-Balance Evaluation Systems Test and Timed Up an Go Test) and posture (photogrammetry and Spinal Mouse).

Results:
Significant differences were found in all Mini Best Test subscales: total (P < 0.001), anticipatory (P = 0.002), reactive postural control (P < 0.001), sensory orientation (P < 0.001), and dynamic gait (P < 0.001), and all Timed Up and Go test subscales: alone (P < 0.001), with manual (P = 0.002) and cognitive task (P = 0.030). Significant differences were also found on spinal cervical angles with a forward head posture in women with CPP; global spine alignment exhibited more deviation in the women with CPP (P < 0.001); and a higher percentage of women with CPP (58%) presented with increased thoracic kyphosis and lumbar lordosis. Cohen's d was used to calculate the effect size. Some subscales of balance and posture tests showed a large effect size (d ≥0.8), indicating a more consistent result.

Conclusions:
Women with CPP presented poor balance including anticipatory, reactive postural control, sensory orientation, dynamic gait, and dual task-related conditions. Posture showed higher values on the dorsal angle and lower sacral inclination, less spine alignment, and a more prevalent posture with increased kyphosis and lumbar lordosis.
A Novel Laryngeal Preservation Technique following Total Glossectomy with Hyoid Bone Resection
Authors: Kurosawa Koreyuki , Imai Takayuki , Matsumoto Ko , Asada Yukinori , Katoh Kengo , Matsuura Kazuto , Goto Takahiro 
Published: April 2018

Summary:
Despite the recent progress of chemotherapy and sophisticated radiotherapy, surgery still remains the most reliable treatment for advanced tongue cancers in terms of survival. The major disadvantage of this treatment is that it should sacrifice the quality of patients’ life. When the tongue cancer is so advanced as to involve the hyoid bone, which is considered a functional part of the larynx, radical operation needs to resect both the entire tongue and the larynx and the hyoid bone en bloc to prevent aspiration pneumonia. As a result of total laryngectomy, the patients will suffer significant disabilities: aphonia and the loss of deglutition that limits the oral intake to only liquid or pasty food. With this clinical background, we have been contriving to overcome these significant surgical shortcomings by conducting larynx-preserving operation. In this case report, we present our newly devised surgical method which consists of free-flap transfer with a combination of laryngeal suspension and a novel reconstructive technique, that is, epiglottis suspension, which enabled favorable swallowing function without aspiration and allowed a sufficiently wide airway for breathing. The operation worked quite successfully for the patient’s quality of life. We believe this novel surgical method would serve as a larynx-preservation treatment for locally advanced tongue cancers with hyoid bone invasion.
Corneal Stiffness and Its Relationship With Other Corneal Biomechanical and Nonbiomechanical Parameters in Myopic Eyes of Chinese Patients
Authors: Zhang Yaohua , Wang Yan , Li Liuyang , Dou Rui , Wu Wenjing , Wu Di , Jhanji Vishal 
Published: April 2018

Purpose:
To investigate corneal stiffness and analyze its possible influence on other corneal biomechanical and nonbiomechanical parameters in myopic eyes of Chinese patients.

Methods:
A total of 387 healthy (right) myopic eyes were included in this study. Corneal visualization Scheimpflug technology was used to measure the corneal stiffness parameter at the first applanation (SP-A1), deformation amplitude ratio at 1.0 and at 2.0 mm, biomechanically corrected intraocular pressure (bIOP), and corneal deformation parameters during the first applanation (A1: A1-time, A1-length, and A1-velocity), second applanation (A2; A2-time, A2-length, and A2-velocity), and highest concavity (HC; HC-time, HC-radius, HC deformation amplitude, and HC peak distance). The Pentacam was used to evaluate central corneal thickness, mean corneal curvature (Km), anterior corneal central elevation, and corneal asphericity (Q value) of the anterior cornea.

Results:
The mean SP-A1 and bIOP values were 90.46 ± 15.39 mm Hg/mm and 13.5 ± 1.85 mm Hg, respectively. The SP-A1 increased with age (β = 0.41 [95% CI, 0.28%–0.54%]; P < 0.0001). Corneal stiffness was positively correlated with central corneal thickness, uncorrected intraocular pressure, and bIOP and was also significantly correlated with all corneal deformation parameters (P < 0.05), except A1-length, HC-time, and HC peak distance. Corneal stiffness was negatively correlated with central corneal elevation of the anterior surface (r = −0.124, P = 0.014) and mean corneal curvature (r = −0.114, P = 0.025) and positively correlated with the Q value of the anterior surface (r = 0.109, P = 0.032).

Conclusions:
Corneal stiffness increased with age. Stronger corneal stiffness may be related to flattening of the cornea and higher intraocular pressure.
Management of Stenotrophomonas maltophilia Infections in Critically Ill Children
Authors: Tokatly Latzer Itay , Paret Gideon , Rubinstein Marina , Keller Nathan , Barkai Galia , Pessach Itai M. 
Published: April 2018

Background:

Stenotrophomonas maltophilia is a life-threatening nosocomial pathogen with profound multidrug-resistant attributes. It is associated with high mortality, particularly in immunocompromised patients. Data on therapy for S. maltophilia infections are scarce, especially in children hospitalized in intensive care settings (pediatric intensive care unit).

Methods:
A retrospective chart review of pediatric patients with isolates of S. maltophilia hospitalized over a 5-year period in 2 pediatric intensive care units.

Results:
Thirty-one patients and 91 isolates from blood, respiratory secretions and soft tissues were identified and reviewed. The overall incidence of S. maltophilia infections increased during the study period (P = 0.003). The all-cause crude mortality was 61%, and the attributed mortality was approximately 16%. Risk factors associated with mortality included longer hospitalization before infection (P = 0.002), septic shock (P = 0.003), mechanical ventilation (P = 0.004), an indwelling central vein catheter (P = 0.03) and prior use of steroids (P = 0.04) and carbapenems (P = 0.004). On multivariate analysis, mortality was associated with mechanical ventilation (P = 0.02) and preinfection hospitalization days (P = 0.01). Combination treatment of trimethoprim and sulfamethoxazole, ciprofloxacin and/or minocycline significantly extended survival time (P < 0.001). The method of treatment did not significantly affect the interval between S. maltophilia isolation to resolution of infection (P = 0.200).

Conclusions:
Combinations of trimethoprim and sulfamethoxazole, ciprofloxacin and minocycline are proposed for pediatric intensive care unit patients harboring S. maltophilia. Meticulous evaluation of central vascular access and prior treatment with carbapenems are indicated, especially for mechanically ventilated and septic children.
Epidemiology of Otitis Media With Otorrhea Among Bangladeshi Children
Authors: Naziat Hakka , Saha Senjuti , Islam Maksuda , Saha Shampa , Uddin Mohammad J. , Hussain Manzoor , Luby Stephen P. , Darmstadt Gary L. , Whitney Cynthia G. , Gessner Bradford D. , Saha Samir K. 
Published: April 2018

Background:
Otitis media (OM) poses a high disease burden on Bangladeshi children, but little is known about its etiologies. We conducted a surveillance study in the largest pediatric hospital to characterize pathogens responsible for OM.

Methods:
In the outpatient ear–nose–throat department of Dhaka Shishu Hospital, which serves 0 to 18-year-old children, we collected ear swabs from OM children with otorrhea from April 2014 to March 2015. We cultured all specimens for bacterial pathogens and assessed serotype and antimicrobial susceptibility of Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hi) isolates.

Results:
We recorded 1111 OM episodes; 88% (981/1111) involved otorrhea, and we collected samples from 91% (891/981) of these children. Fifty-one percent (452/891) were culture positive (contaminants excluded), with Hi (21%, 187/891) and Spn (18%, 164/891) most commonly detected. Overall, 45 distinct single and mixed pathogens were revealed. Dominant pneumococcal serotypes were 19A, 19F, 3 and 14; 98% of Hi isolates were nontypeable. Pneumococcal conjugate vaccine (PCV)10 and PCV10 + 6A serotypes accounted for 8% and 9% of all OM and 46% and 49% of pneumococcus-positive cases, respectively, and were more likely to be nonsusceptible to at least 1 antibiotic (erythromycin and/or trimethoprim-sulfamethoxazole) than nonvaccine serotypes (91% vs. 77%). Staphylococcus aureus (9%, 83/891) and Pseudomonas aeruginosa (4%, 38/891) were also found.

Conclusions:
Nontypeable Hi (NTHi) and Spn are predominant causes of OM in Bangladesh. PCV10, introduced in March 2015, is likely to reduce pneumococcal and overall OM burden. Data collected post-PCV10 will provide comprehensive insight into the effects of this vaccine on these pathogens.
A Prospective Randomized Comparative Clinical Trial to Analyze Pain and Surgical Outcomes Between Frontal Nerve Blocks and Subconjunctival Anesthesia for Conjunctival Mullerectomy Resection
Authors: Zatezalo Chad C. , Tavakoli Mehdi , Ayala-Haedo Juan , Callaway Natalia F. , Ko Marcus J. , Anagnostopoulos Apostolos G. , Vanner Elizabeth A. , Lee Wendy W. 
Published: April 2018

Purpose:
Conjunctival Müller’s muscle resection (CMMR) is a posterior approach surgical technique to correct blepharoptosis. The purpose of this study is to compare patient-reported pain scores and surgical outcomes for patients who received 2 different anesthetic techniques during CMMR, frontal nerve block and subconjunctival injection.

Methods:
A prospective randomized comparative clinical trial enrolled 33 CMMR subjects from one tertiary eye center. Patients undergoing unilateral CMMR were randomized to receive either frontal nerve block or subconjunctival injection. For patients undergoing bilateral CMMR, each side was randomized to one of the injection techniques. Upper eyelid margin reflex distance was measured and recorded for each eye before and after surgery. Patients’ pain scores were quantified using the Wong Baker Pain Scale. Subjects quantified their pain during, immediately after, 12 and 24 hours after surgery.

Results:
Twenty-four bilateral and 9 unilateral cases were enrolled in the study. Twenty-two (92%) subjects were female, and the mean patient age was 69 ± 12 years. The mean margin reflex distance was 1.1 mm preoperatively, which increased to 3.5 and 3.6 mm 2 months postoperatively in frontal nerve block and subconjunctival injection groups, respectively (p value <0.0001). Both paired and nonpaired analyses demonstrated no significant difference in the pain score reported by the patients or the surgical outcomes between the 2 anesthesia techniques at any time during or after the surgery. There were no anesthetic-related complications.

Conclusion:
There was no statistically significant difference in pain scores or surgical outcomes in patients receiving frontal nerve block compared with those receiving subconjunctival injection during CMMR surgery.
A Meta-ethnography of Out-of-Hospital Cardiac Arrest Survivors’ Meanings on Life and Death
Authors: Aristidou Maria , Vouzavali Fotini , Karanikola Maria N. , Lambrinou Ekaterini , Papathanassoglou Elizabeth 
Published: April 2018

Background:
Although out-of-hospital cardiac arrest (OHCA) survivors’ physiological outcomes have been addressed, less is known on the holistic needs of individuals after OHCA, which hinders our ability to prioritize care around what really matters to survivors.

Aim:
The aim of this study was to interpretatively synthesize qualitative findings on OHCA survivors’ perceptions and meanings of life and death and existential issues.

Methods:
We used a meta-ethnographic synthesis of published qualitative studies addressing the experiences of OHCA survivors based on a systematic literature search (CINAHL, PsycINFO, Scopus, PubMed). Studies were selected based on predefined inclusion/exclusion criteria. The identified studies were subjected to a quality appraisal based on the Critical Appraisal Skills Programme.

Results:
Based on eligibility criteria, 6 phenomenological studies were included, of overall medium to high quality. One core theme, “the reality of death,” and 4 main themes were identified: “redefining existence”; “revaluing death”; “being familiar with, yet oblivious of death”; and “living consciously.” Emerging from the realization of death, the themes appeared to describe a gradual progression toward living consciously.

Conclusions:
An existential trajectory and a need for meaning are central in the experience of OHCA survivors. When existential issues are not addressed, the ongoing suffering may interfere with survivors’ recovery and quality of life. Future research needs to address specific needs and ways to support survivors’ meaning-making.
Etiology of Sudden Cardiac Arrest and Death in US Competitive Athletes: A 2-Year Prospective Surveillance Study
Authors: Peterson Danielle F. , Siebert David M. , Kucera Kristen L. , Thomas Leah Cox , Maleszewski Joseph J. , Lopez-Anderson Martha , Suchsland Monica Z. , Harmon Kimberly G. , Drezner Jonathan A. 
Published: April 2018

Objective:
To determine the etiology of sudden cardiac arrest and death (SCA/D) in competitive athletes through a prospective national surveillance program.

Design:
Sudden cardiac arrest and death cases in middle school, high school, college, and professional athletes were identified from July 2014 to June 2016 through traditional and social media searches, reporting to the National Center for Catastrophic Sports Injury Research, communication with state and national high school associations, review of the Parent Heart Watch database, and search of student-athlete deaths on the NCAA Resolutions List. Autopsy reports and medical records were reviewed by a multidisciplinary panel to determine the underlying cause.

Setting and Participants:
US competitive athletes with SCA/D.

Main Outcome Measures:
Etiology of SCA/D.

Results:
A total of 179 cases of SCA/D were identified (74 arrests with survival, 105 deaths): average age 16.6 years (range 11-29), 149 (83.2%) men, 94 (52.5%) whites, and 54 (30.2%) African American. One hundred seventeen (65.4%) had an adjudicated diagnosis, including 83 deaths and 34 survivors. The most common etiologies included hypertrophic cardiomyopathy (19, 16.2%), coronary artery anomalies (16, 13.7%), idiopathic left ventricular hypertrophy/possible cardiomyopathy (13, 11.1%), autopsy-negative sudden unexplained death (8, 6.8%), Wolff-Parkinson-White (8, 6.8%), and long QT syndrome (7, 6.0%). Hypertrophic cardiomyopathy was more common in male basketball (23.3%), football (25%), and African American athletes (30.3%). An estimated 56.4% of cases would likely demonstrate abnormalities on an electrocardiogram.

Conclusions:
The etiology of SCA/D in competitive athletes involves a wide range of clinical disorders. More robust reporting mechanisms, standardized autopsy protocols, and accurate etiology data are needed to better inform prevention strategies.
Comparison of Algorithms to Triage Patients to Express Care in a Sexually Transmitted Disease Clinic
Authors: Chambers Laura C. , Manhart Lisa E. , Katz David A. , Golden Matthew R. , Barbee Lindley A. , Dombrowski Julia C. 
Published: April 2018

Background
The ideal approach to triaging sexually transmitted disease (STD) clinic patients between testing-only express visits and standard visits with clinician evaluation is uncertain.

Methods
In this cross-sectional study, we used classification and regression tree analysis to develop and validate the optimal algorithm for predicting which patients need a standard visit with clinician assessment (i.e., to maximize correct triage). Using electronic medical record data, we defined patients as needing a standard visit if they reported STD symptoms, received any empiric treatment, or were diagnosed as having an infection or syndrome at the same visit. We considered 11 potential predictors for requiring medical evaluation collected via computer-assisted self-interview when constructing the optimized algorithm. We compared test characteristics of the optimized algorithm, the Public Health–Seattle and King County STD Clinic's current 13-component algorithm, and a simple 2-component algorithm including only presence of symptoms and contact to STD.

Results
From October 2010 to June 2015, 18,653 unique patients completed a computer-assisted self-interview. In the validation samples, the optimized, current, and simple algorithms appropriately triaged 90%, 85%, and 89% of patients, respectively. The optimized algorithm had lower sensitivity for identifying patients needing standard visits (men, 94%; women, 93%) compared with the current algorithm (men, 95%; women, 98%), as did the simple algorithm (men, 91%; women, 93%). The optimized, current, and simple algorithms triaged 31%, 23%, and 33% of patients to express visits, respectively.

Conclusions
The overall performance of the statistically optimized algorithm did not differ meaningfully from a simple 2-component algorithm. In contrast, the current algorithm had the highest sensitivity but lowest overall performance.
Shear Wave Elastography Improves Specificity of Ultrasound for Parotid Nodules
Authors: Liu Guangqing , Wu Size , Liang Xian , Cui Xiaojing , Zuo Dongshen 
Published: April 2018

Objectives
This study aimed to determine the performance of Virtual Touch tissue quantification (VTQ) technique in the differential evaluation of parotid gland nodules.

Methods
Acoustic radiation force impulse VTQ technique was used to determine the shear wave velocity (SWV) of 76 patients with parotid nodules and 30 subjects with normal parotid gland. These nodules were assigned to benign and malignant nodules according to histopathology, measurements of SWV were compared, a cutoff point for benign and malignant nodules was obtained with reference to receiver-operating characteristic curve, and relevant sensitivity and specificity were evaluated.

Results
There were 61 of 76 patients with benign parotid nodules and 15 of 76 patients with malignant nodules. The SWV of the malignant nodules was higher than the SWV of the benign nodules, and the SWV of the benign and malignant nodules was higher than the normal parotid glands. There were significant differences between benign and malignant nodules as well as normal parotid glands in terms of the age and SWV of the nodules (all P < 0.001). The area under the curve is 0.893, the cutoff is 2.445 m/s, and the sensitivity and specificity are 80.0% and 91.8%, respectively.

Conclusions
Acoustic radiation force impulse VTQ technique can determine the stiffness of parotid nodules in general, its ability to distinct malignant from benign nodular nodule is still not strong, and overlay of SWV of VTQ between benign and malignant nodules is the main impedance to set cutoff point.
A SoxB gene acts as an anterior gap gene and regulates posterior segment addition in the spiderParasteatoda tepidariorum
Authors: Paese Christian L. B. , Schoenauer Anna , Leite Daniel J. , Russell Steven , McGregor Alistair P. 
Published: April 2018

SummaryThe Sox gene family encode a set of highly conserved HMG domain transcription factors that regulate many key processes during metazoan embryogenesis. In insects, the SoxB geneDichaeteis the only Sox gene known to be involved in embryonic segmentation. To determine if similar mechanisms are used in other arthropods, we investigated the role of Sox genes during segmentation in the spiderParasteatoda tepidariorum. WhileDichaetedoes not appear to be involved in spider segmentation, RNAi knockdown of the closely relatedSox21b-1gene results in a gap like phenotype in the developing prosoma and also perturbs the sequential addition of opisthosomal segments. We show that this is in part due to a role forSox21b-1in regulating the expression ofWnt8and influencing Delta-Notch signalling during the formation of the segment addition zone. Thus, we have found that two different mechanisms for segmentation in a non-mandibulate arthropod are regulated by a Group B Sox gene. Our work provides new insights into the function of an important and conserved gene family across arthropods, and the evolution of the regulation of segmentation in these animals.
Screening of FDA-approved Drugs and Identification of Novel Lassa Virus Entry Inhibitors
Authors: Wang Peilin , Liu Yang , Zhang Guangshun , Wang Shaobo , Guo Jiao , Cao Junyuan , Jia Xiaoying , Zhang Leike , Xiao Gengfu , Wang Wei 
Published: April 2018

ABSTRACTLassa virus (LASV) belongs to the Mammarenavirus genus (family Arenaviridae) and causes severe hemorrhagic fever in humans. At present, there are no Food and Drug Administration (FDA)-approved drugs or vaccines specific for LASV. Herein, high-throughput screening of an FDA-approved drug library was performed against LASV entry using a pseudo-type virus enveloping LASV glycoproteins. Two hit drugs, lacidipine and phenothrin, were identified as LASV entry inhibitors in the micromolar range. A mechanistic study revealed that both drugs inhibited LASV entry by blocking low-pH-induced membrane fusion. Moreover, lacidipine irreversibly bound to the LASV glycoprotein complex (GPC), resulting in virucidal activity. Adaptive mutant analyses demonstrated that replacement of T40, located in the ectodomain of the stable-signal peptide (SSP), with lysine (K) conferred LASV resistance to lacidipine without apparent loss of the viral growth profile. Furthermore, lacidipine showed antiviral activity and specificity against both LASV and the Guanarito virus (GTOV), which is also a category A new world arenavirus. Drug-resistant variants indicate that the V36M in ectodomain of SSP mutant and V436A in the transmembrane domain of GP2 mutant conferred GTOV resistance to lacidipine, suggesting that lacidipine might act via a novel mechanism other than calcium inhibition. This study shows that both lacidipine and phenothrin are candidates for LASV therapy, and the membrane-proximal external region of the GPC might provide an entry-targeted platform for inhibitors.