bluuebunny/crossref_metadata_2025_split huggingface dataset:
TUBERCULOUS CHOROIDITIS IN PATIENT WITH VOGT–KOYANAGI–HARADA DISEASE
Authors: Anderson Erik W. , El Khoury Lara , Schwartzman-Morris Julie S. , Jonisch Jonathan , Goldberg Naomi R. 
Published: August 2018

Purpose:
To describe a novel case of intraocular tuberculosis (TB) arising in a patient undergoing treatment for Vogt–Koyanagi–Harada disease, and to highlight the use of spectral domain optical coherence tomography for helping confirm the diagnosis and monitor treatment response.

Methods:
Case report of a patient with Vogt–Koyanagi–Harada disease on prednisone, with acute clinical changes suspicious for bilateral tuberculous choroiditis. Spectral optical coherence tomography, fundus photography, and B-scan ultrasonography were all used to capture the acute lesions, and to monitor their responses after initiation of anti-TB therapy.

Results:
New subretinal lesions arose bilaterally, as characterized by spectral domain optical coherence tomography, and appeared to regress after a first round of anti-TB therapy, thereby helping confirm the presumed diagnosis of intraocular TB. A new peripheral choroidal lesion arose shortly after temporary cessation of antimicrobial treatment, and again regressed once four-drug therapy was instituted, with no recurrent lesions thereafter.

Conclusion:
The use of multimodal imaging was instrumental in the management of a rare case of intraocular TB arising in the setting of underlying Vogt–Koyanagi–Harada disease.
STELLATE NONHEREDITARY IDIOPATHIC FOVEOMACULAR RETINOSCHISIS IN A PATIENT WITH MACULAR TELANGIECTASIA TYPE 2
Authors: Falb Thomas , Malle Eva Maria , Haas Anton , Weger Martin , Wedrich Andreas 
Published: August 2018

Purpose:
To present a case of unilateral stellate nonhereditary idiopathic foveomacular retinoschisis in a patient with macular telangiectasia (MacTel) Type 2.

Methods:
Single-patient case report.

Results:
A 61-year-old female white patient was referred to our clinic with metamorphopsia and reduction of visual acuity over a period of 2 months on her right eye. Ocular findings in her right eye included reduced best-corrected visual acuity of 20/63 Snellen, foveomacular retinoschisis with extension to the lower middle periphery, central elevation of the neurosensory retina, and macular telangiectasia (MacTel) Type 2. Other causes of foveomacular retinoschisis, such as glaucoma, myopic degeneration, optic or scleral pit, X-linked juvenile retinoschisis, degenerative retinoschisis, and vitreomacular traction, were ruled out. The patient had no history of niacin or taxane medication, which may cause rather similar appearing cases of cystoid macular edema without leakage in fluorescein angiography. Because of the unilateral presentation, uneventful medical history, female sex, and the absence of known hereditary diseases or retinal pathologies in the patient's family history, hereditary predisposition appears to be highly unlikely.

Conclusion:
To our knowledge, this is the first reported case of stellate nonhereditary idiopathic foveomacular retinoschisis in combination with MacTel Type 2. Whether or not MacTel Type 2 plays a role in the development of stellate nonhereditary idiopathic foveomacular retinoschisis or has an impact on its clinical course requires further investigation. Furthermore, we suggest a significant involvement of Henle fiber layer in the process of intraretinal expansion in optical coherence tomography, in accordance with the most recent published nomenclature.
Tuberculosis Transmission in Danish Children: A Nationwide Register-based Study
Authors: Nordholm Anne Christine , Holm Line Lindebo , Svensson Erik , Andersen Peter H , Johansen Isik Somuncu 
Published: August 2018

Background:
Tuberculosis (TB) remains a major public health issue among children worldwide. Data on TB transmission in children living in low-incidence countries is limited.

Methods:
We studied TB transmission in ethnic Danish children younger than 15 years of age between 2000 and 2013. Identification of children with TB disease and information on demographics and TB contacts were retrieved from the national TB surveillance register and the International Reference Laboratory of Mycobacteriology.

Results:
In total, 88 children with TB disease were identified in the study period, corresponding to a mean annual incidence of 6.9 per 1,000,000 children younger than 15 years of age. The male to female ratio was 1.3. Median age was 5 years (interquartile range, 3–8.5). Seventy-three (83%) children had a known TB contact of which 60% was among household contacts with recent TB, predominantly parents. Sixty-six (75%) children were classified as part of epidemiologic clusters. Thirty-five (40%) children had culture verified TB of which information on genotypes was available for 34 (97%). Of these, 35% belonged to cluster C2/1112–15, the most prevalent cluster among adult Danes.

Conclusions:
We found on-going TB transmission in Danish children within the households of a low TB incidence population. These findings emphasize the need for early diagnosis of TB in children, thorough contact tracing and increased focus on risk groups.
Staffing Is More Than a Number: Using Workflow to Determine an Appropriate Nurse Staffing Ratio in a Tertiary Care Neurocritical Care Unit
Authors: Hill Michelle , DeWitt Jessica 
Published: August 2018

ABSTRACT

Objective: To enhance nursing staff retention and ensure a consistently high standard of care, a study was conducted to determine an appropriate nurse staffing model for a neurocritical care unit. In addition to being critically ill, these patients often require extensive diagnostic testing to determine treatment. Nurses traveling with patients leave higher nurse-patient ratios remaining on the unit. Methods: Prospective observation was used to assess relationships between neurologic assessment, documentation, and the amount of time spent traveling with patients. Patient acuity and nursing experience were also measured. Results: Over the 30-day study period, more than 226 hours were spent traveling, equivalent to approximately 38% of a single nurse’s shift. There was no correlation between the experience of nurses and the time necessary to perform a neurologic assessment. When controlling for acuity, a relationship was found between nursing experience and the time needed to chart an assessment. Conclusions: Significant time was spent every day off the floor, in addition to the documentation and performance of frequent assessments. These results advocate for a staffing position without a dedicated patient assignment but to assist with traveling and high-acuity patients so that safe and attentive care can be consistently given.
Cervical Cancer Screening Among Women by Birthplace and Percent of Lifetime Living in the United States
Authors: Endeshaw Meheret , Clarke Tainya , Senkomago Virginia , Saraiya Mona 
Published: August 2018

Objective
The aim of the study was to provide national estimates of Pap test receipt, by birthplace, and percent of lifetime in the United States (US).

Materials and Methods
Pooled nationally representative data (2005, 2008, 2013, 2015) from the National Health Interview Survey were used to examine differences in Pap test receipt among adult US women by birthplace and percent of lifetime in the US. Descriptive estimates were age-adjusted. Regression models were adjusted for selected sociodemographic and healthcare access and utilization factors and presented as predicted margins.

Results
Foreign-born women 18 years and older were more than twice as likely to have never received a Pap test compared with US-born women (18.6% vs 6.8%). Regression models showed that foreign-born women from Mexico (9.8%), South America (12.6%), Caribbean (14.6%), Southeast Asia (13.7%), Central Asia (20.4%), South Asia (22.9%), Middle East (25.0%), Africa (27.8%), Europe (16.4%), and Former Soviet Union (28.2%) were more likely to be unscreened compared with US-born women (7.6%). Foreign-born women who spent less than 25% of their life in the US had higher prevalence of never having a Pap test (20%) compared with foreign-born who spent more than 25% of their life in the US (12.7%).

Conclusions
Using national survey, we found that where a woman is born and the percent of her lifetime spent residing in the US do impact whether she gets screened at least once in her lifetime.

Impact
These findings may inform cervical cancer screening efforts targeting foreign-born women.
Effect of Bisoprolol on the Level of Dabigatran
Authors: Nehaj Frantisek , Sokol Juraj , Ivankova Jela , Mokan Michal , Mokan Marian 
Published: August 2018

Background:
Many patients receiving dabigatran treatment might also require bisoprolol therapy. However, there is a possibility that bisoprolol as significant P-glycoprotein inhibitor might interact with dabigatran.

Study Question:
To investigate the impact of concomitant bisoprolol therapy on dabigatran plasma level in patients with nonvalvular atrial fibrillation.

Study Design:
A pilot drug interaction study in 29 patients with nonvalvular atrial fibrillation on dabigatran therapy. Bisoprolol was administrated in 18 patients. Blood samples were collected at baseline (in the morning, before any medication was administered) and at hour 2 (2 hours after administration of dabigatran and bisoprolol).

Results:
The dabigatran plasma level was significantly higher at baseline and at hour 2 in patients treated with bisoprolol compared with patients without bisoprolol therapy. In addition, we have shown that this increase is affected by dabigatran dosage and concomitant treatment with proton-pump inhibitor and digoxin. The impact of bisoprolol on dabigatran concentration was still significant despite these confounders.

Conclusions:
This study demonstrated the interaction between dabigatran and bisoprolol, which is modulated with dabigatran dosage and concomitant treatment with proton-pump inhibitor and digoxin.
Taking regulatory T-cell therapy one step further
Authors: Sicard Antoine , Boardman Dominic A. , Levings Megan K. 
Published: August 2018

Purpose of review
Adoptive cell therapy using CD4+FOXP3+ regulatory T cells (Treg) has emerged as a promising therapeutic strategy to treat autoimmunity and alloimmunity. Preclinical studies suggest that the efficacy of Treg therapy can be improved by modifying the antigen specificity, stability and function of therapeutic Tregs. We review recent innovations that considerably enhance the possibilities of controlling these parameters.

Recent findings
Antigen-specific Tregs can be generated by genetically modifying polyclonal Tregs to express designated T-cell receptors or single-chain chimeric antigen receptors. The benefits of this approach can be further extended by using novel strategies to fine-tune the antigen-specificity and affinity of Treg in vivo. CRISPR/Cas 9 technology now enables the modification of therapeutic Tregs so they are safer, more stable and long lived. The differentiation and homing properties of Tregs can also be modulated by gene editing or modifying ex-vivo stimulation conditions.

Summary
A new wave of innovation has considerably increased the number of strategies that could be used to increase the therapeutic potential of Treg therapy. However, the increased complexity of these approaches may limit their wide accessibility. Third-party therapy with off-the-shelf Treg products could be a solution.
Macrophage Markers Are Poorly Associated With Liver Histology in Children With Nonalcoholic Fatty Liver Disease
Authors: Kazankov Konstantin , Alisi Anna , Møller Holger J. , De Vito Rita , Rittig Søren , Mahler Birgitte , Nobili Valerio , Grønbæk Henning 
Published: August 2018

ABSTRACTObjectives:We have previously demonstrated associations between the macrophage activation marker soluble (s)CD163 and histology of nonalcoholic fatty liver disease (NAFLD) in adults, and elevated sCD163 levels in children with obesity with NAFLD. Macrophage activation has, however, not been investigated in children with biopsy‐proven NAFLD, which was the objective of the present study.Methods:We used in‐house enzyme‐linked immunosorbent assays to measure sCD163 and the novel macrophage marker soluble mannose receptor (sMR) in a cross‐sectional (n = 155) pediatric NAFLD cohort, and a cohort of NAFLD children (n = 36) undergoing a randomized trial by the probiotic VSL#3. We included 56 healthy nonobese children for comparison.Results:Levels of sCD163 and sMR were higher in both of the NAFLD cohorts compared with controls (P < 0.001). In the cross‐sectional cohort, sCD163 only showed trends toward association with ballooning (rho = 0.14, P = 0.08) and portal inflammation (rho = 0.17, P = 0.08). sMR showed similar associations with liver histology. In the VSL#3 cohort, sCD163 correlated inversely with steatosis (rho = −0.35, P = 0.04), and lobular (rho = −0.57, P < 0.001) and portal inflammation (rho = −0.38, P = 0.02); sMR was not associated with any histological scores. Neither sCD163 nor sMR changed significantly during intervention, and without association with NAFLD resolution.Conclusions:The macrophage activation markers sCD163 and sMR showed poor associations with liver histology in 2 different cohorts of children with biopsy‐proven NAFLD, and none of the markers decreased during successful intervention. These results are in contrast with studies of adult NAFLD and may suggest a possibility of different roles for macrophages in the pathogenesis of adult and pediatric NAFLD.
Silymarin and curcumin effects on virulence and carbapenemase genes among multidrug-resistant Escherichia coli clinical isolates
Authors: Eslami Majid , Ghasemian Abdolmajid , Najafiolya Zahra , Mirforughi S. Ameneh , Nojoomi Farshad 
Published: August 2018

Objective
: Silymarin and curcumin antimicrobial properties have been previously described against some infectious agents. The aims of the current study were the investigation of the antibacterial effects of these compounds on the expression of fimA, cdt, bla
IMP1 and bla
OXA-48 and AcrAB-TolC genes among multidrug-resistant Escherichia coli clinical isolates.

Methods
: A total of five carbapenemase-producing E. coli strains were included. All of them carried bla
IMP1 and bla
OXA-48, ACR-AB, cdt, fimA and QepA genes. The antibiotic susceptibility test, imipenem, cefotaxime and ceftazidime minimum inhibitory concentration (MIC) and combine disk and Carba NP-test for carbapenemase production were performed. Silymarin and curcumin minimum inhibitory and bactericidal concentrations [MIC and minimum bactericidal concentration (MBC), respectively] were determined. The effect of 25 μg/ml concentration was also evaluated against gene expression. The quantitative real-time PCR was performed for the evaluation of genes expression.

Results
: Silymarin MIC and MBC were 256 and more than 256 μg/ml, respectively. Moreover, curcumin MIC and MBC concentrations were 128 and 256 μg/ml, respectively. Silymarin down-expressed the ACR-AB, cdt, fimA genes and QepA genes significantly (P < 0.05), but conferred no significant effect on bla
IMP nor bla
OXA-48 genes. Moreover, curcumin down-expressed the ACR-AB, QepA and bla
IMP genes significantly (P < 0.05), but exhibited no significant effect against bla
OXA-48, cdt and fimA genes.

Conclusion
: In this study, curcumin and silymarin sub-MIC concentrations could significantly inhibit the expression of the ACR-AB, cdt, fimA, QepA and bla
IMP genes at 25 μg/ml. Combating bacterial virulence is a proper strategy not only to inhibit the spread of infections, but also to prevent the appearance and spread of antibiotic nonsusceptible strains.
Use of Web-Based Parent–Adolescent Health Promotion Program Among Puerto Ricans
Authors: Villarruel Antonia M. , Varas-Díaz Nelson , Hanlon Alexandra , Betancourt Elba , Lozano Alicia J. , DiNapoli Lucia 
Published: August 2018

Background
Despite positive attitudes of Latinos using the Internet and the increased availability of health information resources, few studies have been conducted that examine actual use and barriers to web-based health information.

Objective
The aim of this study was to examine whether select sociodemographic factors and technology factors (e.g., computer and Internet access) predicted use of a web-based, parent–adolescent sexual communication program or a physical activity program, entitled Cuídalos, among Puerto Rican parents.

Methods
This study uses data from a randomized controlled trial designed to examine the long-term effectiveness of Cuídalos. Parents were recruited from community-based and school sites throughout Puerto Rico and randomly assigned to a web-based, parent–adolescent sexual communication (n = 245) or a physical activity (n = 247) program. Parents were instructed to complete the two-session program within 1 week and had access to the program for a period of 3 months. Outcomes in this secondary analysis were the number of log-ins and self-reported access during the 3-month period. Reasons for not accessing the program after the 3-month period were assessed.

Results
Self-reported access after completion of the Cuídalos program and the actual number of log-ins over the intervention period were low. There were no statistically significant differences in the number of log-ins between parents who accessed Cuídalos during the 3-month time frame and those who did not (p = .28). Logistic regression analyses demonstrated that the odds of accessing Cuídalos during the 3-month period was 72% higher (OR = 1.72, 95% CI [1.08, 2.75]) among parents with a high school education or less, as compared to parents with a college education (p = .02). Similarly, Poisson regression model results indicated that, with every year increase in age, the expected number of log-ins increased by 1% (RR = 1.01, 95% CI [1.00, 1.02]); compared to those who accessed the program at home, the expected number of log-ins ranged from 10% to 27% lower for parents accessing elsewhere. Reasons for not accessing the program during the 3-month period included not having easy access to a computer (n = 134, 48.6%), or they did not know how to access the program again (n = 56, 20.3%).

Discussion
Despite the availability of web-based and e-health resources, further research is needed to identify how to facilitate greater access and actual use of digital health resources by Latinos. This is an important effort in order to prevent a widening health equity gap caused by a lack of access and use of digital health resources.
Corneal Nerve Migration Rate in a Healthy Control Population
Authors: Al Rashah Khaled , Pritchard Nicola , Dehghani Cirous , Ruggeri Alfredo , Guimaraes Pedro , Russell Anthony , Malik Rayaz A. , Efron Nathan , Edwards Katie 
Published: August 2018

PURPOSE
The purpose of this study was to establish an age-dependent normative range and factors affecting the migration rate of the corneal subbasal nerve plexus in a healthy control population.

METHODS
Corneal nerve migration rate was measured in 60 healthy participants grouped by age: A, aged 20 to 39 years (n = 20); B, 40 to 59 years (n = 20); and C, 60 to 79 years (n = 20). Laser-scanning corneal confocal microscopy was performed on the right eye of all participants at baseline and again after 3 weeks. Fully automated software was used to montage the frames. Distinctive nerve landmarks were manually reidentified between the two montages, and a software program was developed to measure the migration of these landmark points to determine corneal nerve migration rate in micrometers per week (μm/wk).

RESULTS
The mean ± SD age of all participants in the study was 47.5 ± 15.5 years; 62% of participants were male. The average corneal nerve migration rates of groups A, B, and C were 42.0 ± 14.0, 42.3 ± 15.5, and 42.0 ± 10.8 μm/wk, respectively (P = .99). There was no difference in corneal nerve migration rate between male (41.1 ± 13.5 μm/wk) and female (43.7 ± 13.2 μm/wk) participants (P = .47). There was no significant correlation between age (P = .97), smoking (P = .46), alcohol use (P = .61), and body mass index (P = .49, respectively) with corneal nerve migration rate. However, exercise frequency correlated significantly (P = .04) with corneal nerve migration rate.

CONCLUSIONS
Corneal nerve migration rate varies in healthy individuals and is not affected by age, sex, or body mass index but is related to physical activity.
Presenting Characteristics Associated With Outcome in Children With Severe Traumatic Brain Injury: A Secondary Analysis From a Randomized, Controlled Trial of Therapeutic Hypothermia*
Authors: Rosario Bedda L. , Horvat Christopher M. , Wisniewski Stephen R. , Bell Michael J. , Panigrahy Ashok , Zuccoli Giulio , Narayanan Srikala , Balasubramani Goundappa K. , Beers Sue R. , Adelson P. David 
Published: August 2018

Objectives:
To identify injury patterns and characteristics associated with severe traumatic brain injury course and outcome, within a well-characterized cohort, which may help guide new research and treatment initiatives.

Design:
A secondary analysis of a phase 3, randomized, controlled trial that compared therapeutic hypothermia versus normothermia following severe traumatic brain injury in children.

Setting:
Fifteen sites in the United States, Australia, and New Zealand.

Patients:
Children (< 18 yr old) with severe traumatic brain injury.

Measurements and Main Results:
Baseline, clinical, and CT characteristics of patients (n = 77) were examined for association with mortality and outcome, as measured by the Glasgow Outcome Scale—Extended Pediatric Revision 3 months after traumatic brain injury. Data are presented as odds ratios with 95% CIs. No demographic, clinical, or CT characteristic was associated with mortality in bivariate analysis. Characteristics associated with worse Glasgow Outcome Scale—Extended Pediatric Revision in bivariate analysis were two fixed pupils (14.17 [3.38–59.37]), abdominal Abbreviated Injury Severity score (2.03 [1.19–3.49]), and subarachnoid hemorrhage (3.36 [1.30–8.70]). Forward stepwise regression demonstrated that Abbreviated Injury Severity spine (3.48 [1.14–10.58]) and midline shift on CT (8.35 [1.05–66.59]) were significantly associated with mortality. Number of fixed pupils (one fixed pupil 3.47 [0.79–15.30]; two fixed pupils 13.61 [2.89–64.07]), hypoxia (5.22 [1.02–26.67]), and subarachnoid hemorrhage (3.01 [1.01–9.01]) were independently associated with worse Glasgow Outcome Scale—Extended Pediatric Revision following forward stepwise regression.

Conclusions:
Severe traumatic brain injury is a clinically heterogeneous disease that can be accompanied by a range of neurologic impairment and a variety of injury patterns at presentation. This secondary analysis of prospectively collected data identifies several characteristics associated with outcome among children with severe traumatic brain injury. Future, larger trials are needed to better characterize phenotypes within this population.