bluuebunny/crossref_metadata_2025_split huggingface dataset:
Giant Ocular Surface Squamous Neoplasia Wrapping Whole Cornea
Authors: Kumar Dhivya Ashok , Agarwal Amar 
Published: May 2017

Abstract:
We present a giant ocular surface squamous neoplasia (OSSN) measuring approximately 20×18 mm arising from the fornix and wrapping the entire 12 clock hours of the cornea. The surgical excision was performed with preservation of the corneal surface. A 3-mm clear margin was obtained all around the mass. The histopathology confirmed as moderately differentiated squamous cell carcinoma with clear margins. The postoperative period was uneventful, and a clear cornea without a residual scar with best corrected visual acuity of 20/20 was attained. A giant OSSN can demonstrate corneal invasion, making surgical excision both challenging and associated with complications such as subsequent scarring. Extended surgical intervention, chemotherapy, chemoreduction, and immunotherapy have been reported in giant OSSNs. However, we report a giant OSSN wrapping the entire 12 clock hours of the cornea that was managed with single surgery with complete corneal restoration.
Histopathology of Failed Descemet Membrane Endothelial Transfer
Authors: Parker Jack , Verdijk Robert M. , Müller Thomas M. , Lavy Itay , Bruinsma Marieke , Colby Kathryn , Binder Perry S. , Melles Gerrit R. J. 
Published: May 2017

Objectives:
To describe the postmortem histologic features after an unsuccessful Descemet membrane endothelial transfer (DMET) and assess any potential clinical implications.

Methods:
Postmortem, an eye from a patient who previously underwent unsuccessful DMET for pseudophakic bullous keratopathy (PPBK) was harvested and processed for morphologic evaluation.

Results:
Clinically and histologically, the host cornea showed evidence of diffuse stromal edema. Although the edges of the surgical descemetorhexis were well visualized, there was no evidence of endothelial migration or repopulation of the posterior stroma from any direction. A multilayered, retrocorneal membrane was present that appeared to originate from the trabecular meshwork.

Conclusions:
Descemet membrane endothelial transfer and “descemetorhexis alone” may be insufficient treatment for eyes operated on for PPBK, that is, eyes with a significantly depleted or dysfunctional endothelium.
Effect of the Eye Tracking System on the Reproducibility of Measurements Obtained With Spectral-domain Optical Coherence Tomography in Glaucoma
Authors: Abadia Beatriz , Ferreras Antonio , Calvo Pilar , Fogagnolo Paolo , Figus Michele , Pajarin Ana B. 
Published: May 2017

Purpose:
The purpose of this study was to evaluate whether the eye tracking system (ETS) improved the reproducibility of a single circle peripapillary retinal nerve fiber layer (RNFL) measurement acquired with spectral-domain optical coherence tomography (OCT).

Materials and Methods:
The sample comprised 205 individuals divided into 2 groups according to intraocular pressure and visual field outcomes. A total of 100 healthy individuals and 105 patients with open-angle glaucoma underwent imaging of the optic nerve head with OCT 3 times during the same session and 2 additional times in subsequent sessions (30 days apart). Intraclass correlation coefficient (ICC), coefficient of variation, and test-retest variability were calculated for the RNFL thickness acquired with and without the ETS enabled, and compared.

Results:
The glaucoma group mainly comprised patients with moderate glaucoma (mean deviation of standard automated perimetry, −6.73±6.2 dB). The RNFL thicknesses did not differ between acquisitions with or without the ETS activated and disabled. All ICCs were >0.9 in the control and glaucoma groups with or without the ETS activated. The best parameter in the intersession analysis (with ETS activated) was global RNFL thickness (ICC, 0.95; coefficient of variation, 2.7%; and test-retest variability, 2.87 μm). The reproducibility and repeatability of RNFL measurements did not differ significantly between acquisitions with or without the ETS in either group.

Conclusions:
The reproducibility of peripapillary RNFL thicknesses acquired with OCT was excellent. The variability between OCT measurements did not decrease with the ETS activated.
Progressive Decrease of Peripapillary Angioflow Vessel Density During Structural and Visual Field Progression in Early Primary Open-angle Glaucoma
Authors: Holló Gábor 
Published: May 2017

Purpose:
To present a case of early primary open-angle glaucoma in which retinal nerve fiber layer thickness (RNFLT), ganglion cell complex (GCC), and visual field progression were accompanied with significant progression of peripapillary angioflow vessel density (PAFD) measured with optical coherence tomographic angiography.

Methods:
A 68-year-old female patient who was under topical intraocular pressure (IOP) lowering medication for 20 years for ocular hypertension of the right and preperimetric primary open-angle glaucoma of the left eye (with reproducible inferotemporal and superotemporal neuroretinal rim and RNFL loss) was prospectively imaged with the AngioVue OCT for RNFLT, GCC thickness, and PAFD, and investigated with the Octopus Normal G2 visual field test on the same days at 6-month intervals for 18 months, while the IOP of the left eye escaped from control.

Results:
IOP of the left eye fluctuated between 14 and 30 mm Hg in the study period. RNFLT, GCC thickness, and peripapillary PAFD all decreased significantly (linear regression analysis, P=0.030, 0.040, and 0.020, respectively), and a significant 2.1 dB/y progression was seen for a superior visual field cluster. The RNFLT, peripapillary PAFD, and visual field of the right eye remained normal and unchanged.

Conclusions:
In our case IOP elevation, glaucomatous visual field conversion, and structural progression were accompanied with significant progressive decrease of peripapillary PAFD. The simultaneous thinning of RNFLT and GCC and decrease of peripapillary PAFD suggest that PAFD may potentially be an additional indicator of early progression in primary open-angle glaucoma.
Personalized hemodynamic management
Authors: Saugel Bernd , Vincent Jean-Louis , Wagner Julia Y. 
Published: May 2017

Purpose of review
To describe personalized hemodynamic management of critically ill patients in the operating room and the ICU.

Recent findings
Several recent clinical studies have investigated different strategies for optimizing blood pressure (BP) and flow in the operating room and in the ICU. In the past, (early) goal-directed hemodynamic treatment strategies often used predefined fixed population-based ‘normal’ values as hemodynamic targets. Most hemodynamic variables, however, have large interindividual variability and are dependent on several biometric factors. Personalized BP management aims to set specific BP targets for a given patient taking into account blood flow autoregulation and any history of chronic hypertension. To optimize cardiac output and oxygen delivery, individualized hemodynamic management based on functional assessment of fluid responsiveness is used. Innovative noninvasive technologies now enable preoperative assessment of a patient's personal normal hemodynamic values, which can then be targeted in the perioperative phase. In critically ill patients admitted to the ICU, adaptive multiparametric hemodynamic monitoring can help to personalize hemodynamic management.

Summary
Personalized hemodynamic management targets personal normal values of hemodynamic variables, which are adjusted to biometric data and adapted to the clinical situation (i.e., adequate values). This approach optimizes cardiovascular dynamics based on the patient's personal hemodynamic profile.
Mitochondrial DNA in Sepsis
Authors: Harrington John S. , Choi Augustine M.K. , Nakahira Kiichi 
Published: May 2017

Purpose of review
Our understanding of critical illness is transforming as we develop a better understanding of the impact pathogen-associated molecular patterns and damage-associated molecular patterns (DAMPs) have on the pathogenesis of disease. Of the known DAMPs, there is a growing interest in mitochondrial DNA (mtDNA) as a DAMP capable of propagating the inflammatory response seen in sepsis and other conditions. In this review, we describe the varying mechanisms by which mtDNA is translocated from mitochondria into cytosol and the extracellular space where it can illicit an inflammatory response. In addition, we present some of the most recent clinical studies to examine mtDNA in critical illness.

Recent findings
Basic science research provides convincing data that mtDNA can influence the immune system through toll-like receptor 9 and inflammasomes. Clinical trials provide evidence that mtDNA is elevated in critically ill patients and is associated with mortality.

Summary
Although mtDNA is a DAMP shown to be elevated in numerous conditions, the clinical ramifications of this finding remain elusive. Further work is needed to determine if mtDNA can be utilized as a biomarker of disease severity or mortality.
Endocrine disorders and hormonal therapy for adolescent acne
Authors: Nguyen Henry L. , Tollefson Megha M. 
Published: May 2017

Purpose of review
Acne vulgaris is a global disease with increasing prevalence in adolescents. It has a profound impact on their quality of life, especially when endocrine disorders are also involved. Recent concerns regarding antibiotic stewardship, failures with antibiotic usage, and the development of antibiotic-resistant Propionibacterium acnes have led clinicians to consider other therapeutic options for acne treatment. The present review explores hormonal therapies for the treatment of acne vulgaris.

Recent findings
There are now four different combined oral contraceptive pills that are FDA approved for the treatment of acne since its first introduction in 1960. Recent literature has provided more information on the efficacy of different generations of combined oral contraceptive pills, their side-effects, and cancer risks. Furthermore, spironolactone has been gaining wider use among dermatologists in adolescents with endocrine dysfunction. New diagnostic guidelines and treatment recommendations have also been suggested.

Summary
Hormonal therapies are effective and well tolerated options for the treatment of acne vulgaris in adolescents with and without endocrine disorders. They can be used as monotherapy or in conjunction with benzoyl peroxide, topical retinoic acid, or antibiotics.
Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health
Authors: Lopez Ximena , Marinkovic Maja , Eimicke Toni , Rosenthal Stephen M. , Olshan Jerrold S. 
Published: May 2017

Purpose of review
The purpose of this Position Statement is to emphasize the importance of an affirmative approach to the health care of transgender individuals, as well as to improve the understanding of the rights of transgender youth.

Recent findings
Transgender youth have optimal outcomes when affirmed in their gender identity, through support by their families and their environment, as well as appropriate mental health and medical care.

Summary
The Pediatric Endocrine Society Special Interest Group on Transgender Health joins other academic societies involved in the care of children and adolescents in supporting policies that promote a safe and accepting environment for gender nonconforming/transgender youth, as well as adequate mental health and medical care. This document provides a summary of relevant definitions, information and current literature on which the medical management and affirmative approach to care of transgender youth are based.
From Whom Do Student Veterans Seek Help?
Authors: Currier Joseph M. , Deiss Jessie , McDermott Ryon C. 
Published: May 2017

Abstract
The purpose of this brief report was to ascertain student veterans' patterns of help-seeking from professional, informal, and religious sources. In total, 350 veterans from an academic institution on the Gulf Coast completed assessments of help-seeking intentions from a range of potential sources in their communities. Analyses revealed that veterans had a neutral probability to seek help from professional sources (e.g., physicians and psychologists) but were likely to pursue informal sources (e.g., partner/spouse, friend) in a psychological/emotional crisis. However, when compared with their nonclinical counterparts, veterans with a probable need for treatment for PTSD and/or depression generally reported less probability to seek help from informal and religious sources. In addition, sex, ethnicity, and religious background each contributed a significant influence in shaping preferences for seeking help for psychological or emotional concerns. Given unmet mental health needs of student veterans, findings highlight the importance attending to help-seeking preferences in this growing population.
Gut Microbiota and the Gut-Brain Axis: New Insights in the Pathophysiology of Metabolic Syndrome
Authors: de Clercq Nicolien C. , Frissen Myrthe N. , Groen Albert K. , Nieuwdorp Max 
Published: May 2017

ABSTRACT

Objective
Emerging preclinical evidence has shown that the bidirectional signaling between the gastrointestinal (GI) tract and the brain, the so-called gut-brain axis, plays an important role in both host metabolism and behavior. In this review, we discuss the potential mechanisms of the brain-gut axis in relation to the pathophysiology of metabolic syndrome.

Methods
A selective literature review was conducted to evaluate GI and brain interactions.

Results
Evidence suggests reduced microbial diversity in obesity and metabolic dysregulation. However, findings of microbiota composition in obese individuals are inconsistent, and the investigation of causality between gut microbiota and energy homeostasis is complex because multiple variables contribute to the gut microbiota composition. The microbial metabolites short chain fatty acids are found to exert numerous physiologic effects, including energy homeostasis through the regulation of GI hormones such as cholecystokinin, glucagon-like peptide 1, peptide tyrosine-tyrosine, and leptin. Preclinical studies show that modifying rodents' microbiota through fecal transplantation results in alterations of these GI hormones and subsequently an altered metabolism and behavior. However, whether and to what extent preclinical findings translate to human metabolism is unclear.

Conclusions
One of the major limitations and challenges in this field of research is interindividual variability of the microbiome. Future research needs to combine recent insights gained into tracking the dynamics of the microbiome as well as the metabolic responses. Furthermore, advanced mapping of the human microbiome is required to investigate the metabolic implications of the gut-brain axis to develop targeted interventions for obesity and metabolic syndrome.
Child deaths of undetermined intent: An analysis of circumstances using Illinois Violent Death Reporting System data
Authors: Wu Han-Wei , McLone Suzanne G. , Mason Maryann , Sheehan Karen 
Published: May 2017

BACKGROUND
There is little information available about the circumstances surrounding the deaths of children aged 0 to 14 years in which the manner of death is of undetermined intent.

METHODS
We analyzed data collected in the Illinois Violent Death Reporting System to describe victim demographics, location of injury, seasonality, day of week, and circumstances surrounding the victims’ deaths.

RESULTS
From 2005 to 2010 in Cook County, Illinois, 192 cases were identified of children aged 0 to 14 years, in which the manner of death was of undetermined intent. The majority of cases were younger than 1 year (81%), male (62%), and non-Hispanic black (66%); occurred in the City of Chicago (65%); and also occurred most frequently during the months of May (15%) and July (13%) and on Sunday (19%). Circumstances of note were having information on the location of death available for the victim (90%); scene investigation was not performed/unknown/not documented (81%); and the victim not presenting with red petechiae (84%). By ethnicity, a lower proportion of Hispanic victims had parental drug information available compared with non-Hispanic victims (17% and 40%, respectively; p = 0.017); Hispanic victims were more likely than non-Hispanic victims to have a documented acute illness at the time of injury leading to death (57% and 33%, respectively; p = 0.015). The availability of scene information and the successful contact of one or both parents of the victim following the victim’s death varied by location.

CONCLUSIONS
No public health surveillance system exists for the collection of this type of death. There is not enough information provided to develop an effective intervention. The systematic, thorough collection of information surrounding these deaths is necessary to pinpoint possible contributing mechanisms of death for these children.

LEVEL OF EVIDENCE
Epidemiologic, level IV.
Pediatric injury prevention programs: Identifying markers for success and sustainability
Authors: Chaudhary Sofia , Pomerantz Wendy J. , Miller Beverly , Pan Anqi , Agarwal Maneesha 
Published: May 2017

BACKGROUND
Injury is the leading cause of death in children. Although many pediatric hospitals and trauma centers provide injury prevention (IP) programming, there is no national standard. This study aims to identify characteristics of a sustainable and successful IP program by querying programs affiliated with the Injury Free Coalition for Kids (IFCK).

METHODS
The IFCK sites were sent a 30-question survey via e-mail. Questions focused on demographics, scope of IP activities, self-efficacy, and outcome measures including finances, academic productivity, and legislative advocacy. Counts and frequencies were calculated and compared using χ2 tests.

RESULTS
The survey was completed by 38 (90.4%) of 42 sites. The majority were associated with a freestanding children’s hospital (57.9%) and Level I pediatric trauma center (86.8%). Most programs (79%) had at least one dedicated full-time equivalent (FTE) staff. Research was most common on child passenger safety and teen driving. Nearly 30% of programs offered educational curricula to health care providers; these sites were more likely to have FTE support (p = 0.036). Steady sources of funding were identified for 60.5% of programs, with 47.8% citing their hospital as the primary source; 73% of respondents were confident in their program’s capacity to sustain activities; these were more likely to be larger programs (p = 0.001) with steady sources of funding (p < 0.001). Despite 73.7% of sites having academic affiliations, 60.5% had 5 or fewer publications over the previous 5 years. In the prior 2 years, 55.3% of programs impacted legislative or policy changes. Funding, size of program, and FTE had no statistical correlation with research productivity or number of legislative/policy contributions.

CONCLUSIONS
This study characterizes the variation among pediatric IP programs within IFCK sites, while highlighting the association between financial and FTE support from programs’ institutions with sustainable IP programming. These results can assist programs in identifying differences in relation to their peers.
Adolescent motor vehicle crash prevention through a trauma center–based intervention program
Authors: Layba Cathline , Griffin Lance W. , Jupiter Daniel , Mathers Charles , Mileski William 
Published: May 2017

ABSTRACT
Traumatic injuries account for millions of emergency room visits and hospital admissions annually. Motor vehicle crashes (MVCs) remain a leading cause of mortality between the ages of 1 and 44 years. With the popularity of smart devices, drivers are ever more distracted on the road. Programs that educate drivers on safe actions and to raise awareness of the perils of drunk and distracted driving exist, but there are few data that demonstrate a reduction in motor vehicle injury rates. We sought to determine if the implementation of such a program in our community would impact the rates of MVCs. Assessing the effectiveness of the Save A Life Tour, a risk reduction program, this intervention was instituted at a single area high school. The numbers of adolescent drivers aged 16 to 21 years involved in MVCs treated at the regional Level I trauma center were compared over two time intervals and between two adjoining counties. The time intervals consisted of preintervention and postintervention surveillance, each over a period of 3 years. Using our trauma registry, we compared the incidence of MVC between the two counties and between the two age groups. The data were also compared with the incidence among these populations nationally. In the preintervention period, the number of adolescent MVCs treated from the catchment area was 166, and the number in the postintervention period was 105. This represented a risk reduction of 37% (p < 0.05). During the same intervals, the incidence in the nonintervention control catchment area increased by 12%. There was no significant change in the population aged 16 to 21 years over the time intervals in either area. These results suggest that ongoing educational intervention programs aimed at adolescent drunk and distracted driving can have an impact on these life-threatening behaviors and on the incidence of MVCs.

LEVEL OF EVIDENCE
Therapy, level IV.
Characteristics of EEG Seizure-Onset Patterns Recorded From Subdural Electrodes Over MRI-Visible Frontal Focal Cortical Dysplasia Type IIb Lesions
Authors: Hirozawa Daisuke , Terada Kiyohito , Matsuda Kazumi , Usui Keiko , Usui Naotaka , Tottori Takayasu , Kondo Akihiko , Araki Yasukiyo , Omote Yoshio , Kashida Yumi , Mochizuki Hideki , Inoue Yushi 
Published: May 2017

Purpose:
Focal cortical dysplasia (FCD) is intrinsically epileptogenic, and an MRI-visible lesion typically constitutes the core part of the epileptogenic zone. We aimed to identify ictal EEG patterns that represent the epileptogenic zone by using subdural electrodes placed over the MRI-visible FCD lesion.

Methods:
We selected seven patients with frontal lobe epilepsy caused by pathologically proven FCD type IIb who underwent preoperative intracranial EEG evaluation with subdural electrodes followed by resection surgery with seizure-free outcome. The characteristics of ictal EEG patterns, interictal/ictal high-frequency oscillations, and ictal direct current shifts from intracranial electrodes placed over the MRI-visible lesion were analyzed.

Results:
Two seizure-onset patterns (low voltage fast activity and fast spike activity) were identified. Low voltage fast activity was seen in all patients with a lateral frontal lesion, and it was always preceded by preictal spikes. Fast spike activity occurred only in patients with a mesial frontal lesion. Interictal/ictal high-frequency oscillations and ictal direct current shifts were seen in all patients.

Conclusions:
The epileptogenic zone of frontal FCD type IIb may be characterized by EEG seizure-onset patterns consisting of low voltage fast activity and fast spike activity accompanied by ictal high-frequency oscillations and ictal direct current shifts. Further study is needed to determine whether other seizure-onset patterns exist in patients with FCD type IIb.