bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Outcomes of Posterior Approach Levatorpexy for Congenital Ptosis With Reduced Levator Function
Authors: Feldman Ilan , Brusasco Lucas , Malhotra Raman 
Published: January 2018

Purpose:
The authors present a new series of our experience using posterior approach levatorpexy for congenital ptosis with poorer levator function (LF) in comparison with our first published report. This technique avoids a skin incision or any resection in addition to no excision of tissue.

Methods:
A consecutive series of 16 patients. Retrospective review of levatorpexy for congenital ptosis. Data included eyelid margin reflex distance 1, pretarsal show, contour, and complications, including nocturnal lagophthalmos, eyelid lag on downgaze, and dry eye. Surgery was considered successful if the following 4 criteria were simultaneously met: a postoperative margin reflex distance 1 of ≥2 mm and ≤4.5 mm, intereyelid height asymmetry of ≤1 mm, no overcorrection compare to opposite eye, and satisfactory eyelid contour.

Results:
Mean age was 10.3 years (range 1–26 years). Mean LF was 7.3 mm (2–14 mm), while 66% (12) had LF ≤7 mm. Preoperative phenylephrine test was positive in 87.5% of patients. Mean preoperative and postoperative margin reflex distance 1 was 1.34 mm and 3.2 mm, respectively. Fourteen patients (87%) achieved the desired eyelid height and fulfilled our criteria set of success. Among 10 patients with LF ≤7 mm, 9 (90%) achieved the desired eyelid height and fulfilled our criteria set of success. Ninety-four percent did not report nocturnal lagophthalmos. Three patients needed a further levatorpexy procedure due to undercorrection. Mean postoperative follow up was up 11.2 (range 6–36) months.

Conclusions:
Posterior approach levatorpexy is an useful first-line choice for congenital ptosis for all ranges of LF. It is popular among parents due to its avoidance of a skin incision or any resection or excision of tissue.
Effects of a Tablet Computer on Self-care, Quality of Life, and Knowledge
Authors: Melin Michael , Hägglund Ewa , Ullman Bengt , Persson Hans , Hagerman Inger 
Published: January 2018

Background:
Conflicting results have been reported for telemonitoring in patients with heart failure (HF). We wanted to evaluate whether patients using a tablet computer aimed at improving self-care behavior could do so and also whether it affects quality of life and health-related quality of life, disease knowledge, and in-hospital days.

Methods and Results:
Patients with HF (n = 82) were randomized to the intervention group (IG) with a tablet computer (giving information and advice) or the control group (CG) that was subject to standard care. Study was completed by 72 patients, with a mean (SD) age of 75 (8) years, 68% male, and 74% NYHA class III. Self-care behavior measured with the 9-item European Heart Failure Self-Care Behaviour Scale, health related quality of life measured by the Kansas City Cardiomyopathy Questionnaire, quality of life measured by the Swedish version of the Health Survey, knowledge measured by the Dutch Heart Failure Knowledge Scale, days in hospital, and adherence were analyzed. The IG displayed better 9-item European Heart Failure Self-Care Behaviour Scale score (median IG, 16.5 [interquartile range {IQR}, 12–22], vs median CG, 23.5 [IQR, 18.8–30.0]; P < .05) and improved health related quality of life (median IG, 72.7 [IQR, 50.8–87.9], vs median CG, 51.8 [IQR, 40.9–62.8]; P < .05). A significant difference in knowledge was seen, with an 11% increase in IG and a 1% decrease in CG (P < .05), as well as a reduction in hospital days in IG by 2.7 days per patient (relative risk, 0.72; 95% confidence interval, 0.61–0.84; P < .05).

Conclusion:
The tablet computer significantly improved self-care behavior and health related quality of life, increased HF knowledge, and reduced hospital days.
Potential role of type I interferon in the pathogenic process leading to type 1 diabetes
Authors: Qaisar Natasha , Jurczyk Agata , Wang Jennifer P. 
Published: January 2018

Purpose of review
Understanding the relationship between viral infections and the development of type 1 diabetes (T1D) is essential for T1D prevention. Virus-induced innate immune responses, specifically type I interferon (IFN-I) and the IFN gene signature, orchestrate early events of β-cell dysfunction preceding islet autoimmunity. We summarize recent advances in how IFN-I and the IFN gene signature can drive T1D development.

Recent findings
IFN-I, particularly IFN-α, and the IFN gene signature have been detected in islets and peripheral blood of T1D patients. T1D risk genes in the IFN-I signaling pathway regulate antiviral responses in β cells driven by IFN-I and proinflammatory cytokines. Polymorphisms in these genes may cause chronic dysregulated IFN signaling in islets, characterized by hyperexpression of IFN-I, the IFN gene signature, and major histocompatibility complex class I during viral infection. Islet-cell inflammation mediated by aberrant IFN signaling drives β-cell apoptosis by initiating autoreactivity against β-cell antigens. The profound elevation in IFN-I and the IFN gene signature observed in some forms of T1D are also seen in a novel group of human autoimmune and autoinflammatory diseases called interferonopathies.

Summary
Despite significant advances, further studies are required to functionally dissect the mechanisms by which excessive IFN-I contributes to the evolution of autoimmunity that destroys β cells.
Posttraumatic Stress, Depressive Emotions, and Satisfaction With Life After a Road Traffic Accident
Authors: Copanitsanou Panagiota , Drakoutos Evagelos , Kechagias Vasileios 
Published: January 2018

BACKGROUND:
The psychological response of injured people after traffic accidents includes stress and depression.

PURPOSE:
To assess orthopaedic patients' stress, depression, and satisfaction with life after traffic accidents in Greece.

METHODS:
Descriptive, longitudinal, correlational study. Patients' background factors, injury severity, scores on the Impact of Events Scale—Revised (IES-R), the Center for Epidemiologic Studies Depression (CES-D) Scale, and the Satisfaction With Life Quality (SWLQ) Scale were recorded. The principles of the Declaration of Helsinki were applied.

RESULTS:
In total, 60 patients participated in this study during hospitalization following a road traffic accident and 40 patients at 6 months after. Participants were mostly men (75%) with severe injuries (50%). The IES-R score at 6 months was significantly lower than during hospitalization. One out of 3 people had a CES-D score, which is considered of clinical significance. The SWLQ scores were considered high.

CONCLUSION:
As posttraumatic stress and depression seem to affect a considerable percentage of people involved in road traffic accidents in Greece, these individuals should be assessed for posttraumatic stress and depression while still hospitalized.
Do You C What I C
Authors: Burhop James , Gibson Jennifer , de Boer Justin , Heydarian Cyrus 
Published: January 2018

Abstract
Scurvy in modern times may not be as rare as previously thought. The link between adequate intake of vitamin C and scurvy has been known since ancient times and is recorded in Ebers Papyrus. Recent reports indicate that, with restricted diets, vitamin C deficiency is being seen in infants exclusively fed plant-based formula and children with oral aversion, autism, restricted diets, and cerebral palsy. Additional at-risk groups include the older adults and patients having alcoholism. Often costly, emergency department visits and elaborate diagnostic studies lead to fruitless results when a simple diet history is often overlooked. Here, we report a case of pediatric scurvy in an 11-year-old autistic child with a restricted diet who presented with refusal to walk, fatigue, a purpuric rash, and gingival bleeding. The diagnosis was made based on diet history, physical examination findings, and symptom resolution with vitamin C supplementation. Our case report reaffirms that vitamin C deficiency still occurs and should be considered in children with restrictive diets. Early recognition of this disease by physicians provides early diagnosis, avoids costly diagnostic workup and hospitalization, and expedites effective treatment.
Acute Phase Predictors of 6-Month Functional Outcome in Italian Stroke Patients Eligible for In-Hospital Rehabilitation
Authors: Franceschini Marco , Fugazzaro Stefania , Agosti Maurizio , Sola Carlotta , Di Carlo Antonio , Cecconi Lorenzo , Ferro Salvatore 
Published: January 2018

Purpose
The aim of the study was to assess early poststroke prognostic factors in patients admitted for postacute phase rehabilitation.

Methods
A 1-yr multicenter prospective project was conducted in four Italian regions on 352 patients who were hospitalized after a first stroke and were eligible for postacute rehabilitation. Clinical data were collected in the stroke or acute care units (acute phase), then in rehabilitation units (postacute phase), and, subsequently, after a 6-mo poststroke period (follow-up). Clinical outcome measures were represented using the Barthel Index and the modified Rankin Scale. Univariate and multivariate analyses were performed to identify the most important prognostic index.

Results
Modified Rankin Scale score, minor neurologic impairment, and early out-of-bed mobilization (within 2 days after the stroke) proved to be important factors related to a better recovery according to Barthel Index (power of prediction = 37%). Similarly, age, premorbid modified Rankin Scale score, and early out-of-bed mobilization were seen to be significant factors in achieving better overall participation and activity according to the modified Rankin Scale (power of prediction = 48%). Barthel Index at admission and certain co-morbidities were also significant prognostic factors correlated with a better outcome.

Conclusions
According to the Barthel Index and modified Rankin Scale, early mobilization is an early predictor of favorable outcome.

To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives
Upon completion of this article, the reader should be able to: (1) Incorporate prognostic factors of good clinical outcomes after stroke in developing treatment plans for patients admitted to rehabilitation; (2) Identify acute phase indicators associated with favorable 6-mo outcome after stroke; and (3) Recognize the cut-off for early mobilization linked to better outcome in stroke survivors admitted to rehabilitation.

Level
Advanced

Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Percutaneous Ultrasound-Guided Musculoskeletal Applications of Autologous Bone Marrow Aspirate Concentrate
Authors: Garwood Elisabeth R. , Burke Christopher J. , Jazrawi Laith M. , Adler Ronald S. 
Published: January 2018

Abstract
Emerging musculoskeletal applications for local administration of autologous bone marrow aspirate concentrate (BMAC) include treatment of fractures, osteonecrosis, osteochondral injuries, osteoarthritis, ligament injury, tendon injury, and tendonopathies. Ultrasound-guided technique for various BMAC injection sites is detailed in this technical report and our preliminary clinical experience outlined.
Five patients, 1 woman and 4 men, were treated with 6 peri/intratendinous (n = 4) or intraarticular (n = 2) BMAC injections between July 5, 2015 and December 31, 2016 for the clinical indications of common hamstrings origin tendinosis (n = 4), hip labral tear (n = 1), and osteochondral lesion of the talus (n = 1).
All procedures were technically successful, with BMAC locally administered to the therapeutic target and no procedural complications observed. Clinical follow-up was available for 5 of 6 procedures. Four of 5 injections resulted in self-reported symptomatic improvement (clinical follow-up range, 2–12 months). One 72-year-old man with right common hamstrings origin tendinosis reported no improvement after BMAC injection.
The technology is now available to support ultrasound-guided, autologous BMAC administration by the musculoskeletal interventionalist for common indications. Our initial clinical experience is consistent with early reports in the literature. This technique is well tolerated by symptomatic patients on an outpatient basis, and rates of self-reported symptomatic relief are high. Mechanism of action, long-term safety, and long-term clinical efficacy remain largely undefined.
Prevalence and Clinical Correlates of Chronic Hepatitis E Infection in German Renal Transplant Recipients With Elevated Liver Enzymes
Authors: Choi Mira , Hofmann Jörg , Köhler Anja , Wang Bo , Bock Claus-Thomas , Schott Eckart , Reinke Petra , Nickel Peter 
Published: January 2018

Background
Elevated liver enzymes are frequently observed in renal transplant recipients and warrant further exploration. In immunosuppressed patients, hepatitis E virus (HEV) infection may cause chronic hepatitis, cirrhosis, and extrahepatic manifestations such as renal injury.

Methods
We performed a retrospective cross-sectional study investigating the prevalence, clinical correlates, and outcome of chronic HEV infection in a cohort of renal transplant recipients with elevated liver enzymes.

Results
Over a period of 30 months, 140 of 1469 renal transplant recipients had elevated liver enzymes, of which serum samples from 98 patients were available to determine HEV status. Seventeen patients were detected with HEV infection, of which 16 developed chronic HEV infection, while 1 patient controlled viremia (prevalence of chronic infection of 16.3%, with a minimum prevalence of 1.1% in the whole cohort). Increased liver stiffness was indicated by an average FibroScan result of 11.2 kPa in these patients. All 16 patients with chronic HEV infection were treated with ribavirin for a mean duration of 3 months. Five patients developed a viral rebound and received a second treatment course, of which 2 controlled HEV replication. Six months after the end of therapy, HEV clearance was achieved in 81.3% of the patients. One patient developed ribavirin resistance. Hemolytic anemia after ribavirin treatment was frequent, requiring blood transfusion in 3 patients. Four patients developed de novo glomerulonephritis, of which 2 were possibly associated with HEV infection.

Conclusions
This retrospective study showed that prevalence of chronic HEV infection was high in our renal transplant patient cohort and was associated with significant liver impairment and the occurrence of renal injury. Ribavirin treatment was effective and should be initiated early to avoid complications, but the risk of severe hemolytic anemia makes strict monitoring essential.
Phospho-ERK is a response biomarker to a combination of sorafenib and MEK inhibition in liver cancer
Authors: Wang Cun , Jin Haojie , Gao Dongmei , Evers Bastiaan , Jin Guangzhi , Xue Zheng , Wang Liqin , Beijersbergen Roderick , Qin Wenxin , Bernards René 
Published: January 2018

AbstractTreatment of liver cancer remains challenging, due to a paucity of drugs that target critical dependencies. Sorafenib is a multikinase inhibitor that is approved as the standard therapy for advanced hepatocellular carcinoma patients, but it can only provide limited survival benefit for patients. To investigate the cause of this limited therapeutic effect, we performed a CRISPR-Cas9 based synthetic lethality screen to search for kinases whose knockout synergize with sorafenib. We find that suppression of ERK2 sensitizes several liver cancer cell lines to sorafenib. Drugs inhibiting the MEK or ERK kinases reverse unresponsiveness to sorafenib in vitro and in vivo in a subset of liver cancer cell lines characterized by high levels of active phospho-ERK levels through synergistic inhibition of ERK kinase activity. Our data provide a combination strategy for treating liver cancer and suggest that tumors with activation of p-ERK, which is seen in some 30% of liver cancers, are most likely to benefit from such combinatorial treatment.
Control of artefactual variation in reported inter-sample relatedness during clinical use of a Mycobacterium tuberculosis sequencing pipeline
Authors: Wyllie David H , Sanderson Nicholas , Myers Richard , Peto Tim , Robinson Esther , Crook Derrick W , Smith Grace , Walker A Sarah 
Published: January 2018

ABSTRACTContact tracing requires reliable identification of closely related bacterial isolates. When we noticed the reporting of artefactual variation between M. tuberculosis isolates during routine next generation sequencing of Mycobacterium spp, we investigated its basis in 2,018 consecutive M. tuberculosis isolates. In the routine process used, clinical samples were decontaminated and inoculated into broth cultures; from positive broth cultures DNA was extracted, sequenced, reads mapped, and consensus sequences determined. We investigated the process of consensus sequence determination, which selects the most common nucleotide at each position. Having determined the high-quality read depth and depth of minor variants across 8,006 M. tuberculosis genomic regions, we quantified the relationship between the minor variant depth and the amount of non-Mycobacterial bacterial DNA, which originates from commensal microbes killed during sample decontamination. In the presence of non-Mycobacterial bacterial DNA, we found significant increases in minor variant frequencies of more than 1.5 fold in 242 regions covering 5.1% of the M. tuberculosis genome. Included within these were four high variation regions strongly influenced by the amount of non-Mycobacterial bacterial DNA. Excluding these four regions from pairwise distance comparisons reduced biologically implausible variation from 5.2% to 0% in an independent validation set derived from 226 individuals. Thus, we have demonstrated an approach identifying critical genomic regions contributing to clinically relevant artefactual variation in bacterial similarity searches. The approach described monitors the outputs of the complex multi-step laboratory and bioinformatics process, allows periodic process adjustments, and will have application to quality control of routine bacterial genomics.
Perception of corruption in e-government services post-launch of “Digital India”: role of demographic variables
Authors: Saxena Stuti 
Published: January 2018

PurposeThe purpose of this paper is to underline the role of demographic variables as far as the perception of corruption among the Indian respondents is concerned.Design/methodology/approachHierarchical regression analysis is conducted to ascertain the role of demographic variables in line with the study’s objectives.FindingsGender is a demographic factor that influences the perception of corruption by the respondents. Other demographic factors including education, marital status, professional status and age do not have any influence on the user perception of corruption in e-government services. Implicitly, there are differences in the manner in which men and women perceive the prevalence of corruption in India. Therefore, males perceive that corruption has decreased in e-government services post-launch of “Digital India” initiative and women perceive the opposite.Research limitations/implicationsOn the one hand, the study holds significance, in that no empirical investigation has been conducted which seeks to underline the impact of the “Digital India” initiatives on the citizen’s perception of corruption in public services. On the other hand, the present research is limited in the sense that only demographic variables are being probed in the present study with a small sample.Originality/valueStudies in developing countries have remained few and far between despite the growing concern for existence of corruption in government services. The present study seeks to fill the gap by underlining the role of demographic variables as far as the perception of corruption in public services is concerned in the Indian context.
Exploring education-related use of social media: business students perspectives in a changing India
Authors: Bharucha Jehangir 
Published: January 2018

Purpose
Within a connectivist learning model, the purpose of this paper is to investigate the adoption of social media for educational purposes in India, a hitherto unexplored area of research. The basic research thrust is on students’ experiences when social media is incorporated into higher education. This research tries to gather evidence on the effectiveness of this role and its potential future role as a facilitator and enhancer of learning in the Indian system.

Design/methodology/approach
The current research draws on the perspectives of the students regarding the adoption of social media for educational purposes. The data collection was done in two separate stages. Stratified random sampling was applied and a structured questionnaire was sent via e-mail. Usable responses were received from 568 respondents. The second stage consisted of an exploratory qualitative study using in-depth interviews and reflections of 250 students from the original sample.

Findings
Four clear themes emerged from the responses collected via the structured questionnaire and particularly from the in-depth interviews. These include: widespread usage of social media, definite usage in business education, strengths of social media in business education and the flip side of learning with social media. One thing is certain: social media will continue to play an important role in the Indian education sector. A number of colleges and universities in India are including social media in their pedagogy, but the challenge lies in effectively aligning it with curriculum.

Practical implications
Despite the widespread use of online social media for communication and entertainment, the use in the educational sphere seems to be less. This year-long study tries to gather evidence on all these issues. No doubt social media’s contribution in the classroom depicts a rising interest in technology as a tool to assist learning but it also reinforces a paradigm shift in the way students learn.

Social implications
With nearly a billion people on mobile phones, the online system certainly has vast potential to create the right kind of learning. As this study has shown at a micro-level, technology-led reach and easy access is bringing about a socio-economic difference in the lives of Indian learners. While this study certainly supports digital learning in India it points out that higher educational institutions are yet to exploit its full advantage for better student engagement.

Originality/value
One key characteristic of this generation is that they are very education oriented. Due to the relative freshness of the approach in India and fairly restricted use in the Indian higher education system, empirical studies are limited and the impact of social media on student engagement in the higher education system in India is not known.