bluuebunny/crossref_metadata_2025_split huggingface dataset:
Objective Assessment of Vergence after Treatment of Concussion-Related CI: A Pilot Study
Authors: Scheiman Mitchell M. , Talasan Henry , Mitchell G. Lynn , Alvarez Tara L. 
Published: July 2016

ABSTRACT

Purpose
To evaluate changes in objective measures of disparity vergence after office-based vision therapy (OBVT) for concussion-related convergence insufficiency (CI) and determine the feasibility of using this objective assessment as an outcome measure in a clinical trial.

Methods
This was a prospective, observational trial. All participants were treated with weekly OBVT with home reinforcement. Participants included two adolescents and three young adults with concussion-related, symptomatic CI. The primary outcome measure was average peak velocity for 4° symmetrical convergence steps. Other objective outcome measures of disparity vergence included time to peak velocity, latency, accuracy, settling time, and main sequence. We also evaluated saccadic eye movements using the same outcome measures. Changes in clinical measures (near point of convergence, positive fusional vergence at near, Convergence Insufficiency Symptom Survey [CISS] score) were evaluated.

Results
There were statistically significant and clinically meaningful changes in all clinical measures for convergence. Four of the five subjects met clinical success criteria. For the objective measures, we found a statistically significant increase in peak velocity, response accuracy to 4° symmetrical convergence and divergence step stimuli, and the main sequence ratio for convergence step stimuli. Objective saccadic eye movements (5 and 10°) appeared normal pre-OBVT and did not show any significant change after treatment.

Conclusions
This is the first report of the use of objective measures of disparity vergence as outcome measures for concussion-related convergence insufficiency. These measures provide additional information that is not accessible with clinical tests about underlying physiological mechanisms leading to changes in clinical findings and symptoms. The study results also demonstrate that patients with concussion can tolerate the visual demands (over 200 vergence and versional eye movements) during the 25-minute testing time and suggest that these measures could be used in a large-scale randomized clinical trial of concussion-related CI as outcome measures.
Vision Therapy for Binocular Dysfunction Post Brain Injury
Authors: Conrad Joseph Samuel , Mitchell G. Lynn , Kulp Marjean Taylor 
Published: July 2016

ABSTRACT

Purpose
To prospectively evaluate the effectiveness of home-based computer vergence therapy for the treatment of binocular vision disorders in adults at least 3 months after an acquired brain injury.

Methods
Eligibility criteria included presence of binocular dysfunction characterized by receded near point of convergence (≥6 cm break), insufficient positive fusional vergence at near (failing Sheard’s criterion or <15△ blur or break), insufficient negative fusional vergence at near (<12△ blur or break), and/or reduced vergence facility at near (<15 cycles per minute with 12△BO/3△BI). Participants were prescribed 12 weeks of home-based computer vergence therapy. Phoria (cover test), negative fusional vergence, positive fusional vergence, near point of convergence, vergence facility, and symptoms (convergence insufficiency symptom survey [CISS]) were assessed at baseline and after 4, 8, and 12 weeks of prescribed therapy. ANOVA was used to evaluate change in each measure. Percentage successful was also determined.

Results
Nineteen participants were enrolled (mean age 45.4 ± 12.9 years); six participants were lost to follow-up. Baseline findings were orthophoria at distance, 7.2△ exophoria at near, near point of convergence break = 17.5 cm, near point of convergence recovery = 21.8 cm, negative fusional vergence = 12.3△, positive fusional vergence blur = 8.4△, vergence facility = 3.9 cycles per minute, and CISS = 32.1. ANOVA showed a statistically significant improvement for near point of convergence break (p = 0.002) and recovery (p < 0.001), positive fusional vergence blur (p < 0.0001), break (p < 0.0001), and recovery (p < 0.0001), negative fusional vergence blur (p = 0.037), break (p = 0.003), and recovery (p = 0.006), vergence facility (p < 0.0001), and CISS (p = 0.0001). The percentage of patients who were classified as “successful” or “improved” was 69% for near point of convergence (<6 cm or decrease of ≥4 cm), 77% for positive fusional vergence (>15△ and passing Sheard’s criterion or increase of ≥10△), 77% for negative fusional vergence (≥12△ or increase of ≥6△), 62% for positive fusional vergence and near point of convergence composite, and 92% for vergence facility (15 cycles per minute or increase of 3 cycles per minute).

Conclusions
The majority of participants who completed the study experienced meaningful improvements in signs and symptoms.
Survey of Sedation and Analgesia Practice Among Canadian Pediatric Critical Care Physicians*
Authors: Garcia Guerra Gonzalo , Joffe Ari R. , Cave Dominic , Duff Jonathan , Duncan Shannon , Sheppard Cathy , Tawfik Gerda , Hartling Lisa , Jou Hsing , Vohra Sunita 
Published: July 2016

Background:
Despite the fact that almost all critically ill children experience some degree of pain or anxiety, there is a lack of high-quality evidence to inform preferred approaches to sedation, analgesia, and comfort measures in this environment. We conducted this survey to better understand current comfort and sedation practices among Canadian pediatric intensivists.

Methods:
The survey was conducted after a literature review and initial focus groups. The survey was then pretested and validated. The final survey was distributed by email to 134 intensivists from 17 PICUs across Canada using the Research Electronic Data Capture system.

Results:
The response rate was 73% (98/134). The most commonly used sedation scores are Face, Legs, Activity, Cry, and Consolability (42%) and COMFORT (41%). Withdrawal scores are commonly used (65%). In contrast, delirium scores are used by only 16% of the respondents. Only 36% of respondents have routinely used sedation protocols. The majority (66%) do not use noise reduction methods, whereas only 23% of respondents have a protocol to promote day/night cycles. Comfort measures including music, swaddling, soother, television, and sucrose solutions are frequently used. The drugs most commonly used to provide analgesia are morphine and acetaminophen. Midazolam and chloral hydrate were the most frequent sedatives.

Conclusion:
Our survey demonstrates great variation in practice in the management of pain and anxiety in Canadian PICUs. Standardized strategies for sedation, delirium and withdrawal, and sleep promotion are lacking. There is a need for research in this field and the development of evidence-based, pediatric sedation and analgesia guidelines.
The Influence of Different Solvents on Systemic Sclerosis
Authors: Zhao Jiu-Hua , Duan Yu , Wang Yu-Jie , Huang Xiao-Lei , Yang Guo-Jun , Wang Jing 
Published: July 2016

Background
Several studies have collected detailed data to examine which specific solvents account for the association between solvents and risk of systemic sclerosis (SSc). These studies generally reported elevated risks associated with many of the specific solvents examined, such as toluene, xylene, and trichloroethylene. The previous meta-analysis was not able to conduct separate analyses for specific solvent subtypes.

Objective
The aims of the new meta-analysis were to investigate a more comprehensive estimate and to consider the effect of different solvents on SSc.

Methods
We searched PubMed, Biosis Previews, China National Knowledge Infrastructure, and Wanfang for all articles published before July 2015. Fourteen case-control studies (1657 patients and 3838 controls) were included. The quality of studies was scored according to the Newcastle-Ottawa scale. The final odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by a fixed- or random-effects model according to heterogeneity test. Publication bias was assessed using Begg test.

Results
The risk of SSc was significantly different among sex, age, and exposure assessment methods. Separate analyses for specific solvent subtypes indicated that SSc was associated with aromatic solvents (OR, 2.72; 95% CI, 1.21–6.09), trichloroethylene (OR, 2.07; 95% CI, 1.34–3.17), halogenated solvents (OR, 1.49; 95% CI, 1.12–1.99), and ketones (OR, 4.20; 95% CI, 2.19–8.06).

Conclusions
Exposure to identified types solvents does seem to be a risk factor for developing SSc. Needed efforts to decrease such exposures are discussed.
Sleep Quality Is Related to Disease Activity in Patients With Ankylosing Spondylitis
Authors: İn Erdal , Turgut Teyfik , Gülkesen Arif , Yolbaş Servet , Akgöl Gürkan , Koca Süleyman Serdar 
Published: July 2016

Background
Ankylosing spondylitis (AS) is a chronic inflammatory disease that is associated with poor sleep quality.

Objectives
The present study aimed to investigate the relationship between disease activity and sleep quality in patients with AS and to evaluate the potential effect of anti–tumor necrosis factor (TNF) treatment on sleep quality and pattern.

Methods
Fifty-nine patients with AS were consecutively included in the study. Twenty-eight patients (47.5%) were receiving anti-TNF, and 31 (52.5%) patients were receiving only nonsteroidal anti-inflammatory drugs (NSAIDs). Demographic and treatment characteristics, spinal mobility measurements, disease activity measurements, and sleep questionnaire results of each patient were recorded. Each patient underwent a polysomnography examination for the evaluation of sleep patterns.

Results
When compared with the patients on NSAID treatment, patients receiving anti-TNF treatment had significantly greater total sleep time and sleep efficiency (P = 0.003 and P < 0.001, respectively). They had a significantly lower (better) Pittsburgh Sleep Quality Index, sleep onset latency, number of awakenings, and arousal index (P < 0.001, for all). Moreover, they had a significantly shorter superficial sleep period (stage 1) and a significantly longer rapid eye movement sleep period (P < 0.001 and P = 0.02, respectively). Higher indexes of disease activity (Bath AS Disease Activity Index, Bath AS Functional Index, and visual analog scale) were reflecting poorer sleep quality.

Conclusions
Sleep quality and pattern was markedly better in patients with AS on anti-TNF compared with the patients on NSAID treatments. Increased disease activity can impair the quality of sleep in AS. Improved sleep quality and pattern in patients on anti-TNF treatment may be related to improved disease activity.
Leprosy Masquerading as Systemic Rheumatic Diseases
Authors: El-Gendy Hala , El-Gohary Rasmia M. , Shohdy Kyrillus S. , Ragab Gaafar 
Published: July 2016

Abstract
Rheumatologic manifestations not only are encountered in leprosy but also can be the first and even the sole presenting manifestation. The hallmark of leprosy is skin and peripheral nerve affection; however, it can affect a wide range of other organs, with the joints being the commonest. We have searched PubMed with the key words leprosy, arthritis, vasculitis, rheumatic diseases, and autoantibodies in a proper combination. Relevant studies were retrieved from scanning of their abstracts. The relevant references provided in these articles were also selected and reviewed. We summarize the clinical and laboratory manifestations that make leprosy masquerade as a systemic rheumatic disease. Moreover, we report 4 Egyptian patients who presented with rheumatologic manifestations, namely, arthritis and vasculitis that turned out to be leprosy related.
Rheumatology Resources in a Region of Buenos Aires Province, Argentina
Authors: Fara Nauan , Sequeira Gabriel 
Published: July 2016

Background
Accurate knowledge of the available rheumatology workforce and their working conditions results in better care for patients with rheumatic diseases.

Objective
The aim of this study was to assess the rheumatology resources and their distribution within district V of the College of Physicians (COLMED5) of Buenos Aires Province, Argentina.

Methods
All the registered rheumatologists and all the registered public and private institutions within COLMED5 were identified. Aside from these data, phone calls, letters, Internet-derived information, and databases from public and private health insurance providers and the Argentine Society of Rheumatology were included as well. Rheumatologists’ per-capita rates were built for both the whole district and every town. A rate of at least 1 rheumatologist per 50,000 people was deemed an optimal resource.

Results
Thirty-six rheumatologists were identified; the calculated rate was 1 rheumatologist per 68,403 people; 44% of the health care institutions had a rheumatologist; 33% of them were public institutions. Only 25.5% of COLMED5 total population had optimal rheumatology resources in their town, 70.3% did not reach the optimal resource level but at least had a rheumatologist in their town, and 4.2% had no resources whatsoever; 49% of the total population lacked public health care facilities with inpatient settings and rheumatologists in their town.

Conclusions
Although COLMED5 has 72% of the optimal number of rheumatologists, because of their uneven distribution, only 25.5% of the district’s total population has the optimal rheumatology resources in their town. Nearly half COLMED5 total population lacks public health care facilities with inpatient settings and rheumatologists in their town, and 4.2% has no available rheumatology resource at all.
Treatment of Large Thyroglossal Duct Cyst
Authors: Bezerra Júnior Germano de Lelis , Silva Leonardo de Freitas , Pimentel Gabriel Gomes , Laureano Filho José Rodrigues , Nogueira Renato Luiz Maia 
Published: July 2016

Abstract
The thyroglossal duct cyst is the neck congenital abnormality most common in the childhood. Clinically, it shows itself as a solitary neck mass in the region of hyoid bone, it is painless and can be dislocated during de physical examination and tongue protrusion. The most common treatment is its removal through the Sistrunk technique. Patient with diagnosis of thyroglossal duct cyst in neck region with extension to the mouth floor was treated by total surgical removal through intraoral access. The intraoral approach to the treatment of the thyroglossal duct cyst showed itself practicable and permitted the total removal of the lesion with no recurrence signs.
Classification of Kidney Transplant Recipients Using a Combination of Estimated GFR and Albuminuria Reflects Risk
Authors: White Christine A. , Akbari Ayub , Talreja Hari , Lalani Neha , Knoll Greg A. 
Published: July 2016

Background
The 2012 Kidney Dialysis Initiative Global Outcomes chronic kidney disease (CKD) classification scheme subdivides stage 3 CKD and incorporates the urinary albumin-to-creatinine ratio (ACR). The aim of this study was to evaluate whether the novel scheme provides graded risk in kidney transplant recipients (KTRs).

Methods
Prevalent KTRs with available laboratory data were included. The primary outcome was a composite of doubling of serum creatinine, graft failure, or death. Patients were stratified using the CKD-Epidemiolgic Collaboration equation, and ACR and the event rate per 1000 patient-years in each CKD category were calculated.

Results
There were 269 KTRs with a mean follow-up of 4.5 ± 2.0 years. There was a graded increase in outcomes with increasing ACR and decreasing estimated glomerular filtration rate (eGFR). For the primary outcome, the event rate was 15.3 (95% confidence interval, 4.2-39.2) per 1000 patient-years for those with an eGFR greater than 60 mL/min per 1.73 m2 and an ACR less than 30 mg/g, whereas it was 375 (95% confidence interval, 193.8-655.1) for those with an eGFR less than 30 mL/min per 1.73 m2 and an ACR greater than 300 mg/g.

Conclusions
The novel Kidney Dialysis Initiative Global Outcomes classification scheme provides graded risk for important clinical events in KTRs. This information can be used to identify high-risk patients and to tailor follow-up and management strategies aimed at improving outcomes.
MRI Markers Predict Cognitive Decline Assessed by Telephone Interview
Authors: Wright Clinton B. , Dong Chuanhui , Caunca Michelle R. , DeRosa Janet , Kuen Cheng Ying , Rundek Tatjana , Elkind Mitchell S.V. , DeCarli Charles , Sacco Ralph L. 
Published: July 2016

Background:
Brain magnetic resonance imaging (MRI) allows researchers to observe structural pathology that may predict cognitive decline. Some populations are less accessible through traditional in-person visits, and may be under-represented in the literature.

Methods:
We examined white matter hyperintensity volume (WMHV) and cerebral parenchymal fraction (CPF) as predictors of cognitive decline measured by a modified Telephone Interview for Cognitive Status (TICS-m) in the Northern Manhattan Stroke Study, a racially and ethnically diverse cohort study. Participants were stroke-free, above 50 years old, and had no contraindications to MRI. A total of 1143 participants had MRI and TICS-m data available [mean age 70 (SD=9), 61% women, 66% Hispanic, 17% Black, 15% white].

Results:
Those in the third and fourth quartiles of WMHV had significantly greater decline in TICS-m over time as compared with those in the first quartile (Q3: −0.17 points/year, Q4: −0.30 points/year). Those in the bottom 2 quartiles of CPF had significantly greater decline in TICS-m than those in the top quartile (Q1: −0.3 points/year, Q2: −0.2 points/year). Apolipoprotein E (APOE) e4 allele carriers had greater cognitive decline per unit of CPF. Those with greater CPF preserve TICS-m performance better despite greater WMHV.

Conclusions:
Telephone cognitive assessments can detect decline due to white matter lesions and smaller brain volumes.
Optic Disc Metastasis as the Presenting Sign of Lung Adenocarcinoma
Authors: Micieli Jonathan A. , Margolin Edward A. 
Published: July 2016

Abstract:
A 67-year-old woman noticed vision loss in her right eye and was found to have an elevated, well-circumscribed white mass within the right optic disc. The patient underwent an evaluation which revealed 4 brain metastases and a large left hilar mass that proved to be adenocarcinoma of the lung. Because she continued to lose vision, the optic disc metastasis was treated with stereotactic radiotherapy. Although she reported vision improvement, she died soon afterward. There are 9 previous reports in the English literature of isolated optic disc metastasis as the presenting sign of cancer. Familiarity with the features of optic disc metastasis can lead to earlier recognition and treatment of the underlying malignant neoplasm.
Discovery of Cancer Driver Long Noncoding RNAs across 1112 Tumour Genomes: New Candidates and Distinguishing Features
Authors: Lanzós Andrés , Carlevaro-Fita Joana , Mularoni Loris , Reverter Ferran , Palumbo Emilio , Guigó Roderic , Johnson Rory 
Published: July 2016

AbstractLong noncoding RNAs (lncRNAs) represent a vast unexplored genetic space that may hold missing drivers of tumourigenesis, but few such “driver lncRNAs” are known. Until now, they have been discovered through changes in expression, leading to problems in distinguishing between causative roles and passenger effects. We here present a different approach for driver lncRNA discovery using mutational patterns in tumour DNA. Our pipeline, ExInAtor, identifies genes with excess load of somatic single nucleotide variants (SNVs) across panels of tumour genomes. Heterogeneity in mutational signatures between cancer types and individuals is accounted for using a simple local trinucleotide background model, which yields high precision and low computational demands. We use ExInAtor to predict drivers from the GENCODE annotation across 1112 entire genomes from 23 cancer types. Using a stratified approach, we identify 15 high-confidence candidates: 9 novel and 6 known cancer-related genes, includingMALAT1,NEAT1andSAMMSON. Both known and novel driver lncRNAs are distinguished by elevated gene length, evolutionary conservation and expression. We have presented a first catalogue of mutated lncRNA genes driving cancer, which will grow and improve with the application of ExInAtor to future tumour genome projects.
Chaotic propagation of spatial cytoskeletal instability modulates integrity of podocyte foot processes
Authors: Falkenberg Cibele V. , Azeloglu Evren U. , Stothers Mark , Deerinck Thomas J. , Chen Yibang , He John C. , Ellisman Mark H. , Hone James C. , Iyengar Ravi , Loew Leslie M. 
Published: July 2016

AbstractThe kidney podocyte’s function depends on its distinctive morphology. Each podocyte has fingerlike projections, called foot processes, that interdigitate with the processes of neighboring cells to form the glomerular filtration barrier. The integrity of foot process interactions depends on tight spatial control of the dynamics of the underlying actin cytoskeleton, which is regulated by the GTPases, Rac1 and RhoA. To understand how spatially-specific regulation of actin filament dynamics within foot processes controls local morphology, we used a combination of 3-D microscopy and dynamical models. We experimentally determined cell-cell interactions using serial blockface scanning electron microscopy and reconstructed a 3-D spatial representation of a podocyte. We developed a minimal dynamical system for regulation of the actin cytoskeleton; using this 3-D model, we determined how spatial reaction-diffusion dynamics can dysregulate actin bundling, leading to propagation of chaotic foot process effacement. Consistent with experimental observations, our simulations predicted that hyperactive RhoA could destabilize the cytoskeleton. Our simulations showed that deleterious mechanochemical stimuli could lead to local heterogeneity of cytoskeletal dynamics resulting in the emergence of progressive and chaotic loss of foot processes. While global enhancement of Rac1 may result in stronger bundles, the spatial simulations showed that even transient local heterogeneities in polymerization could have dramatic consequences in the stability of multiple foot processes. We conclude that the podocyte morphology optimized for filtration contains intrinsic fragility whereby local imbalances in biochemical and biophysical reactions lead to morphological changes associated with glomerular pathophysiology.