bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vibrotactile Thresholds on the Mastoid and Forehead Position of Deaf Patients Using Radioear B71 and B81
Authors: Fredén Jansson Karl-Johan , Håkansson Bo , Reinfeldt Sabine , Fröhlich Laura , Rahne Torsten 
Published: July 2017

Objectives:
The main objective of this study was to measure the vibrotactile thresholds on the mastoid process and forehead positions using patients with bilateral deafness and to compare the results from the two bone conduction vibrators Radioear B71 and B81.

Design:
There is a possibility that the vibrotactile sensation on the skin makes it difficult to discriminate between sound and vibration. The risk is highest for patients who have bone conduction hearing thresholds in proximity to or worse than their vibrotactile thresholds. All measurements were performed similar to regular bone conduction threshold testing using an audiometer-driven bone conduction vibrator and pulsed warble tones, but the patients were instructed to respond only when feeling vibrations of the bone conduction vibrator instead of when hearing sound. Both the posterior forehead position and the mastoid process position on the temporal bone were tested for comparative reasons. In total, 16 patients participated in the study, 31% females and 69% males of age 29 to 77 years. All subjects were cochlear implant recipients, either uni- or bilaterally implanted. They were selected based on their audiogram data showing unmeasurable unaided hearing.

Results:
The force level at which the vibrotactile thresholds were reached, increased with frequency from 125 up to 500 Hz, but remained constant for higher frequencies up to 2 kHz. A statistically significant difference was found between the 2 devices at 125 Hz at both the mastoid process and forehead position, where the vibrotactile threshold seem to be more sensitive for B71, possibly due to contribution of distortion components. There was no statistically significant difference in vibrotactile thresholds between the mastoid process and forehead position in absolute values (force level in dB re 1 µN), but in terms of hearing levels (dB HL) there was an average difference of 10 and 9 dB for B71 and B81, respectively.

Conclusions:
The results indicate that the vibrotactile thresholds can be confounded with bone conduction hearing thresholds measurements up to 500 Hz when using a standard audiometer and in particular when measuring on the forehead position.
sMap3D Corneo-Scleral Topographer Repeatability in Scleral Lens Patients
Authors: DeNaeyer Gregory , Sanders Donald R. 
Published: July 2017

Objectives:
To determine repeatability of measurements using the sMap3D Corneo-Scleral Topographer in patients presenting for scleral lens fitting.

Methods:
As part of our standard clinical evaluation, 25 eyes of 23 patients who presented for scleral lens fitting were examined twice in the same day with the sMap3D in this retrospective study. Sagittal height (SAG), sMap3D principal toricity magnitude (as calculated by the instrument software), and steep axis location were measured at a 16-mm chord diameter. Up gaze, primary, and down gaze positions of each eye were imaged and “stitched” by the instrument software into a single corneoscleral topography map from which the measurements were derived.

Results:
The mean difference in SAG between the 2 examinations was 14 μm with an SD of 55 μm. Sixty-eight percent of cases had a difference of ≤50 μm, and 95% of cases had a difference of ≤100 μm. The mean difference in sMap3D principal toricity magnitude between examinations was 0.15 diopter (D) with an SD of 0.38 D. Eighty-four percent of cases had a difference of ≤0.5 D, and all cases had a difference of <1 D. Mean toric axis difference between examinations was 2.5° with an SD of 18.4°. Sixty-four percent of cases had an axis difference of ≤10°, and 84% had an axis difference of ≤15°.

Conclusions:
The sMap3D measurements are repeatable with regard to scleral toricity and SAG values at a 16-mm diameter and thus would be suitable to use for scleral lens fitting.
Refractive and Corneal Aberrometric Changes After Crescentic Lamellar Wedge Resection in Pellucid Marginal Degeneration
Authors: Genç Selim , Çakir Hanefi , Güler Emre , Çalli Ümit 
Published: July 2017

Objective:
To evaluate the effectiveness of crescentic corneal lamellar wedge resection for the treatment of pellucid marginal degeneration (PMD) in improving refractive, visual, and corneal aberrometry.

Methods:
The study included 10 eyes of 10 patients who had undergone corneal lamellar wedge resection for PMD. Pellucid marginal degeneration was diagnosed based on the clinical signs and corneal topography. The corneal aberrometry was evaluated with Sirius corneal topography.

Results:
The mean follow-up period was 14.1 months (range, 9–24 months). Uncorrected visual acuity was improved in nine eyes and remained unchanged in 1 case, whereas best-corrected visual acuity was improved in all eyes postoperatively. By vector analysis, the overall mean astigmatic drift at the last visit was calculated to be 13.0±6.3 diopters (D). At last visit, significant reductions were found for all aberrometric measurements. However, the differences were not significant for the measurements of trefoil (P=0.189).

Conclusions:
Corneal lamellar wedge resection is a favorable surgical option for management of PMD, allowing for improved visual acuity, keratometric cylinder, and corneal aberrations.
Translating evidence into practice in acute respiratory distress syndrome: teamwork, clinical decision support, and behavioral economic interventions
Authors: Sjoding Michael W. 
Published: July 2017

Purpose of review
Although the treatment of the acute respiratory distress syndrome (ARDS) with low tidal volume (LTV) mechanical ventilation improves mortality, it is not consistently administered in clinical practice. This review examines strategies to improve LTV and other evidence-based therapies for patients with ARDS.

Recent findings
Despite the well established role of LTV in the treatment of ARDS, a recent multinational study suggests it is under-utilized in clinical practice. Strategies to improve LTV include audit and feedback, provider education, protocol development, interventions to improve ICU teamwork, computer decision support, and behavioral economic interventions such as making LTV the default-ventilator setting. These strategies typically target all patients receiving invasive mechanical ventilation, effectively avoiding the problem of poor ARDS recognition in clinical practice. To more effectively administer advanced ARDS therapies, such as prone positioning, better approaches for ARDS recognition will also be required.

Summary
Multiple strategies can be utilized to improve adherence to LTV ventilation in ARDS patients.
Update in Natural Orifice Translumenal Endoscopic Surgery (NOTES)
Authors: Bernhardt Joern , Sasse Sarah , Ludwig Kaja , Meier Peter N. 
Published: July 2017

Purpose of review
The recent developments and clinical applications of natural orifice translumenal endoscopic surgery (NOTES)-procedures and technologies are going to be presented.

Recent findings
In experimental as well as clinical settings, NOTES-procedures are predominantly performed in hybrid technique. Current experimental studies focus on the implementation of new surgical approaches as well as on the training of procedures. One emphasis in the clinical application is transrectal and transanal interventions. Transanal total mesorectal excision is equivalent to laparoscopic procedures but with the benefit of an even less invasive access. Transvaginal cholecystectomy can achieve results that are comparable to surgeries that are performed with laparoscopic techniques alone. An analysis of the German NOTES-Register concerning appendectomies as well as the national performance of NOTES-interventions in Switzerland is presented. Apart from intraabdominal approaches, several centers proclaim transoral thyroidectomies and transoral mediastinoscopies.

Summary
NOTES-procedures are performed in animal experiments as well as in clinical setting although with less frequency. At this time, hybrid techniques using rigid instruments are mainly applied.
Cholesterol reduction and macrophage function: role of paraoxonases
Authors: White C. Roger , Anantharamaiah G.M. 
Published: July 2017

Purpose of review
Unregulated uptake of oxidized LDL by macrophages to form foam cells is the hallmark for atherosclerosis. The paraoxonase (PON) family of enzymes plays a critical role in attenuating atherosclerotic lesion formation by hydrolyzing lipid peroxides (LOOHs) and preventing the oxidation of LDL particles and by enhancing HDL-mediated cholesterol efflux. Findings in recent years suggest novel mechanisms by which PON isoforms interact with macrophages to regulate cholesterol metabolism and cellular function.

Recent findings
The association of PON with HDL particles facilitates binding of the particle to macrophages and ABCA1-dependent cholesterol efflux. The hydrolysis of membrane phospholipids by PON generates lysophosphatidylcholine which is shown to regulate expression of cholesterol transport proteins. The PON family also regulates multiple aspects of macrophage function. PON attenuates inflammation and prevents induction of apoptosis via activation of a scavenger receptor class B type-1-dependent signaling mechanism. PON limits macrophage-dependent oxidant formation by preventing the activation of the membrane-associated NADPH oxidase and by stabilizing mitochondria. PON also promotes the differentiation of macrophages to an anti-inflammatory phenotype. This function appears to be independent of PON enzymatic activity and, rather, is dependent on the ability of endogenous sulfhydryls to neutralize pro-inflammatory peroxides.

Summary
In recent years, the therapeutic efficacy of HDL-based therapies has been subject to dispute. Pharmacological approaches that target an increase in the expression and/or activity of PON may facilitate macrophage cholesterol metabolism and attenuate inflammatory injury.
Hepatic Portocholecystostomy
Authors: Hery Géraldine , Gonzales Emmanuel , Bernard Olivier , Fouquet Virginie , Gauthier Frédéric , Branchereau Sophie 
Published: July 2017

ABSTRACTObjectives:Approximately 20% of cases of biliary atresia do not involve the gallbladder, the cystic duct, and the common bile duct. In these cases, a hepatoportocholecystostomy (HPC) may be performed instead of the classical hepatoportoenterostomy (HPE).Methods:We reviewed our cohort to investigate the efficacy of HPC and the associated surgical complications and clinical problems.Results:From 1984 to 2009, 97 patients underwent HPC in our institution. In the first 6 months of the postoperative period no patient presented with bacterial cholangitis. Nine patients had bile leakage, and 1 patient had a gallbladder obstruction. For these 10 patients, HPC was modified in HPE. Jaundice clearance was maintained after HPE, but 4 of the patients presented 1 or more cholangitis episodes. After 6 months, there were no cases of cholangitis recorded, 2 patients presented bile leakage and 4 patients experienced gallbladder obstruction. After 5 years of follow‐up, 46% of the patients were jaundice free with their native liver and 29.4% were transplanted.Conclusions:In patients with biliary atresia with patent extrahepatic bile ducts, hepatoportocholecystomy is a good surgical technique that can prevent cholangitis. These results are counterbalanced by specific surgical complications that need to be known and looked for in the postoperative period.
Attention Deficit Hyperactivity Disorder and Functional Defecation Disorders in Children
Authors: Kuizenga‐Wessel Sophie , Koppen Ilan J.N. , Vriesman Mana H. , Di Lorenzo Carlo , van Dijk Marieke , Beelen Maureen L.R. , Groeneweg Michael , Stoffelsen Reino J. , Benninga Marc A. 
Published: July 2017

ABSTRACTObjectives:The aim of the study was to assess the prevalence of attention deficit hyperactivity disorder (ADHD) in children presenting with functional defecation disorders (FDDs) and to assess the prevalence of FDDs in children with ADHD.Methods:A cross‐sectional cohort study was carried out between September 2014 and May 2016. Group 1: Parents of children with FDDs according to the Rome III criteria completed the Child Behavior Checklist and the VvGK (Dutch questionnaire based on the American Disruptive Behavior Disorder rating scale). Patients with ADHD subarea scores ≥70 on the Child Behavior Checklist and/or ≥16 on the VvGK were referred for further psychiatric evaluation. Group 2: Parents of children treated for ADHD at a specialized ADHD outpatient clinic completed a standardized questionnaire regarding their child's defecation pattern.Results:In group 1 (282 children with FDDs), 10.3% (7.1%–13.5% bias‐corrected and accelerate confidence interval) were diagnosed with ADHD. Group 2 consisted of 198 children with ADHD, 22.7% (17.6–28.8 bias‐corrected and accelerate confidence interval) fulfilled the Rome III criteria for an FDD. Children with both an FDD and ADHD reported urinary incontinence significantly more often compared to children with an FDD or ADHD alone: 57.1% in FDD + ADHD versus 22.8% in FDD alone (P < 0.001) and 31.1% in ADHD + FDD versus 7.8% in ADHD alone (P < 0.001).Conclusions:Approximately 10.3% of children with FDDs had ADHD and 22.7% of children with a known diagnosis of ADHD fulfilled the Rome III criteria for an FDD. This observation suggests that screening for behavioral disorders and FDDs should be incorporated into the diagnostic workup of these groups of children.
Noise Reduction to Reduce Patient Anxiety During Cast Removal
Authors: Mahan Susan T. , Harris Marie S. , Lierhaus Anneliese M. , Miller Patricia E. , DiFazio Rachel L. 
Published: July 2017

BACKGROUND:
Noise reduction headphones decrease the sound during cast removal. Their effectiveness in decreasing anxiety has not been studied.

PURPOSE:
Compare pediatric patients' anxiety levels during cast removal with and without utilization of noise reduction headphones combined with use of a personal electronic device.

METHODS:
Quality improvement project. Patients randomly assigned to noise reduction headphone group or standard care group during cast removal. Faces, Legs, Activity, Cry, and Consolability Scale and heart rate were evaluated prior to, during, and after cast removal. Data were compared across groups.

RESULTS:
Fifty patients were included; 25 per group. No difference detected between the 2 groups in Faces, Legs, Activity, Cry, and Consolability Scale score prior to (p = .05) or after cast removal (p = .30). During cast removal, the headphone group had lower FLACC Scale scores (p = .03). Baseline heart rate was lower in the headphone group prior to (p = .02) and after (p = .005) cast removal with no difference during cast removal (p = .24).

CONCLUSION:
Utilizing noise reduction headphones and a personal electronic device during the cast removal process decreases patient anxiety.
Self-Reported Rates of Adherence to Aspirin Prescribed as an Antithrombotic Therapy Following Postoperative Total Joint Replacement
Authors: Wittig-Wells Deborah , Shapiro Susan , Higgins Melinda , Samms-McPherson Jacqueline , Winterboer Donald Shane , Johnson Ifeya , Carter Jessica , Jacob Ani 
Published: July 2017

BACKGROUND:
Patients may not understand the importance of medication adherence when discharged with aspirin (ASA) as an anticoagulant for venous thromboembolism (VTE) prophylaxis after joint replacement surgery.

PURPOSE:
The purpose of this study was to examine self-reported rates of adherence to postoperative use of ASA for VTE prophylaxis.

METHODS:
This was an exploratory, descriptive study using a convenience sample of 99 participants. Adherence was measured with a 4-question self-reporting tool.

RESULTS:
Thirty-seven percent were male and 76% were Caucasian, and median age was 63 years. Ninety-two percent had the dosage correct, 76% knew how long to take the medication, and 100% of the sample was still taking the ASA; 40% had forgotten to take 1 or more doses of the medication. No associations were noted. Overall compliance was 44%.

CONCLUSION:
A significant number missed 1 or more doses. This is an opportunity for nurses to work with patients on innovative ways to improve adherence.
Visual Acuity and Contrast Sensitivity Development in Children: Sweep Visually Evoked Potential and Psychophysics
Authors: Almoqbel Fahad M. , Irving Elizabeth L. , Leat Susan J. 
Published: July 2017

PURPOSEThe purpose of this study was to investigate the development of visual acuity (VA) and contrast sensitivity in children as measured with objective (sweep visually evoked potential) and subjective, psychophysical techniques, including signal detection theory (SDT), which attempts to control for differences in criterion or behavior between adults and children. Furthermore, this study examines the possibility of applying SDT methods with children.METHODSVisual acuity and contrast thresholds were measured in 12 children 6 to 7 years old, 10 children 8 to 9 years old, 10 children 10 to 12 years old, and 16 adults. For sweep visually evoked potential measurements, spatial frequency was swept from 1 to 40 cpd to measure VA, and contrast of sine-wave gratings (1 or 8 cpd) was swept from 0.33 to 30% to measure contrast thresholds. For psychophysical measurements, VA and contrast thresholds (1 or 8 cpd) were measured using a temporal two-alternative forced-choice staircase procedure and also with a yes-no SDT procedure. Optotype (logMAR [log of the minimum angle of resolution]) VA was also measured.RESULTSThe results of the various procedures were in agreement showing that there are age-related changes in threshold values and logMAR VA after the age of 6 years and that these visual functions do not become adult-like until the age of 8 to 9 years at the earliest. It was also found that children can participate in SDT procedures and do show differences in criterion compared with adults in psychophysical testing.CONCLUSIONSThese findings confirm a slightly later development of VA and contrast sensitivity (8 years or older) and indicate the importance of using SDT or forced-choice procedures in any developmental study to attempt to overcome the effect of criterion in children.
A Randomized Trial of Soft Multifocal Contact Lenses for Myopia Control: Baseline Data and Methods
Authors: Walline Jeffrey J. , Gaume Giannoni Amber , Sinnott Loraine T. , Chandler Moriah A. , Huang Juan , Mutti Donald O. , Jones-Jordan Lisa A. , Berntsen David A. 
Published: July 2017

SIGNIFICANCE
The Bifocal Lenses In Nearsighted Kids (BLINK) study is the first soft multifocal contact lens myopia control study to compare add powers and measure peripheral refractive error in the vertical meridian, so it will provide important information about the potential mechanism of myopia control.

PURPOSE
The BLINK study is a National Eye Institute–sponsored, double-masked, randomized clinical trial to investigate the effects of soft multifocal contact lenses on myopia progression. This article describes the subjects’ baseline characteristics and study methods.

METHODS
Subjects were 7 to 11 years old, had −0.75 to −5.00 spherical component and less than 1.00 diopter (D) astigmatism, and had 20/25 or better logMAR distance visual acuity with manifest refraction in each eye and with +2.50-D add soft bifocal contact lenses on both eyes. Children were randomly assigned to wear Biofinity single-vision, Biofinity Multifocal “D” with a +1.50-D add power, or Biofinity Multifocal “D” with a +2.50-D add power contact lenses.

RESULTS
We examined 443 subjects at the baseline visits, and 294 (66.4%) subjects were enrolled. Of the enrolled subjects, 177 (60.2%) were female, and 200 (68%) were white. The mean (± SD) age was 10.3 ± 1.2 years, and 117 (39.8%) of the eligible subjects were younger than 10 years. The mean spherical equivalent refractive error, measured by cycloplegic autorefraction was −2.39 ± 1.00 D. The best-corrected binocular logMAR visual acuity with glasses was +0.01 ± 0.06 (20/21) at distance and −0.03 ± 0.08 (20/18) at near.

CONCLUSIONS
The BLINK study subjects are similar to patients who would routinely be eligible for myopia control in practice, so the results will provide clinical information about soft bifocal contact lens myopia control as well as information about the mechanism of the treatment effect, if one occurs.
Death by “Snow”! A Fatal Forensic Case of Cocaine Leakage in a “Drug Mule” on Postmortem Computed and Magnetic Resonance Tomography Compared With Autopsy
Authors: Flach Patricia Mildred , Gascho Dominic , Fader René , Martinez Rosita , Thali Michael J. , Ebert Lars C. 
Published: July 2017

Abstract
This forensic case presents unique postmortem imaging of a “drug mule” with fatal intoxication due to cocaine leakage on postmortem computed and magnetic resonance (MR) tomography compared with autopsy.
Imaging by postmortem computed and MR tomography was performed before autopsy, histology, and toxicology were commissioned. Forensic imaging revealed 91 hyperdense, uniformly shaped body packs with signs of leakage, which was confirmed by autopsy. Postmortem MR imaging displayed the rarely described hypointense appearance of the body packs in T1- and T2-weighted sequences. Toxicology stated the dosage of cocaine intoxication as lethal.
This case provides an opportunity to image internal cocaine drug containers on postmortem computed and MR tomography. The cause of death could be determined based on imaging and the radiological morphology of these packs by both imaging methods.
Continuous Capnography Reduces the Incidence of Opioid-Induced Respiratory Rescue by Hospital Rapid Resuscitation Team
Authors: Stites Mindy , Surprise Jennifer , McNiel Jennifer , Northrop David , De Ruyter Martin 
Published: July 2017

Objective
The aim of this study was to determine the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory depression (OIRD) in the setting of rapid response.

Methods
A retrospective analysis was conducted in an urban tertiary care facility on the incidence of OIRD in the setting of rapid response as defined by a positive response to naloxone from January 2012 to December 2015. In March 2013, continuous capnography monitoring was implemented for all patients using PCA.

Results
The preintervention incidence of OIRD in the setting of rapid response was 0.4% of patients receiving opioids. After the implementation of capnography, the incidence of OIRD in the setting of rapid response was reduced to 0.2%, which was statistically significant (χ2 = 46.246; df, 1; P < 0.0001). The rate of transfers to a higher level of care associated with these events was also reduced by 79% (baseline, 7.6 transfers/month; postintervention, 1.6 transfers/month).

Conclusions
Continuous capnography monitoring in patients receiving PCA significantly reduces the incidence of OIRD in the setting of rapid response and unplanned transfers to a higher level of care.
Intestinal cestodes
Authors: Webb Camille , Cabada Miguel M. 
Published: July 2017

Purpose of review
Cestodes infections in humans are among the most prevalent parasitosis worldwide. Although tapeworm infection is often asymptomatic, they can be associated with a range of symptoms. The landscape of cestode infections is changing with rapid diagnosis techniques and advanced molecular diagnosis aiding in identification of species specific epidemiology.

Recent findings
Traditional descriptions of species by location have been challenged with molecular diagnostic techniques, which show variation in distribution of species, thought to be because of globalization and importation of disease.

Main themes in literature
Epidemiology, molecular diagnostic techniques.

Summary
Infection by tapeworms is often asymptomatic or accompanied by mild symptoms though can occasionally cause severe disease and contribute to anemia and malnutrition. Tapeworm infection is most prevalent in resource-poor countries but the distribution is worldwide. Epidemiology of infection is changing because of molecular diagnostics, which allow more accurate tracking of species.