bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Client's Perspective on Voluntary Stuttering
Authors: Byrd Courtney T. , Gkalitsiou Zoi , Donaher Joe , Stergiou Erin 
Published: July 2016

Purpose
Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering.

Method
The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use.

Results
A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment.

Conclusions
To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.
Biotechnological approaches to growing green energy from
Jatropha curcas
: challenges due to the undomesticated status of the species.
Authors: Maghuly F. , Haas B. , Laimer M. 
Published: July 2016

Abstract

Jatropha curcas
is one of the major tropical biofuel crops in the Euphorbiaceae family. The species is an attractive candidate for biofuel production at industrial scale, for medicinal purposes and for halting desertification due to its adaptability to diverse environmental conditions. However, major obstacles to these endeavours include limited genetic diversity of the species, limited information about its distribution and domestication, lack of experience with crop performance and agronomy, environmental effects, few and disconnected crop improvement programmes and toxin production, which slow down the realization of the full potential of
J. curcas
. This review presents how
Jatropha
was selected or domesticated by the Mesoamerican civilizations in tropical regions, how it arrived to the subtropical, humid and dry regions of Africa and Asia, and when its genetic improvement was started following different breeding goals. Further, the recent biotechnological advances and new breeding technologies - which improve performance and increase genetic diversity - are highlighted. Newly emerging strategies and technologies and their potential to significantly increase crop production are discussed.
Misreading Narcissus
Authors: Tyminski Robert 
Published: July 2016

ABSTRACTThis article explores the myth of Narcissus as told by Ovid. The author examines why one scene in the story became the focus for the term ‘narcissism’, which has been extrapolated to become a theoretical concept as well a diagnosis. Closer reading of the myth suggests this may have been a distortion. Narcissus as a mythological figure may tell us more about late male adolescence than we have given him credit for. Freud’s paper ‘On Narcissism’ is contrasted with Jung’s views on libido. One legacy of the way in which Freud conceptualized narcissism was to pathologize the development of gay men and women. Two cases are presented to show an alternative understanding of sexual development for young men in mid and late adolescence. The author proposes that a dawning awareness of feminine aspects of sexuality can be experienced as a kind of potentially harmful ‘flowering’, about which young men can feel considerable shame and anxiety.
Modulation of release kinetics by plasma polymerization of ampicillin-loaded β-TCP ceramics
Authors: Labay C , Buxadera-Palomero J , Avilés M , Canal C , Ginebra M P 
Published: July 2016

Abstract
Beta-tricalcium phosphate (β-TCP) bioceramics are employed in bone repair surgery. Their local implantation in bone defects puts them in the limelight as potential materials for local drug delivery. However, obtaining suitable release patterns fitting the required therapeutics is a challenge. Here, plasma polymerization of ampicillin-loaded β-TCP is studied for the design of a novel antibiotic delivery system. Polyethylene glycol-like (PEG-like) coating of β-TCP by low pressure plasma polymerization was performed using diglyme as precursor, and nanometric PEG-like layers were obtained by simple and double plasma polymerization processes. A significant increase in hydrophobicity, and the presence of plasma polymer was visible on the surface by SEM and quantified by XPS. As a main consequence of the plasma polymerisation, the release kinetics were successfully modified, avoiding burst release, and slowing down the initial rate of release leading to a 4.5 h delay in reaching the same antibiotic release percentage, whilst conservation of the activity of the antibiotic was simultaneously maintained. Thus, plasma polymerisation on the surface of bioceramics may be a good strategy to design controlled drug delivery matrices for local bone therapies.
Barriers to Knowledge Translation Regarding the Use of Probiotics as a Risk-Reduction Strategy for Necrotizing Enterocolitis
Authors: Anderson Sharon 
Published: July 2016

Background:
Increasingly, evidence supports enteral probiotics are an important risk-reduction strategy for necrotizing enterocolitis (NEC) among very low birth-weight and extremely low birth-weight preterm infants. Yet, the majority of providers remain reluctant to implement practice changes.

Purpose:
The aim of this study was to better understand the discrepancy between the available evidence and clinical practice regarding the use of probiotics and other NEC prevention strategies in New Jersey.

Methods:
Using an exploratory descriptive design, a multimodal interprofessional survey was developed and executed to elicit intensive care nursery provider knowledge, views, and current practice.

Results:
Although the sample size was small (N = 29), approximately one-half of respondents familiar with the literature rated the quality of the evidence regarding probiotics as “above average” to “excellent.” These respondents were “very likely” to “extremely likely” to recommend probiotics as an NEC prevention strategy; however, none actually prescribed this intervention. The most important reason respondents did not prescribe probiotics was the focus on providing exclusive maternal and donor breast milk feedings. Other confounding factors included provision of oral colostrum care, standardized feeding protocols, and withholding feedings during blood transfusion.

Implications for Practice:
Study results suggested that some providers (primarily nurses) were not familiar with probiotic literature, which may contribute to deficits in knowledge translation to practice.

Implications for Research:
Areas for future study include identifying improved mechanisms for knowledge dissemination, recognizing and addressing barriers and facilitators to knowledge translation, and understanding how probiotics fit and/or contrast with other NEC risk-reduction strategies in the research and clinical settings.
Histologic Chorioamnionitis and Funisitis After Laser Surgery for Twin–Twin Transfusion Syndrome
Authors: Zhao Depeng , Cohen Danielle , Middeldorp Johanna M. , van Zwet Erik W. , De Paepe Monique E. , Oepkes Dick , Lopriore Enrico 
Published: July 2016

OBJECTIVE:
To estimate the incidence of histologic chorioamnionitis and funisitis after fetoscopic laser surgery for the management of twin–twin transfusion syndrome.

METHODS:
A case–control study was performed at the Leiden University Medical Center from 2013 to 2014. All patients with twin–twin transfusion syndrome managed with laser surgery during the study period were included and compared with a control group of all monochorionic twins not treated with laser surgery. We excluded patients with fetal demise or higher order pregnancies. Placentas were reviewed for the presence and degree of chorioamnionitis and presence or absence of fetal inflammatory response. The primary outcome was the incidence of histologic chorioamnionitis and funisitis after laser surgery. Odds ratios (ORs) and 95% confidence intervals (CIs) for primary outcomes were calculated. A P value of <.05 was considered as statistical significance.

RESULTS:
Sixty-two patients treated with laser surgery were included in the study group and compared with 64 patients in the control group. The incidence of histologic chorioamnionitis was 13% (8/62) in the laser group compared with 5% (3/64) in the control group (OR 3.0, 95% CI 0.8–11.9, P=.12). Funisitis occurred in 8% (10/124) in the laser group compared with 0% in the control group (OR 11.1, 95% CI 1.3–96.9, P=.03). Histologic chorioamnionitis with or without funisitis after laser surgery was associated with a shorter laser-to-delivery interval (median 6.6 [range 3.4–14.1] compared with 13.6 [4.4–20.1] weeks, P<.01) and lower gestational age at birth (median 28.1 [range 23.1–32.6] compared with 32.7 [24.4–37.0] weeks, P<.01).

CONCLUSION:
These findings suggest that laser surgery for twin–twin transfusion syndrome is associated with an increased risk of funisitis.
Sharing of Snorting Straws and Hepatitis C Virus Infection in Pregnant Women
Authors: Fernandez Noelle , Towers Craig V. , Wolfe Lynlee , Hennessy Mark D. , Weitz Beth , Porter Stephanie 
Published: July 2016

OBJECTIVE:
To evaluate possible modes of hepatitis C virus (HCV) acquisition in pregnant women found to be HCV-infected in the prenatal period and to assess transmission risk factors.

METHODS:
This was a prospective cohort study conducted from March 2014 through June 2015 involving the distribution of an anonymous survey to HCV-infected pregnant women that assessed for numerous modes of potential HCV transmission involving, intravenous drug use, blood transfusion, organ transplant, sexual contact, tattoos, and snorting drugs with a straw. Participants were drawn from our institutional obstetric high-risk clinic. Statistical analysis involved simple percentages and χ2 comparisons where appropriate; P<.05 was considered significant. To test biologic plausibility, snorting utensils confiscated by law enforcement authorities from patients not in this study were tested for the presence of human blood.

RESULTS:
A total of 189 HCV-infected pregnant patients completed the survey, and no approached patients declined. Of these, 136 (72%, 95% confidence interval [CI] 65–78%) admitted to intravenous drug use, of whom 89 (65%, 95% CI 57–73%) reported sharing needles. Of the 178 (94%, 95% CI 90–97%) who admitted snorting drugs, 164 (92%, 95% CI 87–96%) reported sharing straws. The difference between the proportion reporting sharing of snorting utensils compared with the proportion sharing intravenous drug use utensils was significant (P<.001). Twenty-nine patients (15%, 95% CI 11–21%) reported snorting drugs and sharing straws but denied any other risk factor except sexual contact. Of the 54 straws confiscated by law enforcement authorities, 13 (24%, 95% CI 13–38%) tested positive for the presence of human blood.

CONCLUSION:
Sharing snorting utensils (straws) in noninjection drug use may be an additional risk factor for HCV and other virus transmission.
Diagnostic Biomarkers in Women With Suspected Preeclampsia in a Prospective Multicenter Study
Authors: Duckworth Suzy , Griffin Melanie , Seed Paul T. , North Robyn , Myers Jenny , Mackillop Lucy , Simpson Nigel , Waugh Jason , Anumba Dilly , Kenny Louise C. , Redman Christopher W. G. , Shennan Andrew H. , Chappell Lucy C. 
Published: July 2016

OBJECTIVE:
To evaluate 47 biomarkers (selected from the current medical literature), in isolation or in combination with placental growth factor (PlGF), to determine the need for delivery within 14 days, in women presenting with suspected preterm preeclampsia.

METHODS:
In a prospective, multicenter observational study, 47 biomarkers were measured in 423 women presenting with suspected preterm preeclampsia (in two prespecified groups: group 1 at less than 35 weeks of gestation and group 2 presenting between 35 0/7 and 36 6/7 weeks of gestation) to evaluate their ability to determine the primary endpoint: preeclampsia requiring delivery within 14 days. Using factor analysis and stepwise logistic regression, we sought one or more additional biomarkers for optimal determination of the primary endpoint.

RESULTS:
In women presenting at less than 35 weeks of gestation (n=286), the best performing combination of PlGF, podocalyxin, endoglin, procalcitonin (receiver operating curve [ROC] area 0.90, 95% confidence interval [CI] 0.86–0.93) was not statistically better than PlGF alone (ROC 0.87, 95% CI 0.83–0.92; P=.43) for preeclampsia requiring delivery within 14 days. Two other single markers had test performance that was not significantly different to PlGF (soluble fms-like tyrosine kinase-1 [sFlt-1] ROC 0.83, 95% CI 0.78–0.88; endoglin ROC 0.83, 95% CI 0.79–0.88). Similar findings were found in women presenting between 35 0/7 and 36 6/7 weeks of gestation (n=137): ROC for PlGF alone 0.75 (95% CI 0.67–0.83); ROC for PlGF, cystatin, pregnancy-associated plasma protein A in combination 0.81 (95% CI 0.74–0.88; P=.40).

CONCLUSION:
This study supports the growing body of evidence that a single angiogenesis-related biomarker (PlGF, sFlt-1, or endoglin) alone represents a useful diagnostic test for women presenting with suspected preterm preeclampsia.
Cryopreserved Human Umbilical Cord for In Utero Myeloschisis Repair
Authors: Papanna Ramesha , Fletcher Stephen , Moise Kenneth J. , Mann Lovepreet K. , Tseng Scheffer C. G. 
Published: July 2016

BACKGROUND:
There is an urgent need is for a regenerative patch for in utero repair of spina bifida in situations in which primary closure is difficult.

CASES:
We present two cases of large myeloschisis defects that underwent in utero spina bifida repair at midgestation with closure of the skin defect by using a cryopreserved human umbilical cord patch. The pregnancies were uncomplicated, and the births occurred at 37 weeks by planned cesarean delivery. The repair sites were intact with no evidence of cerebrospinal fluid leakage, with skin regenerated after delivery over a period of 3–4 weeks. The short-term outcomes after delivery showed reversal of hindbrain herniation, minimal spinal cord tethering, and normal function of the lower extremities.

CONCLUSION:
Cryopreserved human umbilical cord may be a suitable patch system for the spina bifida closure.
A Sanitary Pad for Self-Assessment of Rupture of Membranes
Authors: Mor Amir , Haberman Shoshana , Kalgi Bharati , Minkoff Howard 
Published: July 2016

BACKGROUND:
Multistep immunoassay kits for the diagnosis of rupture of membranes are relatively complex and are not designed to be used by pregnant women themselves. These kits require procedural steps of specimen extraction and preparation. We evaluated the ability of a sanitary pad containing a qualitative immunoassay for alpha-fetoprotein (AFP) to serve as a one-step self-test to detect amniotic fluid leakage.

TECHNIQUE:
Four sets of pads were evaluated. The pads in the study set were worn by 288 pregnant women with confirmed rupture of membranes. Three controls were evaluated: 1) pads worn by 93 pregnant women with intact membranes, 2) additional pads instilled with urine specimens obtained from the 381 women described previously (study set plus control set 1), and 3) pads instilled with semen collected from 40 men.

EXPERIENCE:
All 288 pads that absorbed amniotic fluid had positive results. Approximately half of the pads absorbed with normal vaginal discharge had a sufficient amount to yield valid results, which were all negative. All 381 pads with instilled urine and all 40 pads with instilled semen had negative results.

CONCLUSION:
An immunoassay for AFP, embedded in a pad, appears to be a feasible and reproducible self-test for the detection of rupture of membranes.
Early Compared With Delayed Physician Rounds on Patient Satisfaction of Postpartum Women
Authors: Roberts Robyn P. , Blackwell Sean C. , Brown Kelly M. , Pedroza Claudia , Sibai Baha M. , Tyson Jon E. 
Published: July 2016

OBJECTIVE:
To investigate whether delayed timing of physician rounds improves patient satisfaction for postpartum women.

METHODS:
Women were randomized to early (5–7 am) or delayed (8–10 am) physician rounding. Women with stillbirth, high-risk pregnancy, or complications precluding delayed rounding were excluded. At discharge, women completed a modified Hospital Consumer Assessment of Healthcare Providers and Systems survey. The primary outcome was rating of the hospital. Secondary outcomes included patient assessment of patient–physician communication, various hospital experiences, and timing of maternal and neonatal discharge. We estimated that 74 women were needed to detect a 20% difference in rating of the hospital (0–10 score) between groups (assumption P=.05, power 90%). Given limited information on primary outcome, an a priori plan was in place to conduct the study for 2 months.

RESULTS:
One hundred fifty-two women were randomized (n=76 early rounding; n=76 delayed rounding). More women had a cesarean delivery in the early compared with the delayed rounding group (47.4% compared with 22.4%). Median rating of the hospital was higher in the delayed as compared with the early rounding group (9.0 [7.0–9.0] compared with 7.0 [6.0–8.0]; P<.01). Median scores regarding physician communication and perception of hospital experiences were higher in the delayed compared with the early group (8.0 [7.0–9.0] compared with 6.0 [5.0–7.0]; P<.001). Adjustment for delivery mode did not alter results (P<.01). No differences in timing of maternal (P=.47) or neonatal hospital discharge (P=.35) were observed.

CONCLUSION:
Postpartum women receiving delayed physician rounding were more satisfied with their hospital experience and patient–physician communication without prolonging maternal or neonatal discharge.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, https://clinicaltrials.gov, NCT02432573.
Primary Signet-Ring Cell/Histiocytoid Carcinoma of the Eyelid: A “Binocle” Presentation of the “Monocle Tumor”
Authors: Bernárdez Claudia , Macías del Toro Elena , Ramírez Bellver Jose Luis , Martinez Menchón Teresa , Martinez Barba Enrique , Molina-Ruiz Ana María , Requena Luis 
Published: July 2016

Abstract:
Primary cutaneous signet-ring cell carcinoma is a rare and aggressive neoplasm which diffusely involves dermis and subcutis of the eyelid or axillae. Neoplastic cells show a signet-ring cell or histiocytoid morphology in variable number, and can be found intermingled among collagen bundles, sparing the epidermis. This neoplasm typically appears in the eyelids of elderly men, in the form of a painless infiltration and swelling but with no other specific clinical feature, and frequently causes diagnostic retardation and worse prognosis. Frequent involvement of both eyelids of the same eye has given it the name of monocle tumor. Only 29 cases have been described in English literature to date, of which 7 developed metastases, mainly on regional lymph nodes. The authors present a case of involvement of contralateral eyelid, which has only been described previously in 2 cases. The immunohistochemical profile of the involvement in the contralateral eye, and the absence of other metastasis, suggest that it is locally spread from the initial lesion. However the possibility of being a second primary tumor or metastasis cannot be readily ruled out.
High Relative Expression of Pannexin 3 (PANX3) in an Axillary Sweat Gland Carcinoma With Osteosarcomatous Transformation
Authors: Romano Ryan C. , Gardner Jerad M. , Shalin Sara C. , Ram Roopa , Govindarajan Rang , Montgomery Corey O. , Gilley Jasen H. , Nicholas Richard W. 
Published: July 2016

Abstract:
Primary cutaneous sweat gland carcinomas (SGCs) are rare tumors that commonly involve axillae, have a high local recurrence rate, and rarely show sarcomatoid transformation. A 68-year-old man presented with rapid enlargement of a previously stable, asymptomatic pea-sized nodule in the left axilla. Initial excision (with positive surgical margins) at another institution showed characteristic histologic features of a high-grade osteosarcoma and molecular analysis using a 92-gene real-time quantitative reverse transcription–polymerase chain reaction assay confirmed a diagnosis of osteosarcoma with 96% certainty. Notably, the molecular assay demonstrated consistently high relative expression of pannexin 3 (PANX3), a gene involved in normal osteoblast differentiation which, when highly expressed, strongly predicts osteosarcoma per the assay's algorithm. However, on further histologic review, the tumor also contained focal cystic areas, nests, and ducts composed of malignant epithelial cells reminiscent of SGC; these areas directly transitioned into the osteosarcomatous component and were strongly positive for pancytokeratin, CK7, and p63. Within 2 weeks, the lesion recurred and grew rapidly, prompting complete resection, histologic sections of which showed high-grade osteosarcoma without residual epithelial elements. This is the fifth report, to our knowledge, of osteosarcomatous transformation in a SGC, and the only report to date including molecular data. This case demonstrates that osteosarcoma arising from a SGC has a similar molecular profile to de novo primary osteosarcoma of bone. It also emphasizes the importance of histopathologic findings as the established diagnostic gold standard and the need to interpret molecular results within the clinical context.
Atypical Spitzoid Neoplasms in Childhood: A Molecular and Outcome Study
Authors: Lee Christina Y. , Sholl Lauren M. , Zhang Bin , Merkel Emily A. , Amin Sapna M. , Guitart Joan , Gerami Pedram 
Published: July 2016

Abstract:The natural history of atypical Spitz neoplasms remains poorly understood, resulting in significant patient and clinician anxiety. We sought to better characterize outcomes that correlated with molecular features by performing a prospective cohort study of pediatric atypical spitzoid neoplasms in which fluorescence in situ hybridization studies were obtained for diagnosis. Cases with sufficient tissue underwent additional retrospective assessment for translocations inALK,NTRK1,BRAF,RET, andROS1. Among 246 total patients assessed, 13% had a positive fluorescence in situ hybridization result. Follow-up data was available in 85 patients. Two patients had a recurrence of whom 1 had distant metastasis. Both patients had homozygous deletions in 9p21. Homozygous deletions in 9p21 significantly correlated with recurrence of disease (P= 0.027). Fifteen (36%) of 42 cases were found to have a kinase fusion protein. However, the presence of kinase fusions was nonprognostic of recurrence (P> 0.99). This study was limited by the availability and length of follow-up data and the number of adverse outcomes. The majority of atypical spitzoid neoplasms in childhood have indolent behavior. Although the subgroup of patients with homozygous deletions in 9p21 is at higher risk for aggressive clinical behavior, their prognosis seems considerably better than similarly staged conventional melanoma.