bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Silicone Hydrogel and Hydrogel Daily Disposable Contact Lenses
Authors: Diec Jennie , Tilia Daniel , Thomas Varghese 
Published: January 2017

Objective:
To compare subjective, objective and safety performance of silicone hydrogel (SiHy) daily disposable (DD) with hydrogel (Hy) DD contact lenses.

Method:
Retrospective analysis on approximately 40 participants (Px) each in 5 trials. Lenses grouped into SiHy (delefilcon A, somofilcon A, narafilcon A) and Hy (omafilcon A, nelfilcon A). Participants attended follow-up visits at baseline, 2 weeks, 1 and 3 months. Subjective ratings (1–10 scale), adverse events (percentage of Px), physiological variables (0–4 scale), and wearing time were collected at each visit and compared between groups.

Result:
Trials enrolled 201 Px totally. No differences in age, sex, and lens wear experience were found between SiHy and Hy groups (P≥0.09). There was greater increase in limbal redness from baseline in Hy group (0.18±0.38 vs. 0.02±0.47, P<0.001), whereas conjunctival staining and indentation were less in Hy group (P<0.001). No differences in comfortable wearing time were found between groups (P=0.41), and comfort at insertion, during day, and end of day was also no different (P≥0.71). Incidence of corneal infiltrative events (SiHy vs. Hy: 6.7% vs. 2.5%; P=0.32) and mechanical adverse events (SiHy vs. Hy: 0.0% vs. 0.0%; P=1.00) were no different.

Conclusion:
Though some statistical significance was found between the groups, these differences were within measurement error. Neither material types showed superiority in comfort, and adverse event rates were low with both material types. These findings suggest that choice of material is a patient and practitioner preference; however, for patients at risk of hypoxia-related complications, SiHy materials should be considered.
Traditional Sternotomy versus Minimally Invasive Aortic Valve Replacement in Patients Stratified by Ejection Fraction
Authors: Nguyen Tom C. , Thourani Vinod H. , Pham Justin Q. , Zhao Yelin , Terwelp Matthew D. , Balan Prakash , Ocazionez Daniel , Loghin Catalin , Smalling Richard W. , Estrera Anthony L. , Lamelas Joseph 
Published: January 2017

Objective Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. Methods A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed. Patients were stratified into two groups: EF of less than 40% and EF of 40% or more. In each EF group, SAVR and MIAVR patients were propensity matched by age, sex, body mass index, race, diabetes, hypertension, dyslipidemia, dialysis, cerebrovascular disease, cardiovascular disease, cerebro-vascular accident, peripheral vascular disease, last creatinine level, EF, previous MI and cardiogenic shock, and the Society for Thoracic Surgeons (STS) score. Results Among patients with an EF of 40% or more (377 pairs), patients who underwent MIAVR compared with SAVR had decreased intensive care unit hours (56.8% vs 84.6%, P < 0.001), postoperative length of stay (7.1 vs 7.9 days, P = 0.04), incidence of atrial fibrillation (18.8% vs 38.7%, P < 0.001), bleeding (0.8% vs 3.2%, P = 0.04), and a trend toward decreased 30-day mortality (0.3% vs 1.3%, P = 0.22). The STS scores were largely equivalent in patients undergoing MIAVR compared with SAVR (2.4% vs 2.6%, P = 0.09). In patients with an EF of less than 40% (35 pairs), there was no difference in intensive care unit hours (69% vs 72.6%, P = 0.80), postoperative length of stay (10.3 vs 7.2 days, P = 0.13), 30-day mortality (3.8% vs 0.8%, P = 0.50), or the STS score (3.3% vs 3.2%, P = 0.68). Conclusions Minimally invasive aortic valve replacement in patients with preserved EF was associated with improved short-term outcomes compared with SAVR. In patients with left ventricular dysfunction, short-term outcomes between MIAVR and SAVR are largely equivalent.
Breast Milk Is a Potential Vehicle for Human Papillomavirus Transmission to Oral Mucosa of the Spouse
Authors: Louvanto Karolina , Sarkola Marja , Rintala Marjut , Syrjänen Kari , Grenman Seija , Syrjänen Stina 
Published: January 2017

Background:
Human papillomavirus (HPV) DNA has been detected in breast milk, but its origin has remained obscure. The aim of the study was to analyze the prevalence and persistence of HPV in breast milk in the Finnish Family HPV cohort study. The association of breast milk HPV positivity with the family members’ oral HPV status was evaluated.

Methods:
We included 308 families to the study where the mother was breast feeding her offspring. Mothers collected the milk samples manually at day 3, and at months 2, 6 and 12. Cervical and/or oral samples were collected from all family members. HPV testing was performed using nested polymerase chain reaction and Luminex-based Multimetrix kit.

Results:
Breast milk HPV DNA was found in 10.1% (31/308), 20.1% (39/194) and 28.8% (17/59) of samples at day 3, months 2 and 6, respectively. The following HPV genotypes were detected: 6, 16, 18, 33, 45, 53, 56, 59, 66 and 82. Breast milk HPV persisted among 5.5% (9/164) of the lactating mothers. No significant associations were detected between the persistent breast milk HPV and the offspring’s oral incident HPV infection. Breast milk HPV positivity showed a strong association with the fathers’ oral HPV positivity at baseline, as well as at 6- and 12-month follow-up visits, with odds ratio (OR) = 3.24 [95% confidence interval (CI): 1.04–10.12], OR = 6.34 (95% CI: 1.84–21.89) and OR = 14.25 (95% CI: 1.16–174.80), respectively.

Conclusions:
HPV in breast milk is prevalent among the lactating mothers and HPV can also persist in breast milk. The breast milk is a potential vehicle for HPV transmission to oral mucosa of the spouse but not of the offspring.
Primidone inhibits TRPM3 and attenuates thermal nociception in vivo
Authors: Krügel Ute , Straub Isabelle , Beckmann Holger , Schaefer Michael 
Published: January 2017

Abstract
The melastatin-related transient receptor potential (TRP) channel TRPM3 is a nonselective cation channel expressed in nociceptive neurons and activated by heat. Because TRPM3-deficient mice show inflammatory thermal hyperalgesia, pharmacological inhibition of TRPM3 may exert antinociceptive properties. Fluorometric Ca2+ influx assays and a compound library containing approved or clinically tested drugs were used to identify TRPM3 inhibitors. Biophysical properties of channel inhibition were assessed using electrophysiological methods. The nonsteroidal anti-inflammatory drug diclofenac, the tetracyclic antidepressant maprotiline, and the anticonvulsant primidone were identified as highly efficient TRPM3 blockers with half-maximal inhibition at 0.6 to 6 μM and marked specificity for TRPM3. Most prominently, primidone was biologically active to suppress TRPM3 activation by pregnenolone sulfate (PregS) and heat at concentrations markedly lower than plasma concentrations commonly used in antiepileptic therapy. Primidone blocked PregS-induced Ca2+
i influx through TRPM3 by allosteric modulation and reversibly inhibited atypical inwardly rectifying TRPM3 currents induced by coapplication of PregS and clotrimazole. In vivo, analgesic effects of low doses of primidone were demonstrated in mice, applying PregS- and heat-induced pain models, including inflammatory hyperalgesia. Thus, applying the approved drug at concentrations that are lower than those needed to induce anticonvulsive effects offers a shortcut for studying physiological and pathophysiological roles of TRPM3 in vivo.
Making the most of hypomethylating agents in myelodysplastic syndromes
Authors: Bhatt Geetika , Blum William 
Published: January 2017

Purpose of review
Hypomethylating agents (HMA) are the preferred therapy for patients with higher risk myelodysplastic syndromes (MDS) and an alternative therapeutic strategy for older patients with acute myeloid leukemia. These agents have improved both survival and quality of life, but results overall remain poor. The purpose of this review is to highlight recent developments in clinical research with HMA in MDS/acute myeloid leukemia over the last year.

Recent findings
Combination of HMA with B-cell lymphoma-2 inhibitors, hedgehog inhibitors, and a variety of other agents are underway, as are further studies with reformulated HMA that have more favorable pharmacokinetics (including oral bioavailability). HMA may also be promising in maintenance therapy after allogeneic transplantation. Generally speaking, testing new agents in randomized studies after ‘HMA failure,’ however, may be suboptimal for assessing efficacy.

Summary
No clear ‘winner’ as a combination partner with HMA or novel formulation of HMA has yet emerged. We concur with growing trends to test novel agents early in the drug development timeline, including the frontline treatment setting in combination with HMA, to bring new agents to Food and Drug Administration approval more quickly. HMA are standard in name only, clinical research should be the standard of care.
The Effects of Attention Problems on Psychosocial Functioning in Childhood Brain Tumor Survivors: A 2-Year Postcraniospinal Irradiation Follow-up
Authors: Oh Yunhye , Seo Hyunjung , Sung Ki Woong , Joung Yoo Sook 
Published: January 2017

Objective:
To examine the psychosocial outcomes and impact of attention problems in survivors of pediatric brain tumor.

Study Design:
The survivors’ cognitive functioning was measured using the Wechsler Intelligence Scale for Children. The Child Behavior Checklist-Attention Problems scale was used to screen for attention problems, and participants were classified as having attention problems (n=15) or normal attention (n=36). Psychosocial functioning was examined with the Korean Personality Rating scale for Children (K-PRC) at precraniospinal radiation and at 2-year follow-up.

Results:
The attention problem group showed significantly higher depression and externalizing symptoms (delinquency, hyperactivity) and more significant impairment in family relationships than did the normal attention group at baseline. At follow-up, the attention problem group demonstrated significantly more delinquency and impaired family and social relationships. With the K-PRC scores, except for the somatization, social relationship subscale, there were significant differences between groups, but not in terms of treatment by time interaction or within time. At follow-up, multiple linear regressions showed that age at diagnosis significantly predicted K-PRC somatization (B=−1.7, P=0.004) and social relationships (B=−1.7, P=0.004), baseline full-scale intelligence quotient predicted K-PRC depression (B=−0.4, P=0.032) and somatization (B=−0.3, P=0.015), and attention problems at baseline predicted K-PRC depression (B=−15.2, P=0.036) and social relationships (B=−11.6, P=0.016).

Conclusion:
Pediatric brain tumor survivors, in particular, patients with attention problems, had worse psychosocial functioning at baseline and follow-up. Attention problems at baseline need to be carefully evaluated in assessing psychosocial functioning of pediatric brain tumor survivors.
Evaluating Excessive Burden of Depression on Health Status and Health Care Utilization Among Patients With Hypertension in a Nationally Representative Sample From the Medial Expenditure Panel Survey (MEPS 2012)
Authors: Shao Hui , Mohammed Mir Umer , Thomas Nick , Babazadeh Saleh , Yang Shuang , Shi Qian , Shi Lizheng 
Published: January 2017

Abstract
Depression and hypertension frequently present together in clinical practice. Evaluating the interaction between depression and hypertension would help stakeholders better understand the value of depression prevention in primary care. This retrospective study aimed to evaluate the excessive burden of depression on overall health and on health care utilization expenditure among hypertensive patients. A total of 7019 hypertensive patients (ICD-9-CM: 401) were identified from the 2012 Medical Expenditure Panel Survey (MEPS 2012) data, of which 936 patients had depression (ICD-9-CM: 311). Hypertension with depression was associated with worse health status (physical component score, −3.97 [17.9% reduction]; mental component score, −9.14 [9% reduction]), higher utilization of health care services (outpatient visits, 6.4 [63.8% higher]; nights of hospitalization, 0.9 [100% higher]; medication prescription, 22.6 [76.8% higher]), and higher health care expenditures (inpatient, $1953.2 [72% higher]; prescription drugs, $1995.5 [82% higher]).
Evaluation and Management of Female Victims of Sexual Assault
Authors: Vrees Roxanne A. 
Published: January 2017

Sexual assault is characterized by any sexual contact or behavior that occurs without explicit consent. Classifications vary based on the status of the perpetrator’s relationship to the victim (eg, stranger, acquaintance) and characteristics of the victim herself (eg, child, elder adult, mentally disabled adult). Regardless of the classification, sexual assault is a significant individual as well as public health issue affecting women of all ages. While the majority of sexual assault cases are not initially reported to law enforcement, the best available data suggest the lifetime prevalence of sexual assault in the United States is approximately 20% among adult women. With such a significant proportion of women affected by sexual assault, women’s health care providers in both ambulatory and emergency care settings play key roles in the evaluation, management, and advocacy of these victims. Establishing standard protocols based on state laws and on victim-centered practices to avoid revictimization of the patient is critical.
The primary goals of care include the assessment and treatment of physical injuries, psychological assessment and support, pregnancy assessment and prevention, and therapy for prevention of sexually transmitted infections. In addition, evidentiary collection is a critical component of the sexual assault evaluation and subsequent legal proceedings.
This report focuses specifically on the immediate evaluation and management of adult female victims of sexual assault. Best practices include the utility of the Sexual Assault Nurse Examiner and Sexual Assault Forensic Examiner programs, as well as standardized treatment protocols.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objective
After completing this activity, the learner should be better able to (1) be familiar with the clinical and forensic components of the initial evaluation of a female victim of sexual assault; (2) provide counseling and treatment for pregnancy prevention, sexually transmitted infections, and human immunodeficiency virus following a sexual assault; (3) discuss the immediate and long-term sequelae following sexual assault; and (4) identify available local resources for sexual assault victims.
Electrographic Seizures in Children and Neonates Undergoing Extracorporeal Membrane Oxygenation
Authors: Lin Jainn-Jim , Banwell Brenda L. , Berg Robert A. , Dlugos Dennis J. , Ichord Rebecca N. , Kilbaugh Todd J. , Kirsch Roxanne E. , Kirschen Matthew P. , Licht Daniel J. , Massey Shavonne L. , Naim Maryam Y. , Rintoul Natalie E. , Topjian Alexis A. , Abend Nicholas S. 
Published: January 2017

Objective:
We aimed to determine the prevalence and risk factors for electrographic seizures in neonates and children requiring extracorporeal membrane oxygenation support.

Design:
Prospective quality improvement project.

Setting:
Quaternary care pediatric institution.

Patients:
Consistent with American Clinical Neurophysiology Society electroencephalographic monitoring recommendations, neonates and children requiring extracorporeal membrane oxygenation support underwent clinically indicated electroencephalographic monitoring.

Interventions:
We performed a 2-year quality improvement study from July 2013 to June 2015 evaluating electrographic seizure prevalence and risk factors.

Main Results:
Ninety-nine of 112 patients (88%) requiring extracorporeal membrane oxygenation support underwent electroencephalographic monitoring. Electrographic seizures occurred in 18 patients (18%), of whom 11 patients (61%) had electrographic status epilepticus and 15 patients (83%) had exclusively electrographic-only seizures. Electrographic seizures were more common in patients with low cardiac output syndrome (p = 0.03). Patients with electrographic seizures were more likely to die prior to discharge (72% vs 30%; p = 0.01) and have unfavorable outcomes (54% vs 17%; p = 0.004) than those without electrographic seizures.

Conclusions:
Electrographic seizures occurred in 18% of neonates and children requiring extracorporeal membrane oxygenation support, often constituted electrographic status epilepticus, and were often electrographic-only thereby requiring electroencephalographic monitoring for identification. Low cardiac output syndrome was associated with an increased risk for electrographic seizures. Electrographic seizures were associated with higher mortality and unfavorable outcomes. Further investigation is needed to determine whether electrographic seizures identification and management improves outcomes.
Evaluating the Necessity of Antibiotics in the Treatment of Acute Epididymitis in Pediatric Patients
Authors: Cristoforo Thomas A. 
Published: January 2017

Objectives
This literature review and data analysis aims to evaluate the percentage of pediatric patients with acute epididymitis found to have bacterial etiology and the percentage of patients in these studies that were treated with antibiotic therapy versus conservative therapy.

Methods
A search of EBSCO through January 13, 2016, using the key words epididymitis or epididymo-orchitis and child, children, or pediatric, identified 542 potential studies.
Twenty-seven retrospective studies met the inclusion criteria, containing patients aged 21 years or younger with acute epididymitis or epididymoorchitis. The number and age of patients, urine cultures and urinalysis results, number of patients treated with antibiotics, and incidence were extracted.

Results
A total of 1496 patients with acute epididymitis were identified. A urinalysis was obtained for 1124 patients, and 190 (16.9%) were positive. Aurine culturewas obtained for 670 patients, and 100 (14.9%) were positive. Fourteen studies addressed antibiotic administration wherein 652 patients were with acute epididymitis and 554 (85%) received antibiotics.
Of 502 patients with urinalysis results, urine culture results, and antibiotic treatment rates, 54 (10.8%) were positive for a bacterial source. Antibiotics were administered to 410 (81.7%) of these 502 patients.

Conclusions
Practitioners should consider only prescribing antibiotics to patients with acute epididymitis if there is an abnormal urinalysis or urine culture.
Comparison of Resource Utilization and Length of Hospitalization Between Overweight and Healthy-Weight Pediatric Trauma Patients Presenting to a Pediatric Emergency Department With Moderate to Severe Injury
Authors: Romano Theresa , Koutroulis Ioannis , Weiner Evan , Little Anthony , Singh Sabina 
Published: January 2017

Objectives
Our study aimed to compare overweight and healthy-weight pediatric trauma patient outcomes, specifically with respect to hospital length of stay and resource utilization. We hypothesized that overweight pediatric trauma patients would have increased hospital length of stay and radiographic study use compared with their healthy-weight counterparts.

Methods
This was a prospective, observational, cohort study of pediatric trauma patients aged 2 to 19 years presenting to an urban pediatric emergency department over a period of 1 year. Using measured height and weight values, body mass index (BMI) for age was calculated and plotted on the Centers for Disease Control and Prevention BMI-for-age growth charts. Patients were followed up throughout their hospitalization, and the following items were recorded: trauma alert level, mechanism of injury, age, sex, race, Glasgow Coma Scale score, total number of days in hospital, total number of intensive care unit days, total number of radiographs obtained, total number of computed tomography scans obtained, and mechanism of injury.

Results
Our study population included 109 subjects. The mean age of the subjects was 9.7 years. The number of patients meeting the definition of obese (BMI for age ≥95%) was 15, or 14% of the total study population. There was no significant difference between the overweight cohort and the healthy-weight cohort found among any of the variables recorded and analyzed.

Conclusions
Although there are many chronic conditions in children associated with obesity, in the case of trauma, it does not seem to be a strong concern. A continued focus on preventing and reversing childhood obesity for other physical and mental health outcomes may be more important.
Computed Tomography in Cystic Fibrosis: Combining Low-Dose Techniques and Iterative Reconstruction
Authors: Kahn Johannes , Kaul David , Grupp Ulrich , Böning Georg , Renz Diane , Staab Doris , Schreiter Vera , Streitparth Florian 
Published: January 2017

Objective
The aim of the study was to evaluate the impact of iterative reconstruction (IR) and low-kilovolt technique on dose reduction and image quality of chest computed tomography scans obtained in patients with cystic fibrosis (CF).

Methods
A total of 124 CF patients were examined; group A (n = 63) was examined with a dose reduction protocol using IR and group B (n = 61) with a standard protocol using filtered back projection. Further subgroups with tube voltage modulations were established. Quantitative and qualitative image quality was assessed.

Results
The radiation dose in groups with comparable image quality was approximately 40% lower using IR compared with filtered back projection. The IR protocol combined with 80-kV tube voltage showed adequate image quality with a mean effective dose of only 0.47 mSv.

Conclusions
Iterative reconstruction helps extensively reduce radiation dose by improving image quality. It permits the use of low-kilovolt protocols without significantly degrading image reading ability in the monitoring of the predominantly young patients with CF.