bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Practices and Outcomes of Meibomian Gland Dysfunction at a Tertiary Center in Southern India
Authors: Lee Ling , Garrett Qian , Flanagan Judith L. , Vaddavalli Pravin K. , Papas Eric B. 
Published: December 2016

Objective:
To describe the current treatment practices for meibomian gland dysfunction (MGD) at a tertiary eye center, together with the subjective outcomes and compliance behaviors of patients.

Methods:
This retrospective cohort study reviewed medical records for MGD severity grading, treatment prescribed, and follow-up schedule. In addition, participants were surveyed to gauge subjective outcomes and treatment adherence.

Results:
Eight hundred ten patients were diagnosed with “MGD” or “meibomitis” and had a total of 14 different treatment combinations prescribed. In 3.0% of cases, there was no treatment specified. As MGD severity increased, it became more likely that management would be applied and this was also associated with significantly longer treatment durations (P=0.02) and shorter follow-up periods (P<0.001). Posttreatment subjective outcomes and treatment adherence surveys had a response rate of 36.7% and 24.1% respectively. Overall, 53.5% reported sustained improvement, 40.7% no improvement, and 5.7% experienced temporary relief. Although no treatment regimen seemed to be more efficacious than others, patients showed greater adherence when using topical reagents compared with lid hygiene measures (P≤0.002).

Conclusion:
Clinicians, in this large tertiary eye center, use a wide range of treatment regimens to manage MGD. This suggests the need for development of standard management protocols. Whether alone, or in combination, no MGD treatment significantly improved subjective symptoms, a result that may be influenced by compliance behaviors. Use of topical reagents (eye drops or ointment) seemed to be associated with the best compliance. Future focus on more effective MGD treatments is needed to improve practical outcomes.
Pediatric Sacroiliitis
Authors: Donzelli Ambra , Samara Eleftheria , Spyropoulou Vassiliki , Juchler Céline , Ceroni Dimitri 
Published: December 2016

Background:
The aim of this study was to improve knowledge of pediatric pyogenic sacroiliitis (PSI) in the pediatric population based on a consecutive case series.

Method:
We conducted a single-center cross-sectional study on 16 patients admitted to the emergency department of our Hospital between January 1990 and December 2015 with a confirmed diagnosis of PSI. The patients were divided into 2 groups by age: infants (6 months to 4 years) and children–adolescents (4–16 years). The features of PSI, clinical signs and symptoms, laboratory tests, bacteriologic investigations, radiologic examinations and outcome were compared among the 2 groups.

Results:
Patients in the children–adolescent group usually presented with a history of limping and buttock or lower back pain, and methicillin-susceptible Staphylococcus aureus was the most frequent pathogen. We observed a second peak of incidence of PSI in infants with consistent difference in clinical and microbiologic presentation. Infants were more likely to have an ambiguous onset with the refusal to bear weight as the only consistent clinical manifestations, and biologic investigations demonstrated higher erythrocyte sedimentation rate and platelet counts. However, all blood and joint fluid cultures were sterile in the infant group.

Conclusion:
PSI in infants and adolescents may represent 2 different conditions. Although PSI is mainly caused by S. aureus in the children–adolescent group, clinical manifestations and biologic characteristics of PSI in infants suggest Kingella kingae as the etiology osteoarticular infection. Thus, oropharyngeal swab polymerase chain reaction assay for K. kingae and magnetic resonance imaging should be considered for early diagnosis and treatment of this condition in the younger age group.
Rat Bite Fever
Authors: Walker Justin W. , Reyes Lilia B. 
Published: December 2016

Abstract
Cases of rat-bite fever (RBF) were reported in the literature for more than 2000 years. Not until recently, however, were attempts made to differentiate between RBF and Streptobacillus moniliformis septic arthritis, 2 arguably different clinical entities. There are limited data regarding S moniliformis septic arthritis and the features that distinguish it from RBF, and most conclude that although clinically disparate diseases, it is difficult to differentiate between them. We report a case of a 17-year-old girl who presented with S moniliformis bacteremia and symptoms that spanned both RBF and S moniliformis septic arthritis. This case emphasizes the difficulty in differentiating the 2 clinical entities and the importance of early diagnosis, proper clinical suspicion, and prompt treatment to achieve positive outcomes.
Comorbid Conditions are Associated With Emergency Department Visits, Hospitalizations, and Medical Charges of Patients With Systemic Lupus Erythematosus
Authors: Han Guang-Ming , Han Xiao-Feng 
Published: December 2016

Background/ObjectivesIn addition to increase mortality, comorbidities can increase medical costs for systemic lupus erythematosus (SLE). Healthcare utilization can dramatically increase medical costs. It is essential to better understand the comorbidities that can lead to healthcare utilization, such as emergency department visit and/or hospitalization, for SLE patients. Therefore, the objective of this study was to examine the associations between comorbidities and healthcare utilization and medical charges of patients with SLE.MethodsNebraska statewide emergency departments (ED) discharge and hospitals discharge data from 2007 to 2012 were used to study the comorbid conditions of patients with SLE. SLE was defined using the standard International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes (710.0).ResultsThere were more comorbid conditions in patients with SLE than patients without SLE. Comorbid conditions were majorly related to ED visits and hospitalizations of patients with SLE. Chest pain, abdominal pain, injury, acute respiratory infections, symptoms of digestive systems, headache, myalgia and myositis, noninfectious gastroenteritis and colitis, and symptoms of skin and other integumentary systems are common comorbid conditions for ED visits. Infections, cardiovascular diseases, fractures, chronic obstructive pulmonary disease (COPD) and allied conditions, cerebrovascular diseases, and episodic mood disorder are common comorbid conditions for hospitalizations of patients with SLE. In addition, the numbers of comorbid conditions were significantly associated with the length of hospital stay and hospital charges for SLE patients.ConclusionThe findings in this study indicated that comorbid conditions are associated with healthcare utilization and medical charges of patients with SLE.
The Role of 25-Hydroxyvitamin D as a Predictor of Clinical and Radiological Outcomes in Early Onset Rheumatoid Arthritis
Authors: Quintana-Duque Mario Andrés , Caminos Jorge Eduardo , Varela-Nariño Adriana , Calvo-Paramo Enrique , Yunis Juan José , Iglesias-Gamarra Antonio 
Published: December 2016

Objective
The aims of this study were to compare the levels of 25-hydroxyvitamin D (25(OH)D) in patients with early-onset rheumatoid arthritis (EORA) versus a healthy control group and to assess the association of 25(OH)D deficiency and the BsmI polymorphism of the vitamin D receptor gene with clinical, radiological, and laboratory parameters.

Methods
Early-onset RA Colombian patients were enrolled in a 3-year follow-up study. Vitamin D deficiency was diagnosed for 25(OH)D levels of less than 20 ng/mL. Pearson and Spearman correlation coefficients were used to assess data.

Results
Seventy patients and 70 matched healthy subjects were included. 25-Hydroxyvitamin D was lower in the EORA group (27.13 [SD, 13.4] ng/mL vs. 33.74 [SD, 16.7] ng/mL; P = 0.01); 31.4% of EORA patients were vitamin D deficient. Remission was higher in subjects without 25(OH)D deficiency (22.7% vs. 47.9%; P = 0.04). Patients with 25(OH)D deficiency at baseline had higher Health Assessment Questionnaire and Physician Global Disease Activity Assessment scores, fatigue levels, erythrocyte sedimentation rate, and morning stiffness after 3 years. At disease onset, only a relationship between 25(OH)D deficiency with fatigue and morning stiffness was found. Neither radiographic progression nor Sharp van der-Heidje score was associated to hypovitaminosis D after 36-month follow-up. The bb genotype was less frequent in patients with vitamin D deficiency (0% vs. 16.6%; P = 0.04). Patients with BB-Bb genotype had lower 25(OH)D and a propensity to more severe disease.

Conclusions
Our data provide further support for a role of vitamin D as a clinical biomarker for RA. Baseline 25(OH)D could have potential as a predictor of disease severity in EORA.
Longitudinal Computed Tomography Monitoring of Pelvic Bones in Patients With Breast Cancer Using Automated Bone Subtraction Software
Authors: Horger Marius , Thaiss Wolfgang Maximilian , Wiesinger Benjamin , Ditt Hendrik , Fritz Jan , Nikolaou Konstantin , Kloth Christopher 
Published: December 2016

Objective
The aim of this study was to optimize computed tomography (CT) surveillance of skeletal metastases in patients with breast cancer through the use of osseous subtraction maps between baseline and follow-up examinations created by a novel software algorithm. The new postprocessing algorithm segments the original bone followed by image intensity-based rigid alignment creating gray-shaded maps that highlight focal or diffuse loss or increase in bone attenuation.

Materials and Methods
Institutional review board was obtained for this retrospective data evaluation. A total of 33 consecutive patients (31 female; 2 male; mean age, 59.13 ± 12.68 years; range, 32–81 years) with breast cancer were included, who underwent 143 standardized baseline and follow-up CT examinations between February 2014 and June 2016. We classified bone metastases into lytic, sclerotic, and mixed osseous lesions. Any new osteolysis inside a known sclerotic lesion and enlargement of pre-existing sclerotic lesions were considered to represent progressive disease (PD), whereas no change was classified as stable disease (SD). Results were compared additionally with the course of the disease considering the entire skeleton and other involved organs. Software-created automated bone subtraction maps were compared with conventional CT interpretations of axial 5-mm and coronal 1-mm reformatted images. Region of interest measurements were used to quantify new lesions. Results were validated by clinical and CT follow-up. Reading time was evaluated.

Results
Skeletal metastases were present in 17/33 (51%) patients (9 sclerotic, 2 lytic, 6 mixed) at baseline. The use of bone subtraction maps resulted in an overall change of response classification into PD in 9/33 (8.1%) patients. Compared with conventional CT evaluation, the bone subtraction maps disclosed 123 new or enlarging sclerotic and 32 new lytic metastases in 23/33 (30.9%) examinations. Mean attenuation of new bone lesions (sclerotic or lytic) significantly increased or decreased (P < 0.01) in all patients. Bone attenuation in pelvic areas without evident metastatic disease significantly increased in patients with PD (P = 0.019), whereas there was no change in SD (P = 0.076). Lesion-based sensitivity, specificity, accuracy, positive predictive values, and negative predictive values were 98.7%, 79.5%, 94.5%, 95.1%, and 94.5%, respectively. Interobserver agreement was good (κ = 0.80; P = 0.077). Reading time was significantly faster for the bone subtraction maps versus 5-mm axial images (P < 0.001).

Conclusions
Longitudinal bone subtraction maps increase the accuracy and efficiency of CT diagnosis of skeletal metastases in patients with breast cancer.
Symptomatic carotid stenosis: is stenting as safe and effective as carotid endarterectomy?
Authors: Calvet David , Mas Jean-Louis 
Published: December 2016

Purpose of review
Reviewing current evidence on carotid artery stenting (CAS) compared with carotid endarterectomy (CEA) in the prevention of ipsilateral stroke in patients with a symptomatic carotid stenosis.

Recent findings
Randomized clinical trials and registries have consistently shown that CAS is associated with a higher risk of procedural stroke or death and a lower risk of procedural myocardial infarction and local complications compared with CEA. Both procedures are equally effective to prevent late recurrent ipsilateral stroke and are associated with similar low risk of restenosis.
Individual patient data analyses of the Carotid Stenosis Trialists’ Collaboration recently showed that CAS is as safe and as effective in patients younger than 70.

Summary
Although CEA remains the standard treatment in patients with recently symptomatic carotid stenosis, CAS is a safe and effective alternative option in patients younger than 70 and can be also considered when a contraindication to CEA exists.
Neuroplasticity and amblyopia: vision at the balance point
Authors: Tailor Vijay K. , Schwarzkopf D. Samuel , Dahlmann-Noor Annegret H. 
Published: December 2016

Purpose of review
New insights into triggers and brakes of plasticity in the visual system are being translated into new treatment approaches which may improve outcomes not only in children, but also in adults.

Recent findings
Visual experience-driven plasticity is greatest in early childhood, triggered by maturation of inhibitory interneurons which facilitate strengthening of synchronous synaptic connections, and inactivation of others. Normal binocular development leads to progressive refinement of monocular visual acuity, stereoacuity and fusion of images from both eyes. At the end of the ‘critical period’, structural and functional brakes such as dampening of acetylcholine receptor signalling and formation of perineuronal nets limit further synaptic remodelling. Imbalanced visual input from the two eyes can lead to imbalanced neural processing and permanent visual deficits, the commonest of which is amblyopia.

Summary
The efficacy of new behavioural, physical and pharmacological interventions aiming to balance visual input and visual processing have been described in humans, and some are currently under evaluation in randomised controlled trials. Outcomes may change amblyopia treatment for children and adults, but the safety of new approaches will need careful monitoring, as permanent adverse events may occur when plasticity is re-induced after the end of the critical period.

Video abstract
http://links.lww.com/CONR/A42.
Same-day diagnostic and surveillance data for tuberculosis via whole genome sequencing of direct respiratory samples
Authors: Votintseva Antonina A. , Bradley Phelim , Pankhurst Louise , del Ojo Elias Carlos , Loose Matthew , Nilgiriwala Kayzad , Chatterjee Anirvan , Smith E. Grace , Sanderson Nicholas , Walker Timothy M. , Morgan Marcus R. , Wyllie David H. , Walker A. Sarah , Peto Tim E. A. , Crook Derrick W. , Iqbal Zamin 
Published: December 2016

AbstractRoutine full characterization ofMycobacterium tuberculosis(TB) is culture-based, taking many weeks. Whole-genome sequencing (WGS) can generate antibiotic susceptibility profiles to inform treatment, augmented with strain information for global surveillance; such data could be transformative if provided at or near point of care.We demonstrate a low-cost DNA extraction method for TB WGS direct from patient samples. We initially evaluated the method using the Illumina MiSeq sequencer (40 smear-positive respiratory samples, obtained after routine clinical testing, and 27 matched liquid cultures).M. tuberculosiswas identified in all 39 samples from which DNA was successfully extracted. Sufficient data for antibiotic susceptibility prediction was obtained from 24 (62%) samples; all results were concordant with reference laboratory phenotypes. Phylogenetic placement was concordant between direct and cultured samples. Using an Illumina MiSeq/MiniSeq the workflow from patient sample to results can be completed in 44/16 hours at a cost of £96/£198 per sample.We then employed a non-specific PCR-based library preparation method for sequencing on an Oxford Nanopore Technologies MinION sequencer. We applied this to culturedMycobacterium bovisBCG strain (BCG), and to combined culture-negative sputum DNA and BCG DNA. For the latest flowcell, the estimated turnaround time from patient to identification of BCG was 6 hours, with full susceptibility and surveillance results 2 hours later. Antibiotic susceptibility predictions were fully concordant. A critical advantage of the MinION is the ability to continue sequencing until sufficient coverage is obtained, providing a potential solution to the problem of variable amounts ofM. tuberculosisin direct samples.
The career decision-making competence: a new construct for the career realm
Authors: Ceschi Andrea , Costantini Arianna , Phillips Susan D. , Sartori Riccardo 
Published: December 2016

PurposeThis paper aims to link findings from laboratory-based decision-making research and decision-making competence (DMC) aspects that may be central for career-related decision-making processes. Past research has identified individual differences in rational responses in decision situations, which the authors refer to as DMC. Although there is a robust literature on departures from rational responses focused on heuristics and biases (H&B) in decision-making, such evidence is largely confined to group-level differences observed in psychology laboratories and has not been extended to the realm of career development and workforce behavior.Design/methodology/approachBy first introducing the concept of DMC and contextualizing it within organizations and the work environment, the paper outlines a review on recent development concerning debiasing interventions in organizations and provides insights on how these may be effective with regard to organizational performance and individual career development.FindingsThe contribution presents a perspective to improve knowledge about career decision-making competence (C-DMC) by presenting an approach linking decision-making research to interventions aiming at managing H&B and systematic misperceptions in career processes.Originality/valueThis contribution is one of the few linking decision-making research to the applied context of organizations and of career competences. Moreover, while some research has treated decision-making skills as traits, this contribution provides support to consider them developable as competencies.
Competence-based vocational education and training (VET)
Authors: Bohne Christoph , Eicker Friedhelm , Haseloff Gesine 
Published: December 2016

Purpose
The purpose of this paper is to develop a vocational scientific constructivist concept meant for shaping competence-based and networked teaching and learning in vocational education and training (VET).

Design/methodology/approach
VET must enable learners to shape work within the context of conceptions based on the development of society. Refresher trainings cannot realise this. Concepts need a shaping competence-based and networked approach. Teaching and learning networks, learning projects and digital media are the keys to this approach.

Findings
The focus of the planned concept lies on shaping competence-based teaching and learning. This can be realised with innovative teaching and learning networks. Digital media can support this. The planned concept will be justified. The systematic planning of an exemplary learning project will be discussed.

Practical implications
This paper lays the ground to evaluate the relevance and range of shaping competence-based and networked teaching and learning.

Originality/value
The concept was (co-)developed by the University of Rostock. It was tested in first learning projects. These experiences are taken into account. The aim is to emphasise that the intended approach is a justified educational strategy in colleges, companies and other places of learning dealing with VET.
The role of entrepreneurial knowledge as a competence in shaping Iranian students’ career intentions to start a new digital business
Authors: Yaghoubi Farani Ahmad , Karimi Saeid , Motaghed Mahsa 
Published: December 2016

Purpose
This purpose of this paper, drawing on the theory of planned behaviour (TPB), is to develop an integrated model of entrepreneurial career intentions incorporating the role of motivational factors along with entrepreneurial knowledge. Specifically, this study proposes the existence of a relationship between entrepreneurial knowledge and digital entrepreneurial intentions and asserts that this relation is mediated by the motivational factors.

Design/methodology/approach
Data were collected from a sample of 150 computer sciences students from four public Iranian universities using a questionnaire.

Findings
Results indicated that the two motivational factors (namely, attitudes towards digital entrepreneurship and perceived behavioural control) significantly relate to digital entrepreneurial intentions. In addition, entrepreneurial knowledge indicates indirect effects on intentions via these two motivational factors.

Practical implications
The results of this study have clear implications for both educators and policymakers.

Originality/value
The study helps to understand the role of entrepreneurial knowledge in shaping digital entrepreneurial intentions through developing an integrated intention model based on the TPB. The results also indicate that the TPB fully accounts for the indirect effects of entrepreneurial knowledge.
Developing vocational competences during secondary school?
Authors: Behle Heike 
Published: December 2016

PurposeUsing the example of an amalgamated secondary school qualification (International Baccalaureate Career-related Programme – IBCP), in which both vocational education and training (VET) and academic subjects are taught, the paper aims to discuss the use of skills and knowledge gained during the IBCP for post-secondary school activities.Design/methodology/approachThe paper uses mixed method data based on a survey of 57 IBCP graduates and qualitative interviews with 20 IBCP graduates. Findings relate to the role of the IBCP in the careers decision-making process, the skills and competences students gained during their IBCP and its transferability to their current activity.FindingsAfter their IBCP, more than half of all observed students had entered higher education. Whilst a few students did not engage actively in the career decision-making process, some were pro-active and used different sources to gain information. However, a large group of students used their time during the IBCP to test various occupational ideas and, thus, used their VET to further the careers decision-making process. Most students reported that they could transfer the skills and competencies they had gained during their secondary school to their current activity.Originality/valueThe paper calls for a renunciation of the ambivalent signals an amalgamated secondary school degree can provide. IBCP students signal both an increased productivity because of an increased level of vocational skills and a lower level of academic achievement. These signals, however, allow students to enter a highly diverse higher education system, especially in vocational courses.