bluuebunny/crossref_metadata_2025_split huggingface dataset:
ELECTROPHYSIOLOGICAL CHARACTERIZATION OF MACULAR TELANGIECTASIA TYPE 2 AND STRUCTURE–FUNCTION CORRELATION
Authors: Okada Mali , Robson Anthony G. , Egan Catherine A. , Sallo Ferenc B. , Esposti Simona Degli , Heeren Tjebo F. C. , Fruttiger Marcus , Holder Graham E. 
Published: June 2017

Purpose:
To investigate the electrophysiological features of macular telangiectasia Type 2 and their relationship to structure as determined by optical coherence tomography imaging.

Methods:
Forty-two eyes from 21 patients enrolled in the Macular Telangiectasia Natural History Observation Study were reviewed. All patients had full-field and pattern electroretinography (ERG; PERG) with some patients additionally having multifocal electroretinography (mfERG; N = 15) or electrooculography (N = 12). Multiple linear regression modeling assessed the relationship between the ellipsoid zone break size on optical coherence tomography and the central mfERG response.

Results:
Full-field ERG and electrooculography were normal in all eyes. Six eyes (14%) from five patients had subnormal PERG P50 amplitudes. Twenty-two of 30 eyes (73%) had reduced central or paracentral stimulus on mfERG. There was a significant correlation between ellipsoid zone break size and both the P1 amplitude (R2 = 0.37, P = 0.002) and P1:N1 ratio (R2 = 0.32, P = 0.002) of the central response on mfERG.

Conclusion:
The electrophysiological findings in macular telangiectasia Type 2 are those of localized central dysfunction and are consistent with the structural data available from imaging and histologic studies. The ellipsoid zone break size correlates with mfERG reduction. The reduced mfERG P1:N1 ratio is consistent with inner retinal dysfunction.
EFFECT OF DARK ADAPTATION AND BLEACHING ON BLUE LIGHT REFLECTANCE IMAGING IN MACULAR TELANGIECTASIA TYPE 2
Authors: Okada Mali , Heeren Tjebo F. C. , Egan Catherine A. , Rocco Vincent , Bonelli Roberto , Fruttiger Marcus 
Published: June 2017

Purpose:
In patients with macular telangiectasia Type 2, blue light reflectance imaging reveals an oval, parafoveal area in the macula that has increased reflectance compared with its surrounding. Here, we examine how dark adaptation and photobleaching can affect the blue light reflectance imaging pattern.

Methods:
Prospective study of patients with macular telangiectasia enrolled in the MacTel Natural History Observation Study. After dark adaptation, a sequence of images was obtained with a confocal scanning laser ophthalmoscope at 488 nm. Change of reflectance patterns was analyzed over time.

Results:
Eighteen eyes from 16 patients were analyzed. Initially, increased reflectivity in the parafoveal area resulted in higher gray values compared with the paramacular surrounding on blue light reflectance imaging. The difference between parafoveal and paramacular reflectance intensity decreased steadily during imaging, from 17.7 gray-value units (95% confidence interval: 12.1–23.2) down to 2.8 (95% confidence interval: −0.8 to 6.5) after around 30 seconds, and recovered after 5 minutes of dark adaptation.

Conclusion:
A bleaching effect was evident in our study. Understanding these changes is important for both diagnosis and assessment of blue light reflectance phenotype in patients with macular telangiectasia and could also provide further insights into the pathophysiology of this disease.
Comparative effectiveness of laparoscopic versus open prostatectomy for men with low-risk prostate cancer: a matched case-control study
Authors: Parikh Rahul R. , Patel Amil , Kim Sinae , Kim Isaac Yi , Goyal Sharad 
Published: June 2017

Background:
Little data exist on effect of undergoing laparoscopic prostatectomy(LP) versus open prostatectomy(OP) upon 30-day mortality rates among low-risk prostate cancer patients.

Materials and methods:
Using the National Cancer Database, we identified men (2004 to 2013) with biopsy-proven, low-risk prostate cancer who met the eligibility criteria: N0, M0, T-stage≤2A, PSA≤10 ng/mL, and Gleason score=6. We utilized a 1:N matched case-control study, with cases and controls matched by race, insurance status, Charlson-Deyo comorbidity score, surgical margin status, and facility type to investigate the short-term comparative effectiveness of LP versus OP.

Results:
Among the 448,773 patients in the National Cancer Database with low-risk prostate cancer, 116,359 patients met the above inclusion criteria. The target group was restricted to patients who received LP or OP, thus, leaving 44,720 patients for the study. The use of LP (compared with OP) was associated with patients with privately insured patients, treatment at an academic/research centers, high-volume hospitals, and white race (all P<0.01). LP was less frequently utilized for black patients, those who received treatment at community centers, and for those with Medicaid insurance(all P<0.01). The odds ratio of death for surgery type (laparoscopy vs. open) was estimated at 0.31 (95% confidence interval, 0.135–0.701; P<0.05). Thus, the risk of death within 30 days was 69% lower with LP compared with OP.

Conclusions:
We found that the 30-day mortality rate among low-risk prostate cancer patients is significantly lower among patients who received LP when compared with OP, with various clinicopathologic parameters associated with its preferential use.
Vulvodynia—Younger Age and Combined Therapies Associate With Significant Reduction in Self-Reported Pain
Authors: Aalto Anu P. , Vuoristo Silja , Tuomaala Heidi , Niemi Riikka J. , Staff Synnöve M. , Mäenpää Johanna U. 
Published: June 2017

Objectives
Eight percent of women have vulvodynia (VD), a chronic pain disorder with unknown etiology. The aim of our study was to assess the efficacy of given VD treatments measured by numerical rating scale (NRS) for pain and patients' quality of life.

Materials and Methods
Study material consisted of a retrospective VD patient cohort (N = 70). Data were collected by postal questionnaires and review of the medical records.

Results
We report here a statistically significant reduction in NRS only with combination of therapies (median NRS before treatments 8 vs median NRS 4 after treatments, p < .001) but not with any individual therapy alone, i.e., physiotherapy, topical medications, oral pharmaceutical therapy, sexual counseling by a trained nurse, sacral neuromodulation, and laser treatment or surgery. Older age (>30) and frequent (≥6) outpatient clinic visits associated with a significantly minor reduction in NRS (p = .03 and p = .04, respectively).

Conclusions
The results of this retrospective study suggest that an effective, multimodality-based treatment is most beneficial for VD patients and VD at older age may represent a subtype more resistant to therapy.
Clinical and Histopathologic Features of Colorectal Adenocarcinoma in Crohn’s Disease
Authors: Galata Christian , Hirsch Daniela , Reindl Wolfgang , Post Stefan , Kienle Peter , Boutros Michael , Gaiser Timo , Horisberger Karoline 
Published: June 2017

Goals:
The aim of this study was to assess the histopathologic characteristics of colorectal carcinomas (CRC) in patients with Crohn’s disease (CD).

Background:
A higher frequency of microsatellite instability (MSI) is seen in mucinous compared with nonmucinous CRC which suggests that its pathogenesis involves distinct molecular pathways. Several publications reported a higher percentage of mucinous adenocarcinoma in CD patients with CRC. So far, there has been no investigation of MSI in CD patients with mucinous CRC.

Study:
The medical records of patients who underwent surgery for CRC were reviewed and those with a history of CD identified. The data of histologic classification and MSI status of the tumor were investigated.

Results:
Fourteen patients with CD-associated CRC were identified (5 female, 9 male) resulting in 20 CRC in total. Histologic investigation revealed 7 adenocarcinomas without a mucinous or signet ring cell component. All other CRCs harbored a mucinous (n=11) and/or signet ring cell (n=6) component. All tumors assessed for MSI were found to be microsatellite stable.

Conclusions:
Our data indicate that CRCs with signet ring cell and mucinous components were much more common in patients with CD than in patients with sporadic CRC. This observation suggests that CRC in CD represent an own entity with distinct histopathologic and molecular features. This may implicate potential consequences for diagnosis and therapy of CRC in CD in the future as well as new factors to identify patients with an increased risk for developing CRC in CD.
Depression and insomnia among individuals with celiac disease or on a gluten-free diet in the USA: results from a national survey
Authors: Zylberberg Haley M. , Demmer Ryan T. , Murray Joseph A. , Green Peter H.R. , Lebwohl Benjamin 
Published: June 2017

Background
There is uncertainty regarding the prevalence of psychiatric illnesses in patients with celiac disease (CD) and people who avoid gluten (PWAG) without a diagnosis of CD.

Participants and methods
We obtained data from 22 274 participants from the 2009–2014 National Health and Nutrition Examination Survey to compare the prevalence of depression, insomnia, quality-of-life variables, and psychotropic medication use in CD participants and PWAGs to controls. We used multivariable logistic regression to assess for independent associations between CD/PWAG status and the outcomes of these variables.

Results
Depression was present in 8.2% of controls compared with 3.9% of participants with CD (P=0.18) and 2.9% of PWAGs (P=0.002). After adjustment for age, sex, race, income, and access to healthcare, PWAGs maintained lower odds of depression compared with controls (odds ratio=0.25; 95% confidence interval: 0.12–0.51; P=0.0001). The prevalence estimates of sleep difficulty among controls (27.3%) compared to participants with CD or PWAGs were 37.7% (P=0.15) and 34.1% (P=0.11). Those with diagnosed CD had increased odds of sleep difficulty (odds ratio=2.41; 95% confidence interval 1.04–5.60), but this was no longer significant after multivariable adjustment (P=0.17).

Conclusion
Among a nationally representative US sample, participants with CD overall showed no increased odds of depression or sleep difficulty. PWAGs showed lower odds of depression compared with controls. Future research should investigate the relationship between a diagnosis of CD and the development of psychiatric conditions.
Understanding and Promoting Birth Satisfaction in New Mothers
Authors: Hinic Katherine 
Published: June 2017

Abstract

Purpose:
The purpose of this study was to examine the impact of select maternal psychosocial and experiential factors on birth satisfaction of new mothers during early postpartum.

Study Design and Methods:
This is a descriptive correlational study exploring the relationships among birth satisfaction, breastfeeding self-efficacy, and perceived stress in 107 new mothers in the first 4 days postpartum. Instruments used included the Birth Satisfaction Scale-Revised, the Perceived Stress Scale, the Breastfeeding Self-Efficacy Scale-Short Form, and a researcher-generated demographic form. Quantitative analysis included descriptive statistics, correlation, one-way Analysis of Variance, and multiple linear regression.

Results:
Birth satisfaction was negatively correlated with perceived stress (r = -.299, p < .05) and positively correlated with feeling prepared for birth (rho = .243, p < .05) and breastfeeding self-efficacy (r = .226, p < .05). The predictive model for birth satisfaction was significant (R
2 = .204, F [6, 99] = 4.225, p = .001), explaining approximately 20.4% of variance in birth satisfaction in the sample.

Clinical Implications:
Stress reduction and management, establishment of realistic expectations for labor and birth, and promotion of togetherness with newborn immediately after birth are nursing priorities to promote birth satisfaction.
Life-Threatening and Suspicious Lesions Caused by Mechanical Cardiopulmonary Resuscitation
Authors: Milling Louise , Leth Peter Mygind , Astrup Birgitte Schmidt 
Published: June 2017

Abstract
Chest compression devices for mechanical cardiopulmonary resuscitation (CPR) have become more common. Here, we report the case of a young woman who attempted resuscitated with LUCAS™2 after she was found unconscious at home. At autopsy, we found extensive intramuscular hemorrhages in posterior neck, between the scapulae, and in the lumbar region. Investigation of internal organs showed injuries to the lung, spleen, and kidney. The extension of the injuries gave rise to suspicion of homicide by smothering, which police investigation subsequently did not support. The pattern of injury could be attributed to automatic compression decompression CPR with LUCAS™2.
The injuries may have been lethal had the patient survived. For the forensic pathologists, it is important to remain updated on developments in treatment techniques to avoid pitfalls when interpreting injury.
Larger studies, prospective or retrospective, may be able to qualify the possible risks of automatic compression decompression CPR even further.
Promoters and Barriers to Implementation of Tracheal Intubation Airway Safety Bundle: A Mixed-Method Analysis*
Authors: Finn Davis Katherine , Napolitano Natalie , Li Simon , Buffman Hayley , Rehder Kyle , Pinto Matthew , Nett Sholeen , Jarvis J. Dean , Kamat Pradip , Sanders Ronald C. , Turner David A. , Sullivan Janice E. , Bysani Kris , Lee Anthony , Parker Margaret , Adu-Darko Michelle , Giuliano John , Biagas Katherine , Nadkarni Vinay , Nishisaki Akira 
Published: June 2017

Objectives:
To describe promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders.

Design:
Mixed methods.

Setting:
Thirteen PICUs of the National Emergency Airway Registry for Children network.

Intervention:
Remote or on-site focus groups with interdisciplinary ICU staff. Two semistructured interviews with ICU quality improvement leaders with quantitative and qualitative data-based feedbacks.

Measurements and Main Results:
Bundle implementation success (compliance) was defined as greater than or equal to 80% use for tracheal intubations for 3 consecutive months. ICUs were classified as early or late adopters. Focus group discussions concentrated on safety concerns and promoters and barriers to bundle implementation. Initial semistructured quality improvement leader interviews assessed implementation tactics and provided recommendations. Follow-up interviews assessed degree of acceptance and changes made after initial interview. Transcripts were thematically analyzed and contrasted by early versus late adopters. Median duration to achieve success was 502 days (interquartile range, 182–781). Five sites were early (median, 153 d; interquartile range, 146–267) and eight sites were late adopters (median, 783 d; interquartile range, 773–845). Focus groups identified common “promoter” themes—interdisciplinary approach, influential champions, and quality improvement bundle customization—and “barrier” themes—time constraints, competing paperwork and quality improvement activities, and poor engagement. Semistructured interviews with quality improvement leaders identified effective and ineffective tactics implemented by early and late adopters. Effective tactics included interdisciplinary quality improvement team involvement (early adopter: 5/5, 100% vs late adopter: 3/8, 38%; p = 0.08); ineffective tactics included physician-only rollouts, lack of interdisciplinary education, lack of data feedback to frontline clinicians, and misconception of bundle as research instead of quality improvement intervention.

Conclusions:
Implementation of an airway safety quality improvement bundle with high compliance takes a long time across diverse ICUs. Both early and late adopters identified similar promoter and barrier themes. Early adopter sites customized the quality improvement bundle and had an interdisciplinary quality improvement team approach.
Severe Upper Airway Obstruction After Intraoperative Transesophageal Echocardiography in Pediatric Cardiac Surgery: A Retrospective Analysis*
Authors: Michel Jörg , Hofbeck Michael , Schineis Christian , Kumpf Matthias , Heimberg Ellen , Magunia Harry , Schmid Eckhard , Schlensak Christian , Blumenstock Gunnar , Neunhoeffer Felix 
Published: June 2017

Objectives:
The aim of this study was to evaluate if there is a correlation between the use of intraoperative transesophageal echocardiography and an increased rate of extubation failure and to find other risk factors for severe upper airway obstructions after pediatric cardiac surgery.

Design:
Retrospective analysis.

Setting:
Cardiac PICU.

Patients:
Patients 24 months old or younger who underwent surgery for congenital heart disease with cardiopulmonary bypass were retrospectively enrolled and divided into two groups depending on whether they received an intraoperative transesophageal echocardiography or not. We analyzed all cases of early reintubations within 12 hours after extubation due to a documented upper airway obstruction.

Intervention:
None.

Measurements and Main Results:
From a total of 424 patients, 12 patients (2.8%) met our criteria of early reintubation due to upper airway obstruction. Ten of 207 children in the transesophageal echocardiography group had to be reintubated, whereas only two of the 217 children in the control group had to be reintubated (4.8% vs 0.9%; p = 0.018). Logistic regression analysis showed a significant correlation between use of intraoperative transesophageal echocardiography and extubation failure (odds ratio, 5.64; 95% CI, 1.18–27.05; p = 0.030). There was no significant relationship among sex (odds ratio, 4.53; 95% CI, 0.93–22.05; p = 0.061), weight (odds ratio, 1.07; 95% CI, 0.82–1.40; p = 0.601), duration of surgery (odds ratio, 1.04; 95% CI, 0.74–1.44; p = 0.834), duration of mechanical ventilation (odds ratio, 1.00; 95% CI, 0.99–1.00; p = 0.998), and occurrence of trisomy 21 (odds ratio, 3.47; 95% CI, 0.83–14.56; p = 0.089).

Conclusions:
Although the benefits of intraoperative transesophageal echocardiography during pediatric cardiac surgery are undisputed, it may be one factor which could increase the rate of severe upper airway obstruction after extubation with the need for reintubation. We suggest to take precautions before extubating high-risk patients, especially in young male children with genetic abnormalities after cardiac surgery with cardiopulmonary bypass.
Workload of Team Leaders and Team Members During a Simulated Sepsis Scenario
Authors: Tofil Nancy M. , Lin Yiqun , Zhong John , Peterson Dawn Taylor , White Marjorie Lee , Grant Vincent , Grant David J. , Gottesman Ronald , Sudikoff Stephanie N. , Adler Mark , Marohn Kimberly , Davidson Jennifer , Cheng Adam 
Published: June 2017

Objectives:
Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings. Low workload is defined as less than 40, moderate 40–60, and greater than 60 signify high workloads. Our hypothesis is that workload among both team leaders and team members is moderate to high during a simulated pediatric sepsis scenario and that team leaders would have a higher workload than team members.

Design:
Multicenter observational study.

Setting:
Nine pediatric simulation centers (five United States, three Canada, and one United Kingdom).

Patients:
Team leaders and team members during a 12-minute pediatric sepsis scenario.

Interventions:
National Aeronautics and Space Administration-Task Load Index.

Measurements and Main Results:
One hundred twenty-seven teams were recruited from nine sites. One hundred twenty-seven team leaders and 253 team members completed the National Aeronautics and Space Administration-Task Load Index. Team leader had significantly higher overall workload than team member (51 ± 11 vs 44 ± 13; p < 0.01). Team leader had higher workloads in all subcategories except in performance where the values were equal and in physical demand where team members were higher than team leaders (29 ± 22 vs 18 ± 16; p < 0.01). The highest category for each group was mental 73 ± 13 for team leader and 60 ± 20 for team member. For team leader, two categories, mental (73 ± 17) and effort (66 ± 16), were high workload, most domains for team member were moderate workload levels.

Conclusions:
Team leader and team member are under moderate workloads during a pediatric sepsis scenario with team leader under high workloads (> 60) in the mental demand and effort subscales. Team leader average significantly higher workloads. Consideration of decreasing team leader responsibilities may improve team workload distribution.
Kinematic Gait Changes Following Serial Casting and Bracing to Treat Toe Walking in a Child With Autism
Authors: Barkocy Marybeth , Dexter James , Petranovich Colleen 
Published: June 2017

Purpose:
To evaluate the effectiveness of serial casting in a child with autism spectrum disorder (ASD) exhibiting a toe-walking gait pattern with equinus contractures.

Summary of Key Points:
Although many children with ASD toe walk, little research on physical therapy interventions exists for this population. Serial casting has been validated for use in idiopathic toe walking to increase passive dorsiflexion and improve gait, but not for toe walking in children with ASD. Serial casting followed by ankle-foot orthosis use was implemented to treat a child with ASD who had an obligatory equinus gait pattern. Gait analysis supported improvements in kinematic, spatial, and temporal parameters of gait, and the child maintained a consistent heel-toe gait at 2-year follow-up.

Statement of Conclusion and Recommendations for Clinical Practice:
Serial casting followed by ankle-foot orthosis use is a viable treatment option for toe walking in children with ASD.
A Progressive Running Program for an Adolescent With Cerebral Palsy
Authors: Lewis Jessica 
Published: June 2017

Purpose:
To describe the physical therapy intervention and outcomes for a 20-week progressive running program.

Summary of Key Points:
A 12-year-old boy with spastic diplegic cerebral palsy, Gross Motor Function Classification System level II, participated in a 20-week running program. The 6-minute walk test and the 88-item and 66-item versions of the Gross Motor Function Measure (GMFM) were administered at baseline and program completion. After completion of the program, the participant exceeded thresholds for minimally clinically important differences on the GMFM-66 total score and GMFM-88 Dimension D and E scores. He improved gait speed and distance walked during the 6-minute walk test.

Conclusions and Recommendations for Clinical Practice:
Participation in a progressive running program is a feasible intervention to promote improvements in walking speed and gross motor function in some adolescents with spastic diplegic cerebral palsy in Gross Motor Function Classification System level II.