bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cutting Edge: Topical Recombinant Nerve Growth Factor for the Treatment of Neurotrophic Keratopathy—Biologicals as a Novel Therapy for Neurotrophic Keratopathy
Authors: Hamrah Pedram , Yavuz Saricay Leyla , Ozmen M. Cuneyt 
Published: February 2022

Abstract:
Ophthalmologists find management of neurotrophic keratopathy (NK) challenging because conventional therapy lacks efficacy and may result in permanent loss of vision. Recombinant nerve growth factor (cenegermin) targets the underlying pathogenesis of NK by regenerating corneal nerves and healing the corneal epithelium through promotion of proliferation, maturing corneal epithelial cells. It has been approved as Food Drug Association-approved treatment of NK. In this article, the background, clinical trials, and impact of recombinant nerve growth factor as the first neurotrophic factor for the restoration of corneal integrity, homeostasis, and corneal nerve regeneration are discussed.
Prevalence of Sleep Disorders and Associated Factors in People Living With HIV in the Ceará, Brazil: A Cross-sectional Study
Authors: Cunha Gilmara Holanda da , Ramalho Ane Kelly Lima , Fontenele Marina Soares Monteiro , Siqueira Larissa Rodrigues , Fechine Francisco Vagnaldo , Medeiros Melissa Soares 
Published: February 2022

Abstract
The aim of this study was to determine the prevalence of sleep disorders and associated factors in people living with HIV (PLWH). This was a cross-sectional study with a sample of 385 participants followed-up on an outpatient basis in Fortaleza, Ceará, Brazil. Interviews were conducted using the Sociodemographic, Epidemiological and Clinical Form for PLWH and the Pittsburgh Sleep Quality Index. Descriptive statistics and univariate and multivariate logistic regression analysis were performed, and the odds ratio (OR) and 95% confidence interval (95% CI) were calculated, considering p < .05 as statistically significant. The prevalence of sleep disorders was 43.38%. Having children (p = .0054; OR = 1.91; 95% CI = 1.21–3.01), less than 8 years of education (p = .0013; OR = 2.11; 95% CI = 1.34–3.34), and not engaging in regular physical exercise (p = .0001; OR = 2.61; 95% CI = 1.61–4.23) were factors associated with the occurrence of sleep disorders. It was concluded that almost half of the sample had sleep disorders, especially those with children, low level education, and sedentary habits. These data point to the need for increased guidance on sleep hygiene, in addition to the practice of regular physical exercise for this population.
Material Selection for Diabetic Custom Insoles: A Systematic Review of Insole Materials and Their Properties
Authors: Nilsen Fredrik , Molund Marius , Lium Eva Marie , Hvaal Kjetil Harald 
Published: February 2022

ABSTRACT

Introduction
Diabetic foot ulceration is one of the most significant causes of infection and amputation in neuropathic patients. Most often, the plantar surface of the foot is affected. Offloading the foot by custom-molded insoles is considered a crucial step in prevention of diabetic foot ulcers, although the most beneficial choice of materials is not well documented. This review focuses on identifying the most suitable materials and material compositions for offloading the diabetic foot.

Materials and Methods
A systematic review was performed with the aid of a clinical librarian on September 9, 2020. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Studies were included based on the following eligibility criteria: interventions in terms of material selection/properties with outcomes reported as either pressure reduction and/or ulcer prevention. Bench studies were also included. At each level of selection, records were reviewed by two independent reviewers. Clinical studies were appraised using the ROBINS-1 tool.

Results
Through database search, 1131 records were identified and an additional eight records were identified through references and other sources. After removal of duplicates, 927 records were screened, which resulted in 74 full-text records assessed for eligibility. Thirty-seven studies were included in the qualitative synthesis. Twelve studies examined material properties by bench testing. Five studies were based on finite element analysis. Nineteen clinical studies on material parameters were identified. Six studies supported the use of moderately deformable materials for insole production. Six studies showed better performance of combination material insoles in offloading and under sustained loading. Five studies concluded that increasing the thickness of insoles increased the offloading capabilities.

Conclusions
The diversity of studies and study designs to date precludes the ability to recommend one type of material over the other. Still some general considerations can be made. For solo-material insoles, moderately deformable materials are preferable, balancing the need for offloading with the need for durability. Increasing the thickness may increase the longevity of the insoles. Combining materials of different properties seems to enhance both the offloading capability and durability of insoles.

Clinical Relevance
When using a single-material design, moderately deformable materials are preferable. Combining materials of different properties enhances both the offloading capability and durability of insoles.
Clinical and Nonclinical Factors Affecting Quality of Life in Individuals with Lower-Limb Amputation
Authors: Qa'dan Wa'el Nafith , Damhoureyeh Mohammad , Day Sarah 
Published: February 2022

ABSTRACT

Introduction
Amputations lead to great challenges for individuals with amputation that can affect their quality of life (QoL). Clinical and nonclinical factors are expected to affect QoL of individuals with amputation.

Materials and Methods
Seventy-nine individuals with lower-limb amputation participated in the study. The Arabic version of the PEQ and a short added questionnaire evaluating the studied factors were used to evaluate QoL of individuals with amputation. Exploratory factor analysis was used to investigate which factors may have greater effect on QoL.

Results
Age at amputation, etiology, and age of the person with amputation were found to be the factors explaining most of the variance.

Discussion
Age at amputation dictates how much time is available for the individual to adapt to using the prosthesis. Etiology controls how well the individual is. Age is a decisive factor in the general well-being of the person with amputation.

Conclusions
This study shows that age at amputation, etiology, and age of the individual with amputation are the most important factors affecting the QoL of individuals with amputation.

Clinical Relevance
As QoL determines the success of prosthetic rehabilitation, and as several factors affect QoL in individuals with amputation, determining these factors enables providing a better prosthetic experience, resulting in improved prosthetic satisfaction.
An Experiential Learning Activity Using an Online Judgment-Based Pediatric Functional Measure During Hybrid Instruction With Doctor of Physical Therapy Students
Authors: Dumas Helene M. , Golub-Victor Ann C. 
Published: February 2022

Background and Purpose.
Mandated remote instruction provided an opportunity to introduce Doctor of Physical Therapy (DPT) students to online judgment-based measures used in clinical practice. In this method/model presentation, we report the operational feasibility, educational outcomes, and student satisfaction of a new learning activity providing entry-level DPT students with the experience to administer, score, and interpret the results of a pediatric, online, judgment-based functional assessment.

Method/Model Description and Evaluation.
Following introduction and demonstration, student pairs completed the web-based Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) using written case information detailing a child's typical functional mobility performance. Students then completed a course assignment to interpret test results, identify a complementary performance-based test, and develop intervention goals. Operational feasibility (time, technical, and economic needs), educational outcomes (PEDI-CAT scoring accuracy, assignment results), and student survey feedback were retrospectively evaluated.

Outcomes.
Within a 3-semester hour course, 2 hours (13%) were devoted to this activity, which was completed using a free test application and the university-supported learning management system. Student-generated PEDI-CAT normative scores were 100% consistent with instructor scores, and 43 of 46 student pairs (94%) generated scaled scores within the 95% confidence interval for the instructor's PEDI-CAT-generated score. Assignment results (mean grade = 45.7/50) indicated comprehension of material evidenced by test result interpretation and development of a physical therapist (PT) Evaluation and intervention goals. Student feedback was positive for the use of case-based learning and web-based test administration experience as a learning activity.

Discussion and Conclusion.
Use of a written case and an online judgment-based assessment proved feasible and successful for exposing entry-level DPT students to test administration, item content, normative and standard scoring differences, and developing a PT Evaluation statement and intervention goals setting. During mandated hybrid instruction, this learning activity addressed the curriculum objectives related to PT examination in preparation for clinical practice.
Physical Therapy Student Stress During the COVID-19 Pandemic: A Qualitative Study
Authors: Anderson Christina E. P. , Dutton Lisa L. 
Published: February 2022

Introduction.
According to research studies and surveys conducted by the Centers for Disease Control and Prevention, the prevalence of stress, depression, and anxiety have increased with the onset of the COVID-19 pandemic. This is especially true for young adults and has the potential to affect students’ learning outcomes and long-term well-being.

Review of Literature.
Current research on the experience of stress for students in the health professions has focused on nursing and medical students. There are no published studies exploring pandemic-related stress in physical therapy. The purpose of this study was to explore the experience of stress for Doctor of Physical Therapy (DPT) students during the onset of the COVID-19 pandemic.

Subjects.
Twenty-four students in their first, second, and third year of study from 3 physical therapist education programs.

Methods.
Using a phenomenological qualitative approach, 60-minute semi-structured interviews were conducted with each participant through video conference in April and May of 2020. Inductive thematic analysis was used to identify and refine codes and construct themes and subthemes.

Results.
Four themes resulted from analyses of these data: sources of stress, stress management, stress modifiers, and positive aspects of COVID. Sources of stress were related to academics, uncertainty, personal circumstances, and finances. DPT students described stress associated with the transition to online learning related to focus, engagement, workload, and reduced opportunities to practice hands-on skills. Uncertainty was particularly stressful for third-year students who were anxious about clinical experiences, board examinations, and future employment. Stress management strategies were centered on cognitive reappraisal, physical activity, and social support.

Discussion and Conclusion.
While students identified several sources of stress during the onset of the COVID 19 pandemic, important stress modifiers, such as faculty and cohort-based peer support, were highlighted that have the potential to reduce stress for students both in times of crisis and under more typical circumstances. These factors, in combination with findings suggesting that increased flexibility and agency over learning mediated stress responses, have potential implications for instructional delivery and academic program design.
Developmental Disruptions of the Human Stapes
Authors: Elias Thaís Gomes Abrahão , Santos Felipe 
Published: February 2022

Objective:
To evaluate and classify developmental malformations of the human stapes.

Methods:
Twenty-five temporal bone specimens from 18 patients with congenital stapes malformations were identified in the Mass Eye and Ear temporal bone collection. Serial sections stained with hematoxylin and eosin were examined by light microscopy and the morphology of the stapes was compared to age-matched controls.

Results:
Each case of stapes malformation could be classified into one of four malformation types based on our current understanding of the embryologic origin of the subunits of the stapes and timing of development. Twenty-seven percent of stapes malformations had a Type I morphology characterized by a hypoplastic or absent inner footplate and hypoplastic to absent mesoderm footplate or oval window. The crura and capitulum may be absent, monopodal or dysmorphic. Eleven percent expressed a Type II malformation with dysmorphic or monopodal capitulum and crura and a fixed footplate. Twenty-seven percent were of Type III with a dysmorphic or monopodal capitulum and or crura. The footplate, and thereby oval window is present and without fixation. The most common malformation, Type IV, was isolated footplate fixation observed in 33% of cases.

Conclusions:
Malformations of the human stapes follow consistent patterns of early or late disruptions of the stapes subunits of mesodermal and/or neural crest origin. While the molecular events, including temporal coordination, that lead to a normally formed stapes are not yet fully understood, the observed patterns of human stapes malformation can be consistently classified into one of four patterns of developmental disruption.
Associations of leucocyte telomere length with cardio-metabolic risk profile in a South African HIV-infected population
Authors: Ngwa Ndonwi Elvis , Peer Nasheeta , Matsha Tandi E. , de Villiers Anniza , Sobngwi Eugene , Kengne Andre P. 
Published: February 2022

Abstract
Leukocyte Telomere length (LTL) is an independent predictor of cardio-metabolic diseases (CMDs) and Human Immuno Virus (HIV) infection. However, studies are lacking on the association between LTL with CMD profile in people with HIV. Accordingly, we investigated the association between LTL and CMD profile in HIV-infected adult South Africans.
This cross-sectional study included 728 HIV patients (20.6% men; median age 38 years) recruited across 17 public healthcare facilities in Cape Town. CMD markers were compared across quartiles of LTL, and spearman correlations assessed the continuous association of LTL with CMD markers. Linear and logistic regressions were then used to relate LTL with CMD risk profile, with appropriate adjustment for confounders.
The prevalence of obesity, hypertension and diabetes were 34.8%, 36.8%, and 8.4%, respectively. In age, sex and body mass index adjusted models, increasing Log10LTL was associated with decreasing systolic (β = −10.52) and diastolic (β = −6.74) blood pressures, HOMA-β (β = −70.72), increasing total cholesterol (β = 0.544), non-high-density lipoprotein cholesterol (β = 0.472), and waist-to-height-ratio > 0.5 (odds ratio [OR] = 5.67), all P < .05. Compared to those in the bottom quarter, those in the top LTL quarter had lower prevalence of hypertension (OR = 0.65), and higher prevalence of total cholesterol > 5 mmol/L (OR = 1.94), and low-density lipoprotein-cholesterol > 3 mmol/L (OR = 1.62), all P < .05. LTL was not associated with diabetes nor general obesity. It was associated with Alanine Transaminase (ALT) and heart rate in univariable analyses.
LTL shortening was associated with some CMD risk factors in HIV-infected adults on anti-retroviral therapy in South Africa. Prospective research is needed to explore the direction and implications of these associations.
A case of systemic mastocytosis mimicking POEMS syndrome
Authors: Hou Yanqiu , Jiang Suyu , Zhang Lu , Wang Yan , Zhang Liubo , Bao Hongyu , Meng Qingqi , Han Xue , Chen Wanru , Li Tiantian , Peng Jie , Zhu Yilin , Huang Rong , Liu Jingan , Wang Jianning , Fang Chao , Shi Xiaofeng 
Published: February 2022

Abstract

Rationale:
POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is a rare and complicated disease related to multiple organs and systems. Here, we report a case of systemic mastocytosis (SM) that was misdiagnosed as a POEMS syndrome.

Patient concerns:
A 42-year-old man presented with skin changes, diarrhea, and limb numbness.

Diagnoses:
Positron emission tomography/computed tomography revealed extravascular volume overload, organomegaly, lymphadenopathy, and bone lesions with mixed lesions of osteosclerosis and osteolysis. Therefore, POEMS syndrome was suspected. Further histopathological and immunohistochemical examination of the bone marrow, lymph nodes, and gastric mucosa suggested a diagnosis of mastocytosis. The c-Kit D816V mutation confirmed the diagnosis of SM.

Interventions:
The patient received the treatment of pegylated interferon-alpha weekly and glucocorticoid daily.

Outcomes:
The symptoms relieved significantly.

Lessons:
There are many similar features between POEMS syndrome and SM, probably leading to misdiagnosis. This study analyzed the different points between them which can provide help for differentiation.
Subacute thyroiditis complicated with multiple organ failure
Authors: Jiang Hui , Chen Xiaoluo , Wang Li , Qian Xiaoqin , Zhang Yan , Wu Jing , Shao Shihe 
Published: February 2022

Abstract

Rationale:
Subacute thyroiditis is an inflammatory disease of the thyroid gland that is often caused by viral infections. Multiple organ failure (MOF) is mainly caused by acute inflammatory reactions resulting from severe infection or trauma. MOF due to subacute thyroiditis is extremely rare.

Patient concerns:
A 48-year-old woman with a history of type 2 diabetes mellitus was admitted to our hospital because of subacute thyroiditis. However, the patient developed MOF during hospitalization.

Diagnosis:
The patient was diagnosed with subacute thyroiditis complicated by MOF based on clinical symptoms and laboratory tests.

Interventions:
The patient was initially admitted to the endocrinology ward for glucocorticoid and insulin therapies. When the condition deteriorated to MOF, the patient was transferred to the intensive care unit. Ventilator-assisted breathing, blood transfusion, albumin infusion, improved cardiac function, oral glucocorticoids, and insulin were administered to the patient.

Outcomes:
The patient was followed-up at 2-weeks intervals for over 2 months. Her thyroid function returned to normal and her blood sugar level was stable. Transaminase, serum creatinine, albumin, and myocardial enzyme levels were normal.

Lessons:
MOF due to subacute thyroiditis is extremely rare. Especially in patients with elevated blood glucose or other immune dysfunctions, we should be alert to the occurrence of subacute thyroiditis with MOF.
Opacification of refractive bifocal intraocular lens in one month
Authors: Zeng Yanfeng , Liang Min , Fan Cheng , Xu Sen , Liu Fengting , Zhou Xiaoli , Tan Xin , Wang Xiaoqin 
Published: February 2022

Abstract

Rationale:
Multifocal intraocular lenses (IOLs) are used widely. However, the discovery of LS-313 MF15/30 (Oculentis B.V.) opacity during surgery has not yet been reported. This article reports 3 cases of LS-313 MF15/30 (Oculentis B.V.) IOL opacity found during cataract surgery implantation within 1 month.

Patient concerns:
Three patients underwent cataract surgery, and opacification of their IOL (LS-313 MF15/30, Oculentis B.V.) was found intraoperatively.

Diagnosis:
The patient was diagnosed with a postoperative intraocular opacity.

Interventions:
In case 1, the surgeon scrubbed the IOL with intraocular perfusion fluid and a gelatin sponge swab to reduce opacity in the central optical area of the IOL and then implanted it into the capsule bag. In case 2, the surgeon used the infusion-aspiration polishing mode for cleaning. To avoid IOL wear and bag damage, washing was stopped when turbidity in the center of the optical area was reduced. In case 3, we learned from our previous experience that the surgeon cut the IOL into 2 pieces and moved it out at the main incision, which was replaced and implanted with a brand new IOL, after the implanted IOL was again found cloudy.

Outcomes:
In case 1, more than 10 months after the surgery, the IOL was restored to transparency, no obvious eye discomfort was noted, and uncorrected visual acuity was 20/25. In case 2, the patient's IOL surrounding area was still partially turbid after more than 10 months of follow-up. In case 3, the patient's uncorrected visual acuity on postoperative day 1 was 20/20, and the best-corrected visual acuity was 20/20.

Lesson:
There are many reasons for the opacification of the IOL. In addition to the patient's own factors, the material, production, and packaging of the IOL, as well as the influence of external environmental temperature, the influence of the IOL implant instrument should not be ignored and needs to be considered.
Bohring-Opitz syndrome caused by a novel ASXL1 mutation (c.3762delT) in an IVF baby
Authors: Wang Dongbo , Yuan Xin , Guo Haichun , Yan Shuyuan , Wang Guohong , Wang Yanling , Wang Tuanmei , He Jun , Peng Xiangwen 
Published: February 2022

Abstract

Rationale:
Bohring-Opitz syndrome is a severe congenital disorder associated with a de novo mutation in the additional sex combs-like 1 (ASXL1) gene, and it is characterized by symptoms that include developmental delay and musculoskeletal and neurological features.

Patient concerns:
The patient was a girl, an in vitro fertilization (IVF) baby, with delayed motor development, drooling, short stature, slow growth, low muscle tone, image diagnosis of hypoplasia of the corpus callosum, delayed tooth eruption, high palatal arch, adduction of the thumb, drooling, not chewing, excessive joint activity, and ligament relaxation.

Diagnosis:
Whole-exome sequencing analysis detected 1 novel disruptive frameshift mutation in ASXL1 in the proband but wild-type ASXL1 in both parents.

Interventions:
Approximately 1 year of rehabilitation training, which included exercise therapy, toy imitation operation, cognition of daily objects, daily living skills training, gesture language training, oral muscle training, and hand movement training.

Outcomes:
After approximately 1 year of training, the patient was 3 years old and able to eat normally without drooling. She was able to grasp objects and pick them up after they fell. She was able to grasp small objects and actively played with toys. In addition, she was able to crawl on the floor (at slow speed, with poor initiative), stand with assistance, and walk with assistance; she was unstable when standing unassisted (standing unassisted for 8 seconds at most during training).

Lesson:
ASXL1 c.3762delT is a novel mutation that may be caused by IVF. This finding suggests that appropriate gene mutation detection approaches may be necessary for IVF technology.