bluuebunny/crossref_metadata_2025 huggingface dataset:
A phylogeny-based revision of the shrimp genera Altelatipes, Benthonectes and Benthesicymus (Crustacea: Decapoda: Benthesicymidae)
Authors: Vereshchaka Alexander L , Corbari Laure , Kulagin Dmitry N , Lunina Anastasia A , Olesen Jørgen
Published: October 2019

A phylogenetic study of deep-sea dendrobranchiate genera Altelatipes, Benthesicymus and Benthonectes based on four molecular markers and 91 morphological characters is presented. All currently recognized species of these genera, representatives of all other genera and species groups of Benthesicymidae, and three outgroups were included in the analyses. The molecular and morphological methods retrieved similar results, the molecular methods provided better resolution of deeper nodes and higher clade support. Both types of analyses showed paraphyly of Benthesicymus, which encompass five robust clades, four of which are diagnosed as new genera (type species in parentheses): Benthesicymus s.s. (B. crenatus), Bathicaris gen. nov. (Benthesicymus brasiliensis), Dalicaris gen. nov. (Benthesicymus altus), Trichocaris gen. nov. (Benthesicymus bartletti) and Maorrancaris gen. nov. (Benthesicymus investigatoris). Altelatipes was found to be monophyletic. The evolution of the major clades of Benthesicymidae is shown to be linked to trophic specialization, while further divergence at the genus level is mainly related to sexual evolution seen in the elaboration of the copulatory structures. We provide amended diagnoses of the previously recognized and new genera, key to species of each of these genera and include an updated key to genera of Benthesicymidae.
Long intergenic noncoding RNA LINC00284 knockdown reduces angiogenesis in ovarian cancer cells via up‐regulation of MEST through NF‐κB1
Authors: Ruan Zhengyi , Zhao Dong
Published: October 2019

Ovarian cancer (OC) is one of the major causes of cancer‐related mortality in women worldwide. Long noncoding RNAs might play a role as oncogenes or tumor suppressors. Therefore, we investigated the effect and underlying mechanisms of long intergenic noncoding RNA (LINC00) 284 on angiogenesis in OC cells. Expression of LINC00284 in OC tissues and cells was determined. Next, the interaction between LINC00284 and mesoderm‐specific transcript (MEST) was evaluated. Subsequently, OC cells were transfected with overexpressed (oe)‐LINC00284, silenced (si)‐LINC00284, si‐NF‐κB1, oe‐MEST, or si‐MEST plasmids to investigate the underlying mechanism of LINC00284 in OC. Afterwards, the expression of matrix metalloproteinase (MMP)‐2, MMP‐9, B‐cell lymphoma 2 (Bcl‐2), Bcl‐2‐associated protein x (Bax), VEGF, and CD31 was determined to assess the effect of LINC00284 on OC cell proliferation, invasion, migration angiogenesis, and apoptosis. Finally, the effect of LINC00284 on tumorigenesis was investigated in nude mice models of OC. LINC00284 was highly expressed in OC. si‐LINC00284 increased expression of MEST. si‐LINC00284 or si‐NF‐κB1 led to the reduction in cell proliferation, migration, invasion, tube formation, angiogenesis, and tumorigenic ability and promoted apoptosis in OC by down‐regulating MMP‐2, MMP‐9, Bcl‐2, VEGF, and CD31 and up‐regulating Bax. These effects were all reversed following the si‐MEST. In vivo experiments found the same results, confirming the aforementioned findings. Taken together, LINC00284 is involved in angiogenesis during OC development by recruiting NF‐κB1 and down‐regulating MEST.—Ruan, Z., Zhao, D. Long intergenic noncoding RNA LINC00284 knockdown reduces angiogenesis in ovarian cancer cells via up‐regulation of MEST through NF‐κB1. FASEB J. 33, 12047‐12059 (2019). www.fasebj.org
A Rare Case of KID Syndrome: The Use of Hydrosurgery and Strategies for Antiseptic Wound Care
Authors: Kapila Ayush K. , De Baerdemaeker Randy , Bakal Fadi , Hanssens Valerie , Spinnael Jeannine , Hendrickx Benoit , Zeltzer Assaf , Hamdi Moustapha
Published: October 2019

A 14-year-old girl with a history of keratitis-ichthyosis-deafness (KID) syndrome, a rare autosomal dominant condition, was referred to the Department of Plastic Surgery at Brussels University Hospital in June 2016 for progressively worsening inguinoperineal ulceration exacerbated by overapplication of combination drug treclinax (tretinoin and erythromycin). On assessment, a large area of purulent papillomatous hyperkeratosis with follicular plugging, likely superimposed bacterial colonization, and deep ulceration were noted requiring thorough debridement.

A first procedure was performed in June 2016 with hydrosurgical debridement (Versajet IITM; Smith & Nephew, Forth Worth, Texas). During the procedure, significant blood loss was noted, and topical adrenaline, blood transfusion, and a short ICU stay were required for monitoring during which the patient remained hemodynamically stable. The wound was primarily dressed with an antimicrobial barrier silver dressing; meropenem, ceftazidime, and fluconazole were started to treat for Gram-negative, Gram-positive, and anaerobic bacilli, as well as Pseudomonas aeruginosa and fungal infections in situ. A further three debridements were required 6, 12, and 26 days after the initial procedure. The patient was discharged 36 days after admission without any antibiotics and with an outpatient wound care plan.

Not only was this case rare, but it also reflected the importance of a careful approach when tackling KID syndrome’s cutaneous manifestations. Multiple debridements, thorough wound care, and appropriate antibiotic therapy may be required to achieve local healing and a satisfactory result. Hydrosurgical debridement offered a precise and well-controlled method for treating a large ulcerating hyperkeratotic urogenital lesion in this pediatric patient.
Buprenorphine and Naloxone Versus Buprenorphine for Opioid Use Disorder in Pregnancy: A Cohort Study
Authors: Mullins Nathan , Galvin Shelley L. , Ramage Melinda , Gannon Marie , Lorenz Kathleen , Sager Brent , Coulson Carol C.
Published: October 2019

Objective:

To compare maternal and fetal outcomes among dyads prescribed buprenorphine and naloxone or buprenorphine during pregnancy.

Methods:

Retrospective cohort study of patients with opioid use disorder obtaining care in a comprehensive, perinatal program. Patients utilized medication for opioid use disorder: a buprenorphine and naloxone combination product or buprenorphine monotherapy. The primary outcome was neonatal abstinence syndrome requiring treatment. Maternal secondary outcomes included: negative urine drug screen at delivery, obstetrical care attendance, primary cesarean delivery, and preterm delivery. Neonatal secondary outcomes included neonatal biometry, admission to neonatal intensive care, appropriate findings on cord toxicology, and length of stay. Univariate analyses included Chi square, Fisher exact,t-, or Mann-Whitney tests, as appropriate. Multivariate binary logistic regressions examined the association of type of buprenorphine product with diagnosis of neonatal abstinence syndrome requiring treatment and adjusted for variables significantly different in between-group comparisons and correlates of treatments and the primary outcome.

Results:

The rate of neonatal abstinence syndrome was significantly higher (P = 0.007) among infants exposed in utero to buprenorphine versus buprenorphine and naloxone: 59/108 (54.6%) versus 30/85 (35.3%), respectively. The combined product, relative to the monoproduct, was associated with lower odds of neonatal abstinence syndrome: odds ratio (OR) = 0.453 (95% confidence interval [CI] 0.253–0.813;P = 0.008). Adjusting for dose of buprenorphine product at delivery, year of expected delivery, type of prescriber, diagnosis of hepatitis C, and preterm delivery negated these results: adjusted OR = 0.627 (95% CI 0.309–1.275). Secondary outcomes were similar.

Conclusion:

Compared with buprenorphine monotherapy, the combined buprenorphine and naloxone product was an acceptable alternative pharmacologic treatment for opioid use disorder during pregnancy.
The Crooked Rod Sign
Authors: Cheung Jason Pui Yin , Zhang Teng , Bow Cora , Kwan Kenny , Sze Kam Yin , Cheung Kenneth Man Chee
Published: October 2019

Study Design.

Case report.

Objective.

To report a unique mechanical failure of magnetically controlled growing rods (MCGRs) that is related to continuous rod slippage.

Summary of Background Data.

Despite the growing popularity of MCGR in the management of patients with early onset scoliosis, postoperative complications and reoperations are not uncommon. Unique complications or unplanned reoperations are observed in patients with MCGRs that are not seen in traditional growing rods. The complications include rod slippage, mismatch between targeted and achieved distraction length, metallosis, and actuator pin fracture. We have identified an unreported failure mechanism whereby deformed threads occur in the internal distraction mechanism of the MCGR. This phenomenon may indicate increased MCGR internal screw friction and increased distraction resistance. Increased friction and resistance ultimately led to distraction failure and revision surgery.

Methods.

A girl with early onset scoliosis (EOS) was treated by dual MCGRs. She developed proximal junctional kyphosis (PJK) and continuous rod slippage. Distractions in the out-patient clinic and under sedation did not achieve successful rod lengthening. A tell-tale “crooked rod” radiological sign was identified by angulation between the actuator and the extendable portion of the rod.

Results.

Rod exchange was performed and she is now 2 years after revision surgery with successful lengthening episodes. Upon review of the extracted MCGR, distraction was not possible even after rod removal and was only resumed after the screw was manually reinserted along its correct threads.

Conclusion.

Deformed threads is a complication that cannot be reverted without rod removal and exchange. Users should be aware of this potential failure mechanism and proceed to early rod exchange rather than attempting any further distractions.

Level of Evidence: 4
Leukocytoclastic vasculitis associated with sorafenib treatment for hepatocellular carcinoma
Authors: Prejac Juraj , Kekez Domina , Belev Borislav , Kocić Lidija , Bulimbašić Stela , Pleština Stjepko
Published: October 2019

Small-vessel vasculitis is an uncommon diagnosis associated with many causes, including certain medication. Characteristic findings are immune complex deposition, vessel wall damage, and erythrocyte extravasation. We present a case of a 77-year-old man with advanced hepatocellular carcinoma who was treated with sorafenib. Twenty days post introduction to sorafenib, the patient experienced high fever and painful purpura on the lower limbs. The results of the skin biopsy confirmed the diagnosis. More extensive diagnostics was undertaken, which excluded other possible causes of vasculitis and infectious disease. Following a full recovery, after the steroid treatment was completed, sorafenib has been continued until the progression of the carcinoma. This is the second described case of hepatocellular carcinoma associated with sorafenib treatment and leukocytoclastic vasculitis. Sorafenib is a potential cause of vasculitis, and clinicians should bear in mind to differentiate it from hand-foot skin reaction, which is a common side effect of multikinase inhibitors. The result of our assessment is important considering that vasculitis requires more specific diagnostic procedures, treatment, and often drug discontinuation.
Multiple systemic treatment options in a patient with malignant tenosynovial giant cell tumour
Authors: Rebuzzi Sara Elena , Grassi Massimiliano , Catalano Fabio , Buscaglia Michele , Bertulli Rossella , Satragno Camilla , Belgioia Liliana , Comandini Danila
Published: October 2019

Tenosynovial giant cell tumour (TGCT) is a group of rare soft tissues neoplasia affecting synovial joints, bursae and tendon sheaths and is classified as localized type or diffuse type. The diffuse type (TGCT-D), also known as ‘pigmented villonodular (teno)synovitis’ is characterized by local aggressivity, with invasion and destruction of adjacent soft-tissue structures, and high local recurrence rate. Radical surgery remains the standard therapy while adjuvant radiotherapy may help to control local spread. Malignant TGCT is characterized by high rate of local recurrences and distant metastasis. Few cases of malignant TGCT and very few evidences on systemic therapies are described in the literature, so, to date, no systemic treatment is approved for this rare disease. We report the case of a malignant TGCT patient treated with many different systemic therapies, including chemotherapy and tyrosine-kinase inhibitors, and performed a review of the literature on the systemic treatment options of this rare tumour.
A Review of Sclerosing Foam Stability in the Treatment of Varicose Veins
Authors: Bai Taoping , Liu Yuqiu , Jiang Wentao , Li Yalan , Liu Jiche , Yu Chenhao , Fan Yubo
Published: October 2019

BACKGROUND

Varicose veins are common clinical entities. Foam sclerotherapy is a minimally invasive and simple procedure; however, the side effects, efficacy, and stability of sclerosing foam are not ideal.

OBJECTIVE

To summarize the current studies on sclerosing foam stability and promote foam sclerotherapy development.

MATERIALS AND METHODS

We reviewed the literature before June 2018 and included only representatives studies on sclerosing foam stability. We summarized the foam half-life time (FHT) of polidocanol (POL) under 17 preparation conditions and the FHT of sodium tetradecyl sulfate under 21 preparation conditions. The preparation conditions included various combinations of temperature, liquid–gas ratio, preparation method, etc.

RESULTS

The FHT of POL varied between 40 and 4,000 seconds under different conditions. The FHT of sodium tetradecyl sulfate varied from 25.7 to 390 seconds. The higher the drug concentration, the lower the temperature required to increase foam stability. The addition of surfactant greatly increased foam stability. For different gas compositions, the FHT sequence was as follows: CO2 < CO2 + O2 < O2 < air.

CONCLUSION

Foam stability can be improved by changing the preparation conditions; therefore, the role of surfactants and predictive methods for FHT are worth investigating further.
Noncollagen Dermal Fillers: A Summary of the Clinical Trials Used for Their FDA Approval
Authors: Jiang Betty , Ramirez Mary , Ranjit-Reeves Roshni , Baumann Leslie , Woodward Julie
Published: October 2019

BACKGROUND

Many noncollagen dermal fillers (NCDFs) have been approved by the FDA and are currently the second-most performed noninvasive cosmetic procedure.

OBJECTIVE

To summarize and compare the clinical trials reviewed by the United States FDA in the approval of NCDFs.

METHODS

The FDA Premarket Approval (PMA) site was queried, and the year of approval, indication, design, primary end points, touch-ups, retreatments, and study duration were extracted and tabulated.

RESULTS

Twenty-one FDA-approved NCDFs from 2003 to 2018 and 24 Summary of Safety and Effectiveness documents were reviewed. Differences in the trial design and in reporting of data make comparisons difficult. This article provides comparative tables to make interpreting the various trial results more straightforward.

Limitations

Primary efficacy end points and the way that filler volumes were reported varied by company. This article does not focus on secondary end points or safety data.

CONCLUSION

A comprehensive and comparative review of clinical trials of NCDFs by the FDA demonstrates that differences in data reporting, especially for touch-ups and retreatments, make filler duration difficult to compare and interpret. Understanding of the trial design will allow the clinician to become more astute and allow for better management of patient expectations in clinical practice.
Length of Fellowship Training in Population Health Research and Long-term Bibliometric Outcomes
Authors: Holland Tiffany L. , Kim Keewan , Nobles Carrie J. , Lu Ya-Ling , Seeni Indulaxmi , Mumford Sunni L. , Gilman Stephen E. , Levine Lindsay D. , Andriessen Victoria C. , Schisterman Enrique F.
Published: October 2019

Background:

The length of research fellowships, the number of doctorates pursuing them, and the academic job market have changed dramatically in recent years. However, there is limited investigation on attributes of fellowships most relevant to future scientific achievement. We analyzed the association of a modifiable aspect of research training, fellowship length, with future achievement and differences across research discipline in the Division of Intramural Population Health Research (DIPHR), Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.

Methods:

Demographics of 88 DIPHR trainees from 1998 to 2016 were collected from publicly available annual reports. Research performance metrics, including total publication count and H index through 2016, were collected via Scopus. We used linear regression models for associations between fellowship length, including both total exposure to research training and duration of postdoctoral training alone, and research performance adjusted for start year, publications at entry, branch (e.g., Biostatistics and Bioinformatics, Epidemiology, and Health Behavior), and mentor seniority.

Results:

Each additional year of research training in DIPHR was associated with a 15% increase in H index (95% confidence interval [CI] = 3.0, 28.4) and 21% more lifetime publications (95% CI = 3.0, 41.9). Results were similar, although attenuated, when evaluating postdoctoral training alone. Differences by discipline were observed, with the strongest positive associations in the Biostatistics and Bioinformatics and Epidemiology Branches.

Conclusions:

Longer training at DIPHR was associated with improved measures of research performance, though this relationship varied by discipline. Additional research is needed to tailor training programs to optimize success of trainees.
Weight Gain After Smoking Cessation and Lifestyle Strategies to Reduce it
Authors: Jain Priyanka , Danaei Goodarz , Manson JoAnn E. , Robins James M. , Hernán Miguel A.
Published: October 2019

Background:

Weight gain following smoking cessation reduces the incentive to quit, especially among women. Exercise and diet interventions may reduce postcessation weight gain, but their long-term effect has not been estimated in randomized trials.

Methods:

We estimated the long-term reduction in postcessation weight gain among women under smoking cessation alone or combined with (1) moderate-to-vigorous exercise (15, 30, 45, 60 minutes/day), and (2) exercise and diet modification (≤2 servings/week of unprocessed red meat; ≥5 servings/day of fruits and vegetables; minimal sugar-sweetened beverages, sweets and desserts, potato chips or fried potatoes, and processed red meat).

Results:

Among 10,087 eligible smokers in the Nurses’ Health Study and 9,271 in the Nurses’ Health Study II, the estimated 10-year mean weights under smoking cessation were 75.0 (95% CI = 74.7, 75.5) kg and 79.0 (78.2, 79.6) kg, respectively. Pooling both cohorts, the estimated postcessation mean weight gain was 4.9 (7.3, 2.6) kg lower under a hypothetical strategy of exercising at least 30 minutes/day and diet modification, and 5.9 (8.0, 3.8) kg lower under exercising at least 60 minutes/day and diet modification, compared with smoking cessation without exercising.

Conclusions:

In this study, substantial weight gain occurred in women after smoking cessation, but we estimate that exercise and dietary modifications could have averted most of it.
A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial
Authors: Paraiso Marie Fidela R. , Ferrando Cecile A. , Sokol Eric R. , Rardin Charles R. , Matthews Catherine A. , Karram Mickey M. , Iglesia Cheryl B.
Published: October 2019

Objective:

The aim of the study was to compare 6-month efficacy and safety for treatment of vaginal dryness/genitourinary syndrome of menopause in women undergoing fractionated CO2 vaginal laser therapy to women using estrogen vaginal cream.

Methods:

This multicenter, randomized trial compared fractionated CO2 laser to estrogen cream at 6 institutions. We included menopausal women with significant vaginal atrophy symptoms and we excluded women with prolapse below stage 2, recent pelvic surgery, prior mesh surgery, active genital infection, history of estrogen sensitive malignancy, and other autoimmune conditions. The primary outcome was the visual analog scale vaginal dryness score. Secondary outcomes included evaluation of vaginal atrophy, quality of life symptoms, assessment of sexual function, and urinary symptoms. Adverse events (AEs) and patient global impression of improvement (PGI-I) and satisfaction were also assessed.

Results:

Sixty-nine women were enrolled in this trial before enrollment was closed due to the Federal Drug Administration requiring the sponsor to obtain and maintain an Investigational Device Exemption. Of the 69 participants enrolled, 62 completed the 6-month protocol; 30 women were randomized to the laser and 32 to estrogen cream from June 2016 to September 2017. Demographics did not differ between groups except the laser group was less parous (0 [range 0-4] vs 2 [0-6], P = 0.04). On patient global impression, 85.8% of laser participants rated their improvement as “better or much better” and 78.5% reported being either “satisfied or very satisfied” compared to 70% and 73.3% in the estrogen group; this was not statistically different between groups. On linear regression, mean difference in female sexual function index scores was no longer statistically significant; and, vaginal maturation index scores remained higher in the estrogen group (adj P value 0.02); although, baseline and 6-month follow-up vaginal maturation index data were only available for 34 participants (16 laser, 18 estrogen).

Conclusions:

At 6 months, fractionated CO2 vaginal laser and vaginal estrogen treatment resulted in similar improvement in genitourinary syndrome of menopause symptoms as well as urinary and sexual function. Overall, 70% to 80% of participants were satisfied or very satisfied with either treatment and there were no serious adverse events.

Video Summary:

http://links.lww.com/MENO/A470.
An Ideal Female Breast Shape in Balance with the Body Proportions of Asians
Authors: Lee Hun Joo , Ock Jae Jin
Published: October 2019

Background:

Defining an ideal breast shape is one of the most fundamental and essential parts for a breast surgery. To propose a set of criteria for determining an ideal breast shape of Asians, the authors performed a survey using a questionnaire based on important esthetic elements of a breast.

Methods:

The authors created a 11-item questionnaire, asking breast shape preference in the frontal and the lateral views. Each question had multiple options, each of which was accompanied by adequate illustrations.

Results:

A total of 1,012 Asian responses were collected. In the frontal view, preferences converged for position of the nipple to be at 45% of the SU (distance from the sternal notch to the umbilicus) and the inframammary fold at 60% of the SU. For lateral bulging of the breast, the respondents preferred it to be 100% of the upper buttock, and 100% of the interacromion width. As for the lower pole height, breast width ratio of 50% was the most preferred. In the lateral view, straight slope of the upper breast was the most preferred, along with a 1.0 projection ratio and a front-facing nipple. The most ideal vertical proportion of the breast footprint was selected as 65:35, and for the anterior breast as 55:45.

Conclusion:

The authors used a questionnaire analysis, which considers a proportional balance between the breast and the whole body shape, and proposed that an ideal breast shape can be used effectively in planning for and assessing the outcomes of breast surgery
Levels of Evidence in Plastic and Reconstructive Surgery Research: Have We Improved Over the Past 10 Years?
Authors: Sugrue Conor M. , Joyce Cormac W. , Carroll Sean M.
Published: October 2019

Levels of evidence (LOE) aid in the critical appraisal of evidence by ranking studies based on limitation of its design. Analyzing LOE provides insight into application of evidence-based medicine. The aim of this study is to determine if the quality of evidence in plastic surgery research has improved over the past 10 years. Systematic review of research published in Plastics and Reconstructive Surgery journal over the years, 10-year period (2008, 2013, 2018), was performed. LOE for each article was determined using the American Society of Plastic Surgeons (ASPS) guidelines. Each level was calculated as percentage of publications per year and compared yearly and between different topics. Eight hundred eighty-four studies were included in the final analysis. The LOE of the research improved over the study period. Level 4 evidence was the most frequent published (50.6%, 447/884), with a decline from 63.2% in 2008 to 41.3% in 2018. Level 1 evidence improved each year and accounted for 2.1% of all research in 2018. Aesthetic surgery was the most frequent published topic with upper limb research demonstrating an 18.5% increase in high-quality evidence over the study period. Increased awareness of evidence-based medicine has improved the quality of plastic surgery research over the past decade. It is vital this continues to provide gold standard patient care.
Restoration of Bilateral Cranial Defects by Hybridization of Microvascular Free Flaps and Artificial Bones
Authors: Mashiko Takanobu , Minabe Toshiharu , Ohnishi Fumio , Momosawa Akira
Published: October 2019

Although treatment methods for cranial reconstruction have significantly improved over the past decades, patients having potentially negative influences, such as a history of infection, epidural dead space, or inadequate scalp, remain at high risk of postoperative failure from implant infection and exposure necessitating removal. A 41-year-old male patient sustained severe craniofacial injuries in a traffic accident. Cranioplasty with titanium mesh implants failed due to implant infection, leading to implant removal and debridement. Following repeated local infections and a craniectomy, the patient developed large bilateral complex cranial defects. We then performed a multistage operation, consisting of vascularized free-flap transfers to cover the intracranial dead spaces, and bony reconstruction using hydroxyapatite implants, which achieved full restoration of the defects. We believe that this is the better operative plan for treatment of cranial defects in patients with high-risk factors.
Revisiting the Safety of the Corneal Collagen Crosslinking Procedure: Evaluation of the Effect of Ultraviolet A Radiation on Retinal Function and Structure
Authors: Lazaridis Apostolos , Tsamassiotis Spiros , Droutsas Konstantinos , Besgen Volker , Sekundo Walter , Schroeder Frank Michael , Wenner Yaroslava
Published: October 2019

Purpose:

To evaluate the effect of ultraviolet A radiation on retinal function and structure after the corneal collagen crosslinking procedure.

Methods:

In the present prospective, single-center cohort study 17 eyes of 17 patients who underwent collagen crosslinking (Dresden protocol) for the treatment of corneal ectasia were examined preoperatively and at 2 and 6 weeks postoperatively with multifocal electroretinogram and optical coherence tomography. The P1 amplitude density (P1-AD) of the central retinal response was documented in 5 concentric rings, with ring 1 (R1) representing the foveal response and rings 2 to 5 (R2–R5) corresponding to successive annuli of stimulation. Visual acuity, corneal densitometry at the 0 to 2 mm zone and at the 2 to 6 mm annulus, and macular thickness (MT; central, 1 mm, 3 mm, and 5 mm zones) were recorded.

Results:

The preoperative values of P1-AD were R1 = 109.96 ± 28.96, R2 = 49.8 ± 14.46, R3 = 29.85 ± 8.9, R4 = 19.33 ± 6.3, and R5 = 16.39 ± 5.48 nV/deg2. At 2 weeks, these values were R1 = 77.54 ± 24.47, R2 = 36.55 ± 12.53, R3 = 21.53 ± 7.71, R4 = 15.3 ± 6.13, and R5 = 13.32 ± 5.48, showing a significant reduction for R1-R4 (P ≤ 0.026). The 6-week P1-AD was R1 = 99.8 ± 31.23, R2 = 40.67 ± 16.39, R3 = 24.98 ± 7.13, R4 = 16.35 ± 4.84, and R5 = 13.76 ± 3.98, showing no significant differences compared with preoperative values (P ≥ 0.054). Corneal densitometry increased significantly at 2 weeks (P < 0.001) and remained increased at 6 weeks (P < 0.001), showing statistically insignificant correlations with 2-week P1-AD (P ≥ 0.553). The central MT increased (P = 0.787), whereas MT at 1 mm (P = 0.444), 3 mm (P = 0.039), and 5 mm (P < 0.001) zones decreased.

Conclusions:

The return of P1-AD to preoperative (physiologic) values at 6 weeks confirms the safety standards of the duration and intensity of ultraviolet A radiation, as proposed by the Dresden protocol. However, temporary postoperative retinal dysfunction cannot be excluded.
Exploratory Investigation into Energy Expenditure Using Tuned versus Nontuned Ankle-Foot Orthoses–Footwear Combinations in Children with Cerebral Palsy
Authors: Eddison Nicola , Chockalingam Nachiappan , Healy Aoife , Needham Robert , Unnithan Vish
Published: October 2019

Introduction

Children with cerebral palsy (CP) commonly expend two to three times as much energy to walk as typically developing children. Research shows that the effects of nontuned ankle-foot orthoses (AFOs) on energy expenditure are inconclusive. Tuning of an ankle-foot orthosis–footwear combination (AFO-FC) has demonstrated an improvement in the kinetics and kinematics of pathological gait, particularly knee flexion during stance phase, which are key determinants of an energy-efficient gait. The objective of this study was to compare the submaximal energy expenditure via indirect calorimetry and speed and distance walked of tuned and nontuned AFO-FCs and barefoot gait in children with CP.

Methods

This study is a performance assessment of four children aged between 7 and 10 years with a diagnosis of CP (one hemiplegic and three diplegic participants, two female and two male, with a Gross Motor Function Classification System [GMFCS] of 2) at a gait analysis laboratory.

Results

There was a reduction in gross submaximal energy expenditure and energy efficiency index (EEI) based on O2in three of the four participants tested when wearing tuned compared with a nontuned AFO-FC. The reduction ranged from 9.2% to 33.7%. Speed and distance covered also showed improvement in the tuned condition.

Conclusions

Tuning the AFO-FC of children with CP has the potential to decrease energy expenditure and increase speed and distance compared with providing a nontuned AFO-FC.
Management of gastric glomus tumor
Authors: Wang Xingcheng , Hanif Shahbaz , Wang Binsheng , Chai Chen
Published: October 2019

Rationale:

Gastric glomus tumor (GGT) is a rare gastrointestinal tumor and its preoperative imaging features are significant to make a correct diagnosis, while the assessment of the pathological and immunohistochemical characteristics of the specimen are the main methods used for its diagnosis. This study introduces the clinical uniqueness, endoscopic ultrasonography, radiology, histology and immunohistochemistry results of a patient with GGT to discuss the imaging and clinico-pathological features, diagnosis and differential diagnosis of GGT.

Patient concerns:

The patient expressed a complaint concerning an “intermittent abdominal pain for 4 months”.

Diagnoses:

The patient was diagnosed with gastric stromal tumor according to the clinical manifestations and imaging examination before the operation. The pathological examination of an intra-operative frozen sample confirmed the benign nature of the tumor, while post-operative immunohistochemistry results indicate the presence of a GGT. The postoperative histology revealed a tumor tissue composed of irregular blood vessels and glomus cells of same size with interstitial hyaline and mucoid degeneration. Immunohistochemical staining showed positivity for SMA (+), vimentin (3+), CD 34 (vascular +), and Factor VIII (vascular +).

Interventions:

The tumor was completely removed by surgery.

Outcomes:

The patient recovered well, and was discharged from the hospital. Five months after the operation, a normal gastric mucosa was observed by gastroscopic examination.

Lessons:

Most of the GGTs are benign lesions, surgical resection is the preferred treatment and they result in a good prognosis. However, malignant GGT should be treated as soon as possible because of its metastatic potential and recurrence. Adjuvant radiotherapy or chemotherapy might be useful after operation.
Monocytes may be favorable biomarker and predictor of long-term outcome in patients with chronic heart failure
Authors: Charach Gideon , Rogowski Ori , Karniel Eli , Charach Lior , Grosskopf Itamar , Novikov Ilya
Published: October 2019

Although some studies found that an increased monocyte count is a predictive, short-term marker of unfavorable outcomes for patients with acute heart failure (HF), others have reported that monocytosis predicts prolonged survival.

The current follow-up study aimed to identify different monocyte count patterns and their prognostic association with HF outcomes.

Baseline blood samples for complete blood counts, differential counts, renal function tests, and lipid profiles of 303 chronic HF patients (average NYHA classification 2.8) were prospectively obtained to evaluate whether there is an association between monocyte count and clinical outcomes.

Mean follow-up was 11.3 years (range 1 month to 16 years) and 111 (36.6%) patients died during follow-up. Mean monocyte count was 10.6 ± 5.5 and mean left ventricular ejection fraction (LVEF) was 36%. Patients with low monocyte counts (≤6%) had significantly lower survival rates than did those with monocyte counts 6.1% to 14%, or >14% (14.3% vs 70.2% vs. 88%, P < .001). Poorest survival was predicted for patients with NYHA class 3 to 4 and monocyte counts ≤6. Regression analysis showed that monocyte levels, NYHA class, and LVEF values were predictors of mortality, in decreasing importance.

The total monocyte count was found to be an important prognostic factor that was inversely associated with predicted long-term mortality among patients with chronic HF. A low total monocyte count was strongly correlated with NYHA class and B-type natriuretic peptide levels, but no correlation was found with LVEF and oxidized low-density lipoproteins. It emerged as an independent risk factor for mortality in patients with chronic HF.
Cupping for patients with chronic urticaria
Authors: Xiao Xianjun , Shi Yunzhou , Zhang Leixiao , Cao Wei , Liu Ying , Zhou Siyuan , Chen Mingling , Zheng Qianhua , Li Ying
Published: October 2019

Background:

The program aims to evaluate the effectiveness and safety of cupping in patients with chronic urticaria (CU).

Methods:

We will search the databases including PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China Science Journal Database, China National Knowledge Infrastructure, Wan-fang Database, and China Biomedical Literature Database from their inception to May 2019. In addition, we will manually search the list of medical journals as a supplement. The clinical randomized controlled trials or quasi-randomized controlled trials related to cupping for the treatment of CU will be included in the study. Data were synthesized by using a fixed-effect model or random effect model depend on the heterogeneity test. The primary outcome is the total effective rate. Secondary outcomes include skin disease quality of life index scores, adverse events, and recurrence rates. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, then a descriptive analysis will be conducted. Data synthesis will use the risk ratio and the standardized or weighted average difference of continuous data to represent the results.

Results:

This study will provide a comprehensive review of the available evidence to assess the effectiveness and safety of cupping for patients with CU.

Conclusion:

This systematic review (SR) will provide evidence to judge whether cupping is an effective intervention for patients with CU.

Ethics and dissemination:

The protocol of the SR does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences.

Systematic review registration:

PROSPERO, CRD42019137451
Successful pregnancy in a woman with bilateral fallopian tube obstruction and diminished ovarian reserve treated with electroacupuncture
Authors: Sun Biyun , Liu Zhishun
Published: October 2019

Rationale:

Fallopian tube obstruction and diminished ovarian reserve (DOR) are main factors including female infertility. Acupuncture might be effective in the treatment of the disease.

Patient concerns:

A 39-year-old woman diagnosed with fallopian tube obstruction and DOR has been unable to conceive in the past 5 years, despite of receiving various treatments and 3-time in vitro fertilization (IVF) in different countries.

Diagnoses:

Under comprehensive consideration of clinical manifestations and hysterosalpingography examinations results, the patient was diagnosed as female infertility due to fallopian tube obstruction and DOR.

Intervention:

Electroacupuncture treatment was performed 3 times per week for about 3 months.

Outcomes:

After 2-months of electroacupuncture treatment, the patient's menstrual cycle was back to normal, and she conceived after 3-month treatment and gave birth to a healthy baby boy finally.

Lessons:

Electroacupuncture might be a complementary or alternative treatment for female infertility, particularly for women with fallopian tube obstruction and DOR.
Anomalous origin of left coronary arteries from the pulmonary artery in an asymptomatic adult
Authors: Al Shaarani Majd , Alzubaidi Yasir , Jin Long
Published: October 2019

Rationale:

Anomalous Origin of Left Coronary Arteries from the Pulmonary Artery (ALCAPA), also known as Bland-White-Garland (BWG), is a rare form of coronary artery anomaly that is usually discovered in the first few months of life. Only rarely can patients with this anomaly reach adulthood without symptoms.

Patient concerns:

A 28-year-old female was witnessed suddenly collapse with a seizure-like episode by her colleagues at work.

Diagnosis and Intervention:

Routine cardiopulmonary resuscitation was performed by emergency medical service technologists. The patient was unable to be revived. Postmortem examination revealed the patient had ALCAPA with a focal chronic ischemic injury of the left ventricle. Moreover, a high take-off of the right coronary artery was also discovered.

Outcomes:

The patient passed away due to ALCAPA. The mechanism of death was cardiac arrhythmia being triggered by myocardial ischemic changes.

Lessons:

In the rare cases where ALCAPA manifests in an asymptomatic adult, the mortality rate is very high. This case demonstrates the importance of awareness of such patients living under the tremendous risk of sudden cardiac death.
Can we cure stage IV triple-negative breast carcinoma?
Authors: Chue Ben Man-Fai , La Course Bryce Douglas
Published: October 2019

Rationale:

Triple-negative breast cancer has a dismal prognosis, especially once it has spread to other organs, due to the lack of effective treatments available at this time. Finding an effective treatment for metastatic triple-negative breast cancer remains an unmet medical need.

Patient concerns:

A 60-year-old woman was diagnosed with stage IIIC triple-negative breast cancer after undergoing a mastectomy. Her mastectomy was followed by adjuvant chemotherapy and radiation therapy. Approximately 1 year later, the patient presented with enlarging lymph nodes in her neck. A biopsy of a left supraclavicular lymph node was positive for recurrent disease. Positron emission tomography and computed tomography scans performed after the biopsy showed metabolic activity in the T6 vertebral body and the right level IIB lymph nodes.

Diagnoses:

The patient was diagnosed with recurrent metastatic triple-negative breast carcinoma with metastases to the bone and lymph nodes.

Interventions:

The patient was treated with weekly metronomic chemotherapy, sequential chemotherapy regimens, and immunotherapy.

Outcomes:

The patient is now 68 years old and 7 years out from her diagnosis of metastatic disease. She achieved a complete response to her treatment and routine scans continue to show no evidence of recurrent disease.

Lessons:

Utilizing sequential weekly metronomic chemotherapy regimens in combination with immunotherapy looks to be a promising treatment option for patients with metastatic triple-negative breast carcinoma. This is a second case where we were able to achieve long-term remission by using the above treatment strategy. These exciting results warrant further investigation of this treatment methodology. We hope that the treatment strategy described in this article can provide an outline for researchers and give patients with this disease more treatment options.
Robot-assisted retroperitoneal laparoscopic partial nephrectomy without hilar occlusion VS classic robot-assisted retroperitoneal laparoscopic partial nephrectomy
Authors: Guo Ju , Zhang Cheng , Zhou Xiaochen , Wang Gongxian , Fu Bin
Published: October 2019

To discuss the feasibility, safety, and effectiveness of off-clamp robotic partial nephrectomy via retroperitoneal approach and provide data for evidence based medicine in the surgical treatment of renal tumor.

The clinical data was documented and compared between robotic retroperitoneal partial nephrectomy with and without hilar occlusion (clamp group and off-clamp group) performed between January 1, 2015 and December 31, 2017.

Six-months post-operative renal function was superior in the off-clamp group compared with clamp group, while long-term results remained to be elucidated. No significant difference in post-operative hospital stay was found between the 2 groups. Estimated blood loss in off-clamp group was significantly higher than clamp group, while no significant difference was found in transfusion rate.

Off-clamp robotic partial nephrectomy via retroperitoneal approach is a safe and effective technique for the removal of renal tumor while the indication of surgery is strictly limited to small (<4 cm) and exophytic renal tumor.
The influence of interleukin 28B polymorphisms on the risk of hepatocellular carcinoma among patients with HBV or HCV infection
Authors: Qin Shaoyou , Wang Jiangbin , Zhou Changyu , Xu Yan , Zhang Yonggui , Wang Xu , Wang Song
Published: October 2019

Single nucleotide polymorphisms (SNPs) of the interleukin 28B (IL28B) gene has proven to be associated with the clinical outcome of patients with chronic hepatitis virus B or C (HBV or HCV) infections. However, whether IL28B SNPs have an influence on the risk of hepatocellular carcinoma (HCC) among patients with HBV or HCV infection remains controversial. Therefore, this study aims to determine the association between IL28B polymorphisms and the risk of HCC in individuals with HBV or HCV infection.

PubMed, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) databases were used to identify studies meeting the selection requirements using the terms “interleukin 28B”, “IFN-lambda-3”, “IFNL3”, “single nucleotide polymorphisms”, “SNPs”, “hepatocellular carcinoma”, “HCC”, “liver cancer”.

A total of 24 eligible original studies (1 cohort study and 23 case-control studies) involved 20238 individuals (HCC group = 8725 vs control group = 11,513) were included. Both IL28B rs12979860 CC and rs8099917 TT genotypes were significantly associated with a decreased risk of HCC among patients with HBV or HCV infection (OR = 0.71, 95% CI = 0.57–0.88; OR = 0.82, 95% CI = 0.72–0.94, respectively). Egger test and Begg test revealed no‘ publication bias (P > .05). Sensitivity analyses suggested the robustness of the results in this meta-analysis.

Both IL28B rs12979860 CC and rs8099917 TT genotypes are protective factors for the development of HCC among patients with HBV or HCV infection. Future prospective studies examining the impact of IL28B polymorphisms on the risk of HCC and investigating the underlying mechanism for the protective role of IL28B polymorphisms in HCC development are warranted.
Dramatic thrombolysis after rapid injection of tissue plasminogen activator
Authors: Park Jin-Sung , Hwang Jaechun
Published: October 2019

Rationale:

The regimen of the recombinant tissue plasminogen activator (rt-PA) is identical in every case where it is indicated in the treatment of cerebral infarction. We report a case of efficient recanalization of large arterial occlusion after rapid injection of rt-PA.

Patient concerns:

A 78-year-old man was admitted with right-sided hemiplegia and global aphasia that occurred an hour ago.

Diagnoses:

His brain computed tomography (CT) revealed no hemorrhage, suggesting cerebral infarction.

Interventions:

Ten percent of a total rt-PA dose was injected over 1 minute promptly. The remainder of rt-PA was designed to be infused for 60 minutes. Unexpectedly, during the study of CT angiography, administration of rt-PA was completed within 5 minutes. CT angiography showed occlusion from carotid bifurcation to the middle cerebral artery.

Outcomes:

After 2 hours of rt-PA administration, the patient began to regain strength in his right arm and leg. By the next day, he had only mild dysarthria and aphasia. Follow-up CT angiography revealed recanalized internal cervical artery and severe residual stenosis with a plaque. He was discharged without any neurologic symptoms.

Lessons:

The infusion protocol of rt-PA administration is established in 1995 and has not changed. Successful recanalization of long segmental large vessel occlusion with only intravenous rt-PA is relatively low. In our case, a high concentration of rt-PA may have influenced the successful dissemination of large thrombus in the whole internal cervical artery. Our case is of significance as it raises the question of unanswered efficacy of diverse injection protocol according to thrombus size and bleeding risk.
Upper Lip Reconstruction With Modification for Creating a Philtrum With Single-Stage Full-Thickness Skin Graft in Burned Face Injury
Authors: Yen Cheng-I , Chen Hung-Chang , Hsiao Yen-Chang , Chang Shu-Yin , Chuang Shiow-Shuh
Published: October 2019

Background

The philtrum plays an important role in determining the shape and form of the upper lip and creates individual identity. Postburn scar contracture in this area often leads to severe functional and aesthetic disfigurement. In this report, we present a novel method of philtrum reconstruction using full-thickness skin grafts (FTSGs) after burn injury.

Methods

Between August 2011 and October 2017, 8 patients with postburn philtrum deformity who underwent FTSG for replacement of the whole upper lip unit with a silastic tube for creation of the philtral dimple were included. A review of photographic documentation was used to evaluate the aesthetic results.

Results

The size of FTSG ranged from 4 × 9 to 6 × 17 cm. No patient had immediate postoperative complications, such as hematoma, infection, or necrosis. The crests of the ridges preserved their height and length, and the dimple remained visible after an average follow-up of 30.4 months (range, 3–69 months). All patients were satisfied with both functional and aesthetic results.

Conclusions

This technique of single-stage reconstruction of the upper lip and philtrum with FTSG and silastic tube produced favorable results in the formation of the philtral ridges and the dimple. Through thoughtful preoperative design, meticulous scar release, and skin grafting, satisfactory functional and aesthetic results are achievable.