bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orbital dynamics of highly probable but rare Orionid outbursts possibly observed by the ancient Maya
Authors: Kinsman J H , Asher D J 
Published: January 2020

ABSTRACT
Using orbital integrations of particles ejected from Comet Halley’s passages between 1404 and 240 BC, the authors investigate possible outbursts of the Orionids (twin shower of the Eta Aquariids) that may have been observed in the Western hemisphere. In an earlier orbital integration study, the authors determined there was a high probability linking probable outbursts of the Eta Aquariid meteor shower with certain events recorded in inscriptions during the Maya Classic Period, AD 250–900. This prior examination was the first scientific inquiry of its kind into ancient meteor outbursts possibly recorded in the Western hemisphere where previously no pre-Columbian observations had existed. In the current paper, the aim is to describe orbital dynamics of rare but probable Orionid outbursts that would have occurred on or near applicable dates recorded in the Classic Maya inscriptions. Specifically, significant probable outbursts are found in AD 417 and 585 out of 30 possible target years. The driving mechanisms for outbursts in those two years are Jovian 1:6 and 1:7 mean motion resonances acting to maintain compact structures within the Orionid stream for over 1 kyr. Furthermore, an Orionid outburst in AD 585 recorded by China is confirmed.
Final report from Intergroup NCCTG 86-72-51 (Alliance): a phase III randomized clinical trial of high-dose versus low-dose radiation for adult low-grade glioma
Authors: Breen William G , Anderson S Keith , Carrero Xiomara W , Brown Paul D , Ballman Karla V , O’Neill Brian P , Curran Walter J , Abrams Ross A , Laack Nadia N , Levitt Ralph , Galanis Evanthia , Buckner Jan C , Shaw Edward G 
Published: January 2020

AbstractBackgroundThe optimal radiation dose for adult supratentorial low-grade glioma is unknown. The aim of this study was to provide a final update on oncologic and cognitive outcomes of high-dose versus low-dose radiation for low-grade glioma.MethodsBetween 1986 and 1994, 203 patients with supratentorial low-grade glioma were randomized (1:1) to 50.4 Gy in 28 fractions versus 64.8 Gy in 36 fractions after any degree of resection.ResultsFor all patients, median overall survival (OS) was 8.4 years (95% CI: 7.2–10.8). Median progression-free survival (PFS) was 5.2 years (95% CI: 4.3–6.6). Median follow-up is 17.2 years for the 33 patients still alive. High-dose radiation did not improve 15-year OS (22.4%) versus low-dose radiation (24.9%, log-rank P = 0.978) or 15-year PFS (high dose, 15.2% vs low dose, 9.5%; P = 0.7142). OS was significantly better for patients with preoperative tumor diameter &lt;5 cm and baseline Mini-Mental State Examination (MMSE) &gt;27 and who underwent gross total resection. PFS was improved for patients with oligodendroglioma versus astrocytoma, preoperative tumor diameter &lt;5 cm, patients who had gross total resection, and patients with baseline MMSE &gt;27. For patients who had normal MMSE at baseline, at 7 years only 1 patient (5%) had a clinically significant decrease in MMSE from the previous time point, with the remainder (95%) stable. None had decrease in MMSE at 10, 12, or 15 years.ConclusionsLong-term follow-up indicates no benefit to high-dose over low-dose radiation for low-grade gliomas. Cognitive function appeared to be stable after radiation as measured by MMSE.
Prevalence of extra-articular manifestations in psoriatic arthritis: a systematic review and meta-analysis
Authors: Pittam Bradley , Gupta Sonal , Harrison Nicholas L , Robertson Selina , Hughes David M , Zhao Sizheng Steven 
Published: January 2020

AbstractObjectiveTo describe the prevalence of extra-articular manifestations—enthesitis, dactylitis, nail disease, uveitis and IBD—in PsA, and their impact on longitudinal disease outcomes.MethodsWe searched Medline, PubMed, Scopus and Web of Science using a predefined protocol in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies using imaging to define extra-articular manifestations (EAMs) were excluded. Where possible, we performed meta-analyses of prevalence estimates, reported as percentages (95% CI). Heterogeneity (I2 statistic) was examined according to study characteristics.ResultsWe identified 65 studies amounting to a total of 163 299 PsA patients. Enthesitis was assessed in 29 studies with an average prevalence of 30% (95% CI: 24%, 38%). Dactylitis was reported in 35 studies with an average prevalence of 25% (95% CI: 20%, 31%). Nail disease was present in 60% (95% CI: 52%, 68%) across 26 studies, but definitions were often unclear. Uveitis (3.2%; 95% CI: 1.9%, 5.3%) and IBD (3.3%; 95% CI: 1.5%, 7.1%) were less common. Heterogeneity was high (&gt;95%) in all meta-analyses, but could not be explained by study characteristics. No studies examined the impact of EAMs on longitudinal disease outcomes, except that dactylitis increases radiographic progression.ConclusionEnthesitis, dactylitis and nail disease are highly prevalent in PsA, but not uveitis and IBD. EAM patterns differ from axial SpA despite their shared disease mechanisms, which may help further understand differences between spondyloarthritides. More studies are needed on the impact of EAMs on disease outcomes such as response to treatment.
Examining Gene–Environment Interactions Using Aggregate Scores in a First-Episode Psychosis Cohort
Authors: Mas Sergi , Boloc Daniel , Rodríguez Natalia , Mezquida Gisela , Amoretti Silvia , Cuesta Manuel J , González-Peñas Javier , García-Alcón Alicia , Lobo Antonio , González-Pinto Ana , Corripio Iluminada , Vieta Eduard , Castro-Fornieles Josefina , Mané Anna , Saiz-Ruiz Jeronimo , Gassó Patricia , Bioque Miquel , Bernardo Miquel ,   PEPs Group
Published: January 2020

Abstract
Gene–environment (GxE) interactions have been related to psychosis spectrum disorders, involving multiple common genetic variants in multiple genes with very small effect sizes, and several environmental factors that constitute a dense network of exposures named the exposome. Here, we aimed to analyze GxE in a cohort of 310 first-episode psychotic (FEP) and 236 healthy controls, by using aggregate scores estimated in large populations such as the polygenic risk score for schizophrenia and (PRS-SCZ) and the Maudsley environmental risk score (ERS). In contrast to previous findings, in our study, the PRS-SCZ did not discriminate cases from controls, but the ERS score explained a similar percentage of the variance as in other studies using similar approaches. Our study supports a positive additive interaction, indicating synergy between genetic susceptibility to schizophrenia (PRS-SCZ dichotomized according to the highest quartile distribution of the control population) and the exposome (ERS &gt; 75% of the controls). This additive interaction showed genetic and environmental dose dependence. Our study shows that the use of aggregate scores derived from large and powered studies instead of statistics derived from specific sample characteristics is a powerful tool for the study of the effects of GxE on the risk of psychotic spectrum disorders. In conclusion, by using a genetic risk score and an ERS we have provided further evidence for the role of GxE in psychosis.
Resolution of estate and trust disputes: mediation and Alternative Dispute Resolution in Canada
Authors: Whaley Kimberly A 
Published: January 2020

Abstract
This article will start with a brief overview of Alternative Dispute Resolution in Canada and then focus on a Canadian perspective on mediating estate disputes with some tips and steps that lawyers can consider in improving the chances of a successful mediation. This article is written with a focus on estate mediation rules and procedures in the province of Ontario; however, all provinces and territories in Canada have their own corresponding mediation rules and procedures.
The law applicable to third-party effects of assignment and the conflict rules for insolvency according to EU law
Authors: Heinze Christian , Warmuth Cara 
Published: January 2020

Abstract
In March 2018, the European Commission issued its proposal for a regulation on the law applicable to third-party effects of assignments of claims, aiming to put an end to the ongoing debate on this issue and the legal uncertainty associated with it. On the basis of the Commission’s decision in favour of the application of the law of the assignor’s habitual residence, this article discusses the consequences of the Proposal under European Union (EU) insolvency law. For that purpose, the coherence of the Proposal with the Insolvency Regulation will be examined, first in general and then in more detail. The analysis comes to the result that the Commission’s objective of aligning the Proposal with the legal framework of the Insolvency Regulation has predominantly been well achieved. The authors point out remaining minor inaccuracies that may be clarified in the further legislative process or by later case law. It is concluded that, from the perspective of international insolvency law, the proposed uniform conflict-of-laws rule at the EU level offers a good opportunity to promote legal certainty with regard to cross-border assignments of claims in the future.
An oral drug for chronic lymphocytic leukemia
Authors: Koehler Amber 
Published: January 2020

ABSTRACT
Ibrutinib is a new first-line drug for treating chronic lymphocytic leukemia (CLL), and could change frontline treatment of CLL from traditional IV chemotherapy to oral targeted therapy. Lymphocytosis often worsens with initiation of ibrutinib, but typically resolves over 6 to 18 months. Though patients generally tolerate ibrutinib well, the drug can cause adverse reactions including hypertension, atrial fibrillation, bleeding, and infections such as fungal pneumonia.
A Cross-sectional Study of Group B Streptococcus–Associated Sepsis, Coinfections, and Antibiotic Susceptibility Profile in Neonates in Pakistan
Authors: Asghar Samra , Khan Junaid Ali , Mahmood Muhammad Shahid , Arshad Muhammad Imran 
Published: January 2020

Background:
Neonatal sepsis is a leading cause of morbidity and early-life mortality worldwide, and previous data have reported the highest neonatal mortality rate in Pakistan.

Purpose:
The present study aimed to decipher the prevalence of group B Streptococcus (GBS)–associated sepsis, coinfections, and antibiotic susceptibility of isolated microbes in neonates.

Methods:
Blood samples of 100 cases of neonatal sepsis were subcultured on blood agar, GBS agar, and MacConkey agar for isolation of GBS and suspected microbes.

Results:
Of 100 neonatal blood samples, 85 blood samples were culture-positive, including mixed culture growth (n = 18), 25 samples as early-onset neonatal sepsis (EONS) and 60 as late-onset neonatal sepsis (LONS). Staphylococcus aureus showed high percent positivity (31.4%), followed by Candida sp (16.5%), GBS (14.1%), Klebsiella (14.1%), Staphylococcus epidermidis (11.8%), Pseudomonas (9.4%), Acinetobacter (9.4%), Esherichia coli (8.2%), and Enterococcus (5.9%). GBS was isolated more frequently from EONS than from LONS with 50% coinfections. Mode of delivery, gender, and respiratory distress in neonates were significantly associated with culture-positive sepsis. GBS isolates were highly (91.7%) susceptible to vancomycin, cefotaxime, and chloramphenicol, followed by penicillin (83.3%), ampicillin, and tetracycline (75%). GBS isolates were resistant to erythromycin, clindamycin, ciprofloxacin, and linezolid.

Implications for Practice:
Our findings evidenced GBS-associated risk factors and antibiotic susceptibility pattern of neonatal sepsis, which will help clinicians in management, control, and treatment of neonatal sepsis.

Implications for Research:
The epidemiological evidence of GBS-associated neonatal sepsis, demographic characteristics, risk factor data analysis, and drug resistance pattern has disease prevention implications in neonates in low-income countries including Pakistan.
Missed Diagnosis and Acute Management of Radial Head Dislocation With Plastic Deformation of Ulna in Children
Authors: Singh Vivek , Dey Sukalyan , Parikh Shital N. 
Published: January 2020

Background:
Radial head dislocation with ulnar bowing (Monteggia type I equivalent injury) is a frequently missed injury. If not recognized acutely, these missed injuries can lead to serious long-term complications. The purpose of this study was to evaluate the rate of missed diagnosis and to report on the characteristics and early management of this specific injury pattern.

Methods:
A total of 112 patients with Monteggia fracture-dislocation were identified, of which 18 patients had sustained a Monteggia type I equivalent injury. The total duration between injury, diagnosis, and treatment was noted. Medical records were reviewed to identify cases with the initially missed diagnosis. The radiographic assessment included the direction of radial head dislocation and location/displacement of the apex of the ulnar bow. Clinical outcomes were evaluated using Kim elbow performance score.

Results:
Thirteen of 18 cases with Monteggia equivalent injury were missed at the initial presentation. The diagnosis was established when the patients followed up in the orthopaedic clinic. Of these 18 patients, 11 were treated by closed reduction/cast and 7 patients required surgery. Significant differences were found between the closed reduction/cast and operative group for the mean time from injury to treatment (3.2±2.6 vs. 12.7±13.6 d). For each day of delay in treatment, the odds for surgical intervention increased by a factor of 1.126 (12.6%). There were no significant differences between the location and magnitude of the apex of the ulnar deformity between the 2 groups. Kim elbow score was excellent in all cases at the latest follow-up.

Conclusions:
Clinical suspicion and careful radiographic assessment are of utmost importance for every child with forearm and elbow injury without an apparent fracture, as there is a high rate of missed diagnosis for this specific Monteggia injury pattern. Prompt treatment would allow for successful closed reduction while even minor delays would increase the need for surgical intervention.

Level of Evidence:
Therapeutic, level III.
Histopathological Features of Riehl Melanosis
Authors: Kim So Min , Lee Eun-So , Sohn Seonghyang , Kim You Chan 
Published: January 2020

Abstract:
Histological features of Riehl melanosis have rarely been compared between lesional and perilesional normal skin and have not been precisely described using quantitative or immunohistochemical analysis or electron microscopic findings. To investigate the histopathological and immunohistochemical features of lesional and perilesional normal skin of patients with Riehl melanosis, we retrospectively evaluated the electronic medical records and skin biopsy specimens of 48 patients with Riehl melanosis. In addition, electron microscopy was performed on 1 case. Fontana–Masson staining for melanin and immunohistochemical staining for Melan-A, NKI/beteb, tyrosinase, and microphthalmia-associated transcription factor were performed. Although the difference was statistically insignificant, melanin pigment was increased in the epidermis of lesional skin compared with that of perilesional normal skin in patients. The number of melanocytes and their activity were significantly increased in lesional epidermal skin. Melanin pigment was also significantly increased in the lesional dermis. Pigmentary incontinence, basal cell liquefaction, dilated vessels, epidermal spongiosis, and colloid bodies were found in the lesional skin as well as in the perilesional normal skin to a lesser extent. Under electron microscopy of 1 randomly selected subject, many fibrocytes contained numerous melanosome particles in the cytoplasm of the lesional dermis. In perilesional normal skin, fibroblasts also contained melanosome particles; however, the number of melanosome-containing cells was less than that in lesional skin. Riehl melanosis is characterized by increased epidermal melanocytes and pigmentation, primarily involving the dermis, with histologically typical changes at the interface. Unlike that in other pigmentary diseases, most perilesional normal-appearing skin in Riehl melanosis also shows typical histopathological changes, although to a lesser extent.
ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY AFTER IMMUNIZATION WITH MULTIPLE VACCINES
Authors: Kraemer Laura S. , Montgomery Jay R. , Baker Katherine M. , Colyer Marcus H. 
Published: January 2020

Purpose:
To report a case of acute posterior multifocal placoid pigment epitheliopathy occurring in temporal association with multiple immunizations in a previously healthy 25-year-old woman.

Methods:
Acute posterior multifocal placoid pigment epitheliopathy was diagnosed based on ophthalmological findings of bilateral placoid subretinal lesions complicated by a serous retinal detachment in the left eye.

Results:
Through HLA typing, the patient was found to possess the HLA-B*40 and HLA-DB1*15 alleles. She was treated with topical prednisolone acetate 1% and monitored for several months. The serous retinal detachment resolved, and visual acuity returned to normal.

Conclusion:
This case report adds to the body of knowledge regarding possible atypical interplay between vaccines and specific T-cell receptors of the host immune system and adds Polio and Tetanus to the growing list of vaccines potentially triggering acute posterior multifocal placoid pigment epitheliopathy. Increased awareness of the presentation of acute posterior multifocal placoid pigment epitheliopathy and that it may arise after immunization may also improve evaluation of acute changes in visual acuity.
Short-Term Clinical Outcomes of a Novel Corneal Prosthetic Device in a Rabbit Model
Authors: Akpek Esen K. , Van Court Shanna , Glass Spencer , Schmiedel Thomas , Troutman Mitchell 
Published: January 2020

Purpose:
To evaluate the clinical performance and biocompatibility of a novel synthetic corneal device.

Methods:
Synthetic, single-piece, foldable, suturable, optic-and-skirt design prototype devices were fabricated using expanded polytetrafluoroethylene. A combination of intralamellar and full-thickness penetrating techniques was used for implantation. A topical antibiotic-steroid regimen was used postoperatively. Rabbits were examined weekly using penlight and at monthly intervals under an operating microscope with integrated optical coherence tomography. Optical quality, retention, and complication rates at 3 and 6 months were assessed.

Results:
Nineteen rabbits underwent surgery. There were no device-related intraoperative complications. Creation of lamellar pocket was problematic in 2 younger rabbits with inadequate chamber depth. Two rabbits had early postoperative infectious keratitis attributed to bandage contact lens wear, which was ceased. Rabbits were treated using fourth-generation fluoroquinolone drops and did well over a period of 6 months without device extrusion or further complications. Four other rabbits had late postoperative infectious keratitis because of exposed suture(s), which progressed to endophthalmitis. One rabbit had sterile keratolysis and retraction of the anterior corneal lamella. There was no retinal detachment, glaucoma, anterior or posterior synechiae, or cataract formation in any of the rabbits. All devices remained in situ with clear optics without spoliation. Light microscopic examination of the globes demonstrated intact epithelium overlying the skirt and new collagen integration into the porous structure of the skirt without significant inflammation.

Conclusion:
Our results demonstrated favorable short-term anatomical clinical outcomes of this novel synthetic corneal prosthesis. Further studies are warranted to characterize the biointegration of this device.
Development of Corneal Sensation With Remodeling of the Epithelium and the Palisades of Vogt After Corneal Neurotization
Authors: Lathrop Kira L. , Duncan Katherine , Yu Jennifer , Shah Parth R. , Goldstein Jessie , Nischal Ken K. 
Published: January 2020

Purpose:
Neurotrophic keratopathy (NK) produces persistent epithelial erosion which is hard to treat effectively. Recently, corneal neurotization surgery has produced reinnervation of the cornea with resolving neurotrophic keratopathy. We hypothesized that the generation of corneal epithelial nerves after neurotization surgery would not only restore the integrity of corneal epithelium but also produce a change in the configuration of the palisades of Vogt (POV), which houses the corneal epithelial stem cells.

Methods:
We assessed a patient with unilateral congenital corneal anesthesia with optical coherence tomography pre-neurotization and post-neurotization.

Results:
Over the course of 2 years, the patient gained corneal epithelial sensation and corneal and limbal epithelium was restored to normal thickness with corresponding changes in the POV.

Conclusions:
The intimate relationship between epithelium and sensory nerves of the cornea has been well documented; however, changes in the corneal epithelial stem cell niche in conjunction with development of innervation have not previously been reported. Considering the architecture of the corneal nerves in conjunction with the architecture of the POV may assist in developing treatments that can support the regeneration and maintenance of epithelium during nerve regeneration.
5-Year Outcomes of Descemet Stripping Only in Fuchs Dystrophy
Authors: Artaechevarria Artieda June , Wells Matthew , Devasahayam Raj N. , Moloney Gregory 
Published: January 2020

Purpose:
To report the 5-year outcomes of the first reported case of bilateral Descemet stripping only (DSO) for Fuchs endothelial corneal dystrophy (FECD) at our center. Visual, biomicroscopic, and confocal microscopic findings are described.

Methods:
A retrospective case report.

Results:
A 55-year-old woman with bilateral FECD was referred with decreased visual acuity and blurred vision that interrupted activities of daily living. She underwent sequential 4-mm DSO procedures 6 months apart, with early postoperative results previously reported. Subjective visual symptoms, visual acuity, and corneal edema were analyzed at 1 month, 3 months, 6 months, 12 months, 2 years, 3 years, and 5 years postoperatively. Best corrected visual acuity of 0.0 (logarithm of the minimum angle of resolution) and corneal clearance were achieved in the third month after the procedure. These results have remained stable in the 5-year follow-up period.

Conclusions:
Early postoperative results from DSO surgery are encouraging, but questions remain regarding its longevity. Publication of longer-term outcomes such as this is necessary to establish the validity of this procedure as an intervention for FECD.