bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histamine H2 antagonists for functional dyspepsia
Authors: Li Juanjuan , Wang Fengyun , Lv Lin , Xu Lin , Zeng Enjin , Tang Xudong 
Published: November 2019

Abstract

Background:
Functional dyspepsia (FD) is a prevalent gastrointestinal disorder. Histamine H2 antagonists (H2RAs) are the pharmacological treatment option for FD, but no potent evidence has been found for the efficacy of these drugs in the condition. Therefore, this systematic review protocol aims to examine the efficacy and safety of H2RAs in the treatment of FD.

Methods:
We will perform a systematic search in the following electronic databases: the Cochrane Central Register of Controlled Trials (to October 2019), MEDLINE (OvidSP; to October 2019), EMBASE (OvidSP; to October 2019). Only randomized clinical trials (RCTs) comparing any H2RA with placebo for the treatment of FD will be included. The primary outcome will be an improvement in global symptoms of dyspepsia. Study selection, data extraction, and study quality will be performed by 2 independent reviewers. Dichotomous data will be presented as a risk ratio (RR) with 95% confidence intervals (CI), and continuous data as mean difference (MD) or standardized MD (SMD) with 95% CI. RevMan v.5.3 software will be used for all statistical analyses.

Results:
This study will provide a high-quality synthesis to examine the role of H2RAs in FD as reflected by the improvement of global symptoms of dyspepsia, quality of life scores, and adverse events.

Conclusion:
This systematic review will provide updated evidence to judge whether H2RAs are of benefit in FD.
Sclerosing stromal tumor of the ovary in a postmenopausal woman with estrogen excess
Authors: Zhao Zhiyi , Yan Li , Lv Hongtao , Liu Hongtao , Rong Fengnian 
Published: November 2019

Abstract

Rationale:
Sclerosing stromal tumor (SST) of the ovary is rare. We describe the first case of ovarian SST with estrogen excess with both clinical and serological evidence in a postmenopausal woman.

Patient concerns:
A 70-year-old female who referred menopause 14 years ago was admitted with postmenopausal bleeding for 3 months. Ultrasonography revealed thickened endometrium of 6 mm and no adnexal masses. An elevated serum estradiol level of 49.78 ng/L was revealed in laboratory examination with normal ranges less than 27.25 ng/L in postmenopausal women.

Diagnoses:
The final histology diagnosis is SST of left ovary and endometrial hyperplasia with polyps.

Interventions:
Laparoscopic hysterectomy and bilateral salpingo-oophorectomy were performed and a solid tumor with a diameter of 3 cm × 2 cm from the left ovary was found intraoperatively.

Outcomes:
Three days after removal of the tumor, the serum estrogen level was decreased to normal which indicated the estrogen activity of the tumor.

Lessons:
To the best of our knowledge, it is the first reported case of ovarian SST with estrogen excess with both clinical and serological evidence. The present case illustrates the necessity to consider the rare possibility of ovarian SST as a cause for estrogen excess leading to postmenopausal bleeding. Hormonal evaluation (estrogens, androgens) should be considered in women with postmenopausal bleeding regardless of imaging examination.
Thromboprophylaxis an update of current practice
Authors: Ricci William M. , Broekhuyse Henry , Keating John F. , Teague David C. , White Timothy O. 
Published: November 2019

Abstract
Diagnosis, prophylaxis, and management of venous thromboembolism (VTE) in patients with fractures remain a highly controversial topic with little consensus in clinical practice or the literature. The following manuscript represents a summary of evidence presented at the 2017 OTA Annual Meeting Symposium; “Thromboprophylaxis an Update of Current Practice: Can We Reach A Consensus?” The need for prophylaxis in pelvic and acetabular fracture patients; the existing body of evidence related to VTE, pulmonary embolism (PE), and prophylaxis for patients with fractures about the knee; current evidence in Edinburgh Scotland, regarding VTE prophylaxis in patients with isolated ankle fractures and the risk of VTE in patients with a hip fracture are topics that are addressed. The reader will benefit from the wisdom of this compilation of global contributions on thromboprophylaxis.
The Relationship Between Multiple Sclerosis Symptom Severity Measures and Performance on Driving Variability Metrics in a Virtual Reality Simulator
Authors: Raphail Ann-Marie A. , Vickers Kayci L. , Leist Thomas P. , Schultheis Maria T. 
Published: November 2019

Objective
Driving ability can be compromised in individuals with multiple sclerosis (MS); however, the progressive nature of multiple sclerosis makes it difficult for clinicians to assess when performance on functional tasks, such as driving, has started to decline. The aim of the study was to evaluate the relationship between two measures of multiple sclerosis severity, the Expanded Disability Status Scale and the Multiple Sclerosis Functional Composite, and minor driving errors in a virtual reality driving simulator.

Design
Symptom severity was measured in 31 active drivers with multiple sclerosis using the Expanded Disability Status Scale and Multiple Sclerosis Functional Composite. Driving performance was measured using a standardized virtual reality driving simulator route. Executive functioning, a cognitive function commonly related to driving, was evaluated using the Trail Making Test B.

Results
Greater impairment on the Multiple Sclerosis Functional Composite was related to increased difficulty maintaining lane positioning (r = −0.49, P = 0.01) and poorer executive functioning (r = −0.52, P < 0.01). In contrast, the Expanded Disability Status Scale was not related to either measure.

Conclusions
These findings suggest that poorer performance on the Multiple Sclerosis Functional Composite, and not the Expanded Disability Status Scale, may indicate vulnerability to minor driving errors as an early sign of driving compromise. The use of screening tools, such as the Multiple Sclerosis Functional Composite, could help clinicians identify increased driving risk and consider comprehensive driving evaluations earlier, before a major driving violation or accident occurs.

To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives
Upon completion of this article, the reader should be able to: (1) Describe the relationship between symptom severity and driving performance in a virtual reality driving simulator, and how the relationship may vary based on which symptom severity measure is used; (2) Identify nuanced differences between two commonly used multiple sclerosis (MS) symptom severity measures when assessing functional abilities such as driving; and (3) Utilize symptom severity screeners that can assist in monitoring symptom progression and assessing whether further driving evaluation is needed.

Level
Advanced.

Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Management of Teeth in the Line of Mandibular Angle Fractures Treated with Open Reduction and Internal Fixation: A Systematic Review and Meta-Analysis
Authors: Khavanin Nima , Jazayeri Hossein , Xu Thomas , Pedreira Rachel , Lopez Joseph , Reddy Sashank , Shamliyan Tatyana , Peacock Zachary S. , Dorafshar Amir H. 
Published: November 2019

Background:
Mandibular angle fractures are common and frequently involve a tooth in the fracture line. Despite trends toward more conservative indications for tooth extraction during open repair, the literature remains heterogeneous. This review aims to ascertain the effect of tooth extraction/retention on patient outcomes following mandible open reduction and internal fixation and to evaluate the evidence surrounding indications for extraction.

Methods:
PubMed, EMBASE, the Cochrane Library, Elsevier text mining tool database, and clinicaltrials.gov were queried through March of 2018 for English language publication on adults with traumatic mandibular fractures. The review protocol was not registered online. Quality of evidence was assigned using the Grading of Recommendations Assessment, Development and Evaluation methodology. Meta-analyses were performed when definitions of outcomes were deemed similar.

Results:
Overall, 26 of 1212 identified studies met inclusion criteria. Indications for tooth extraction and rates of extraction varied considerably across studies. The quality of evidence was low or very low for all outcomes. Tooth retention was associated with lower overall complications (OR, 0.54; 95 percent CI, 0.37 to 0.79), major complications requiring readmission or reoperation (OR, 0.47; 95 percent CI, 0.24 to 0.92), and malocclusion (OR, 0.56; 95 percent CI, 0.32 to 0.97); there was no difference in wound issues or nonunion. Removal of asymptomatic teeth was associated with inferior alveolar nerve injury (39.4 percent versus 16.1 percent).

Conclusions:
The literature is limited by retrospective study deign and poor follow-up; however, when indicated, tooth extraction is not associated with an increased risk of infection or nonunion. Removal of asymptomatic teeth was associated with a risk of inferior alveolar nerve injury. Additional high-quality studies are needed to evaluate potentially expanded indications for tooth extraction.
Novel Expanded Safe Zone for Reduction of Submental Fullness with ATX-101 Injection
Authors: Shridharani Sachin M. , Chandawarkar Akash A. 
Published: November 2019

Background:
ATX-101 (deoxycholic acid injection; Kybella) provides an approved nonsurgical treatment option for reduction of submental fullness caused by submental fat. Current one-size-fits-all recommendations for the use of ATX-101 limit treatment to a central area, which may not provide complete resolution of submental fat for some patients. An expanded safe zone is described, allowing for individualized, comprehensive treatment of submental fat with ATX-101 according to each patient’s anatomy and desired outcomes.

Methods:
A retrospective review was conducted of patients treated with ATX-101 for excess submental fat between June of 2015 and December of 2016 at a single plastic surgery practice. The expanded safe zone was developed to isolate the distinct fat compartments of the submental area and includes a no-treatment zone to avoid the marginal mandibular nerve. The extent of ATX-101 treatment required in each zone was determined by assessment of subcutaneous adipose tissue. A 1-cm grid was used to mark the treatment area before injection of ATX-101 (2 mg/cm2). Improvement (defined as decreased palpable and/or visible submental fullness) was determined at least 4 months after the final treatment. Adverse events were recorded at each visit and reported by patients by means of telephone.

Results:
Overall, 167 patients were included in this analysis. Improvement in submental fullness was achieved in 160 of 167 patients (95.8 percent). The majority of adverse events consisted of temporary injection-site edema, numbness, and tenderness.

Conclusion:
An understanding of submental anatomy and careful assessment of each patient’s submental fat allows for individualized treatment with ATX-101 beyond the central region of the neck without increased risk of adverse events.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Measuring the contribution of γδ T cells to the persistent HIV reservoir
Authors: James Katherine S. , Trumble Ilana , Clohosey Matthew L. , Moeser Matthew , Roan Nadia R. , Adimora Adaora A. , Joseph Sarah B. , Archin Nancie M. , Hudgens Michael , Soriano-Sarabia Natalia 
Published: November 2019

Objective:
To study the contribution of γδ T cells to the persistent HIV reservoir.

Design:
Fifteen HIV-seropositive individuals on suppressive ART were included. We performed parallel quantitative viral outgrowth assays (QVOA) of resting CD4+ T (rCD4) cells in the presence or absence of γδ T cells.

Methods:
Resting αβ+CD4+ T cells were magnetically isolated from PBMCs using two different custom cocktails, only one kit contained antibodies to deplete γδ T cells, resulting in two populations: rCD4 cells and rCD4 cells depleted of γδ cells. Frequency of infection was analyzed by QVOA and DNA measurements.

Results:
Recovery of replication-competent HIV from cultures of rCD4 cells was similar in 11 individuals despite the presence of γδ T cells. In four donors, HIV recovery was lower when γδ T cells were present. Expression of the cytotoxic marker CD16+ on Vδ2 cells was the only variable associated with the lower HIV recovery. Our results highlight the potency of those responses since a mean of 10 000 γδ T cells were present within 2.5 million rCD4 cells. However, despite the low frequency of γδ T cells, the presence of cytotoxic Vδ2 cells correlated with lower HIV recovery from cultures of rCD4 cells.

Conclusion:
Results of this study show that quantification of the contribution of γδ T cells to the reservoir is challenging because of their low numbers compared with conventional rCD4 cells and highlights the potent antiviral function of γδ T cells and the impact of their presence on the frequency of latent HIV infection.
Presence of Epstein–Barr virus DNA in cerebrospinal fluid is associated with greater HIV RNA and inflammation
Authors: Lupia Tommaso , Milia Maria Grazia , Atzori Cristiana , Gianella Sara , Audagnotto Sabrina , Imperiale Daniele , Mighetto Lorenzo , Pirriatore Veronica , Gregori Gabriella , Lipani Filippo , Ghisetti Valeria , Bonora Stefano , Di Perri Giovanni , Calcagno Andrea 
Published: November 2019

Objective:
The current study aimed to investigate whether cerebrospinal fluid (CSF) Epstein–Barr virus (EBV) or cytomegalovirus (CMV) DNA was associated with viral, inflammatory and neuronal damage biomarkers in people living with HIV (PLWH).

Design:
A cross-sectional diagnostic study on CSF fluid samples in patients undergoing lumbar punctures for clinical reasons, to better understand the role of EBV and CMV in the CNS on HIV RNA replication, blood-brain-barrier (BBB) damage and biomarkers of neuronal damage/inflammation.

Methods:
EBV, CMV DNA and HIV RNA were measured on CSF, through real time (RT)-PCR, from PLWHs undergoing lumbar punctures for clinical reasons (excluding oncho-haematological comorbidities). Immune-enzymatic assays evaluated blood–brain barrier inflammation and damage. Patients were stratified according to plasma HIV RNA levels in viremic (≥50 copies/ml) and aviremic (<50 copies/ml).

Results:
We included 297 participants. Among 167 viremic patients CSF EBV and CMV DNA were detectable in 42 (25.1%) and 10 (6.3%) participants; among 130 aviremic individuals CSF EBV and CMV DNA were detectable in 12 (9.2%) and 0 (0%) participants, respectively. In viremic group detectable CSF EBV DNA was associated with CSF pleocytosis (P < 0.001), higher CSF HIV RNA (P < 0.001) and neopterin levels (P = 0.002). In aviremic participants detectable EBV DNA was associated with pleocytosis (P = 0.056), higher neopterin (P = 0.027) and immune globulins (P = 0.016) in the CSF; CSF escape was more common in those with detectable EBV DNA (50 vs. 21.2%, P = 0.036).

Conclusion:
EBV DNA was frequently detected in the CSF of viremic and fewer aviremic patients on antiretroviral treatment. In PLWH without clinical evidence of encephalitis CSF EBV DNA was associated with higher biomarkers levels of neuronal damage/inflammation. The role of EBV reactivation in HIV-associated central nervous system disorders warrants further studies.
Nonmineralized and Mineralized Silk Fibroin/Gelatin Hybrid Scaffolds: Chacterization and Cytocompatibility In Vitro for Bone-Tissue Engineering
Authors: Meng Xiangyun , Gong Kun , Sun Chao , Liu Dianwei , Du Pinggong , Xu Dapeng 
Published: November 2019

AbstractIn this study, nonmineralized silk fibroin/gelatin (SF/G) hybrid scaffolds and the mineralized SF/G/hydroxyapatite (SF/G/HA) hybrid scaffolds were fabricated using vacuum freeze-drying method and biomineralization technique. The morphology and mechanical properties of the 2 hybrid scaffolds were characterized. Furthermore, the cytotoxic profiles of the hybrid scaffolds were investigated in vitro by seeding the human osteoblast cells (hFOB1.19). The 2 hybrid scaffolds were both highly porous and the pore sizes of the SF/G as well as SF/G/HA hybrid scaffolds were 260 ± 58 μm and 210 ± 35 μm, respectively. Compared with the SF/G hybrid scaffold, the SF/G/HA hybrid scaffolds exhibited significantly enhanced compressive strength and modulus. Significant early cell adhesion and proliferation on the SF/G hybrid scaffolds were observed, while SF/G/HA hybrid scaffolds effectively improved osteogenic differentiation of hFOB1.19 after 10 days of coculture. The results confirmed that the 2 hybrid scaffolds were both cytocompatible and had almost no negative effects on the hFOB1.19 in vitro. However, the SF/G/HA hybrid scaffolds tended to be more promising for application in bone-tissue engineering with good mechanical property and osteogenic differentiation.
Modelling strain localization in Ti–6Al–4V at high loading rate: a phenomenological approach
Authors: Zhou Rongxin , Pang Ka Ho , Bisht Anuj , Roy Anish , Suwas Satyam , Silberschmidt Vadim V. 
Published: November 2019

A phenomenological approach, based on a combination of a damage mechanism and a crystal plasticity model, is proposed to model a process of strain localization in Ti–6AI–4V at a high strain rate of 10
3
s
−1
. The proposed model is first calibrated employing a three-dimensional representative volume element model. The calibrated parameters are then employed to investigate the process of onset of strain localization in the studied material. A suitable mesh size is chosen for the proposed model by implementing a mesh-sensitivity study. The influence of boundary conditions on the initiation of the strain localization is also studied. A variation of crystallographic orientation in the studied material after the deformation process is characterized, based on results for different boundary conditions. The study reveals that the boundary conditions significantly influence the formation of shear bands as well as the variation of crystallographic orientation in the studied material. Results also indicate that the onset of strain localization can affect considerably the material's behaviour.

This article is part of the theme issue ‘Modelling of dynamic phenomena and localization in structured media (part 2)’.
Fault-tolerant elastic–plastic lattice material
Authors: Ryvkin Michael , Slesarenko Viacheslav , Cherkaev Andrej , Rudykh Stephan 
Published: November 2019

The paper describes a fault-tolerant design of a special two-dimensional beam lattice. The morphology of such lattices was suggested in the theoretical papers (Cherkaev and Ryvkin 2019Arch. Appl. Mech.89, 485–501; Cherkaev and Ryvkin 2019Arch. Appl. Mech.89, 503–519), where its superior properties were found numerically. The proposed design consists of beam elements with two different thicknesses; the lattice is macro-isotropic and stretch dominated. Here, we experimentally verify the fault-tolerant properties of these lattices. The specimens were three-dimensional-printed from the VeroWhite elastoplastic material. The lattice is subjected to uniaxial tensile loading. Due to its morphology, the failed beams are evenly distributed in the lattice at the initial stage of damage; at this stage, the material remains intact, preserves its bearing ability, and supports relatively high strains before the final failure. At the initial phase of damage, the thinner beams buckle; then another group of separated thin beams plastically yield and rupture. The fatal macro-crack propagates after the distributed damage reaches a critical level. This initial distributed damage stage allows for a better energy absorption rate before the catastrophic failure of the structure. The experimental results are supported by simulations which confirm that the proposed fault-tolerant material possesses excellent energy absorption properties thanks to the distributed damage stage phenomenon.This article is part of the theme issue ‘Modelling of dynamic phenomena and localization in structured media (part 2)’.
Equilibration of energies in a two-dimensional harmonic graphene lattice
Authors: Berinskii I. , Kuzkin V. A. 
Published: November 2019

We study dynamical phenomena in a harmonic graphene (honeycomb) lattice, consisting of equal particles connected by linear and angular springs. Equations of in-plane motion for the lattice are derived. Initial conditions typical for molecular dynamic modelling are considered. Particles have random initial velocities and zero displacements. In this case, the lattice is far from thermal equilibrium. In particular, initial kinetic and potential energies are not equal. Moreover, initial kinetic energies (and temperatures), corresponding to degrees of freedom of the unit cell, are generally different. The motion of particles leads to equilibration of kinetic and potential energies and redistribution of kinetic energy among degrees of freedom. During equilibration, the kinetic energy performs decaying high-frequency oscillations. We show that these oscillations are accurately described by an integral depending on dispersion relation and polarization matrix of the lattice. At large times, kinetic and potential energies tend to equal values. Kinetic energy is partially redistributed among degrees of freedom of the unit cell. Equilibrium distribution of the kinetic energies is accurately predicted by the non-equipartition theorem. Presented results may serve for better understanding of the approach to thermal equilibrium in graphene.
This article is part of the theme issue ‘Modelling of dynamic phenomena and localization in structured media (part 2)’.
One-way interfacial waves in a flexural plate with chiral double resonators
Authors: Carta G. , Colquitt D. J. , Movchan A. B. , Movchan N. V. , Jones I. S. 
Published: November 2019

In this paper, we demonstrate a new approach to control flexural elastic waves in a structured chiral plate. The main focus is on creating one-way interfacial wave propagation at a given frequency by employing double resonators in a doubly periodic flexural system. The resonators consist of two beams attached to gyroscopic spinners, which act to couple flexural and rotational deformations, hence inducing chirality in the system. We show that this elastic structure supports one-way flexural waves, localized at an interface separating two sub-domains with gyroscopes spinning in opposite directions, but with otherwise identical properties. We demonstrate that a special feature of double resonators is in the directional control of wave propagation by varying the value of the gyricity, while keeping the frequency of the external time-harmonic excitation fixed. Conversely, for the same value of gyricity, the direction of wave propagation can be reversed by tuning the frequency of the external excitation.
This article is part of the theme issue ‘Modelling of dynamic phenomena and localization in structured media (part 2)’.