bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smartphone-based Ophthalmic Imaging Compared With Spectral-domain Optical Coherence Tomography Assessment of Vertical Cup-to-disc Ratio Among Adults in Southwestern Uganda
Authors: Idriss Baimba R. , Tran Tu M. , Atwine Daniel , Chang Robert T. , Myung David , Onyango John 
Published: December 2020

Precis:
Using optical coherence tomography (OCT) measurements as a reference standard for vertical cup-to-disc ratio (vCDR), a smartphone-based ophthalmic camera has a sensitivity of 67.7% and specificity of 96.7% to detect a vCDR>0.5.

Purpose:
The purpose of this study was to assess the performance of a smartphone-based ophthalmic camera system using an Apple iPhone 6S and an adapter, Paxos Scope, to obtain adequate dilated fundus photos to measure clinically useful vCDR cutoffs.

Patients and Methods:
Adult patients from a government tertiary level eye hospital in Southwestern Uganda were prospectively recruited from January to April 2019. All patients experienced a comprehensive eye examination, dilated posterior segment indirect ophthalmoscope imaging with the Paxos Scope, and spectral-domain OCT imaging with a Cirrus HD-OCT to measure vCDR. Patients’ eyes excluded had media opacities or existing disease precluding a view of the fundus. Fundus images underwent a single masked review to assign vCDR at increments of 0.1. Descriptive statistics, parametric and χ2 tests for significance, repeated measures correlation, κ, receiver operating characteristics curve, and Bland-Altman were used to assess the data.

Results:
Among 467 (consecutive) individuals, fundus photographs acquired with the Paxos Scope demonstrated a 67.7% [95% confidence interval (CI), 63.0-72.0] sensitivity and 96.7% (95% CI, 94.2-98.3) specificity to detect a vCDR>0.5, using OCT as the reference standard. A total of 138 eyes were excluded due to poor imaging acquisition, such as dense cataract, rendering 796 eyes for analysis. The vCDR from graded Paxos Scope images and OCT correlated well with repeated measures correlation of 0.82 (95% CI, 0.77-0.86, P<0.001) and agreement, dichotomized as >0.5 or ≤0.5, was 80.9% (κ=0.63±0.034, P<0.001). Among glaucoma and glaucoma suspects (85 eyes), the sensitivity and specificity dichotomized using vCDR>0.5 were 97.5% (95% CI, 91.3-99.7) and 80.0% (95% CI, 28.4-99.5), respectively. The area under the receiver operating characteristics curve was 0.92 (95% CI, 0.89-0.94) for all eyes and 0.98 (95% CI, 0.78-1.0) for glaucoma and glaucoma suspects.

Conclusions:
The Paxos Scope produced images that can be reliably used to estimate vCDR, which is closely aligned with the automated algorithm from the OCT optic disc cube scan. The low-cost, ready-to-integrate adapter, and minimal training requirements make it a viable option for population-based screening in low-resource settings.
Intracanalicular Vestibular Schwannoma: A Systematic Review and Meta-analysis of Therapeutics Outcomes
Authors: Neves Cavada Marina , Fook-Ho Lee Michael , Jufas Nicholas Emmanuel , Harvey Richard John , Patel Nirmal P. 
Published: December 2020

Objective:
To perform a systematic review and meta-analysis summarizing the current evidence on the management of intracanalicular vestibular schwannoma.

Data Sources:
Embase (1947–), Medline (1946–), Cochrane library (1947–), Scopus (2010–), and CINAHL (1961–) were searched from 1969 to October 5, 2019 (50 years).

Study Selection:
A search strategy was performed to identify patients with vestibular schwannoma confined to the internal auditory canal without extension to the cerebellopontine angle. Studies with patients aged less than 18, Neurofibromatosis type 2, revision cases, and non-English language were excluded.

Data Extraction:
A standardized collection sheet was used for the extracted data and a quality assessment was performed using the Newcastle-Ottawa Scale with the comparability criterion omitted.

Data Synthesis:
Seventy-one studies were included with 24 on observation, 14 on radiotherapy, and 34 on surgery. The primary outcome was serviceable hearing preservation. Secondary outcomes were preservation of facial nerve function, growth, involution, and dizziness. Sub-analysis on the type of surgery and type of radiotherapy were performed. Excel 2016 with MIX 2.0 Pro add-on package was used to analyze the data and create forest plots. Data were presented in proportion with a 95% confidence interval.

Conclusions:
Serviceable hearing was observed in 31% of patients after observation, 56% after radiotherapy, and 51% after surgical treatment with mean follow-up time of 4.04 years, 4.92 years, and 2.23 years, respectively. Facial nerve function was found to be best preserved in both observation and radiotherapy groups. Vestibular schwannoma growth occurred in 33% of patients under observation. Involution occurred in 2% of patients under observation and in 38% after radiotherapy.
Which Inner Ear Disorders Lie Behind a Selective Posterior Semicircular Canal Hypofunction on Video Head Impulse Test?
Authors: Castellucci Andrea , Piras Gianluca , Del Vecchio Valeria , Ferri Gian Gaetano , Ghidini Angelo , Brandolini Cristina 
Published: December 2020

Objective:
To assess all different patterns of associated abnormalities on audiometry, bithermal caloric test (BCT) and cervical/ocular vestibular-evoked myogenic potentials (VEMPs) to air/bone-conduction in patients with selective posterior semicircular canal (PSC) hypofunction and to correlate them with underlying disorders.

Study Design:
Retrospective review.

Setting:
Tertiary referral center.

Patients:
51 patients (23 men, 28 women, mean age 57.5 yr) with isolated PSC deficit (one bilateral).

Interventions:
Correlation with instrumental data and underlying diagnoses.

Main Outcome Measures:
Video-oculographic findings, objective measurements on audiometry, BCT, VEMPs and video-head impulse test (vHIT).

Results:
Ongoing or previous acute vestibular loss (AVL) was diagnosed in 13 patients (25.5%, 3 inferior vestibular neuritis, 10 AVL with sudden sensorineural hearing loss [SSNHL]), Meniere's disease (MD) in 12 (23.5%), cerebellopontine angle (CPA) lesion in 9 (17.6%), various causes in 7 (13.7%), benign paroxysmal positional vertigo (BPPV) involving the non-ampullary arm of PSC in 5 cases (9.8%) whereas unknown pathology in 5 (9.8%). Involvement of at least one additional receptor besides PSC was seen in 89.8% of cases. Cochlear involvement was diagnosed in 74.5% with pure-tone average significantly greater in patients with AVL+SSNHL (p < 0.05). Overall involvement of labyrinthine receptors or afferents was highest in patients with AVL+SSNHL (p < 0.01), MD and CPA lesions (p < 0.05).

Conclusions:
Isolated loss of PSC function on vHIT is mostly accompanied by additional labyrinthine deficits that could only be identified through an accurate instrumental evaluation. Assessment of all receptors and afferents should be always pursued to identify the lesion site and better understand the underlying pathophysiological mechanisms.
Comparative Performance of Lateral Wall and Perimodiolar Cochlear Implant Arrays
Authors: Sturm Joshua J. , Patel Vir , Dibelius Greg , Kuhlmey Megan , Kim Ana H. 
Published: December 2020

Objective:
The physical shape of cochlear implant (CI) arrays may impact hearing outcomes. The goal of this study was to compare post-operative speech and melody perception between patients with lateral wall (LW) and perimodiolar (PM) electrode arrays across a range of lengths and manufacturers.

Study Design:
Retrospective chart review.

Setting:
Tertiary Care Hospital.

Patients:
119 adult patients with post-lingual hearing loss who underwent cochlear implantation.

Main Outcome Measures:
A total of seven different electrodes were evaluated including 5 different LW electrodes (CI422 [Cochlear American], 1J [Advanced Bionics], Medium [Med El], Standard [Med El], Flex28 [Med El]) and 2 PM electrodes (Contour [Cochlear American], MidScala [Advanced Bionics]). Speech perception outcomes (n = 119 patients) were measured by Consonant-Nucleus-Consonant (CNC) scores collected 3, 6, 12 and 24 months after implantation. Melody perception outcomes (n = 35 CI patients and n = 6 normal hearing patients) were measured by Melodic Contour Identification (MCI).

Results:
CNC scores increased over time after implantation across all array designs. PM designs exhibited higher CNC scores compared to LW electrodes, particularly 6-months after implantation. Pre-operative pure tone averages did not correlate with post-operative CNC scores. PM arrays outperformed LW electrodes in terms of MCI scores.

Conclusions:
The physical shape of cochlear implant electrode arrays may impact hearing performance. Compared to LW designs, PM arrays appear to offer superior speech perception during the first 6 months after implantation, with performance equalizing between groups by 24 months. Compared to LW designs, PM arrays also appear to afford superior melody perception.
When to Refer a Hearing-impaired Patient for a Cochlear Implant Evaluation
Authors: Hunter Jacob B. , Tolisano Anthony M. 
Published: December 2020

Objectives:
To explore the predictive value of utilizing routine audiometry to best determine cochlear implant (CI) candidacy using AzBio sentences.

Methods:
A retrospective chart review was performed between 2011 and 2018 for 206 adult patients who underwent CI evaluation assessed with AzBio sentences. Better hearing ear word recognition score (WRS) using Northwestern University-6 word lists presented at decibel hearing level from a standard audiogram was used to determine when best to refer a patient for CI evaluation. Predicted AzBio scores from multivariate regression models were calculated and compared with the actual CI candidacy to assess accuracy of the regression models.

Results:
Race, marital status, hearing aid type, better hearing ear WRS, and HL were all independently and significantly associated with AzBio testing in quiet on univariate analyses. Better hearing ear WRS and better hearing ear decibel hearing level predicted AzBio Quiet on multivariate regression analysis. For AzBio +10 dB signal-to-noise ratio (SNR), sex, and better hearing ear WRS each significantly predicted speech perception testing. Predicted CI candidacy was based on AzBio sentence testing of ≤60% for the ease of statistical analysis. Regression models for AzBio sentence testing in quiet and +10 dB SNR agreed with the actual testing most of the time (85.0 and 87.9%, respectively). A generalized linear model was built for both AzBio testing in quiet and +10 dB SNR.

Conclusion:
A WRS of <60% in the better hearing ear derived from a routine audiogram will identify 83.1% of CI candidates while appropriately excluding 63.8% of patients.
Biomechanical Analysis of Cervical Motion With a Pediatric Immobilization and Extrication Device
Authors: Hontoria Hernández María Isabel , Gordillo Martin Raquel , Juguera Rodriguez Laura , Serrano Martinez Francisco Javier , Alonso Ibañez Lourdes , Rico Berbegal Pablo , Horodyski MaryBeth , Pardo Ríos Manuel 
Published: December 2020

Objective
To determine the motions produced during pediatric extrication when using a system of motion estriction and extrication.

Methods
Simulation-based biomechanical analysis study conducted with inertial sensors to measure motion produced in the cervical spine of a pediatric simulator during extrication from a vehicle.

Results
The mean of the movements was 3.5° (SD ±1.35°). The mean time was 4 minutes 1 second (SD, ±45.09 seconds). The mean rotation toward the right was 3.34° (SD ±3.52°) and toward the left 2.62° (SD ±2.26°). The mean for lateralization was 6.24° (SD ±3.20°) toward the right and 2.50° (DE ±2.76°) toward the left. The mean for flexion was 2.36° (SD ±2.10°) and for extension 4.21° (SD ±2.15°).

Conclusions
The device analyzed allows for the extrication of the pediatric patient with high levels of motion restriction of the spinal column with the Pediatric Immobilization and Extrication System.
Mesenchymal Stem/Stromal Cells Increase Cardiac miR-187-3p Expression in a Polymicrobial Animal Model of Sepsis
Authors: Ektesabi Amin M. , Mori Keisuke , Tsoporis James N. , Vaswani Chirag M. , Gupta Sahil , Walsh Chris , Varkouhi Amir K. , Mei Shirley H.J. , Stewart Duncan J. , Liles W. Conrad , Marshall John C. , Hu Pingzhao , Parker Thomas G. , dos Santos Claudia C. 
Published: December 2020

ABSTRACT
Sepsis-induced myocardial dysfunction (MD) is an important pathophysiological feature of multiorgan failure caused by a dysregulated host response to infection. Patients with MD continue to be managed in intensive care units with limited understanding of the molecular mechanisms controlling disease pathogenesis. Emerging evidences support the use of mesenchymal stem/stromal cell (MSC) therapy for treating critically ill septic patients. Combining this with the known role that microRNAs (miRNAs) play in reversing sepsis-induced myocardial-dysfunction, this study sought to investigate how MSC administration alters miRNA expression in the heart. Mice were randomized to experimental polymicrobial sepsis induced by cecal ligation and puncture (CLP) or sham surgery, treated with either MSCs (2.5 × 105) or placebo (saline). Twenty-eight hours post-intervention, RNA was collected from whole hearts for transcriptomic and microRNA profiling. The top microRNAs differentially regulated in hearts by CLP and MSC administration were used to generate a putative mRNA-miRNA interaction network. Key genes, termed hub genes, within the network were then identified and further validated in vivo. Network analysis and RT-qPCR revealed that septic hearts treated with MSCs resulted in upregulation of five miRNAs, including miR-187, and decrease in three top hit putative hub genes (Itpkc, Lrrc59, and Tbl1xr1). Functionally, MSC administration decreased inflammatory and apoptotic pathways, while increasing cardiac-specific structural and functional, gene expression. Taken together, our data suggest that MSC administration regulates host-derived miRNAs production to protect cardiomyocytes from sepsis-induced MD.
Hypobaria Exposure Worsens Cardiac Function and Endothelial Injury in AN Animal Model of Polytrauma: Implications for Aeromedical Evacuation
Authors: Lopez Kerri , Suen Andrew , Yang Yang , Wang Sheng , Williams Brittney , Zhu Jing , Hu Jiang , Fiskum Gary , Cross Alan , Kozar Rosemary , Miller Catriona , Zou Lin , Chao Wei 
Published: December 2020

ABSTRACT

Background:
Aeromedical evacuation can expose traumatically injured patients to low pressure (hypobaria) and hypoxia. Here, we sought to assess the impact of hypobaria on inflammation, organ injury, and mortality in a mouse model of polytrauma.

Methods:
Eight to 12-week-old male C57BL/6J mice were subjected to sham or polytrauma consisting of bowel ischemia by superior mesenteric artery occlusion, hindlimb muscle crush, and tibia fracture. Two hours after injury, animals were randomized to undergo either 6 h of hypobaria or sea-level, room air conditions. At 8 or 24 h after injury, transthoracic echocardiography was performed. Acute kidney injury (AKI) biomarkers were measured by qRT-PCR. Plasma cytokine and endothelial injury markers were determined by enzyme-linked immunosorbent assay.

Results:
Eight hours after traumatic injury, mice exhibited a marked increase in plasma IL-6 (57 pg/mL vs. 1,216 pg/mL), AKI with increased Ngal and Kim-1, and endothelial injury as evidenced by significantly increased plasma hyaluronic acid (96 ng/mL vs.199 ng/mL), thrombomodulin (23.2 ng/mL vs. 58.9 ng/mL), syndecan-1 (0.99 ng/mL vs. 4.34 ng/mL), and E-selectin (38.6 ng/mL vs. 62.7 ng/mL). The trauma mice also developed cardiac dysfunction with decreased cardiac output and stroke volume at 8 h postinjury. Hypobaric exposure after polytrauma led to decreased ejection fraction (81.0% vs. 74.2%, P < 0.01) and increased plasma hyaluronic acid (199 ng/mL vs. 260 ng/mL, P < 0.05), thrombomodulin (58.9 ng/mL vs. 75.4 ng/mL, P < 0.05), and syndecan-1 (4.34 ng/mL vs. 8.33 ng/mL, P < 0.001) at 8 h postinjury.

Conclusions:
Hypobaria exposure appeared to worsen cardiac dysfunction and endothelial injury following polytrauma and thus may represent a physiological “second hit” following traumatic injury.
Enisamium reduces influenza virus shedding and improves patient recovery by inhibiting viral RNA polymerase activity
Authors: Zubkova Tatiana G. , te Velthuis Aartjan J.W. , Shaw Megan , Mehle Andrew , Boltz David , Gmeinwieser Norbert , Stammer Holger , Milde Jens , Müller Lutz , Margitich Victor 
Published: December 2020

AbstractInfections with respiratory viruses constitute a huge burden on our health and economy. Antivirals against some respiratory viruses are available, but further options are urgently needed. Enisamium iodide (laboratory code FAV00A, trade name Amizon®) is an antiviral marketed in countries of the Commonwealth of Independent States for the treatment of viral respiratory infections, but its clinical efficacy and mode of action are not well understood. Here, we investigated the efficacy of FAV00A in patients aged between 18-60 years with confirmed influenza and other viral respiratory infections. FAV00A treatment resulted in reduced influenza virus shedding (at day 3, 71.2% in FAV00A group tested negative versus 25.0% in placebo group, p < 0.0001), faster patient recovery (at day 14, 93.9% in FAV00A group had recovered versus 32.5 % in placebo group, p < 0.0001), and reduced disease symptoms compared to placebo (from 9.6 ± 0.7 to 4.6 ± 0.9 score points in FAV00A group versus 9.7 ± 1.1 to 5.6 ± 1.1 score points in placebo group, p < 0.0001). Using mass-spectrometry, and cell-based and cell-free viral RNA synthesis assays, we identified a hydroxylated metabolite of FAV00A, VR17-04. VR17-04 is capable of inhibiting influenza virus RNA synthesis and present in plasma of patients treated with FAV00A. VR-17-04 inhibits the activity of the influenza virus RNA polymerase more potently than its parent compound. Overall, these results suggest that FAV00A is metabolized in humans to an inhibitor of the influenza virus RNA polymerase that reduces viral shedding and improves patient recovery in influenza patients.Clinical data are available on ClincalTrials.gov under NCT04682444.
Recombinant VEGF-C (Cys156Ser) protein restores mesenteric lymphatic drainage and improves gut immune surveillance in experimental liver cirrhosis
Authors: Juneja Pinky , Rahman Syed Nazrin Ruhina , Tripathi Dinesh M , Kaur Impreet , Rohilla Sumati , Gupta Abhishek , Rawal Preety , Baweja Sukriti , Rastogi Archana , Naidu VGM , Sarin Shiv K , Banerjee Subham , Kaur Savneet 
Published: December 2020

AbstractBackground and AimLymphatic vessels (LVs) are crucial for maintaining abdominal fluid homeostasis and immunity. In liver cirrhosis, mesenteric LVs (mLVs) are dilated and dysfunctional. Given an established protective role of VEGF-C in LVs, we hypothesized that VEGF-C treatment could improve functions of mLVs in cirrhosis.MethodIn this study, we developed a nanoformulation comprising LV-specific growth-factor, recombinant human VEGF-C(Cys156Ser) protein(E-VEGF-C) and delivered it orally in rat models of liver cirrhosis to target mLVs. Nanoformulation without VEGF-C served as vehicle. Drainage of mLVs was analyzed using tracer dye. Portal and systemic physiological assessments and computed-tomography were performed to measure portal pressures and ascites. Gene expression of mesenteric lymphatic endothelial cells (LyECs) was studied. Immune cell subsets in mesenteric lymph nodes (MLNs) were quantified by flow-cytometry. Gut bacterial translocation to MLNs was examined using GFP-labelled bacteria.ResultsIn cirrhotic rats, mLVs were dilated and leaky with impaired drainage. Treatment with E-VEGF-C induced proliferation of VEGFR3+ mLVs, reduced their diameter and improved functional drainage. Ascites and portal pressures were significantly reduced in E-VEGF-C treated rats compared to vehicle. At molecular level, E-VEGF-C treatment upregulated the expression of cell adhesion and permeability genes (VCAM1, VE-Cad) in LyECs. In MLNs of E-VEGF-C rats, there was an increased percentage of CD8+CD134+ T-cells and decreased CD25+Treg-cells. Bacterial translocation was also limited to MLNs only in E-VEGF-C treated rats with reduced levels of endotoxins in ascites in comparison to vehicle.ConclusionE-VEGF-C treatment ameliorates mesenteric lymph drainage, portal pressure, and strengthens cytotoxic immune responses in MLNs in experimental cirrhosis. It may thus serve as a promising therapy to manage ascites and portal pressure and reduce gut bacterial translocation in patients with cirrhosis.Lay SummaryA human recombinant pro-lymphangiogenic growth factor, VEGF-C, was encapsulated in nanolipocarriers (E-VEGF-C) and orally delivered in rat models of decompensated liver cirrhosis to facilitate its gut lymphatic vessel uptake. E-VEGF-C administration significantly increased mesenteric lymphatic vessel proliferation and improved lymph drainage, attenuating abdominal ascites and portal pressures in the animal models. E-VEGF-C treatment limits bacterial translocation to MLNs only with reduced gut bacterial load and ascitic endotoxins. E-VEGF-C therapy holds the potential to manage ascites and portal pressure and reduce gut bacterial translocation in patients with decompensated cirrhosis.Graphical Abstract
AIE-nanoparticle assisted ultra-deep microscopy in thein vivomouse brain under 1300-nm excitation
Authors: Li Dong-yu , Zhang He-qun , Streich Lina L. , Lu Ping , Wang Ling , Prevedel Robert , Qian Jun 
Published: December 2020

AbstractAggregation-induced emission nanoparticles serve as promising fluorescence probes for multi-photon excitation microscopy due to the large absorption cross-section at NIR-IIb region. Here we present organic AIE nanoparticles that feature high aborption cross-section under three-photon excitation. We show that these enable ultra-deep NIR-IIa excited three-photon imaging in the in-vivo mouse brain.
Aspen leaves as a “chemical landscape” for fungal endophyte diversity – Can nitrogen and herbivory shape the community composition in controlled conditions?
Authors: Witzell Johanna , Decker Vicki Huizu Guo , Agostinelli Marta , Tapia Carmen Romeralo , Cleary Michelle , Albrectsen Benedicte Riber 
Published: December 2020

AbstractThe endophytic microbiome may influence the ecological performance of plants, including forest trees. Various abiotic and biotic factors may shape the endophyte communities directly but also indirectly, by modifying the quality of host plants as a substrate. We hypothesized that potentially antifungal or fungistatic condensed tannins (CTs) would determine the quality of aspen (Populus tremula) leaves as a substrate for endophytic fungi. By subjecting the plants to nitrogen fertilization (N) or herbivory (H; leaf beetles) we aimed to change the internal “chemical landscape”, especially the CT levels, in aspen leaves. We expected that this would lead to changes in the fungal community composition, in line with the predictions of heterogeneity-diversity relationship hypothesis. To test this we conducted a greenhouse study where aspen plants were subjected to N and H treatments, individually or in combination. The chemical status of the leaves was analysed using GC/MS (114 metabolites), LC/MS (11 phenolics) and UV-spectrometry (CTs) and the endophytic communities were characterized using culture-dependent sequencing. Nitrogen treatment, alone or in combination with herbivory had a suppressing effect on the concentration and within-treatment variation in the CT precursors, catechins, and resulted in similar trend also in CTs. Nitrogen increased the concentration of certain amino acids, and it also tended to increase most of the analysed sugars sugars. Herbivory had a negligible effect on chemical traits. In N-treated plants, the endophyte richness and abundance were higher than in plants exposed to H, but in general, the diversity of the culturable endophytes remaind stable despite the subtle changes in leaf chemistry.