bluuebunny/crossref_metadata_2025_split huggingface dataset:
Squamous Cell Carcinoma of the Hand: A Retrospective Study in Immunosuppressed and Immunocompetent Individuals
Authors: Mull Jamie L. , Phelan Patrick S. , Mull Aaron B. , Russell Aaron J. , Hurst Eva A. , Council M. Laurin 
Published: February 2020

BACKGROUND
Cutaneous squamous cell carcinoma (SCC) of the hand presents a treatment challenge because of the anatomical complexity of this location. Immunosuppressed patients are disproportionately affected by cutaneous SCC. Existing data on SCC of the hand are primarily presented in the orthopedic literature, and may thus be affected by referral bias.

OBJECTIVE
Characterization of epidemiology and treatment outcomes for hand versus nonhand cutaneous SCC in immunosuppressed versus immunocompetent patients, across all clinical departments.

MATERIALS AND METHODS
Single-institution retrospective cohort study of cutaneous SCC evaluated over 3 years and hand SCC over an additional 5 years.

RESULTS
A cohort of 522 hand SCC cases (1,746 total SCC) was ascertained among 1,064 patients, of whom 175 were immunosuppressed. Occurrence on the hand was more common for SCC arising in immunosuppressed versus immunocompetent patients (38% vs 24% of cases respectively). Hand SCC cases demonstrated balanced laterality and comparable spectra of differentiation regardless of immunosuppression. No cases of hand SCC metastasis were observed over greater than 2 years' mean follow-up, and digital amputation was only required in approximately 1% of hand SCCs.

CONCLUSION
In our cohort, assessment of hand SCC across all clinical departments suggests more favorable prognosis than reflected in the previous literature.
A review of the intriguing interaction between testosterone and neurocognitive development in males with 47,XXY
Authors: Samango-Sprouse Carole A. , Yu Christine , Porter Grace F. , Tipton Elizabeth S. , Lasutschinkow Patricia C. , Gropman Andrea L. 
Published: February 2020

Purpose of review
Although 47,XXY (Klinefelter syndrome) was first discovered more than 50 years ago, there have been limited comprehensive studies on this disorder. The present review explains the study of neurodevelopmental dysfunction and the impact of testosterone replacement at specific junctions in the life of males with 47,XXY. The intricate relationship between testosterone, neurodevelopment, health, and well being warrants an in-depth investigation in order to achieve optimal outcomes.

Recent findings
Current literature suggests that the implementation of biological treatment has a positive impact on numerous areas of neurodevelopment. Further research is needed to determine ideal dosage, timing, and frequency of biological treatment for efficacy and safety of the child with 47,XXY.

Summary
As noninvasive prenatal screening has detected increasing numbers of fetuses with 47,XXY, parents may benefit from both prenatal and postnatal counseling, including the latest innovative biological treatment, that may further optimize the child's outcome, especially when coupled with targeted early intervention services.
17-year Follow-up after Mandibular Distraction Performed in an Infant with Robin Sequence
Authors: Nakao Takako , Katayama Misato , Fujimori Yasushi , Kawai Shuichi , Nuri Takashi , Ueda Koichi 
Published: February 2020

Summary:
Robin sequence is a congenital anomaly, first described by Pierre Robin as a triad of micrognathia, upper airway obstruction and glossoptosis. The most significant airway management technique is the use of distraction osteogenesis to advance the mandible. On the other hand, late complications such as permanent dentition loss and malformation of the damaged teeth have been reported. Therefore, long-term follow-up after mandibular distraction is important. In our case report, we describe 17 years of follow-up after mandibular distraction performed in a 4-month-old male infant with Robin sequence. The patient was a male with a cleft palate. The tracheotomy and tongue–lip adhesion was performed 1 month after birth, because the percutaneous oxygen saturation decreased to 70% during feeding and crying. However, postoperative X-ray examination revealed that he could not obtain sufficient airway after the operation. For the purpose of closing the tracheotomy early, we performed bilateral mandibular distraction at the age of 4 months. The bilateral corticotomy was performed on the mandibular body and an internal traction device was placed. The mandible was bilaterally lengthened by 17.5 mm, and expansion of the airway was confirmed by X-ray. A cleft palate operation was performed at the age of 17 months. At the age of 3 years, the tracheostomy orifice closed and speech/language training and orthodontics were begun. Dental panoramic radiographs showed favorable mandibular growth. No additional operation has been performed. Finally, his orthodontic treatment was completed without any complications at age 17.
V-Y Hemi-keystone Advancement Flap: A Novel and Simplified Reconstructive Modification
Authors: Petukhova Tatyana A. , Navrazhina Kristina , Minkis Kira 
Published: February 2020

Background:
The keystone perforator flap design has been gaining popularity for reconstruction of cutaneous defects due to its robust vascular supply and high rates of flap survival. However, the design requires significant tissue mobilization relative to the defect and is consequently technically demanding, time intensive, and has associated morbidity. We present a novel, simplified modification of the keystone flap that may increase its reconstructive applications.

Methods:
A retrospective chart review was conducted of patients who underwent V-Y hemi-keystone advancement flap reconstruction of cutaneous defects by a single surgeon. Outcomes of interest included wound healing complications.

Results:
Eighty-six consecutive V-Y hemi-keystone advancement flaps were performed with an overall complication rate of 7% (6/86). Reconstruction sites included lower extremities (75/86, 87.2%), upper extremities (9/86, 10.5%), and the trunk (2/86, 2.3%). Mean follow-up time was 26.3 weeks. Four out of 5 surgical site infections occurred on lower extremity wounds. There were no cases of complete or partial flap loss.

Conclusions:
The current series presents a simplification of the traditional keystone flap that decreases surgical complexity and time required for successful reconstruction of cutaneous defects, especially in challenging wounds on the lower extremities. The complication rates were similar, or lower, than previously reported series of keystone flap reconstructions. The consistently favorable outcome of this technique supports the integration of the V-Y hemi-keystone advancement flap into reconstructive surgery.
Toll-like receptor 7-driven lupus autoimmunity induces hypertension and vascular alterations in mice
Authors: Robles-Vera Iñaki , Visitación Néstor De La , Toral Marta , Sánchez Manuel , Gómez-Guzmán Manuel , O’valle Francisco , Jiménez Rosario , Duarte Juan , Romero Miguel 
Published: February 2020

Objective:
To investigate whether toll-like receptor 7 (TLR7) activation induces an increase in blood pressure and vascular damage in wild-type mice treated with the TLR7 agonist imiquimod (IMQ).

Methods:
Female BALB/c mice (7–9 week old) were randomly assigned to two experimental groups: an untreated control group and a group treated topically with IMQ (IMQ-treated) for 4 or 8 weeks. A group of IMQ-treated mice that take a combination of the antioxidants tempol and apocynin, and another treated IL-17-neutralizing antibody were also performed.

Results:
TLR7 activation gradually increased blood pressure, associated with elevated plasma levels of anti-dsDNA autoantibodies, splenomegaly, hepatomegaly, and severe expansion of splenic immune cells with an imbalance between proinflammatory T cells and regulatory T cells. TLR7 activation induced a marked vascular remodeling in mesenteric arteries characterized by an increased media--lumen ratio (≈40%), and an impaired endothelium-dependent vasorelaxation in aortas from wild-type mice after 8 weeks of treatment. In addition, an increased ROS production, as a result of the upregulation of NADPH oxidase subunits, and an enhanced vascular inflammation were found in aortas from IMQ-treated mice. These functional and structural vascular alterations induced by IMQ were improved by antioxidant treatment. Anti-IL-17 treatment reduced blood pressure and improved endothelial dysfunction in IMQ-treated mice.

Conclusion:
Our results demonstrate that TLR7 activation induces the development of hypertension and vascular damage in BALB/c mice, and further underscore the increased vascular inflammation and oxidative stress, mediated in part by IL-17, as key factors contributing to cardiovascular complications in this TLR7-driven lupus autoimmunity model.
Impact of ambulatory SBP and overweight on executive function performance in children and adolescents
Authors: Chrysaidou Katerina , Kotsis Vasilios , Chainoglou Athanasia , Tzovaras Filimon , Gidaris Dimos , Chatzipapa Nikoleta , Zafeiriou Dimitrios , Stabouli Stella 
Published: February 2020

Background and aim:
Neurocognitive impairment has recently emerged as a hypertensive target organ damage in children and adolescents. In the present study, we aimed to examine the effect of hypertension and overweight on executive function performance in youth.

Methods:
The study population included 116 consecutive children and adolescents referred to our outpatient hypertension clinic who underwent ambulatory blood pressure monitoring (ABPM) and assessment of executive function by Behavior Rating Inventory of Executive Function (BRIEF).

Results:
Children and adolescents with hypertension presented higher T scores in shift sub-scale of Behavior Regulation Index (BRI) compared with normotensives. Participants with hypertension in the ABPM also presented higher T scores in subscales of metacognition (metacognition index). Night-time SBP correlated with BRI (r = 0.21, P < 0.05) and metacognition index (r = 0.19, P < 0.05) composite scales. BMI z score also correlated with BRI (r = 0.28, P < 0.005) and metacognition index (r = 0.22, P < 0.05) scales. The associations of night-time SBP with monitor and plan/organize subscales of metacognition index remained significant after adjustment for BMI z score and socioeconomical status. However, the associations of BMI z score with monitor scale was found to be mediated by night-time SBP. In ROC curve analysis, only night-time SBP could predict impaired performance in monitor and plan/organize scales (AUC 0.68 and 0.70, respectively).

Conclusion:
Night-time SBP may predict a poor performance in domains of executive function in youth. Although overweight/obese status was negatively associated with executive performance, mediation analysis showed that not obesity per se, but BP exerted negative impact on executive performance.
The Third Annual Thomas S. Tenforde Topical Lecture HPS Ask the Experts: The Most Intriguing Questions and Answers
Authors: Roessler Genevieve S. , Baes Fred , Classic Kelly 
Published: February 2020

Abstract
The Health Physics Society (HPS) conceived of the idea of an online “Ask the Experts” (ATE) feature in 1999 when the Society created its website. ATE features are popular now, but at that time it was a novel idea, so there was no assurance it would succeed. Now 20 y later, the HPS considers its ATE feature a success and the most valuable service the Society offers for the public. Nearly 13,000 questions have been submitted to the feature. They come both from members of the public and from health physicists. All have been answered personally by radiation safety experts. While it is important to answer questions personally, it is recognized that the most far-reaching impact of the feature is the written material on the ATE section of the website, which is provided for people searching for answers to their concerns and questions. Posted material includes frequently asked questions, summary papers on topics of interest, and links to other pertinent information. This is in addition to answers to a select group of submitted questions. To enhance the information search, all postings, including answers to questions, have headlines. These serve as keywords that facilitate website searches. The feature, managed by one lead editor, 20 topic editors, and more than 300 experts, draws over one million visitors per year. This statistic suggests that a substantial number of people are finding answers to their questions on the site and, therefore, do not need to submit personal questions. ATE editors have learned much about effective interaction with questioners, especially members of the public. Most important, answers should show compassion, present the bottom line first, be brief, and use plain language. Heavy reliance on peer-reviewed documents adds to the credibility of the information. Questions from the public cover a wide range of subjects; however, by far the most frequent deal with medical exposures, especially computed tomography procedures. Other questions deal with a wide range of concerns including products from Japan, granite countertops, radon, smoke detectors, luggage and whole-body scanners, and radiation exposure from airline travel. Another major concern is exposure to nonionizing radiation sources such as cell phones, radar, ultraviolet radiation, lasers, and power lines. Examples are provided of the most intriguing questions that have come to the ATE feature and the answers provided by the experts.
Yazd Province of Iran ICD Registry for the Years 2014–2016
Authors: Malekpour Maliheh , Dehghani-Tafti Faezeh , Ratki Seid Kazem Razavi , Seifpoor Zeinolabedin , Namiranian Nasim , Shafiee Mohammad , Mali Shahryar , Seyed Hosseini Seyed-Mostafa 
Published: February 2020

Objective:
This study aimed to investigate the trends in the care of patients undergoing implantable cardioverter-defibrillator (ICD) implantation in our region and to analyze whether the quality of care is the same as the other centers or not?

Methods:
Adult patients with an indication for ICD implants were enrolled in our registry and followed over a 19–43-month period.

Results:
The ICD implantation rate was 100/million per year. The mean age of patients treated with ICD was 62.36 (±12.93) years old and the majority of patients were men (77.6%). Most patients had ischemic heart failure (65.2%). Nearly half of the patients had NYHA class III (53.8%) and the mean of ejection fraction was 26.7 (±9.8%). ICDs were frequently implanted for primary prevention (71.9%). Single chamber ICDs (ICD-VR) were chosen in 25.2%, dual-chamber ICDs in 37.1% (ICD-DR) and biventricular ICDs (CRT-D) in 37.6%, respectively. Complications related to ICD implantation occurred in about 7.49% of all procedures. During follow-up period death occurred in 14.8% of our patients. Also, 13.3% of patients received ICD shock which was appropriate in 71% of patients.

Conclusions:
In comparison between our registry and NCDR registry, baseline patient characteristics and ICD type were almost the same, but the complication rate was higher. There is still a need to perform a large multicenter registry in our community to improve our knowledge in this Era.
ACUTE FOVEALITIS
Authors: Ledesma-Gil Gerardo , Spaide Richard F. 
Published: February 2020

Purpose:
To describe the clinical, optical coherence tomography (OCT), and OCT angiography findings of a patient with a foveal disturbance from the acute phase to the resolution of the visual disturbances.

Method:
The patient had a comprehensive ophthalmic examination to include OCT and OCT angiography.

Results:
A 36-year-old man presented with decreased vision and distortion in the right eye. The right eye showed yellow-white punctate opacities in the central fovea. OCT showed numerous, well-defined, globular, aggregated, hyperreflective lesions that corresponded to the visible opacities along with a focal discontinuity of the outer retinal layers. Over 3 weeks, the patient's findings resolved, and the VA improved to 20/20. No abnormalities of the choriocapillaris flow were detected using OCT angiography. The lesion resolved without pigmentary change.

Conclusion:
The configuration of the hyperreflective deposits, the lack of pigmentary change, and the absence of OCT angiographic findings of flow problems in the choriocapillaris argue against a primary retinal pigment epithelial or choriocapillaris abnormality as the fundamental cause of the disease. The name acute fovealitis is suggested.
Laser in Situ Keratomileusis and Surface Ablation in Breastfeeding Patients
Authors: Alonso-Santander Nuria , Ortega-Usobiaga Julio , Beltrán-Sanz Jaime , Druchkiv Vasyl , Llovet-Osuna Fernando , Baviera-Sabater Julio 
Published: February 2020

Purpose:
Our objectives were to determine the anatomical and functional (visual and refractive) outcomes of corneal refractive surgery during breastfeeding and to compare the results with those of women who stopped breastfeeding at least 3 months before the procedure. We also evaluated predictability, safety, and efficacy indexes; number of retreatments; and adverse effects reported in babies.

Methods:
We performed a multicenter, retrospective, interventional case series review of patients who were breastfeeding and who underwent laser in situ keratomileusis or surface ablation (photorefractive keratectomy) from September 11, 2002 to December 12, 2017 (group 1, n = 142 eyes in the case group). Patients were compared with women who stopped breastfeeding at least 3 months before the procedure from September 11, 2002 to December 12, 2017 (group 2, n = 95 eyes in the control group). A total of 168 women (237 eyes) were included. Patients were incorporated consecutively. Functional (visual and refractive) and anatomical outcomes are described.

Results:
No significant intraoperative or postoperative complications were recorded. There were no significant differences between the groups in visual acuity, postoperative spherical equivalent, efficacy index, predictability, safety index, or retreatments. No infants experienced adverse effects.

Conclusions:
In our experience, laser in situ keratomileusis and photorefractive keratectomy can be performed effectively and safely in breastfeeding women.
Comparative corneal endothelial cell toxicity of differing intracameral moxifloxacin doses after phacoemulsification
Authors: Chang David F. , Prajna N. Venkatesh , Szczotka-Flynn Loretta B. , Benetz Beth Ann , Lass Jonathan H. , O'Brien Robert C. , Menegay Harry J. , Gardner Susanne , Shekar Madhu , Rajendrababu Sharmila , Rhee Douglas J. 
Published: February 2020

Purpose:
To determine whether intracameral moxifloxacin 500 μg is noninferior to 250 μg for central endothelial cell loss (ECL) after phacoemulsification.

Setting:
Aravind Eye Care System.

Design:
Prospective masked randomized study.

Methods:
Eyes with bilateral nuclear cataracts, central endothelial cell density (ECD) of more than 2000 cells/mm2, and ECD not differing between eyes by more than 200 cells/mm2 underwent phacoemulsification at least 14 days apart. Intraoperatively, the first eye was randomized to receive either a 500 or 250 μg dose of moxifloxacin intracamerally and received the other dose for the second-eye surgery. Postoperative course was monitored at 1 day, 1 week, 1 month, and 3 months. Preoperative and 30-day and 90-day postoperative central ECD was determined by a reading center for a masked analysis of ECL at 3 months postoperatively.

Results:
Fifty eyes of 25 patients (aged 48 to 69 years) underwent uneventful surgery and had normal postoperative courses. The point estimate (PE) and 95% CI for the mean difference in % ECL between the 500 μg and 250 μg doses at 3 months postoperatively was 0.8% (−5.8%, 7.4%). Upon identifying and removing 2 outliers, noninferiority was proven with a mean difference of the PE, −2.2% (CI, −6.5%, 2.1%).

Conclusions:
Clinical and corneal endothelial cell were comparable in this study population for the 250 μg and 500 μg doses of intracameral moxifloxacin. Both doses were well tolerated clinically, supporting the use of the higher dose for improved antimicrobial coverage for the prevention of postoperative endophthalmitis.
Visual performance comparison of 2 extended depth-of-focus intraocular lenses
Authors: Schojai Merita , Schultz Tim , Jerke Corinna , Böcker Jörg , Dick H. Burkhard 
Published: February 2020

Purpose:
To compare the visual acuity and satisfaction outcomes of 2 different concepts of extended depth-of-focus intraocular lenses (EDOF IOLs).

Setting:
University Eye Hospital Bochum, Germany.

Design:
Prospective randomized comparative clinical trial.

Methods:
Patients undergoing cataract surgery with the implantation of 2 different concept EDOF IOLs. In the first group (IC-8 Group), a monofocal 1-piece Tecnis Z B00 IOL (Johnson & Johnson Vision Care, Inc.) was implanted in the dominant eye, and an IC-8 IOL (AcuFocus) was implanted in the nondominant eye. In the second group (Symfony Group), a Tecnis Symfony IOL (Johnson & Johnson Vision Care, Inc.) was implanted in both eyes. The target refraction of the dominant eye was emmetropia and slight myopia (mini-monovision, −0.75 diopters) in the nondominant eye. Visual and refractive outcomes and patient satisfaction rates were evaluated 3 months postoperatively.

Results:
This study comprised 76 eyes of 38 patients. No intraoperative or postoperative complications occurred in either group. Target refraction was reached in both groups without statistically significant differences. The uncorrected distance visual acuity (UDVA, photopic and mesopic light conditions) was excellent in both groups with statistically significantly better results in the IC-8 goup (logarithm of the minimum angle of resolution; IC-8 Group (0.1 ± 0.07 logarithm of the minimum angle of resolution [logMAR]; Symfony Group 0.07 ± 0.1 logMAR, P value .02 [photopic]; IC-8 group 0.12 ± 0.09 logMAR, Symfony group 0.22 ± 0.1 logMAR, P value < .01 [mesopic]). Binocular uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA) were also good in both groups without statistically significant differences (UIVA: IC-8 Group, 0.01 ± 0.07 logMAR, Symfony Group 0.01 ± 0.08 logMAR, P value .35; UNVA: IC-8 Group 0.14 ± 0.11, Symfony Group 0.09 ± 0.08, P value .14). Subjective satisfaction was high in both groups.

Conclusions:
Both EDOF IOLs provided a very good UDVA with superior results in the IC-8 Group, and a good UIVA and UNVA under photopic light conditions. Subjective patient satisfaction was higher in the IC-8 Group.