bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single Bolus Rosuvastatin Accelerates Calcium Uptake and Attenuates Conduction Inhomogeneity in Failing Rabbit Hearts With Regional Ischemia–Reperfusion Injury
Authors: Chou Chung-Chuan , Lee Hui-Ling , Huang Yu-Chang , Wo Hung-Ta , Wen Ming-Shien , Chu Yen , Chang Po-Cheng 
Published: December 2019

Abstract:
Acute statin therapy reduces myocardial ischemia/reperfusion (IR) injury–induced ventricular fibrillation (VF), but the underlying electrophysiological mechanisms remain unclear. This study sought to investigate the antiarrhythmic effects of a single bolus rosuvastatin injection in failing rabbit hearts with IR injury and to unveil the underlying molecular mechanisms. Rabbits were divided into rosuvastatin, rosuvastatin + l-NAME, control, and l-NAME groups. Intravenous bolus rosuvastatin (0.5 mg/kg) and/or l-NAME (10 mg/kg) injections were administered 1 hour and 15 minutes before surgery, respectively. Heart failure was induced using rapid ventricular pacing. Under general anesthesia with isoflurane, an IR model was created by coronary artery ligation for 30 minutes, followed by reperfusion for 15 minutes. Plasma NO end product levels were measured during IR. Then, hearts were excised and Langendorff-perfused for optical mapping studies. Cardiac tissues were sampled for Western blot analysis. Rosuvastatin increased plasma NO levels during IR, which was abrogated by l-NAME. Spontaneous VF during IR was suppressed by rosuvastatin (P < 0.001). Intracellular calcium (Cai) decay and conduction velocity were significantly slower in the IR zone. Rosuvastatin accelerated Cai decay, ameliorated conduction inhomogeneity, and reduced the inducibility of spatially discordant alternans and VF significantly. Western blots revealed significantly higher expression of enhancing endothelial NO-synthase and phosphorylated enhancing endothelial NO-synthase proteins in the Rosuvastatin group. Furthermore, SERCA2a, phosphorylated connexin43, and phosphorylated phospholamban were downregulated in the IR zone, which was attenuated or reversed by rosuvastatin. Acute rosuvastatin therapy before ischemia reduced IR-induced VF by improving SERCA2a function and ameliorating conduction disturbance in the IR zone.
Difference Distributions Applicable to Certain Health Physics Measurements
Authors: Justus Alan L. 
Published: December 2019

Abstract
This paper discusses calculational methods for the determination of the difference distributions associated with certain health physics measurements. These measurements include the check-source response counts relative to an initial reference count, the Albatross (i.e., HPI model 2080B) neutron tube counts relative to the gamma tube counts, and those that involve the use of the automatic background subtraction feature of portable health physics instrumentation. Examples are provided that illustrate the methods for a few specific measurements. For the comparison of a daily source count to its previously determined reference value, minimum counts for various scenarios were presented in order to reliably meet required tolerance limits of ±10% and ±20%. In either case, it was found beneficial that the initial reference readings be established using a counting interval of longer length than the daily interval. For the comparison of Albatross neutron counts to the gamma counts, it was seen that the relative error in the difference distribution was still related to that of the parent distribution. It was seen, therefore, that an effective way of reducing the gamma influence on the Albatross was to increase the counting interval used, hence yielding a significantly larger mean count per interval. For the automatic background subtraction feature, it was noted that net count values near 0 counts would almost always have the negative values of the difference distribution truncated to 0 counts by commercially available off-the-shelf instrumentation, whereas significant net count values would be displayed correctly but with a larger associated variance than the gross count itself. This paper therefore also provides a technical basis for the necessary source strength of a check source in order to meet daily limits, the gamma field limitations of the HPI 2080B Albatross, as well as the consequences of automatic background subtraction.
Robotic Dispersal Technique for 35 GBq of 140La in an L-polygon Pattern
Authors: Beckman Blake , Green Anna Rae , Sinclair Laurel , Fairbrother Blaine , Munsie Tim , White Dan 
Published: December 2019

Abstract
In 2018, Defence Research and Development Canada, in partnership with Natural Resources Canada, led a field trial of survey and mapping of a large dispersion of radioactivity using Unmanned Aerial Vehicles (UAVs). The intent was to disperse 140La material in a 3,200 m2 L-polygon with an approximate activity level of 10 MBq m−2 and to measure the radioactive material using sensors carried by UAVs. Due to the potential radiological hazard to personnel, the activity was approved only if Unmanned Ground Vehicles (UGVs) were able to completely handle and disperse the material remotely. One UGV was equipped with a traditional agricultural sprayer to disperse the material, and one UGV was equipped with a force feedback manipulator arm. Due to the freezing temperatures during dispersal, the 35 GBq of 140La was dispersed non-uniformly as one sprayer boom failed to perform as tested. However, rough analysis of the electronic dosimetry on the UGV concluded that 99% of the material was dispersed on the ground. The dosimeter placed closest to the robot manipulator arm, used for dispersal of material, indicated a contact dose of 33.5 mSv. The electronic dosimeter placed where the driver would have sat on the sprayer vehicle if it were not unmanned indicated a dose of 22.3 mSv. Thus, the use of UGVs for material dispersion substantially reduced the external exposure to personnel. The use of UGVs eliminated the potential of internal exposure as well. The Radiation Safety Officer received the highest dose at approximately 3 μSv, with the majority of the exposure coming from the handling of the Type A container.
PROLONGED OZURDEX-MACULAR CONTACT FOLLOWING VITRECTOMY FOR MACULAR HOLE
Authors: Kelkar Aditya S. , Kelkar Jai A. , Agarwal Aanchal A. , Mehta Hetal M. , Kelkar Shreekant B. 
Published: December 2019

Purpose:
To evaluate the outcome of prolonged ozurdex-macular contact following vitrectomy for macular hole.

Methods and Patients:
A 63-year-old woman with subtle vitreomacular traction and macula edema in the left eye underwent femto laser-assisted cataract surgery with lens implant and ozurdex injection. Postoperatively, patient developed macular hole for which she underwent vitrectomy.

Results:
The steroid implant that remained in contact with the fovea for 16 weeks disappeared on its own without causing any retinal toxicity, and the best-corrected visual acuity improved to 6/9.

Conclusion:
Vitreomacular traction with edema may worsen after cataract surgery and ozurdex injection. Ophthalmologists should keep in mind this rare possible complication and make patients aware of the same.
Correlation Between Angle Parameters and Central Corneal Thickness in Fuchs Endothelial Corneal Dystrophy
Authors: Watanabe Shinya , Oie Yoshinori , Miki Atsuya , Soma Takeshi , Koh Shizuka , Kawasaki Satoshi , Tsujikawa Motokazu , Jhanji Vishal , Nishida Kohji 
Published: December 2019

Purpose:
To evaluate the correlation between anterior chamber parameters and central corneal thickness (CCT) or peripheral corneal thickness (PCT) in patients with Fuchs endothelial corneal dystrophy (FECD) using anterior segment optical coherence tomography.

Methods:
This case–control study included 20 eyes from 20 patients with FECD and 31 eyes from 31 patients with healthy corneas. CCT was measured as an indicator of FECD severity. Anterior chamber angle parameters, including trabecular–iris angle (TIA500) and angle opening distance (AOD500), were measured as an indicator of peripheral anterior chamber morphology. We also analyzed PCT and lens vault (LV). The relationships between CCT or PCT and anterior chamber parameters were also analyzed in patients with FECD.

Results:
Patients with FECD had a larger CCT (593.9 ± 54.6 μm vs. 533.0 ± 25.4 μm, P < 0.001), smaller TIA500 (21.8 ± 9.9 vs. 32.5 ± 11.2 degrees, P = 0.002), smaller AOD500 (0.21 ± 0.11 vs. 0.34 ± 0.18 mm, P = 0.002), and greater LV (0.60 ± 0.27 vs. 0.40 ± 0.29 mm, P = 0.02) than control subjects. In patients with FECD, CCT was negatively correlated with the angle parameters TIA500 (R2 = 0.29, P = 0.009) and AOD500 (R2 = 0.19, P = 0.03). There were no significant correlations between PCT and TIA500 (R2 = 0.008, P = 0.29) or AOD500 (R2 = 0.007, P = 0.29). There were also no significant correlations between CCT and LV (R2 = 0.02, P = 0.55).

Conclusions:
Larger CCT was significantly associated with narrower anterior chamber angle width, but not with LV. We showed that the severity of FECD is associated with angle chamber morphology.
Bristle Worm-Induced Keratouveitis: A Case Report
Authors: Kirk Jonathan , Gunn David , Wong Nathan , Minchin Emily , Darcy Kieren 
Published: December 2019

Purpose:
To report keratouveitis arising from corneal penetration by a bristle worm seta (bristle).

Methods:
We report on a 64-year-old woman presenting with uniocular pain, redness, reduced vision, discharge, and pustular rash of the hands after cleaning out her marine aquarium containing bristle worms and rubbing her eye.

Results:
Slit-lamp biomicroscopy showed pseudomembranous conjunctivitis, corneal punctate erosions, stromal infiltrate, and edema, but no visible foreign body. The anterior chamber developed 3+ cells with hypopyon within 24 hours. Laboratory testing of corneal and hand samples was negative. In vivo confocal microscopy revealed a hair-like seta in the anterior corneal stroma, 25 to 105 μm wide, with surrounding inflammatory cells. Anterior chamber washout was performed. Topical prednisolone 0.5% was commenced, and corneal edema gradually resolved over 3 months.

Conclusions:
Bristle worms thrive as detritivores in marine aquarium sediment. Aquarium owners risk touching their setae during tank cleaning. Ophthalmia nodosa describes ocular reaction to caterpillar, vegetable, and spider hairs: features include posterior migration of hairs, granulomatous inflammation, and uncertain prognosis. Eye specialists should be alerted to the possibility of bristle worm-induced ophthalmia nodosa. Confocal microscopy may be useful in identifying microscopic setae.
Trigeminal neuralgia associated with a solitary pontine lesion: clinical and neuroimaging definition of a new syndrome
Authors: Tohyama Sarasa , Hung Peter Shih-Ping , Cheng Joshua C. , Zhang Jia Y. , Halawani Aisha , Mikulis David J. , Oh Jiwon , Hodaie Mojgan 
Published: December 2019

Abstract
Conventional magnetic resonance imaging of patients with trigeminal neuralgia (TN) does not typically reveal associated brain lesions. Here, we identify a unique group of TN patients who present with a single brainstem lesion, who do not fulfill diagnostic criteria for multiple sclerosis (MS). We aim to define this new clinical syndrome, which we term TN associated with solitary pontine lesion (SPL-TN), using a clinical and neuroimaging approach. We identified 24 cases of SPL-TN, 18 of which had clinical follow-up for assessment of treatment response. Lesion mapping was performed to determine the exact location of the lesions and site of maximum overlap across patients. Diffusion tensor imaging was used to assess the white-matter microstructural properties of the lesions. Diffusivity metrics were extracted from the (1) SPL-TN lesions, (2) contralateral, unaffected side, (3) MS brainstem plaques from 17 patients with TN secondary to MS, (4) and healthy controls. We found that 17/18 patients were nonresponders to surgical treatment. The lesions were uniformly located along the affected trigeminal pontine pathway, where the site of maximum overlap across patients was in the area of the trigeminal nucleus. The lesions demonstrated abnormal white-matter microstructure, characterized by lower fractional anisotropy, and higher mean, radial, and axial diffusivities compared with the unaffected side. The brainstem trigeminal fiber microstructure within a lesion highlighted the difference between SPL-TN lesions and MS plaques. In conclusion, SPL-TN patients have identical clinical features to TN but have a single pontine lesion not in keeping with MS and are refractory to surgical management.
Acute Effects of Concussion in Youth With Pre-existing Migraines
Authors: Terry Douglas P. , Reddi Preethi J. , Cook Nathan E. , Seifert Tad , Maxwell Bruce A. , Zafonte Ross , Berkner Paul D. , Iverson Grant L. 
Published: December 2019

Objective:
To examine associations between pre-existing migraines and postconcussion symptoms and cognitive performance acutely (within 72 hours) after a suspected concussion.

Design:
Nested case–control study.

Setting:
High schools in Maine, USA.

Participants:
From a sample of 39 161 adolescent athletes who underwent baseline preseason testing, 633 were assessed within 3 days of a suspected concussion. Of these, 59 reported a history of treatment for migraines at baseline (9.3%). These athletes were individually matched to 2 athletes who had a suspected concussion but denied preinjury migraines (total N = 177; age: M = 15.8, SD = 1.3).

Assessment of Risk Factors:
Self-reported history of treatment for migraines by a physician.

Main Outcome Measures:
Post-Concussion Symptom Scale total score, ImPACT composite scores, and individual symptom endorsement.

Results:
Individuals with a pre-existing migraine disorder endorsed greater symptom severity (M = 8.4, SD = 9.9) compared with controls (M = 4.5, SD = 6.5; Cohen's d = 0.47) at preinjury baseline and acutely after suspected injury (migraine: M = 26.0, SD = 25.5; controls: M = 16.7, SD = 15.4; d = 0.44). Acutely after a suspected concussion, greater proportions of athletes with migraine disorders reported mental fogginess (49.2% vs 33.9%) and memory problems (39.0% vs 24.6%; P < 0.05). Baseline ImPACT composite scores were similar between migraine and control groups (d = 0.04-0.13). Adolescents with pre-existing migraine disorders performed worse after a suspected concussion compared with the control participants on verbal memory (F = 4.32, P = 0.041) and visual memory (F = 3.95, P = 0.049).

Conclusions:
Individuals with pre-existing migraine disorders may be at higher risk for worse outcomes, including greater overall burden of symptoms and worse cognitive functioning in the memory domain, in the first 72 hours after concussion.
Knee Biomechanical Deficits During a Single-Leg Landing Task Are Addressed With Neuromuscular Training in Anterior Cruciate Ligament–Reconstructed Athletes
Authors: Nagelli Christopher V. , Di Stasi Stephanie , Wordeman Samuel C. , Chen Albert , Tatarski Rachel , Hoffman Joshua , Hewett Timothy E. 
Published: December 2019

Objective:
Faulty neuromuscular and biomechanical deficits of the knee are nearly ubiquitous in athletes after anterior cruciate ligament (ACL) reconstruction (ACLR). Knee biomechanical deficits are directly associated with an increased risk of second ACL injury, which typically occurs during a sports-related movement on a single limb. To date, the biomechanical effects of a neuromuscular training (NMT) program on knee biomechanics during a single-leg landing task have not been investigated.

Design:
Prospective Cohort Study.

Setting:
Controlled laboratory setting.

Participants:
Eighteen ACLR and 10 control athletes.

Interventions:
Neuromuscular training.

Main Outcome Measures:
Knee kinematics and kinetics.

Results:
There were no significant interactions of session and limb (P > 0.05) for the athletes with ACLR after training. However, there were several significant main effects of session (P < 0.05) for knee kinematics and kinetics during the single-leg landing task. After training, the athletes with ACLR landed with greater knee flexion angles, decreased knee abduction angles, increased knee flexion range of motion, and decreased knee excursion. Also, the ACLR athletes landed with lower knee flexion moments, greater knee adduction moments, and lower peak vertical ground reaction force. Post-training comparison of the ACLR and control cohorts found no significant interactions of group and limb (P > 0.05) and only a significant main effect of group (P < 0.05) for frontal plane knee angle at initial contact. The athletes with ACLR landed with greater knee adduction angles than the control group.

Conclusions:
Deficits in knee biomechanics that are associated with an increased risk of ACL injury are attenuated after completion of this NMT program.
Part II: Comparison of Crossfit-Related Injury Presenting to Sports Medicine Clinic by Sex and Age
Authors: Sugimoto Dai , Zwicker Rebecca L. , Quinn Bridget J. , Myer Gregory D. , Stracciolini Andrea 
Published: December 2019

Objective:To examine CrossFit-related injuries based on sex and age.Design:Retrospective case series.Setting:A tertiary-level pediatric sports medicine clinic.Participants:CrossFit athletes.Main Outcome Measures:CrossFit-related injuries by sex (males vs females) and age groups (≤19 years vs >19 years) using a χ2analysis withP= 0.05, odds ratio (OR), and 95% confidence interval (95% CI).Results:Among injured CrossFit athletes, female athletes sustained lower extremity injuries more frequently than male athletes (P= 0.011; OR, 2.65; 95% CI, 1.25-5.65). In observed CrossFit injuries, shoulder injuries were more frequently observed in male athletes compared with female athletes (P= 0.049; OR, 2.79; 95% CI, 0.98-7.95). Additionally, a greater proportion of CrossFit athletes aged 19 years and younger suffered trunk/spine injuries than those older than 19 years (P= 0.027; OR, 2.61; 95% CI, 1.10-6.21) in injured CrossFit athletes.Conclusions:The current results indicated sex- and age-specific susceptibility to CrossFit-related injuries based on body parts and diagnoses. The presented information may be useful to develop a safer exercise program, especially for pediatric and adolescent CrossFit participants.
Performance of 4 Molecular Assays for Detection of Chlamydia and Gonorrhea in a Sample of Human Immunodeficiency Virus-Positive Men Who Have Sex With Men
Authors: Footman Alison , Dionne-Odom Jodie , Aaron Kristal J. , Raper James L. , Van Der Pol Barbara 
Published: December 2019

Background
Nucleic acid amplification testing (NAAT) is the preferred method to detect Chlamydia trachomatis and Neisseria gonorrhoeae, but information regarding performance of currently available assays is needed. This study evaluated the performance of the Aptima Combo 2, GeneXpert, cobas4800, and ProbeTec QX (CTQ/GCQ) to detect chlamydia and gonorrhea in pharyngeal, rectal, and urine specimen.

Methods
Adult male patients seen at an urban human immunodeficiency virus clinic in Birmingham, Alabama who reported sex with men (men who have sex with men) and no antibiotic use in the past 30 days were enrolled between November 2014 and December 2016. Following a baseline survey, rectal and initial void urine specimens were self-collected. A composite infection standard was used, where 1 assay was compared with 3 others to determine sensitivity and specificity estimates for rectal and urine samples. Two pharyngeal samples were clinician-collected for chlamydia and gonorrhea testing and both had to be positive to be considered a true positive.

Results
Among the 181 men enrolled into the study, 15.5% and 7.2% had at least 1 positive chlamydia and gonorrhea result at any site, respectively. Among all 4 assays, chlamydia sensitivity rates ranged from 82% to 96% among rectal samples. Rectal gonorrhea sensitivity estimates ranged from 67% to 99%. The GCQ assay was less sensitive in detecting rectal gonorrhea compared with the other assays (P = 0.02).

Conclusions
More than 80% of chlamydia and gonorrhea infections would have been missed with urine-only screening, highlighting the importance in using NAATs to detect chlamydia and gonorrhea infections among men who have sex with men.
Detection-Based Monetary Incentives to Improve Syphilis Screening Uptake: Results of a Pilot Intervention in a High Transmission Setting in Southern China
Authors: Smith M. Kumi , Shen Hongcheng , Huang Shujie , Zheng Heping , Yang Bin , Wiesen Christopher , Wang Cheng 
Published: December 2019

Background
Underscreening of syphilis in clinical settings is a pervasive problem in resource-constrained settings where heavy patient loads and competing health priorities inhibit health providers' ability to meet screening coverage targets. A “detection-based” pay-for-performance (P4P) strategy can incentivize more targeted testing by rewarding providers with a monetary bonus for every confirmed case.

Methods
Five clinics in a high transmission setting of China participated in the 6-month pilot intervention. Seropositive proportions during the P4P intervention were compared with those during the preintervention phase using multilevel logistic regression models adjusted for age and sex of clinic attendees.

Results
There were 8423 patients that sought care at 1 of the 6 clinics over the course of the study. Adjusted odds of a positive syphilis screen were greater during the intervention period compared to the preintervention interval (odds ratio, 1.33; 95% confidence interval, 1.14–1.56). Variability in clinic-level effects was substantial given the small number of sites of this pilot study.

Conclusions
Results of this detection-based P4P pilot study demonstrate the feasibility and preliminary effectiveness of this approach for improving syphilis case detection in resource-constrained clinical settings. A fully powered randomized trial is needed to inform the full utility of this approach for improving sexually transmitted disease detection globally.
Beyond Point-of-Care Ultrasound
Authors: Scheier Eric , Balla Uri 
Published: December 2019

Abstract
Cancer is diagnosed in 1 in 7000 children annually. Here, we report 6 cases of a mass identified by the author, a novice sonographer in a pediatric emergency medicine fellowship, using point-of-care ultrasound, from January of 2017 to May of 2018. Identification of these cases early in presentation allowed for earlier involvement of the relevant specialist and shorter time to diagnosis and treatment, and might be expected to increase parent satisfaction as well.