bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporomandibular Joint Ankylosis Following Mandibular Distraction Osteogenesis: A Dreadful Complication
Authors: Schlund M. , Touzet-Roumazeille S. , Nicot R. , Ferri J. 
Published: October 2019

Introduction:
Mandibular distraction osteogenesis (MDO) is an effective treatment for severe micrognathia, as it helps to avoid tracheostomy but has some adverse effects on the temporomandibular joint (TMJ). TMJ ankylosis is a serious condition leading to feeding difficulties and growth impairment, and could result in worse consequences in cases with micrognathia who already have limited growth potential. Here, we aimed to report on cases with TMJ ankylosis—a rare but devastating complication of MDO. In total, we described 3 syndromic cases with TMJ ankylosis that developed after MDO and reviewed the associated literature.

Material and Methods:
We retrospectively enrolled 3 patients who presented with TMJ ankylosis following MDO at the Oral and Maxillofacial Surgery Department of the University Hospital of Lille, France.

Results:
All 3 patients had craniofacial syndrome with micrognathia. MDO was performed at least twice in each case, and the 3 patients developed subsequent TMJ ankylosis. They all presented with TMJ ankylosis and micrognathia in our Department.

Discussion:
MDO leads to a certain amount of stress on the TMJ, and in cases with congenital TMJ deformation, such stress could lead to TMJ ankylosis. To our knowledge, 12 cases of TMJ ankylosis after MDO have been described in studies involving 309 patients while it is not reported in other publications. They were all syndromic patients. Thus, TMJ health should be carefully monitored during and after MDO to avoid TMJ ankylosis, and alternative treatments such as costochondral grafts should be considered.
Pituitary Adenoma Deposit in the Nasolabial Region Following Sublabial Transsphenoidal Surgery in the Setting of Nelson Syndrome
Authors: Wallace Aaron , Liu Palmila , Cipriani Nicole A. , Ginat Daniel , Portugal Louis 
Published: October 2019

Abstract
Pituitary adenomas are a group of tumors arising from the anterior pituitary gland, and with the exception of prolactin-secreting adenomas, transsphenoidal resection is the cornerstone of treatment. Although most adenomas are located within the pituitary fossa, ectopic adenomas have been reported, primarily occurring along the route of embryologic development. In this article, we present the case of an ectopic pituitary adenoma in the nasolabial fold that likely resulted from seeding during transsphenoidal resection via sublabial approach.
Trends in the Use of Medications and Supplements to Treat or Prevent Dementia
Authors: Stoehr Gary P. , Jacobsen Erin , Jia Yichen , Snitz Beth E. , Ganguli Mary 
Published: October 2019

Objective:
To examine older adults’ use over time of agents to treat or prevent dementia or enhance memory.

Design:
Longitudinal community study with 10-year annual follow-up (2006-2017).

Setting:
Population-based cohort.

Participants:
A total of 1982 individuals with a mean (SD) age of 77 (7.4) years at baseline.

Measurements:
Demographics, self-report, direct inspection of prescription antidementia drugs and nonprescription supplements, cognitive and functional assessments, Clinical Dementia Rating (CDR®) Dementia Staging Instrument.

Results:
Supplement use was reported by 27% to 42% of participants over 10 years. Use was associated with younger age, high school or greater education, good to excellent self-reported health, higher memory test scores, and absence of cognitive impairment or dementia (CDR=0). Over the same period, about 2% to 6% of participants took prescription dementia medications over 10 years. Use was associated with lower memory test scores, at least mild cognitive impairment (CDR≥0.5), fair to poor self-rated health, and high school or lesser education.

Conclusions:
The use of both prescription drugs and supplements increased over time, except for decreases in ginkgo and vitamin E. Prescription drug use appeared in line with prescribing guidelines. Supplement use was associated with higher education and better self-rated health; it persists despite a lack of supportive evidence.
Clustering and Additive Effects of Nongenetic Risk Factors in Non–Autosomal-Dominant Degenerative and Vascular Young Onset Dementia
Authors: Cations Monica , Withall Adrienne , Low Lee-Fay , Radford Kylie , Trollor Julian , Brodaty Henry , Sachdev Perminder , Gonski Peter , Broe Gerald Anthony , Cumming Robert G. , Draper Brian 
Published: October 2019

Introduction:
Both genetic and nongenetic factors contribute to the risk profile of young onset dementia (YOD), but risk factors often co-occur. This matched case-control study examined whether nongenetic risk factors cluster together, to inform targeted prevention efforts.

Methods:
Ninety-six participants with non–autosomal-dominant degenerative and/or vascular YOD and 175 controls were recruited to 2 Australian epidemiological studies. Risk exposure was retrospectively self-reported and/or informant-reported.

Results:
Each additional exposure increased the risk for YOD, though only where vascular dementia was included in the analysis. Cluster analysis identified 4 risk groups, one of which reported a high probability of exposure to all risks and a significantly higher risk for YOD.

Discussion:
Results suggest that combinations of nongenetic risk factors confer more risk for young onset vascular dementia, and possibly primary degenerative YOD, than a single factor on its own. Compared with their same-age peers, some people with YOD experience a lifetime of risk exposure starting from early in life.
Wallerian degeneration as a therapeutic target in traumatic brain injury
Authors: Koliatsos Vassilis E. , Alexandris Athanasios S. 
Published: October 2019

Purpose of review
Diffuse or traumatic axonal injury is one of the principal pathologies encountered in traumatic brain injury (TBI) and the resulting axonal loss, disconnection, and brain atrophy contribute significantly to clinical morbidity and disability. The seminal discovery of the slow Wallerian degeneration mice (Wlds) in which transected axons do not degenerate but survive and function independently for weeks has transformed concepts on axonal biology and raised hopes that axonopathies may be amenable to specific therapeutic interventions. Here we review mechanisms of axonal degeneration and also describe how these mechanisms may inform biological therapies of traumatic axonopathy in the context of TBI.

Recent findings
In the last decade, SARM1 [sterile a and Toll/interleukin-1 receptor (TIR) motif containing 1] and the DLK (dual leucine zipper bearing kinase) and LZK (leucine zipper kinase) MAPK (mitogen-activated protein kinases) cascade have been established as the key drivers of Wallerian degeneration, a complex program of axonal self-destruction which is activated by a wide range of injurious insults, including insults that may otherwise leave axons structurally robust and potentially salvageable. Detailed studies on animal models and postmortem human brains indicate that this type of partial disruption is the main initial pathology in traumatic axonopathy. At the same time, the molecular dissection of Wallerian degeneration has revealed that the decision that commits axons to degeneration is temporally separated from the time of injury, a window that allows potentially effective pharmacological interventions.

Summary
Molecular signals initiating and triggering Wallerian degeneration appear to be playing an important role in traumatic axonopathy and recent advances in understanding their nature and significance is opening up new therapeutic opportunities for TBI.
Bilateral Scalp Necrosis in Giant Cell Arteritis
Authors: Somani Anisha N. , Al Othman Bayan , Kini Tonse , Lee Andrew G. 
Published: October 2019

Abstract:
Giant cell arteritis (GCA) is a medium-to-large vessel vasculitis of the elderly. Common constitutional clinical features include headache, scalp tenderness, and jaw claudication. Severe unilateral or bilateral visual loss is the most feared ophthalmic complication of GCA. Scalp necrosis is a known ischemic complication of GCA with approximately 100 cases reported in the literature to date. We report a case of scalp pain and an erythematous cutaneous lesion in the distribution of ophthalmic division of the trigeminal nerve that mimicked herpes zoster ophthalmicus. A temporal artery biopsy was positive for GCA, and small vessel arteritis was seen at the time of simultaneous skin biopsy. To the best of our knowledge, this is the first such report in the English language ophthalmic literature.
Reliability Testing of Augmented Reality Glasses Technology
Authors: Kaylor Jennifer , Hooper Vallire , Wilson Angela , Burkert Randy , Lyda Marlena , Fletcher Kirstie , Bowers Emily 
Published: October 2019

PURPOSE:
To test the fidelity and feasibility of using augmented reality glass (ARG) telehealth technology for comprehensive wound, ostomy, and continence (WOC) service delivery to underserved rural practice settings.

DESIGN:
Intrarater reliability design focusing on treatment integrity.

SAMPLE AND SETTING:
Adult patients in a tertiary care hospital and a rural long-term care setting who were scheduled for routine wound care consults.

METHODS:
Intra- and interrater reliability were assessed using a documentation-based wound assessment tool comprising 6 discrete assessment points. The wound teleassessment was first conducted by the telehealth “hub” WOC nurse remotely in collaboration with a bedside nurse wearing the ARG. The same hub WOC nurse then conducted an assessment at the bedside. Initial assessment points and treatment plans were compared to establish assessment and treatment intrarater reliability. A different WOC nurse, blinded to the first assessment, also conducted a bedside assessment and provided treatment recommendations, which were then compared to the hub WOC nurse's initial remotely ARG-generated treatment plan to establish treatment interrater reliability.

RESULTS:
Sixteen patients with 21 wounds were assessed. Six wound assessment components were included, yielding a total of 126 total observation points. Intrarater assessment reliability was 98%. Treatment plan interrater reliability was 100%.

CONCLUSIONS:
Results support further evaluation of ARG technology as a tool to enhance the delivery of wound care services in remote underserved settings. Implementation and evaluation of this technology on clinical and financial outcomes in multiple wound care delivery environments should be determined moving forward. Successful implementation should serve as a template to expand evidence-based WOC nursing care across the globe.
Genetic determinants of trehalose utilization are not associated with severe Clostridium difficile infection
Authors: Saund Katie , Rao Krishna , Young Vincent B. , Snitkin Evan S. 
Published: October 2019

ABSTRACTIn a case-control study of patients with C. difficile infection we found no statistically significant association between the presence of trehalose utilization variants in infecting C. difficile strains and development of severe infection. These results do not support trehalose utilization conferring enhanced virulence in the context of human C. difficile infections.
A target product profile for electronic clinical decision support algorithms combined with point-of-care diagnostic test results to support evidence-based decisions during patient consultations by health workers
Authors: Pellé Karell G. , Rambaud-Althaus Clotilde , D’Acremont Valérie , Moran Gretchen , Sampath Rangarajan , Katz Zach , Moussy Francis , Mehl Garrett L. , Dittrich Sabine 
Published: October 2019

ABSTRACTHealth workers in low-resource settings often lack the support and tools to follow evidence-based clinical recommendations for diagnosing, treating and managing sick patients. Digital technologies, by combining patient health information and point of care diagnostics with evidence-based clinical protocols, can help improve the quality of care, the rational use of resources (humans, diagnostics and medicines) and save patient lives. The development of a target product profile for electronic clinical decision support algorithms (CDSAs) aimed at guiding preventive or curative consultations, and that integrate diagnostic test results will help align developer and implementer processes and specifications with the needs of end-users, in terms of quality, safety, performance and operational functionality. To identify characteristics for a CDSA, experts from academia, research institutions, and industry as well as policy makers with expertise in diagnostic and CDSA development, and implementation in LMICs were convened. Experts discussed the critical characteristics of a draft TPP which was revised and finalised through a Delphi process to facilitate consensus building. Experts were in overwhelming agreement that, given that CDSAs provide patients’ management recommendations, the underlying clinical algorithms should be available in human readable format and evidence-based. Whenever possible, the algorithm output should take into account pre-test disease probabilities, diagnostic likelihood ratios of clinical or laboratory predictors and disease probability thresholds to test and to treat. Validation processes should at a minimum ensure the CDSA are implementing faithfully the evidence-based algorithm they are based on (internal validation through clinical association and analytical validation). Additionally, clinical validation, bringing practice evidence about the impact of the CDSA use on health outcomes, was recognized as a good to have. The CDSAs should be designed to fit within clinic workflows, connectivity challenges and high volume settings. Data collected through the tool should conform to local patient privacy regulations and international data standards.
A Markov Chain approach for ranking treatments in network meta-analysis
Authors: Chaimani Anna , Porcher Raphaël , Sbidian Émilie , Mavridis Dimitris 
Published: October 2019

ABSTRACTWhen interpreting the relative effects from a network meta-analysis (NMA), researchers are usually aware of the potential limitations that may render the results for some comparisons less useful or meaningless. In the presence of sufficient and appropriate data, some of these limitations (e.g. risk of bias, small-study effects, publication bias) can be taken into account in the statistical analysis. Very often, though, the necessary data for applying these methods are missing and data limitations cannot be formally integrated into ranking. In addition, there are other important characteristics of the treatment comparisons that cannot be addressed within a statistical model but only through qualitative judgements; for example, the relevance of data to the research question, the plausibility of the assumptions, etc. Here, we propose a new measure for treatment ranking called the Probability of Selecting a Treatment to Recommend (POST-R). We suggest that the order of treatments should represent the process of considering treatments for selection in clinical practice and we assign to each treatment a probability of being selected. This process can be considered as a Markov chain model that allows the end-users of NMA to select the most appropriate treatments based not only on the NMA results but also to information external to the NMA. In this way, we obtain rankings that can inform decision-making more efficiently as they represent not only the relative effects but also their potential limitations. We illustrate our approach using a NMA comparing treatments for chronic plaque psoriasis and we provide the Stata commands.
Implications ofMGMTpromoter methylation and its downstreamhMSH2mRNA in primary malignant glioma
Authors: Manuel Jeru-Manoj , Narasinga Rao K V L , Chetan G K 
Published: October 2019

AbstractBackgroundHypermethylation of 06-methylguanine DNA methyltransferase (MGMT)promoter seen in high grade gliomas (HGG) leads to the accumulation of O6-meG DNA damage which mispairs with thymine, requiring recognition by mismatch repair protein dimer MutSα, whose primary component is coded by Human MutS homolog protein 2 (hMSH2). O6-meG repair necessitates the interaction/combined action of MGMT andhMSH2 to maintain genomic stability. Analysis of the correlation betweenMGMTmethylation andhMSH2mRNAexpression in HGG and their role in the prognosis was explored.MethodsStudy was performed on 54 primary-frontal lobe HGG tumors,MGMTpromoter methylation was detected by Q-MSP and Q-PCR was used to analysehMSH2m-RNA expression levels.ResultsMGMTmethylation was seen in 62%patients the mean percentage of methylation (PoM) being (17.62±17.20) %.MGMTPoM≥10% had improved Progression free survival (p=0.015) and ≥8% had better Overall survival (p=0.043), indicating its predictive significance. Over expression ofhMSH2was seen in 50% patients with a median fold change of 2.74 (p=0.021). Univariate analysis of highhMSH2expression with therapy(CT+RT) showed poor PFS (p=0.002). There was no correlation betweenMGMTmethylation andhMSH2expression.ConclusionMGMTPoM of ≥10% is a significant prognostic marker. Over expression ofhMSH2is prognostic marker for poor treatment response. Lack of/aberrant correlation betweenMGMTandhMSH2could indicate impaired DNA repair of O6-meG in HGG, and this could be one of the factors responsible for both, gliomagenesis and variations in treatment response.
The importance of adolescent girls and “epidemic gearing” on HIV prevalence across West Africa
Authors: Prudden Holly J , Mukandavire Zindoga , Gorgens Marelize , Wilson David , Panovska-Griffiths Jasmina , Watts Charlotte 
Published: October 2019

AbstractBackgroundIn West Africa HIV prevalence varies between 0.1-6% in female and between 0.1-4% in the male general population. Male circumcision is almost universal, and it is unclear what drives this variation. We use mathematical modelling to identify the determinants of this variation across fourteen West African countries.MethodsWe developed a novel dynamic model of HIV transmission between population cohorts of female sex workers (FSWs), their clients, females with 2+ partners in the past year and other sexually active women and men in the general population. Parameter ranges were determined from the literature and sampled using Latin Hypercube sampling to identify parameter sets that fit West African HIV prevalence data. Partial-rank correlation coefficients between different model parameters and the HIV prevalence in general male and female population across 14 countries were calculated to determine to most significantly correlated model parameters to HIV prevalence.ResultsThe key determinant of HIV in females when prevalence is between 0-3% is the size of the brothel and non-brothel FSW groups. When female HIV prevalence >3%, the percentage of sexually active adolescent females with 2+ partners has greater influence on HIV prevalence. The size of the FSW groups has the most significant impact on HIV prevalence for males.ConclusionsOur findings confirm the role of FSWs in West Africa as an important determinant of HIV risk, but also identify, in countries with higher HIV prevalence, the emerging role of a group of adolescent girls with 2+ partners is an important determinant of risk. In fact, our findings suggest that this group may enable the epidemic to be effectively “geared up” when partnerships are formed with higher-risk males, indicating additional prevention needs amongst this group.FundingThis study was funded by UNAIDS.
The prevalence and risk factors for phantom limb pain in people with amputations: a systematic review and meta-analysis
Authors: Limakatso K. , Bedwell G. J. , Madden V. J. , Parker R. 
Published: October 2019

Background and objectivePhantom limb pain (PLP) is a common complication in people with limb amputations. There are conflicting reports in the literature regarding the prevalence of PLP in people with limb amputations. Therefore, this review aimed to determine the estimated pooled prevalence of PLP, and risk factors associated with this complication.MethodsArticles published between 1980 and July 2019 were identified through a systematic search of the following electronic databases: MEDLINE/PubMed, PsycINFO, PsycArticles, Cumulative Index to Nursing and Allied Health Literature, Africa−Wide Information, Health Source: Nursing/Academic Edition, SCOPUS, Web of Science and Academic Search Premier. Grey literature was searched on databases for preprints. Two reviewers independently performed the screening of articles, data extraction and risk of bias assessment. The meta−analyses were conducted using the random−effects model. A statistically significant level for the analyses was set at p>0.05.ResultsThe pooling of all studies demonstrated a prevalence estimate of 63% [95% CI: 58.23−67.05] with high heterogeneity [I2=95.70% (95% CI: 95.10−96.20)]. The prevalence of PLP was significantly lower in developing countries compared to developed countries [53.98% vs 64.55%; p=0.04]. Persistent pre−operative pain, proximal site of amputation, lower limb amputation, stump pain and phantom sensations were identified as risk factors for PLP.ConclusionThis systematic review and meta−analysis estimates that six of every 10 people with an amputation report PLP − a high and important prevalence of PLP. Health care professionals ought to be aware of the high rates of PLP and implement strategies to reduce PLP by addressing known risk factors, specifically those identified by the current study.
Eligibility for Subcutaneous Implantable Cardioverter Defibrillator in Congenital Heart Disease
Authors: Wang Linda , Javadekar Neeraj , Rajagopalan Ananya , Rogovoy Nichole M. , Haq Kazi T. , Broberg Craig S. , Tereshchenko Larisa G. 
Published: October 2019

AbstractBackgroundThe goals of this study were: assess left-and right-sided subcutaneous implantable cardioverter-defibrillator (S-ICD) eligibility in adult congenital heart disease (ACHD) patients, use machine learning to predict S-ICD eligibility in ACHD patients, and transform 12-lead ECG to S-ICD 3-lead ECG, and vice versa.MethodsACHD outpatients (n=101; age 42±14 y; 52% female; 85% white; left ventricular ejection fraction (LVEF) 56±9%) were enrolled in a prospective study. Supine and standing 12-lead ECG was recorded simultaneously with a right- and left-sided S-ICD 3-lead ECG. Peak-to-peak QRS and T amplitudes, RR, PR, QT, QTc, QRS intervals, Tmax, and R/Tmax(31 predictor variables) were tested. Model selection, training, and testing were performed using supine ECG datasets. Validation was performed using standing ECG datasets and out-of-sample non-ACHD population (n=68; age 54±16 y; 54% female; 94% white; LVEF 61±8%).ResultsA 40% of participants were ineligible for S-ICD. Tetralogy of Fallot patients passed right-sided screening (57%) more often than left-sided (21%; McNemar’s χ2P=0.025). The ridge model demonstrated the best cross-validation function. Validation of the ridge models was satisfactory for standing left-sided [ROC AUC 0.687 (95%CI 0.582-0.791)] and right-sided [ROC AUC 0.655(95%CI 0.549-0.762)] S-ICD eligibility prediction. Out-of-sample validation in the non-ACHD population yielded a 100% sensitivity of the pre-selected threshold for the elastic net model. Validation of the transformation matrices showed satisfactory agreement (<0.1 mV difference).ConclusionNearly half of the contemporary ACHD population is ineligible for S-ICD. Machine-learning prediction of S-ICD eligibility can be used for screening of S-ICD candidates.