bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Presentation and Surgical Treatment of Peribulbar Dermolipomas
Authors: Vahdani Kaveh , Rose Geoffrey E. 
Published: October 2020

Purpose:
To evaluate the presentation, treatment, and outcome for patients with peribulbar dermolipomas and describe a reliable technique for excision of large lesions.

Patients and methods:
Retrospective chart review for patients seen at Moorfields Eye Hospital between 1976 and 2019. Patient demographics, clinical features, imaging (CT or MRI, where available), histopathology, and surgical outcomes were reviewed.

Results:
One hundred and ninety-six eyes of 187 patients (117 females; 63%) were identified as having dermolipoma, the patients presenting at an average age of 21.5 years and—where recorded in 163 patients—had first symptoms at an average age of 12.9 years. Although 8/187 (4%) patients were asymptomatic, the commonest symptom was increasing size of a longstanding peribulbar lump (136 patients; 73%); other symptoms included ocular irritation (24%), episodic localized conjunctival injection (12%), and mucoid discharge (12%). One-third of dermolipomas had visible hairs (some with localized giant papillary conjunctivitis), lateral canthal widening was present in 44 patients, aberrant lacrimal gland ductules opening onto skin in 8, and a complex lateral canthal anomaly—with both an external dermoid and an internal dermolipoma—was present in 9 patients. Complete management details were available for 120 patients (those treated after 1990) and 40 (33%) electing for observation, 71 (59%) had excision for long-term irritation and discharge and 9 (8%) for cosmesis: together with the integral subdermal fat lobule, in all cases the abnormal, nonwetting squamous epithelium was delineated and excised under microscopic control, and the conjunctival defect closed directly (59/80 eyes) or with a “V-to-Y” closure (21 eyes; 26%). The presenting symptoms were cured in all except 1 patient, who required excision of residual abnormal epithelium causing persistent symptoms. Two patients developed symblepharon to the lateral canthus after direct conjunctival closure, this having no functional effect, and 2 other patients had slight restriction of extreme horizontal gaze.

Conclusion:
Dermolipomas may require surgery when they become more prominent with age, or start causing ocular irritation and discharge. Complications are few with meticulous removal of the nonwetting squamous epithelium and direct conjunctival closure, or when using a “V-to-Y” conjunctivoplasty for larger defects.
Incidence of corneal transplantation after challenging cataract surgery in patients with and without corneal guttata
Authors: Viberg Andreas , Byström Berit 
Published: October 2020

Purpose:
To study the risk for corneal transplantation after phacoemulsification with dense cataract or posterior capsule rupture (PCR) and the impact of corneal guttata.

Setting:
Forty-nine Swedish cataract surgical units and 8 Swedish cornea transplantation units.

Design:
Registry-based cohort study.

Methods:
Patient data from the Swedish National Cataract Registry (2010 to 2012) were linked with data from the Swedish Cornea Transplant Registry (2010 to 2017). The outcome measures were risk for future corneal transplantation, visual acuity, and self-assessed visual function after phacoemulsification. Logistic and Poisson regression analyses with adjustment for confounder effects were used to investigate the association of the outcome measures with dense cataract, indicated by trypan blue capsular staining (TB) and PCR, separately and together.

Results:
Altogether, data from 276 362 cataract patients were linked with data from 2091 patients with endothelial failure who underwent corneal transplantation.The risk for future corneal transplantation increased more than 3-fold with the presence of dense cataract or PCR, and a trend toward an ever-higher risk with the combination of TB and PCR together, but without any significant synergy of corneal guttata. Dense cataract, but not PCR, was significantly associated with an increased probability of inferior visual acuity after phacoemulsification. The impact on satisfaction was not statistically significant for any of the factors.

Conclusions:
Challenging cataract surgery increases the risk for future corneal transplantation equally in patients both with and without corneal guttata, despite a more vulnerable endothelium in the guttata group. This supports a strategy where PCR is limited and handled optimally and that cataract surgery is performed before the cataract turns critically dense.
Comparison of central topographic maps from a swept-source OCT biometer and a Placido disk–dual Scheimpflug tomographer
Authors: Wang Li , Canedo Ana Laura C. , Wang Yvonne , Xie Kate C , Koch Douglas D. 
Published: October 2020

Purpose:
To compare central topography (CT) from IOLMaster 700 with predicate topographic (PT) maps from a Placido disk–dual Scheimpflug tomographer in detection of irregularities that would influence the decision-making for implanting premium intraocular lenses (IOLs) (toric, multifocal, or extended depth-of-focus).

Setting:
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

Design:
Prospective comparative case series.

Methods:
Eyes with various corneal conditions were randomly selected: regular/irregular corneas, previous corneal refractive surgery, and keratoconus or pellucid marginal degeneration. Three observers compared the CT and PT maps and answered a questionnaire for each eye. The questionnaire focused on (1) overall shape similarity between CT and PT and (2) decision-making for premium IOL implantation based on CT and PT. Answers to the questionnaire and agreement in answers among observers were evaluated.

Results:
The study included 105 eyes. Comparing CT and PT, similar shape was observed in 68.6% to 89.5% of cases, and comparable map symmetries were reported in 60.0% to 83.8%; the same decision regarding premium IOL implantation was made in 75.2% to 97.1% of cases. There were significant interobserver agreements among 3 observers for all questions, with Fleiss κ values ranging from 0.141 to 0.450 (all P < .05). Peripheral corneal steeping or flattening was the primary finding that was visible on PT but not on CT.

Conclusions:
Compared with the PT, CT provided similar overall shape and comparable symmetries in most cases. The same decision was made whether to recommend a premium IOL based on CT and PT in 75% to 97% of cases.
Endoscopic and histologic evaluation of the gastrointestinal tract in patients with sarcoidosis
Authors: Wu Hao , Shen Bo 
Published: October 2020

Background
The involvement of gastrointestinal tract is rare in sarcoidosis. Endoscopic and histologic evaluation likely provides diagnostic clue in sarcoidosis patients. The aims were to assess the frequency of abnormal endoscopy and histology in patients with sarcoidosis undergoing endoscopic evaluation and to characterize the endoscopic and histologic features in sarcoidosis of the gastrointestinal tract.

Methods
This was a retrospective study that included 230 patients with a confirmed diagnosis of sarcoidosis in a tertiary care center. The endoscopic and pathology reports were assessed, and serum angiotensin converting enzyme analysis was performed.

Results
Of 230 patients, 63 upper endoscopies and 142 colonoscopies were performed. The most common indication for upper endoscopy was abdominal pain (36.8%) while colonoscopy was most frequently performed for colorectal cancer screening (58.2%). There were 25 upper gastrointestinal biopsies performed (biopsy rate 39.7%) with a diagnostic yield of 92.0% abnormal biopsies, of which the main findings were esophageal tissue eosinophilia, gastritis and duodenal villous blunting. There were 99 lower gastrointestinal biopsies (biopsy rate 64.1%) with a diagnostic yield of 68.7% abnormal biopsies for adenocarcinoma, adenoma, inflammation, low-grade dysplasia, or polyp. Only one gastric biopsy revealed evidence of non-necrotizing granulomas. Of note, patients undergoing esophagogastroduodenoscopy or colonoscopy were more likely to have underlying gastrointestinal comorbidities (62.5%, P < 0.001).

Conclusion
Patients with sarcoidosis undergoing endoscopic evaluation have high histologic abnormalities with a low probability of characteristic histologic (i.e. granulomas, Schaumann and asteroid bodies) findings.
Evaluation of the efficacy and safety of direct oral anticoagulants in the treatment of portal vein thrombosis
Authors: Ilcewicz Haley N. , Martello Jay L. , Piechowski Kara 
Published: October 2020

Objective
The purpose of this study was to evaluate the efficacy and safety of direct oral anticoagulants vs. warfarin for portal vein thrombosis treatment.

Methods
This was a single-center, retrospective study. Adult patients initiated on a direct oral anticoagulant or warfarin for treatment of a new portal vein thrombosis were included. The primary failure outcome was the absolute difference in recurrent thromboembolic events 90 days following initiation of a direct oral anticoagulant vs. warfarin. The primary safety outcome was the absolute difference in bleeding events 90 days following initiation of a direct oral anticoagulant vs. warfarin. Descriptive statistics, Fisher’s exact, and Student’s t-tests were utilized as appropriate.

Results
Thirty-three patients were included. Thirteen (39.4%) patients received direct oral anticoagulants, and 20 (60.6%) received warfarin. None of the patients receiving direct oral anticoagulants experienced a primary failure event compared to four receiving warfarin (P < 0.001). None of the patients receiving direct oral anticoagulants experienced a primary safety event vs. one receiving warfarin (P < 0.001).

Conclusion
Direct oral anticoagulants appear to be effective and safe in the treatment of portal vein thrombosis and in preventing recurrent thromboembolic events. Future studies with larger sample sizes are warranted to confirm direct oral anticoagulants’ efficacy in portal vein thrombosis.
The potential value of miRNA-223 as a diagnostic biomarker for Egyptian colorectal patients
Authors: Bader El Din Noha G. , Farouk Sally , Abdel-Salam Lubna O. , Khairy Ahmed 
Published: October 2020

Objectives
Colorectal cancer (CRC) is the third lethal malignancy worldwide. Dysregulation of microRNAs (miRNAs) mediates several growth factors signaling pathways and induces abnormal genes expression, which leads to colorectal carcinogenesis. We aimed to comprehensively assess the expression of miRNA-200c, miRNA-203a, miRNA-223 in Egyptian CRC tissue and their corresponding serum samples and to explore if they have any potential prognostic or diagnostic value for CRC patients.

Methods
A total of 195 subjects (120 CRC patients and 75 healthy controls) participated in exploration and validation sets. The relative expression of miRNA-200c, miRNA-203a, and miRNA-223 was measured in both CRC tissue and serum samples, and the expressed miRNAs were compared in different CRC grades and types and the prognostic value was evaluated.

Results
The expression levels of miRNA-200c and miRNA-203a were reduced in CRC tissue samples than adjacent noncancerous tissues. miRNA-223 level was significantly upregulated in both CRC tissue and serum samples with a positive association between them (r = 0.85, P = 0.001). The miRNA-223 can effectively discriminate CRC patients from controls and can significantly differentiate between colon and rectal cancer patients. The association between serum miRNA-223 expression and CRC development was validated in the second set and the ROC curve showed highly significant prognostic value with 90.1% sensitivity, 87% specificity, and area under the curve of 0.914 (95% confidence interval: 0.830–0.978, P = 0.0001). These results showed the association between miRNA-223 upregulation and the CRC carcinogenesis.

Conclusion
Circulating miRNA-223 can be a potential noninvasive prognostic biomarker for Egyptian CRC patients.
Variceal bleeding has increased mortality compared to nonvariceal bleeding only in males
Authors: Erasmus Hans-Peter , Bektas Rukiye , Orland Katharina , Trifonova Svetlozara , Gu Wen-Yi , Uschner Frank Erhard , Brol Maximilian J. , Chang Johannes , Praktiknjo Michael , Strassburg Christian P. , Trebicka Jonel , Jansen Christian 
Published: October 2020

Background
Gastrointestinal bleedings (GIBs) are frequent in cirrhotic patients and lead to high morbidity and mortality. Lately, there have been conflicting reports on the role of and bleeding type [variceal bleeding and nonvariceal bleeding (NVB)]. This study investigated the predictors of mortality in patients with variceal bleeding and NVB with relationship to sex differences.

Materials and methods
A total of 271 patients with suspected upper GIB who underwent endoscopy were included. Patients were followed up at 1 week, 6 months and 1 year after admission. Univariate and multivariate logistic or Cox regression analyses investigated correlations of predictive factors and clinical outcomes. Propensity score matching was performed to control for severity of disease and compare groups for sex and bleeding type.

Results
A total of 42 patients were excluded (cirrhosis or bleeding not confirmed). The remaining patients were classified by bleeding type into patients with variceal bleeding (n = 115) or NVB (n = 156). Males (n = 155) had higher mortality in variceal bleeding than in NVB, while in females (n = 116) mortality was similar in the two bleeding types. This was confirmed after matching in males (n = 116) and females (n = 82). Further independent predictors of mortality in males were model for end-stage liver disease (MELD) at baseline, blood urea nitrogen, alanine aminotransferase, while in females age, leukocytes, MELD, history of ascites and hepatic encephalopathy.

Conclusion
This study shows that variceal bleeding has higher mortality in males compared to NVB, while in females the type of GIB does not impact the outcome. This highlights that sex-specific clinical management should be based on bleeding type after endoscopy.
The association of plasma high-density lipoprotein cholesterol levels and cirrhosis development in obese patients with chronic hepatitis B: a cohort study
Authors: Wang Xian , Chen Hui-Zhen , Liu Wan-Ting , Liu Min , Zhou Dong-Qi , Chen Qiu , Peng Bo 
Published: October 2020

Objective
Metabolic disorder is a common risk factor for cirrhosis in Asia, and it will increase the risk of cirrhosis in patients with Chronic hepatitis B (CHB). However, studies on the efficacy of plasma lipid markers which predict the happening and development of cirrhosis in obese CHB patients are limited.

Methods
In total, 3327 patients who were followed for more than 4 years’ follow-up in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine joined the program. Finally, 287 obese CHB patients were included in this study according to the results of metabolic tests. The data of baseline and follow-up were collected, and the association between them was analyzed.

Results
Based on the follow-up results, enrolled patients were divided into a group of cirrhosis (n = 146) and a group of noncirrhosis (n = 141). Plasma glucose and high-density lipoprotein cholesterol (HDL-C) levels in the noncirrhosis group (5.2 and 1.2 mmol/L, respectively) were significantly higher than that in the cirrhosis group (5.0 and 1.0 mmol/L, respectively), while the amount of total bile acid (TBA) in the cirrhosis group was lower than that in the cirrhosis group. Levels of HDL-C and total cholesterol were associated with liver function. Plasma HDL-C was an independent indicator of cirrhosis in patients with CHB. Patients with HDL-C levels less than 1.03 mmol/L had a 2.21-fold higher incidence rate of cirrhosis, and patients over 40 years old or the levels of HDL-C less than 1.03 mmol/L were more likely to generate cirrhosis.

Conclusions
Plasma HDL-C was an appropriate marker in predicting cirrhosis for patients with CHB.
Building Capacity in Health Professionals to Conduct Quality Improvement
Authors: Plummer Carolyn , Ruco Arlinda , Smith Kerry-Ann , Chandler Jillian , Ash Peter , McMillan Sarah , Di Prospero Lisa , Morassaei Sara , Nichol Kathryn 
Published: October 2020

Background:
The Toronto Academic Health Sciences Network Health Professions Innovation Fellowship Program began in 2014 as a pilot initiative among 4 academic teaching hospitals in Toronto, Ontario. The purpose of the Program was to cultivate applied leadership, interprofessional collaboration, and quality improvement capacity among health professionals.

Purpose:
This article reports on the evaluation findings from the initial year as well as an update on current program status and sustainability.

Methods:
A formative evaluation was conducted focused on the impact on clinical practice, participant skill development, participant experience, and cross-organizational partnerships. Data were collected through a focus group, interviews, and pre- and postsurveys.

Results:
Data from the initial pilot showed increases in leadership practices, project management, and quality improvement knowledge, with changes in leadership practices being significant. Positive changes in clinical practice at both the individual and unit/team levels and capacity for building relationships were also reported. Since the pilot, more than 160 participants from 15 health professions and 9 organizations have participated. Several graduates have taken on leadership roles since their participation in the Program.

Conclusions:
Health care organizations wishing to advance academic practice may benefit from implementing a similar collaborative program to reap benefits beyond organizational silos.
Childhood Trauma in Schizophrenia Spectrum Disorders
Authors: Álvarez María-José , Masramom Helga , Foguet-Boreu Quintí , Tasa-Vinyals Elisabet , García-Eslava Jairo Santiago , Roura-Poch Pere , Escoté-Llobet Santiago , Gonzalez Anabel 
Published: October 2020

Abstract
Current evidence suggests a high prevalence of childhood trauma (CT) among adult patients diagnosed with schizophrenia spectrum disorders. Exposure to CT might lead to clinical differences eventually observed in these patients. We present a cross-sectional study with 54 patients with schizophrenia spectrum disorder (schizophrenia and schizoaffective disorder). We obtained sociodemographic data, as well as data on CT, dissociation, suicide history, and intensity of positive and negative psychotic symptoms. More than 75% of the patients reported a history of CT. We observed a link between CT and suicidal behavior. Patients showed high rates of dissociation. Dissociative experiences were related to CT, both in terms of intensity of trauma and number of traumas experienced. All CT forms except emotional neglect showed direct correlations with dissociative experiences. We found no correlation between intensity of CT and intensity of positive psychotic symptoms, yet we observed a moderate inverse correlation with negative psychotic symptoms.
Hyper-Activation of Endogenous GLP-1 System to Gram-negative Sepsis Is Associated With Early Innate Immune Response and Modulated by Diabetes
Authors: Bloch Olga , Perl Sivan H. , Lazarovitch Tsilia , Zelnik-Yovel Dana , Love Itamar , Mendel-Cohen Lior , Goltsman Galina , Flor Hadar , Rapoport Micha J. 
Published: October 2020

ABSTRACT

Background:
Culture-positive gram-negative sepsis induces greater magnitude of early innate immunity /inflammatory response compared with culture-negative sepsis. We previously demonstrated increased activation of anti-inflammatory Glucagon Like Peptide-1 (GLP-1) hormone in initial phase of sepsis more pronounced in diabetes patients. However, whether GLP-1 system is hyperactivated during the early innate immune response to gram-negative sepsis and modulated by diabetes remains unknown.

Objectives:
Total and active GLP-1, soluble Dipeptidyl peptidase 4 (sDPP-4) enzyme, and innate immunity markers presepsin (sCD14) and procalcitonin (PCT) in plasma were determined by ELISA on admission and after 2 to 4 days in 37 adult patients with and without type 2 diabetes and gram-negative or culture-negative sepsis of different severity.

Results:
Severe but not non-severe sepsis was associated with markedly increased GLP-1 system response, which correlated with PCT and the organ dysfunction marker lactate. Culture-positive gram-negative bacteria but not culture-negative sepsis induced hyper-activation of GLP-1 system, which correlated with increased innate immune markers sCD14, PCT, and lactate. GLP-1 inhibitory enzyme sDPP-4 was down regulated by sepsis and correlated negatively with sCD14 in gram-negative sepsis. Diabetic patients demonstrated increased GLP-1 response but significantly weaker innate immune response to severe and gram-negative sepsis.

Conclusions:
Early stage of gram-negative sepsis is characterized by endogenous GLP-1 system hyperactivity associated with over activation of innate immune response and organ dysfunction, which are modulated by diabetes. Total GLP-1 may be novel marker for rapid diagnosis of gram-negative sepsis and its severity.
The 1919 eclipse results that verified general relativity and their later detractors: a story re-told
Authors: Gilmore Gerard , Tausch-Pebody Gudrun 
Published: October 2020

Einstein became world famous on 7 November 1919, following press publication of a meeting held in London on 6 November 1919 where the results were announced of two British expeditions led by Eddington, Dyson and Davidson to measure how much background starlight is bent as it passes the Sun. Three data sets were obtained: two showed the measured deflection matched the theoretical prediction of Einstein's 1915 Theory of General Relativity, and became the official result; the third was discarded as defective.
At the time, the experimental result was accepted by the expert astronomical community. However, in 1980 a study by philosophers of science Earman and Glymour claimed that the data selection in the 1919 analysis was flawed and that the discarded data set was fully valid and was not consistent with the Einstein prediction, and that, therefore, the overall result did not verify General Relativity. This claim, and the resulting accusation of Eddington's bias, was repeated with exaggeration in later literature and has become ubiquitous.
The 1919 and 1980 analyses of the same data provide two discordant conclusions. We reanalyse the 1919 data, and identify the error that undermines the conclusions of Earman and Glymour.