bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scientific and Logistical Considerations When Screening for Radiation Risks by Using Biodosimetry Based on Biological Effects of Radiation Rather than Dose: The Need for Prior Measurements of Homogeneity and Distribution of Dose
Authors: Swartz Harold M. , Flood Ann Barry , Singh Vijay K. , Swarts Steven G. 
Published: March 2020

Abstract
An effective medical response to a large-scale radiation event requires prompt and effective initial triage so that appropriate care can be provided to individuals with significant risk for severe acute radiation injury. Arguably, it would be advantageous to use injury rather than radiation dose for the initial assessment; i.e., use bioassays of biological damage. Such assays would be based on changes in intrinsic biological response elements; e.g., up- or down-regulation of genes, proteins, metabolites, blood cell counts, chromosomal aberrations, micronuclei, micro-RNA, cytokines, or transcriptomes. Using a framework to evaluate the feasibility of biodosimetry for triaging up to a million people in less than a week following a major radiation event, Part 1 analyzes the logistical feasibility and clinical needs for ensuring that biomarkers of organ-specific injury could be effectively used in this context. We conclude that the decision to use biomarkers of organ-specific injury would greatly benefit by first having independent knowledge of whether the person’s exposure was heterogeneous and, if so, what was the dose distribution (to determine which organs were exposed to high doses). In Part 2, we describe how these two essential needs for prior information (heterogeneity and dose distribution) could be obtained by using in vivo nail dosimetry. This novel physical biodosimetry method can also meet the needs for initial triage, providing non-invasive, point-of-care measurements made by non-experts with immediate dose estimates for four separate anatomical sites. Additionally, it uniquely provides immediate information as to whether the exposure was homogeneous and, if not, it can estimate the dose distribution. We conclude that combining the capability of methods such as in vivo EPR nail dosimetry with bioassays to predict organ-specific damage would allow effective use of medical resources to save lives.
Characteristics of a Brisk or Sluggish Pupillary Light Reflex: A Nursing Perspective
Authors: Dance Sophie , Scholefield Barnaby R. , Morris Kevin P. , Kanthimathinathan Hari Krishnan 
Published: March 2020

ABSTRACT

BACKGROUND
Pupillary light reflex (PLR) has traditionally been assessed using a pen torch (light). Although the terms “brisk” or “sluggish” are often used, it is unclear what characteristics of the PLR result in this description. More recently, automated infrared pupillometry has enabled us to quantify the different components of a PLR.

METHODS
We conducted a 2-part questionnaire survey of pediatric intensive care unit (PICU) nurses. In part 1, nurses were requested to describe the key characteristics that they associate with a brisk or sluggish PLR in free-text responses. In part 2, after an introduction to pupillometry and the different components of a PLR, nurses were asked to rank the relative importance of latency (time taken for pupil to start reacting to light), percentage change (in pupil size after light stimulus), and constriction velocity (rate of constriction after light stimulus) in relation to a pupil being described as “brisk” and “sluggish.

RESULTS
Fifty nurses responded. In part 1, “Quick” was the commonest term used (36% of respondents) to describe a brisk PLR, and 72% used “slow” for a sluggish PLR. Most descriptions most closely mapped to features of latency and/or constriction velocity. In part 2, latency was ranked the most important component on pupillometry for describing brisk (32%) and sluggish (34%) PLRs. Constriction velocity was ranked as the most important by 18% (brisk) and 20% (sluggish), whereas 44% (brisk) and 46% (sluggish) ranked percentage change behind the other 2 characteristics.

CONCLUSION
Latency, followed by the constriction velocity, was felt by PICU nurses to be the most important characteristic of the PLR that results in terms “brisk” or “sluggish” being used at the bedside to describe a PLR. We plan to compare these subjective opinions with objective findings from pupillometry.
Development and Validation of VM-PATHI: Vestibular Migraine Patient Assessment Tool and Handicap Inventory
Authors: Sharon Jeffrey D. , Krauter Roseanne , Kirk Laura , Pasquesi Lauren , Allen Isabel E. , Formeister Eric J. , Michael Rebecca L. , Levin Morris 
Published: March 2020

Objective:
The aim of this article is to develop and validate a disease-specific, patient-reported outcome measure for vestibular migraine.

Setting:
Tertiary care vestibular center.

Patients:
Adult patients with definite or probable vestibular migraine per Barany Society Criteria.

Study Design:
This was a prospective cohort study. VM-PATHI (Vestibular Migraine Patient Assessment Tool and Handicap Inventory) was developed with expert input, literature review, and patient feedback. VM-PATHI scores were compared between those with vestibular migraine and controls, across several time points, and to other dizziness and quality of life (QoL) measures.

Results:
A 25-item questionnaire was developed. Cronbach's α was high at 0.92. Test–retest reliability was excellent (r = 0.90, p < 0.001). Scores were much higher in patients with vestibular migraine (mean 42.5, SD = 16.1) than control patients (mean = 9.6, SD = 8.5). VM-PATHI scores were responsive to treatment (p = 0.01). Scores were well correlated with general QoL, depression, and anxiety scores. Scores were also correlated with the Dizziness Handicap Inventory (r = 0.69). An exploratory factor analysis was performed, which revealed 6 distinct factors that corresponded well to different aspects of disease-related symptomatology.

Conclusion:
VM-PATHI is a valid, reliable, and responsive measure of disease severity in vestibular migraine.
Cochlear Implant Outcomes in Patients With Severe Compared With Profound Hearing Loss
Authors: Birman Catherine S. , Sanli Halit 
Published: March 2020

Objective:
To compare the speech perception outcomes for patients with preoperative severe versus profound hearing loss with a cochlear implant (CI).

Study Design:
Retrospective patient review.

Setting:
Cochlear implant program.

Patients:
Cochlear implant adult recipients (16 yr and above) having surgery between 2008 and 2015 with speech perception results and four frequency averaged severe (70–89 dBHL) or profound (90 dBHL and above) hearing loss. Prelingual deaf adults were included in the data.

Intervention:
Cochlear implant.

Main Outcome Measures:
Speech perception scores with CUNY sentences and monosyllabic (CNC/CVC) word scores at preoperative and 3, 6, and 12 months postoperatively testing. Mann–Whitney U test was performed to compare outcomes of the two groups. Interquartile comparisons were also made.

Results:
The severe group had significantly better speech perception than the profound hearing loss group for CUNY sentences and CNC/CVC word scores preoperatively (p < 0.001) (p < 0.001), at 6 months (p < 0.001) (p < 0.001), and at 12 months (p < 0.01) (p < 0.001), respectively. At 3 months there was no significant difference. The number of patients in each severe or profound group at the different time points ranged from 92 to 367 patients for CUNY sentences and from 52 to 216 patients for the word scores. The 12 months’ lower quartile score for CUNY sentences for severe and profound groups was 83% and 75% respectively. The lower quartile score for words was 32% and 26% respectively.

Conclusion:
Adult CI recipients showed marked improvements in speech perception with a CI. Those with severe hearing loss have significantly better outcomes compared with profound hearing loss patients. These outcomes can inform CI candidacy evaluation criteria.
20 Year Review of Three-dimensional Tools in Otology: Challenges of Translation and Innovation
Authors: Mukherjee Payal , Cheng Kai , Wallace Gordon , Chiaravano Elodie , Macdougall Hamish , O’Leary Stephen , Solomon Michael 
Published: March 2020

Introduction:
Three-dimensional (3D) tools have played a significant role in advancing anatomical knowledge, in simulation and clinical practice in Otology. Technology is evolving at a rapid rate with new applications being reported at an overwhelming pace. It is important to continuously review new applications, assess emerging trends, and identify challenges to innovation so clinical translation progresses in an efficient and evidenced-based manner.

Methods:
A review of 20 years of literature in 3D technology specific to Otology was undertaken using Medline, Embase, PubMed, and Google Scholar search engines. Trends in the literature were analyzed as applications are evaluated and adopted into clinical practice. A literature review was conducted to identify barriers to translation.

Results:
There was increasing volume of literature reporting innovations in 3D technology in Otology with a more recent increase in reviews and meta-analysis. The most marked trend was in literature regarding clinical applications of such technology and in 3D printing. Where this may indicate that translation of these technologies is adequate, this is not reflected in routine clinical practice or even in education and training platforms.

Conclusion:
Barriers to translation of 3D tools specific to Otology include ongoing challenges in attaining high-resolution data, rendering parameters and with the advent of 3D printing a multitude of new variables in software, printers, and materials adding complexity to selecting most appropriate options. These need methodical evaluation to selectively customize solutions to clinical challenges so effective translation, scale, and adoption can occur without causing confusion about choices.
Diabetes distress, happiness, and its associated factors among type 2 diabetes mellitus patients with different therapies
Authors: Liu Shun-Ying , Huang Jin , Dong Qiao-Liang , Li Bei , Zhao Xue , Xu Rong , Yin Hong-Fang 
Published: March 2020

Abstract
This study aimed to investigate diabetes distress, happiness, and its associated factors of patients with type 2 diabetes mellitus (T2DM) treated by different therapies, and to analyze the related impact factors. A total of 1512 patients with T2DM were randomly selected from 18 tertiary hospitals in Hunan province from January 2016 to April 2016 who has been treated with oral antidiabetics monotherapy, insulin monotherapy, and combination therapy. Use the general information questionnaire, WHO-5 (the World Health Organization 5 well-being index) and PAID (the problem areas in diabetes scale) to collect the data. There are 846 (55.95%) patients that have serious emotional disorders, and the diabetes related distress in insulin treatment group was higher than that in combination treatment group (P < .05). Happiness of T2DM patients in combination therapy was higher than oral antidiabetic drug monotherapy and insulin monotherapy (P < .05). There was a negative correlation between diabetic suffering and happiness in patients with different treatments (R ranged from –0.335 to –0.436, P < .001). Age and happiness experience could explain 14.8% of the variance. Acute and chronic complications, controlled blood glucose level, lifestyle, therapies, and school education can explain 18.3% variance. Under different therapies, the suffering and happiness of T2DM patients differed from each other. The suffering and happiness of T2DM were related to different therapies, age, complications, glycaemic control, lifestyle, school education, and so on.
Does well-functioning hand constraint induce stress in forced-use therapy for children with unilateral cerebral palsy?
Authors: Ko Eun Jae , Sung In Young , Yuk Jin Sook 
Published: March 2020

AbstractThis study investigated the stress induced by well-functioning hand constraint in forced-use therapy (FUT) for children with unilateral spastic cerebral palsy (CP).Seventeen children with unilateral spastic CP (mean age 5.8 years) received FUT: 4-week unaffected upper limb immobilization with a short-arm Scotchcast and were encouraged to incorporate it to their daily routines and plays. They were evaluated at pretreatment, immediate post-treatment, and 6 months post-treatment. The Korea-Child Behavior Checklist (K-CBCL) was used to assess the stress degree; box and block test (BBT), Erhardt Developmental Prehension Assessment (EDPA), Quality of Upper Extremity Skill Test (QUEST), and Pediatric Motor Activity Log (PMAL), upper limb function; and Pediatric Evaluation of Disability Inventory (PEDI), daily living activities.In the preschoolers, most scores of K-CBCL tended to increase after FUT; however, there was no significant change in all scale findings after FUT. In the school-aged children, most scores of K-CBCL tended to decrease after FUT; however, there was no significant change in all scale findings after FUT. The findings of the BBT, QUEST, PMAL how often and well subscales significantly improved post-treatment (P < .05).The 4-week FUT with well-functioning hand constraint significantly improved the UL function and did not induce emotional and behavioral problems in children with unilateral spastic CP.
No difference in clinical outcome and survivorship after total knee arthroplasty with patellar resurfacing and nonresurfacing after minimum 10-year follow-up
Authors: Feng Bin , Ren Yi , Lin Jin , Jin Jin , Qian Wenwei , Weng Xisheng 
Published: March 2020

Abstract
The study aims to evaluate the clinical outcomes and surgery survivorship for over 10 years following patellar resurfacing or nonresurfacing in total knee arthroplasty (TKA) in a cohort of Chinese patients.
From 1998 to 2003, 355 patients underwent primary TKA in our institute. The survivorship of TKA between the patellar resurfacing and nonresurfacing groups and the clinical outcome of Hospital for Special Surgery knee score, Western Ontario and McMaster Universities index score, patellar score, patellar related complications, and radiological results were studied at latest follow-up.
There was no statistically significant difference for the Hospital for Special Surgery score, Western Ontario and McMaster Universities score, and the patellar score between the 2 groups after an average 12.4-year follow-up. Nonresurfacing group had higher anterior knee pain than the resurfacing group (13.2% vs 5.6%). The patients with rheumatoid arthritis had a 2.9-fold higher rate of patellar-related complications than did the patients with osteoarthritis. The 10-year survival rate was not significantly different between the 2 groups both for revision surgery (P = .505) and for patellar-related complication (P = .194).
There was no significant difference in the long-term clinical outcome and survivorship between patellar resurfacing and nonresurfacing. Patellar nonresurfacing could be advisable during primary TKA for osteoarthritis patients. Selective patellar resurfacing for RA patients could achieve lower patellar-related complications.
Incidence of contralateral neurosensitive changes and persistent postoperative pain 6 months after mastectomy
Authors: Masgoret Paula , de Soto Inés , Caballero Ángel , Ríos José , Gomar Carmen 
Published: March 2020

Abstract
Mirror image sensory dysfunction (MISD) after breast surgery has not yet been studied. This prospective observational study aimed to determine the incidence of MISD, persistent postoperative pain (PPP) and mirror image pain (MIP) during 6 months after total unilateral mastectomy.
Visual analogue scale (VAS), Neuropathic Pain Symptom Inventory (NPSI), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Life orientation test (LOT) and Quantitative Sensory Testing (QST) (in ipsi and contralateral breast, axilla and thigh) were recorded. VAS > 3 at 1, 3, and 6 postoperative months was considered PPP. Contralateral changes of QST at any time was considered indicative of MISD and spontaneous contralateral VAS ≥ 1 as MIP.
Sixty-four patients were included. PPP at 1, 3 and 6 months was 18.8%, 56.2%, and 21.3%, respectively Ten patients presented MIP. MISD was detected in 79.7% patients in contralateral breast and 62.5% in contralateral axilla. Furthermore, changes in QST were present in 39.1% of patients in thigh. Electronic Von Frey (EVF) changes in both contralateral breast and axilla, and in thigh significantly diminished at all postoperative times. Changes of postoperative EVF ≥ 20% in contralateral breast were associated to higher VAS values. NPSI scores were significantly higher at all postoperative times. At 1 month, PCS, depression HADS subscale and LOT scores were significantly worse than all the other periods.
MISD incidence was almost 80%, and 15.6% of patients showed spontaneous contralateral VAS ≥ 1. At 6 months 21.3% of patients manifested PPP. The worst alteration of factors related to PPP occurred at 1 postoperative month. Most consistent QST was EVF.
Uterine tumor resembling ovarian sex-cord tumor (UTROSCT) with sarcomatous features without recurrence after extended radical surgery
Authors: Sato Miho , Yano Mitsutake , Sato Shimpei , Aoyagi Yoko , Aso Saki , Matsumoto Harunobu , Yamamoto Ichiro , Nasu Kaei 
Published: March 2020

Abstract

Rationale:
The malignant potential and the appropriate treatment of uterine tumor resembling ovarian sex-cord tumor (UTROSCT) is controversial. Although these tumors generally have benign outcomes, several reports have described recurrences, metastases, and deaths associated with this disease.

Patient concerns:
A 57-year-old Japanese woman (gravida 2, para 2) was referred to our hospital for the evaluation and treatment of uterine fibroids. Magnetic resonance imaging revealed a right ovarian mass and multiple fibroids in the uterine myometrium.

Diagnoses:
The patient was diagnosed with UTROSCT with sarcomatous features.

Interventions:
She initially underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy, followed by second-stage surgery comprising pelvic and para-aortic lymphadenectomy and subtotal omentectomy.

Outcomes:
No postoperative recurrence was observed in the patient in 36 months.

Lessons:
In this case, extended radical surgery prevented the development of recurrent disease in a patient with UTROSCT with sarcomatous features. These clinicopathological findings suggest that UTROSCT is associated with several risk factors, including older age, presence of necrosis, lymphovascular invasion, significant nuclear atypia, and significant mitotic activity. This lesion type should be considered malignant and treated with curative intent.
Obesity is a risk factor for preoperative hypoxemia in Stanford A acute aortic dissection
Authors: Wu Zhiyong , Wang Zhiwei , Wu Hongbing , Hu Rui , Ren Wei , Hu Zhipeng , Chang Jinxing 
Published: March 2020

Abstract
Obese individuals are apt to develop Stanford A acute aortic dissection (AAD) complicated with acute lung injury (ALI), but the mechanism is still not well defined. We aim to investigate whether oxidative stress and inflammatory are involved in the aortic dissection lung injury caused by obesity.
Seventy-nine patients were categorized into AAD with obesity group (n = 17) and AAD without obesity group (n = 62) according to body mass index (BMI). Inflammatory reactions including interleukin 1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6, C-reactive protein (CRP) and white blood cell (WBC) count, and oxidative stress including malondialdehyde (MDA), superoxide dismutase were determined using enzyme-linked immunosorbent assays and chemiluminescence. All the patients received ascending aorta replacement combined with total arch replacement and stented elephant trunk. The postoperative complications were recorded.
The incidence of preoperative hypoxemia (94.1% vs 35.5%, P < .01) and postoperative ALI (88.2% vs 40.3%, P < .01) in obese patients was significantly higher than that in non-obese patients. Besides, the ICU stay (119.2 ± 59.2 vs 87.8 ± 31.2 h, P < .01) and hospitalization duration (18.8 ± 8.5 vs 14.3 ± 8.1d, P = .048) were increased in the obese patients with AAD. The expression of IL-1β, TNF-α, IL-6, CRP, and WBC was remarkably increased (P < .01) in obese group compared with non-obese group.
Oxidative stress and inflammatory response may be involved in the process of ALI of aortic dissection caused by obesity, which provides new ideas for the treatment of ALI of the aortic dissection.
The efficacy and safety of panitumumab supplementation for colorectal cancer
Authors: Wang Chengchen , Tan Chunyan , Chen Xiaopin , Chen Shuangdong 
Published: March 2020

Abstract

Background:
The efficacy of panitumumab supplementation for colorectal cancer remains controversial. We conduct a systematic review and meta-analysis to explore the influence of panitumumab supplementation on treatment efficacy of colorectal cancer.

Methods:
We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2019 for randomized controlled trials (RCTs) assessing the efficacy of panitumumab supplementation for colorectal cancer. This meta-analysis is performed using the random-effect model.

Results:
Five RCTs are included in the meta-analysis. Overall, compared with control group for colorectal cancer, panitumumab supplementation is associated with the increase in objective response for wild-type (WT) KRAS (RR = 1.70; 95% CI = 1.07–2.69; P = .03), but has no remarkable influence on objective response for mutant KRAS (RR = 0.92; 95% CI = 0.79–1.08; P = .32), objective response (RR = 1.35; 95% CI = 1.00–1.83; P = 0.05), progressive disease for WT KRAS (RR = 0.94; 95% CI = 0.85–1.02; P = .15), mortality (RR = 0.86; 95% CI = 0.69–1.08; P = .20), or mortality for WT KRAS (RR = 0.94; 95% CI = 0.84–1.05; P = .28). In addition, grade 3 and 4 adverse events are found to be higher in panitumumab group than those in control group (RR = 1.17; 95% CI = 1.08–1.27; P = .0001; Fig. 8).

Conclusions:
Panitumumab supplementation can provide some improvement in objective response for colorectal cancer patients with WT KRAS, but results in the increase in grade 3 and 4 adverse events.
A novel EDA1 missense mutation in X-linked hypohidrotic ectodermal dysplasia
Authors: Wang Xu , Zhang Zhiyu , Yuan Shuo , Ren Jiabao , Qu Hong , Zhang Guozhong , Chen Wenjing , Zheng Shushen , Meng Lingqiang , Bai Jiuping , Du Qingqing , Yang Dongru , Shen Wenjing 
Published: March 2020

Abstract
A mutation in the epithelial morphogen gene ectodysplasin-A1 (EDA1) is responsible for the disorder X-linked hypohidrotic ectodermal dysplasia (XLHED), the most common form of ectodermal dysplasia. XLHED is characterized by impaired development of hair, eccrine sweat glands, and teeth. This study aimed to identify potentially pathogenic mutations in four Chinese XLHED families.
Genomic DNA was extracted from the peripheral blood and sequenced. Sanger sequencing was used to carry out mutational analysis of the EDA1 gene, and the three-dimensional structure of the novel mutant residues in the EDA trimer was determined. Transcriptional activity of NF-κB was tested by Dual luciferin assay.
We identified a novel EDA1 mutation (c.1046C>T) and detected 3 other previously-reported mutations (c.146T>A; c.457C>T; c.467G>A). Our findings demonstrated that novel mutation c.1046C>T (p.A349 V) resulted in XLHED. The novel mutation could cause volume repulsion in the protein due to enlargement of the amino acid side chain. Dual luciferase assay revealed that transcriptional NF-κB activation induced by XLHED EDA1 protein was significantly reduced compared with wild-type EDA1.
These results extend the spectrum of EDA1 mutations in XLHED patients and suggest a functional role of the novel mutation in XLHED.