bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wernicke Encephalopathy as a Complication of Hyperemesis Gravidarum: Case Report
Authors: Damaso Ênio Luis , Reis Estella Thaisa Sontag dos , Jesus Felipe Alves de , Marcolin Alessandra Cristina , Cavalli Ricardo de Carvalho , Moisés Elaine Christine Dantas 
Published: October 2020

AbstractWernicke encephalopathy (WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism. We report a rare case of WE due to hyperemesis gravidarum in a 25-year-old pregnant patient at 13 weeks and 5 days of gestation. Initially, the disease manifested as weakness, mental confusion, anterograde amnesia, and visual and auditory hallucinations. The diagnosis was established after the detection of suggestive findings of WE in the thalamus by magnetic resonance imaging (MRI) and a rapid improvement in the patient's clinical status subsequent to treatment with thiamine. Hyperemesis is a rare cause of WE, which makes the reported case important in the literature and reinforces the need for attention in clinical practice to rare but important complications of this common condition (hyperemesis gravidarum).
Laboratorial Aspects of Cytolytic Vaginosis and Vulvovaginal Candidiasis as a Key for Accurate Diagnosis: A Pilot Study
Authors: Sanches José Marcos , Giraldo Paulo César , Bardin Marcela Grigol , Amaral Rose , Discacciati Michelle Garcia , Rossato Luana 
Published: October 2020

Abstract
Objective To identify clinical, microscopic, and biochemical characteristics that differentiate cytolytic vaginosis (CV) from vulvovaginal candidiasis (VVC).
Methods The present cross-sectional study analyzed the vaginal contents of 24 non-pregnant women aged 18 to 42 years who were attended at the Genital Infections Clinic at Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas (CAISM-UNICAMP). They were diagnosed either with (CV = 8, VVC = 8) or without vulvovaginitis or vaginal dysbiosis (controls). The socio-demographic, clinical, and gynecological data were obtained from a detailed patient interview. Samples of the vaginal contents were collected for analysis of vaginal pH, gram stain, and specific fungal culture. The Kruskal-Wallis and Fisher exact tests were used to compare the differences between the groups. Odds ratios were used to compare the categorical variables. The significance level was considered at p < 0.05.
Results Both women with CV and VVC had a lumpy vaginal discharge (p = 0,002) and vaginal hyperemia (p = 0.001), compared with controls. The inflammatory process was more intense in the VVC group (p = 0.001). In the CV group, there was statistical significance for the lactobacillus amount (p = 0.006), vaginal epithelium lysis (p = 0.001), and vaginal pH (p = 0.0002).
Conclusion Cytolytic vaginosis and VVC diagnoses rarely differ on clinical characteristics but have different laboratorial findings. The present study highlights the importance of conducting an accurate investigation through laboratory tests rather than clinical criteria to avoid misdiagnosis.
The Relationship between Serum Ischemia-Modified Albumin Levels and Uterine Artery Doppler Parameters in Patients with Primary Dysmenorrhea
Authors: Sen Ertugrul , Ozdemir Ozhan , Ozdemir Seyda , Atalay Cemal Resat 
Published: October 2020

Abstract
Objective Primary dysmenorrhea occurs due to abnormal levels of prostanoids, uterine contractions, and uterine blood flow. However, the reasons for pain in primary dysmenorrhea have not yet been clarified. We examined the blood flow alterations in patients with primary dysmenorrhea and determined the relationship between ischemia-modified albumin (IMA) levels, as an ischemia indicator, and primary dysmenorrhea.
Methods In the present study, 37 patients who had primary dysmenorrhea and were in their luteal and menstrual phase of their menstrual cycles were included. Thirty individuals who had similar demographic characteristics, who were between 18 and 30 years old and did not have gynecologic disease were included as control individuals. Their uterine artery Doppler indices and serum IMA levels were measured.
Results Menstrual phase plasma IMA levels were significantly higher than luteal phase IMA levels, both in the patient and in the control groups (p < 0.001). Although the menstrual phase IMA levels of patients were significantly higher than those of controls, luteal phase IMA levels were not significantly different between the two groups. Menstrual uterine artery pulsatility index (PI) and resistance index (RI) of primary dysmenorrhea patients were significantly different when compared with luteal uterine artery PI and RI levels. There was a positive correlation between menstrual phase IMA and uterine artery PI and RI in the primary dysmenorrhea.
Conclusion Ischemia plays an important role in the etiology of the pain, which is frequently observed in patients with primary dysmenorrhea. Ischemia-modified albumin levels are considered as an efficient marker to determine the severity of pain and to indicate ischemia in primary dysmenorrhea.
The Utility of Virtual Reality Simulation in Cataract Surgery Training: A Systematic Review
Authors: Winebrake James P. , McMahon Jeffrey F. , Sun Grace 
Published: October 2020

AbstractIntroduction Cataract surgery is a fundamental intraocular procedure with a steep learning curve. Virtual reality simulation offers opportunity to streamline this aspect of ophthalmic education by exposing trainees to operative techniques in a controlled setting.Materials and Methods A systematic review of the PubMed database was conducted through December 2019 for English language studies reporting on use of virtual reality simulation in cataract surgery training to assess usefulness. Studies meeting inclusion criteria were examined for pertinent data: study design, number of subjects and live cases, simulator model, training regimen, surgical skills assessed, and overall outcomes.Results Of the 41 analyzed studies, 15 investigated the impact of virtual reality simulation-based training on performance in live surgery or wet laboratories; 20 used simulation as a device for direct assessment of operative proficiency; 6 explored simulation-based training's effect on performance in simulated surgery. Thirty-seven studies employed an iteration of the Eyesi simulator, though methodologies varied widely with a few randomized trials available. The literature endorsed validity of simulator-based assessment and benefits of structured training on live complication rates, operative times, and self- and faculty-perceived competency, particularly in novice surgeons.Discussion The literature surrounding simulation in cataract surgery training is characterized by significant heterogeneity in design. However, most works describe advantages that may outweigh the costs of implementation into training curricula. Collaborative efforts at establishing a structured, proficiency-based cataract surgery curriculum built around virtual reality and wet laboratory simulation have the potential to improve outcomes and enhance future surgical training.
Utilizing Electronic Medical Records to Standardize Handoffs in Academic Ophthalmology
Authors: Sun Lynn W. , Stahulak Andrea L. , Costakos Deborah M. 
Published: October 2020

Abstract
Purpose Formalized handoff procedures have been shown to increase patient safety and quality of care across multiple medical and surgical specialties,1–4 but literature regarding handoffs in ophthalmology remains sparse. We instituted a standardized handoff utilizing an electronic medical record (EMR) system to improve care for patients shared by multiple resident physicians across weekday, weeknight, and weekend duty shifts. We measured efficiency, efficacy, and resident satisfaction before and after the standardized handoff was implemented.
Methods Resident physicians surveyed were primarily responsible for patient care on consult and call services at two quaternary academic medical centers in a major metropolitan area. Patient care was performed in outpatient, emergency, and inpatient settings. Annual anonymous questionnaires consisting of 6 questions were used to collect pre- and postintervention impressions of the standardized EMR handoff process from ophthalmology resident physicians (9 per year; 3 preintervention years and 1 postintervention year). An additional anonymous postintervention questionnaire consisting of 12 questions was used to further characterize resident response to the newly implemented handoff procedure.
Results Prior to implementation of a standardized EMR-based handoff procedure, residents unanimously reported incomplete, infrequently updated handoff reports that did not include important clinical and/or psychosocial information. Following implementation, residents reported a statistically significant increase in completeness and timeliness of handoff reports. Additionally, resident perception of EMR handoff utility, efficiency, and usability were comprehensively favorable. Residents reported handoffs only added a mean of 6.5 minutes to a typical duty shift.
Conclusion Implementation of our protocol dramatically improved resident perceptions of the handoff process at our institution. Improvements included increased quality, ease-of-use, and efficiency. Our standardized EMR-based handoff procedure may be of use to other ambulatory-based services.
Identification and Outcomes of Hospitalized Medically Ill Patients Who Are Candidates for Extended Duration Thromboprophylaxis
Authors: Coleman Craig I. , Piazza Gregory , Ashton Veronica , Bunz Thomas J. , Spyropoulos Alex C. 
Published: October 2020

Abstract
Background Extended duration thromboprophylaxis (ET) for approximately 30 days can effectively and safely reduce venous thromboembolism (VTE) risk in appropriately selected medically ill patients. We sought to estimate the proportion of hospitalized medically ill patients potentially qualifying for ET and assess their post-discharge clinical and economic outcomes using a large claims database.
Methods Using MarketScan claims from January 2012 to September 2018, we identified medically ill patients hospitalized with a primary diagnosis of heart failure, respiratory insufficiency, ischemic stroke, infection, or inflammatory disease and ≥1-additional risk factor for VTE. Patients < 40 years old, a length-of-stay < 3 or >30 days, receiving oral anticoagulation prior to index hospitalization or having an indication for full-dose anticoagulation were excluded, as were patients deemed high-risk for bleeding due to active, in-hospital treated cancer, gastroduodenal ulcer or bleeding within the prior 3 months, bronchiectasis, pulmonary cavitation or hemorrhage, or dual antiplatelet therapy use.
Results We identified 2,782,988 patients ≥40 years of age and admitted for a high-risk medical illness. Of these, 724,531 patients (26.0%) were identified as ET candidates. Patients' VTE risk appeared highest in the first 30 days post-discharge (1,532/724,531, 0.2%). Adjusted post-index hospitalization costs (2018 US$) for patients with a VTE within 30 days were higher than those without VTE (Δ = $32,623 at 30 days, Δ = $43,325 at 90 days, Δ = $53,668 at 365 days; p < 0.001 for all).
Conclusion Post-discharge VTE in high-risk patients with medical illness is associated with substantially increased costs.
The False Positive Rate of Transcutaneous Tissue Oximetry Alarms in Microvascular Breast Reconstruction Rises after 24 Hours
Authors: Tran Phu C. , DeBrock Will , Lester Mary E. , Hartman Brett C. , Socas Juan , Hassanein Aladdin H. 
Published: October 2020

Abstract
Background Transcutaneous tissue oximetry is widely used as an adjunct for postoperative monitoring after microvascular breast reconstruction. Despite a high sensitivity at detecting vascular issues, alarms from probe malfunctions/errors can generate unnecessary nursing calls, concerns, and evaluations. The purpose of this study is to analyze the false positive rate of transcutaneous tissue oximetry monitoring over the postoperative period and assess changes in its utility over time.
Patients and Methods Consecutive patients undergoing microvascular breast reconstruction at our institution with monitoring using transcutaneous tissue oximetry were assessed between 2017 and 2019. Variables of interest were transcutaneous tissue oximetry alarms, flap loss, re-exploration, and salvage rates.
Results The study included 175 patients (286 flaps). The flap loss rate was 1.0% (3/286). Twelve patients (6.8%) required re-exploration, with 9 patients found to have actual flap compromise (all within 24 hours). The salvage rate was 67.0%. The 3 takebacks after 24 hours were for bleeding concerns rather than anastomotic problems. Within the initial 24-hour postoperative period, 43 tissue oximetry alarms triggered nursing calls; 7 alarms (16.2%) were confirmed to be for flap issues secondary to vascular compromise. After 24 hours, none of the 44 alarms were associated with flap compromise. The false positive rate within 24 hours was 83.7% (36/43) compared with 100% (44/44) after 24 hours (p = 0.01).
Conclusion The transcutaneous tissue oximetry false positive rate significantly rises after 24 hours. The benefit may not outweigh the concerns, labor, and effort that results from alarms after postoperative day 1. We recommend considering discontinuing this monitoring after 24 hours.
A Comparative Analysis of Outcomes of Free Nipple Areolar Grafting in Autologous Breast Reconstruction
Authors: Egan Katie G. , Lai Eric , Holding Julie , Butterworth James A. 
Published: October 2020

Abstract
Background Preserving the nipple areolar complex (NAC) increases satisfaction in breast reconstruction. This study aims to describe outcomes using free NAC grafts in microvascular breast reconstruction.
Methods A case–control study evaluated prospective outcomes of microvascular breast reconstruction with free NAC grafts compared with matched controls with tattoo or local flap nipple reconstruction. Eligible patients for NAC grafting required correction of ptosis or nipple malposition. Postoperative photographs were rated for complications and aesthetics by the four study authors and two additional unbiased board-certified plastic surgeons. Satisfaction was measured with the BREAST-Q.
Results Twenty patients who underwent 35 autologous breast reconstructions were analyzed. Nipple areolar reconstruction with grafts was completed with 13 NACs in 7 patients. The majority of free NAC grafts (11/13, 85%) were completed in immediate reconstruction, and 15% (2/13) were completed in delayed reconstruction. Partial graft hypopigmentation (mean 18.0%, standard deviation [SD] 7.5) was noted in all grafts. Less than half of grafts had areas of depigmentation (6/13, mean 6.1%, SD 7.5). Minor areas of partial loss occurred in 6/13 grafts (mean 2.9%, SD 4.6). Nipple projection was maintained in 54% of nipples (7/13). Depigmentation, hypopigmentation, graft loss, and projection were not statistically correlated with NAC aesthetic or overall aesthetic rating. However, NAC size (p = 0.003), position (p = 0.022), and symmetry (p = 0.028) were all correlated with aesthetic outcomes. Outcomes and satisfaction were similar to those seen with local flap reconstruction, although partial loss was less common in NAC grafts.
Conclusion Nipple reconstruction can successfully be performed in microvascular breast reconstruction using free grafts. Although partial graft hypopigmentation is common, smaller areas of graft loss or depigmentation are anticipated and do not affect aesthetic outcomes. The use of free NAC grafts may allow additional patients to use their own nipples as part of their microvascular reconstruction and avoid secondary NAC reconstruction procedures.
Analysis of a Laxity Index Database and Comparison with the Fédération Cynologique Internationale Grades of This Population
Authors: Saunders Jimmy H. , Broeckx Bart J.G. , Bertal Mileva , Vezzoni Aldo , Van der Vekens Elke , Polis Ingeborgh 
Published: October 2020

AbstractObjective This study aimed to analyse the distribution of the laxity indices (LI) in a dog population, to compare the LI with the Fédération Cynologique Internationale (FCI) grades and to search for differences of LI between breeds.Study Design The database was composed of all dogs presented to the University Hospital of the Faculty of Veterinary Medicine in Ghent for obligatory hip screening between January 2016 and February 2019, and all patients presented to orthopaedic consultation between January 2017 and January 2019 for a complaint of hindlimb lameness, which underwent both a standard extended ventrodorsal radiograph of the hips and a stress radiograph revealing hip joint laxity. The latter was obtained by means of the Vezzoni-modified Badertscher distension device and the LI was calculated. For each dog of the population, the LI was then compared with the FCI grade.Results The LI values ranged between 0.15 and 1.04, with a mean of 0.46. The LI and the FCI grade increased together, and showed a moderate-to-good correlation. There was a highly significant overall difference in the mean value of LI per FCI grade group (p < 0.001). The mean LI of the Labrador Retrievers was slightly but significantly lower than the mean LI of the Golden Retrievers (p < 0.01).Conclusion The LI calculated on a stress radiograph taken with the Vezzoni-modified Badertscher distension device shows a good correlation with the FCI grade assigned on a standard extended ventrodorsal projection. A wide range of passive hip joint laxity exists in dogs considered to be phenotypically normal based on the FCI grading method.
Exposure to news grows less fragmented with an increase in mobile access
Authors: Yang Tian , Majó-Vázquez Sílvia , Nielsen Rasmus K. , González-Bailón Sandra 
Published: October 2020

Significance
Access to diverse news strengthens democratic citizenship. Whether digital technologies have narrowed or widened news diets fosters contentious debates. Previous research shows the abundance of digital news sources might be leading to more fragmented audiences, ideological segregation, and echo chambers. Our study resorts to an unprecedented combination of data to show that the increase in mobile access to news actually leads to higher exposure to diverse content and that ideological self-selection explains only a small percentage of co-exposure to news. We also find that more than half of Internet users in the United States do not use online news. Future research should avoid generalizations from desktop-only data and pay attention to the increasing divide between informed citizens and news avoiders.
Loss of TDP-43 in astrocytes leads to motor deficits by triggering A1-like reactive phenotype and triglial dysfunction
Authors: Peng Audrey Yi Tyan , Agrawal Ira , Ho Wan Yun , Yen Yi-Chun , Pinter Ashley J. , Liu Jerry , Phua Qi Xuan Cheryl , Koh Katrianne Bethia , Chang Jer-Cherng , Sanford Emma , Man Jodie Hon Kiu , Wong Peiyan , Gutmann David H. , Tucker-Kellogg Greg , Ling Shuo-Chien 
Published: October 2020

Significance
Aberrant TDP-43 aggregation is one of the defining pathological hallmark proteins of two overlapping adult-onset neurodegenerative diseases, amyotrophic lateral sclerosis and frontotemporal dementia. While TDP-43 aggregates are also found in astrocytes, it is not known how loss of astroglial TDP-43 affects neuronal function and disease pathogenesis. Herein, we show that TDP-43 is required for maintaining the protective properties of astrocytes, such that loss of astroglial TDP-43 causes triglial abnormalities that result in motor deficits. These findings establish that TDP-43–mediated dysfunction in different cell types uniquely contributes to neurodegenerative disease through cell-type–specific mechanisms. Delineating these etiologies could facilitate the discovery of novel strategies to treat neurological disorders caused by TDP-43 proteinopathy.
First-in-class humanized FSH blocking antibody targets bone and fat
Authors: Gera Sakshi , Sant Damini , Haider Shozeb , Korkmaz Funda , Kuo Tan-Chun , Mathew Mehr , Perez-Pena Helena , Xie Honglin , Chen Hao , Batista Rogerio , Ma Kejun , Cheng Zhen , Hadelia Elina , Robinson Cemre , Macdonald Anne , Miyashita Sari , Williams Anthony , Jebian Gregory , Miyashita Hirotaka , Gumerova Anisa , Ievleva Kseniia , Smith Pinar , He Jiahuan , Ryu Vitaly , DeMambro Victoria , Quinn Matthew A. , Meseck Marcia , Kim Se-Min , Kumar T. Rajendra , Iqbal Jameel , New Maria I. , Lizneva Daria , Rosen Clifford J. , Hsueh Aaron J. , Yuen Tony , Zaidi Mone 
Published: October 2020

Significance
We report the development and characterization of a first-in-class humanized antibody to follicle-stimulating hormone (FSH). We have shown previously that blocking FSH action on its receptor increases bone mass, reduces body fat, and enhances energy expenditure. Furthermore, FSH has been reported to increase serum cholesterol. Therefore, an anti-FSH agent has the potential of preventing and treating obesity, osteoporosis, and hypercholesterolemia, diseases that affect millions of women and men worldwide. Our study provides the framework for further preclinical and subsequent clinical testing of our humanized antibody to FSH.
Parameter Optimization Analysis of Gmapping Algorithm Based on Improved RBPF Particle Filter
Authors: Liu Zhaohua , Cui Zhi , Li Yong , Wang Wei 
Published: October 2020

Abstract
Aiming at the problem of inaccurate mapping caused by the robot hardware configuration that cannot meet the needs when the Gmapping algorithm is used for indoor mapping, a method for optimizing algorithm parameters is proposed. First, the principle of the Gmapping algorithm based on improved Rao-Blackwellised particle filtering is analyzed. By using the open source robot operating system (ROS) to run the Gmapping algorithm on a mobile robot, an indoor map is constructed. Then, by configuring different parameters, the accuracy of map construction is optimized. The experimental results show that by optimizing the algorithm parameters in an indoor environment, the algorithm can better adapt to the hardware configuration and improve the quality of the map.
The Optimization of Surface Quality and Smoothness Property with Orthogonal Function Algorithm
Authors: Meng Fanwen , Zhang Yuxiang , Ma Fengwei 
Published: October 2020

Abstract
In free surface fitting, the method of increasing control points to improve surface fitting accuracy is generally utilized. But with the increment of control points, the order of surface continuity decreases. According to the disadvantages of the traditional method of surface reconstruction, the surface fitting algorithm with orthogonal function is proposed in the paper. It avoids irregular points to implement surface fitting, which can ensure the smoothness of the surface. 3x3 order surface and 36 control points are used in surface fitting with the maximum error 0.0770mm, and the surface patches are G2 continuous. Experimental results show that the proposed method realizes the best matching of surface control points, surface curvature and reconstruction precision. The quality of surface reconstruction is greatly improved.
Knowledge-driven SPARQL Query Construction Based on Feedback Mechanism
Authors: Hu Jing , Zhang Mei , Zhang Zhi 
Published: October 2020

Abstract
According to the survey, the performance of the existing knowledge graph answering system in entity linking, relation linking and SPARQL query construction in terms of execution time and accuracy cannot meet the requirements of knowledge graph answering system. For this challenge, a new feedback mechanism based Knowledge-Driven query construction method is proposed. This method takes the entity set and predicate set in the problem as input, and constructs SPARQL query statements in a knowledge-driven way to solve simple and complex problems, and further proposes heuristic ideas to deal with implicit entity problems. At the same time, the method also proposes to feed back the query results of the knowledge graph to the entity link and relationship connection steps, so that the SPARQL query statement is optimized again. The evaluation results of the LC_QuAD data show that this method outperform the existing state of the art in precision and recall rate.