bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of enterocyte-specific gene polymorphisms in response to adjuvant treatment for stage III colorectal cancer
Authors: Suenaga Mitsukuni , Cao Shu , Zhang Wu , Matsusaka Satoshi , Okazaki Satoshi , Berger Martin D. , Miyamoto Yuji , Schirripa Marta , Barzi Afsaneh , Yamamoto Noriko , Yamaguchi Toshiharu , Lenz Heinz-Josef 
Published: July 2020

Objectives
The enterocyte subtype of colorectal cancer (CRC) responds favorably to oxaliplatin-based adjuvant treatment for stage III CRC. We examined the clinical significance of single-nucleotide polymorphisms (SNPs) in enterocyte-related genes MS4A12 and CDX2 in response to adjuvant treatment for stage III CRC.

Patients and methods
A total of 350 patients with stage III CRC were included: 274 received adjuvant treatment with surgical resection (discovery cohort) and 76 received surgery alone (control cohort). In the discovery cohort, 68 patients received FOLFOX and 206 received oral fluoropyrimidine. SNPs were analyzed by PCR-based direct sequencing.

Results
In the discovery cohort, the MS4A12 rs4939378 G/G variant was associated with lower 5-year survival than any A allele [70% vs. 90%, univariate: hazard ratio (HR) 2.29, 95% confidence interval (CI) 1.03–5.06, P = 0.035; multivariate: HR 2.58, 95% CI 1.15–5.76, P = 0.021]. Patients with the CDX2 rs3812863 G/G variant had better overall survival than those with any A allele, although this was not significant in multivariate analysis (5 year-survival: 95% vs. 82%, univariate: HR 0.34, 95% CI 0.12–0.97, P = 0.034; multivariate: HR 0.39, 95% CI 0.13–1.11, P = 0.078). The SNPs did not show significant association with overall survival in the control cohort, and significant interaction was observed between MS4A12 genotypes and groups (P = 0.007).

Conclusions
Our findings suggest that MS4A12 and CDX2 gene polymorphisms may predict outcome in stage III CRC. However, the clinical significance of SNPs for response to oxaliplatin may differ by tumor stage.
Physiologic vasomotor symptoms are associated with verbal memory dysfunction in breast cancer survivors
Authors: Fogel Jessica , Rubin Leah H. , Kilic Ece , Walega David R. , Maki Pauline M. 
Published: July 2020

Abstract

Objective:
Vasomotor symptoms (VMS), sleep disturbance, and cognitive complaints are common among women with a history of breast cancer and contribute to decreased quality of life. Studies in healthy women showed an association between verbal memory performance and physiologic VMS measured with ambulatory skin conductance monitors but not with VMS by self-report. We hypothesized that we would find a similar association in women with breast cancer.

Methods:
Participants included 30 female breast cancer survivors (mean age 52.7 y; 26.7% African-American) with moderate-to-severe VMS enrolled in a larger clinical trial of a nonhormonal intervention for VMS. At baseline, participants completed assessments of physiologic VMS, actigraphy-based assessments of sleep, questionnaires about mood, and two tests of verbal memory – Logical Memory (LM) and the California Verbal Learning Test (CVLT). Using baseline data, we conducted multivariate regression analyses to examine the association between VMS and memory, controlling for sleep and other factors.

Results:
On average, women reported 46% of total physiologic VMS. A higher frequency of physiologic VMS – but not reported VMS – was significantly associated with lower scores on the California Verbal Learning Test short-delay free recall (r[28] = −0.41, P = 0.03), long-delay free recall (r[28] = −0.42, P = 0.03), and total clustering, (r[28] = −0.39, P = 0.04). These associations were independent of sleep, mood, and other factors.

Conclusions:
Independent of their effect on sleep, VMS may be a modifiable contributor to memory difficulties in women with breast cancer. These findings underscore the importance of objective measurement of VMS in cognitive studies.

Video Summary:
http://links.lww.com/MENO/A623.
LONG-TERM SURGICAL OUTCOMES OF LENS CAPSULAR FLAP TRANSPLANTATION IN THE MANAGEMENT OF REFRACTORY MACULAR HOLE
Authors: Peng Jie , Chen Chunli , Zhang Hongtao , Zhang Lihua , Liu Jingjing , Ren Jianing , Zhao Peiquan 
Published: July 2020

Purpose:
To report long-term surgical outcomes of autologous and allogenic lens capsular flap transplantation (LCFT) in refractory macular hole (MH) treatment.

Methods:
Fifty consecutive eyes with refractory MH who received LCFT were reviewed retrospectively. Twelve eyes underwent autologous LCFT (LCF obtained from the same eye in 7 eyes and the fellow eye in 5 eyes) and 38 eyes with allogenic LCFT. All eyes underwent complete vitrectomy, internal limiting membrane peeling if not peeled, LCF transplantation, and 15% perfluoropropane tamponade. Simultaneous autologus whole-blood application was applied in 31 eyes to reduce LCF dislocation. The patients maintained a facedown position for 2 weeks postoperatively. Demographic information, functional results, and structural changes were evaluated.

Results:
The mean preoperative MH diameter was 1,102.00 µm ± 561.63 µm. The mean follow-up duration was 18.50 months ± 6.05 months (range, 12.0–38.9 months). The MH was completely closed in 48 eyes (96.00%) (18 eyes receiving autologous LCFT and 30 receiving allogenic LCFT). There are no differences of age, previous MH surgery times, MH diameter, preoperative and postoperative best-corrected visual acuity, and closure rate between the subgroups. The median visual acuity improved from 1.78 (interquartile range, 1.28–1.85) logarithm of the minimum angle of resolution (median Snellen acuity: 20/1,200) preoperatively to 1.00 (interquartile range, 0.90–1.70) logarithm of the minimum angle of resolution (median Snellen acuity: 20/200) (P < 0.01) in all patients.

Conclusion:
Both autologous and allogenic LCFT application may provide anatomical and visual improvements in refractory MH cases. Blood application can be applied in selected cases to reduce LCF dislocation. LCFT can be performed as first-line treatment for refractory MHs.
PARACENTRAL ACUTE MIDDLE MACULOPATHY IN A PATIENT WITH FREQUENT MIGRAINE WITH AURA: A CASE REPORT
Authors: Dasari Vijaya R. , Selliyan Ananth , Gratton Sean M. 
Published: July 2020

Background/Purpose:
To explore the possible relationship between Paracentral Acute Middle Maculopathy (PAMM) and migraine. Paracentral acute middle maculopathy is a recently described clinical and optical coherence tomography entity involving infarction of the inner nuclear layer secondary to deep retinal capillary ischemia. It presents as a painless paracentral scotoma and often results in permanent visual deficits. Migraine, especially migraine with aura, has been shown to cause structural changes in the retinal microvasculature and to be a risk factor for retinal ischemia.

Methods:
A case report and review of the literature.

Results:
A 39-year-old woman with migraine with visual aura presented with a discrete, monocular, painless “buffalo-shaped” paracentral scotoma, which started during a period of frequent typical visual auras. Her exam and optical coherence tomography were consistent with PAMM.

Conclusion:
We propose that migraine is a risk factor for the development of PAMM. The changes in retinal microvasculature in migraine may increase a patient's susceptibility to retinal ischemia. Other risk factors for retinal ischemia, including diabetes, hypertension, hyperlipidemia, sickle cell disease, and orbital trauma, have been shown to be associated with PAMM. Further research should be conducted to determine whether there is a definite relationship between migraine and PAMM.
Cosmetic Keratopigmentation in Sighted Eyes: Medium- and Long-term Clinical Evaluation
Authors: D'Oria Francesco , Alio Jorge L. , Rodriguez Alejandra E. , Amesty Maria A. , Abu-Mustafa Sabat K. 
Published: July 2020

Purpose:
To assess the medium- and long-term outcomes of keratopigmentation (KTP) as a surgical alternative to change the cosmetic appearance of healthy eyes.

Methods:
A prospective, interventional, consecutive, multicenter, series of cases of cosmetic KTP was included in the study. Forty consecutive patients underwent KTPs with mineral micronized pigments using a femtosecond laser–assisted intrastromal or superficial technique. Main outcomes were cosmetic evaluation, subjective patients' satisfaction, and complications. The outcomes were evaluated at 6 months after the last operation and then yearly.

Results:
This study included 79 eyes of 40 patients, with a mean age of 34 ± 11 years; femtosecond laser–assisted intrastromal keratopigmentation was performed in 39 patients (97.5%) and superficial automated keratopigmentation in 1 patient. Mean follow-up was 29 months (range 6–69). Observer's evaluation was excellent in 90% of cases, and patient's satisfaction was excellent in 92.5% of cases. Twenty-eight eyes (35.4%) were reoperated; of them, 7 eyes (8.9%) had 2 color touch ups and 4 eyes (5.1%) had 3 color touch ups. After the retreatments, all the patients were satisfied with the cosmetic aspect. Light sensitivity at first month was the most common complication (30%), followed by change in the color (7.5%), color fading (5%), and visual field limitations in a case with 4.5-mm pupil size (2.5%). One patient with a previous laser in situ keratomileusis developed corneal ectasia.

Conclusions:
Cosmetic KTP achieves good cosmetic results and is associated with high patient satisfaction. Most of the complications could be managed adequately. It might offer a safe and effective new surgical alternative for those patients motivated to change the apparent color of their eyes.
Free Tarsal Graft and Free Skin Graft for Lower Eyelid Reconstruction
Authors: Bortz John G. , Al-Shweiki Sameer 
Published: July 2020

Purpose:
To determine whether reconstruction of lower eyelid defects involving the eyelid margin with a free tarsal graft and an overlying free skin graft, without retention or provision of any vascular support, would yield acceptable functional and cosmetic results.

Methods:
We present here a clinical series of 4 patients treated between April 2019 and September 2019 who underwent reconstruction of large postcarcinoma excision, eyelid-margin-inclusive eyelid defects. Surgery was performed by the same surgeon (J.G.B.) at the Westchester Medical Center, Department of Ophthalmology and Dobbs Ferry Hospital in New York. Without retaining a conjunctival pedicle (modified Hughes procedure), and without a myocutaneous or other vascularized flap, the lower eyelids were reconstructed with a free tarsal graft and a separate overlying free skin graft. The primary outcomes measured were eyelid apposition to the globe, margin reflex distance 2 at least 6 months postoperatively, ocular surface integrity, and patient comfort and patient satisfaction with the procedure.

Results:
The patients included in the clinical series ranged in age from 73 to 82, 3 were men and 1 women. Each had recent Moh’s excision of carcinoma (3 basal; 1 squamous) resulting in large tissue defects of the lower eyelids. All carcinomas were T1N0M0. The mean postoperative margin reflex distance 2 of the reconstructed eyelids was 5.5 mm, range 5–7.5 mm. Two of the 4 patients underwent a secondary revision within 2–3 weeks following initial reconstruction for lateral ectropion or dehiscence. All eyelids were well-opposed to the globes after revision (except for the nasal eyelid in patient number 2 who had a preexisting ectropion from prior carcinoma excision in the same eyelid). Functional and esthetic results were on par with those of the modified Hughes procedure. All 4 patients were pleased that they had chosen to undergo the procedure being discussed.

Conclusion:
In this clinical series of 4 patients, reconstruction of lower eyelid defects with a free tarsal graft and overlying free skin graft resulted in an acceptable functional and esthetic lower eyelid suggesting that retention of or provision of vascular support in either the anterior or posterior lamella may not be necessary.
Combined effects of obesity and di-(2-ethylhexyl) phthalate on testosterone levels and kisspeptin/GPR54 expression in hypothalamus and testes of male mice
Authors: Zhai Ling-Ling , Zhao Jian , Bai Ying-Long , Wei Wei , Sun Qi , Jia Li-Hong 
Published: July 2020

Background:This study evaluated whether obese male mice exposed to di-(2-ethylhexyl) phthalate (DEHP) showed synergistic effects on testosterone levels and the potential underlying mechanism.Methods:Forty-eight male mice were assigned to six groups for 12-week treatments as follows: normal, DEHP100, diet-induced obesity (DIO), DIO + DEHP30, DIO + DEHP100, and DIO + DEHP300. Serum hormone levels, including testosterone (T), luteinizing hormone (LH), and leptin, were detected by ELISA. The levels of Ob-R, kisspeptin, and GPR54 protein expression in hypothalamus and testicular tissues were measured by western blot.Results:There were significantly lower levels of serum T and LH, higher levels of serum leptin and Ob-R, and kisspeptin and GPR54 protein expression were reduced in hypothalamus and testicular tissues in the DIO and DEHP groups compared with controls. Moreover, serum T and leptin levels were more severe in the combined DIO and DEHP exposure group than in the single exposure groups. Serum LH levels and GPR54 expression in the testis were significantly decreased in DIO + DEHP300 mice compared with DIO mice (p< 0.05).Conclusion:Obesity- and DEHP-only exposure had adverse effects on testosterone levels in mice, which may be due to high leptin levels and decreased Ob-R, kisspeptin, and GPR54 expression. Obesity combined with DEHP exposure had an additive adverse effect on testosterone levels in mice. One of the potential mechanisms is higher leptin levels and decreased GPR54 expression in the testes.
The Average Effect of Emergency Department Admission on Readmission and Mortality for Older Adults With Chest Pain
Authors: Alvarez Avendaño Sebastian A. , Cochran Amy L. , Patterson Brian , Shah Manish , Smith Maureen , Zayas-Cabán Gabriel 
Published: July 2020

Background:Many older adults (65+) present to the Emergency Department (ED) with chest pain, but do not have otherwise clear clinical indication of whether they should be admitted or discharged. This uncertainty leads to decisions that are highly variable—in addition to already being costly—which could have adverse consequences, since older adults are particularly vulnerable from hospitalization.Objective:The objective of this study was to determine whether admitting versus discharging an older adult presenting to the ED with chest pain reduces risk of mortality and readmission.Study Design:Electronic health records were curated from an academic hospital system between January 1, 2014, and September 27, 2018. Average effects of admission on 30-day readmission and mortality were estimated using a new causal inference approach based on a latent-variable model of the admission process. Additional analyses assessed moderators and robustness of estimates.Subjects:Older patients (n=3090) presenting to University of Wisconsin Hospital ED.Measures:Readmission and mortality within 25, 30, and 35 days of discharge from the ED for discharged patients or the hospital for admitted patientsResults:For older chest pain patients, admission is estimated to lower the 30-day risk of readmission by 42.8% (95% confidence interval: 41.0%–44.6%) but increase the 30-day risk of mortality by 0.8% (95% confidence interval: 0.4%–1.2%). Individuals with higher hierarchical conditional category scores or diabetes with complications have both lower 30-day risk of readmission and higher 30-day risk of mortality compared with their counterparts (P≤0.02).Conclusions:Our findings suggest ED admission may prevent readmission at the cost of increasing mortality risk for older chest pain patients, especially those with comorbidity. Additional studies are needed to validate these findings.
Health Care Costs of Alzheimer’s and Related Dementias Within a Medicare Managed Care Provider
Authors: Fishman Paul A. , White Lindsay , Ingraham Bailey , Park Sungchul , Larson Eric B. , Crane Paul , Coe Norma B. 
Published: July 2020

Background:
Although one third of Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans, there is limited information about the cost of treating Alzheimer disease and related dementias (ADRD) in these settings.

Objective:
The objective of this study was to estimate direct health care costs attributable to ADRD among older adults within a large MA plan.

Research Design:
A retrospective cohort design was used to estimate direct total, outpatient, inpatient, ambulatory pharmacy, and nursing home costs for 3 years before and after an incident ADRD diagnosis for 927 individuals diagnosed with ADRD relative to a sex-matched and birth year-matched set of 2945 controls.

Subject:
Adults 65 years of age and older enrolled in the Kaiser Permanente Washington MA plan and the Adult Changes in Thought (ACT) Study, a prospective longitudinal cohort study of ADRD and brain aging.

Measures:
Data on monthly health service use obtained from health system electronic medical records for the period 1992–2012.

Results:
Total monthly health care costs for individuals with ADRD are statistically greater (P<0.05) than controls beginning in the third month before diagnosis and remain significantly greater through the eighth month following diagnosis. Greater total health costs are driven by significantly (P<0.05) greater nursing home costs among individuals diagnosed with ADRD beginning in the third month prediagnosis. Although total costs were no longer significantly greater at 8 months following diagnosis, nursing home costs remained higher for the people with dementia through the 3 years postdiagnosis we analyzed.

Conclusion:
Greater total health care costs among individuals with ADRD are primarily driven by nursing home costs.
Does 68Ga-DOTA-NOC-PET/CT impact staging and therapeutic decision making in pulmonary carcinoid tumors?
Authors: Purandare Nilendu C. , Puranik Ameya , Agrawal Archi , Shah Sneha , Kumar Rajiv , Jiwnani Sabita , Karimundackal George , Pramesh C.S. , Rangarajan Venkatesh 
Published: July 2020

Objective
Purpose of this study was to assess the utility of 68Ga-DOTA-NOC-PET/computed tomography (CT) (Ga-NOC-PET) in tumor detection, pathological differentiation and baseline staging of pulmonary carcinoids as well as to study its impact on therapeutic decision making.

Patients and methods
Patients who underwent a Ga-NOC-PET for initial evaluation of bronchopulmonary carcinoid tumors from August 2014 to December 2019 were included. Detection rate of Ga-NOC-PET for the primary lesion was calculated by visual estimation of tracer uptake as per Krenning score. SUVmax of typical and atypical carcinoid tumors was measured and difference compared using nonparametric statistical tests. Proportion of patients with distant metastases was also calculated and its impact on intended treatment was assessed.

Results
Imaging, histopathology and treatment details of 119 patients were available for analysis. Majority of tumors had an endobronchial location (74.7%) and showed histopathologic features of typical carcinoid (82.3%). Ga-NOC-PET showed a detection rate/sensitivity of 92.4%. Oncocytic variant on histopathology and smaller tumor size accounted for majority of negative results. Typical carcinoids showed significantly higher SUVmax than atypical tumors (median SUVmax 38.4 vs. 15.7, P = 0.002). Metastases to distant sites outside the thorax were seen in 14 patients (11.7%), primarily in liver and bones changing the intent of treatment from surgery to systemic therapy.

Conclusion
Ga-NOC-PET detects asymptomatic distant metastatic disease in a sizeable number of patients (11.7%) with pulmonary carcinoid and thus contribute to clinical management by precluding futile surgeries. It shows a high sensitivity for tumor detection and can help differentiate between typical and atypical carcinoid variants by virtue of their variable tracer uptake. PET/CT using Ga-labeled DOTA peptides should be an integral part of diagnostic workup of patients with lung carcinoid.
Association of α 1 Antitrypsin Phenotype and Development of Advanced Liver Disease and Pulmonary Complications Before and After Liver Transplantation
Authors: Abu Rmilah Anan , Fencl Robert , Watt Kymberly , Krowka Michael , Wiesner Russell , Murray David , Nyberg Scott , Leise Michael 
Published: July 2020

Background.
The role of MZ phenotype of α 1 antitrypsin (α1AT) deficiency as a potential cofactor in advanced liver disease arising from other primary causes is not widely understood. In the general population, MZ phenotype accounts for 2%–4% in Europe and 2%–7.1% in North America. The aim of this study was to determine the prevalence of the MZ phenotype among various causes of cirrhosis in the United States in the modern era and its impact on pulmonary function before and after liver transplantation.

Methods.
This retrospective study included adult patients with cirrhosis who underwent liver transplantation at Mayo Clinic. Participants’ data including pathogenesis of cirrhosis, model for end-stage liver disease-Na score, α1AT phenotype, liver decompensation events, and pulmonary outcomes was determined by retrospective review of the liver transplantation database.

Results.
One hundred thirty of 1341 adult patients with cirrhosis (9.7%) were α1AT MZ carriers. When comparing the distribution of protease inhibitor (PI) MZ among different pathogenesis, the prevalence of MZ was significantly increased in nonalcoholic steatohepatitis (NASH), alcoholic liver disease (ALD), and cryptogenic cirrhosis compared with other causes. Thirty-seven of 171 with NASH (22%), 37 of 187 with ALD (20%), and 9 of 39 with cryptogenic cirrhosis (23.1%) were identified as PI MZ, while in other subgroups; we detected 18 of 320 with viral hepatitis, and 11 of 339 with primary biliary cholangitis/primary sclerosing cholangitis. Also, MZ patients were more likely to develop preoperative chronic obstructive lung disease, and postoperative pulmonary hypertension and pulmonary embolism than MM patients.

Conclusions.
The rates of preoperative and postoperative pulmonary complications were found to be higher in PI MZ patients than in PI MM patients. The MZ phenotype was significantly enriched in NASH, ALD, and cryptogenic cirrhosis.