bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain and patellofemoral functionality in total knee arthroplasty: a comparative cohort study of two prosthesis designs
Authors: Cely Luis Miguel , Rocha Cesar Hernando 
Published: December 2020

Background:
Total knee arthroplasty designs have changed from the original design, with the goal of becoming as close to normal knee biomechanics and anatomy as possible. Since 2009, Optetrak® Logic incorporated modifications to the previous product Optetrak® PS (Exactech, Gainsville, FL), with a change of the anterior surface of the tibial post of the polyethylene insert and the surface that articulates with the femoral component box. Also, the sagittal geometry of the femoral trochlea was changed, which decreased rates of anterior knee pain and “patellar clunk.” The purpose of this study was to determine if there are differences in terms of pain and patellofemoral functionality between Optetrak PS and Optetrak Logic.

Methods:
A prospective follow-up was performed comparing the results of the Kujala pain and patellofemoral functionality scale. Clinical and functional follow-up was performed in 132 knees (66 from the Optetrak Logic group and 66 from the Optetrak PS group) that underwent total knee arthroplasty from January 2015 to August 2019.

Results:
Global results of the functional tests were: Oxford postoperative 50; Knee Society Score postoperative 85; Kujala postoperative 76. In comparing the two groups the Kujala score for Optetrak PS was 71 and the Kujala score for Optetrak Logic was 81.

Conclusions:
Patellofemoral knee pain and functionality before and after total knee arthroplasty must be analyzed with functional scales. The new prosthetic designs are gentler to the patellofemoral joint, and this has been verified by objective analysis with functional scales such as the Kujala scale.

Level of Evidence:
Level III.
Examining the use of the pressure modulated knee rehabilitation machine (PMKR) with traditional physical therapy versus traditional physical therapy alone following total knee arthroplasty: a randomized control study
Authors: Cien Adam , Riggle Patrick K. , Brazier Brett G. , Popovich John M. , Crawford Stan , Cochran Jason M. 
Published: December 2020

Background:
Total knee arthroplasty (TKA) is considered a successful operation, however, 8% to 25% of patients are not satisfied with their TKA after surgery, with contracture being a common reason. The purpose of this study was to compare range of motion (ROM), patient-reported outcomes, and patient satisfaction between patients who utilized the X10™ Pressure Modulated Knee Rehabilitation (PMKR) machine (X10 Therapy, Franklin, MI) in addition to physical therapy and patients who only had physical therapy after TKA.

Methods:
Patients were randomized to either the PMKR plus traditional physical therapy group or the traditional physical therapy only group. Patient-reported outcome scores and ROM were recorded at baseline, 2 wk, 4 wk, and 4 mo postoperatively. Patient satisfaction was also assessed.

Results:
A total of 107 patients underwent TKA surgery (50 PMKR group, 57 traditional therapy alone group). At 4 wk, the PMKR group exceeded the minimally clinical important difference of 5 degrees after TKA; however, this was not sustained at 4 mo. There were no statistically significant differences in the patient-reported outcome scores, but patients in the PMKR group had statistically significantly higher satisfaction.

Conclusions:
In summary, our results demonstrate that patients who utilize a PMKR machine in addition to traditional physical therapy may have an initial increase in postoperative knee ROM; however, this clinical relevance was not sustained at the 4-month time point. Even though this difference in ROM was not maintained over the entire study, patients who used the PMKR machine had greater satisfaction with their TKA than those who underwent traditional physical therapy alone.

Level of Evidence:
Level II.
A Novel Low-Cost Ventilator for Use in a Worldwide Pandemic: The Portsmouth Ventilator
Authors: Cole Jacob H. , Hughey Scott B. , Rector Christopher H. , Booth Gregory J. 
Published: December 2020

Objectives:
The ongoing severe acute respiratory syndrome coronavirus 2 or coronavirus disease 2019 pandemic has demonstrated the potential need for a low-cost, rapidly deployable ventilator. Based on this premise, we sought to design a ventilator with the following criteria: 1) standard components that are accessible to the public, 2) “open-source” compatibility to allow anyone to easily recreate the system, 3) ability to ventilate in acute respiratory distress syndrome, and 4) lowest possible cost to provide adequate oxygenation and ventilation.

Design:
We pursued development of a pneumatic-type ventilator. The basic design involves three electrically controlled solenoid valves, a pressure chamber, the patient breathing circuit, a positive end-expiratory pressure valve, and an electronics control system. Multiple safety elements were built into the design. The user-friendly interface allows simple control of ventilator settings. The ventilator delivers a hybrid form of pneumatic, assist-control ventilation, with predicted tidal volumes of 300–800 mL, positive end-expiratory pressure 0–20 cm H2O, and Fio
2 21–100%.

Main Results:
The ventilator was extensively tested with two separate high-fidelity lung simulators and a porcine in vivo model. Both lung simulators were able to simulate a variety of pathologic states, including obstructive lung disease and acute respiratory distress syndrome. The ventilator performed well across all simulated scenarios. Similarly, a porcine in vivo model was used to assess performance in live tissue, with a specific emphasis on gas exchange. The ventilator performed well in vivo and demonstrated noninferior ventilation and oxygenation when compared with the standard ventilator.

Conclusions:
The Portsmouth Ventilator was able to perform well across all simulated pathologies and in vivo. All components may be acquired by the public for a cost of approximately $250 U.S.D. Although this ventilator has limited functionality compared with modern ventilators, the simple design appears to be safe and would allow for rapid mass production if ventilator surge demand exceeded supply.
Stability of Do-Not-Resuscitate Orders in Hospitalized Adults: A Population-Based Cohort Study*
Authors: Mehta Anuj B. , Walkey Allan J. , Curran-Everett Douglas , Matlock Daniel , Douglas Ivor S. 
Published: December 2020

Objectives:
Prior work has shown substantial between-hospital variation in do-not-resuscitate orders, but stability of do-not-resuscitate preferences between hospitalizations and the institutional influence on do-not-resuscitate reversals are unclear. We determined the extent of do-not-resuscitate reversals between hospitalizations and the association of the readmission hospital with do-not-resuscitate reversal.

Design:
Retrospective cohort study.

Setting:
California Patient Discharge Database, 2016–2018.

Patients:
Nonsurgical patients admitted to an acute care hospital with an early do-not-resuscitate order (within 24 hr of admission).

Interventions:
None.

Measurements and Main Results:
We identified nonsurgical adult patients who survived an initial hospitalization with an early-do-not-resuscitate order and were readmitted within 30 days. The primary outcome was the association of do-not-resuscitate reversal with readmission to the same or different hospital from the initial hospital. Secondary outcomes included association of readmission to a low versus high do-not-resuscitate-rate hospital with do-not-resuscitate reversal. Among 49,336 patients readmitted within 30 days following a first do-not-resuscitate hospitalization, 22,251 (45.1%) experienced do-not-resuscitate reversal upon readmission. Patients readmitted to a different hospital versus the same hospital were at higher risk of do-not-resuscitate reversal (59.5% vs 38.5%; p < 0.001; adjusted odds ratio = 2.4; 95% CI, 2.3–2.5). Patients readmitted to low versus high do-not-resuscitate-rate hospitals were more likely to have do-not-resuscitate reversals (do-not-resuscitate-rate quartile 1 77.0% vs quartile 4 27.2%; p < 0.001; adjusted odds ratio = 11.9; 95% CI, 10.7–13.2). When readmitted to a different versus the same hospital, patients with do-not-resuscitate reversal had higher rates of mechanical ventilation (adjusted odds ratio = 1.9; 95% CI, 1.6–2.1) and hospital death (adjusted odds ratio = 1.2; 95% CI, 1.1–1.3).

Conclusions:
Do-not-resuscitate reversals at the time of readmission are more common than previously reported. Although changes in patient preferences may partially explain between-hospital differences, we observed a strong hospital effect contributing to high do-not-resuscitate-reversal rates with significant implications for patient outcomes and resource.
Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma With Secondary Cutaneous Involvement: A Diagnostic Challenge
Authors: Olmos-Alpiste Ferran , Vázquez Ivonne , Gallardo Fernando , Sánchez-Gonzalez Blanca , Colomo Luis , Pujol Ramon M. 
Published: December 2020

Abstract:
A 45-year-old woman presented with a solitary breast nodule that histologically corresponded to a dense dermal/subcutaneous infiltration of atypical cytotoxic T-lymphocytes (CD3+, CD8+, CD56+, TIA-1+, CD5−, CD4−, CD30−, EBV−), resembling subcutaneous panniculitic T-cell lymphoma. The presence of TCRδ gene rearrangement and the absence of βF1 expression let to suspect the diagnosis of primary cutaneous γδT-cell lymphoma. As a consequence of jejunum perforation following chemotherapy treatment, a mucosal atypical lymphoid infiltration with marked epitheliotropism was observed in the resected intestinal sample, and the diagnosis of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) was finally established. Disease progression appeared with multiple erythematous plaques showing a dense lichenoid atypical cytotoxic T-cell infiltrate with intense epidermotropism, mimicking primary cutaneous epidermotropic aggressive CD8+ T-cell lymphoma. MEITL is an uncommon and aggressive peripheral T-cell lymphoma that often presents in adults with gastrointestinal symptoms. Secondary cutaneous involvement is a rare phenomenon that may show clinicopathologic and immunohistochemical features that overlap with different subtypes of primary cutaneous cytotoxic T-cell lymphomas. In the absence of gastrointestinal symptoms, the diagnosis may be challenging, and only the evidence of underlying MEITL may allow to establish the definite diagnosis.
Ocular Features in a Large Cohort of Indians With Xeroderma Pigmentosum
Authors: Nandyala Sushma , Mohamed Ashik , Chaurasia Sunita , Kaliki Swathi , Ramappa Muralidhar , Vemuganti Geeta K. 
Published: December 2020

Purpose:
Xeroderma pigmentosum (XP) is an extreme hypersensitivity to sunlight causing skin freckling and pigmentary changes because of defective DNA repair mechanisms. The purpose of this article is to evaluate the spectrum of ocular and systemic features in XP at a tertiary eye care center in India over 32 years.

Methods:
Data from 418 eyes of 209 patients diagnosed with XP from 1987 to 2018 were reviewed retrospectively for demographics, complaints, ocular features, systemic associations, and their management.

Results:
Median age at diagnosis was 2 years (interquartile range, 0.5–5 years). A total of 124 patients (59.3%) were men. There was parental consanguinity in 74.4% cases. Common ocular complaints were photophobia (47.1%), ocular discomfort (45%), defective vision (36.6%), redness (13.4%), tissue growth (12%), white spot (11.2%), and pain (10.5%). At presentation, 43.5% had corneal scars (45.5% were located inferiorly and 70.9% covered visual axis). Corneal vascularization and limbal stem cell deficiency were noted in 37.4%. A total of 56% of patients had at least 1 tumor, and 6.7% had neurological abnormalities. At least 1 ocular surgery was performed in 37.8% of patients. Ophthalmic surgical interventions included tumor excision (23%), keratoplasty (13.4%), and nontumor ocular surface surgery (3.4%).

Conclusions:
XP is a disorder that has high ocular morbidity in Indian patients. The recognition of common signs and symptoms and relative frequency of various ocular complications with time trends will help in managing and reducing the sequelae of this otherwise untreatable and progressive disease.
Severe Keratitis and Corneal Perforation by Paenibacillus glucanolyticus
Authors: Hassan Ali , Rampat Radhika , Vasquez-Perez Alfonso 
Published: December 2020

Purpose:
To report the first case of Paenibacillus glucanolyticus, a spore-forming bacteria, to be isolated in a human ocular infection.

Methods:
We describe a severe case of noncontact lens-related microbial keratitis due to P. glucanolyticus presenting with a large corneal abscess, severe ocular inflammation, and a large epithelial defect.

Results:
The corneal scrapes with no growth initially cultured P. glucanolyticus on blood agar after 48 hours, with sensitivity to gentamicin and fluoroquinolones. No other organism was cultured. The patient had severe keratitis with a protracted course requiring cyanoacrylate glue patching because of keratolysis and perforation. The patient may benefit from a penetrating keratoplasty and extracapsular cataract extraction in due course to aid visual rehabilitation.

Conclusions:
This is the first reported ocular case of P. glucanolyticus demonstrating its bacterial virulence and pathogenic potential when infecting the cornea. Rapid identification with newer technology enable us to accurately identify these opportunistic bacteria and may give a more favorable visual outcome as correct sensitivities lead to timely treatment administration.
Trends in Female Authorship in Cornea From 2007 to 2019
Authors: Amarasekera Dilru C. , Lam Sophia S. , Rapuano Christopher J. , Syed Zeba A. 
Published: December 2020

Purpose:
To identify female authorship trends in first author and last author positions in Cornea from 2007 to 2019.

Methods:
First and last authors of all Clinical Science and Basic Investigation publications in Cornea over 13 years were sorted by sex. Identification of sex was based on the author's institutional profile or a Google-based name identifier in cases of equivocal names. The proportion of female board-certified ophthalmologists between 2007 and 2019 was collected from the American Board of Ophthalmology total roster of certified diplomats.

Results:
First and last author sexes were collected from 2313 publications (1837 Clinical Science and 476 Basic Investigation). Between 2007 and 2019, the percentage of female first authors increased from 30.5% to 41.5%, although this change was not significant (P = 0.240). Female last author percentage increased significantly from 14.9% to 26.6% (P = 0.016). The percentage of female American Board of Ophthalmology–certified diplomats also increased significantly from 17.4% to 24.5% (P < 0.001). Similarly, when comparing 2007 and 2008 with 2018 and 2019, we noted a significant increase in the proportion of women in the last author (P < 0.001) but not in the first author (P = 0.208) position. We also identified a significantly higher proportion of female first authors than that of female board-certified ophthalmologists (P < 0.001). Finally, there was a strong association between first author sex and last author sex (P < 0.001) across manuscripts.

Conclusions:
The proportion of women in last author positions increased over 13 years among manuscripts in Cornea. Despite these advances in academic female representation within the cornea subspecialty, a gender gap in authorship persists.
Herpes Simplex Virus–Related Conjunctivitis Resistant to Aciclovir: A Case Report and Review of the Literature
Authors: Esra Nira , Hollhumer Roland 
Published: December 2020

Purpose:
To report a rare case of herpes virus type 2–related conjunctivitis, resistant to aciclovir (ACV).

Methods:
Case report and review of literature.

Results:
A 28-year-old human immunodeficiency virus-positive man presented with chronic, recurrent follicular conjunctivitis. Multiplex reverse transcription polymerase chain reaction assay testing was positive for herpes simplex virus (HSV); subsequent typing with HSV assay revealed the presence of HSV type 2. Oral ACV failed to control the disease, and the patient continued to worsen clinically until resistance testing was performed. This revealed an M183stop within thymidine kinase, thus confirming the suspected resistance. The patient improved after 14 days of high-dose continuous intravenous infusion of ACV.

Conclusions:
This is a rare case of isolated conjunctivitis due to herpes virus type 2, in an human immunodeficiency virus-positive patient, which was found to be resistant to ACV. Drug-resistant HSV is likely to emerge as an important clinical entity in the future, increasing the need for new drugs with novel mechanisms of action.
Psychosexual knowledge and education in autism spectrum disorder individuals
Authors: Chianese Alexander A. , Jackson Stefanie Z. , Souders Margaret C. 
Published: December 2020

ABSTRACT

Background:
Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental condition. Autism spectrum disorder individuals are interested in sexual activity and pursuing romantic relationships, yet they often lack psychosexual knowledge and engage in risky sexual behaviors. The special learning needs of ASD individuals influence their exclusion from educational and social settings, resulting in fewer opportunities to acquire sex knowledge from reliable sources.

Objectives:
This review aimed to explore factors influencing sexual knowledge and evaluate outcomes of comprehensive, ASD-tailored psychosexual education.

Data sources:
PubMed, PsychINFO, and EBSCOhost databases were used to locate peer-reviewed articles in English in the 5 years between 2013 and 2018. Keywords included “autism spectrum disorder,” “child abuse,” “sexual,” “sexual offenses,” “sexual abuse,” and “sexual education.”

Conclusions:
Nine articles were included in the review. Compared with neurotypical adults, ASD adults had less sex-related knowledge, more victimization experiences, and obtained sexual information from more nonsocial sources. Knowledge is a partial mediator between ASD diagnosis and sexual victimization. Parents expressed having little support to educate their offspring and provided less sex education to children with intellectual disability and severe symptoms. Psychosexual education programs that are tailored to suit developmental and cognitive differences of ASD individuals increase knowledge and improve parent–child communication, especially for younger adolescents.

Implications for practice:
Nurse practitioners who care for ASD individuals should assess knowledge and victimization experiences, assess parent perceptions and concerns, and provide guidance for developmentally and intellectually appropriate sex education. These should be incorporated into practice starting at a young age and continue across the lifespan.
Relationship Between the Cochlear Aqueduct and Internal Auditory Canal: Surgical Implications for Transcanal Transpromontorial Approaches to the Lateral Skull Base
Authors: Molinari Giulia , Yacoub Abraam , Bonali Marco , Wimmer Wilhelm , Alicandri-Ciufelli Matteo , Caversaccio Marco , Presutti Livio , Anschuetz Lukas 
Published: December 2020

Hypothesis:
The cochlear aqueduct (CA) is subject to considerable anatomical variability. We hypothesize a topographical relationship between the CA and the internal auditory canal (IAC).

Background:
The CA represents the lower limit of dissection during transcanal transpromontorial approaches to the lateral skull base due to its close relationship to the lower cranial nerves and jugular vein.

Methods:
Three-dimensional models from high-resolution computed tomography scans of normal human temporal bones were created using threshold-based segmentation. The CA was classified into four categories. Five points were determined on the three-dimensional models to measure the surgically relevant relationships.

Results:
Segmentation was performed on 26 high-resolution computed tomography scans. The average length of the virtual and visual part of the CA was 6.6 mm (SD ±1.7 mm) and 5.5 mm (SD ±1.3 mm) respectively. The mean distance between the IAC and the medial end of the visual part of the CA was 3.8 mm (±0.7 mm), while the average distance between the IAC and the lateral end was 1.4 mm (±0.6 mm). The distance between the visual part of the CA and the IAC increased by 0.25 mm per from the fundus of the IAC.

Conclusion:
A close relationship between the CA and the IAC could be established, despite the anatomical variability of the CA. The distance between CA and IAC increases by 0.25 per mm from the fundus to the porus of the IAC. These findings quantify the inferior limit of dissection of the transcanal transpromontorial approach to the lateral skull base.
Fluctuating Posterior Canal Function in Benign Paroxysmal Positional Vertigo Depending on How and Where Otoconia Are Disposed
Authors: Castellucci Andrea , Malara Pasquale , Martellucci Salvatore , Delmonte Silvia , Ghidini Angelo 
Published: December 2020

Objective:
Though fluctuations in vestibular function represent a common finding in Menière's disease, we describe how benign paroxysmal positional vertigo (BPPV) may result in fluctuations of vestibulo-ocular reflex for the involved canal depending on the disposition of otoliths.

Patient:
A 54-year-old woman suffering from refractory posterior canal (PC)-BPPV resulting in fluctuating PC function.

Interventions:
Diagnostic evaluation and rehabilitative treatment for BPPV involving the affected PC.

Main Outcome Measures:
Video-Frenzel and video-head impulse test (vHIT) findings before and after canalith repositioning procedures for PC-BPPV.

Results:
BPPV involving the nonampullary arm of right PC was diagnosed based on presenting positional downbeat nystagmus and selective right PC hypofunction at the vHIT. During physical treatment, nystagmus first became positional paroxysmal upbeat likely due to a shift of debris into the ampullary arm of the canal, then turned to spontaneous downbeat nystagmus consistently with a plug effect exerted by particles entrapped within the nonampullary arm of PC and finally receded proving an otoliths fall within the utriculus. Simultaneously, vHIT documented fluctuations for right PC vestibulo-ocular reflex gain as it first increased to normal values, then severely declined and finally normalized, respectively. High-resolution computed tomography scan detected ipsilateral superior canal dehiscence.

Conclusions:
In accordance with recently reported vHIT findings in different types of BPPV, fluctuation of PC function could be likely explained by the effect of particles on cupular dynamic responses depending on the portion of the canal gradually involved. Superior canal dehiscence may have played a role facilitating otoliths mobilization by reducing labyrinthine impedance.