bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethics in Eye Banking: Understanding Professional Attitudes Toward Industry Changes
Authors: Ahmad Samera , Vong Gerard , Pentz Rebecca D. , Dixon Margie , Davis Keenan W. , Khalifa Yousuf M. 
Published: March 2020

Purpose:
To describe the ethical attitudes of corneal surgeons and eye bank leadership toward for-profit entities in corneal donation, processing, and distribution.

Methods:
Fifty postfellowship corneal surgeons practicing in the United States and 25 eye bank leaders (eg, eye bank directors, CEOs, or presidents) for the Eye Bank Association of America–accredited eye banks completed a 22-question interview, focusing on corneal donation industry changes, including the entry of for-profit institutions.

Results:
Most participants in both study groups agreed that they have concerns with the entry of for-profit businesses into eye banking (62% corneal surgeons, 68% eye bank leadership), although physicians partnered with a for-profit corneal processor were significantly more likely to have no concerns with the entry of for-profits into eye banking than corneal surgeons partnered with a nonprofit processor (P = 0.04). The most frequently identified concerns with the entry of for-profit businesses into corneal banking were the hypothetical loss of donor trust (56% corneal surgeons, 64% eye bank leadership, P = 0.04) and the potential exploitation of donor generosity (72% corneal surgeons, 60% eye bank leadership). Qualitative theme analysis suggests that both study groups may view increased research/innovation as a potential benefit (64% corneal surgeons, 66% eye bank leadership) of for-profits in eye banking.

Conclusions:
Key stakeholders in eye banking do hold relevant ethical beliefs toward recent industry changes, and these attitudes should be considered in the future creation of the ethical corneal donation policy. Further research is needed to assess the attitudes of potential donors and donor families.
The Adnexal Phenotype of Sagging Eye Syndrome
Authors: Ugradar Shoaib , Joshi Sarala , Goldberg Robert A. , Demer Joseph L. 
Published: March 2020

Purpose:
The sagging eye syndrome (SES) describes a condition that presents with age-related distance esotropia, alone or in combination with cyclovertical strabismus. It has a high prevalence in those aged over age 40 years presenting with binocular diplopia. The authors aim to characterize the adnexal phenotype of those who have been diagnosed with SES.

Methods:
In this case–control study, patients were recruited from a prospectively maintained clinical and imaging database. The inclusion criteria required that subjects be above the age of 18 years and have a diagnosis of age-related distance esotropia or cyclovertical strabismus due to SES. Age-matched controls were selected from a validated database of normal faces that were not affected by any medical or surgical conditions. The margin to reflex distance from the upper eyelid, margin to reflex distance to the lower eyelid, the tarsal platform show, intracanthal distance, and inferior scleral bow were measured. Differences in the measurements between patients and controls were analyzed using a 2-tailed Student t tests.

Results:
Twenty-two patients and 22 age-matched controls (11 males and 11 females per group) were included for study. Females with SES had a significantly greater margin to reflex distance to the lower eyelid and inferior scleral bow, with a lower tarsal platform show and margin to reflex distance from the upper eyelid than controls. Male patients with SES had a significantly greater margin to reflex distance to the lower eyelid and inferior scleral bow with a significantly lower margin to reflex distance from the upper eyelid and tarsal platform show than controls.

Discussion:
This study supports the growing body of evidence which suggests that the SES represents age-related mechanical changes in the orbit that manifest as a specific adnexal phenotype.
Electron Microscopic Features of Canalicular Concretions
Authors: Ali Mohammad Javed , Heichel Jens , Singh Swati , Paulsen Friedrich 
Published: March 2020

Purpose:
The aim of this study was to examine electron microscopic features of canalicular concretions obtained from patients with canaliculiths.

Methods:
Canalicular concretions were obtained from 10 patients diagnosed as canaliculiths and were immediately fixed for ultrastructural analysis. Surface structure and transmission electron microscopical sections were studied. Multiple longitudinal and transverse ultrathin sections were obtained at different levels and all were studied using standard protocols of scanning electron microscopy and transmission electron microscopy.

Results:
Three different types of canalicular concretions were noted; predominantly coccoid and bacilloid, predominantly filamentous, and mixed varieties. The surfaces and the cut sections showed typical and distinctive features for each of the concretion types. The filamentous subtypes were common accounting for 50% (5/10) of all canalicular concretions. The surface of predominantly filamentous concretions revealed typical honeycomb patterns, the walls and base of which were formed by definitive and peculiar arrangement of Actinomyces. Transmission electron microscopy confirmed the findings of scanning electron microscopy and demonstrated typical structural features of Actinomyces and some other bacteria undergoing binary fission. The most interesting feature was the lack of immune cells and blood products within the substance of canalicular concretions as compared with the mucopeptide concretions.

Conclusions:
Ultrastructural features of canalicular concretions reveal 3 distinct microbial subtypes and opens up avenues toward better understanding of the etiopathogenesis of canaliculiths and possible structural resistance to host defenses or antibiotics.
Prognostic significance of X-linked inhibitor of apoptosis protein in patients with gastrointestinal tract cancers
Authors: Ieong Chengcheng , Yang Hong , Ma Junpeng , Lai Wenli 
Published: March 2020

Abstract

Background:
The aim of this meta-analysis was to systematically evaluate the prognostic significance of X-linked inhibitor of apoptosis protein (XIAP) in patients with gastrointestinal tract (GIT) cancers.

Methods:
PubMed, Web of Science, EMBASE, Cochrane Library and China National Knowledge Infrastructure were searched for potentially eligible literature. The baseline characteristics and relevant data were extracted. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to assess the prognostic role of XIAP in patients with GIT cancers.

Results:
Twelve studies with 2,477 patients were included. The pooled HRs of higher expression of XIAP for overall survival (OS) and recurrence free survival (RFS) in patients with GIT cancers were 1.64 (95% CI, 1.27–2.13) and 1.06 (95% CI, 0.96–1.16), respectively. Subgroup analysis and sensitivity analysis were also performed. No significant publication bias was found.

Conclusion:
Our results suggested that XIAP could be a prognostic marker for OS but not RFS in patients with GIT cancers. Higher expression of XIAP was related to poorer OS. These findings may help evaluate the prognosis of patients and assist future research on novel therapeutic strategies of GIT cancers by targeting XIAP. However, more well-designed studies are warranted to verify the results.
The outcome of human mosaic aneuploid blastocysts after intrauterine transfer
Authors: Hong Baoli , Hao Yan 
Published: March 2020

Abstract
To explore whether mosaic/aneuploid embryos can be transferred when there is no normal embryo available for transplant.
The clinical pregnancy outcomes and amniocentesis outcomes of transplanted mosaic embryos during 28 preimplantation genetic testing (PGT) cycles were retrospectively analyzed. Chromosomes of 4 donated mosaic blastocysts were comprehensively screened by next-generation sequencing.
About 10 (35.7%) of the 28 transferred mosaic embryos were implanted and had a gestational sac. But 5 women miscarried due to lack of fetal heartbeat between the 7th and 12th week of pregnancy. Five women had full-term pregnancies and gave birth to 5 healthy babies. Three of the 4 donated mosaic blastocysts had normal trophectoderm and inner cell mass, but the other 1 had abnormal embryonic cell mass.
When no normal transplantable embryo is available in the PGT cycles, but the underlying risk must be fully informed.
Eleven-year follow-up of reconstruction with autogenous iliac bone graft and implant-supported fixed complete denture for severe maxillary atrophy
Authors: Lee Jae-Hyun , Yeo In-Sung Luke 
Published: March 2020

Abstract

Rationale:
The iliac bone graft procedure is one of the treatment options for individuals with extremely resorbed alveolar bones. An autogenous block bone graft can allow the use of an implant-supported fixed dental prosthesis, rather than conventional removable dentures, by completely edentulous patients. However, the iliac bone graft technique is an invasive procedure and should be carefully selected based on its long-term clinical results. This case report describes 11-year long-term outcomes for implant-supported complete denture on the grafted iliac bone.

Patient concerns:
A 68-year-old Asian man was referred for oral rehabilitation with fixed dental prostheses. The patient had been unsatisfied with his removable dental prostheses in masticatory performance.

Diagnosis:
Radiographical examination revealed severely atrophied maxilla.

Interventions:
The atrophied maxilla was reconstructed with an iliac block bone graft, after which an implant-supported fixed complete denture was placed.

Outcomes:
During 11 years of follow-up, several prosthetic and mechanical complications were encountered. Nevertheless, no biological complications were observed. Marginal bone levels around the implants were well-maintained on the radiographs after 11 years of prosthetic use.

Lessons:
Iliac bone graft can be chosen as a predictable treatment option that allows patients with extremely atrophic maxilla to use a fixed dental prosthesis instead of a removable denture.
r-tPA with loading dose of clopidogrel and aspirin therapies for capsular warning syndrome attributed to middle cerebral artery atherosclerotic stenosis
Authors: Xu Jinghan , Zhuang Meiting , Bao Guanshui , Zhai Yu , Yang Guo-Yuan , Xue Gang , Li Qiang 
Published: March 2020

Abstract

Rationale:
The capsular warning syndrome (CWS) is a rare and special type of transient ischemic attacks (TIAs) syndrome. The pathophysiology of CWS is very complicate, and intracranial atherosclerotic stenosis (ICAS) is rare cause. Moreover, the effective and standard therapy has not yet been established.

Patient concerns:
A 47-year-old man experienced repeated and exacerbated TIAs of right hemiparesis and dysarthria. Fourteen hours after the first episode of TIAs, he developed more severe right hemiparesis and dysarthria, the National Institute of Health Stroke Scale (NIHSS) score was 12 points, and did not recover in a long time.

Diagnosis:
The computed tomography (CT) angiography displayed high stenosis in the M1 segment of the left middle cerebral artery. The patient was diagnosed as CWS with ICAS.

Interventions:
Loading dose of clopidogrel and aspirin were started but were ineffective, then we used recombinant tissue plasminogen (r-tPA) for thrombolysis therapy after repeat CT scan that showed small acute infarcts in the right putamen and no bleeding.

Outcomes:
The patient was successfully treated by r-tPA intravenous thrombolysis after loading dose of dual-anti-platelet. He recovered rapidly, and the NIHSS score was 0 point, modified Rankin Scale score was 0 point, and Barthel Index score was 100 points at 3-month follow-up.

Lessons:
r-tPA combined with loading dose of dual antiplatelet appears safe and effective in carefully selected CWS patients with ICAS. The collection of similar cases and further randomized controlled trial research would be desirable.
Divergence of group a rotavirus with genetic variations before and after introduction of rotavirus vaccines in northern Taiwan
Authors: Chen Ying-Fang Elaine , Lee Chung-Chan , Chiu Cheng-Hsun , Chang Yu-Chung , Tsai Chi-Neu , Chao Hsun-Ching , Kong Shu-Sing , Chen Shih-Yen 
Published: March 2020

Abstract
Despite the development of vaccines in 2006, rotavirus is still a major cause of acute gastroenteritis worldwide. This study was performed to analyze the presence of circulating rotaviruses before and after the introduction of rotavirus vaccines to allow phylogenetic comparisons of vaccine strains in northern Taiwan.
Rotavirus genotyping and sequencing of rotavirus VP7 and VP4 PCR products were performed by Reverse Transcriptase Polymerase Chain Reaction and DNA autosequencing. Phylogenies were constructed by the neighbor-joining and maximum-likelihood methods using CLUSTAL W software included in the MEGA software package (version 6.0).
Between April 2004 and December 2012, a total of 101 rotavirus specimens from pediatric patients with acute gastroenteritis hospitalized in Chang Gung Children's Hospital were amplified, and their VP4 and VP7 sequences were determined. These 101 specimens consisted of 55 pre-vaccine strains (G1 [13, 23.6%], G2 [12, 21.8%], G3 [16, 29.1%], and G9 [14, 25.5%]) and 46 post-vaccine strains (G1 [25, 54.3%], G2 [12, 26.1%], G3 [5, 10.9%], and G9 [4, 8.7%]). The most common combination of the G and P types was G2P[4], accounting for 36% cases, followed by G9P[8] (25%), G1P[8] (20%), G3P[4] (15%), G3P[8] (10%), G1P[4] (5%), and G2P[8] (5%). Phylogenetic analysis showed that only the G1 and P[8] genotypes clustered in the same lineages with the rotavirus vaccine strains.
Based on our results, the inclusion of G9, modified G2 and G3 with target lineages, and the combination G2P[4] and G9P[8] in the rotavirus vaccines in Taiwan is warranted as a vaccination strategy.
Effect of subcutaneous needling on visual analogue scale, IgG and IgM in patients with lumbar disc herniation
Authors: Yang Jiangxia , Yang Chen , Wang Yajie , Li Ning , Yao Xingzhang , Yang Bowen , Xu Xia , Li Xingyong 
Published: March 2020

Abstract

Background:
Lumbar disc herniation (LDH) is a disease commonly seen in clinical practice. In the majority of such patients presenting in clinic, the symptoms can be relieved or even abolished after non-surgical treatment. Floating needle therapy has attracted considerable attention as a promising non-surgical technique to treat LDH, as demonstrated in previous studies. The purpose of the present study was to evaluate the outcomes of patients treated using this therapy in a single blind and randomized controlled trial by recording patient report questionnaires and objective test data, and to explore the feasibility and preliminary effects of floating needle therapy for patients with LDH.

Methods:
A total of 80 patients who fulfilled the inclusion criteria were randomly divided into a Fu's subcutaneous needling (FSN) group and an acupuncture group then treated in accordance with procedures appropriate for a single blind and randomized controlled trial. The FSN group received 12 FSN therapy sessions over a 3-week period, and the acupuncture group received acupuncture therapy at specified points using acupuncture needles. The principal measurements were scored using the visual analogue scale (VAS), Japanese Orthopedic Association (JOA) Score, and Oswestry disability index (ODI) before and 3 weeks after treatment. Secondary measurements included immune function IgG and IgM measurements performed at the same time and adverse reactions during treatment.

Results:
The results of this trial will be published on the website of China Clinical Trial Registration Center (http://www.chictr.org.cn/searchprojen.aspx) and in peer-reviewed journals or academic conferences.

Conclusions:
This study will explore the feasibility and preliminary effects of floating needle therapy for the treatment of patients with LDH.

Registration:
PROSPERO (registration number ChiCTR1900024045).
Equilibrium radionuclide angiography compared with tissue doppler imaging for detection of right ventricular dyssynchrony and prediction of acute response to cardiac resynchronization therapy
Authors: Chen Yu , Xue Xue , Gu Yang , Xu Haiyan , Zhang Xiwen 
Published: March 2020

Abstract

Objective:
The aim of this study was to compare tissue doppler imaging (TDI) and equilibrium radionuclide angiography (ERNA) for detection of right ventricular (RV) dyssynchrony and prediction of the acute response to cardiac resynchronization therapy (CRT).

Methods:
This study was approved by the local ethics committee of Huai’an First People's Hospital. Patient consent was not provided due to the use of completely anonymous images from which the individual could not be identified in this study. Thirty-three patients with nonischemic dilated cardiomyopathy underwent both TDI and ERNA before and within 48 hour after CRT implantation. RV dyssynchrony was measured with TDI using the difference in time to peak systolic velocity between the RV free wall and ventricular septum (RV-T). With ERNA, the standard of RV mean phase angle and RV phase standard deviation (RVmPA% and RVPSD%) were assessed.

Results:
Moderate positive correlations were observed among baseline RVmPA%, RVPSD% and RV-T (r = 0.689 and 0.716, P < .001). Twenty patients (61%) with a reduction of at least 15% in LV end-systolic volume were categorized as acute responders after CRT. Responders showed significant reduction in RVmPA% and RVPSD% after CRT (53.60 ± 4.15% to 43.95 ± 6.88% and 14.00 ± 2.41% to 10.40 ± 1.67%, P < .05), whereas RV-T remained unchanged (50.10 ± 10.28 ms to 49.25 ± 13.64ms, NS). Receiver operating characteristic curve showed that the cut-off value of RV-T was 48.5ms, yielding 65% sensitivity and 77% specificity to predict acute respond to CRT. The cut-off value of RVmPA% was 49.5%, yielding 85% sensitivity and 85% specificity and the cut-off value of RVPSD% was 11.5%, yielding 85% sensitivity and 92% specificity.

Conclusion:
ERNA might be an appropriate alternative to TDI for assessment of RV dyssynchrony. Either RVmPA% or RVPSD% was highly predictive for acute response to CRT.
Fractional amplitude of low frequency fluctuation in drug-naïve first-episode patients with anorexia nervosa
Authors: Lai Jianbo , Xu Tingting , Zhang Haorong , Xi Caixi , Zhou Hetong , Du Yanli , Jiang Jiajun , Wu Lingling , Zhang Peifen , Xu Yi , Hu Shaohua , Xu Dongrong 
Published: March 2020

Abstract
To characterize the fractional amplitude of low-frequency fluctuation (fALFF) in drug-naïve first-episode female patients with anorexia nervosa (AN) using resting-state functional magnetic resonance imaging (rs-fMRI).
Whole brain rs-fMRI data were collected from 7 drug-naïve first-episode female patients with DSM-5 AN and 14 age-matched healthy female controls. fALFF values were calculated and compared between the two groups using a two-sample t test. Correlation analysis between the fALFF values in the entire brain and body mass index (BMI) was performed.
Compared with the healthy controls, increased fALFF values were observed in the AN patients in their right hippocampus and left superior frontal gyrus, while decreased fALFF values were observed in their left rectus and left middle occipital gyrus. Moreover, low BMI was significantly associated with decreased fALFF in the left inferior frontal gyrus but increased fALFF in the left calcarine. In particular, the z-standardized fALFF (zfALFF) value of the left rectus was positive associated with BMI.
Our findings suggest that spontaneous brain activity in the frontal region, hippocampus and rectus, characterized by fALFF values, was altered in drug-naïve, first-episode female patients with AN.
Salter-Harris type II fractures of the distal tibia
Authors: Margalit Adam , Peddada Kranti V. , Dunham Alexandra M. , Remenapp Craig M. , Lee R. Jay 
Published: March 2020

Abstract
We assessed factors associated with premature physeal closure (PPC) and outcomes after closed reduction of Salter-Harris type II (SH-II) fractures of the distal tibia. We reviewed patients with SH-II fractures of the distal tibia treated at our center from 2010 to 2015 with closed reduction and a non-weightbearing long-leg cast. Patients were categorized by immediate postreduction displacement: minimal, <2 mm; moderate, 2 to 4 mm; or severe, >4 mm. Demographic data, radiographic data, and Lower Extremity Functional Scale (LEFS) scores were recorded.
Fifty-nine patients (27 girls, 31 right ankles, 26 concomitant fibula fractures) were included, with a mean (±SD) age at injury of 12.0 ± 2.2 years. Mean maximum fracture displacements were 6.6 ± 6.5 mm initially, 2.7 ± 2.0 mm postreduction, and 0.4 ± 0.7 mm at final follow-up. After reduction, displacement was minimal in 23 patients, moderate in 21, and severe in 15. Fourteen patients developed PPC, with no significant differences between postreduction displacement groups. Patients with high-grade injury mechanisms and/or initial displacement ≥4 mm had 12-fold and 14-fold greater odds, respectively, of PPC. Eighteen patients responded to the LEFS survey (mean 4.0 ± 2.1 years after injury). LEFS scores did not differ significantly between postreduction displacement groups (P = .61).
The PPC rate in this series of SH-II distal tibia fractures was 24% and did not differ by postreduction displacement. Initial fracture displacement and high-grade mechanisms of injury were associated with PPC. LEFS scores did not differ significantly by postreduction displacement.

Level of Evidence: Level IV, case series
Cricothyroidotomy needle length is associated with posterior tracheal wall injury
Authors: Katayama Atsuko , Watanabe Kunitaro , Tokumine Joho , Lefor Alan Kawarai , Nakazawa Harumasa , Jimbo Ippei , Yorozu Tomoko 
Published: March 2020

Abstract

Background:
Cricothyroidotomy is the final strategy in the “cannot intubate, cannot oxygenate” scenario, but half of needle cricothyroidotomy attempts result in failure. The most frequent complication in needle cricothyroidotomy is posterior tracheal wall injury. We hypothesized that needle length is related to posterior wall injury and compared needle cricothyroidotomy with a commercial kit to a modified shorter needle to evaluate success and posterior wall injury rates.

Methods:
The commercial kit has a needle stopper to prevent posterior wall injury, with a penetrating length of 25 mm. We made long stopper to shorten the length by 5 mm (net 20 mm penetrating length). Residents were recruited, received a lecture about cricothyroidotomy and practiced needle cricothyroidotomy using the commercial kit on a simulator. They then performed cricothyroidotomy using the commercial kit or the shorter needle on an ex-vivo porcine larynx covered with artificial skin. An intra-tracheal endoscope recorded the procedure. The video was evaluated for success/failure or posterior wall injury by independent evaluators. Larynxes with a distance from the outer surface to the inner lumen exceeding 13 mm were excluded. The distance in each larynx was measured by dissection after the study. Success and posterior wall injury rates were analyzed using Fisher exact test (P < .05 was statistically significant).

Results:
Forty-seven residents participated in the study. Data for two residents were excluded. There was no statistically significant difference in success rate between the commercial kit (100%, 45/45) and the shorter needle (91%, 41/45, P = .12). Failure was defined if the needle tip did not reach the lumen in four trials. Cannulated but complicated by posterior wall injury occurred in 33% (15/45) with the commercial kit and 5% (2/43) with the shorter needle (P < .01).

Conclusion:
During needle cricothyroidotomy, force is needed for the needle to penetrate the cricothyroid ligament. The advancing needle sometimes cannot be stopped after penetrating the cricothyroid ligament. These data suggest that needle length is associated with posterior wall injury.