bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vivo Histology of the Cornea – from the “Rostock Cornea Module” to the “Rostock Electronic Slit Lamp” – a Clinical “Proof of Concept” Study
Authors: Bohn Sebastian , Stahnke Thomas , Sperlich Karsten , Linke Stephan J. , Farrokhi Sanaz , Klemm Maren , Allgeier Stephan , Köhler Bernd , Reichert Klaus-Martin , Witt Martin , Stachs Oliver , Guthoff Rudolf F. 
Published: November 2020

Abstract
Introduction Confocal in vivo microscopy is an established method in ophthalmology research. As it requires contact coupling and calibration of the instruments is suboptimal, this method has been only rarely used in clinical routine work. As a result of close collaboration between physicists, information scientists and ophthalmologists, confocal laser scanning microscopy (CLSM) of the eye has been developed in recent years and a prototype can now be used in patients. The present study evaluates possible clinical uses of this method.
Material and Methods The essential innovations in CLSM are (1) a newly designed coupling element with superficial adaptation to corneal curvature and (2) the use of a dual computerised piezo drive for rapid and precise focusing. In post-processing and after elastic imaging registration of the individual images parallel to the surface, it is also possible to produce sagittal sections resembling a split lamp and with resolution in the micrometer range. The concept was tested on enucleated pig bulbi and tested on normal volunteers and selected patients with diseases of the cornea.
Results Simultaneous imaging in planes parallel to the surface and in sagittal planes provided additional information that can help us to understand the processes of wound healing in all substructures of the cornea and the role of immune competent cells. Possible clinical uses were demonstrated in a volunteer with healthy eyes and several groups of patients (keratoconus after CXL, recurrent keratitis, status after PRK). These show that this new approach can be used in morphological studies at cellular level in any desired and appropriate test plane.
Conclusions It could be shown that this new concept of CLSM can be used clinically. It can provide valuable and novel information to both preclinical researchers and to ophthalmologists interested in corneal disease, e.g. density of Langerhans cells and epithelial stratification in ocular surface diseases.
Laparoscopic Management of Mechanical Small Bowel Obstruction Secondary to Meckel's Diverticulum with a Double Basis. A Rare Anatomic Presentation
Authors: Mariani Aurora , Siddiqui Mohammed , Boulard Nicolas , Berrebi Dominique , Bonnard Arnaud 
Published: November 2020

AbstractMeckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Intestinal occlusion due to MD is a commonly observed consequence of intussusception or volvulus. Here, we report a case of an 11-year-old boy who presented to the emergency department with acute abdominal pain, bilious vomiting, and abdominal rebound tenderness. Computed tomography scan concluded a diagnosis of intestinal occlusion with no apparent cause. The patient was submitted to diagnostic laparoscopy, and mechanical occlusion by the permeable Meckel with double base was identified. A diverticulectomy by staplers was performed, and occlusion was alleviated. MD is a rare disease (for only 0.3–2.9% of the general population), and only 4.2 to 9% of patients diagnosed with MD have associated complications. MD can be a large base or a narrow base, with a mesodiverticular band but the diverticulum is usually a blind recess. In our case, the tube connected two intestinal segments. To the best of our knowledge, we have reported the first case of an MD-like permeable tube with a double basis.
Endoscopic Transnasal Odontoidectomy
Authors: Zoia Cesare , Bongetta Daniele , Luzzi Sabino 
Published: November 2020

Abstract
Background Odontoidectomy may represent the treatment of choice for symptomatic ventral craniovertebral junction stenosis in selected cases. An endoscopic transnasal approach has been proposed as an alternative to a classic transoral approach.
Method We report a case of a patient with a craniovertebral junction stenosis due to the ossification of the posterior ligament. The clinical and radiological records of the patient and a step-by-step description of the surgical technique are presented (Fig. 1).
Conclusion Endoscopic transnasal odontoidectomy provides a direct access to the dens and adjacent structures of the anterior upper cervical spine with a less invasive burden on the oropharingeal structures.The link to the video can be found at: https://youtu.be/Ofrk1sFTV9I.
Possible Role of High-Dose Barbiturates and Early Administration of Parenteral Ketogenic Diet for Reducing Development of Chronic Epilepsy in Febrile Infection-Related Epilepsy Syndrome: A Case Report
Authors: Baba Shimpei , Okanishi Tohru , Ohsugi Koichi , Suzumura Rika , Niimi Keiko , Shimizu Sayuri , Sakihama Hiroshi , Itamura Shinji , Hirano Keiko , Nishimura Mitsuyo , Fujimoto Ayataka , Enoki Hideo 
Published: November 2020

AbstractWe describe the efficacy of high-dose barbiturates and early administration of a parenteral ketogenic diet (KD) as initial treatments for acute status epilepticus (SE) in an 8-year-old girl with febrile infection-related epilepsy syndrome (FIRES). The patient was admitted to our hospital with refractory focal SE. Abundant epileptic discharges over the left frontal region were observed on electroencephalogram (EEG). Treatment with continuous infusion of thiamylal for 4 hours, increased incrementally to 40 mg/kg/h, successfully ended the clinical SE, and induced a burst-suppression coma. The infusion rate was then gradually decreased to 4 mg/kg/h over the next 12 hours. Parenteral KD was administered from days 6 to 21 of illness. Continuous infusion of thiamylal was switched to midazolam on day 10 without causing seizures or EEG exacerbations. The patient has remained seizure free in the 15 months since hospital discharge. The effectiveness of KD for the treatment of FIRES has attracted attention amongst clinicians, but KD treatment may need to last for 2 to 4 days before it can stop SE, a time period that could cause irreversible brain damage. Considering the severity of SE in our patient and the dose of barbiturates needed to treat it, we consider this case to have had a good clinical outcome. The results suggest that rapid termination of seizure using high-dose barbiturates in conjunction with early administration of parenteral KD could reduce the development of chronic epilepsy in patients with FIRES.
Transvaginal Sonographic Imaging and Associated Techniques for Diagnosis of Ovarian, Deep Endometriosis, and Adenomyosis: A Comprehensive Review
Authors: Aas-Eng Mee Kristine , Montanari Eliana , Lieng Marit , Keckstein Joerg , Hudelist Gernot 
Published: November 2020

AbstractImaging of endometriosis and in particular deep endometriosis (DE) is crucial in the clinical management of women facing this debilitating condition. Transvaginal sonography (TVS) is the first-line imaging method and magnetic resonance imaging (MRI) may provide supplemental information. However, the delay in diagnosis of up to 10 years and more is of concern. This problem might be overcome by simple steps using imaging with emphasis on TVS and referral to tertiary care. Finally, TVS is crucial in mapping extent and location of disease in planning surgical therapy and counseling women regarding various therapeutic options. This review presents the available data on imaging of endometriosis with a focus on TVS and MRI for DE, adenomyosis, and ovarian endometriomas including endometriomas in pregnancy as well as the use of “soft markers.” The review presents an approach that is in accordance with the International Deep Endometriosis Analysis (IDEA) group consensus statement.
Risk Factors and Predictors of Rebound Hyperbilirubinemia in a Term and Late-Preterm Infant with Hemolysis
Authors: Almohammadi Hanaa , Nasef Nehad , Al-Harbi Aziza , Saidy Khalid , Nour Islam 
Published: November 2020

Objective This study aimed to assess the incidence and predictors of rebound in term and late-preterm infants with hemolytic hyperbilirubinemia postphototherapy.
Study Design A 4-year retrospective data analysis of neonates with hemolytic indirect hyperbilirubinemia admitted to the neonatal intensive care unit (NICU) of Medina Maternity and Children's Hospital was conducted. Bilirubin rebound was defined as the return of total serum bilirubin (TSB) to phototherapy threshold within 72 hours of postphototherapy.
Results Of 386 identified neonates; 44 (11%) experienced rebound. Neonates in the rebound group demonstrated significantly higher levels of peak TSB, TSB at discontinuation of phototherapy, and lower value of relative TSB (difference between TSB at phototherapy termination and the American Academy of Pediatrics [AAP] threshold for phototherapy at concurrent age) compared with nonrebound group (p-value: <0.001, <0.001, and 0.007, respectively). Lower value of relative TSB at stoppage of phototherapy was the single independent predictor for rebound hyperbilirubinemia by mutivariate regression (p < 0.001). A cut-off value for relative TSB at stoppage of phototherapy of 190 µmol/L had 98% sensitivity and 32% specificity to predict rebound hyperbilirubinemia.
Conclusion Relative TSB at phototherapy termination is the best predictor for postphototherapy rebound hyperbilirubinemia in neonates with hemolytic etiology.
Key Points
Wide Excision with Immediate Reconstruction of the Mandible Using Free Fibular Flap in Ameloblastoma of the Mandible—A Need of Time: Our Experience of 37 Cases
Authors: Saraiya Hemant A. 
Published: November 2020

Abstract
Background Ameloblastoma is a benign yet locally aggressive odontogenic tumor of the jaw with high recurrence rates. Despite many studies, the search is still on for the treatment approach which can render the acceptable recurrence rates with good functional and esthetic results.
Methods In this prospective study, we operated on 37 patients of mandibular ameloblastoma between 2009 and 2018. Two patients were treated with curettage and chemical sterilization of the cavity. Resection of a tumor with a 2-cm margin was performed in the rest of 35 patients. The mandibular defect was primarily reconstructed with the microvascular free fibular flap in 29 patients.
Results The follow-up ranged from 6 months to 7.7 years with a mean of 5.1 years. A tumor recurred within a year in all two patients (100%) treated with curettage. Out of 35 radical excisions, only one patient (2.85%) developed recurrence 3 years after the disease-free interval. Good mouth opening, intelligible speech, satisfactory lower jaw shape, and facial profiles were achieved in all 29 patients who were treated with primary free fibular flap.
Conclusion We prefer wide excision with 2-cm margins on each side of a tumor with the primary reconstruction of the mandible in all cases of mandibular ameloblastoma. The free fibular microvascular flap is our treatment of choice as all defects of the mandible can be reconstructed with the free fibular flap. Wide excision is the key to prevent a recurrence.
Return to Sport and Work after Randomization for Knee Distraction versus High Tibial Osteotomy: Is There a Difference?
Authors: Hoorntje Alexander , Kuijer P. Paul F. M. , Koenraadt Koen L. M. , Waterval-Witjes Suzanne , Kerkhoffs Gino M. M. J. , Mastbergen Simon C. , Marijnissen Anne C. A. , Jansen Mylène P. , van Geenen Rutger C. I. 
Published: November 2020

AbstractKnee joint distraction (KJD) is a novel technique for relatively young knee osteoarthritis (OA) patients. With KJD, an external distraction device creates temporary total absence of contact between cartilage surfaces, which results in pain relief and possibly limits the progression of knee OA. Recently, KJD showed similar clinical outcomes compared with high tibial osteotomy (HTO). Yet, no comparative data exist regarding return to sport (RTS) and return to work (RTW) after KJD. Therefore, our aim was to compare RTS and RTW between KJD and HTO. We performed a cross-sectional follow-up study in patients <65 years who previously participated in a randomized controlled trial comparing KJD and HTO. Out of 62 eligible patients, 55 patients responded and 51 completed the questionnaire (16 KJDs and 35 HTOs) at 5-year follow-up. The primary outcome measures were the percentages of RTS and RTW. Secondary outcome measures included time to RTS/RTW, and pre- and postoperative Tegner's (higher is more active), and Work Osteoarthritis or Joint-Replacement Questionnaire (WORQ) scores (higher is better work ability). Patients' baseline characteristics did not differ. Total 1 year after KJD, 79% returned to sport versus 80% after HTO (not significant [n.s.]). RTS <6 months was 73 and 75%, respectively (n.s.). RTW 1 year after KJD was 94 versus 97% after HTO (n.s.), and 91 versus 87% <6 months (n.s.). The median Tegner's score decreased from 5.0 to 3.5 after KJD, and from 5.0 to 3.0 after HTO (n.s.). The mean WORQ score improvement was higher after HTO (16 ± 16) than after KJD (6 ± 13; p = 0.04). Thus, no differences were found for sport and work participation between KJD and HTO in our small, though first ever, cohort. Overall, these findings may support further investigation into KJD as a possible joint-preserving option for challenging “young” knee OA patients. The level of evidence is III.
Are Elevated Nicotine and Cotinine Levels Associated with Early Femoral Component Subsidence in Press-Fit, Primary Total Hip Arthroplasty?
Authors: Muffly Brian T. , Jacobs Cale A. , Duncan Stephen T. 
Published: November 2020

AbstractTobacco exposure negatively affects bone mineral density and early osseointegration of surgical implants. We sought to determine if elevated nicotine and/or cotinine levels prior to primary total hip arthroplasty (THA) are associated with early femoral component subsidence. We hypothesize that tobacco users will have higher rates of readmission/reoperation and increased radiographic subsidence. We conducted an institutional review of 75 patients (average age = 52.9 years; 55% females; body mass index = 31.3) who underwent THA from April 2017 to January 2018. Immediate postoperative radiographs were compared with those obtained at 2 to 6 weeks postoperatively to determine early femoral component subsidence. Of the 75 patients, 10 (13.3%) had early radiographic femoral component subsidence ≥ 2 mm. In this group, preoperative nicotine levels were significantly elevated (7.2 vs. 1.5ng/mL; p = 0.04), whereas preoperative cotinine levels did not statistically differ (108.3 vs. 33.8 ng/mL; p = 0.45). A significantly greater magnitude of subsidence was seen in those with elevated preoperative nicotine levels compared with those with normal levels (1.7 vs. 0.5 mm; p = 0.04). The mean time to radiographic follow-up was 2.6 weeks. Surgical approach, implant type, categorical variables, and patient readmission were not associated with ≥ 2 mm of early subsidence. There was a single reoperation for periprosthetic fracture, but none was related to instability from subsidence. Early femoral component subsidence was more prevalent in patients with elevated preoperative nicotine levels. Rates of readmission/reoperation at 90 days did not differ between those with and without elevated tobacco markers. Clinically relevant thresholds of preoperative nicotine and/or cotinine values are needed to better delineate appropriate surgical candidates to achieve optimal surgical outcomes.
Ex Vivo Ovine Model for Surgical and Microsurgical Training on Parotidectomy and Facial Nerve Reanimation: Proposal of Structured Training Program
Authors: Ghirelli Michael , Federici Gaia , Melchiorri Claudio , Malagoli Andrea , Presutti Livio , Fernandez Ignacio Javier 
Published: November 2020

Abstract
Introduction Facial nerve palsy has a great physical and psychological impact on patients, so the avoidance of facial nerve damage during surgery and its reanimation are important for Otolaryngologists and head and neck surgeons. The acquisition of anatomical knowledge and surgical training regarding the parotid surgery and facial nerve is mandatory, but not easy to achieve. Surgical simulation is a reliable alternative to the on-the-job learning. In the study, we tested an ex vivo animal model to obtain the basic and advanced skills of parotid gland surgery and facial nerve reconstruction/reanimation.
Materials and Methods A prospective cohort study has been conducted on ovine head and neck specimen. A junior resident, a senior resident, and an expert surgeon were involved in a step-by-step preplanned dissection, divided in macroscopic and microscopic. Each procedure was recorded and evaluated by an expert surgeon following an adapted rating scale.
Results A statistically significant improvement in terms of execution times and quality of the work was show in most of the surgical steps and for many quality items by the junior and senior residents, while the expert surgeon, as expected, did not show any improvement.
Discussion Our ex vivo ovine model provided the trainee with close-to-real tissues in term of elastic resistance and consistency, to learn the skills requested in a head and neck surgery, on a reproducible environment. It is mandatory to have a feedback, which focuses on the quality of the work through valid and reliable assessment of technical skills. The judgment parameters should be reproducible and focused on the specific surgical procedure. Some limitations to this study are present, such as anatomical differences between ovine and human and the limited number of study participants.
Conclusion This proposal of training program on the ex vivo ovine model for the acquisition of skills needed in head and neck surgery proved to be feasible, effective, repeatable, and cheap.
Leukopenia and Neutropenia at Birth and Sepsis in Preterm Neonates of <32 Weeks' Gestation
Authors: Shah Jyotsna , Balasubramaniam Tharshini , Yang Jie , Shah Prakesh S. 
Published: November 2020

Objective This study aimed to evaluate associations between leukopenia or neutropenia at birth and risk of sepsis in very preterm neonates.
Study Design We conducted a retrospective unmatched cohort study of neonates of <32 weeks' gestation. Those with leukopenia (≤5,000/µL) were compared with a unmatched cohort without leukopenia. Comparisons were also made for patients with neutropenia and without neutropenia. The outcomes were early-onset sepsis, late-onset sepsis, and mortality.
Results We identified 271 neonates with leukopenia at birth and 271 without. Multivariable analyses identified higher odds of early-onset sepsis (adjusted odds ratio [AOR] = 4.85, 95% confidence interval [CI]: 1.29–18.20) in leukopenic neonates. Of neonates with leukopenia, 183 had both leukopenia and neutropenia and were associated with the highest odds of early-onset sepsis (AOR = 6.94, 95% CI: 1.77–27.15) compared with those with neither or with either alone.
Conclusion Leukopenia, neutropenia, and both leukopenia and neutropenia at birth were associated with early-onset sepsis in very preterm neonates.
Key Points
Structure of theDietziaMrp complex reveals molecular mechanism of this giant bacterial sodium proton pump
Authors: Li Bin , Zhang Kaiduan , Nie Yong , Wang Xianping , Zhao Yan , Zhang Xuejun C. , Wu Xiao-Lei 
Published: November 2020

SignificanceMultiple resistance and pH adaptation (Mrp) complexes are the most sophisticated known cation/proton exchangers and are essential for the survival of a vast variety of alkaliphilic and/or halophilic microorganisms. Moreover, this family of antiporters represents the ancestor of cation pumps in nearly all known redox-driven transporter complexes, including the complex I of the respiratory chain. For the Mrp complex, an experimental structure is lacking. We now report the structure of Mrp complex at 3.0-Å resolution solved using the single-particle cryo-EM method. The structure-inspired functional study of Mrp provides detailed information for further biophysical and biochemical investigation of the intriguingly pumping mechanism and physiological functions of this complex, as well as for exploring its potential as a therapeutic drug target.
β-Cyclodextrin modified Pt(II) metallacycle-based supramolecular hyperbranched polymer assemblies for DOX delivery to liver cancer cells
Authors: Chen Wenzhuo , Li Xuefeng , Liu Chengfei , He Jia , Qi Miao , Sun Yue , Shi Bingbing , Sepehrpour Hajar , Li Hui , Tian Wei , Stang Peter J. 
Published: November 2020

Significance
The development of chemotherapeutic drugs for cancer treatment has been limited by problems such as adverse side effects and inefficient performance of the drugs. To deliver multiple anticancer drugs for accurate and synergistic liver cancer treatment, a Pt(II) metallacycle-based drug delivery system, with endogenous redox and nitric oxide stimuli responsiveness and two chemotherapeutic agents is designed via the orthogonal self-assembly strategy. In vitro studies demonstrate that this system has good ability to deliver hydrophobic anticancer drug doxorubicin to HepG2 liver cancer cells. It also efficiently inhibits tumor cell growth for enhanced liver cancer treatment. This study provides an opportunity for the further design of metallacycle-based drug delivery systems for cancer therapy.
An empirical evaluation of Chinese college admissions reforms through a natural experiment
Authors: Chen Yan , Jiang Ming , Kesten Onur 
Published: November 2020

Significance
While college admission decisions impact the educational experiences and labor market outcomes for millions of students each year, the best method to determine admissions has been vigorously debated by academics and policymakers across the globe. Driving this debate are a number of major theoretical and practical innovations over the past 2 decades. Using a natural experiment from China, we evaluate the performance of the immediate acceptance mechanism, used for many years for college admissions in China and school choice in the United States, and the newer parallel mechanism. We find that when provinces move to the parallel mechanism, students apply to more colleges and list more prestigious colleges first. We further find that the student–college matchings become more stable.
Unbiased optical mapping of telomere-integrated endogenous human herpesvirus 6
Authors: Wight Darren J. , Aimola Giulia , Aswad Amr , Jill Lai Chi-Yu , Bahamon Christian , Hong Karl , Hill Joshua A. , Kaufer Benedikt B. 
Published: November 2020

Significance
Low-complexity and repetitive elements are difficult to study using existing sequencing technologies. Determination of the boundaries and structures of the termini of inherited chromosomally integrated HHV-6 (iciHHV-6) genomes is particularly challenging, as it integrates into highly repetitive human telomeres. We therefore developed a genome imaging approach that revealed the chromosomal location of the virus, its orientation, the presence of long internal telomeres at the host−virus junction, and the lengths of the distal telomeres capping the integrated virus genome. This genome imaging approach has wide applications for mapping transposable elements or large viruses that integrate into low-complexity regions of host genomes.