bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical Tacrolimus in Thygeson Superficial Punctate Keratitis
Authors: Shoughy Samir S. , Tabbara Khalid F. 
Published: December 2019

Purpose:
To evaluate the efficacy of topical tacrolimus 0.02% eye drops in the treatment of patients with Thygeson superficial punctate keratitis.

Methods:
Ten consecutive patients with Thygeson superficial punctate keratitis were included retrospectively. Seven patients were unresponsive to topical steroids and/or lubricants. Diagnosis was made based on the history and clinical findings. All patients were treated with topical tacrolimus 0.02% solution twice daily. Outcome measures included improvement in symptoms of tearing and photophobia, whereas improvement in signs included decrease in the number of the lesions, resolution of the lesions, flattening of the lesions, and decrease in stain of the lesions.

Results:
There were 3 male and 7 female patients with an age range of 3 to 51 years (mean 17 years). All patients had bilateral ocular involvement. Duration of treatment ranged from 1 to 42 weeks (mean 10 weeks). All patients had subjective improvement in symptoms of tearing and photophobia and resolution of the superficial punctate keratitis. The response to treatment was noted 72 hours after initiation of therapy in all patients. Topical tacrolimus was well tolerated in all patients.

Conclusions:
Topical tacrolimus 0.02% is safe and effective in reducing ocular surface inflammation in patients with Thygeson superficial punctate keratitis who are not responsive to conventional therapy. Tacrolimus is helpful as a steroid-sparing agent to avoid vision-threatening complications.
Effects of Different Doses of Systemic Isotretinoin on Eyes: A Histopathological and Immunohistochemical Study in Rats
Authors: Karadag Remzi , Karadag Ayse Serap , Ozlu Emin , Oguztuzun Serpil , Simsek Gulcin Guler , Esmer Oktay , Onder Sevda , Bilgili Serap Gunes 
Published: December 2019

Purpose:
To evaluate ocular side effects associated with systemic isotretinoin histopathologically.

Methods:
In this multicenter study, a total of 15 male and 15 female rats were randomly divided into 3 equal groups according to the oral dose of isotretinoin they were administered: 0 mg/kg/d (group A), 7.5 mg/kg/d (group B), and 15 mg/kg/d (group C). Biopsy specimens were taken from the globe conjunctiva, cornea, and eyelid conjunctiva. Expression levels of human beta-defensin-1, human beta-defensin-2, toll-like receptor (TLR)-2, and TLR-4 were evaluated by immunohistochemical methods.

Results:
The number of goblet cells in eyelid conjunctiva was significantly lower in group B than that in group A and group C (P = 0.002). The sizes of meibomian gland acini were significantly smaller in group B and group C than those in group A (P < 0.001). Fibrosis of eyelid conjunctiva was significantly higher in group C and group B than that in group A (P = 0.002). The levels of staining of TLR-4 in the cornea with group B were significantly lower compared with group C (P = 0.035).

Conclusions:
Our study suggests that isotretinoin in the early period affects eyelid conjunctiva and meibomian glands without affecting the globe conjunctiva and cornea. Occurrence of the initial symptoms of isotretinoin on the eyelids, especially on the meibomian glands, suggests that the symptoms of patients occur because of evaporative dry eye.
Relationship Between Bereavement Reaction With Posttraumatic Stress Disorder and Depression in Organ Donor Families in Iran
Authors: Tirgari Batool , Samareh Hamideh , Forouzi Mansooreh Azzizadeh 
Published: December 2019

ABSTRACT

BACKGROUND: This study aimed to determine the relationship among bereavement, depression, and posttraumatic stress disorder (PTSD) in organ donor families in Iran. METHODS: This is a correlational study of 96 family members of brain-dead patients whose organs were donated. Using census sampling method, we approached the families through the Kerman University's Organ Donation Center. Data were collected using the Core Bereavement Items, Beck Depression Inventory, and Impact of Event Scale-Revised. RESULTS: The mean (SD) total score of bereavement, depression, and PTSD were 38.44 (9.25), 18.01 (12.92), and 41.90 (12.69), respectively. Among bereavement subscales, the highest mean (SD) score belonged to the “Images and Thoughts” (15.96 [4.16]) and the lowest belonged to “Grief” (10.57 [3.16]). Among different aspects of PTSD, the Intrusion subscale had the highest mean (SD) score (19.25 [6.22]), and the Hyperarousal subscale had the lowest (11.23 [5.34]). The Pearson correlation coefficient showed that bereavement was positively correlated with both depression (r = 0.72, P < .001) and PTSD (r = 0.59, P < .001). CONCLUSION: Donor families experienced bereavement, PTSD, and depression after organ donation. Healthcare professionals should approach and assess these families for potential emotional-psychological consequences, provide emotional and practical support to alleviate their depression and PTSD, and assist them through the bereavement process.
Proceedings From the Ice Hockey Summit III: Action on Concussion
Authors: Smith Aynsley M. , Alford Patrick A. , Aubry Mark , Benson Brian , Black Amanda , Brooks Alison , Burke Charles , D'Arcy Ryan , Dodick David , Eaves Michael , Eickhoff Chad , Erredge Kristen , Farrell Kyle , Finnoff Jonathan , Fraser Douglas D. , Giza Christopher , Greenwald Richard M. , Hoshizaki Blaine , Huston John , Jorgensen Janelle , Joyner Michael , Krause David , LaVoi Nicole , Leaf Matthew , Leddy John , Margarucci Kevin , Margulies Susan , Mihalik Jason , Munce Thayne , Oeur Anna , Prideaux Cara , Roberts William O. , Shen Francis , Soma David , Tabrum Mark , Stuart Michael B. , Wethe Jennifer , Whitehead James , Wiese-Bjornstal Diane , Stuart Michael J. 
Published: December 2019

Objectives:
The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these 5 objectives: (1) describe sport related concussion (SRC) epidemiology; (2) classify prevention strategies; (3) define objective, diagnostic tests; (4) identify treatment; and (5) integrate science and clinical care into prioritized action plans and policy.

Methods:
Our action plan evolved from 40 scientific presentations. The 155 attendees (physicians, athletic trainers, physical therapists, nurses, neuropsychologists, scientists, engineers, coaches, and officials) voted to prioritize these action items in the final Summit session.

Results:
To (1) establish a national and international hockey database for SRCs at all levels; (2) eliminate body checking in Bantam youth hockey games; (3) expand a behavior modification program (Fair Play) to all youth hockey levels; (4) enforce game ejection penalties for fighting in Junior A and professional hockey leagues; (5) establish objective tests to diagnose concussion at point of care; and (6) mandate baseline testing to improve concussion diagnosis for all age groups.

Conclusions:
Expedient implementation of the Summit III prioritized action items is necessary to reduce the risk, severity, and consequences of concussion in the sport of ice hockey.
An Uneven Playing Field: Athlete Injury, Illness, Load, and Daily Training Environment in the Year Before the FINA (Aquatics) World Championships, 2017
Authors: Mountjoy Margo , Junge Astrid , Slysz Josh , Miller Jim 
Published: December 2019

Objective:
To assess athlete's training environment and health problems before the FINA World Championships (WC) (2017) and to analyze the differences between the 6 disciplines, gender, and countries with different medal rankings during the championships.

Design:
Retrospective anonymous questionnaire.

Setting:
FINA WC 2017.

Participants:
Registered aquatic athletes (swimmers, divers, high divers, water polo players, artistic swimmers, open water swimmers).

Main Outcome Measures:
The outcome measures included the following: training and competition load, availability of support staff, performance of injury prevention exercises, and prevalence of health problems. The independent variables included gender, aquatic discipline, and country group based on medal ranking.

Results:
In the 12 months preceding the Championships, 67% of the athletes reported physical complaints and 41% trained or competed with a diagnosed injury. Only half of the athletes reported that injury prevention exercises were always (29.9%) or often (23.4%) a regular part of their daily training. In the daily training environment, support staff (excluding coach) was not available or available only if the athlete pays in 28.4% (specialized trainer) to 58.9% (sport scientist) of cases. About one-quarter of the athletes rated the support offered by their National Team program as poor or very poor. There were discrepancies in training loads and support staff among the 6 aquatic disciplines. Availability of support staff, athlete's satisfaction with their training environment/support, and regular use of injury prevention exercises were higher in countries that ranked higher in the medal list.

Conclusions:
Injury prevention strategies should be promoted in aquatic sports, with prospective surveillance for the early identification of physical complaints. The facilitation of access to sport-specific experts could improve athlete's health and performance, especially in countries with low medal ranking.
A New In-Skates Balance Error Scoring System for Ice Hockey Players
Authors: Robert Antony , Moroz Mickey , Correa Jose A. , Var Danny , Delaney J. Scott 
Published: December 2019

Objective:
Evaluate a new in-skates balance error scoring system (SBESS) for ice hockey players wearing their equipment.

Design:
Prospective, randomized, single blinded study.

Setting:
Sport Medicine Clinic.

Participants:
Eighty university hockey players.

Intervention:
A control group performed the SBESS assessment at rest on 2 separate occasions and an experimental group performed the assessment at rest and after exertion. The SBESS consists of maintaining different stances on ice skates for 20 seconds each, while wearing full equipment (no stick, gloves and helmet) and standing on a hard rubber surface. Three independent reviewers scored the video recorded assessments.

Main Outcomes Measures:
Primary outcome was the number of balance errors and the secondary outcome was the number of falls.

Results:
The control group's median SBESS scores were 2 and 3 on the first and second attempts at rest, respectively. The experimental group's median SBESS scores were 2 at rest and 2 after exertion. There was no fatigue effect and no athletes fell while performing the test. Of the 4 stances tested, the tandem stance had the highest variability in error scores between athletes and when repeated by the same athlete. The intraclass correlation coefficient (ICC) for interrater reliability was above 0.82, and the intrarater reliability ICC was above 0.86 for all SBESS scores. There was no concordance between the SBESS and the modified BESS.

Conclusions:
The SBESS, omitting the tandem stance, is a safe and reproducible sideline balance assessment of ice hockey players wearing full equipment.
Single Intraosseous Injection of Simvastatin Promotes Endothelial Progenitor Cell Mobilization, Neovascularization, and Wound Healing in Diabetic Rats
Authors: Liu Can , Zhu Junxiong , Hai Bao , Zhang Wen , Wang Hong , Leng Huijie , Xu Yingsheng , Song Chunli 
Published: December 2019

Background:
This study explored the effect of a single local intraosseous application of a small dose of simvastatin on the wound healing process in type 1 diabetic rats and related mechanisms.

Methods:
The authors chose the streptozotocin-induced type 1 diabetic rat to establish a full-thickness dermal wound using a 12-mm-diameter sterile disposable punch. The rats (n = 32) were divided randomly into four groups: (1) normal control rats, (2) type 1 diabetic rats with intraosseous injection of hydrogel vehicle, (3) type 1 diabetic rats with intraosseous injection of simvastatin (0.5 mg), and (4) type 1 diabetic rats with intragastric administration of simvastatin (20 mg/kg per day). Wound closure was followed by digital planimetry. Mobilization of endothelial progenitor cells into the circulatory system was studied using fluorescence-activated cell sorting. Neovascularization was analyzed with immunofluorescence histochemical staining. The relative levels of adiponectin and stromal cell-derived factor 1 (SDF-1) in serum, bone, and wound tissues were examined by enzyme-linked immunosorbent assay and Western blot.

Results:
Diabetic rats exhibited impaired wound healing. Intraosseous administration of simvastatin accelerated wound healing beginning at day 4, and angiogenesis was more obvious than in the control group. Enzyme-linked immunosorbent assay revealed that adiponectin concentrations in the diabetic rats with intraosseous injection of hydrogel vehicle plus simvastatin 0.5-mg group were significantly higher compared with the diabetic rats with intraosseous injection of hydrogel vehicle group beginning at day 4. Intraosseous administration of simvastatin decreased the expression of adiponectin and SDF-1 in bone tissue but enhanced the expression of adiponectin in wounded skin.

Conclusions:
A single local intraosseous application of simvastatin promotes wound healing in type 1 diabetic rat. The underlying mechanisms may be attributed to the regulation of the adiponectin/SDF-1 pathway, which plays a pivotal role in endothelial progenitor cell mobilization and angiogenesis.
Social Isolation, Loneliness, and All-Cause Mortality in Patients With Cardiovascular Disease: A 10-Year Follow-up Study
Authors: Yu Bin , Steptoe Andrew , Chen Li-Jung , Chen Yi-Huei , Lin Ching-Heng , Ku Po-Wen 
Published: December 2019

ABSTRACT

Objective
Social isolation and loneliness have been associated with increased incidence of cardiovascular disease (CVD), but few studies have evaluated the impact of social isolation and loneliness on mortality in people with existing CVD, and these are limited to Western populations. We examined whether social isolation and loneliness are associated with increased risk of mortality in individuals with established CVD in Taiwan.

Methods
The cohort was composed of 1267 patients with confirmed CVD 65 years or older followed up for up to 10 years. Cox proportional hazard regression models were used to examine the association between social isolation and loneliness at baseline and mortality at follow-up by adjusting for demographic variables, health-related behaviors, and health status.

Results
There were 593 deaths during the follow-up period. Social isolation was associated with increased risk of mortality after accounting for established risk factors (hazard ratio [HR] = 1.16; 95% confidence interval [CI] = 1.06–1.26), whereas loneliness was not associated with increased risk of mortality (HR = 0.95; 95% CI = 0.82–1.09). When both social isolation and loneliness were included in the model, social isolation maintained an association with mortality (HR = 1.16; 95% CI =1.07–1.27).

Conclusions
Social isolation is associated with an increased risk of mortality in patients with CVD, and the effects are independent of loneliness. These findings expand our knowledge about the impact of social isolation on the outcomes of CVD in non-Western countries. Efforts to reduce isolation may have substantial benefits in terms of mortality in patients with CVD.
Pediatric Ventriculoperitoneal Shunt Infection: The Role of Shunt Tract Debridement in Mycobacterium abscessus Eradication
Authors: Abu-Ghname Amjed , Davis Matthew J. , Davies Lesley W. , Whitehead William E. , Buchanan Edward P. 
Published: December 2019

Abstract
Ventricular shunt infections caused by nontuberculous mycobacteria are uncommon, and those caused by Mycobacterium abscessus are particularly rare. This mycobacterium is intrinsically resistant to first-line anti-tuberculous drugs and is considered the most pathogenic of the atypical, rapidly growing mycobacteria. Given the paucity of reported M. abscessus ventricular shunt infections, the appropriate surgical treatment for these cases, especially in the pediatric setting, has yet to be described. The authors present a 4-year-old male with history of intraventricular hemorrhage resulting in hydrocephalus who presented with an M. abscessus ventricular shunt infection that disseminated to the skin and soft tissue of the entire shunt tract. Despite aggressive antimicrobial therapy, several shunt exchanges, and numerous incisions and debridements of separate infected tract areas, the patient's clinical course was prolonged by multiple relapses and re-admissions. Only after opening and debriding the entire length of the infected tract, which measured 100 cm2 and extended from the scalp to the groin, and months of intrathecal antibiotics did CSF and tissue culture results become negative, and the entire tract was able to be closed. This article describes the management of the second-encountered pediatric M. abscessus shunt infection along with the management of the 4 previously reported cases. In addition, it highlights the vital role of early, aggressive surgical debridement to achieve infection eradication.
The Role of Overriding Preseptal Orbicularis Oculi Muscle in Development of Involutional Lower Eyelid Entropion: Microscopic Viewpoints
Authors: Valencia Regina Paula , Kitaguchi Yoshiyuki , Nakano Takashi , Naito Munekazu , Ikeda Hiroshi , Kakizaki Hirohiko , Takahashi Yasuhiro 
Published: December 2019

Abstract
The aim of this study was to demonstrate the extent of preseptal orbicularis oculi muscle (OOM) override onto the pretarsal OOM in the lower eyelids. In this experimental microscopic study, 22 exenterated specimens from 22 Japanese cadavers were prepared as full-thickness sagittal sections. All exenterated specimens were devoid of lower eyelid entropion. The tarsal dimension and distance from the lower tarsal edge to the tip of overriding OOM were microscopically measured. The rotation axis of the tarsus was presumed to pass through the tarsal centroid and the distance from an estimated tarsal centroid to the lower tarsal edge was calculated. Consequently, 2 eyelids did not exhibit any overriding of the OOM. In the remaining 20 eyelids with OOM override, the average distance of the overriding OOM was found at a level covering 48.0% of the whole tarsal height. In 15 out of the 20 eyelids, the tip of the overriding OOM was located lower than the centroid. These microscopic findings suggest that overriding of the preseptal OOM does not always produce an inward rotational force on the tarsus.
Bite Force Simulator: A Novel Technique to Simulate Craniofacial Strain In Vitro
Authors: Ip Kenneth K.C. , You Peng , Moore Corey C. , Ferreira Louis M. 
Published: December 2019

Abstract
Existing in vitro simulators rely on external manipulation of the skull to replicate masticatory forces; however, external manipulations do not accurately represent internal loads as in physiological muscle forces.
The purpose of the project is to develop an in vitro simulator that internally replicates the forces of mastication. The simulator has 3-dimensional-printed piston mounts that are reverse-engineered using a computed tomography scan of the specimen. The mounts are attached to the skull at muscle attachment sites using adhesive. The pneumatic pistons are sutured to muscle tendons; when the pistons are activated, they pull on the tendons which proportionally replicate muscle loads. The force output of the pistons can be individually modified by a custom software. Strain gauges are attached to craniofacial bones to measure deformation under replicated muscle loads. A 6 degrees-of freedom force sensor is placed intraorally to measure the generated bite force.
The methodology was validated on 6 fresh-frozen cadaveric heads. Change in strain measurements was observed with change in simulated muscle loads. The simulator can validate computer simulation models and provide an experimental platform for craniofacial and dental implants. It sets the framework for a new, more physiologically consistent way of studying craniofacial stresses.
Calvarial Reconstruction With Autologous Sagittal Split Rib Bone Graft and Latissimus Dorsi Rib Myoosseocutaneous Free Flap
Authors: Hong Seung Heon , Lim So Young 
Published: December 2019

Objective:
Cranioplasty is essential because cranial defects cause cosmetic and functional problems, and neurologic sequalae in patients. However, reconstruction options are limited in patients with unfavorable conditions. This study aimed to review our experience with skull defect reconstruction using autogenous bone with sagittal split rib bone grafts or latissimus dorsi rib myoosseocutaneous free flaps.

Methods:
Patients who underwent autogenous bone graft for cranial defect coverage from December 2011 to November 2015 at our institution were reviewed. Rib bone graft or latissimus dorsi rib myoosseocutaneous free flaps were done to cover the defect. The patient follow-up period ranged from 3 months to 7 years.

Results:
There were 6 patients, with 9 surgeries. Two cases of latissimus dorsi rib myoosseocutaneous free flap procedures were performed in 2 patients and 7 sagittal split rib bone grafts were performed in 6 patients. There were no postoperative infections in any patients, despite 4 patients had previous surgical site infection histories. Two patients with neurologic sequalae showed improvement after the surgeries.

Conclusion:
Sagittal split rib bone graft and latissimus dorsi rib myoosseocutaneous free flap procedures could be fine options for calvarial reconstruction of defects under the unfavorable conditions of bilateral cranial defects or previous infection history.
Course of the Maxillary Vein and its Positional Relationship With the Mandibular Ramus Require Attention During Mandibuloplasty
Authors: Odaka Kento , Matsunaga Satoru 
Published: December 2019

Purpose:
The maxillary vein is associated with major hemorrhage, an intraoperative risk factor during mandibuloplasty. Our objectives in this study were to identify the anatomical course of the maxillary vein relative to the mandible, and to ascertain the relationship of its course with that of the maxillary artery.

Methods:
Thirteen sides of 13 cadavers in the possession of the Department of Anatomy of Tokyo Dental College were used. The maxillofacial region was first dissected, after which the upper part of the mandibular ramus was removed and the maxillary artery, maxillary vein, and pterygoid venous plexus were identified. The length of the maxillary vein and its height from the mandibular plane were then measured, and its anatomical course was recorded.

Results:
The maxillary vein ran downward along the inner aspect of the temporal muscle, then from the base of the coronoid process it ran horizontally near the bone surface of the inner aspect of the mandibular ramus. After joining the inferior alveolar vein, it joined the superficial temporal vein to form the retromandibular vein. The mean length of the maxillary vein was 22.2 ± 3.2 mm. At the posterior margin of the mandibular ramus, its mean height above the mandibular plane was 34.2 ± 5.4 mm. From the posterior margin of the mandibular ramus to the lowest point of the mandibular notch, the maxillary vein was located within the areolar connective tissue directly above the periosteum adjoining the inner aspect of the mandibular ramus.

Conclusions:
In the wide area from the center of the maxillary notch to the posterior margin of the mandibular ramus, the maxillary vein runs extremely close to the periosteum on the inner aspect of the mandibular ramus, suggesting that it may pose a risk of hemorrhage in various oral surgical procedures.