bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Retrospective Study of Treatment Outcomes and Prognostic Factors of Intense Pulsed Light Therapy Combined With Meibomian Gland Expression in Patients With Meibomian Gland Dysfunction
Authors: Tang Yun , Liu Ruixing , Tu Ping , Song Wenjing , Qiao Jing , Yan Xiaoming , Rong Bei 
Published: April 2020

Objectives:
To evaluate clinical changes after intense pulsed light and meibomian gland expression (IPL/MGX) treatment in meibomian gland dysfunction (MGD) patients, and to identify ideal candidates, and the therapeutic window, for IPL/MGX.

Methods:
This retrospective study reviewed the medical records of 44 MGD patients (44 eyes). The IPL/MGX treatment was applied on the eyelids three times at intervals of 4 weeks. Age, sex, relevant ocular history, Standard Patient Evaluation of Eye Dryness (SPEED), Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), corneal fluorescein staining score (CFSS), meiboscore, meibomian gland loss score (MGLS), meibomian glands yielding secretion score (MGYSS), meibomian glands yielding clear secretion (MGYCS), and meibomian glands yielding liquid secretion (MGYLS) were analyzed.

Results:
Standard Patient Evaluation of Eye Dryness, OSDI, TBUT, CFSS, MGYSS, MGYLS, and MGYCS were significantly improved after three IPL/MGX treatments, but the meiboscore and MGLS remained unchanged. In patients who had better treatment outcomes (improvement in MGYSS >7), younger age (36.0, 22.5 vs. 53.0, 25.0 years; P=0.012), a longer TBUT (8.0, 4.5 vs. 6.0, 3.0 sec; P=0.010), better meiboscore (1.0, 0.5 vs. 2.0, 1.0; P=0.012), and less gland loss (19.8%, 20.3% vs. 41.1%, 30.2%; P=0.008) before IPL/MGX were noted. Sex, relevant ocular history, SPEED, OSDI, MGYSS, MGYLS, and MGYCS before IPL/MGX showed no significant differences between patients with an improvement in MGYSS >7 versus those with an improvement of ≤7. Meibomian glands yielding secretion score changes in patients who had a meiboscore of 0 to 1 and MGYSS of 0 before IPL/MGX (12.0, 10.0) were significantly higher than those who had a meiboscore of 2 to 3 and MGYSS of 0 (6.5, 9.3; P=0.031), or a meiboscore of 0 to 1 and MGYSS >0 (5.0, 11.5; P=0.041).

Conclusions:
Improved dry eye symptoms, TBUT, corneal staining, and meibomian gland secretion were observed in MGD patients after IPL/MGX. Patients in the early stages of MGD maybe benefited most from IPL/MGX treatment.
Comparisons of Cornea Cold, a New Corneal Storage Medium, and Optisol-GS
Authors: Ho Joanne W. , Jung Hoon , Chau Mimi , Kuchenbecker James A. , Banitt Michael 
Published: April 2020

Purpose:
This study compares the quality of donor corneal tissue stored in Optisol-GS and Cornea Cold.

Methods:
Seventeen pairs of donor corneas were obtained from an eye bank. One of each pair was stored in Cornea Cold or Optisol-GS. Endothelial cell loss (ECL), central corneal thickness (CCT), and endothelial cell density (ECD) were measured at 7 and 21 days of storage. Qualitative metrics were evaluated by using a slit lamp.

Results:
At days 7 and 21, there were no observed differences in qualitative corneal health of the samples. There were no statistical differences in the mean ECL at 7 and 21 days between the 2 groups (P = 0.07 and P = 0.50, respectively). At 7 days, the mean CCT was 644 ± 52 μm in the Cornea Cold group and 591 ± 64 μm in the Optisol-GS group (P = 0.001). At 21 days, CCT was 714 ± 55 μm in the Cornea Cold group and 708 ± 58 μm in the Optisol-GS group (P = 0.70). The mean ECD was not statistically different between the groups (P = 0.56 at 7 days and P = 0.14 at 21 days).

Conclusions:
Storage of corneal donor tissue in the Optisol-GS and Cornea Cold storage media resulted in statistically comparable ECL and ECD for up to 21 days. CCT was higher in Cornea Cold at 7 days, but this discrepancy disappeared at 21 days.
Orbital Schwannoma—Management and Clinical Outcomes
Authors: Yong Kai-Ling , Beckman Timothy J. , Cranstoun Matthew , Sullivan Timothy J. 
Published: April 2020

Purpose:
To evaluate the clinical features, management, and outcomes of orbital schwannomas.

Methods:
Retrospective study analyzing 20 orbital schwannomas in 18 patients managed in an orbital service over 26 years. Clinical, radiological, histological, and surgical procedural data were analyzed.

Results:
Mean age of the study population was 40.89 ± 20.84 years. The most common nerve of origin was frontal nerve (50%), and majority of patients (70%) had a superior and/or posteriorly located tumor. Five patients (27.8%) had optic neuropathy at presentation, and 3 of them showed improved vision after intervention. Surgical resection was performed for all except for 1 patient who underwent fractionated stereotactic radiotherapy. Six subjects had extension of tumor into the cavernous sinus, and 3 of them underwent combined neurosurgical intervention with stereotactic neuronavigation. Outcomes were largely favorable with majority achieving complete excision. Two out of 6 incomplete resections experienced regrowth requiring second surgical intervention. Surgical complications include decreased vision, diplopia, ptosis, and mydriasis.

Conclusion:
Orbital schwannomas are uncommon slow-growing tumors which can result in visual loss. Prognosis can be favorable even in presence of pre-operative optic neuropathy if there is early intervention. Schwannomas confined to the orbit can usually be completely excised with good outcomes. Schwannomas extending intra-cranially may undergo incomplete excision to preserve vital structures, leaving residual disease, but generally have satisfactory results. Stereotactic neuronavigation and frozen section are useful intra-operative tool to aid management and minimize complications. Fractionated radiotherapy can be considered as an alternative or adjunctive treatment for patients not amenable for surgical resections.
Incidence and Risk Factors of Moderate to Severe Postoperative Pain Following the Placement of Primary and Secondary Orbital Implants: A Prospective Observational Study
Authors: Zhu Yanling , Li Zuohong , Chen Wenshi , Fan Peiting , Yang Shiying , Liu Xuehua , Guo Wenjun , Gan Xiaoliang 
Published: April 2020

Purpose:
To prospectively explore the incidence and risk factors of moderate to severe pain after primary and secondary orbital implantation following evisceration or enucleation surgery.

Methods:
One hundred eighteen patients under general anesthesia for orbital implantation were enrolled in this study. In 91 patients, primary orbital implantation followed evisceration, and in 27 patients, the implantation was secondary after previous evisceration or enucleation surgery. Medical interventions for all participants were followed by standardized surgical, anesthetic, and analgesic protocols. Postoperative pain (POP) intensity was quantified by an 11-point numerical rating scale within 72 hours after the surgery, numerical rating scale ≥4 was considered moderate to severe POP. Multivariate logistic regression was utilized to identify the risk factors related to the development of POP.

Results:
Thirty-five patients (29.7%) displayed moderate to severe POP, particularly within 6 to 24 hours after surgery, which peaked at 24 hours. Of these patients, 26 patients who were unable to tolerate the pain received additional doses of analgesics during in-hospital stay. Logistic regression model revealed that preoperative anxiety (odds ratios = 4.890; p = 0.002), congenital microphthalmia (odds ratios = 14.602; p = 0.038), and surgical time longer than 60 minutes (odds ratios = 5.586; p = 0.001) were significantly associated with moderate to severe POP after orbital implantation.

Conclusions:
Orbital implantation after evisceration or enucleation surgery is likely to cause moderate to severe pain intensity in the early postoperative period. Preoperative anxiety, prolonged surgical time, and congenital microphthalmia were the risk factors.
Topical Corticosteroid Use Associated With Increased Degree of Ptosis and Rate of Ptosis Repair Failure
Authors: Dermarkarian Christopher R. , Williams Katherine J. , Sweeney Adam R. , Allen Richard C. , Yen Michael T. 
Published: April 2020

Purpose:
To compare the degree of ptosis and the risk of ptosis repair failure among patients with and without a history of topical corticosteroid use.

Methods:
Retrospective, case-controlled study examining topical corticosteroid use among adults with ptosis who underwent external levator advancement/resection (ELR) or Müller muscle conjunctival resection with at least 3 months postoperative follow-up. Comparative statistical analyses of surgical outcomes were performed amongst patients with and without history of topical corticosteroid use.

Results:
A total of 240 patients (406 eyelids) met study criteria, of which 36 patients (44 eyelids) had history of topical corticosteroid use. Mean preoperative margin reflex distance was 0.20 mm and 0.58 mm for topical corticosteroid and non-corticosteroids users (p = 0.01). Mean preoperative levator function was 9.78 mm and 10.38 mm for topical corticosteroid and non-corticosteroid users (p = 0.02). The rate of ptosis repair failure was 30% and 16% in patients with and without a history of topical corticosteroid use (odds ratio 2.25, 95% confidence interval 1.10–4.55; p = 0.03). The rate of recurrence per surgical type in eyelids with and without history of topical corticosteroid use was: external levator advancement/resection 11/27 (41%) and 48/266 (18%) (odds ratio = 3.12, confidence interval 1.36–7.15 0; p = 0.01); Müller muscle conjunctival resection 2/17 (12%) and 9/96 (9%) (odds ratio 1.29, confidence interval 0.25–6.56; p = 0.76).

Conclusions:
Topical corticosteroid use is associated with more severe presenting ptosis and increased rates of ptosis repair failure. Compared to Müller muscle conjunctival resection, there is a significantly higher rate of ptosis repair failure in patients undergoing external levator advancement/resection.
Validity and Reliability Study of the Turkish Version of Multiple Sclerosis Self-Management Scale
Authors: Erbay Öznur , Usta Yeşilbalkan Öznur , Yüceyar Nur , Baklan Meltem , Karadakovan Ayfer , Tekindal Mustafa Agah 
Published: April 2020

ABSTRACT

OBJECTIVE
This study aimed to establish the equivalence, reliability, and validity of the Multiple Sclerosis Self-Management Scale Turkish Version (MSSM-T).

METHODS
This methodological study consisted of 240 multiple sclerosis (MS) patients who were followed in an outpatient clinic of a university hospital between October 2016 and April 2017. Data were collected using the demographic characteristics form and the 24-item MSSM-T. Language equivalence, content validity, and construct validity methods were used for the validity of the scale; internal consistency, item analysis, and test-retest methods were used for the reliability. Explanatory factor analysis was used for construct validity, and principal component analysis and varimax rotation were used in the analysis of factor structure.

RESULTS
The item-total correlations for the Turkish version were found to be sufficient (between 0.238 and 0.674). The Cronbach α reliability coefficient was 0.85, indicating high reliability. The test-retest reliability coefficient was 0.84, indicating high consistency. The Turkish version was found to have 5 factors for the 24 items (F1, healthcare provider relationship/communication; F2, knowledge and information about MS; F3, treatment adherence/barriers; F4, maintaining health behavior; and F5, social/family support), which accounted for the 62.584% of the characteristics in question.

CONCLUSION
The MSSM-T is valid and reliable in determining the self-management behaviors of patients with MS for Turkish patients.
Transitioning to non-insulin therapy in a patient receiving high dose insulin
Authors: Mishriky Basem M. , Cummings Doyle M. , Mendez Carlos E. , Patil Shivajirao P. , Powell James R. 
Published: April 2020

ABSTRACT
In people with type 2 diabetes with evidence of obesity-related insulin resistance, use of insulin to treat hyperglycemia has not been shown to reduce macrovascular complications, despite widespread use for many years. However, newer classes of diabetes medications, designed to address the prevalent pathophysiologic defect of type 2 diabetes, have emerged. Consequently, in many patients, reduction of insulin doses or even total elimination is possible after the addition of these newer agents. The authors suggest a cautious approach in which people with type 2 diabetes and established cardiovascular disease who are on high insulin doses (>1.0 unit/kg/day) be treated with diabetes medications that showed evidence of cardiovascular benefit (such as glucagon-like peptide-1 receptor agonists [GLP-1RAs]), on whom close monitoring is crucial because they may be at particular risk for developing hypoglycemia. This approach can be labor intensive and may be challenging for busy primary care providers for who may have limited time to evaluate and follow the patient. The authors present a case report of adding a GLP-1RA to high insulin doses. If the hemoglobin A1c is <8.0% when GLP-1RA is added, insulin doses should be reduced by 20%. Patients should be monitored at least every 4 weeks initially until it is confirmed there is no hypoglycemia risk. If glycemic targets (defined as fasting or preprandial glucose level between 80 and 130 mg/dl) are consistently achieved, providers may consider proactively reducing insulin doses by 10–20% to avoid hypoglycemia. The authors recommend creating appropriate goals and expectation before initiating this process.
The Incidence of Hemorrhagic Complications Was Lower With the Guide Sheath Than With the Conventional Forceps Biopsy Method
Authors: Horinouchi Hirohisa , Asano Fumihiro , Okubo Kenichi , Okada Yoshinori , Ohsaki Yoshinobu , Komase Yuko , Hashizume Toshinori , Kohno Mitsutomo , Aoe Motoi 
Published: April 2020

Background:
The Japan Society for Respiratory Endoscopy performed a nationwide survey to evaluate the current status and complications of bronchoscopy. Data on deaths due to bronchoscopy, complications after bronchoscopy, and particularly, complications of forceps biopsy were surveyed.

Methods:
The survey form was mailed to 532 facilities accredited by the society. The numbers of procedures, complications, and deaths were investigated.

Results:
The response rate was 79.1% (421 facilities). Deaths attributable to diagnostic bronchoscopy occurred in 11 (0.011%) of 98,497 cases.
In regards to forceps biopsy, the guide sheath method was applied in 23,916 cases and the conventional method in 31,419 cases was done with conventional method. Complications of forceps biopsy developed in 1019 cases in total, with an incidence rate of 1.84%. The most frequent complication was pneumothorax (0.70%), followed by pneumonia/pleurisy (0.46%) and hemorrhage (0.45%). The incidence of hemorrhagic complication was significantly lower in the guide sheath group than in the non-guide sheath group (0.29% vs. 0.58%; P<0.001). The overall incidence of complications (1.63% vs. 2.00%; P=0.002) and the mortality rate (0% vs. 0.02%; P=0.04) were significantly lower in the guide sheath group.

Conclusion:
The incidence of hemorrhagic complications in forceps biopsy of peripheral pulmonary lesions was lower when the guide sheath method was applied. It is necessary to increase the awareness for safety control in diagnostic bronchoscopy for new procedures.
Ethanolamine Oleate for Bronchopleural Fistula
Authors: Alcaraz Sandra R. , García Maria Del Mar , Giménez Andrés , Fernández Cleofé , Sesma Julio , Bolufer Sergio , Martín Concepción 
Published: April 2020

Background:
Bronchopleural fistula (BPF) is a severe complication of pulmonary resection associated with high morbidity and mortality. Treatment options include both surgical and endoscopic procedures. The size of the fistula and the functional status of the patient are decisive factors in the choice of treatment. The aim of this study is to describe the experience of using ethanolamine oleate (EO) in endoscopic treatment for BPFs.

Methods:
A prospective observational, descriptive study, involving patients with subcentimeter BPF and treated with EO. The diagnosis of the fistula was confirmed by flexible bronchoscopy. Patients under conscious sedation received a perifistular injection of EO with a Wang 22-G needle. The procedure was repeated every to 2 weeks until definitive closure.

Results:
Eight patients were included: in 7 (87.5%), the fistula was a complication of lung cancer surgery. The number of sessions needed before the resolution of the BPF was from 1 to 4. Only 1 patient received 4 sessions. Complete closure was obtained in 6 patients (75%). None of the fistulas reopened, and there were no serious complications.

Conclusion:
Sclerosis with EO through endoscopic injection enables the closure of small (<1 cm) BPFs after a limited number of sessions and with scarce morbidity. These results suggest that EO could be a valid treatment option for selected patients.
A 17-gene expression-based prognostic signature associated with the prognosis of patients with breast cancer
Authors: Qian Jin-Xian , Yu Min , Sun Zhe , Jiang Ai-Mei , Long Bo 
Published: April 2020

Abstract
Identification of reliable predictive biomarkers for patients with breast cancer (BC).
Univariate Cox proportional hazards regression model was conducted to identify genes correlated with the overall survival (OS) of patients in the TCGA-BRCA cohort. Functional enrichment analysis was conducted to investigate the biological meaning of these survival related genes. Then, patients in TCGA-BCRA were randomly divided into training set and test. Least absolute shrinkage and selection operator (LASSO) penalized Cox regression model was performed and the risk score of BC patients in this model was used to build a prognostic signature. The prognostic performance of the signature was evaluated in the training set, test set, and an independent validation set GSE7390.
2519 genes were demonstrated to be significantly associated with the OS of BC patients. Functional annotation of the 2519 genes suggested that these genes were associated with immune response and protein synthesis related gene ontology terms and pathways. 17 genes were identified in the LASSO Cox regression model and used to construct a 17-gene signature. Patients in the 17-gene signature low risk group have better OS and event-free survival compared with those in the 17-gene signature high risk group in the TCGA-BRCA cohort. The prognostic role of the 17-gene signature has been confirmed in the validation cohort. Multivariable Cox proportional hazards regression model suggested the 17-gene signature was an independent prognostic factor in BC.
The 17-gene signature we developed could successfully classify patients into high- and low-risk groups, indicating that it might serve as candidate biomarker in BC.
Ingested a fish bone-induced ileal perforation
Authors: Song Junchuan , Yang Weijin , Zhu Yuewen , Fang Yongchao , Qiu Jiandong , Qiu Jianshen , Lin Lan , Wu Weihang , Lin Chen , Wang Yu 
Published: April 2020

Abstract

Introduction:
Gastrointestinal perforation due to foreign body intake is rare and often secondary to unintentional intake; hence, a misdiagnosis is likely. Herein, we report a case of perforation of the ileum due to fish bone.

Case presentation:
A 57-year-old woman presented with right lower abdominal pain. She did not provide any information about having a history of swallowing foreign bodies. Surgery for uterine fibroids and subtotal gastrectomy was performed 6 years ago.

Diagnosis:
Laboratory tests and imaging examination showed normal results. During laparotomy, a fish bone was found at the end of the ileum. Two senior radiologists re-evaluated the computed tomography scan, and confirmed the presence of the suspected foreign body.

Interventions:
Partial intestinal resection and manual ileum end anastomosis were performed.

Outcomes:
The patient recovered well after surgery and recalled that she had eaten fish the night before experiencing abdominal pain.

Conclusion:
An accurate diagnosis of complications due to fish bone intake, often secondary to the unintentional intake, is quite challenging. Detailed history-taking about the patient's diet and eating habits is therefore important. Clinical manifestations are mainly determined by the location of perforation, which typically occurs at the junction of the ileum and rectal sigmoid colon. Imaging examination and surgery are often used for definite diagnosis.
Association between CD24 Ala/Val polymorphism and multiple sclerosis risk
Authors: Yang Wan , Zhou Wang , Zhang Bo-Kang , Kong Ling-Suo , Zhu Xing-Xing , Wang Rui-Xiang , Yang Yue , Chen Yun-Fei , Chen Lan-Ren 
Published: April 2020

Abstract

Background:
The aim of this study was to explore the association between CD24 Ala/Val polymorphism and susceptibility of multiple sclerosis (MS).

Methods:
A comprehensive literature search for relevant studies was performed on google scholar, PubMed, Web of science, Embase, the Chinese National Knowledge Infrastructure and the Chinese Biology Medicine. This meta-analysis was conducted using the STATA 11.0 software and the pooled odds ratio with 95% confidence interval was calculated.

Results:
Seven case-control studies were included in this meta-analysis. The results showed significant association between CD24 Ala/Val polymorphism and susceptibility to MS. Stratified analysis by areas also showed significant association in Asians. However, no association was found in Europeans.

Conclusion:
This study suggested that the CD24 Val allele was associated with an increased risk of MS and larger-scale studies of populations are needed to explore the role of CD24 Ala/Val polymorphism during the pathogenesis of MS.
Gait pattern analysis and clinical subgroup identification: a retrospective observational study
Authors: Kyeong Sunghyon , Kim Seung Min , Jung Suk , Kim Dae Hyun 
Published: April 2020

AbstractTo identify basic gait features and abnormal gait patterns that are common to different neurological or musculoskeletal conditions, such as cerebral stroke, Parkinsonian disorders, radiculopathy, and musculoskeletal pain.In this retrospective study, temporal-spatial, kinematic, and kinetic gait parameters were analyzed in 424 patients with hemiplegia after stroke, 205 patients with Parkinsonian disorders, 216 patients with radiculopathy, 167 patients with musculoskeletal pain, and 316 normal controls (total, 1328 subjects). We assessed differences according to the condition and used a community detection algorithm to identify subgroups within each condition. Additionally, we developed a prediction model for subgroup classification according to gait speed and maximal hip extension in the stance phase.The main findings can be summarized as follows. First, there was an asymmetric decrease of the knee/ankle flexion angles in hemiplegia and a marked reduction of the hip/knee range of motion with increased moment in Parkinsonian disorders. Second, three abnormal gait patterns, including fast gait speed with adequate maximal hip extension, fast gait speed with inadequate maximal hip extension, and slow gait speed, were found throughout the conditions examined. Third, our simple prediction model based on gait speed and maximal hip extension angle was characterized by a high degree of accuracy in predicting subgroups within a condition.Our findings suggest the existence of specific gait patterns within and across conditions. Our novel subgrouping algorithm can be employed in routine clinical settings to classify abnormal gait patterns in various neurological disorders and guide the therapeutic approach and monitoring.