bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traction Applying Technique on Bicanalicular Crawford Silicone Tube to Overcome the Notching Deformity After Lacrimal Canalicular Repair
Authors: Baek Sang Oon , Kim Jae Won , Lee Jun Yong , Kwon Ho 
Published: August 2020

Abstract
Lower eyelid avulsion injury with lower canalicular laceration generally occur just medial to the punctum with insufficient skin remnant for repair causing tension on repair margins. The inevitable blinking force, along with the tension widens the repair margin, resulting in an aesthetically challenging notch at the medial lower lid. The authors attempted to minimize this notching deformity with a traction applying technique on bicanalicular silicone tube.
Fifteen patients were enrolled and divided into 2 groups: the experimental group with 10 patients which received the traction technique, and the control group with 5 patients which the traction technique was omitted. Each end of the bicanalicular silicone tube was intubated through both puncta and the lacerated canaliculus. No canalicular anastomosis was performed. The tube ends were retrieved through the nostril, followed by medial canthal tendon, orbicularis oculi muscle, and skin repair. The tube ends were pulled to create a tension on the loop, until upper and lower puncta apposed each other, creating a dimple in the medial canthal area. The tube ends were tied and anchored at internal valve of the nostril to maintain the traction tension. Medial lower lid notching (>2 mm width), epiphora, and conjunctival injection were evaluated and compared in the 2 groups.
Patients with traction technique showed symmetric medial canthal angle and minimized lower lid notching deformity when compared with the control group (P = 0.025). No conjunctival injections and epiphora were observed in either group. Symmetric and aesthetically satisfactory results were achieved by traction applying technique on bicanalicular silicone tube.
Biomechanical and Biochemical Analyses of the Effects of Propranolol on the Osseointegration of Implants
Authors: Tekin Samet , Dundar Serkan , Demirci Fatih , Bozoglan Alihan , Yildirim Tuba Talo , Karaman Tahir , Gul Mehmet 
Published: August 2020

Abstract
This study aimed to investigate the effects of systemic propranolol on the osseointegration of titanium implants. After the surgical insertion of titanium implants into the metaphyseal part of the tibiae of rats, the rats were randomly divided into three equal groups: the control (n = 8), propranolol dosage-1 (PRP-1) (n = 8), and propranolol dosage-2 (PRP-2) (n = 8) groups. In the control group, the rats received no further treatment during the 4-week experimental period after the surgery. After the surgical insertion of the implants, the rats in the PRP-1 and PRP-2 groups were given 5 mg/kg and 10 mg/kg propranolol, respectively, every 3 days for the 4-week experimental period. After the experimental period, the rats were euthanized. Blood sera were collected for biochemical analysis, and the implants and surrounding bone tissues were used for the biomechanical reverse torque analysis. One-way ANOVA and Tukey's honest significant difference test were used for statistical analysis. The student t-test was used to analyze the data obtained from the tests and the controls. There were no significant differences in the reverse torque analysis results and the biochemical parameters (alkaline phosphatase, calcium, and phosphorus) of the groups (P > 0.05). Alkaline phosphatase was, however, found to be higher in test animals compared to the controls (P < 0.05). Also, propranolol did not biomechanically affect the osseointegration of titanium implants, while alkaline phosphatase activity was higher in the test animals.
Location of Central Sulcus According to Coronal Suture
Authors: Ekşi Murat Şakir , Güdük Mustafa , Usseli Murat Imre , Pamir M. Necmettin 
Published: August 2020

Background:
It is essential to localize the central sulcus in patients with lesions within or nearby the sensorial and/or motor cortex. The coronal suture is a valuable bony landmark in neurosurgical practice; it could be used to localize the central sulcus. There are scarce amount of literature about normal values of the distance between the central sulcus and the coronal suture. In the present study, the authors aimed to learn normative values of the distance between the central sulcus and the coronal suture in a patient sample representing Turkish population. The authors also aimed to look for any difference in values according to sex and age.

Methods:
The authors retrospectively reviewed a prospectively collected database. Patients were evaluated on cranial computed tomography (CT) reformatted in 3 planes (axial, coronal, and sagittal). Intracranial and extracranial pathologies were scanned. If there was no pathology, the reviewed CT scan was added up to the database. The coronal suture and the central sulcus were identified at the midline location on axial and sagittal view CT images. Vertical distance between coronal suture and central sulcus was measured.

Results:
Mean distance of the central sulcus to the coronal suture was 47.5 ± 7.6 mm (range = 26.2–67.3 mm).

Conclusions:
Identifying the central sulcus relative to the coronal suture is essential to preserve the primary motor and/or sensory cortices in neurosurgical procedures. The distance of the central sulcus to the coronal suture is approximately 4.7 cm in adult patients from Turkey, which did not differ according to age or sex.
Adequacy of the Italian National Tariff for Orthognathic Surgery: A Cost Analysis Using the Activity Based Costing (ABC) Method
Authors: Tewfik Karim , Chiarelli Pasquale , Battaglia Salvatore , Catanzaro Susanna , Pederneschi Nicola , Copelli Chiara , Manfuso Alfonso , Cassano Lazzaro , Longo Francesco 
Published: August 2020

Abstract
The reduced economic resources in health care and the consequent spending review have brought great interest in surgical costs. The aim of the study is to determine direct hospital costs for Orthognathic procedures using the Activity based costing method and evaluate the adequacy of the refund provided by the Italian National Health Service. From January 2017 to December 2017 9 consecutive patients underwent the following Orthognathic procedures at IRCCS Casa Sollievo della Sofferenza (San Giovanni Rotondo, Italy): bimaxillary osteotomy (n = 7), Le Fort I osteotomy (n = 1) and Bilateral Sagittal Split Osteotomy (BSSO) (n = 1). Activity based costing was used to obtain costs of each single hospitalization split into surgery, instay, and services. The mean total cost for a bimaxillary osteotomy was 7596.40€. We observed a total cost of 3925.00€ for Le Fort I osteotomy and of 4334.50€ for BSSO. The refund of 4378.00€ provided by the Italian National Health Service system for Orthognathic surgery seems insufficient to cover costs of bimaxillary osteotomy but consistent for single osteotomy (Le Fort I or BSSO).
Use of a Monoblock Gunning Splint in a Bilateral Condylar Fracture in an Edentulous Patient
Authors: Hwang Kun , Ma Sung Hwan 
Published: August 2020

Abstract
This paper presents the outcomes of a conservative approach to a bilateral condylar fracture in an edentulous patient. Serial changes of the inclination angle were measured in an edentulous mandibular fracture treated with a monoblock Gunning splint.
After being hit by a motor vehicle, a 67-year-old man fell onto his face. He had been edentulous for 7 years and did not use dentures. His mouth-opening was 28 mm between the edentulous maxilla and the mandible. X-rays and computed tomography revealed a comminuted mandibular angle fracture and bilateral condylar fractures. Stone casts were made from maxillary and mandibular alginate impressions. Maxillary and mandibular labiolingual splints were constructed using an autopolymerizing acrylic resin. In the most comfortable jaw position, the wax-bite was inter-positioned between the upper and lower splints and the vertical dimension was measured. Using a calibration resin, the inter-positional segment containing the eyelet wire was fixed between the splints with glue. A monoblock Gunning splint was applied and intermaxillary fixation (IMF) was performed with circummandibular and circumzygomatic wiring. The inclination of the fractured condyle was compared with the contralateral side. The difference in inclination between the fractured and contralateral sides was plotted over time.
On post-IMF day 34, the inclination angle had decreased to 22.9°, only 3.2° greater than the contralateral side. The difference in inclination was fitted to an exponential regression model (y = 11.378e−0.043x, R2 = 0.766, P = 0.022).
This case shows that a condylar fracture in an edentulous patient can be treated by vertical lengthening using a monoblock Gunning splint and IMF.
Management of Complications Related to Removal of the Buccal Fat Pad
Authors: Pimentel Thais , Hadad Henrique , Statkievicz Cristian , Alcantara-Júnior Albertino Gomes de , Vieira Eduardo Hochuli , Souza Francisley Ávila , Garcia-Júnior Idelmo Rangel 
Published: August 2020

AbstractRemoval of the buccal fat pad (BFP) is an important topic of discussion in the literature. Several studies have reported improvements in facial esthetics as a result of this technique. The BFP is close to vital structures, such as the facial nerve, parotid duct, and vessels. Injuries related to these structures may occur during the surgical procedure. This manuscript aimed to report and discuss 2 clinical cases of the complications after removal of the BFP. Besides the case presentation, a comprehensive review of the literature was also provided. The reported cases were 2 patients aged 31 and 38 years who were attended by the oral and maxillofacial surgery teams after a complication in the BFP surgery. The first case involved swelling due to Stensen's duct injury, and the second involved uncontrolled bleeding from the internal maxillary artery. Removal of the BFP must have precise indications. Complications may occur during or after surgery; hence, anatomical knowledge is fundamental to appropriate patient management.
Utilization of Visual Acuity Retroilluminated Charts for the Assessment of Afferent Visual System Dysfunction in a Pediatric Neuroimmunology Population
Authors: Sguigna Peter V. , McCreary Morgan C. , Conger Darrel L. , Graves Jennifer S. , Benson Leslie A. , Waldman Amy T. , Greenberg Benjamin M. ,   on behalf of the PERCEPTION Collaboration
Published: August 2020

Background:
Visual acuity has been a significant outcome measure in clinical trials for patients suffering from neuro-ophthalmological diseases and multiple sclerosis; however, there are limited data on the comparison of various testing strategies in pediatric patients with these disorders. Clinical trials using vision as an outcome could include a variety of tools to assess the acuity, including 2-m and 4-m standardized retroilluminated charts.

Methods:
We investigated the difference in Early Treatment Diabetic Retinopathy Study (ETDRS) scores obtained using 2-m and 4-m charts, as well as the impact of optic neuritis, use of vision correction, age, and gender on visual acuity data from 71 patients with pediatric neuroimmunological conditions in a cross-sectional study.

Results:
We determine that the ETDRS letter scores obtained using 4-m charts are on average 3.43 points less (P = 0.0034) when testing monocular ETDRS letter scores and on average 4.14 points less (P = 0.0008) when testing binocular ETDRS letter scores, relative to that obtained using the 2-m charts. However, we find that when performing monocular testing, optic neuritis in the eye being tested did not result in a statistically significant difference between 2-m and 4-m ETDRS letter scores.

Conclusions:
Although visual acuity charts are formatted by the distance, there are significant differences in the number of letters correctly identified between 2-m and 4-m charts. Although the differences may not impact the clinical acuity, research protocols should consider these differences before collapsing data across disparate studies.
Bedside Assessment of Vergence in Stroke Patients
Authors: Anagnostou Evangelos , Koutsoudaki Penelopi , Tountopoulou Argyro , Spengos Konstantinos , Vassilopoulou Sophia 
Published: August 2020

Background:
Given the widely distributed network of midbrain, pontine, cerebellar, and cortical areas involved in the neural control of vergence, one might expect various vergence deficits in stroke patients. In this article, we investigated the localizing value of bedside vergence testing with respect to different supratentorial and infratentorial infarction locations.

Methods:
Three hundred five stroke patients and 50 age-matched controls were examined prospectively by means of bedside tests to assess slow and fast binocular (i.e., symmetrical) as well as slow and fast monocular (i.e., asymmetrical) convergence. Infarction locations, as identified on MRI, were correlated with vergence performance using multinomial logistic regression.

Results:
Vergence deteriorated with age in both stroke patients and healthy controls. Most infarction locations did not show significant associations with vergence parameters, apart from cases with parietal lobe lesions, which exhibited insufficient asymmetrical, slow and fast vergence for both the left and the right eye. Finally, patients with severe ischemic small vessel disease showed a slight but significant decrease in their fast binocular vergence performance.

Conclusions:
There is only a limited localizing value of vergence deficits in stroke. Parietal lobe infarctions are more frequently associated with insufficient binocular and monocular vergence. Midbrain strokes were too few to draw final conclusions. However the most robust factor to emerge from our data is age. Older subjects show poor slow binocular as well as slow and fast monocular vergence. Extended white matter lesions are also correlated with deficient vergence ability suggesting a role for subcortical wide range connections in maintaining an intact vergence circuitry.
Seven-Year Follow-Up of a Patient With a Retained Needlefish Jaw Fragment Abutting Against His Left Internal Carotid Artery
Authors: Daigle Patrick , Mehta Sonul , Bhayana Rajesh , Das Sunit , Bharatha Aditya , Nijhawan Navdeep 
Published: August 2020

Abstract:
A 51-year-old man presented to the ophthalmology service with binocular diplopia and facial numbness. The patient was returning from a trip to Mexico. He reported having been hit in the left periocular region by a fish while swimming. Local doctors repaired a laceration in the left lateral canthus shortly after the incident. Orbital imaging revealed 2 needle-like foreign bodies corresponding to retained pieces of a needlefish jaw in the left orbit. Given the location of the foreign bodies, observation with repeat imaging was deemed more appropriate than surgical exploration. Subsequent imaging studies showed no migration of the foreign body, and the patient did not suffer from any related complications more than 7 years after the initial injury.
The Usefulness of Anti-acetylcholine Receptor Binding Antibody Testing in Diagnosing Ocular Myasthenia Gravis
Authors: Chung In Young , Sheth Shivanand J. , Wells Kristen K. , Campbell Thomas G. 
Published: August 2020

Background:
Anti-acetylcholine receptor antibody (AChR–Abs) testing is a safe and simple ancillary method for confirming the diagnosis of myasthenia gravis. Despite the test's high sensitivity (85%–90%) for generalized myasthenia gravis, AChR–Abs testing has been reported to have a low sensitivity 44%–66% for ocular myasthenia gravis (OMG). The aim of the study is to assess the effectiveness of AChR binding Abs testing for diagnosing OMG by evaluating the test's sensitivity, specificity, positive predictive value, and negative predictive value.

Methods:
A retrospective chart review on 114 OMG suspects who presented to the emergency department of a tertiary eye center in Victoria, Australia, was completed. The patients presented with diplopia alone, ptosis alone, or the combination of diplopia and ptosis. All participants were followed up longitudinally in the neuro-ophthalmology outpatient clinics for the average of 2.8 months, where they have received AChR binding testing. The final diagnosis was only given to the patients who either were seropositive for AChR binding Abs and had a high clinical suspicion of OMG, or the patient who was seronegative for AChR binding Abs but was regarded as likely to have OMG clinically and responded to the diagnostic treatments (pyridostigmine bromide and immunosuppressant therapy).

Results:
The sensitivity of AChR binding Abs testing in diagnosing OMG was higher (80%; 95% confidence interval [CI], 51.91%–95.67%) than previously reported (44%–66%). AChR binding Abs testing also had a high specificity (98.99%; 95% CI, 94.50%–99.97%) and positive predictive value (92.31%; 95% CI, 62.68%–98.85%).

Conclusion:
The study suggests the higher utility of the AChR binding Abs testing in diagnosing OMG due to its high sensitivity, specificity, and positive predictive value.
Neuro-Ophthalmic Manifestations of Acute Leukemia
Authors: Alrobaian Malek A. , Henderson Amanda D. 
Published: August 2020

Background:
Ophthalmic involvement in acute leukemia is common, with 36% of patients having ophthalmic involvement at the time of diagnosis. However, neuro-ophthalmic involvement is relatively rare. We present a characterization of neuro-ophthalmic findings in patients with acute leukemia and discuss the implications of these findings on patient management and prognosis.

Methods:
We performed a retrospective review of cases of acute leukemia with central nervous system (CNS) involvement and neuro-ophthalmic manifestations that were evaluated at the Wilmer Eye Institute between January 2013 and September 2019. Data collected included demographic information, leukemia details, results of diagnostic testing, and features of associated neuro-ophthalmic manifestations.

Results:
Twelve patients with mean age 42 years (range 9–65, median 39) were included. Seven (58%) patients were men and 5 (42%) women. Eight (67%) were diagnosed with acute myeloid leukemia and 4 (33%) with acute lymphoid leukemia. Neuro-ophthalmic findings included 4 patients with isolated sixth nerve palsies, 2 with multiple cranial nerve palsies, 2 with orbital lesions with proptosis, 4 with optic disc swelling, and 1 with isolated fourth nerve palsy. Five (42%) neuro-ophthalmic presentations were associated with known CNS disease, 3 (25%) were associated with active disease but heralded the discovery of CNS involvement, 3 (25%) were the presenting features of relapse, and 1 (8%) led to the original leukemia diagnosis. Neuroimaging showed 4 with leptomeningeal enhancement, 4 with cranial nerve enhancement/thickening, 3 with optic nerve/sheath enhancement, 1 with lytic lesion of bone, 1 with soft tissue mass, and 1 with cytotoxic brain edema. One case had normal neuroimaging. Overall, patients had a poor prognosis, with 7 patients dying from leukemia or its complications and only 1 achieving a sustained remission. In 58% of the cases in our series, the discovery of neuro-ophthalmic leukemic involvement directly led to a change in leukemia treatment.

Conclusions:
Neuro-ophthalmic manifestations of leukemia may occur as presenting features of diagnosis, relapse, or CNS involvement, and portend a poor prognosis. Detection of neuro-ophthalmic involvement often triggers a prompt change in management. Therefore, familiarity with potential neuro-ophthalmic presentations of acute leukemia may avoid delayed diagnosis, and resultant inadequate treatment, of primary disease, relapse, or CNS involvement.
Antibody response to SARS-CoV-2 infection in humans: a systematic review
Authors: Post Nathan , Eddy Danielle , Huntley Catherine , van Schalkwyk May C. I. , Shrotri Madhumita , Leeman David , Rigby Samuel , Williams Sarah V. , Bermingham William H. , Kellam Paul , Maher John , Shields Adrian M. , Amirthalingam Gayatri , Peacock Sharon J. , Ismail Sharif A. 
Published: August 2020

ABSTRACTIntroductionProgress in characterising the humoral immune response to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) has been rapid but areas of uncertainty persist. This review comprehensively evaluated evidence describing the antibody response to SARS-CoV-2 published from 01/01/2020-26/06/2020.MethodsSystematic review. Keyword-structured searches were carried out in MEDLINE, Embase and COVID-19 Primer. Articles were independently screened on title, abstract and full text by two researchers, with arbitration of disagreements. Data were double-extracted into a pre-designed template, and studies critically appraised using a modified version of the MetaQAT tool, with resolution of disagreements by consensus. Findings were narratively synthesised.Results150 papers were included. Most studies (75%) were observational in design, and included papers were generally of moderate quality based on hospitalised patients. Few considered mild or asymptomatic infection. Antibody dynamics were well described in the acute phase, and up to around 3 months from disease onset, although inconsistencies remain concerning clinical correlates. Development of neutralising antibodies following SARS-CoV-2 infection is typical, although titres may be low. Specific and potent neutralising antibodies have been isolated from convalescent plasma. Cross reactivity but limited cross neutralisation occurs with other HCoVs. Evidence for protective immunity in vivo is limited to small, short-term animal studies, which show promising initial results in the immediate recovery phase.InterpretationPublished literature on immune responses to SARS-CoV-2 is of variable quality with considerable heterogeneity with regard to methods, study participants, outcomes measured and assays used. Antibody dynamics have been evaluated thoroughly in the acute phase but longer follow up and a comprehensive assessment of the role of demographic characteristics and disease severity is needed. The role of protective neutralising antibodies is emerging, with implications for therapeutics and vaccines. Large, cross-national cohort studies using appropriate statistical analysis and standardised serological assays and clinical classifications should be prioritised.
Modelling acceptable novelty transitions with emotional habituation: Effects of uncertainty and prediction error on preference changes
Authors: Sekoguchi Takahiro , Yanagisawa Hideyoshi 
Published: August 2020

AbstractPrevious mathematical models developed to optimize the degree of novelty in product design have represented novelty by emotional dimensions such as arousal (surprise) and valence (positivity and negativity). Formalizing arousal as Bayesian information gain and valence as a function of arousal based on Berlyne’s arousal potential theory, the model indicates that novelty becomes acceptable with repeated exposure and changes the preferences of the users. Hence, acceptable novelty transitions are important in the design of long-term product experience. We propose a mathematical model of acceptable novelty transitions with emotional habituation based on the emotional dimension model. We formalized valence as a function of information-theoretic free-energy and expressed free-energy as a function of three parameters: initial prediction error, initial uncertainty, and noise of sensory stimulus. To verify whether the transition speed of acceptable novelty depends on the initial uncertainty in our model, we analysed the responses of participants to historic artworks; we manipulated the uncertainty level by varying the obscurity of the presented pieces and the prediction error by rendering them in different artistic styles. We used the subjective reports of valence in response to the samples as measures of valence levels. The experimental results support our hypothesis.