bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Utility of Additional Axillary and Velpeau Radiographs in the Evaluation of Suspected Shoulder Trauma
Authors: Cruz Sebastian A. , Castillo Hector , Chintapalli Ravi Theja V. , Adams Olufemi E. , Morgan Vince K. , Koh Jason L. , Lee Michael J. , Shi Lewis L. 
Published: March 2020

Objectives:
To investigate the clinical utility of additional axillary or Velpeau views in evaluating potential shoulder trauma after a standard radiograph series of anteroposterior, Grashey, and/or trans-scapular views.

Design:
Retrospective study.

Setting:
Level I academic medical center.

Patients:
All patients in a 10-year span who received an initial shoulder radiograph series followed by additional axillary/Velpeau views within 24 hours.

Main Outcome Measurements:
The clinical utility of the additional axillary/Velpeau views, including the final diagnosis and treatment plan, as ascertained through examination of radiology reports, progress notes, and radiograph images.

Results:
A total of 271 cases were reviewed, with 35 patients being excluded from the final cohort because they received post-treatment radiographs to confirm a successful therapeutic outcome. The additional axillary/Velpeau views did not affect clinical decision making in 230 (97.5%) of the remaining 236 cases. All 6 patients whose care benefitted from the additional views carried the diagnosis of shoulder instability, accounting for 40% of this diagnostic group. The additional views confirmed an equivocal finding in 5 of these 6 cases and changed the diagnosis (demonstrating a posterior dislocation that was not evident on initial radiographs) and treatment plan (leading to a closed glenohumeral reduction procedure) in the other case.

Conclusions:
Additional axillary/Velpeau views of suspected shoulder trauma rarely led to a change in the final treatment plan, except in patients in which a definitive diagnosis of stability or instability could not be made based on initial radiographs. A cost/benefit analysis is required to weigh the cost of additional radiographs with the benefit of capturing infrequent yet serious dislocations (usually posterior).

Level of Evidence:
Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Gene therapy beyond luxturna: a new horizon of the treatment for inherited retinal disease
Authors: Prado Dominic A. , Acosta-Acero Marcy , Maldonado Ramiro S. 
Published: March 2020

Purpose of review
Gene therapy offers, for the first time, the possibility to cure diseases such as retinitis pigmentosa. The positive outcomes that led to the U.S. Food and Drug Administration (FDA) approval of Luxturna to treat Leber congenital amaurosis caused by RPE65 mutations created an optimistic atmosphere in the research, clinical and patient community. Despite this first success, we must understand that this is not a ‘one treatment for all’. This review aims to explain the basic concepts of gene therapy and how they translate in different approaches that are utilized in ongoing clinical trials here reviewed.

Recent findings
In 2017, the FDA approved the first gene therapy treatment. In parallel, other approaches have gained attention. Different delivery methods (adeno-associated virus, lentivirus), injection sites (subretinal, intravitreal, suprachoroidal) and methodologies (gene replacement, silencing, editing) are currently being tested.

Summary
Gene therapy is an evolving field in medicine and ophthalmology. Its success and application depends on several factors that are specific to the disease to treat. For now, we know it's a relatively safe approach and we look forward to the continued advancements of current ongoing clinical trials.
Clinical outcomes after topography-guided LASIK: comparing results based on a new topography analysis algorithm with those based on manifest refraction
Authors: Lobanoff Mark , Stonecipher Karl , Tooma Tom , Wexler Stephen , Potvin Richard 
Published: March 2020

Purpose:
To compare short-term refractive and visual acuity outcomes after topography-guided laser in situ keratomileusis (LASIK) planned with a new topography analysis system to those based on the manifest refraction.

Setting:
Four clinical sites in the United States.

Design:
Double-arm, nonmasked, nonrandomized retrospective chart review.

Methods:
This was a retrospective study of postoperative refraction and visual acuity at least 2 months after uneventful LASIK using the Contoura Vision algorithm on the WaveLight Topolyzer VARIO laser. One arm comprised eyes treated using the manifest refraction (manifest), while the other included eyes treated with an ablation profile determined by the Phorcides Analytic Engine (analytic).

Results:
Clinical results from a matched group of 317 manifest eyes and 323 analytic eyes were available for analysis. Residual refractive results, both sphere and cylinder, were similar between groups. However, significantly more eyes had 20/16 or better (−0.1 logarithm of the minimum angle of resolution) uncorrected distance visual acuity (UDVA) (62.5% analytic, 41.3% manifest) and corrected distance visual acuity (CDVA) (77.1% analytic, 51.4% manifest) in the analytic group. All eyes but 1 had a CDVA of 20/20 or better postoperatively. The number of patients with a UDVA better than their preoperative CDVA was significantly higher in the analytic group (36.5%) relative to the manifest group (23.0%). No eye in either group lost more than 1 line of CDVA; significantly more eyes in the analytic group (42.7%) gained 1 or more lines of CDVA relative to the manifest group (30.3%).

Conclusions:
Using the Phorcides Analytic Engine for topography-guided surgery planning increased the likelihood of 20/16 UDVA and CDVA relative to using the manifest refraction.
Skin Cancer
Authors: Davis Kyleen E. 
Published: March 2020

ABSTRACT
Basal cell carcinoma (BCC) is the most common form of skin cancer in the United States, with an estimated 4.3 million cases diagnosed each year. The major risk for BCC is primarily related to sun exposure; however, multiple modifiable and nonmodifiable risk factors contribute to the development of this condition. Although it rarely metastasizes, BCC can cause significant morbidity through local tissue destruction and infiltration into vital underlying organs. There are multiple treatment options for BCC, but Mohs micrographic surgery is considered to be the gold standard of therapy. For individuals with unresectable or metastatic BCC, new and emerging therapies involving inhibition of the Hedgehog signaling pathway have shown promising results. This article discusses the most current literature for dermatology nurses on the epidemiology, assessment, and treatment of BCC with the focus on early detection and management to lower morbidity and offer better patient outcomes.
The Use of Artificial Intelligence to Program Cochlear Implants
Authors: Waltzman Susan B. , Kelsall David C. 
Published: March 2020

Objective:
Cochlear implant (CI) technology and techniques have advanced over the years. There has not been the same degree of change in programming and there remains a lack of standardization techniques. The purpose of this study is to compare performance in cochlear implant subjects using experienced clinician (EC) standard programming methods versus an Artificial Intelligence, FOXTM based algorithm for programming.

Study Design:
Prospective, nonrandomized, multicenter study using within-subject experimental design

Setting:
Tertiary referral centers.

Patients:
Fifty-five adult patients with ≥ 3 months experience with a Nucleus 5, 6, Kanso, or 7 series sound processor.

Intervention:
Therapeutic Main Outcome Measures: CNC words and AzBio sentences in noise (+10 dB SNR) tests were administered in a soundproof booth followed by a direct connect psychoacoustic battery using the EC program. Tests were repeated 1 month later using the optimized FOX program. Subjective measures of patient satisfaction were also measured.

Results:
Performance for the EC program was compared to the FOX program for both measures. Group mean results revealed equivalent performance (Kruskal–Wallis ANOVA p = 0.934) with both programming methods. While some patients had better performance with the FOX method and some performed more poorly, the majority had equivalent performance and preferred the FOX system.

Conclusion:
The study demonstrated that on average, FOX outcomes are equivalent to those using traditional programming techniques. In addition, the FOX programming method can effect standardization across centers and increase access for many individuals who could benefit.
Association between serum uric acid levels and dyslipidemia in Chinese adults
Authors: Chen Shenghui , Yang Hua , Chen Yishu , Wang Jinghua , Xu Lei , Miao Min , Xu Chengfu 
Published: March 2020

Abstract
This study aimed to investigate the association of serum uric acid (SUA) levels with dyslipidemia and its components and to further explore the age- and gender-specific association of SUA levels with dyslipidemia in Chinese adults.
A cross-sectional study was performed among 8642 adults who underwent health examinations. A meta-analysis covering 17 studies was conducted to confirm the results.
The prevalence of hyperuricemia and dyslipidemia was 9.25% and 20.44%, respectively. Participants with hyperuricemia had higher prevalence of dyslipidemia than those without hyperuricemia (34.42% vs 19.01%, P < .005). Compared with participants with SUA in the first quintile, the odds ratio (OR) (95% confidence interval) of dyslipidemia in the second, third, fourth, and fifth quintiles of SUA were 1.095 (0.901–1.332), 1.582 (1.315–1.904), 2.095 (1.752–2.505), and 3.212 (2.702–3.818), respectively. Subgroup analysis showed that SUA quintiles were significantly correlated with the likelihood of dyslipidemia in females aged > 50 years and in males, but not in females aged ≤50 years. The meta-analysis also showed that hyperuricemia increased the likelihood of dyslipidemia and the pooled OR for the highest uric acid level vs the lowest uric acid level was 1.84 (1.49–2.28).
SUA levels are significantly associated with dyslipidemia, and this association is impacted by age and gender.
Effect of breast-conserving surgery and modified radical mastectomy on operation index, symptom checklist-90 score and prognosis in patients with early breast cancer
Authors: Qiu Han , Xu Wen-Hui , Kong Jun , Ding Xiao-Jun , Chen Deng-Feng 
Published: March 2020

Abstract
The present study aims to analyze the effects of breast-conserving surgery and modified radical mastectomy on operation indexes, Symptom checklist-90 scores and prognosis in patients with early breast cancer.
The clinical data of 128 patients with breast cancer who were treated in our hospital from May 2015 to May 2016 were included into the analysis. These patients were divided into 2 groups, according to the different modes of operation (n = 64): control group, patients underwent modified radical mastectomy; observation group, patients underwent early breast conserving surgery. Then, the surgical indexes and prognosis were compared between these 2 groups.
Intraoperative bleeding volume, incision length and hospitalization duration were better in the observation group than in the control group (P < .05). Furthermore, postoperative symptom checklist-90 scores in the observation group were better than scores before the operation, and were better than the scores in the control group (P < .05). Moreover, the incidence of postoperative complications was lower in the observation group (3.13%) than in the control group (21.88%, P < .05).
Early breast-conserving surgery is more advantageous for breast cancers and results to lesser bleeding, rapid recovery, and fewer complications.
The different benefits and side effects of nivolumab combined with ipilimumab in diverse cancer
Authors: Tong Hongxuan , Hao Yu , Wang Kaili , Xiang Lekang , Lu Tao 
Published: March 2020

Abstract

Introduction:
This systematic review protocol aims to provide the methods used to assess the total benefits and side effects in all cancer patients and their respective benefits and side effects in different cancers.

Methods and analysis:
The following electronic bibliographic databases will be selected without any language restriction: PubMed, EMBASE, The Cochrane Library, Scopus and Web of Science without an upper-limit date until July 12, 2019. Searches will also be performed in the following trials registers: ClinicalTrials.gov (www.ClinicalTrials.gov), the ISRCTN registry (www.isrctn.com), the WHO International Clinical Trials Registry Platform (www.who.int/trialsearch/Default.aspx) and the EU Clinical Trials Register (www.clinicaltrialsregister.eu). All randomized controlled trials related to the combination of nivolumab and ipilimumab for cancer patients will be included. Outcomes will include curative effect, chemotherapeutic response rate, adverse events. Study inclusion, data extraction and quality assessment will be performed independently by two reviewers. Assessment of risk of bias and data synthesis will be performed using Review Manager software.

Ethics and dissemination:
Ethics approval is not required because individual patients’ data are not included. The findings of this systematic review will be disseminated through peer-reviewed publication.

PROSPERO registration number:
CRD42018109732
Electrocardiographic characteristics for successful radiofrequency ablation of right coronary cusp premature ventricular contractions
Authors: Im Sung Il , Lee Sung Ho , Gwag Hye Bin , Park Youngjun , Park Seung-Jung , Kim June Soo , On Young Keun , Park Kyoung-Min 
Published: March 2020

Abstract
Electrocardiographic (ECG) criteria identifying right- and left-sided outflow tract origins have been established. The purpose of this study was to define the criteria for premature ventricular contractions (PVCs) originating from the right coronary cusp (RCC) adequately.
We analyzed ECG and electrophysiologic study data from patients who underwent successful ablation of PVCs originating from the RCC and right ventricular outflow tract (RVOT). Eighteen RCC and 28 septal RVOT PVCs were studied. Among these 18 successful RCC PVCs, a predominantly positive QRS in lead I in 18/18 (100%), longer V1–2 R-wave duration (81.4 ± 31.1 vs 44.8 ± 7.0 ms, P = .02), V1–2 R wave duration index (RWDI) (51.3 ± 22.0 vs 31.2 ± 7.5%, P = .06) were observed compared to those with posteroseptal RVOT. Local ventricular activation time preceding QRS onset was significantly earlier (−38 ± 12 ms) at the successful RCC ablation site compared to the failed ablation site of the septal RVOT (−22 ± 8 ms), even without good pace mapping at the RVOT (P < .001). The receiver operating characteristic curve showed that a pre-QRS time of ≥−31 ms predicted successful RCC ablation with 67% sensitivity and 94% specificity. A predominantly positive QRS in lead I, longer R-wave duration and RWDI in lead V1 or V2 with a local ventricular activation preceding QRS onset by an average of −31 ms suggests an effective RCC ablation site.
Hyperthermia associated with spinal radiculopathy as determined by digital infrared thermographic imaging
Authors: Park Tae Yoon , Son Seong , Lim Tae Gyu , Jeong Taeseok 
Published: March 2020

Abstract
In general, in digital infrared thermographic imaging (DITI) of patients with unilateral spinal radicular pain, the thermal pattern of the extremities of the side of lesion shows hypothermia compared to the opposite, intact side. However, sometimes, DITI shows hyperthermia on the side of the lesion, and this variation can cause confusion. We compared the data of both hypothermia and hyperthermia patients to clarify the factors determining different thermal characteristics in spinal radiculopathy.
We retrospectively collected data from patients who underwent DITI at a single center. The final cohort (n = 224) was allocated into 2 groups, a hypothermia group (n = 180) or a hyperthermia group (n = 44). We compared the various factors, including demographic factors and symptom-related factors, that might affect the results of DITI.
Except the presence of trauma history (13.9% vs 31.8%, odds ratio 2.893, P = .008), no significant intergroup difference was found in baseline demographic factors, including age, gender, diabetes mellitus, spinal level of pathology, and intervention history. Among symptom-related factors, in the hyperthermia group, the symptom duration was shorter (10.64 weeks [95% confidence interval (CI) 8.36–13.04] vs 2.10 weeks [95% CI 1.05-3.53], P < .001) and Visual Analogue Scale (VAS) of radicular pain was higher (4.23 ± 1.29 vs 5.18 ± 1.40, P < .001) than in the hypothermia group. Also, in the regression analysis, significant factors for hyperthermia include the presence of trauma history, shorter symptom duration (cut-off value 2.50 weeks or less) and higher VAS of radicular pain (cut-off value 4.50 or more).
In patients with trauma history, acute phase, and severe radicular pain, hyperthermia in DITI is not unusual and careful interpretation of the DITI results is necessary for proper diagnosis and treatment decisions in spinal radiculopathy.
Can hypothyroidism be a protective factor for hepatocellular carcinoma in cirrhosis?
Authors: Sahin Tolga , Oral Alihan , Turker Fatih , Kocak Erdem 
Published: March 2020

Abstract
Despite many studies, the molecular mechanisms of hepatocellular carcinoma (HCC) development remain unclear. Thyroid hormone (TH) levels may vary in many chronic diseases including cirrhosis. The aim of this study was to evaluate TH status in patients with cirrhosis and HCC and to investigate the relationship between THs and HCC development.
Five hundred seventy-seven patients with cirrhosis who applied to Demiroğlu Bilim University, Faculty of Medicine, Gastroenterology Department between 2004 and 2019 were included the study. Three hundred sixty-seven patients who applied to Internal Medicine Unit for general health check-up were included in the study as healthy control group. Demographic, laboratory, and imaging findings of study groups were retrospectively reviewed and recorded from hospital information system.
In the cirrhosis group, 252 patients had HCC (43.67%), and 325 patients had non-HCC cirrhosis (56.33%). Free thyroxine (FT4) levels were higher in the control group than in the cirrhotic group but there was no significant difference (P = .501). Thyroid-stimulating hormone (TSH) and FT4 levels were similar between groups, while free triiodothyronine (FT3) levels were significantly different between HCC group, non-HCC cirrhosis group, and control group (P = .299 for TSH, P = .263 for FT4, P < .001 for FT3). FT3 levels were significantly higher in HCC group than non-HCC cirrhosis group, but significantly lower than control group (P < .05).
Our study confirmed the presence of hypothyroidism in cirrhosis patients and clearly demonstrated a strong relationship between FT3 levels and HCC development.
Prognostic nutritional index as a novel marker for prediction of prognosis in patients with peripartum cardiomyopathy
Authors: Tak Bahar Tekin , Cay Serkan , Pamukcu Hilal Erken , Ekizler Firdevs Aysenur , Kafes Habibe , Cetin Elif Hande Ozcan , Ulvan Nedret , Ozeke Ozcan , Ozcan Firat , Topaloglu Serkan , Aras Dursun 
Published: March 2020

Abstract
The clinical significance of poor nutritional status in patients with peripartum cardiomyopathy (PPCM) is not clearly understood. Prognostic nutritional index (PNI) is a simple nutritional assessment tool, which was first demonstrated to be valuable in patients with colorectal surgeries. We aimed to investigate the predictive value of PNI in patients with PPCM.
A total of 92 patients diagnosed with PPCM were enrolled in this study. PNI was calculated using the following formula: 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count. The primary endpoint was defined as composite adverse cardiac events that included cardiac death or hospitalization due to worsening heart failure (HF). Cardiac death, hospitalization due to worsening HF, and persistent left ventricular (LV) systolic dysfunction were evaluated, respectively, as secondary endpoints.
Primary composite endpoint was higher in the lower PNI group. After adjusting for other risk factors, PNI was found to be as an independent predictor of primary composite endpoint (odds ratio 0.805; 95% confidence interval 0.729–0.888; P
< .001). In addition, PNI was significantly associated with secondary endpoints; persistent LV systolic dysfunction as well as cardiac death.
This study identified nutritional status assessed by the PNI seems to be a novel predictor of adverse cardiovascular outcomes in patients with PPCM.
Percutaneous transhepatic cholangiography versus endoscopic retrograde cholangiography for the pathological diagnosis of suspected malignant bile duct strictures
Authors: Chang Hai-Yang , Liu Bin , Wang Yong-Zheng , Wang Wu-Jie , Wang Wei , Li Dong , Li Yu-Liang 
Published: March 2020

Abstract
To compare the diagnostic performance of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography for the pathological assessment of suspected malignant bile duct stricture, using brush cytology and forceps biopsy.
The study group comprised 79 consecutive patients who underwent pathological assessment for suspected malignant biliary stricture, 38 of whom underwent percutaneous transhepatic cholangiography (group A) and the other 41 underwent endoscopic retrograde cholangiography (group B). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. A subset analysis was performed to determine the effect of location and pathological type of the stricture on diagnostic performance, and complications were analyzed.
The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 86.7%, 100%, 100%, 66.7%, and 89.5%, respectively, in group A, and 77.1%, 100%, 100%, 42.9%, and 80.4%, respectively, in group B. For hilar biliary strictures, the sensitivity and accuracy were superior in group A than in group B. Mild complications (transient c and bile leakage) were identified in 7 cases in each group, all resolved spontaneously within 3 to 5 days.
Both brush cytology and forceps biopsy performed during percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography provided good diagnostic sensitivity and accuracy. Therefore, both diagnostic approaches can play an important role in planning therapeutic strategy. However, for strictures located at the hilum, pathology sampling via percutaneous transhepatic cholangiography is preferable to endoscopic retrograde cholangiography, as it provides higher sensitivity and accuracy.