bluuebunny/crossref_metadata_2025_split huggingface dataset:
Versatility of Hard Occlusal Splints in Optimizing Outcomes in Patients with Old Pan-facial Fractures
Authors: Hussein Mohammed Ahmed , Besher Abdelaziz , Saad Mohammed Aly , Wilson Adel Michel 
Published: October 2021

Background:
Pan-facial fracture repair is considered one of the most challenging complex reconstructive procedures to perform. It is always better to treat facial fractures as soon as possible. A delay of several days or weeks makes an ideal anatomic reduction difficult, if not impossible.

Methods:
Patients presenting late with noncompound pan-facial fractures and interrupting maxillary and mandibular arches who were candidates for ORIF were included. Patients had been divided randomly into two groups: group A was managed by the ordinary sequence of repair, and group B was managed with the aid of occlusal dental splint.

Results:
In total, 20 patients presented late (3–9 weeks post insult) due to serious injuries that required previous intervention. The time until obtaining optimal occlusion ranged between 80 and 120 minutes in the study group, whereas in the control group, the time ranged between 120 and 180 minutes (P < 0.0001). Postoperative malocclusion was noticed to be less frequent in the splint group than in the control group: only one patient with residual malocclusion in the study group versus two patients in the control group.

Conclusions:
Occlusal splints could be a good modality for restoring the pre-morbid occlusion in patients with delayed pan-facial fractures. It is a simple, reliable technique that could be easily integrated into our daily practice, and could help decrease the intraoperative time needed for restoration of optimal occlusion and decrease the postoperative malocclusions.
Evaluation of Efficacy, Efficiency, and Cell Viability of a Novel Descemet Membrane Endothelial Keratoplasty Graft Preparation Device, DescePrep, in Nondiabetic and Diabetic Human Donor Corneas
Authors: Solley Katherine D. , Berges Alexandra , Diaz Christine , Ostrander Benjamin T. , Ding Andy S. , Larson Sara A. , Frank Kendall , Lee Darrell , Guerrero Juan , deCarvalho Tagide , Ruppel Edward , Haileyesus Ailon , Dou Yueheng , Schweitzer Shannon , Pramanik Sudeep , Yazdi Youseph , Parikh Kunal S. 
Published: October 2021

Purpose:
The purpose of this study was to evaluate the safety, efficacy, and efficiency of a Descemet membrane endothelial keratoplasty (DMEK) graft preparation device, DescePrep, through measurement of graft viability, yield, and preparation time in both healthy and diabetic (high-risk) donor eyes.

Methods:
Twenty nondiabetic and 10 diabetic donor corneas were processed using DescePrep, which standardizes the liquid bubble technique. Corneas were stained with trypan blue and then processed. Cell counts through specular microscopy, optical coherence tomography imaging, and slit-lamp analysis were used for the evaluation of graft separation and viability in 5 nondiabetic corneas. The remaining 25 corneas (15 nondiabetic and 10 diabetic) were evaluated for preparation success rate and processing time. Ten corneas (5 nondiabetic and 5 diabetic) were randomly selected for further evaluation of global cell loss through staining.

Results:
Ninety-seven percent of corneas (29 of 30) were prepared successfully with DescePrep. The average preparation time was 2.83 ± 1.8 minutes. There was no significant difference in the time of preparation between the nondiabetic and diabetic groups (P = 0.077). The overall average cell death after processing was 7.9% ± 3.7% for all corneas. There was no significant difference in cell viability between diabetic and nondiabetic tissues after DescePrep processing (P = 0.769).

Conclusions:
DescePrep is a new DMEK preparation technique that can process both nondiabetic and diabetic donor corneas at high yields in minutes. High-yield preparation of diabetic corneas may offer eye banks access to a larger donor pool, which is important because the demand for DMEK grafts continues to rise worldwide.
The Effect of COVID-19 Infection During Pregnancy; Evaluating Neonatal Outcomes and the Impact of the B.1.1.7. Variant
Authors: Murphy Claire A. , O’Reilly Daniel P. , Edebiri Osasere , Donnelly Jennifer C. , McCallion Naomi , Drew Richard J. , Ferguson Wendy 
Published: October 2021

Background:
Coronavirus disease 2019 (COVID-19) infection during pregnancy has been associated with adverse perinatal outcomes. We aim to evaluate the neonatal outcomes including the incidence of preterm birth, admission to the neonatal unit and incidence of congenital anomalies in this cohort. We will also describe these outcomes in the context of the B.1.1.7. variant outbreak, the dominant variant in Ireland since January 2021, which has had a greater impact on pregnant patients.

Methods:
This was a retrospective study of liveborn infants, delivered between 1st March 2020 and 1st March 2021, to women with a severe acute respiratory syndrome coronavirus 2 diagnosis during pregnancy, in a tertiary maternity hospital (8,500 deliveries/year). Clinical data were collected, and analyses were performed to evaluate the impact of maternal symptom status, time from diagnosis to delivery and the B.1.1.7. variant on neonatal outcome.

Results:
In total 133 infants (1.6%) were born to women with severe acute respiratory syndrome coronavirus 2 identified during pregnancy. The median birth weight was 3.45 kg and gestational age at birth was 39.3 weeks. 14 infants (10.5%) were preterm. 22 infants (16.5%) required admission to the neonatal unit and 7 (5.3%) were small for gestational age. There was no difference in growth, preterm birth or neonatal unit admission based on maternal symptom status or infection after the outbreak of B.1.1.7. as the dominant strain.

Conclusions:
Following a COVID-19 infection in pregnancy, there was no increase in the incidence of preterm birth or neonatal intensive care unit admission compared with 5-year hospital data. Maternal symptom status did not influence neonatal outcomes. Further studies to evaluate the impact of COVID-19 in early pregnancy, the variants of concern, particularly the emerging Delta variant and COVID-19 placentitis are required.
Audiologic Outcomes of Footplate Drillout for Obliterative Otosclerosis
Authors: Conway Robert M. , Sioshansi Pedrom C. , Babu Seilesh C. , Tu Nathan C. , Schettino Amy E. , Bojrab Dennis I. , Schutt Christopher A. 
Published: October 2021

Objective:
To evaluate the audiologic outcomes of microdrill fenestration for obliterative otosclerosis compared to traditional stapedotomy technique.

Study Design:
Retrospective chart review.

Setting:
Tertiary referral center.

Patients:
Adult patients undergoing stapedotomy for otosclerosis.

Main Outcome Measure(s):
Patients were separated into groups that underwent either microdrill or laser fenestration based on intraoperative severity of disease. Audiologic outcomes and complications were compared between the two groups.

Results:
There were 588 ears in 519 patients that were evaluated. There was a significant postoperative improvement in pure tone average, air-bone gap, and mean bone conduction thresholds for both the obliterative and nonobliterative group (p < 0.001). There was no significant difference in the pre- or postoperative hearing status between the two groups. There was no significant difference in complications between the two groups, including no cases of postoperative profound hearing loss in the drill fenestration group.

Conclusions:
Audiologic outcomes are similar between microdrill fenestration and laser fenestration for otosclerosis. Pure tone average, air-bone gap, and mean bone conduction thresholds all improved postoperatively and were similar between groups.
Clinical and microbiological characteristics of men with nonobstructive acute pyelonephritis
Authors: Park Min Gu , Cho Sung Yong , Kwon Se Yun , Choi Hoon , Lee Jeong Woo 
Published: October 2021

Abstract
To investigate the differences in clinical and microbiological features in men hospitalized with community-acquired (CA) and healthcare-associated (HA) nonobstructive acute pyelonephritis (APN), as well as the predictive factors associated with bacteremia.
Men discharged from urological centers with nonobstructive APN were identified using an electronic medical records system. We compared the clinical and microbiological data between subjects with CA-APN and HA-APN.
Of the 245 men with nonobstructive APN, 175 had CA-APN, and 70 had HA-APN. The HA group was significantly older, had a longer hospital stay, and had more underlying diseases, bacteremia, and intensive care unit admissions than the CA group. The most commonly cultured microorganism was Escherichia coli. The susceptibility of the cultured bacteria to fluoroquinolone was 68.7% in the CA group and 45.3% in the HA group (P = .005). The proportion of extended-spectrum beta-lactamase-producing bacteria was 22.7% for CA and 53.5% for HA (P < .001). The sensitivity to piperacillin/tazobactam was 94.9% for CA and 90.0% for HA, and the sensitivity to amikacin was more than 95% for both groups. The multivariate analysis revealed that an age ≥65 years and chronic liver disease were independent predictive factors for bacteremia.
The incidence of antibiotic resistance and bacteremia was higher in the HA group than in the CA group. However, resistance to fluoroquinolone and the presence of extended-spectrum beta-lactamase-producing bacteria were high in both groups. Piperacillin/tazobactam and amikacin may be suitable treatment options in men with nonobstructive APN.
Total lesion glycolysis as a predictor of clinical T3–4a laryngeal cancer with laryngectomy or nonlaryngectomy
Authors: Suzuki Hidenori , Tamaki Tsuneo , Terada Hoshino , Nishio Masami , Nishikawa Daisuke , Beppu Shintaro , Sawabe Michi , Hanai Nobuhiro 
Published: October 2021

Abstract
The purpose of the present study is to investigate whether the 18F-fluorodeoxyglucose (18F-FDG) uptake parameter is related to survival outcomes for patients with clinical T3–T4a laryngeal cancer with various definitive treatments including total laryngectomy (TL). Parameters of 18F-FDG uptake in the primary tumors of 46 cases which were assessed by positron emission tomography with computed tomography were enrolled in the present observation study. Monovariate or multivariate survival analyses were performed with log-rank test or Cox regression model, with the hazard ratio (HR) and 95% confidence interval (CI), respectively. Cutoff values of the 18F-FDG uptake parameters were determined by the lowest P-value for monovariate overall survival. In the monovariate analysis, both metabolic tumor volume ≥13.1 and total lesion glycolysis (TLG) ≥46.5 were significantly associated with shorter overall survival, and TLG ≥46.5 was also related to a reduction in distant metastasis-free survival. In the multivariate analysis adjusting for clinical T classification (cT4/cT3) and treatment group (TL/non-TL), TLG (≥46.5/<46.5) was associated with both poorer overall (HR: 3.16, 95% CI: 1.10–9.49) and distant metastasis-free (HR: 8.91, 95% CI: 1.93–62.6) survival. In conclusion, TLG is a predictor for survival in laryngeal cancer.
Comparison of long-term outcome according to involved aganglionic segments of total colonic aganglionosis
Authors: Youn Joong Kee , Yang Hee-Beom , Ko Dayoung , Park Kwi-Won , Jung Sung-Eun , Kim Hyun-Young 
Published: October 2021

Abstract
Total colonic aganglionosis (TCA) is a rare form of Hirschsprung disease, with more severe symptoms than rectosigmoid Hirschsprung disease. We aimed to evaluate the surgical outcomes according to the involved segments of TCA.
Patients with aganglionosis extending from the anus to at least the ileocecal valve were included. The medical records of 33 TCA patients from 1981 to 2014 were reviewed. Three groups were analyzed based on the involved segment (jejunum, jejunoileal junction, and distal ileum).
The median age at the pull-through operation was 6.2 (3.3–114) months. The median follow-up duration was 216 (21–411) months. Transition zone in the jejunum, jejunoileal junction, and distal ileum was identified in 3, 5, and 25 patients, respectively. The most common method of operation was Duhamel pull-through. Perianal excoriation and enterocolitis were the most common postoperative complications. The complication rates were 45% to 51% and not different among the groups. The defecation frequency normalized 3 years postoperatively, and body weight started to recover after 2 years irrespective of the involved segment.
Therefore, close monitoring with proper management of defecation and body weight for at least 2 to 3 years postoperatively is required.
The efficacy and safety of glucokinase activators for the treatment of type-2 diabetes mellitus
Authors: Gao Qian , Zhang Wenjun , Li Tingting , Yang Guojun , Zhu Wei , Chen Naijun , Jin Huawei 
Published: October 2021

Abstract

Background:
Glucokinase activators (GKAs) are a novel family of glucose-lowering agents used for the treatment of type-2 diabetes mellitus. Treatment with different GKAs has been shown to reduce blood glucose levels in these patients. We compared the efficacy/safety of GKAs in patients with type-2 diabetes mellitus through a meta-analysis.

Methods:
We searched the PubMed, Excerpt Medica Database, and Cochrane Central Register of Controlled Trials databases for articles published before December 30, 2020. We computed the weighted mean difference (WMD) and 95% confidence interval (CI) for the change from baseline to the study endpoint for GKA versus placebo treatments.

Results:
A total of 4 articles (5 studies) were included in the meta-analysis. GKAs were associated with reductions in glycated hemoglobin levels from baseline (WMD, −0.3%; 95% CI, −0.466% to −0.134%). No significant difference between GKA and placebo treatment was observed in the results of fasting plasma glucose levels from baseline (WMD 0.013 mmol/L; 95% CI, −0.304–0.33 mmol/L). A significantly higher change in 2-hour postprandial plasma glucose (2-h PPG) levels (WMD −2.434 mmol/L; 95% CI, −3.304 to −1.564 mmol/L) was observed following GKA than placebo treatment. GKAs were associated with a higher prevalence of causing hypoglycemic events than placebo treatment (risk difference [RD], 0.06; 95% CI 0.013–0.106). GKAs had no association with the risk of developing adverse effects (RD, 0.038; 95% CI, −0.03–0.106) and serious adverse events (RD, 0.01; 95% CI, −0.004–0.023).

Conclusions:
GKAs were more effective for postprandial blood glucose control. However, these agents showed a significantly high risk of causing hypoglycemia.

PROSPERO registration number:
CRD42021220364.
Updates in the understanding and management of diverticular disease
Authors: Eckmann Jason D. , Shaukat Aasma 
Published: October 2021

Purpose of review
Diverticulosis leads to significant morbidity and mortality and is increasing in prevalence worldwide. In this paper, we review the clinical features, diagnosis, and management of diverticular disorders, followed by a discussion of recent updates and changes in the clinical approach to diverticular disease.

Recent findings
Recent literature suggests that antibiotics are likely not necessary for low-risk patients with acute uncomplicated diverticulitis, and not all patients with recurrent diverticulitis require colectomy. Dietary restrictions do not prevent recurrent diverticulitis. Visceral hypersensitivity is increasingly being recognized as a cause of persistent abdominal pain after acute diverticulitis and should be considered along with chronic smoldering diverticulitis, segmental colitis associated with diverticula, and symptomatic uncomplicated diverticular disease.

Summary
Clinicians should be aware that traditionally held assumptions regarding the prevention and management of diverticular disorders have recently been called into question and should adjust their clinical practice accordingly.
Reviewing the Outcomes of Different Treatment Approaches in Elderly Pancreatic Cancer Patients
Authors: Doyle James , Amundsen Tyson , Hall James A. , Raiyani Chandni , Wong Lucas 
Published: October 2021

Objectives
The incidence of pancreatic cancer is age dependent. Ninety percent of new diagnoses occur in patients older than 55 years. Despite the association with age and cancer, elderly patients are historically underrepresented in clinical trials. Thus, optimal management of elderly patients has a lack of data. The purpose of this retrospective study was to investigate the outcomes of palliative chemotherapy in elderly patients with pancreatic cancer compared with supportive care alone.

Methods
Unicentric data were reviewed on all elderly patients (defined as age >65 years) with a diagnosis of pancreatic cancer from 2008 through 2019 to compare outcomes in those who received chemotherapy versus supportive care alone.

Results
The study reviewed 665 patients with a median age of 75 years (mean, 75.7 years) and average Charlson Comorbidity Score of 5.74. Of them, 291 received chemotherapy and 363 received supportive care only. Chemotherapy was associated with a median overall survival of 250 versus 93 days with supportive care (P < 0.0001). Analysis showed improved survival for all age ranges, cancer stages, and Charlson Comorbidity Scores.

Conclusions
Elderly pancreatic cancer patients can benefit from palliative chemotherapy, and it should be considered, especially in patients with fewer medical comorbidities and better functional status.
Wilson Disease Prevalence
Authors: Lorente‐Arencibia Pascual , García‐Villarreal Luis , González‐Montelongo Rafaela , Rubio‐Rodríguez Luis A. , Flores Carlos , Garay‐Sánchez Paloma , delaCruz Tanausú , Santana‐Verano Milagros , Rodríguez‐Esparragón Francisco , Benitez‐Reyes Juana N. , Fernández‐Fuertes Fernando , Tugores Antonio 
Published: October 2021

ABSTRACTObjectives:Diagnosis of Wilson disease (WD) is difficult and, as early detection may prevent all symptoms, it is essential to know the exact prevalence to evaluate the cost‐efficacy of a screening program. As the number of WD patients was high in our population, we wished to estimate prevalence by determining the carrier frequency for clinically relevant ATP7B mutations.Methods:To estimate prevalence, screening for the most prevalent mutation was performed in 1661 individuals with ancestry in Gran Canaria, and the frequency of other mutations was estimated from patient records. Alternatively, ATP7B mutations were detected from exomes and genomes from 851 individuals with Canarian ancestry, 236 from Gran Canaria, and a public Spanish exome database.Results:Estimated carrier frequencies in Gran Canaria ranged from 1 in 20 to 28, depending on the method used, resulting in prevalences of 1 case per 1547 to 3140 inhabitants. Alternatively, the estimated affected frequencies were 1 in 5985 to 7980 and 1 in 6278 to 16,510 in the archipelago or mainland Spain respectively.Conclusions:The number of carriers predicts much higher prevalences than reported, suggesting that WD is underdiagnosed; specific mutations may remain unnoticed due to low penetrance or no signs of disease at all; regional prevalence rather than national prevalence should be considered in cost‐efficacy models to approach preventive screening in the asymptomatic population and genetic screening strategies will have to deal with the genetic heterogeneity of ATP7B in the general population and in patients.
Agreement and Repeatability of Corneal Thickness and Radius among Three Different Corneal Measurement Devices
Authors: Biswas Sayantan , Biswas Partha 
Published: October 2021

SIGNIFICANCE
Corneal refractive surgery screening, orthokeratology, and contact lens fitting require accurate estimation of the corneal thickness and curvature. We found that any of the imaging devices used in this study can be used to image a healthy myopic cornea, which is essential to screen for corneal ectasia.

PURPOSE
This study aimed to compare agreement and repeatability of corneal thickness and radius measurements obtained using Scheimpflug imaging (Pentacam HR), swept-source optical coherence tomography (Casia SS-1000), and Placido-Scheimpflug tomography (Topographic Modeling System, version 5 [TMS-5]).

METHODS
Sixty eyes of 60 subjects with myopia were measured with Casia, TMS-5, and Pentacam for their central corneal thickness (CCT), thinnest corneal thickness, central corneal radius of the steep meridian (Ks), central corneal radius of the flat meridian (Kf), mean central corneal radius (Km), and anterior and posterior best-fit spheres. Two readings were obtained from each instrument. Central corneal thickness was also measured with ultrasound pachymetry. Intraclass correlation coefficient, repeatability coefficient, and coefficient of variation were calculated.

RESULTS
Repeatability coefficient, coefficient of variation, and intraclass correlation coefficient of CCT among the instruments ranged between 2.48 and 12.79, 0.17 and 0.86, and 0.98 and 1.00, respectively. Mean CCT measurements were similar between Casia, TMS-5, Pentacam, and ultrasound pachymetry (P = .13). Intraclass range of correlation for agreement was 0.95 to 0.99 for CCT among instruments. The range of 95% limits of agreement (LoAs) for ultrasound CCT was narrowest with Casia (31.94 μm). Casia–TMS-5 displayed a narrow range of 95% LoA for CCT (12.14 to −12.44), thinnest corneal thickness (12.31 to −11.31), and Ks (0.56 to −0.53), whereas Casia-Pentacam showed a narrow range of 95% LoA for Kf (0.56 to −0.42), Km (0.41 to −0.27), and anterior best-fit sphere (0.03 to −0.07). A significant difference in posterior best-fit sphere measurements was noted among all instruments (P = .01).

CONCLUSIONS
Casia, TMS-5, and Pentacam can be used interchangeably to measure corneal thickness and radius measurement in healthy eyes. Casia had the best agreement with ultrasound pachymeter CCT and exhibited the highest repeatability.
Case Report: Dry Eye Management Leads to Early Diagnosis of Seventh Nerve Schwannoma
Authors: Hyde Clark Benjamin 
Published: October 2021

SIGNIFICANCE
Facial nerve schwannomas are rare tumors that are usually benign and relatively slow in their progression. Common symptoms include facial neuropathy, auditory deficiencies, and parotid masses. Because of slow progression, symptoms are often present for over a year before an appropriate diagnosis is made.

PURPOSE
The purpose of this study was to present a case in which comprehensive dry eye assessments and management led to diagnosis of facial nerve shwannoma in a patient who had no presenting symptoms of auditory deficiencies or facial weakness.

CASE REPORT
A 36-year-old woman presented for a contact lens examination with concerns of progressively worsening symptoms of irritation and dryness in her right eye that began 6 months earlier. Dry eye assessment visits and management strategies were implemented. Although this regimen was initially successful, symptoms returned after 7 months. At this visit, a new finding of incomplete blink in her right eye was manifested. Further in-office assessments revealed a weakened right orbicularis oculi and right frontalis muscle. These findings, combined with patient risk factors and no history of trauma, prompted MRI of the seventh nerve. Imaging revealed the presence of seventh nerve schwannoma, the location of which correlated with the geniculate ganglion and greater superficial petrosal nerve. This patient was later referred to a neurosurgeon, who assessed the risks and benefits of schwannoma removal. It was decided that the risks of the surgery outweighed the benefits, and regular MRI was scheduled for monitoring purposes. Appropriate management of the patient's chronic dry eye disease continues.

CONCLUSIONS
Facial nerve schwannomas can and do present with no presenting subjective facial neuropathy symptoms aside from mild unilateral dry eye and can be detected with comprehensive dry eye management. This case may contribute to future minor adjustments in clinical practice guidelines for asymmetric dry eye assessments.