bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gummy candies production with natural sugar source: Effect of molasses types and gelatin ratios
Authors: Kurt Abdullah , Bursa Kubra , Toker Omer Said 
Published: February 2021

Nowadays, attention has been dedicated towards the development of foodstuffs whose constituents are from natural sources. In this study, grape, mulberry, and carob molasses containing natural sugars were evaluated in order to replace the use of sugar syrup and artificial additives in the production of gummy candy which was prepared by varied gelatin ratios. The molasses which have similar °Brix values (78–79) presented different types and amounts of sugar components. High invert sugar with low sucrose was observed in grape and mulberry but high sucrose with low fructose and glucose appeared in carob molasses. Unlike grape and mulberry, carob based jellies had a whitish appearance possibly as a result of the crystallization due to its high sucrose/invert sugar ratio. For all parameters of TPA, carob candy with 5 g/100 g gelatin and grape candy with 10 g/100g gelatin had the lowest and highest values, respectively. Gelatin concentration dependency trend of hardness, gumminess, chewiness and resilience was determined as grape > mulberry > carob. No significant effect ( p > 0.05) on gelling temperatures (21–29 °C) but significant effect (p < 0.05) on melting points (33–39 °C) of molasses types were observed for candies. The properties of grape based candy having higher thermal stability and lower temperature sensitivity were attributed to its higher total sugar contents than other samples. The sensorial acceptability score for molasses gummy candies obtained more than 3.0 on a 5-point hedonic scale. These results illustrate the potential for the use of molasses in a healthier confectionery product development instead of commonly used sugars.
Lateral transorbital canthopexy using a silicone tube in patients with paralytic ectropion
Authors: González-Cannata María G , González-Hinojosa Diana I , Aguilera-Ruíz Karla J , González-Núñez Martha P , Medina-Zarco Alfredo , Acevedo-Moreno Lou-Anne G , González-Navarro Mauricio 
Published: February 2021

Purpose: We describe the efficacy of lateral transorbital canthopexy using a silicone tube in managing severe paralytic ectropion. Methods: Patients with paralytic ectropion involving at least two-third of lower eyelid length and scleral exposure of 3 mm or more were considered. A silicone prosthetic was inserted during canthopexy. Results: Lateral transorbital canthopexy using a silicone tube was performed on 10 eyelids in nine patients. All patients had corneal surface abnormalities. Scleral exposure resolved completely in three cases. At 8-month follow-up, residual scleral exposure of 1 mm and 2 mm persisted in n = 6 and n = 1 cases, respectively. Conclusions: Lateral transorbital canthopexy using a silicone tube is an effective therapeutic option for paralytic ectropion, facilitating both functional and cosmetic results that proved durable over time.
Intracorneal circular ring implant with femtosecond laser: Pocket versus tunnel
Authors: Izquierdo Luis , Rodríguez Ana M , Sarquis Ramón A , Altamirano Diego , Henriquez Maria A 
Published: February 2021

Purpose: To evaluate and compare visual and refractive outcomes after implantation of the intracorneal continuous ring 360° arc (ICCR) versus the intracorneal ring segment 340° arc (ICRS) using femtosecond laser for central keratoconus. Setting: Research Department, Oftalmosalud, Instituto de Ojos, Lima, Peru. Methods: Randomized study that included 40 eyes of 32 patients diagnosed with central keratoconus between November 2014 and March 2015. Twenty eyes had an implantation of ICCR (MyoRing, Dioptex GmbH, Austria) through an intrastromal pocket and 20 eyes had an implantation of ICRS (Keraring, Mediphacos, Brazil) through an intrastromal tunnel. Both procedures were performed with a femtosecond laser (LDV Z6 model, Ziemer Ophthalmic Systems AG). Visual acuity (VA), refraction, and Scheimpflug imaging analysis were performed pre- and postoperatively at 1 month and 1 year. Comparisons of means were performed using the Student’s t-test. Results: At 1 year, uncorrected VA improved 0.77 LogMAR ( p < 0.001) in the ICCR group and 0.79 LogMAR ( p = 0.01) in the ICRS group; mean sphere improvement was 5.13 Diopters (D) in the ICCR group and 6.27 D in the ICRS group ( p < 0.001 both); mean Steeper Keratometry improvement was 4.24 D in the ICCR group and 5.53 D in the ICRS group ( p < 0.001 both). In the ICCR group, mean decrease in the pachymetry at the thinnest point of the cornea was 32.16 µm ( p = 0.01), and in the ICRS group, mean increase was 4.2 µm at 1 year ( p = 0.61). Conclusion: Intracorneal continuous ring 360° arc (ICCR) and intracorneal ring segment 340° (ICRS) are effective treatments for central keratoconus. No significant differences between rings were found on visual acuity, refraction, and keratometry improvement.
The FICI grading for a dacryocystorhinostomy ostium
Authors: Ali Mohammad Javed , Gupta Adit , Lakshmi Chittabhathina Sri , Ali Mohammad Hasnat 
Published: February 2021

Purpose: The objective of this study is to propose a simple grading to assess the health of a dacryocystorhinostomy (DCR) ostium. Methods: Prospective case series of 237 Ostia evaluated following dacryocystorhinostomy were included in the study. All the ostia were assessed for 10 parameters in detail using the earlier published DCR ostium scoring (DOS scoring). Each of the 10 parameters were scored individually, and final DOS scores were obtained. The anatomical and functional outcomes of each of the surgery were noted. The most significant parameters that influenced the success were determined using the binary recursive partitioning in a conditional inference framework. Data management and statistical tests were performed using the statistical “Software R” and the library “partykit” toolkits. Results: The most significant DCR ostium parameters that influenced the outcomes were anatomical and functional fluorescein dye transit ( p < 0.001), dynamicity of internal common opening (ICO) on the blink ( p < 0.001), end-on threats to ICO from granuloma, membrane or a synechia, and cicatricial closure of the Ostia. Each of these significant factors (FICI – Fluorescein endoscopy dye test, ICO dynamicity, Cicatricial ostium closure and ICO threats) were assigned simple scoring and the final scores were graded from 0 (poor DCR ostium) to +5 (excellent DCR ostium). FICI grading can guide the physician on the health status of the DCR ostium and the possible need for intervention. Conclusion: FICI DCR ostium grading is a simple, easy to perform, and physician-friendly system. More studies with larger sample size would help in further validating the FICI grading.
Comparative evaluation of visual outcomes after bilateral implantation of an advanced or conventional monofocal intraocular lens
Authors: Lopes Diogo , Loureiro Tomás , Carreira Rita , Rodrigues Barros Sandra , Cardoso João Nobre , Campos Paul , Machado Inês , Campos Nuno 
Published: February 2021

Purpose: To assess the clinical outcomes and patient satisfaction of the Tecnis Eyhance, an advanced monofocal intraocular lens (IOL), compared to a conventional monofocal IOL. Design: Retrospective case-control study. Methods: This study included 120 eyes of 60 patients (30 patients in each group) who underwent bilateral cataract surgery either with the implantation of conventional monofocal IOLs (Tecnis PCB00), as a control group, or advanced monofocal IOLs (Tecnis Eyhance ICB00). Ophthalmological evaluation included the measurement of binocular corrected distance visual acuity (CDVA), monocular and binocular uncorrected distance visual acuity (UDVA), and uncorrected intermediate VA (UIVA). In addition the binocular defocus curve was analyzed. Furthermore a subjective questionnaire (Catquest-9SF) was used to assess vision and life quality. Results: The average binocular UDVA was 20/22 in the ICB00 group and 20/20 in the PCB00 model ( p = 0.62). The average monocular UIVA was 20/32 in the ICB00 group and 20/40 in the control group ( p < 0.001). We found the binocular UIVA, had a mean value of 20/30 in the ICB00, compared to 20/40 in the control group ( p < 0.001). The reported dysphotopsia was not significantly different between both groups ( p = 0.56). Regarding the life quality questionnaire, the ICB00 group showed less difficulty in activities requiring intermediate vision. Conclusion: Our results demonstrated a significant improvement in visual acuity for intermediate distance in the ICB00 group compared to the control group, without compromising distance visual acuity. We also found a greater capability for intermediate distance activities (namely for computer use and reading price tags) when comparing ICB00 patients with the control group.
Long-term clinical and radiological outcome in patients with severe Legg-Calvé-Perthes disease after Chiari pelvic osteotomy: a mean of 14 years follow-up
Authors: Dammerer Dietmar , Braito Matthias , Ferlic Peter , Kaufmann Gerhard , Kosiol Juana , Biedermann Rainer 
Published: February 2021

Introduction: The Chiari pelvic osteotomy (CPO) has been recommended as a salvage procedure to improve head coverage in case of hip joint incongruence in paediatric hip disease. In this study, we aimed to assess the long-term results of CPO for severe Legg-Calvé-Perthes disease (LCPD). Methods: A total of 39 patients who underwent a CPO at our department between 1995 and 2010 were prospectively followed both radiologically (Stulberg classification) and clinically (Harris Hip Score [HHS], conversion into total hip arthroplasty). In this study, we retrospectively reviewed the cases of 12 hips (12 patients, 3 girls, 8 left hips) treated by CPO for severe LCPD (Catterall grade 3 or 4) with hip joint incongruence. Mean follow-up was 14.0 (range 7.6–21.3) years. Results: Mean age at surgery was 10.2 (range 8.2–17.8) years. Additional femoral osteotomy was performed in 8 patients. A good radiological result (Stulberg I or II) was achieved in 2 patients, a fair result (Stulberg III) in 4 patients, and a poor outcome (Stulberg IV or V) in 6 patients. Mean postoperative HHS averaged 93 (range 65–100) points. An excellent functional outcome (HHS 90–100 points) was achieved in 9 patients. No patient underwent total hip arthroplasty during follow-up. Postoperative limb-length discrepancy was found in 3 patients. Conclusions: CPO for severe LCPD with hip joint incongruence resulted in good long-term clinical outcome in about ⅔ of our patients after a mean of 14 years. Our results suggest that CPO can still be considered as a salvage joint-conserving procedure in this selected group of younger patients.
Use of a monoblock dual-mobility acetabular component in primary total hip arthroplasty in patients at high risk of dislocation
Authors: Yang JaeWon , Bryan Andrew J , Drabchuk Roman , Tetreault Matthew W , Calkins Tyler E , Della Valle Craig J 
Published: February 2021

Introduction: Dislocation is amongst the most common complications following total hip arthroplasty (THA). Dual-mobility bearings have been suggested as one way to reduce the risk of dislocation, particularly among patients at increased risk. The purpose of this study was to determine the outcomes of a monoblock dual-mobility shell for patients at high risk for dislocation following primary THA. Methods: A total of 155 primary THAs with a monoblock, cementless dual-mobility acetabular component were performed in patients at high risk for dislocation. Two patients died prior to their two-year follow-up. The remaining 153 THAs were followed for a mean of 5.1 years (range: 2.1 to 9.3). Results: There were no dislocations; however, four patients underwent revision surgery: one for an early periprosthetic acetabular fracture, one for an early periprosthetic femoral fracture, one for a late periprosthetic femoral fracture, and one for leg-length discrepancy. Intraoperative complications included one periprosthetic acetabular fracture treated with protected weight-bearing and one intraoperative proximal femoral fracture treated with cerclage wiring. Harris Hip Scores improved from a mean of 42.4 points preoperatively to a mean of 82.4 points postoperatively ( p < 0.001). No cups were radiographically loose. At a mean follow-up of 5.1 years, survivorship of the acetabular component was 99.3% (95% CI, 98.1–100%) and survivorship without any reoperation was 97.4% (95% CI, 95.9–100%). Discussion: Although there were no dislocations in this high-risk population, periprosthetic fractures of the femur and acetabulum were common with the implants utilised.
Application and implications of a standardised reporting system for arteriovenous access graft infection
Authors: Kingsmore David , Stevenson Karen , Jackson Andrew , Richarz Sabine , Isaak Andrej , White Beth , Thomson Peter 
Published: February 2021

Introduction: The perception that arteriovenous graft infection (AVGi) is frequent and severe is not based on contemporary data from large units using modern AVG. Furthermore, older reports compounded misperceptions by using non-standardised reporting that prevents easy comparison against the alternative modalities. The aim of this article is to use a recently published reporting scheme to analyse the frequency, management and outcome of AVGi in a large series of sequential early-cannulation AVG with long-term follow-up. Methods: A single-center series analysis was performed of 277 early-cannulation AVG with minimum 1-year follow-up (total 120,082 days). Infections relating to the AVG were classified, root-cause analysed and the outcomes presented. Results: Sixteen percent of all AVG implanted (51 episodes) developed infection related to the AVG. Primary AVGi (related to the insertion procedure or within 28 days) occurred in 9 (3%); secondary AVGi (related to AVG in use) occurred 33 times (rate 0.27/1000 haemodialysis days), at a mean of 382 days, and tertiary AVGi (in AVG no longer in use) occurred nine times. Only 1/3 of all AVGi led to bacteraemia, and ½ did not lead to loss of functional access. Summary: AVG infection is not common, caused a systemic infection in only one-third, did not lead to metastatic infection, and importantly, was treatable without loss of access in one-half of all cases. Using an objective system that discriminates between aetiology and outcome allows a more complete objective understanding of relative infection risks and outcomes for AVG that can inform discussions with patients requiring vascular access for haemodialysis.
Quality of Life and Glycemic Control in Saudi Children with Type 1 Diabetes at Different Developmental Age Groups
Authors: Babiker Amir , Al Aqeel Bothainah , Marie Sarah , Omer Hala , Bahabri Aban , Al Shaikh Adnan , Zahrani Nada , Badri Motasim , Al Dubayee Mohamed , Al Alwan Ibrahim 
Published: February 2021

Background: Children with type 1 diabetes (T1D) at different stages of development have age-specific needs, which can influence their perception of quality of life (QoL). In our study, we aimed to emphasize these age-specific needs and assess the perception of QoL in Saudi children with T1D, as well as their parents correlating QoL scores with children’s glycemic control. Methods: This is a cross-sectional study in which children with T1D and their parents from 2 tertiary institutes in Saudi Arabia have answered a standard diabetes-specific QoL questionnaire (PedsQL™ 3.0 diabetes module, translated in Arabic). We also reported glycated hemoglobin (HbA1c) results for these children within a month of completing the questionnaire. The QoL total aggregate and domain scores for self (children) and proxy (parents’) reports were compared and correlated with children’s HbA1c. Results: A sample was 288 self and proxy reports from 144 children with T1D of 3 age groups: 5 to 7 years (7%), 8 to 12 years (49%), and 13 to 18 years (44%), and their parents. QoL differed significantly between self and proxy reports in the total aggregate and domain scores ( P-values range from .02 to <.001). The impact on QoL was significantly higher in female patients ( P = .043). Insulin pump users had better HbA1c ( P = .007), and HbA1c level was worse in those who intended to fast at Ramadan ( P = .005). Conclusion: Children with T1D at different developmental age groups perceive QoL differently than their parents. Adjusting management as per age-specific challenges could potentially improve these children’s QoL and glycemic control.
Autologous haematopoietic stem cell transplantation as a first-line disease-modifying therapy in patients with ‘aggressive’ multiple sclerosis
Authors: Das J , Snowden JA , Burman J , Freedman MS , Atkins H , Bowman M , Burt RK , Saccardi R , Innocenti C , Mistry S , Laud PJ , Jessop H , Sharrack B 
Published: February 2021

Background: Autologous haematopoietic stem cell transplantation (AHSCT) is an effective treatment for patients with multiple sclerosis (MS) who have highly active disease, despite the use of standard disease-modifying therapies (DMTs). However, the optimal time for offering AHSCT to patients with ‘aggressive’ MS is yet to be established. Objectives: The objective was to explore the safety and efficacy of AHSCT as a first-line DMT in patients with ‘aggressive’ MS. Methods: All patients with ‘aggressive’ MS who received AHSCT as a first-line DMT in five European and North American centres were retrospectively evaluated. Results: Twenty patients were identified. The median interval between diagnosis and AHSCT was 5 (1–20) months. All had multiple poor prognostic markers with a median pre-transplant Expanded Disability Status Scale (EDSS) score of 5.0 (1.5–9.5). After a median follow-up of 30 (12–118) months, the median EDSS score improved to 2.0 (0–6.5, p < 0.0001). No patient had further relapses. Three had residual magnetic resonance imaging (MRI) disease activities in the first 6 months post-transplant, but no further new or enhancing lesions were observed in subsequent scans. Conclusion: AHSCT is safe and effective as a first-line DMT in inducing rapid and sustained remission in patients with ‘aggressive’ MS.
Differential effects and discriminative validity of motor and cognitive tasks varying in difficulty on cognitive–motor interference in persons with multiple sclerosis
Authors: Veldkamp Renee , Kalron Alon , Baert Ilse , Hämäläinen Paivi , Tacchino Andrea , D’hooge Mieke , Giffroy Xavier , Van Geel Fanny , Raats Joke , Coninx Karin , Van Wijmeersch Bart , Feys Peter 
Published: February 2021

Background: Cognitive–motor interference (CMI) has been well recognized in persons with multiple sclerosis (pwMS); however, there are limited data on effects of task difficulty. Objective: Examine (1) the effects of motor and cognitive tasks varying in difficulty on the magnitude of CMI and (2) the discriminative validity of CMI between pwMS and healthy controls (HC). Methods: Nine cognitive–motor dual-task (DT) conditions (combinations of three cognitive and three walking tasks) were examined. Outcome measures were DT-performance and dual-task cost (DTC) of gait parameters and correct answers. Task differences and overall group-effects were analysed by mixed model analysis, plus the Wilcoxon signed-rank tests or multivariate analysis of variances (MANOVAs), respectively. Results: Task effects were examined in 82 pwMS (Expanded Disability Status Scale (EDSS): 3.3 ± 1.0) and discriminative validity in a subsample (35 pwMS and 33 HC). Motor-DTC and DT-performance were affected by difficulty of both the cognitive task ( p < 0.001) and the walking condition ( p ⩽ 0.002), while cognitive-DTC only varied between cognitive tasks with a large difference in difficulty ( p ⩽ 0.005) and not between walking conditions ( p ⩾ 0.125). None of the DTCs differed between groups. Conclusion: CMI, and especially motor performance, is affected by difficulty of the DT. Although pwMS performed worse on the tasks than HC, none of the DT-conditions showed a discriminative DTC.
Operationalization of a frailty index in patients with multiple sclerosis: A cross-sectional investigation
Authors: Belvisi Daniele , Canevelli Marco , Baione Viola , Buscarinu Maria Chiara , Pellicciari Giulia , Fantozzi Roberta , Creta Armando , Cecchi Gianluca , Cola Gaia , Nicoletti Carolina Gabri , Cortese Antonio , De Giglio Laura , Tartaglia Matteo , Crisafulli Sebastiano Giuseppe , Bruno Giuseppe , Ferraro Elisabetta , Marfia Girolama Alessandra , Centonze Diego , Salvetti Marco , Conte Antonella 
Published: February 2021

Background: Frailty is an age-related status of increased vulnerability to stressors caused by the accumulation of multiple health deficits. This construct may allow to capture the clinical complexity of patients with multiple sclerosis (MS). Objective: To investigate the relationship between frailty and the clinical manifestations of MS. Methods: Patients with MS were consecutively enrolled at five tertiary dedicated services. Disability and fatigue were assessed. The phenotypes of MS were also identified. Frailty was measured using a frailty index (FI), computed by cumulatively considering 42 age-related multidimensional health deficits. Results: Overall, 745 MS patients (mean age = 48.2 years, standard deviation = 11.7 years; women 68%) were considered. The median FI value was 0.12 (interquartile range = 0.05–0.19) and the 99th percentile was 0.40. FI scores were associated with MS disease duration, disability, fatigue, as well as with the number of previous disease-modifying treatments and current symptomatic therapies. A logistic regression analysis model showed that FI score was independently associated with the secondary progressive phenotype. Conclusion: Frailty is significantly associated with major characteristics of MS. The findings of the present cross-sectional investigation should be explored in future longitudinal studies.
The frequency and characteristics of MS misdiagnosis in patients referred to the multiple sclerosis centre of Catalonia
Authors: Midaglia Luciana , Sastre-Garriga Jaume , Pappolla Agustín , Quibus Laura , Carvajal René , Vidal-Jordana Angela , Arrambide Georgina , Río Jordi , Comabella Manuel , Nos Carlos , Castilló Joaquin , Galan Ingrid , Rodríguez-Acevedo Breogan , Auger Cristina , Tintoré Mar , Montalban Xavier , Rovira Àlex 
Published: February 2021

Background: Multiple sclerosis (MS) misdiagnosis may cause physical and emotional damage to patients. Objectives: The objective of this study is to determine the frequency and characteristics of MS misdiagnosis in patients referred to the Multiple Sclerosis Centre of Catalonia. Methods: We designed a prospective study including all new consecutive patients referred to our centre between July 2017 and June 2018. Instances of misdiagnosis were identified, and referral diagnosis and final diagnosis were compared after 1 year of follow-up. Association of misdiagnosis with magnetic resonance imaging (MRI) findings, presence of comorbidities and family history of autoimmunity were assessed. Results: A total of 354 patients were referred to our centre within the study period, 112 (31.8%) with ‘established MS’. Misdiagnosis was identified in eight out of 112 cases (7.1%). MRI identified multifocal white matter lesions, deemed non-specific or not suggestive of MS in all misdiagnosed cases. Patients with MS misdiagnosis had more comorbidities in general than patients with MS ( p = 0.026) as well as a personal history of autoimmunity ( p < 0.001). Conclusion: A low frequency of MS misdiagnosis was found in our clinical setting. Multifocal non-specific white matter lesions in referral MRI examinations and the presence of comorbidities, including a personal history of autoimmunity, seem to be contributing factors to misdiagnosis.