bluuebunny/crossref_metadata_2025_split huggingface dataset:
RETINITIS PIGMENTOSA SINE PIGMENTO
Authors: Lee Eun Kyoung , Lee Sang-Yoon , Ma Dae Joong , Yoon Chang Ki , Park Un Chul , Yu Hyeong Gon 
Published: December 2021

Purpose:
To investigate the clinical findings, natural course, and pigment development of patients with retinitis pigmentosa (RP) sine pigmento using multimodal imaging.

Methods:
We reviewed the medical records of 810 consecutive patients with RP and assessed serial ultra-widefield fundus photography, fundus autofluorescence, and optical coherence tomography images. Electrophysiological and visual field analysis findings were also reviewed.

Results:
Of the 774 patients with RP who met the inclusion criteria, 88 were diagnosed with RP sine pigmento, with a prevalence of 11.4%. The mean age of the patients was 35.57 years compared with 49.83 years for patients with typical RP. Fifty-nine patients (67%) demonstrated minimal color change, whereas 29 (33%) presented with grayish flecks in the retinal pigment epithelium on fundus photography. All patients with RP sine pigmento had abnormalities on fundus autofluorescence, and the commonest fundus autofluorescence findings were punctate or reticular hypoautofluorescence. Of the 62 patients without pigmentation at the first visit and at the follow-up visits, 14 (22.6%) had developed pigmentation at their follow-up visit, with an average time of 3.92 years. Most patients retained a visual acuity of ≥20/50 within the age of 50 years.

Conclusion:
Diagnosing RP sine pigmento based solely on ophthalmoscopic findings is more difficult than in more typical cases. Multimodal imaging can provide insights into the clinical characteristics to facilitate the diagnosis, classification, and follow-up of patients.
CILIOCHOROIDAL EFFUSION IN CENTRAL SEROUS CHORIORETINOPATHY
Authors: Terao Nobuhiro , Imanaga Naoya , Wakugawa Sorako , Sawaguchi Shota , Tamashiro Tamaki , Yamauchi Yukihide , Koizumi Hideki 
Published: December 2021

Purpose:
To investigate the prevalence of ciliochoroidal effusion (CE) in central serous chorioretinopathy (CSC) using anterior-segment optical coherence tomography and its association with the clinical features of CSC.

Methods:
Overall, 164 eyes of 164 patients with CSC and 51 eyes of 51 age- and sex-matched normal control participants were retrospectively examined. Anterior-segment optical coherence tomography was used to assess patients with CSC and control subjects for CE and scleral thickness. Central serous chorioretinopathy eyes were divided into two groups: eyes with CE (CE group) and eyes without CE (non-CE group). Scleral thickness was measured at the point that was 6 mm posterior to the scleral spur in four directions.

Results:
Among the 164 eyes with CSC, 32 eyes (19.5%) displayed CE, and this proportion was significantly higher than that in control subjects (2.0%) (P = 0.001). Scleral thickness was significantly greater in the CE group compared with the non-CE group at all four directions (P < 0.05 for all). Multivariable analysis revealed that the mean scleral thickness (odds ratio: 1.01; 95% confidence interval: 1.00–1.02; P = 0.007) was significantly associated with the incidence of CE.

Conclusion:
Central serous chorioretinopathy may accompany fluid accumulation in the anterior segment more frequently than previously expected in association with thick sclera.
Exploring the Impacts of Alcohol and Other Drug Use on HIV Care Among Older African American Adults in Kentucky: A Constructivist Grounded Theory Study
Authors: Harris Lesley M. , Silverstein Sydney M. , Crawford Timothy N. , Kerr Jelani C. , Ball Diana 
Published: December 2021

Abstract
This grounded theory study examined the use of alcohol and other drugs (AOD) on the management of HIV disease among 27 older African Americans (≥50 years). Interview transcripts were analyzed using constructivist grounded theory analytic techniques. Participants reported facing (a) environmental impacts of AOD use and (b) discrimination from the health care system. The analysis revealed six phases of AOD use, occurring at various stages of the HIV care continuum: (a) linking AOD use as the cause of HIV diagnosis, (b) having AOD use facilitate denial of HIV, (c) experiencing problematic use as a barrier to care engagement, (d) “testing the waters,” (e) relying on AIDS service organizations and medical providers, and (f) changing or maintaining patterns of AOD use to maintain engagement with care. Recommendations include assessing a patient's AOD use in relationship to the care continuum to evaluate patients' experiences and barriers within systems of care.
Analysis of Reported Adverse Events With Colonic Stents
Authors: Ramai Daryl , DeLuca Matthew , Facciorusso Antonio , Ofosu Andrew , Girotra Mohit , Tabibian James H. , Rodrigues-Pinto Eduardo , Adler Douglas G. , Barakat Monique T. 
Published: December 2021

Background:
Colonic stents are indicated for preoperative and palliative decompression of large bowel obstruction. We aim to investigate post Food and Drug Administration (FDA) approval outcomes associated with colonic stents.

Materials and Methods:
We analyzed postmarketing surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database from January 2011 to December 2020.

Results:
During the study period, 691 device issues and 742 patient complications were identified. The number of adverse events reported to the FDA mildly increased from 6.40% in 2011 to 7.4% in 2020. Most device complications were due to a positioning problem (n=201, 29%), followed by device break (n=60, 8.6%), delamination (n=41, 6.3%), and migration or expulsion device (n=38, 5.55%). A number of reports described an unclassified adverse event without specifying device or operator problem (n=141, 20.3%). The most reported patient adverse events were perforation (n=150, 20.1%), death (n=47, 6.3%), abdominal pain/discomfort (n=27, 3.6%), and peritonitis (n=24, 3.2%).

Conclusion:
Findings from the MAUDE database highlight rare but important patient and device complications which endoscopists and referring providers should be aware of before consideration for colonic stent placement.
Less Emergency Department Abdominopelvic Computed Tomography for Patients With Crohn’s Disease
Authors: Riskin Geuz Kinneret S. , Schwartz Doron 
Published: December 2021

Background:
In recent years, the use of abdominal pelvic computed tomography (APCT) in the emergency department (ED) for patients with Crohn’s disease (CD) has risen steadily. Thus, exposing these patients to recurrent radiation, despite studies showing that only 30% to 40% had significant findings in ED APCT.

Goal:
Our aim was to find clinical and laboratory variables that can predict substantial findings on ED APCT, which may require invasive intervention.

Methods:
We analyzed ED visits of patients with known CD that underwent an emergent APCT for gastrointestinal complaints, over a 10-year period. Patients with positive and negative findings in the APCT were compared in order to evaluate independent effects of different variables, including patients’ characteristics, CD history, ED complaints, and laboratory tests.

Results:
In 44% of 183 ED visits, there were significant findings on ED APCT, however, only 22% of them underwent invasive intervention. Laboratory tests: C-reactive protein >50 mg/L, neutrophil count >75%, platelet count >350×109/L, and ileocolon location at diagnosis were all positive predicting factors. Whereas, smoking or ED complaints of diarrhea/fever reduced the risk for significant findings.

Conclusions:
Using the 7 most significant predicting factors, we built an easy to use scoring system—Crohn Assessment Tool for CT upon Hospitalization (CATCH) for ED clinicians. This scoring system could have prevented unnecessary ED APCT from 42% of the patients in our study, without missing those who required invasive intervention.
Validation of the IBD-Disk in a Portuguese cohort
Authors: Silva Mendes Sofia , Ferreira Patrícia , Antunes Pedro , Gonçalves Margarida , Leal Tiago , Gonçalves Bruno , Rebelo Ana , Arroja Bruno , Caetano Ana C. , Gonçalves Raquel , Soares João B. 
Published: December 2021

Objective
The aim of this study was to validate the IBD-Disk in a Portuguese cohort according to the COnsensus-based Standards for the selection of the health Measurement INstruments (COSMIN) recommendations.

Methods
After translation of the original IBD-Disk to Portuguese, a group of IBD patients was invited to complete the IBD-Disk at baseline (T0), after 1-4 weeks (T1) and after more than 3 months (T2), from July 2020 to February 2021. At T0 and T2, the patients also completed the IBD Disability Index. We evaluated reliability (internal consistency, test-retest, interrater reliability and measurement error), construct validity, responsiveness, interpretability of IBD-Disk, sociodemographic and clinical factors associated with IBD-Disk.

Results
At T0, 154 patients (107 - Crohn’s disease; 46 - ulcerative colitis) completed the IBD-Disk; 1 - IBD-unclassified). At T1 and T2, 64 and 114 patients repeated the questionnaire, respectively. Factor analysis confirmed the unidimensionality of the scale and reduced the final version to 10 items. Internal consistency was excellent with a Cronbach’s α of 0.916. The intraclass correlation coefficient was 0.95 for test-retest (T0 and T1). To evaluate construct validity, the IBD-Disk was compared with the IBD Disability Index and Manitoba IBD Index with a significative positive correlation (r = 0.850 and r = 0.459, respectively; P < 0.001 for both). IBD-Disk scores ranged from 0 to 93 with a mean of 38.18 ± 25.39. Female sex, professional inactivity, longer IBD duration and clinical activity were associated with significantly higher IBD-Disk scores.

Conclusion
The Portuguese version of IBD-Disk is a reliable and valid tool to assess disability in Portuguese IBD patients.
Lipids and brain inflammation in APOE4-associated dementia
Authors: Duro Marlon V. , Ebright Brandon , Yassine Hussein N. 
Published: December 2021

Purpose of review
To highlight recent developments in studying mechanisms by which the apolipoprotein E4 (APOE4) allele affects the metabolism of brain lipids and predisposes the brain to inflammation and Alzheimer's disease (AD) dementia.

Recent findings

APOE4 activates Ca2+ dependent phospholipase A2 (cPLA2) leading to changes in arachidonic acid (AA), eicosapentaenoic acid and docosahexaenoic acid signaling cascades in the brain. Among these changes, the increased conversion of AA to eicosanoids associates with sustained and unresolved chronic brain inflammation. The effects of APOE4 on the brain differ by age, disease stage, nutritional status and can be uncovered by brain imaging studies of brain fatty acid uptake. Reducing cPLA2 expression in the dementia brain presents a viable strategy that awaits to be tested.

Summary
Fatty acid brain imaging techniques can clarify how changes to brain polyunsaturated fatty acid metabolism during the various phases of AD and guide the development of small molecules to mitigate brain inflammation.
Learning Longitudinal Patterns and Subtypes of Pediatric Crohn Disease Treated With Infliximab via Trajectory Cluster Analysis
Authors: Chen Andrew , Stein Ronen , Baldassano Robert N. , Huang Jing 
Published: December 2021

ABSTRACTBackground:The objective of this study is to identify subgroups of pediatric Crohn disease (CD) who had differential responses to the infliximab treatment through trajectory cluster analysis of disease activity using data from electronic health records.Methods:We conducted a retrospective study of 295 pediatric patients with CD who had been treated with infliximab for a minimum of one year at the Center for Inflammatory Bowel Disease at The Children's Hospital of Philadelphia between January 2010 and December 2017. The evolution of disease was described, and subgroups of patients were identified using trajectory analysis of longitudinal data of C‐reactive protein (CRP). We compared patient characteristics, biomarker for disease activity, and long‐term surgical outcomes across subgroups. Cox regression models were used to evaluate the added value of the subgroup classification to baseline phenotype and location in prediction of long‐term surgical outcomes.Results:We identified three subgroups of patients with differential relapse‐and‐remission profiles (n = 33, 65 and 197 from subgroup 1 to 3), which represented patients with a higher risk of infliximab non‐response, with infliximab response but with occasional disease flares, and patients with long‐term response. Patients with the best treatment response had a significantly lower frequency of complicated disease phenotypes (P = 0.01), including perianal involvement (P = 0.05), lower baseline CRP (P < 0.01) and calprotectin (P = 0.01), and lowest risk of IBD‐related gastrointestinal surgery within 10 years of starting treatment (P < 0.01).Conclusions:Readily available longitudinal data from electronic health records can be leveraged to provide deeper characterization of treatment response in pediatric CD.
Student-Centered Reflection During Debriefing
Authors: Nagle Amy , Foli Karen J. 
Published: December 2021

Background:
Guided reflection during a debriefing after the simulation is a critical component of learning and is essential for clinical judgment development. However, the literature describing student-centered reflection during debriefing is only beginning to emerge.

Purpose:
This study aimed to explore concordance between student-centered reflection concept characteristics and describe students' experiences related to reflection during an optimal simulation debriefing.

Methods:
This was a descriptive, mixed-methods study.

Results:
Quantitative responses (N = 175; 67% response rate) confirmed participants' concordance with student-centered reflection concept analysis attributes, antecedents, and consequences. Analysis of open-ended questions highlighted internal and external factors influencing students' reflections. A recurring theme was the importance of faculty and peers in creating a safe, supportive environment for reflections.

Conclusions:
Findings support the concordance of student-centered reflection and provide valuable insights into the internal and external factors influencing this reflection.
Dynamic Reconstruction of the Lower Lip With Free Functioning Gracilis Muscle Transfer
Authors: Krakowczyk Łukasz , Opyrchał Jakub , Bula Daniel , Wierzgoń Janusz , Szymczyk Cezary , Maciejewski Adam 
Published: December 2021

Abstract:
The restoration of large full-thickness lip defects still remains a formidable challenge for the reconstructive surgeons. Traumatic injuries, infections and tumors (primarily squamous cell carcinoma) are the most common source of the lip defects. Lower lips are more important in providing oral competence, unfortunately throughout the life-time they are significantly more exposed to ultraviolet radiation and thus are the most common site for the lip cancers (89%). This type of defect requires a complex reconstruction of an adequate sphincter function, defined vermilion, proper oral lining and sufficient mouth opening. To maintain the oral competence, it is of paramount importance to restore the function of orbicularis oris, which principally composes the body of the lip. Currently, the dynamic reconstructions are gaining considerable interest. They enables not only improvement of appearance but also a restoration of function and preservation of health-related quality of life. The use of the free gracilis muscle transfer to reconstruct the lower lip and its dynamic character in contrast to other, static reconstructions can provide the sufficient movement of the lower lip, which does not depend on function of other mimic muscles as it becomes an independent motor unit with its own neurotization. In our opinion the free functioning gracilis muscle flap, due to its anatomic and functional features as well as low-rate donor-site morbidity is the worth considering option for a lower lip reconstruction.
The Use of Computer-Guided Half Propeller Genioplasty for the Correction of Mandibular Asymmetry (A Mandibular Orthognathic Surgery Without a Condylar Intervention Technical Strategy)
Authors: El Dien Hany Hossam , Zaki Ahmed Hany , El Hadidi Yasser Nabil , Gaber Ramy Mohamed 
Published: December 2021

Introduction:Mandibular asymmetry is a facial deformity that results from multiple causes; among these are growth deficiency like hemifacial microsomia and growth excess as in condylar hyperplasia. The facial asymmetry caused by condylar hyperplasia has been treated over the years with different surgical and nonsur-gical modalities dependent on the age of the patient and the severity of the condition. The authors in this article introduce a modified version of the propeller genioplasty technique.Materials and Methods:A new surgical technique “modified propeller genioplasty” is introduced for the management of facial asymmetry. Virtual surgical planning of the osteotomies and segment repositioning was done virtually. A cutting guide, positioning guides and 3D model of the corrected chin were 3D printed, to facilitate replication ofthe virtually planned osteotomies, prebending of plates, and segment repositioning.Results:The esthetically accepted result was achieved using this technique with minimal postoperative complications.Conclusions:The technique appeared to be accurate, simple, and more cost efficient when compared to patient-specific plates.
ETS-Related Gene Activation Preserves Adherens Junctions and Permeability in Microvascular Endothelial Cells
Authors: Tharakan Binu , Hunter Felicia A. , Muthusamy Saravanakumar , Randolph Sonya , Byrd Crystal , Rao Veena N. , Reddy E Shyam P. , Childs Ed. W. 
Published: December 2021

ABSTRACT
ERG (ETS-related gene) is a member of the ETS (Erythroblast-transformation specific) family of transcription factors abundantly present in vascular endothelial cells. Recent studies demonstrate that ERG has important roles in blood vessel stability and angiogenesis. However, it is unclear how ERG is potentially involved in microvascular barrier functions and permeability. A wide variety of diseases and clinical conditions including trauma-hemorrhagic shock and burn injury are associated with microvascular dysfunctions, which causes excessive microvascular permeability, tissue edema and eventually, multiple organ dysfunction and death. The main purpose of this study was to determine the specific role of ERG in regulating microvascular permeability in human lung microvascular endothelial cells (HLMEC) and to evaluate if exogenous ERG will protect the barrier. The HLMECs were grown on Transwell inserts as monolayers and were transfected with ERG CRISPR/cas9 knockdown plasmid, ERG CRISPR activation plasmid, recombinant ERG protein or their respective controls. Recombinant vascular endothelial growth factor (VEGF) was used as an inducer of permeability for evaluating the effect of ERG activation on permeability. Changes in barrier integrity and permeability were studied using monolayer permeability assay and immunofluorescence of adherens junction proteins (VE-cadherin and β-catenin) respectively. CRISPR/cas9-based ERG knockdown as well as VEGF treatment induced monolayer hyperpermeability, VE-cadherin, and β-catenin junctional relocation and cytoskeletal F-actin stress fiber formation. CRISPR based ERG activation and recombinant ERG transfection attenuated VEGF-induced monolayer hyperpermeability. ERG activation preserved the adherens junctions and cytoskeleton. These results demonstrate that ERG is a potent regulator of barrier integrity and permeability in human lung microvascular endothelial cells and endogenously or exogenously enhancing ERG provides protection against barrier dysfunction and hyperpermeability.
A scoping review of nontechnical skill assessment tools to evaluate trauma team performance
Authors: Bhangu Avneesh , Stevenson Christina , Szulewski Adam , MacDonald Aidan , Nolan Brodie 
Published: December 2021

BACKGROUND
The objective of this scoping review was to identify assessment tools of trauma team performance (outside of technical skills) and assess the validity and reliability of each tool in assessing trauma team performance.

METHODS
We searched Embase, Cochrane Library, Web of Science, Ovid Medline, and Cumulative Index to Nursing and Allied Health Literature from inception to June 1, 2021. English studies that evaluated trauma team performance using nontechnical skill assessment tools in a simulation or real-world setting were included. Studies were assessed by two independent reviewers for meeting inclusion/exclusion criteria. Data regarding team assessment tools were extracted and synthesized into behavior domains. Each tool was then assessed for validity and reliability.

RESULTS
The literature search returned 4,215 articles with 29 meeting inclusion criteria. Our search identified 12 trauma team performance assessment tools. Most studies were conducted in the United States (n = 20 [69%]). Twenty studies (69%) assessed trauma team performance in a simulation setting; Team Emergency Assessment Measure (TEAM) and Trauma Nontechnical Skills Scale (T-NOTECHS) were the only tools to be applied in a simulation and real-world setting. Most studies assessed trauma team performance using video review technology (n = 17 [59%]). Five overarching themes were designed to encompass behavioral domains captured across the 12 tools: (1) Leadership, (2) Communication, (3) Teamwork, (4) Assessment, and (5) Situation Awareness. The reliability and validity of T-NOTECHS were investigated by the greatest number of studies (n = 13); however, TEAM had the most robust evidence of reliability and validity.

CONCLUSION
We identified 12 trauma team performance tools that assessed nontechnical skills to varying degrees. Trauma Nontechnical Skills Scale and TEAM tools had the most evidence to support their reliability and validity. Considering the limited research in the impact of trauma team performance on patient outcomes, future studies could use video review technology in authentic trauma cases to further study this important relationship.

LEVEL OF EVIDENCE
Systematic reviews and meta-analyses, level IV.
Host-derived lipids from tuberculous pleurisy impair macrophage
microbicidal-associated metabolic activity
Authors: Franco José Luis Marín , Genoula Melanie , Corral Dan , Duette Gabriel , Ferreyra Malena , Maio Mariano , Dolotowicz María Belén , Aparicio-Trejo Omar Emiliano , Patiño-Martínez Eduardo , Fuentes Federico , Soldan Vanessa , Moraña Eduardo José , Palmero Domingo , Ostrowski Matías , Schierloh Pablo , Sánchez-Torres Carmen , Hernández-Pando Rogelio , Pedraza-Chaverri José , Rombouts Yoann , Layre Emilie , Hudrisier Denis , Vérollet Christel , Neyrolles Olivier , Sasiain María Del Carmen , Lugo-Villarino Geanncarlo , Balboa Luciana 
Published: December 2021

SUMMARY
Mycobacterium tuberculosis (Mtb) regulates the
macrophage metabolic state to thrive in the host. Yet, the responsible
mechanisms remain elusive. Macrophage activation towards the microbicidal (M1)
program depends on the HIF-1 α-mediated metabolic shift from oxidative
phosphorylation towards glycolysis. Here, we asked whether a tuberculosis (TB)
microenvironment changes the M1 macrophage metabolic state. We exposed M1
macrophages to the acellular fraction of tuberculous pleural effusions (TB-PE),
and found lower glycolytic activity, accompanied by elevated levels of oxidative
phosphorylation and bacillary load, compared to controls. The host-derived lipid
fraction of TB-PE drove these metabolic alterations. HIF-1α stabilization
reverted the effect of TB-PE by restoring M1 metabolism. As a proof-of-concept,
Mtb-infected mice with stabilized HIF-1α displayed lower bacillary loads and a
pronounced M1-like metabolic profile in alveolar macrophages. Collectively, we
demonstrate that host-derived lipids from a TB-associated microenvironment alter
the M1 macrophage metabolic reprogramming by hampering HIF-1α functions, thereby
impairing control of Mtb infection.