bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREDICTIVE FACTORS FOR PROLIFERATIVE VITREORETINOPATHY FORMATION AFTER UNCOMPLICATED PRIMARY RETINAL DETACHMENT REPAIR
Authors: Xu Kunyong , Chin Eric K. , Bennett Steven R. , Williams David F. , Ryan Edwin H. , Dev Sundeep , Mittra Robert A. , Quiram Polly A. , Davies John B. , Parke David Wilkin , Boldt Herbert Culver , Almeida David R. P. 
Published: May 2018

Purpose:
To determine predictive factors of proliferative vitreoretinopathy (PVR) formation after uncomplicated primary retinal detachment repair.

Methods:
Retrospective, single-center, case–control study of 74 consecutive patients with (37 eyes) and without (37 eyes) PVR formation after undergoing uncomplicated primary surgery for retinal detachment repair. Logistic regression was used to assess factors associated with PVR formation.

Results:
Retinal detachment involving the macula was 4.2 times (adjusted odds ratio; 95% confidence interval, 1.4–12.9; P = 0.0119) more likely to have PVR formation compared with those without. Patients who were current or former smokers were 3.6 times (adjusted odds ratio; 95% confidence interval, 1.1–11.7; P = 0.0352) more likely to have PVR formation compared with nonsmokers. Compared with 25-gauge (g) vitrectomy, larger gauge vitrectomy (20 g or 23 g) was 3.6 times (adjusted odds ratio; 95% confidence interval, 1.2–11.3; P = 0.0276) more likely to have PVR formation. Duration of retinal detachment symptoms, high myopia, lens status, lattice degeneration, location of retinal break, number of retinal breaks, and surgical technique (e.g., scleral buckle with or without vitrectomy versus vitrectomy alone) were not found to be predictive of PVR formation.

Conclusion:
Cigarette smoking and macular involvement are significant risk factors predictive of PVR formation after uncomplicated primary retinal detachment repair.
Use of Moulage to Evaluate Student Assessment of Skin in an Objective Structured Clinical Examination
Authors: Zorn Jennifer , Snyder Jennifer , Guthrie Jennifer 
Published: May 2018

Purpose
This study investigated the physician assistant (PA) student evaluation of skin and the use of moulage in an objective structured clinical examination (OSCE).

Methods
Clinical-year PA students participated in an OSCE, taking a history, completing a physical examination, and writing a focused clinical note. The standardized patient's history simulated a primary diagnosis of right-sided carpal tunnel syndrome and an incidental skin lesion consistent with melanoma, only if the student made an inquiry in this replication study. Faculty members' assessments of students' physical examinations were standardized using an agreed-upon rubric. Students completed an anonymous survey on the OSCE experience immediately following the activity.

Results
All students identified the primary diagnosis of carpal tunnel. Sixty-three percent of students verbalized examination of the skin; however, only 38% identified an atypical skin lesion in their clinical note documentation. Of those, only 33% of students referred the patient for biopsy. Most students believed that the use of moulage increased the realism of the standardized patient encounter. Sixty percent of students reported that they noticed a skin lesion but did not believe that it was part of the simulated experience.

Conclusions
Moulage increased the realism of the OSCE. This study found that the ability of a student to verbalize the evaluation of a particular body system did not necessarily mean that they adequately or correctly assessed that system upon physical examination. Implementation of an OSCE and use of moulage provided an opportunity to explicitly assess student performance related to evaluation and assessment of skin. It provided a mechanism for meaningful, formative feedback of students' performance.
Nonalcoholic fatty liver disease and albuminuria: a systematic review and meta-analysis
Authors: Wijarnpreecha Karn , Thongprayoon Charat , Boonpheng Boonphiphop , Panjawatanan Panadeekarn , Sharma Konika , Ungprasert Patompong , Pungpapong Surakit , Cheungpasitporn Wisit 
Published: May 2018

Background/objectives
The relationship between nonalcoholic fatty liver disease (NAFLD) and albuminuria has been shown in many epidemiologic studies, although the results were inconsistent. This meta-analysis was conducted to summarize all available data and to estimate the risk of albuminuria among patients with NAFLD.

Methods
Comprehensive literature review was conducted utilizing Medline and Embase database through January 2018 to identify studies that compared the risk of albuminuria among patients with NAFLD versus those without NAFLD. Effect estimates from each study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird.

Results
Nineteen studies (17 cross-sectional studies and two cohort studies) with 24 804 participants fulfilled the eligibility criteria and were included in this meta-analysis. The risk of albuminuria among patients with NAFLD was significantly higher than those without NAFLD with the pooled odds ratio (OR) of 1.67 [95% confidence interval (CI): 1.32–2.11]. Subgroup analysis demonstrated the significantly increased risk of albuminuria among patients with NAFLD without diabetes with pooled OR of 2.25 (95% CI: 1.65–3.06). However, we found no significant association between albuminuria and NAFLD among diabetic patients [pooled OR 1.28 (95% CI: 0.94–1.75)].

Conclusion
A significantly increased risk of albuminuria among patients with NAFLD was observed in this meta-analysis. Physicians should pay more attention to the early detection and subsequent treatment of individuals with microalbuminuria especially in patients with NAFLD.
Dot Motion Perception in Young Adult Emmetropes and Myopes
Authors: Kuo Hui-Ying , Atchison David A. , Schmid Katrina Leanne 
Published: May 2018

SIGNIFICANCECentral motion perception, as assessed by minimum displacement detection, was reduced in highly myopic eyes. Peripheral motion detection may be influenced by myopia, particularly in the inferior-nasal retina.PURPOSEMotion discrimination is a complex visual task processed mainly via the magnocellular pathway. We investigated whether it is affected in myopia.METHODSNinety young adults aged 18 to 28 years participated: 30 emmetropes (spherical equivalent refractions +1.00 to −0.50 diopters [D]), 30 low myopes −1.00 to −4.75 D) and 30 higher myopes (<−5 D). Random dot patterns were used to measure motion perception thresholds for minimum displacement (Dmin), maximum displacement (Dmax), and motion coherence tasks. Each task was performed centrally and at four oblique peripheral visual field locations (at 3.65 and 12 degrees forDminandDmaxtasks, respectively). Macular retinal thickness was measured with optical coherence tomography.RESULTSThe centralDmintask was correlated significantly with refraction (r= −0.303,P= .004) and axial length (r= +0.224,P= .04), and the superior-temporal fieldDmintask was correlated significantly with axial length (r= 0.230,P= .04). Higher myopes had poorer performance than emmetropes by 25% (higher values). For theDminperipheral task and forDmaxand coherence tasks at both central and peripheral locations, there were no significant correlations with refraction or axial length. At three of four positions, the peripheralDmintask was correlated significantly with thickness in the corresponding retinal region: superior-temporalDmin(Pearsonr= −0.357,P< .001), inferior-nasalDmin(r= −0.237,P= .03) and inferior-temporalDmin(r= −0.233,P= .03).CONCLUSIONSCentral motion perception, as assessed by minimum displacement detection, was reduced by 25% in highly myopic eyes. Peripheral motion detection may be influenced by myopia, particularly in the inferior-nasal retina. Retinal stretching due to axial elongation may be linked to reduced performance in higher myopes.
The Effect of Contact Lens Wear on the Cellular Morphology of the Lid Wiper Area
Authors: Alghamdi Waleed M. , Markoulli Maria , Papas Eric B. 
Published: May 2018

SIGNIFICANCE
This cross-sectional study presented a link between contact lens wear and changes on the cellular morphology characteristics of the lid wiper (LW) epithelium, which was not visible by LW staining.

PURPOSE
The aim of this study was to establish if the duration of contact lens (CL) wear affects the cellular morphology of the LW epithelium.

METHODS
This was a cross-sectional study of 100 individuals with different exposures to CL wear: short, moderate, and long experience of CL wear; previous CL wearers; and nonwearers (NWs) as controls. Impression cytology samples were collected from the central upper lid margin (LW area). After fixing, samples were stained with periodic acid–Schiff and haematoxylin for cell morphology analysis and subsequently graded according to the Nelson 0- to 3-point scale. Lid wiper staining was assessed with the aid of lissamine green and graded using the Korb (0- to 3-point) scale. One-way Kruskal-Wallis analysis followed by the Dunn multiple-comparisons test was used for statistical comparison.

RESULTS
The Nelson grade for LW epithelium morphology was significantly different between groups (P = .003). Abnormal epithelial morphology as defined by grade 2 or 3 was evident in 66.7% of CL wearers with short experience and 76.5% of CL wearers with moderate experience. This was significantly higher than NWs of whom only 21.5% showed greater than grade 1 (P = .02 and .005, respectively). There was no significant difference between NWs and other groups. Lid wiper staining did not significantly differ between groups (P = .50) or correlate with the Nelson grade (Spearman r = 0.02, P = .08).

CONCLUSIONS
Metaplasia of the LW epithelium was significantly greater in the early to moderate stages of CL. This supports the view that mechanical irritation is responsible for LW changes in CL wear. Ceasing CL wear seems to lead to recovery. Lid wiper staining did not reflect the underlying morphological changes.
Moonshot Objectives: Catalyze New Scientific Breakthroughs—Proteogenomics
Authors: Rodland Karin D. , Piehowski Paul , Smith Richard D. 
Published: May 2018

Abstract
Breaking down the silos between disciplines to accelerate the pace of cancer research is a key paradigm for the Cancer Moonshot. Molecular analyses of cancer biology have tended to segregate between a focus on nucleic acids—DNA, RNA, and their modifications—and a focus on proteins and protein function. Proteogenomics represents a fusion of those two approaches, leveraging the strengths of each to provide a more integrated vision of the flow of information from DNA to RNA to protein and eventually function at the molecular level. Proteogenomic studies have been incorporated into multiple activities associated with the Cancer Moonshot, demonstrating substantial added value. Innovative study designs integrating genomic, transcriptomic, and proteomic data, particularly those using clinically relevant samples and involving clinical trials, are poised to provide new insights regarding cancer risk, progression, and response to therapy.
Progress Toward Cancer Data Ecosystems
Authors: Grossman Robert L. 
Published: May 2018

Abstract
One of the recommendations of the Cancer Moonshot Blue Ribbon Panel report from 2016 was the creation of a national cancer data ecosystem. We review some of the approaches for building cancer data ecosystems and some of the progress that has been made. A data commons is the colocation of data with cloud computing infrastructure and commonly used software services, tools, and applications for managing, integrating, analyzing, and sharing data to create an interoperable resource for the research community. We discuss data commons and their potential role in cancer data ecosystems and, in particular, how multiple data commons can interoperate to form part of the foundation for a cancer data ecosystem.
The Evolving Role of Blending of the Lid-Cheek Junction in Lower Blepharoplasty
Authors: Rohrich Rod J. , Mahedia Monali , Hidalgo David , Shah Nilay 
Published: May 2018

Background:
Lower blepharoplasty has evolved from traditional lower blepharoplasty involving skin-muscle flaps and fat resection to newer concepts that emphasize blending the lid-cheek junction. It is the objective of this review to evaluate these new concepts for their efficacy in blending the lid-cheek junction.

Methods:
A comprehensive review of literature was performed using PubMed/MEDLINE to identify studies evaluating fat conservation, fat augmentation, fat repositioning, orbicularis retaining ligament (ORL) release, septal reset, and use of fillers in deep cheek fat compartments to obtain aesthetically pleasing lid-cheek junction.

Results:
A total of 22 studies meeting inclusion criteria and evaluating fat conservation, fat augmentation, fat repositioning, ORL release, septal reset, and use of fillers in deep cheek fat compartments are analyzed and discussed.

Conclusions:
This review provides the current evidence for various strategies that can be used alone or combined to obtain youthful lid-cheek junction. It provides the current evidence-based scientific rationale for optimal management of the lower eyelid cheek area for facial rejuvenation.
Computed Diffusion Weighted Imaging of the Liver Using Extrapolation Technique in Patients Who Underwent Liver Transplantation With Hepatocellular Carcinomas: Initial Experience and Feasibility Study
Authors: Park Michael Yong , Choi Joon-Il , Yu Hon , Lall Chandana 
Published: May 2018

Objective
This study aimed to evaluate the feasibility and image quality of computed diffusion weighted imaging (DWI) of the liver in patients with hepatocellular carcinoma (HCC).

Methods
Twenty-four patients who underwent liver transplantation with HCC were enrolled. Computed DWI was synthesized for b-values of 800 (cDWI800) and 1200 s/mm2 (cDWI1200) using directly acquired DWI with b-values of 0, 50, and 500 s/mm2. Signal intensity of HCC, background liver, and contrast-to-noise ratio were evaluated for directly acquired DWI of 800 s/mm2 (dDWI800), cDWI800, and cDWI1200. Two radiologists evaluated the image quality for contrast between HCC and liver, suppression of background signal and T2 shine-through, and overall image quality.

Results
cDWI1200 showed the lowest contrast-to-noise ratio. Qualitative scores for background suppression and decreased T2 shine-through were highest for cDWI1200. However, contrast between HCC and background liver was worst in cDWI1200.

Conclusions
In computed DWI of high b-values, contrast between HCC and background liver was very low.
Acute Appendicitis Involving a De Garengeot Hernia
Authors: Freeman Kyle S. , Picard Melissa M. , Kovacs Mark D. 
Published: May 2018

Abstract
We present a case of appendicitis within a De Garengeot hernia. The patient presented to the emergency department with 4 days of worsening abdominal pain. Computed tomography examination revealed an inflamed appendix within a femoral hernia. The patient underwent appendectomy and repair of the femoral defect. Pathological examination was consistent with acute appendicitis. De Garengeot hernia is a rare phenomenon, with less than 5% of femoral hernias containing the appendix and 0.08% to 0.13% containing an incarcerated acute appendicitis.
Evaluation of Stomach Neoplasms With 3-Dimensional Computed Tomography: Focus on the Potential Role of Cinematic Rendering
Authors: Rowe Steven P. , Chu Linda C. , Fishman Elliot K. 
Published: May 2018

Abstract
Evaluation of stomach neoplasms by traditional 3-dimensional (3D) computed tomography methods such as volume rendering and maximum-intensity projection plays an important role in lesion detection and characterization, preoperative planning, staging, and follow-up. Recently, a new 3D visualization method has become available known as cinematic rendering (CR). This novel technique makes use of a complex global lighting model to impart photorealistic levels of detail to 3D images. Although this new technique has yet to be systematically studied for the evaluation of stomach neoplasms, its intrinsic ability to create realistic shadowing effects to enhance understanding of the 3D relative locations of anatomic structures and to enhance detail and texture may prove valuable for a variety of applications. In this article, we demonstrate the CR appearance of multiple different gastric neoplasms, describe potential advantages of CR, and suggest future research directions.
Logistics of air medical transport: When and where does helicopter transport reduce prehospital time for trauma?
Authors: Chen Xilin , Gestring Mark L. , Rosengart Matthew R. , Peitzman Andrew B. , Billiar Timothy R. , Sperry Jason L. , Brown Joshua B. 
Published: May 2018

BACKGROUND
Trauma is a time sensitive disease. Helicopter emergency medical services (HEMS) have shown benefit over ground emergency medical services (GEMS), which may be related to reduced prehospital time. The distance at which this time benefit emerges depends on many factors that can vary across regions. Our objective was to determine the threshold distance at which HEMS has shorter prehospital time than GEMS under different conditions.

METHODS
Patients in the Pennsylvania trauma registry 2000 to 2013 were included. Distance between zip centroid and trauma center was calculated using straight-line distance for HEMS and driving distance from geographic information systems network analysis for GEMS. Contrast margins from linear regression identified the threshold distance at which HEMS had a significantly lower prehospital time than GEMS, indicated by nonoverlapping 95% confidence intervals. The effect of peak traffic times and adverse weather on the threshold distance was evaluated. Geographic effects across EMS regions were also evaluated.

RESULTS
A total of 144,741 patients were included with 19% transported by HEMS. Overall, HEMS became faster than GEMS at 7.7 miles from the trauma center (p = 0.043). Helicopter emergency medical services became faster at 6.5 miles during peak traffic (p = 0.025) compared with 7.9 miles during off-peak traffic (p = 0.048). Adverse weather increased the distance at which HEMS was faster to 17.1 miles (p = 0.046) from 7.3 miles in clear weather (p = 0.036). Significant variation occurred across EMS regions, with threshold distances ranging from 5.4 to 35.3 miles. There was an inverse but non-significant relationship between urban population and threshold distance across EMS regions (ρ, −0.351, p = 0.28).

CONCLUSION
This is the first study to demonstrate that traffic, weather, and geographic region significantly impact the threshold distance at which HEMS are faster than GEMS. Helicopter emergency medical services was faster at shorter distances during peak traffic while adverse weather increased this distance. The threshold distance varied widely across geographic region. These factors must be considered to guide appropriate HEMS triage protocols.

LEVEL OF EVIDENCE
Therapeutic, level IV.
Hemorrhagic shock alters fracture callus composition and activates the IL6 and RANKL/OPG pathway in mice
Authors: Bundkirchen Katrin , Macke Christian , Angrisani Nina , Schäck Luisa M. , Noack Sandra , Fehr Michael , Krettek Christian , Neunaber Claudia 
Published: May 2018

Background
Fracture and hemorrhagic shock often lead to impaired fracture healing. To elucidate underlying pathogenesis, this study aimed to analyze histological properties during fracture healing after hemorrhagic shock and involved signaling pathways in mice.

METHODS
Male C57BL/6NCrl mice were assigned into five groups. Control group underwent no interventions. Sham group had a catheter and external fixator but neither blood loss nor osteotomy. Trauma-hemorrhage (TH) group received a pressure-controlled hemorrhagic shock; osteotomy (Fx) group, an osteotomy and fixator; and combined trauma (THFx) group, both hemorrhagic shock and externally fixed osteotomy. After 1, 2, 3, and 4 weeks, the animals were killed. Undecalcified bones were analyzed histologically and signaling pathways relevant for fracture healing by polymerase chain reaction and Western blot. Statistical significance was set at 0.05 or less. Comparisons were performed using the Mann-Whitney U or Kruskal-Wallis test.

RESULTS
In the THFx group, a decreased bone formation after 3 weeks, a reduction of both bone and cartilage after 2 weeks, and an enhanced activation of the RANKL/OPG and IL6 signaling pathway after 1 week were shown in comparison to Fx.

CONCLUSIONS
Hemorrhagic shock has a retarding effect on fracture healing in the early phase of fracture healing and leads to activation of the IL6 and RANKL/OPG signaling pathways.
Extending the golden hour for Zone 1 resuscitative endovascular balloon occlusion of the aorta: Improved survival and reperfusion injury with intermittent versus continuous resuscitative endovascular balloon occlusion of the aorta in a porcine severe truncal hemorrhage model
Authors: Kuckelman John P. , Barron Morgan , Moe Donald , Derickson Michael , Phillips Cody , Kononchik Joseph , Lallemand Michael , Marko Shannon , Eckert Matthew , Martin Matthew J. 
Published: May 2018

BACKGROUND
Noncompressible hemorrhage can be controlled using resuscitative endovascular balloon occlusion of the aorta (REBOA). Prolonged ischemia limits REBOA application during Zone 1 deployment. Intermittent inflation/deflation may effectively mitigate this problem.

METHODS
A lethal abdominal vascular injury was created in 28 swines. Animals were randomized to controls (n = 7), 60 minutes full REBOA (FR, n = 5), time-based intermittent REBOA (iRT, n = 7), and pressure-based REBOA (iRP, n = 9). Intermittent groups had an initial inflation for 15 minutes, followed by 10-minute inflation: 3-minute deflation cycles (iRT), or an inflate/deflate schedule based on mean arterial pressure (MAP) less than 40 mm Hg (iRP). Experiments were concluded after 120 minutes or death (MAP < 20 mm Hg).

RESULTS
Intermittent REBOA animals all survived to 120 minutes versus 15 minutes for controls and 63 minutes for FR (p < 0.001). After 60 minutes, FR animals were more hypotensive (MAP 20 mm Hg vs. 80 mm Hg [iRP] and 100 mm Hg [iRT]; p < 0.001), had lower cardiac output (1.06 mL/min vs. 5.1 L/min [iRP] and 8.2 L/min [iRT]; p < 0.001), higher lactate (12.5 mg/dL vs. 8.5 mg/dL [iRP], p = 0.02), and decreased clot firmness on rotational thromboelastometry than iRP/T (64 mm vs. 69 mm [iRP] and 69 mm [iRT], p = 0.04). Acidosis was worse in iRT versus iRP at 120 minutes (pH 7.28 vs. pH 7.12; p = 0.02), improved lactate (11.9 mg/dL vs. 16.3 mg/dL; p = 0.04), and decreased whole blood resuscitation (452 mL vs. 646 mL, p = 0.05). Blood loss (clot weight) was higher in controls (2.0 kg) versus iRT and iRP (1.16 kg and 1.23 kg; p < 0.01) and not different from FR (0.87 kg; p = 0.10).

CONCLUSION
Intermittent REBOA can maintain supraceliac hemorrhage control while decreasing distal ischemia in a swine model. Prolonged survival times, decreased acidosis, and lower resuscitation requirements indicate that this technique could potentially extend Zone 1 REBOA deployment times. Schedules based on MAP may be superior to time-based regimens.