bluuebunny/crossref_metadata_2025_split huggingface dataset:
A longitudinal study of choroidal changes following cataract surgery in patients with diabetes
Authors: Yip Vivien Cherng-Hui , Laude Augustinus , Tan Kara Anne , Ding Jianbin , Wong Elizabeth , Agrawal Rupesh 
Published: April 2019

Objective: To study the structural changes in the choroid of diabetic patients following cataract surgery, using choroidal vascularity index and choroidal thickness. Methods: A prospective case–control study was conducted in 18 diabetic and 18 non-diabetic patients undergoing cataract surgery (phacoemulsification) in one eye. Enhanced depth imaging optical coherence tomography images were obtained before and after surgery. Niblack’s image binarization of images was performed to derive the choroidal vascularity index. Independent sample T-test compared the differences of choroidal vascularity index and choroidal thickness between diabetic and non-diabetic patients. Results: The baseline choroidal vascularity index was significantly lower in diabetic patients for both operated (mean difference vs non-diabetic: 0.0184, 95% CI: 0.004–0.0324, p = 0.012) and non-operated (mean difference vs non-diabetic: 0.0145, 95% CI: 0.003–0.0256, p = 0.012) eyes. Choroidal thickness increased following cataract surgery (diabetes: mean difference = 12.4, 95% CI: 0.70–24.0, adjusted p = 0.036; non-diabetic: mean difference = 21.0, 95% CI: 4.39–37.6, adjusted p = 0.011). Conclusion: Diabetic patients have reduced choroidal vascularity index than non-diabetic patients, suggestive of possible reduction in choroidal vascularity in diabetes. Choroidal thickness increased following cataract surgery in both diabetic and non-diabetic patients.
Metabolic lipid muscle disorders: biomarkers and treatment
Authors: Angelini Corrado , Pennisi Elena , Missaglia Sara , Tavian Daniela 
Published: April 2019

Lipid storage myopathies (LSMs) are metabolic disorders of the utilization of fat in muscles due to several different defects. In this review, a molecular update of LSMs is presented and recent attempts of finding treatment options are discussed. The main topics discussed are: primary carnitine deficiency, riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency, neutral lipid storage disorders and carnitine palmitoyl transferase deficiency. The most frequent presentations and genetic abnormalities are summarized. We present their diagnosis utilizing biomedical and morphological biomarkers and possible therapeutic interventions. The treatment of these metabolic disorders is a subject of active translational research but appears, in some cases, still elusive.
Revision of Syndesmosis Screw Fixation
Authors: Bafna Kunaal R. , Jordan Richard , Yatsonsky David , Dick Steven , Liu Jiayong , Ebraheim Nabil A. 
Published: April 2019

Background: Many syndesmosis screw fixations do not achieve success at the first attempt. Currently, there are no data available to evaluate revision of syndesmosis screw failure. Methods: A total of 160 consecutive patients who underwent syndesmosis screw fixation from 2014 to 2016 were reviewed. The current study focuses on 13 of 160 patients who underwent revision surgery and analyzes reasons, methods, and outcomes of syndesmotic screw revisions. Results: Thirteen out of 160 patients had revision surgeries. Incidence of recurrent diastasis was 92.3%. Seven out of 19 screws had broken. Two patients had screw loosening, 9 patients underwent early weightbearing, 1 patient developed osteomyelitis, 1 patient developed osteoarthritis, and 1 patient had fibular nonunion. Eleven patients underwent removal, 3 patients underwent clamp reduction, and 4 patients underwent fibular osteotomy. Six patients experienced good reduction with 0/10 pain, 3 patients experienced good reduction with some pain, 1 patient experienced poor reduction; 1 patient developed osteomyelitis and subsequent 7/10 pain; 1 patient underwent fusion with 5/10 pain, and 1 patient experienced medial malleolar mal-union with 3/10 pain. Conclusion: It was found that the main reason for syndesmosis revision was reoccurring diastasis. Most patients ultimately experienced good reduction and were able to ambulate, despite some residual pain. Levels of Evidence: Level IV: Case series
Leukotriene Receptor Antagonist Addition to H1-Antihistamine Is Effective for Treating Allergic Rhinitis: A Systematic Review and Meta-analysis
Authors: Seresirikachorn Kachorn , Chitsuthipakorn Wirach , Kanjanawasee Dichapong , Khattiyawittayakun Likhit , Snidvongs Kornkiat 
Published: April 2019

Background Histamine and leukotriene are released after being triggered by allergen exposure. The combination of leukotriene receptor antagonist (LTRA) and H1-antihistamine (AH) is utilized to control the allergic rhinitis (AR) symptoms after the failure of either AH or LTRA. Objective This study aimed to investigate the effects of the combination of H1-antihistamine and leukotriene receptor antagonist (AH-LTRA) in patients with AR. Methods Randomized controlled trials studying the effects of AH-LTRA versus AH alone on rhinoconjuncitivits symptoms in patients with AR were included. Data were pooled for meta-analysis. The outcomes were nasal symptoms, ocular symptoms, disease-specific quality of life, and adverse events. Meta-analyses were performed to compare the outcomes between AH-LTRA and AH. Subgroup analyses by AR subtype, asthma, and pediatric patients were performed. Results Fourteen studies (3271 participants) met the inclusion criteria. The results favored the effects of AH-LTRA on (1) composite nasal symptom score (standardized mean difference [SMD]: −0.20; 95% confidence interval [CI]: −0.36, −0.03), (2) rhinorrhea (SMD: −0.14; 95% CI: −0.27, −0.02), and (3) sneezing (SMD: −0.15; 95% CI: −0.27, −0.02). Subgroup analyses revealed that results favored the effects of AH-LTRA for perennial AR (SMD: −0.57; 95% CI: −0.87, −0.26) but not in the seasonal AR subgroup (SMD: −0.09; 95% CI: −0.21, 0.04), P = .004. There were no differences between AH-LTRA and AH on nasal obstruction, itching, ocular symptoms, Rhinoconjunctivitis Quality of life Questionnaire and adverse events. Due to limited number of included studies, effects on asthma and pediatric subgroups could not be assessed. Conclusion For controlling rhinoconjunctivitis symptoms in patients with AR, AH-LTRA provided greater beneficial effects on composite nasal symptoms, rhinorrhea, and sneezing compared to AH alone. These effects were shown in patients with perennial AR.
Incremental value of high-frequency QRS analysis for diagnosis and prognosis in suspected exercise-induced myocardial ischaemia
Authors: Schaerli Nicolas , Abächerli Roger , Walter Joan , Honegger Ursina , Puelacher Christian , Rinderknecht Therese , Müller Deborah , Boeddinghaus Jasper , Nestelberger Thomas , Strebel Ivo , Badertscher Patrick , du Fay de Lavallaz Jeanne , Twerenbold Raphael , Wussler Desiree , Hofer Johanna , Leber Remo , Kaiser Christoph , Osswald Stefan , Wild Damian , Zellweger Michael J , Mueller Christian , Reichlin Tobias 
Published: April 2019

Aim:
Exercise stress testing is used to detect myocardial ischaemia, but is limited by low sensitivity and specificity. The authors investigated the value of the analysis of high-frequency QRS components as a marker of abnormal depolarization in addition to standard ST-deviations as a marker of abnormal repolarization to improve the diagnostic accuracy.

Methods and results:
Consecutive patients undergoing bicycle exercise stress nuclear myocardial perfusion imaging were prospectively enrolled. Presence of myocardial ischaemia, the primary diagnostic endpoint, was adjudicated using MPI and coronary angiography. Automated high-frequency QRS analysis was performed in a blinded fashion. The prognostic endpoint was major adverse cardiac events (MACEs) during two years of follow-up. Exercise-induced ischaemia was detected in 147/662 patients (22%). The sensitivity of high-frequency QRS was similar to ST-deviations (46% vs. 43%, p=0.59), while the specificity was lower (75% vs. 87%, p&lt;0.001). The combined use of high-frequency QRS and ST-deviations classified 59% of patients as ‘rule-out’ (both negative), 9% as ‘rule-in’ (both positive) and 32% in an intermediate zone (one test positive). The sensitivity for ‘rule-out’ and the specificity for ‘rule-in’ improved to 63% and 97% compared with ST-deviation analysis alone (both p&lt;0.001). MACE-free survival was 90%, 80% and 42% in patients in the ‘rule-out’, intermediate and ‘rule-in’ groups (p&lt;0.001). After adjustment for age, gender, ST-deviations and clinical post-test probability of ischaemia, high-frequency QRS remained an independent predictor for the occurrence of MACEs.

Conclusion:
The use of high-frequency QRS analysis in addition to ST-deviation analysis improves the diagnostic accuracy during exercise stress testing and adds independent prognostic information.
Sex and gender differences in polypharmacy in persons with dementia: A scoping review
Authors: Trenaman Shanna C , Rideout Megan , Andrew Melissa K 
Published: April 2019

Purpose: To date, research studies in most disciplines have not made sex-based analysis a priority despite increasing evidence of its importance. We now understand that both sex and gender impact medication prescribing, use, and effect. This is particularly true for older adults with dementia who have alterations in drug metabolism, drug response, and the permeability of the blood–brain barrier. To better understand the influence of sex and gender on drug use in older adults with dementia, we conducted a scoping review. Methods: This scoping review systematically searched the Medline, Embase, Web of Science, CINAHL, and ProQuest databases to find published reports on polypharmacy in populations of older adults with dementia that included a sex- or gender-based analysis. Results: A total of 12 published reports were identified. Findings were cohort studies and case-control trials that commented on sex-related differences in medication use as a secondary analysis to the studies’ primary objective. These studies showed that community-dwelling women received more potentially inappropriate medications and more psychotropic medications, while nursing home dwelling men received more potentially inappropriate medications, cholinesterase inhibitors, and antipsychotics. None of the identified studies explicitly examined gender-related differences in medication use. Conclusion: This scoping review supports that there is inadequate understanding of both sex and gender differences in drug use in older men and women with dementia. To tailor medication-specific interventions to improve drug therapy for older adults with dementia, it is important that future work includes sex- or gender-based analysis of drug use.
Attitudes towards Oral Health in Patients with Rheumatoid Arthritis: A Qualitative Study Nested within a Randomized Controlled Trial
Authors: Serban S. , Dietrich T. , Lopez-Oliva I. , de Pablo P. , Raza K. , Filer A. , Chapple I.L.C. , Hill K. 
Published: April 2019

Introduction: Patients with rheumatoid arthritis (RA) present a higher incidence and severity of periodontitis than the general population. Our study, Outcomes of Periodontal Treatment in Patients with Rheumatoid Arthritis (OPERA), was a randomized waiting-list controlled trial using mixed methods. Patients randomized to the intervention arm received intensive periodontal treatment, and those in the control arm received the same treatment with a 6-mo delay. Aim: The nested qualitative component aimed to explore patients’ experiences and priorities concerning oral health and barriers and facilitators for trial participation. Methods: Using purposive sampling until thematic saturation was reached, we conducted 21 one-to-one semistructured interviews with randomized patients in either of the 2 treatment arms as well as with patients who did not consent for trial participation. Results: The patients described their experiences about RA, oral health, and study participation. Previous experiences with dental care professionals shaped patients’ current perceptions about oral health and the place of oral health on their list of priorities compared with other conditions. Patients also highlighted some of the barriers and facilitators for study participation and for compliance with oral health maintenance. The patients, in the control arm, presented their views regarding the acceptable length of waiting time for the intervention. Conclusion: The associations between periodontal and systemic health are increasingly recognized by the literature. Our study provided an insight into RA patients’ experiences and perceptions about oral health. It also highlighted some of the barriers and facilitators for participating in a periodontal interventional study for this group. We hope that our findings will support the design of larger interventional periodontal studies in patients with RA. The complex challenges faced by the burden of RA and the associated multimorbidities in this patient group might highlight opportunities to improve access to oral health services in this patient population. Knowledge Transfer Statement: This article provided insights into the experiences and perceptions of rheumatoid arthritis patients about their oral health to improve patient participation in a definitive clinical trial.
Association between Medical Well-Child Visits and Dental Preventive Visits: A Big Data Report
Authors: Tiwari T. , Rai N. , Brow A. , Tranby E.P. , Boynes S.G. 
Published: April 2019

Objective: This study evaluated the impact of well-child visits (WCVs) on promoting preventive visits to the dentist. Effects by age, race, gender, and dental diagnosis were investigated. Methods: Administrative claims data for 1.85 million Medicaid-enrolled children aged 4 or less in 13 states in 2013 were identified from the Truven MarketScan Medicaid Database. A cohort for all children who had a WCV in 2013 was generated and followed for 365 d to identify the date of closest preventive dental visit. Results: The cohort included 1,308,719 Medicaid-enrolled children with a WCV in 2013. Three percent of children under the age of 1 with a WCV had an oral health assessment within 1 y compared to only 0.4% of all Medicaid-enrolled children in that age group. Similar patterns were seen in all age groups: age 1 (13% vs. 9%), age 2 (32% vs. 23%), age 3 (50% vs. 37%), and age 4 (59% vs. 48%). On average, about 1.4% of children received an oral health assessment during their WCV, and another 0.6% were diagnosed with a dental condition. These children had a higher proportion of visits to the dentist for a preventive visit after a WCV. Children of all races (White, Hispanic, and Black) with a prior WCV had higher preventive dental compared to total enrolled. However, Hispanic children with a WCV reported the highest preventive dental visits within 1 y (White 24%, Black 29%, and Hispanic 46%). Furthermore, Hispanic children visited the dentist earlier than White and Black children; 16.9% of Hispanic children visited the dentist within 90 d of the WCV compared to 8.5% of White and 10% of Black children. Conclusion: This study demonstrated increased utilization of dental preventive visits for the children who received a well-child visit. Knowledge Transfer Statement: Results of this study indicate a higher number of preventive dental visits for children with prior WCV. Clinical implications of this study would be to continually increase and promote the inclusion of oral health within primary care. This can increase the likelihood of preventative dental visits and, ultimately, better dental health in children.
Isomerization of limonene over natural zeolite-clinoptilolite
Authors: Retajczyk Monika , Wróblewska Agnieszka , Szymańska Alicja , Michalkiewicz Beata 
Published: April 2019

AbstractThe isomerization of limonene over natural the zeolite, clinoptilolite, was studied. The main products of limonene isomerization were terpinolene, α-terpinene, γ-terpinene and p-cymene. These products have numerous applications in the cosmetic, food and pharmaceutical industries. The main parameters affecting limonene isomerization were reaction time, temperature and catalyst content. These parameters varied within the following ranges: reaction time 15–1440 min; temperature 155–175°C; and catalyst content 5–15 wt.%. Terpinolene was obtained after reaction for 60 min at 175°C using 10 wt.% catalyst. p-Cymene was produced using similar conditions as for terpinolene except for a longer reaction time of 1440 min. The use of optimum experimental conditions allowed the greatest amounts of the desired products to be obtained in the shortest time.
IGF1R as druggable target mediating PI3K-δ inhibitor resistance in a murine model of chronic lymphocytic leukemia
Authors: Scheffold Annika , Jebaraj Billy Michael Chelliah , Tausch Eugen , Bloehdorn Johannes , Ghia Paolo , Yahiaoui Anella , Dolnik Anna , Blätte Tamara Jacqueline , Bullinger Lars , Dheenadayalan Rashmi Priyadharshini , Li Li , Schneider Christof , Chen Shih-Shih , Chiorazzi Nicholas , Dietrich Sascha , Seiffert Martina , Tannheimer Stacey , Döhner Hartmut , Mertens Daniel , Stilgenbauer Stephan 
Published: April 2019

Abstract
Targeted therapy is revolutionizing the treatment of cancers, but resistance evolves against these therapies and derogates their success. The phosphatidylinositol 3-kinase delta (PI3K-δ) inhibitor idelalisib has been approved for treatment of chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma, but the mechanisms conferring resistance in a subset of patients are unknown. Here, we modeled resistance to PI3K-δ inhibitor in vivo using a serial tumor transfer and treatment scheme in mice. Whole-exome sequencing did not identify any recurrent mutation explaining resistance to PI3K-δ inhibitor. In the murine model, resistance to PI3K-δ inhibitor occurred as a result of a signaling switch mediated by consistent and functionally relevant activation of insulin-like growth factor 1 receptor (IGF1R), resulting in enhanced MAPK signaling in the resistant tumors. Overexpression of IGF1R in vitro demonstrated its prominent role in PI3K-δ inhibitor resistance. IGF1R upregulation in PI3K-δ inhibitor–resistant tumors was mediated by functional activation and enhanced nuclear localization of forkhead box protein O1 transcription factors and glycogen synthase kinase 3β. In human CLL, high IGF1R expression was associated with trisomy 12. CLL cells from an idelalisib-treated patient showed decreased sensitivity to idelalisib in vitro concomitant with enhanced MAPK signaling and strong upregulation of IGF1R upon idelalisib exposure. Thus, our results highlight that alternative signaling cascades play a predominant role in the resistance and survival of cancer cells under PI3K-δ inhibition. We also demonstrate that these pathway alterations can serve as therapeutic targets, because inhibition of IGF1R offered efficacious salvage treatment of PI3K-δ inhibitor–resistant tumors in vitro and in vivo.
Role of urine immunofixation in the complete response assessment of MM patients other than light-chain-only disease
Authors: Lahuerta Juan-José , Jiménez-Ubieto Ana , Paiva Bruno , Martínez-López Joaquín , González-Medina José , López-Anglada Lucía , Cedena María-Teresa , Puig Noemi , Oriol Albert , Blanchard María-Jesús , Ríos Rafael , Martin Jesús , Martínez Rafael , Sureda Anna , Hernández Miguel Teodoro , de la Rubia Javier , Krsnik Isabel , Cabañas Valentín , Palomera Luis , Bargay Joan , Mateos María-Victoria , Rosiñol Laura , San Miguel Jesús F. , Blade Joan 
Published: April 2019

Abstract
Response criteria for multiple myeloma (MM) require monoclonal protein (M-protein)–negative status on both serum immunofixation electrophoresis (sIFE) and urine (uIFE) immunofixation electrophoresis for classification of complete response (CR). However, uIFE is not always performed for sIFE-negative patients. We analyzed M-protein evaluations from 384 MM patients (excluding those with light-chain-only disease) treated in the GEM2012MENOS65 (NCT01916252) trial to determine the uIFE-positive rate in patients who became sIFE-negative posttreatment and evaluate rates of minimal residual disease (MRD)–negative status and progression-free survival (PFS) among patients achieving CR, CR but without uIFE available (uncertain CR; uCR), or very good partial response (VGPR). Among 107 patients with M-protein exclusively in serum at diagnosis who became sIFE-negative posttreatment and who had uIFE available, the uIFE-positive rate was 0%. Among 161 patients with M-protein in both serum and urine at diagnosis who became sIFE-negative posttreatment, 3 (1.8%) were uIFE positive. Among patients achieving CR vs uCR, there were no significant differences in postconsolidation MRD-negative (&lt;10−6; 76% vs 75%; P = .9) and 2-year PFS (85% vs 88%; P = .4) rates; rates were significantly lower among patients achieving VGPR. Our results suggest that uIFE is not necessary for defining CR in MM patients other than those with light-chain-only disease.
Liver Stiffness Measurement With FibroScan: Use the Right Probe in the Right Conditions!
Authors: Berger Arthur , Shili Sarah , Zuberbuhler Floraine , Hiriart Jean-Baptiste , Lannes Adrien , Chermak Faiza , Hunault Gilles , Foucher Juliette , Oberti Frederic , Fouchard-Hubert Isabelle , Cales Paul , de Ledinghen Victor , Boursier Jerome 
Published: April 2019

INTRODUCTION:
FibroScan's M and XL probes give significantly different results, which could lead to misevaluation of liver fibrosis if the correct probe is not chosen. According to the manufacturer, the M probe should be used when the skin–liver capsule distance (SCD) is <25 mm, and the XL probe should be used when SCD is ≥25 mm. We aimed at validating this recommendation and defining the conditions of use for FibroScan probes in clinical practice.

METHODS:
Four hundred thirty-nine patients with biopsy-proven chronic liver disease were included. Of them, 382 had successful examinations with both M and XL probes. Advanced fibrosis was defined as Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) F ≥3 or Metavir F ≥2.

RESULTS:
In a same patient, XL probe results were significantly lower than M probe results: 7.9 (5.6–11.7) vs 9.5 (6.7–14.6) kPa, respectively (P < 0.001). After matching for age, sex, liver fibrosis, and serum transaminases, M probe results in patients with SCD <25 mm and XL probe results in those with SCD ≥25 mm did not significantly differ: 8.8 (6.0–12.0) vs 9.1 (6.7–12.8) kPa, respectively (P = 0.175). Of note, 81.4% of patients with body mass index (BMI) <32 kg/m2 had SCD <25 mm, and 77.7% of patients with BMI ≥32 kg/m2 had SCD ≥25 mm. A practical algorithm using BMI first and then the FibroScan Automatic Probe Selection tool was proposed to help physicians accurately choose which probe to use in clinical practice.

CONCLUSIONS:
There is no significant difference in results between M and XL probes when they are used in the right conditions. In clinical practice, the probe should be selected according to the BMI and the Automatic Probe Selection tool.