bluuebunny/crossref_metadata_2025_split huggingface dataset:
BLOOD CHROMIUM-COBALT LEVELS IN PATIENTS AFTER TOTAL KNEE ARTHROPLASTY AND THEIR EFFECT ON THE RETINAL NERVE FIBER LAYER AND MACULAR GANGLION CELL COMPLEX
Authors: Oğurel Tevfik , Serbest Sancar , Oğurel Reyhan , Tiftikçi Uğur , Ölmez Yaşar 
Published: April 2019

Purpose:
To study blood cobalt (Co) and chromium (Cr) levels in patients who have undergone total knee arthroplasty and their effect on the retinal nerve fiber layer and macular ganglion cell complex.

Methods:
One hundred patients who had undergone total knee arthroplasty and 50 healthy individuals who had no implants were included in the study. The patients were separated into two groups based on how long ago the prosthesis had been implanted (Group 1: 1 to 5 years; Group 2: 5 to 10 years). After a complete ophthalmological examination, retinal nerve fiber layer and macular ganglion cell complex of the patients were evaluated with optical coherence tomography, performed on dilated pupils. To assess the metal ion levels of the patients, venous blood samples were drawn from each patient.

Results:
The mean age of the patients was 64.72 ± 6.26 years in Group 1, 67.80 ± 8.07 years in Group 2, and 63.42 ± 7.90 years in the control group. In the comparison of age and sex, there were no statistically significant differences between the groups and the control group. Co and Cr levels were statistically higher in Group 1 and Group 2 compared with the control group (P < 0.001). Mean retinal nerve fiber layer thicknesses and mean macular ganglion cell complex thicknesses in Group 1 and Group 2 were statistically lower than in the control group.

Conclusion:
Levels of Co and Cr are higher in patients who undergone total knee arthroplasty than healthy subjects, and these higher levels were associated with changes in the retinal nerve fiber layer and macular ganglion cell complex.
Microscope-Integrated Optical Coherence Tomography-Guided Drainage of Acute Corneal Hydrops in Keratoconus Combined With Suturing and Gas-Aided Reattachment of Descemet Membrane
Authors: Siebelmann Sebastian , Händel Alexander , Matthaei Mario , Bachmann Björn , Cursiefen Claus 
Published: April 2019

Purpose:
The treatment of acute corneal hydrops due to keratoconus has so far been limited to awaiting the spontaneous resorption of corneal edema, supportive care, and finally keratoplasty. A recent publication describes the surgical reattachment of Descemet Membrane (DM) facilitated by pre-Descemetic sutures and anterior chamber air/gas filling. Here, we present a novel microscope-integrated intraoperative optical coherence tomography (MI-OCT)-guided technique for the immediate reattachment of DM in corneal hydrops due to keratoconus in 2 male patients with small central DM defects.

Methods:
Case series of 2 consecutive patients with acute corneal hydrops due to keratoconus. The novel technique consists of the MI-OCT-guided puncture and drainage of intrastromal fluid pockets combined with anterior chamber sulfur hexafluoride-fill and pre-descemetic sutures using a commercially available MI-OCT (iOCT; Haag Streit Surgical, Wedel, Germany).

Results:
After uneventful surgery, corneal edema showed fast resolution and DM was reattached to the corneal stroma. In both patient's central corneal thickness decreased after surgery and visual acuity improved.

Conclusions:
MI-OCT guided micropuncture of stromal edema combined with compression sutures and SF6 tamponade is a new therapeutic option in acute corneal hydrops with small Descemet membrane defects.
Rapid Onset of Femoral Head Osteonecrosis After a Single Intra-articular Hip Joint Injection of Corticosteroid
Authors: Thompson Austin R. , Ensrud Erik R. 
Published: April 2019

Abstract
We outline a case in which osteonecrosis of the femoral head developed in temporal association with a single intra-articular injection of corticosteroid (triamcinolone acetonide) in a 72-yr-old woman, resulting in a total hip arthroplasty. We conclude that the risk of developing osteonecrosis after a single intra-articular injection of corticosteroid needs to be considered in the informed consent process.
Does a Web-Based Exercise Programming System Improve Home Exercise Adherence for People With Musculoskeletal Conditions?
Authors: Bennell Kim L. , Marshall Charlotte J. , Dobson Fiona , Kasza Jessica , Lonsdale Chris , Hinman Rana S. 
Published: April 2019

Objective
The aim of the study was to evaluate whether a web-based exercise programming system improves adherence to a home exercise program for people with musculoskeletal conditions.

Design
Eligible patients with a musculoskeletal condition presenting to a physical therapist in private practice were randomized to the following: (a) control (home exercise prescribed by therapist’s usual methods) or (b) intervention (home exercise prescribed using a web-based exercise programming system). The primary outcome was self-rated exercise adherence measured at week 3 via 11-point Numeric Rating Scales. Secondary outcomes were satisfaction with exercise delivery and confidence in ability to undertake prescribed exercise. Process measures were also included.

Results
We enrolled 305 participants, with loss to follow-up of 14.5% (22/152) and 13.7% (21/153) in intervention and control groups, respectively. Compared with controls, the intervention group reported higher exercise adherence (mean difference Numeric Rating Scale units (95% confidence intervals): adherence overall −1.0 [−1.6 to −0.3] and regarding number of exercises in session −0.7 [−1.3 to −0.1], number of repetitions −0.8 [−1.4 to −0.2], and number of sessions −1.0 [−1.6 to −0.3]). The intervention group showed greater confidence to exercise than control, with no difference in satisfaction.

Conclusions
A web-based exercise programming system improved home exercise adherence and confidence in ability to undertake exercise, although the clinical relevance of the results needs to be established.
Anabolic-androgenic Steroid Use Among Gynecomastia Patients
Authors: Vojvodic Miliana , Xu Fang Zhou , Cai Runting , Roy Mélissa , Fielding J. Craig 
Published: April 2019

Background
Anabolic-androgenic steroids (AAS) are widely implicated in gynecomastia development. Surgery is the definitive treatment for cases persisting after cessation of AAS use. Currently, the relevance of AAS use to the surgical approach of gynecomastia has not been well explored. This study aims to compare patient characteristics, surgical outcomes, and surgical management of gynecomastia correction in AAS users versus nonusers.

Methods
A retrospective cohort study was performed with patients who underwent bilateral gynecomastia reduction surgery between January 2005 and August 2015 by a single surgeon at an academic hospital. Demographic data, AAS usage details, operative documentation, and follow-up outcomes were reviewed.

Results
A total of 964 cases were reviewed. Eleven percent (n = 105) of the patients had a history of AAS use. Compared with non-AAS users, AAS users were older at time of gynecomastia onset (15 years vs 13 years, P < 0.001) and surgery (28 years vs 25 years, P < 0.001). The AAS users had higher body mass index (27.3 kg/m2 vs 25.7 kg/m2, P < 0.001) and a greater proportion of patients self-identified as bodybuilders (40.0% vs 22.4%, P = 0.002). Although no difference was found in the excised bilateral mastectomy volume (92.1 cm3 vs 76.4 cm3, P = 0.20), The AAS users had significantly less lipoaspirate fat volume (250 mL vs 300 mL, P = 0.005). No difference was found in total complication rates. However, AAS users had significantly more revision mastectomy surgeries (3.8% vs 1.1%; P = 0.02).

Conclusions
The unique breast composition of AAS users necessitates a surgical approach with meticulous intraoperative hemostasis and careful glandular excision to minimize recurrence and achieve comparable low complication rates.
Which Fat Processing Can Achieve Optimal Transplantation in Patients With Insufficient Fat Resource?
Authors: Kang Deni , Fu Su , Luan Jie 
Published: April 2019

Background
Autologous fat transfer has been widely used in breast augment surgery. The breast fat graft is different form facial, it needs megavolume grafts. However, most Asian women are thin, who often encounter the fat resource insufficiency during breast augmentation. In fact, some processing methods do contribute to great loss of potential fat that could have been grafted. How to choose a best processing method to achieve optimal transfer in patients with insufficient fat resources is fairly important.

Methods
Lipoaspirate was obtained from 10 healthy female patients who underwent liposuction from abdomen. According to the processing methods, 10-mL initial fat grafts divided into 4 groups: decantation (group A), centrifugation (group B), cotton pad (group C), and cell-assisted lipotransfer (CAL) (group D). Lipoaspirate from each group was compared in the vitro and vivo experiments. The content and function of stromal vascular fraction (SVF) were compared as well as lipoaspirate survival after grafting in nude mice.

Results
The SVFs were counted in decantation group 4.32 ± 0.75 × 106/mL, centrifuge group 3.48 ± 0.78 × 106/mL, cotton pad group 1.64 ± 0.84 × 106/mL, CAL group 4.08 ± 0.73 × 106/mL. The decantation group was higher than the cotton pad group (P < 0.05). All the groups' SVFs had capability of multilineage differentiation. The fat graft weight in decantation group: 0.3908 ± 0.023 g, centrifuge group 0.3073 ± 0.015 g, cotton pad group 0.1726 ± 0.019 g, and CAL group 0.2396 ± 0.021 g. The weight of the fat graft in the decantation group was greater than that of the centrifugation group, cotton pad group and CAL group (P < 0.05). There was no significant difference in cell integrity, necrotic cysts and fibrosis between the groups. The vascularization degree in the cotton pad group was lower than that in the decantation group (P < 0.05).

Conclusions
Decantation processing can achieve optimal transplantation in patients who have insufficient fat resources.
Early Breast Angiosarcoma Development After Radiotherapy
Authors: Wei Nicholas J. J. , Crowley Timothy P. , Ragbir Maniram 
Published: April 2019

Abstract
This is a short clinical report depicting an exceptionally early presentation of radiation-induced angiosarcoma and overview of the literature. This case highlights the need for a high level of clinical suspicion in those patients presenting with unresolving cutaneous skin changes after radiotherapy for breast cancer.
Breast-conserving therapy, comprising breast-conserving surgery and adjuvant radiotherapy, has largely replaced mastectomy in the treatment of early-stage breast carcinoma. Breast angiosarcoma is a rare but severe long-term complication associated with postoperative radiotherapy (Int J Radiat Oncol Biol Phys. 2002;52:1231–1237). It often presents as a bluish/purple skin lesion in a breast previously treated for breast cancer. This case explores an unexpectedly early presentation of radiation-induced breast angiosarcoma, which was initially thought to be benign bruising. Management remains challenging and prognosis is poor because of its aggressive local and regional invasion and early metastasis, commonly to the lungs and liver. Early surgical resection with wide margins is the treatment of choice (J Plast Reconstr Aesthet Surg. 2011;64:1036–1042).
Buccal Myomucosal Flap Reconstruction After Resection of Palatal Mucoepidermoid Carcinoma
Authors: Kimia Rotem , Shakir Sameer , Jackson Oksana A. , Nguyen Phuong D. 
Published: April 2019

AbstractSalivary gland tumors are rare, constituting approximately 0.5% of pediatric malignancies, yet account for over 50% of malignant salivary gland neoplasms, of which a majority are mucoepidermoid carcinomas (MECs). We present a case of MEC involving the palatal minor salivary gland of an adolescent patient successfully reconstructed using buccal myomucosal flap. The subject presented as a 17-year-old male with a painless left hard palatal mass found to have imaging suspicious for minor salivary gland tumor and punch biopsy consistent with a low-grade MEC. The subject underwent wide local excision of a 1.0 × 1.2 cm mass with 1.0 cm margins down to hard palate nasal mucosa excluding the abutting first and second molars of the ipsilateral maxilla. Pathology confirmed low-grade MEC confined to hard palate. Two weeks, thereafter, the subject underwent buccal myomucosal flap reconstruction inset into the palatal defect and divided 2 weeks thereafter. Postoperative course was complicated by a pinpoint oronasal fistula at the posterior aspect of the flap-palate junction requiring reelevation and advancement. The subject subsequently recovered without complication. Mucoepidermoid carcinomas represent rare, malignant minor salivary gland tumors with nonspecific presentations that require multidisciplinary workup and management. The authors recommend reconstruction of resultant palatal defects to prevent progression to oronasal fistulae or speech and swallow impairment.
Patient- and Family-Centered Electroconvulsive Therapy
Authors: Fox Herbert A. 
Published: April 2019

Abstract
This article builds upon prior efforts to improve the quality of electroconvulsive therapy (ECT) practice and care by encouraging the participation of family members in the ECT process. This participation included the presence of a family member or significant other (SO) in the treatment room during the ECT procedure. Suggestions for limiting that presence to the induction process and for providing limited physical contact with the patient are proposed. The participation of the SO during the pretreatment assessment process is encouraged. Because of possible impairment of memory and judgment, accurate information about the patient's condition and intercurrent life events, as provided by the SO, is often crucial. Furthermore, the patient's report may be influenced by the common experience of fear of ECT. Under these circumstances, an alliance with the SO may at times be more crucial than the alliance with the patient. The importance of establishing a therapeutic alliance with both patient and SO is emphasized. An illustrative clinical vignette is provided.
Characterization of prophages in Salmonella Typhimurium definitive type 8
Authors: Thapa Salina , Mohammed Manal 
Published: April 2019

Background
Salmonella Typhimurium DT8 has been associated with human outbreaks. Anderson phage typing scheme has been used for more than four decades for subtyping of Salmonella Typhimurium, but it has shown some limitations. Here, we characterize prophages among Salmonella Typhimurium DT8 strains to test the potential use of prophage sequence profiles for subtyping.

Method
A total of 54 isolates of Salmonella Typhimurium DT8 were selected for this study which was part of an outbreak study by Ashton et al. (2015)*. Twenty-six isolates were associated with an outbreak in the States of Jersey in 2013 and 28 isolates were non-outbreak-associated isolates. Comparative genomics using a range of bioinformatic tools was carried out including SPAdes for de novo assembly of WGS data. PHASTER was used for characterisation of prophages (http://phaster.ca/).

Result
All DT8 strains are lysogenic for three prophages (RE-2010, ST64B and Gifsy-2). Moreover, the three prophages showed identical sequence among outbreak and non-outbreak isolates. Interestingly, prophage SSU5 was detected in one non-outbreak isolate. Prophage SSU5 is closely related to cryptic plasmid pHMC2 that infects only rough strains of Salmonella Typhimurium. This study is the first to report the presence of prophage SSU5 in Salmonella Typhimurium DT8.

Conclusion
It is crucial to use accurate, reliable and highly discriminative subtyping methods for epidemiological characterisation and outbreak investigation of Salmonella Typhimurium. Prophage profiling might be unsuitable subtyping method. The emerging genetic analysis should be combined with the conventional method for epidemiological surveillance until WGS-based analysis can be improved and standardized. *https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336196/
Cyclic di-nucleotides – what is their role in biofilm formation and pathogenicity of Fusobacterium nucleatum?
Authors: Muchova Maria , Slade Daniel J. , Cameron Gary A. , Milward Michael R. , Cooper Paul R. , Kuehne Sarah A. 
Published: April 2019

Introduction
Cyclic di-nucleotides (CDNs) act as important second messengers in bacteria, regulating multiple cellular functions, including biofilm formation. Fusobacterium nucleatum is a key player in disease-associated biofilms in periodontitis (gum disease). Previous studies revealed the importance of CDNs in the virulence of other dental pathogens such as Porphyromonas gingivalis, but their function in F. nucleatum virulence remains elusive. Here, we aim to elucidate their importance in the pathogenicity of F. nucleatum.

Methods
Using bioinformatics, we identified a putative dual adenylyl/guanylyl cyclase in the genome of F. nucleatum ATCC 23726, the only currently genetically tractable strain. Consequently this target gene was deleted from the chromosome. Wild-type and mutant strains were grown in single- and multi-species biofilms, the amount of biomass quantified by crystal-violet assay and the biofilm topography analysed using scanning electron microscopy. Additionally, intracellular CDNs were quantified using LC-MS/MS.

Results
Differences in biofilm formation comparing wild-type, mutant and further F. nucleatum subspecies will be presented. Furthermore the level of CDN production of those strains will be shown.

Conclusions
Disease-associated biofilms in periodontitis affect over 50 % of the adult UK population. The disease can be debilitating, potentially leading to tooth loss and the bacteria involved have also been associated with systemic diseases such as cardiovascular disease, arthritis or certain types of cancer. Understanding the involvement of CDNs in the pathogenicity of F. nucleatum and its interaction with various periodontal pathogens might provide new insights into prevention and treatment of periodontitis and other conditions.
A retrospective regional audit of Cytomegalovirus (CMV) laboratory diagnostics in Crohn’s/Colitis patients in Northern Ireland – ‘towards a diagnostic algorithm’
Authors: Feeney Susan , Turner Graham , Murphy Seamus , Tham Tony , Jacob George , Morrison Graham , Watson Peter , Kelly Paul , Patterson Lynsey , Coyle Peter V 
Published: April 2019

Introduction
Concurrent cytomegalovirus (CMV) in inflammatory bowel disease (IBD) related colitis, (Ulcerative Colitis (UC) or Crohn’s Disease (CD) is an important yet complex scenario associated with high rates of colectomy and other morbidity. This regional audit aimed to identify baseline standards for a virological diagnostic-based approach for the identification of those at risk of CMV reactivation (flare) in the setting of IBD.

Methods
Retrospective, cross-sectional study over a three year time-period, January 2010–March 2013, involving all five Northern Ireland HSC Trusts. Sample cohort n=277 IBD patients of which n=106 further grouped as SRC ‘severe acute colitis and/or steroid refractory colitis’. Seven audit standards were assessed including specimen(s) submission for CMV diagnostic analysis, antiviral therapy, ascertainment of colectomy rate, and result communication protocol.

Findings
Audit primarily found a need to better define test requesting protocols (optimal sample required for optimal serology and molecular diagnostics), and a need to work towards timeliness in both test requesting and result reporting. This audit also identified the high risk patient group (SRC) when test positive for CMV (PCR and/or histopathology) three times more likely to undergo colectomy (OR 3.16, 95 % CI (0.74, 13.21; P=0.06).

Conclusions
Diagnostic-based patient identification is optimal to identify those most at risk of CMV reactivation in the IBD setting. The serological IgG profile is key in risk assessment of potential reactivation, together with quantitative CMV PCR in colonic tissue, with/without supportive histopathology, as the most sensitive and timely means of identify those high risk patients.
Candida albicans TLOs and fitness: phenotypic analysis of a TLO null strain of C. albicans generated via CRISPR-Cas9 mutagenesis
Authors: Fletcher Jessica , Flanagan Peter , Sullivan Derek , Moran Gary 
Published: April 2019

Background

Candida albicansis a fungus that is both a commensal and opportunistic pathogenic in humans. Genomic analysis has highlighted the expansion of the telomere associated ORF (TLO) gene family as unique in C. albicans. In C. albicans there are 15 different members of the TLO family present, compared to only two in its closest relative, C. dubliniensis. Here we show that deleting all TLOs from C. albicans reduces fitness and effects multiple phenotypes.

Method
A guide RNA (gRNA) with sequence with homology to the TLOgenes was introduced to C. albicans AHY940 (aLEU2/Δleu2), along with the other components of the CRISPR-Cas9 (Nguyen et al. 2017).

Results
The Δtlo strain was found to be generally pseudohyphal in morphology, compared to the wild type. It also showed defective growth in nutrient rich YEPD and YEP-Galactose. Growth on YEPD agar produced colonies similar in appearance to WT, however hyphal induction via growth on Spider agar was greatly reduced in the mutant strain compared to WT. Resistance to oxidative stress was examined and the Δtlostrain was more susceptible to stress induced by both H2O2 and tBOOH. In tests to determine the resistance of the Δtlostrain to cell wall perturbating compounds it was seen that this strain is much less resistant to Congo Red and Calcofluor white than WT. Biofilm formation on plastic surfaces also was reduced in the Δtlo strain compared to that of the WT.

Conclusions
Deletion of the TLO genes in C. albicans greatly impacts phenotypes associated with virulence, and generally results in a less fit strain of C. albicans.
The role of SARM in the control of immune response driven by Klebsiella pneumonia infection
Authors: Feriotti Claudia , Bengoechea Jose 
Published: April 2019

Introduction

Klebsiella pneumonia is a Gram-negative, capsulated bacteria, which is an important cause of community-acquired and nosocomial pneumonia. Klebsiella co-opts cellular functions dedicated to control immune balance to limit the activation of inflammatory responses. SARM (Sterile α-and armadillo-motif containing protein), the fifth identified member of the TIR (Toll-interleukin 1 receptor (1LR)) adaptor family, negatively regulates IRF and NF-kB activation by affecting TLR4 and TLR3 TRIF-dependent signalling. It is currently unclear the role, if any, of SARM in bacterial infections. Here, we aim to dissect the contribution of SARM in Klebsiella infections, and, specifically, to investigate whether Klebsiella may exploit SARM as part of the pathogen’s portfolio immune evasion strategies.

Results
SARM contributed to Klebsiella anti-inflammation strategies in macrophages through by increasing AKT phosphorylation (to limit phagosome-lysosome fusion), and preventing the activation of NF-kB (to control inflammatory responses). SARM also negatively regulated type I IFN regulatory factor (IRF3) by decreasing IRF3 phosphorylation. Notably, SARM played a role as inflammasome inhibitor, as observed by increased IL-1β secretion in the supernatants of infected sarm-/-. SARM also inhibited ASC oligomerization in Klebsiella-infected macrophages as seen by the increased ASC monomers release by sarm-/- BMDMs. SARM was also required for pyroptosis following Klebsiella infection. Interestingly, Klebsiella induced the expression of SARM in a TLR4-TRAM-TRIF-IRF3-IFNAR dependent manner, demonstrating that Klebsiella exploits type I IFN to trigger SARM to control inflammasome activation, and the activation of inflammatory responses.

Conclusions
These findings have uncovered how Klebsiella manipulates the TLR adaptor SARM to dampen the activation of host defences.