bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Diagnostic Power of Optic Nerve Head and Posterior Sclera Configuration Parameters on Myopic Normal Tension Glaucoma
Authors: Kim Yong Chan , Cho Bum Joo , Jung Kyoung In , Park Chan Kee 
Published: July 2019

Purpose:
The aim of this study was to compare the diagnostic power of optic nerve head and posterior scleral configuration parameters obtained with the swept-source optical coherence tomography (SSOCT) on myopic normal-tension glaucoma (NTG).

Materials and Methods:
A total of 203 eyes of 203 participants with myopia diagnosed at Seoul Saint Mary’s Hospital between September 2016 and February 2018 were divided into myopic NTG group (n=113) and nonglaucomatous myopia group (n=90). Established optic nerve head (ONH) parameters such as disc torsion, horizontal tilt, and vertical tilt, and novel parameters representing posterior sclera, were quantified using SSOCT. The posterior sclera was presented with the relative position of the deepest point of the eye (DPE) from the optic disc by measuring the distance, depth, and angle. The mean and the statistical distribution of each index were calculated. Differences in distribution led to another novel marker, absolute misaligned angle, which represents the displaced direction of the ONH from the sclera. The ONH was classified as misaligned when the degree of misalignment was >15 degrees in either direction. The area under the receiver operating characteristic curves and multivariate logistic regression analysis were used to test the diagnostic power in the presence of myopic NTG.

Results:
No significant difference was observed with respect to age, sex, refractive error, axial length, and central corneal thickness between the 2 groups. However, 20 (22.22%) of 90 eyes in the nonglaucomatous group showed misalignment, whereas 60 (53.09%) of 113 eyes in the NTG group had misalignment (odds ratio: 3.962, P<0.001). The absolute misaligned angle (0.696) and the horizontal tilt (0.682) were significantly associated with myopic NTG, which significantly exceeded other parameters in area under the receiver operating characteristic curves (both P<0.001). The multivariate logistic regression also showed that the absolute misaligned angle (hazard ratio=1.045, 95% confidence interval=1.023-1.068, P<0.001) and the horizontal tilt (hazard ratio=1.061, 95% confidence interval=1.015-1.109, P=0.009) were associated significantly with the presence of NTG.

Conclusions:
The diagnostic power of absolute misaligned angle and the horizontal tilt angle significantly exceeded other parameters on myopic NTG. These parameters may be associated with a displaced direction of the ONH to the posterior sclera, which can be linked to the altered sclera configuration of myopic NTG subjects.
Validating a New Tablet-based Tool in the Determination of Cochlear Implant Angular Insertion Depth
Authors: Canfarotta Michael W. , Dillon Margaret T. , Buss Emily , Pillsbury Harold C. , Brown Kevin D. , O’Connell Brendan P. 
Published: July 2019

Objective:
The objective of this study is to determine the reliability of a new tablet-based software that utilizes postoperative computed tomography to determine angular insertion depth (AID), cochlear duct length (CDL), and the cochlear place frequency of individual electrodes in cochlear implant recipients.

Patients:
Twenty adult cochlear implant recipients with lateral-wall electrode arrays of varying lengths were included in the study.

Intervention:
Cochlear and electrode array measurements were made by 2 otolaryngologists using a tablet-based software. The user manually identifies the modiolus, round window, and each electrode contact to calculate AID. The user also manually identifies cochlear landmarks to calculate the CDL. The AID and CDL are applied to the Greenwood function to obtain an estimate of the cochlear place frequency for each electrode.

Main Outcome Measure(s):
The primary outcome measure was the reliability of the instrument, as assessed with intra and interrater reliability of measured AID and CDL. The resultant differences in the estimated cochlear place frequency of the most apical electrode were also evaluated.

Results:
A broad range of AIDs were observed (390°–659°). Intraclass correlation coefficients for intra (0.991) and interrater reliability (0.980) of AID of the most apical electrode contact were excellent. Intra (0.820) and interrater reliability (0.784) of CDL were also excellent. The estimated cochlear place frequency for the most apical electrode differed by an average of 6.7% (0–18.7%) across the 2 raters.

Conclusion:
There is excellent agreement amongst clinicians in the determination of AID and CDL, resulting in small changes in estimated cochlear place frequency of the most apical electrode using this new software.
Breath Methane Does Not Correlate With Constipation Severity or Bloating in Patients With Constipation
Authors: Singh Prashant , Duehren Sarah , Katon Jesse , Rangan Vikram , Ballou Sarah , Patel Raxitkumar , Iturrino Johanna , Lembo Anthony , Nee Judy 
Published: July 2019

Goals:We aimed to study (1) if the breath methane level on glucose breath testing (GBT) was associated with constipation severity and (2) compare methane levels between patients with constipation and diarrhea.Background:The breath methane level has been associated with constipation and its severity. However, a few recent studies have questioned these associations.Study:Patients presenting consecutively to a tertiary care gastroenterology motility laboratory for GBT were included. GBT was performed using 75-g glucose load following a standard, institutional protocol. Constipation and irritable bowel syndrome (IBS) severity was measured using Patient Assessment of Constipation Symptoms (PAC-SYM) and IBS-symptom severity scale (IBS-SSS).Results:In the cohort of 79 constipated patients, there was no significant correlation between baseline or maximum methane levels with total PAC-SYM score. IBS-SSS or bloating severity also did not correlate with baseline or maximum methane levels. The baseline or maximum methane levels of ≥3 and 5 ppm were equally distributed among those with constipation (n=79) and diarrhea (n=122). Only baseline methane levels of ≥10 and ≥20 ppm significantly correlated with constipation (P<0.001 for both).Conclusions:We found that constipation and bloating severity did not correlate with methane levels on GBT. In addition, only higher baseline methane levels (≥10 and ≥20 ppm) significantly correlated with constipation as baseline methane levels up to 5 ppm were equally common in patients with diarrhea and constipation. Baseline methane levels had better correlation with constipation compared with maximum levels of methane achieved.
The effect of magnesium sulfate on surgical field during endoscopic sinus surgery
Authors: Liu Wei , Jiang Hong , Pu Hong , Hu Dongli , Zhang Yinglong 
Published: July 2019

Abstract

Introduction:
The benefits of magnesium sulfate for surgical field during endoscopic sinus surgery remain controversial. We conduct a systematic review and meta-analysis to explore the influence of magnesium sulfate versus placebo on surgical field during endoscopic sinus surgery.

Methods:
We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through November 2018 for randomized controlled trials (RCTs) assessing the effect of magnesium sulfate versus placebo on surgical field during endoscopic sinus surgery. This meta-analysis is performed using the random-effect model.

Results:
Four RCTs and 404 patients are included in the meta-analysis. Overall, compared with control group endoscopic sinus surgery, magnesium sulfate has remarkably positive impact on surgical field scores (MD = −1.76; 95% CI = −2.33 to −1.18; P < .00001), and intraoperative blood loss (MD = −89.09; 95% CI = −163.20 to −14.97; P = .02), but shows no markedly effect on surgery duration (MD = −7.08; 95% CI = −21.38 to 7.22; P = .33), fentanyl (MD = −0.64; 95% CI = −1.97 to 0.70; P = .35), and vecuronium (MD = −3.64; 95% CI = −10.99 to 3.70; P = .33).

Conclusions:
Magnesium sulfate exerts positive impact on surgical field and blood loss reduction for endoscopic sinus surgery.
Is blood transfusion associated with an increased risk of infection among spine surgery patients?
Authors: He Yu-Kun , Li Hui-Zi , Lu Hua-Ding 
Published: July 2019

Abstract

Background:
Blood transfusions are associated with many adverse outcomes among spine surgery patients, but it remains unclear whether perioperative blood transfusion during spine surgery and postoperative infection are related. Recently, many related cohort studies have been published on this topic.

Methods:
This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The PubMed, Embase, and Cochrane Library databases were searched for eligible published studies. The Newcastle–Ottawa Scale (NOS) was used to assess the methodological quality of the studies, and a random-effects model was used to calculate the odds ratios (ORs) with 95% CIs. Sensitivity analyses were conducted to explore the source of heterogeneity.

Results:
The final analysis included 8 cohort studies with a total of 34,185 spine surgery patients. These studies were considered to be of high or moderate quality based on their NOS scores, which ranged from 5 to 9. Pooled estimates indicated that blood transfusion increased the infection rate (OR, 2.99; 95% CI, 1.95 to 4.59; I
2 = 86%), which was consistent with the sensitivity analyses.

Conclusions:
Our results suggest that perioperative blood transfusion is a risk factor for postoperative infection among spine surgery patients. Further study is necessary to identify other influencing factors and to establish the mechanism underlying this relationship. Additional measures may be needed to reduce unnecessary blood transfusions during spine surgery.
The effectiveness and safety of acupuncture for knee osteoarthritis
Authors: Li Juan , Li Yu-Xi , Luo Liao-Jun , Ye Jing , Zhong Dong-Ling , Xiao Qi-Wei , Zheng Hui , Geng Chun-Mei , Jin Rong-Jiang , Liang Fan-Rong 
Published: July 2019

Abstract

Background:
Knee osteoarthritis (KOA), known as severe degenerative arthritis, commonly occurs in middle-aged and elderly people all over the world. Acupuncture as traditional oriental intervention is getting widely used and several systematic reviews (SRs) have reported the effectiveness of acupuncture on pain relief and functional recovery in patients with KOA.

Objective:
Conducting an overview of SRs to provide more reliable evidence-based medical references for clinical practitioners and researchers of the effectiveness and safety of acupuncture for KOA.

Data sources:
EMBASE, Medline, Web of science, the Cochrane library, China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, China Biology Medicine, Wan Fang Digital Journals, and PROSPERO databases from inception to December 2018, magazines, websites, and unpublished sources.

Selection criteria:
Potential SRs were independently selected by 2 reviewers following a predetermined protocol.

Data extraction:
Data information of included SRs were independently extracted by 2 reviewers following a predetermined standardized data extraction form.

Review appraisal:
The risk of bias and reporting quality of included SRs were evaluated by the Risk of Bias in Systematic reviews (ROBIS) tool and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The quality of evidence of outcomes was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results:
A total of 12 SRs were included. All the SRs were published in recent 12 years, ranging from 2006 to 2017. According to ROBIS, 4 SRs were in low risk in domain 1 and 7 in domain 3 of phase 2, and 2 SRs were low risk in phase 3. Among 27 items of PRISMA, 19 items were reported over 70% of compliance. Using GRADE assessment, of 34 outcomes, high quality of evidence was found in 5 outcomes, 17 outcomes were rated moderate quality, and 11 outcomes were low quality. According to high-quality outcomes, acupuncture had more total effective rate, short-term effective rate, and less adverse reactions than western medicine in treating KOA. In terms of Lequesne index and Lysholm knee score scale score, the effectiveness of electroacupuncture was better than that of western medicine.

Limitations:
There might be missing information. There may be duplicated clinical trials included by each SR that might have impact on the synthetic findings.

Conclusions:
According to the high-quality evidence, we concluded that acupuncture may have some advantages in treating KOA. However, there are some risk of bias and reporting deficiencies still needed to be improved.
Factors affecting the occurrence of gastrointestinal bleeding in acute ischemic stroke patients
Authors: Fu Jia 
Published: July 2019

Abstract
Gastrointestinal bleeding (GIB) is a common complication that occurs after stroke, and GIB may negatively affect patient prognosis. In this study, we aimed to examine:
(1) the risk factors of GIB in acute cerebral infarction patients;
(2) association between GIB and 1-year mortality in patients with acute cerebral infarction.
Patients with acute cerebral infarction were divided into 2 groups based on the occurrence of GIB during acute stroke stage. Patient characteristics, clinical presentation, stroke risk factors, comorbidities, laboratory data, medication, and outcomes were investigated to analyze the associations between the variables and the probability of having GIB. In addition, patients in the study were matched individually by age, gender. A 1:1 matched case-control method and conditional logistic regression models for single and multiple factors were used to assess the risk factors of GIB in acute cerebral infarction patients.
Clinical data of patients with acute cerebral infarction were reviewed and analyzed during the years 2015 and 2016. Finally, 1662 patients with acute cerebral infarction were included in this study, of whom 139 (8.5%) patients had GIB at admission. Multivariate logistic regression analysis revealed that the independent risk factors for GIB in patients with acute cerebral infarction were advanced age (OR = 1.030, P = .009), low Glasgow Coma Scale (GSC) score (OR = 0.850, P = .014), infection (OR = 4.693, P < .001), high NIHSS score (OR = 1.114, P = .001), and posterior circulation infarction (OR = 4.981, P = .010). The case-control study ultimately included 136 case-control pairs. Stepwise conditional regression analyses revealed that the independent risk factors for GIB in patients with acute cerebral infarction were low Glasgow Coma Scale (GSC) score (RR = 0.645, P = .011), infection (RR = 15.326, P = .001), and posterior circulation infarction (RR = 6.129, P = .045). The group with GIB had a higher rate of mortality and disability level (mRS grade ≥ 4) than the group without GIB (P < .001) within 1 year after stroke. In addition, independent risk factors of death within 1 year after stroke in patients were GIB (OR = 6.096, P < .001), infection (OR = 4.493, P < .001), mRS grade ≥ 4 (OR = 4.129, P < .001), and coronary heart disease (OR = 3.718, P = .001).
GIB is a common complication after ischemic stroke. These identified factors may help clinicians identify risks of GIB before it develops. GIB is associated with increased risk of 1-year mortality and poor functional outcome in acute cerebral infarction patients.
Relationship between oxidative balance score and quality of life in patients with osteoarthritis
Authors: Lee Joo-Hyun , Joo Young Bin , Han Minkyung , Kwon Seong Ryul , Park Won , Park Kyung-Su , Yoon Bo Young , Jung Kyong-Hee 
Published: July 2019

Abstract
Osteoarthritis (OA) has a multifactorial etiology that includes oxidative stress. Oxidative balance score (OBS) is a well-known indicator of oxidative stress. However, the association between OBS and OA has not been assessed. Thus, this study aimed to investigate the associations of OBS with OA and quality of life (QOL) in patients with OA.
By using data from the Korea National Health and Nutrition Examination Survey VI, patients previously diagnosed and/or treated by a physician were considered to have OA regardless of the affected joints. The control group was defined as participants without any form of chronic arthritis. OBS was calculated by combining 10 pro-oxidant and antioxidant factors through a baseline nutritional and lifestyle assessment. Higher OBS scores indicated a predominance of antioxidant exposure. Multivariable logistic regression was used to estimate the adjusted odds ratios (ORs) for OA, and the EuroQoL five-dimensional questionnaire (EQ5D) was used in patients with OA after adjusting for demographic factors and comorbidities.
Among the 14,930 participants, 296 patients with OA, and 1,309 controls were included in the analysis. In the age- and sex-adjusted model, the OR of the total OBS for OA was significant. In the full model adjusted for age, sex, education, income, and comorbidities, the total OBS for OA was not significant. Only the non-dietary pro-oxidant OBS had a significant inverse association with OA. The patients with OA who had a high EQ5D score had a higher total OBS than those with a low EQ5D score. The OR of the total OBS for a high EQ5D score was 1.14 in the multivariable logistic regression model. As we analyzed the OBS as a categorical variable (reference = Q1), the ORs of the Q2, Q3, and Q4 (highest) total OBS were 1.43, 2.71, and 2.22, respectively.
In the fully adjusted model, the total OBS was not associated with OA. However, a positive association was observed between the total OBS and QOL in the patients with OA, indicating that antioxidative status was associated with better QOL in patients with OA.
Aorta coarctation and systemic lupus erythematosus
Authors: Li Jiarong , Wang Xuan , Zhang Huali , Wang Wei , Pei Yigang , Xie Tingting , Lin Wei , Zuo Xiaoxia , Zhang Weiru 
Published: July 2019

Abstract

Rationale:
Vasculitis is one of the common pathological hallmarks of systemic lupus erythematosus (SLE). Vascular lesions in SLE commonly involve medium- and small-sized vessels. Rarely, vasculitis in SLE may involve large vessels such as the aorta leading to life-threatening complications. Reported cases of large vessel lesions in SLE included aortic aneurysm and aortic dissection.

Patient concerns:
Here, we report a 52-year-old Chinese woman with SLE, who was stable on oral glucocorticoid, but showed sudden intractable hypertension and heavy proteinuria before we found aorta coarctation in her computed tomography (CT) scan of the aorta.

Diagnoses:
This patient's large vascular lesions were likely secondary and not a primary manifestation of lupus activity.

Interventions and outcomes:
After endovascular stent graft repair of the abdominal aorta, her hypertension and proteinuria were controlled.

Lessons:
In the context of reported cases of large vessel lesions in SLE, our case further supports the significance of having a wide differential for vascular lesions in SLE, especially when an SLE patient presents sudden hypertension and heavy proteinuria. This case also demonstrates that vascular lesions in SLE may lead to serious, potentially fatal consequences.
Predicting recurrence of nonmuscle-invasive bladder cancer (Ta-T1)
Authors: Lu Mengxin , Chen Song , Zhou Qiang , Wang Lu , Peng Tianchen , Wang Gang 
Published: July 2019

Abstract
The aim of this study was to determine clinical recrudescent risk factors of 477 patients with newly discovered nonmuscle-invasive bladder cancer (NMIBC) (Ta-T1) in our hospital, and based on these factors, to establish a recurrence risk prediction model of each NMIBC patient.
This study included 477 patients with newly discovered NMIBC (Ta-T1) from January 2012 to December 2016; all patients were treated surgically by transurethral resection of bladder tumor (TURBT). The outcomes of patients were with or without recurrence within 2 years. The nomograms were based on Cox regression analyses, and the calibration curves were founded to evaluate the agreements of the predicted probability with the actual observed probability.
Of the 477 patients with NMIBC, 392 were males (82.2%) and 85 were females (17.8%), with median age 64 years. Recurrence was identified in 327 cases (68.6%). The results showed that old age, female sex, smoking history, large size of tumor, multifocal tumors, high grade, and high stage are risk factors for NMIBC recurrence, whereas no significant association was seen between tumor location and recurrence in our study. Based on the results of Cox regression analyses, several independent risk factors, including smoking history, tumor size, multifocal, immediate infusion therapy, T stage, and tumor grade, were used to establish a nomogram to calculate the recurrence probability of each NMIBC patient, and the calibration curve displayed that this nomogram had a great value of prediction.
Old age, female sex, smoking history, large size of tumor, multifocal tumors, high grade, and high stage are risk factors for NMIBC recurrence, whereas immediate infusion therapy is a protective factor. And a nomogram was established as a prediction model to calculate the recurrence probability of NMIBC patients.
Effects of exercise on the levels of BDNF and executive function in adolescents
Authors: de Azevedo Kesley Pablo Morais , de Oliveira Segundo Victor Hugo , de Medeiros Gidyenne Christine Bandeira Silva , de Sousa Mata Ádala Nayana , García Daniel Ángel , de Carvalho Leitão José Carlos Gomes , Knackfuss Maria Irany , Piuvezam Grasiela 
Published: July 2019

Abstract

Backoground:
Evidence available in the literature suggests that physical exercise increases the release of brain-derived neurotrophic factor (BDNF) in humans and may possibly be related to improvements in executive function. However, studies of this phenomenon in adolescents are still scarce. The objective of this work is to describe the protocol for a systematic review (SR) and meta-analysis of interventional studies aiming to determine the effect of physical exercise on BDNF levels and executive function in adolescents.

Methods:
This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) and by the Cochrane Handbook of Systematic Reviews of Interventions. The databases to be searched are PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. Interventional studies conducted on adolescents with different exercise protocols and evaluations of BDNF levels and executive function in pre- and post-intervention periods will be included in the systematic review. The characteristics of the studies, participants, and main results will be described, then the evaluation of the risk of biases and the level of evidence obtained by the protocol will be assessed. The selection of studies, data extraction, and evaluation of the methodological quality will be performed by 2 experienced reviewers independently.

Conclusion:
The systematic review will present the effects of the practice of physical exercises on the BDNF and executive function levels. The results will strengthen the interventions with the focus on the brain health of adolescents through general orientations and the evidences described shall direct future research.

PROSPERO registration number:
CRD42018110683