bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPERREFLECTIVE FOVEAL SPOTS IN PATIENTS WITH VITREORETINAL ANOMALIES
Authors: Pierro Luisa , Arrigo Alessandro , Capone Luigi , Aragona Emanuela , Marchese Alessandro , Iuliano Lorenzo , Bandello Francesco 
Published: March 2019

Purpose:
To describe structural optical coherence tomography (OCT) and OCT angiography features in patients who have developed hyperreflective foveal spots with or without vitreomacular interface abnormalities or with vitreous adhesion alone.

Methods:
The study design was observational and cross sectional. The presence of defined epiretinal membrane was considered an exclusion criterion. All patients underwent complete ophthalmologic examination, with structural OCT and OCT angiography acquisitions. Both qualitative and quantitative analyses of OCT angiography reconstructions were performed for superficial capillary plexus, deep capillary plexus, and choriocapillaris.

Results:
Thirty patients (20 men; mean age, 55.2 years) showing hyperreflective foveal spots on structural OCT and 30 healthy control subjects (20 men; mean age, 54.7 years) were enrolled. Best-corrected visual acuity was 0.0 ± 0.0 logarithm of the minimum angle of resolution (20/20 Snellen) for both patients and control subjects. Following global and parafoveal/extrafoveal analyses, both superficial capillary plexus and deep capillary plexus showed significant reduction (P < 0.001). Significant superficial capillary plexus and deep capillary plexus changes were also detected in contralateral eyes (P < 0.001).

Conclusion:
Hyperreflective foveal spots might be seen as the initial effect of traction forces causing Müller cell and external retinal layer disruption, leading to the onset of vitreomacular disease. These changes also have an effect on the retinal vascular network. Further larger prospective studies are necessary to confirm our findings.
Optical Coherence Tomography Assessment of the Cornea During Corneal Swelling: Should the Term “Descemet Membrane Folds” Be Reconsidered?
Authors: Annadanam Anvesh , Stoeger Christopher G. , Galloway Joshua D. , Hikes Matthew T. , Jun Albert S. 
Published: March 2019

Purpose:
Previous work has suggested that Descemet membrane (DM) folds arise in response to corneal swelling. However, their origin has not been closely explored. In this study, we used optical coherence tomography to evaluate whether DM folds arise secondary to folds in the middle stroma.

Methods:
Serial optical coherence tomography images of donor cornea pairs in deionized water were taken for each of the following corneal manipulations: 1) untreated, 2) DM and the endothelium removed, 3) excised in the region of the deep middle/posterior stroma, and 4) excised in the middle stroma.

Results:
For intact corneas, increasing duration in deionized water was marked by a progressive increase in corneal thickness and number of folds along the posterior surface. With DM and the endothelium removed, a similar phenomenon was observed. In the third set of corneas, the plane of resection created a structural separation in the region of the deep middle/posterior stroma. Folds were seen originating anterior to the resection plane. For corneas with the posterior and part of the middle stroma removed, the typical folds on the posterior surface as seen in the previous conditions were not observed. Instead, less numerous and smaller irregularities of the posterior surface of the resection plane were present.

Conclusions:
Folds in DM associated with corneal edema originate in the middle and posterior stroma and are secondarily transmitted into DM. On the basis of the stromal origin of these anatomic changes, “stromal folds” should be considered a more accurate term to replace “Descemet membrane folds.”
Bicanalicular Silicone Intubation for the Management of Punctal Stenosis and Obstruction in Patients With Allergic Conjunctivitis
Authors: Alsulaiman Naif , Alsuhaibani Adel H. 
Published: March 2019

Purpose:
To evaluate the use of bicanalicular silicone intubation for the management of punctal stenosis and obstruction in patients with allergic conjunctivitis.

Methods:
A retrospective interventional case series of patients with acquired epiphora due to stenotic or obstructed puncta as a result of allergic conjunctivitis was performed. Punctal dilation and bicanalicular silicone intubation were performed in all patients. Munk Scale for grading of epiphora along with grading of fluorescein dye disappearance test was used to evaluate the functional improvement. Grading of punctal stenosis using Kashkouli’s grading system was applied to evaluate the anatomical improvement. Patients having canalicular or nasolacrimal duct obstruction, punctal stenosis, and obstruction due to other causes were excluded.

Results:
Fifty-one patients met the inclusion criteria with male-female ratio of 1:1.55 and an average age of 46 years at presentation. High patient tolerances without complications with the use of tubes were reported. Significant improvement 6 months after tube removal in comparison to preoperative period was found with anatomical and functional success rate of 91.83% and 87.75%, respectively. Two patients had a recurrence of the punctal stenosis many months after stent removal because of the early tube prolapse and exacerbation of the allergic conjunctivitis.

Conclusions:
Bicanalicular silicone intubation seems to be a well-tolerated and effective tool in the management of acquired punctal stenosis or obstruction secondary to allergic conjunctivitis. Bicanalicular silicone intubation appears to be a good option as patients with allergic conjunctivitis typically present with bilateral involvement of both puncti.
Eyelid Spontaneous Blink Analysis and Age-Related Changes Through High-Speed Imaging
Authors: DeAngelis Kendra D. , Rider Alex , Potter Whitney , Jensen Jason , Fowler Brian T. , Fleming James C. 
Published: March 2019

Purpose:
To analyze the spontaneous eyelid blink and sphincter closure activity of the orbicularis oculi by measuring the horizontal eyelid movement.

Methods:
Individuals 18+ years of age, any ethnicity, and gender were recruited. Participants completed a questionnaire to determine eligibility. Exclusion criteria included the following: history of facial trauma, nerve palsy, surgery, use of periorbital neuromodulators or filler within the past year, thyroid eye disease, and eyelid or ocular surface disease. Data were collected from participants by decade. Eyelid blinks were recorded using the FPS 1000HD. The motions of 3 spontaneous blinks in primary gaze were recorded. All blinks were reviewed and one chosen for most accurate analysis. Horizontal palpebral fissure width and its changes of open and closed eye measurements were taken using National Institute of Health ImageJ software version 2.0. The data were subjected to SAS version 9.4 analysis using paired t test, t test, and linear models.

Results:
One hundred thirty-six patients were recruited. Fourteen patients were excluded; 122 patients were used in analysis. Ages ranged from 22 to 90 years. Participants were divided into 6 groups according to age (20–29, 30–39, 40–49, 50–59, 60–69, and 70+ years of age). The average horizontal fissure length across all ages was 24.23 mm. Average change in horizontal fissure length decreased 1.42 mm among all ages. There was a statistically significant difference comparing age 20–29 decade to age 70+ decade.

Conclusions:
Horizontal fissure length changes with eyelid blink and defines 1 component of the eyelid sphincter.
Custom-Soldered, Double-Ring Retained Silicone Finger Prosthesis
Authors: Palled Varsha , Rao Jitendra , Singh Saumyendra V. , Chand Pooran , Arya Deeksha , Aggarwal Himanshi , Sharma Vijai P. 
Published: March 2019

ABSTRACT

Introduction
Accomplishment of adequate retention in prosthesis is vital to patient comfort. The purpose of this article is to present a technique of fabrication of a nonimplant, nonadhesive retained silicone finger prosthesis for a short, flabby residual digit.

Materials and Methods
To achieve adequate retention in this compromised clinical scenario, two rings were used: one on the residual finger and the other on the adjacent finger, which were soldered at accurate orientation using a custom-made putty index.

Results
Retention of the prosthesis was found to be satisfactory and alleviated the apprehension of the patient regarding surgical placement of implants.

Conclusions
The technique described in this report provides an effective, reversible, and straightforward method of managing the compromised situation. The double-ring technique offers a nonsurgical alternative to rehabilitation of patients with compromised residual digits.
Trauma systems in North America
Authors: Lundy Douglas W. , Harvey Edward J. , Jahangir A. Alex , Leighton Ross K. 
Published: March 2019

Abstract
North American trauma systems are well developed yet vary widely in form across the continent. Comparatively, the Canadian trauma system is more unified, and approximately 80% of Canadians live within 1 hour of a level I or II center. In the United States, trauma centers are specifically verified by the individual states and thus there tends to be more variability across the country. Although many states use the criteria developed by the American College of Surgeons Committee on Trauma, the individual agencies are free to utilize their own verification standards. Both Canada and the United States utilize efficient prehospital care, and both countries recognize that postdischarge care is a financial challenge to the system. Population dense areas offer rapid admission to well-developed trauma centers, but injured patients in remote areas may have challenges regarding access. Trauma centers are classified according to their capabilities from level I (highest ability) to level IV. Although each trauma system has opportunities for improvement, they both provide effective access and quality care to the vast majority of injured patients.
Evaluating the Influence of Social Engagement on Cognitive Impairment and Mobility Outcomes Within the Boston RISE Cohort Study
Authors: Steere Hannah K. , Quach Lien , Grande Laura , Bean Jonathan F. 
Published: March 2019

Objective
We investigated the associations between mild cognitive impairment (MCI), social engagement (SE), and mobility.

Design
We evaluated data from a cohort study of older adult primary care patients (N = 430). Outcomes included self-reported function (Late-Life Function Instrument [LLFI]) and performance-based mobility (Short Physical Performance Battery score [SPPB]). Linear regression models evaluated the association between MCI and mobility, MCI and SE, mobility measures and SE, and whether SE mediated the association between MCI status and mobility.

Results
Participants with MCI had significantly lower mobility and lower SE as compared with those without MCI (LLFI: 53.5 vs. 56.9, P < 0.001; SPPB: 7.9 vs. 9.3, P < 0.001; SE score: 44.9 vs. 49.0, P < 0.001). Mild cognitive impairment was significantly associated with both LLFI and SPPB (LLFI β = −2.93, P < 0.001; SPPB β = −1.26, P < 0.001) and SE (β = −3.20, P < 0.001). Social engagement was significantly associated with both LLFI and SPPB (LLFI β = 0.22; P < 0.001; SPPB β = 0.08; P < 0.001). There was a positive association between SE and mobility (P< 0.05). A mediator effect of SE was supported when evaluating the association between MCI and mobility.

Conclusions
Among older adult primary care patients at risk for mobility decline, higher levels of SE mitigate the association between MCI and mobility.
Suboptimal Recent and Regular HIV Testing Among Black Men Who Have Sex With Men in the United States: Implications From a Meta-Analysis
Authors: Liu Yu , Silenzio Vincent M. B. , Nash Robertson , Luther Patrick , Bauermeister Jose , Vermund Sten H. , Zhang Chen 
Published: March 2019

Background:
The continuum of HIV care among black men who have sex with men (BMSM) continues to be the least favorable in the United States. BMSM are disproportionally HIV-infected-but-unaware, despite expanded HIV testing efforts among this subgroup.

Methods:
We meta-analytically analyzed various HIV testing patterns [lifetime, after 24 months, after 12 months, after 6 months, and frequent (every 3–6 months) testing] among BMSM using the PRISMA guideline. PubMed, MEDLINE, Web of Science, and PsycINFO were searched for relevant articles, reports, conference proceedings, and dissertations published between January 1, 1996, and April 25, 2018. Two independent investigators reviewed and abstracted data into a standardized form. We used the DerSimonian–Laird random-effect model to pool the HIV testing prevalence and I-square statistics to measure heterogeneity. Funnel plots and Egger tests were used to assess for publication bias. We also performed subgroup and meta-regression analyses to explore aggregate-level characteristics that explain the heterogeneity across studies.

Results:
Our meta-analysis includes a total of 42,074 BMSM pooled from 67 studies. Lifetime HIV testing prevalence was high, 88.2% [95% confidence interval (CI): 86.2% to 90.1%], but recent (after 6 months = 63.4%; 95% CI: 59.3% to 67.4%) and frequent (42.2%, 95% CI: 34.1% to 50.3%) HIV testing prevalence was low. Meta-regression suggests that younger age (borderline significant), lower annual income, and homelessness were correlated with lower lifetime/recent HIV testing prevalence; while ever having condomless insertive/receptive sex, alcohol consumption, and illicit drug use were associated with higher lifetime/recent HIV testing prevalence.

Conclusions:
Recent and frequent HIV testing remains suboptimal among BMSM. Future testing programs should prioritize strategies to enhance self-initiated, regular HIV testing among BMSM.
A Comparison of Metabolic Outcomes Between Obese HIV-Exposed Uninfected Youth From the PHACS SMARTT Study and HIV-Unexposed Youth From the NHANES Study in the United States
Authors: Jao Jennifer , Jacobson Denise L. , Yu Wendy , Borkowsky William , Geffner Mitchell E. , McFarland Elizabeth J. , Patel Kunjal , Williams Paige L. , Miller Tracie ,   for the Pediatric HIV/AIDS Cohort Study
Published: March 2019

Background:
Metabolic perturbations in HIV-exposed uninfected (HEU) obese youth may differ from those in the general obese pediatric population.

Methods:
Metabolic parameters of obese (body mass index Z-score >95th percentile) HEU youth in the Pediatric HIV/AIDS Cohort Study (PHACS) Surveillance Monitoring of ART Toxicities (SMARTT) study were compared with a matched sample of obese youth from the US National Health and Nutrition Examination Survey (NHANES). We evaluated systolic and diastolic hypertension (blood pressure ≥90th percentile for age, sex, and height), total cholesterol >200 mg/dL, high-density lipoprotein cholesterol <35 mg/dL, low-density lipoprotein cholesterol >130 mg/dL, triglycerides (TGs) >150 mg/dL, and Homeostatic Model Assessment–Insulin Resistance >4.0. Modified Poisson regression models were fit to quantify the prevalence ratio (PR) of each outcome comparing the 2 cohorts, adjusting for confounders.

Results:
The blood pressure outcome analytic subgroup included 1096 participants (n = 304 HEU), the total cholesterol and high-density lipoprotein cholesterol subgroup 1301 participants (n = 385 HEU), and the low-density lipoprotein cholesterol, TG, and Homeostatic Model Assessment–Insulin Resistance subgroup 271 (n = 83 HEU). After adjustment, obese HEU youth had a higher prevalence of systolic and diastolic hypertension [PR = 3.34, 95% confidence interval (CI): 2.48 to 4.50; PR = 2.04, 95% CI: 1.18 to 3.52, respectively], but lower prevalence of insulin resistance (PR = 0.67, 95% CI: 0.54 to 0.85) and hypercholesterolemia (PR = 0.67, 95% CI: 0.44 to 1.01) compared with obese NHANES youth.

Conclusions:
In the United States, obese HEU youth seem to have an increased risk of hypertension, but lower risk of insulin resistance and hypercholesterolemia, compared with a general obese pediatric population. Monitoring for cardiovascular morbidity in adulthood may be warranted in HEU children.
Vein Graft Interposition: A Training Model Using Gradually Thawed Cryopreserved Vessels
Authors: Safi Ali-Farid , Safi Sema , Tayeh Mahmoud , Gojowy David , Timmer Marco , Goldbrunner Roland , Kauke Martin 
Published: March 2019

Introduction:
Microsurgical interposition of vein grafts is an extraordinarily filigree surgical technique, which requires both sound theoretical knowledge and solid manual skills. Although there are a large number of training models, the majority of these are either relatively expensive, technically complex, or employ synthetic materials with poor resemblance to human tissue. The authors’ model allows training of ex vivo vein graft interposition on gradually thawed cryopreserved vessels and it, therefore, is cost-efficient and readily available when needed. Furthermore, it respects the 3R-principle (Reduce-Refine-Replace), as it is based on rat cadaveric vessels.

Methods:
Three trainees with basic microsurgical experience, but without prior performance of vein graft interpositioning, were chosen to perform 20 femoral vein graft (5 mm) interpositions into femoral artery defects. The patency and leakage rate served as qualitative variable and operation time as a quantitative variable for efficiency control.

Results:
For the first half of trials, the trainees had a patency failure rate of 50% and for the second half a rate of 13.3%. The leakage rate noticeably decreased from 44.4% in the first half of trials to 10% in the second half. Although the trainees needed 60 minutes on average for their first 10 trials, they improved to 51 minutes for their last 10 anastomoses.

Conclusion:
The authors’ microsurgical model offers a simple, low-cost simulation training, specifically designed for learning of vein graft interposition into arterial defects. The model is associated with a high learning curve, based on an objective control of the anastomoses by assessment of the patency, leakage, and operation time.
Epidemiology, Socioeconomic Analysis, and Specialist Involvement in Dog Bite Wounds in Adults
Authors: Lee Christine J. , Santos Pauline Joy F. , Vyas Raj M. 
Published: March 2019

Abstract
Dog bites have been well described and characterized in the pediatric population. Comparatively, dog-bite injuries in adults and the settings in which surgeons become involved are less studied. An electronic hospital database identified all patients 18 years or older who were treated for dog bites from 2010 to 2014. Demographics, injury information, intervention type, and payer source were collected. Socioeconomic analysis was performed using Geographic Information Systems mapping. A total of 189 adults presented to the emergency department with dog-bite-related injuries. The most common injury location was the hand (n = 62, 32.8%), followed by the head and neck (n = 36, 19.1%). Of the 189 patients, 33 adults (17.5%) were forwarded to a surgical subspecialist for repair. A head and neck injury was significantly more likely to be repaired by a surgical specialist (P = 0.011). The most common breed of dog identified was pit bull (n = 29, 47.5%). The majority of pit bull attacks involved the extremities (65.5%) compared to other breeds of dogs. Pit bull victims were noted to have a lower average annual income compared to other breed victims ($64,708 versus $75,004; P = 0.16). Annual income between intervention group and no intervention group was not significantly different (P = 0.26). This study is the 1st to perform a socioeconomic analysis in the adult dog-bite population and encourages the use of a surgical specialist in the setting of a head and neck bite.
Alveolar Septal Widening as an “Alert” Signal to Look Into Lung Antibody-mediated Rejection: A Multicenter Pilot Study
Authors: Calabrese Fiorella , Hirschi Sandrine , Neil Desley , Montero-Fernandez Angeles , Timens Wim , Verbeken Erik , Chenard Marie-Pierre , Ivanovic Marina , Le Pavec Jerome , Pena Tahuanty , Dorfmüller Peter , Roux Antoine , Rice Alexandra , Perissinotto Egle , Lunardi Francesca , Levine Deborah J. , Cozzi Emanuele , Goddard Martin 
Published: March 2019

Background.
Antibody-mediated rejection (AMR) plays an important role in allograft dysfunction. Acute lung injury (ALI), endotheliitis, capillary inflammation, and C4d positivity have been described as morphological features conventionally associated with lung AMR. A multidisciplinary, international task force reviewed AMR cases in the context of four face-to-face meetings. Septal widening was a frequent, striking histological feature recognized first and easily at low-power magnification. This study aimed to evaluate whether septal widening could represent an “alert” signal for AMR.

Methods.
Following the face-to-face meetings that enabled the classification of cases as AMR or non-AMR, morphometry was performed on biopsies from 48 recipients with definite, probable or possible AMR, 31 controls (negative for any posttransplant injury) and 10 patients with nonimmune-related ALI.

Results.
Mean alveolar septal thickness was greater in AMR patients than in controls (P < 0.001). Septal thickness was not significantly different between AMR-ALI and non–AMR-ALI. Unexpectedly septal widening was the only histological change detected in some cases with probable or possible AMR that lacked the histological lesions conventionally associated with AMR. The thickness in these cases was similar to that observed in AMR cases with more severe histological injury such as ALI or neutrophilic capillaritis.

Conclusions.
Our data suggest that, even if unspecific as the other lesions conventionally associated with AMR, septal widening may represent an “alert” signal to look into lung AMR. A larger prospective study is mandatory to confirm the potential value of septal widening in the multidisciplinary approach of AMR.
MALVA: genotyping by Mapping-free ALlele detection of known VAriants
Authors: Bernardini Giulia , Bonizzoni Paola , Denti Luca , Previtali Marco , Schönhuth Alexander 
Published: March 2019

AbstractThe amount of genetic variation discovered and characterized in human populations is huge, and is growing rapidly with the widespread availability of modern sequencing technologies. Such a great deal of variation data, that accounts for human diversity, leads to various challenging computational tasks, including variant calling and genotyping of newly sequenced individuals. The standard pipelines for addressing these problems include read mapping, which is a computationally expensive procedure. A few mapping-free tools were proposed in recent years to speed up the genotyping process. While such tools have highly efficient run-times, they focus on isolated, bi-allelic SNPs, providing limited support for multi-allelic SNPs, indels, and genomic regions with high variant density.To address these issues, we introduceMALVA, a fast and lightweight mapping-free method to genotype an individual directly from a sample of reads.MALVAis the first mapping-free tool that is able to genotype multi-allelic SNPs and indels, even in high density genomic regions, and to effectively handle a huge number of variants such as those provided by the 1000 Genome Project. An experimental evaluation on whole-genome data shows thatMALVArequires one order of magnitude less time to genotype a donor than alignment-based pipelines, providing similar accuracy. Remarkably, on indels,MALVAprovides even better results than the most widely adopted variant discovery tools.