bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human Lacrimal Production Rates from Modified Schirmer-Tear Test
Authors: Li Songhao , Kim Young Hyun , Li Wing , Lin Meng C. , Radke Clayton J. 
Published: March 2018

SIGNIFICANCE
A simple methodology is presented to quantify basal tear production with a modified Schirmer-tear test.

PURPOSE
We introduce a simple clinical procedure to measure quantitative basal tear-production flowrates, Q

L
, from a modified Schirmer-tear test (STT).

METHODS
Eight healthy subjects aged at least 18 years underwent modified STTs on both eyes for two visits each. Schirmer strips were sheathed with transparent tape before insertion. Topical anesthetic minimized reflex tearing. Wetting lengths were measured every 30 s for 5 min; Q

L
was calculated from the linear slope of wetting length versus time. Determination of Q

L
requires mass–balance equations on the tear prism and Schirmer strip with strip imbibition kinetics obeying Darcy and Young–Laplace laws.

RESULTS
Basal tear production rates varied from essentially 0 to about 2 μl/min. With some exceptions, right and left eyes showed similar tear production rates.

CONCLUSIONS
By following the modified STT, Q

L
is established with minimal additional effort over a standard Schirmer test. We predict and observe four different subtypes of imbibition kinetics depending on how short or long the time is for first appearance of the wetting front and on how fast or slow is tear production. For slow lacrimal production rates, the standard 5-min wetting length does not correlate with basal tear production.
The ipRGC-Driven Pupil Response with Light Exposure, Refractive Error, and Sleep
Authors: Abbott Kaleb S. , Queener Hope M. , Ostrin Lisa A. 
Published: March 2018

SIGNIFICANCEWe investigated links between the intrinsically photosensitive retinal ganglion cells, light exposure, refractive error, and sleep. Results showed that morning melatonin was associated with light exposure, with modest differences in sleep quality between myopes and emmetropes. Findings suggest a complex relationship between light exposure and these physiological processes.PURPOSEIntrinsically photosensitive retinal ganglion cells (ipRGCs) signal environmental light, with pathways to the midbrain to control pupil size and circadian rhythm. Evidence suggests that light exposure plays a role in refractive error development. Our goal was to investigate links between light exposure, ipRGCs, refractive error, and sleep.METHODSFifty subjects, aged 17–40, participated (19 emmetropes and 31 myopes). A subset of subjects (n = 24) wore an Actiwatch Spectrum for 1 week. The Pittsburgh Sleep Quality Index (PSQI) was administered, and saliva samples were collected for melatonin analysis. The post-illumination pupil response (PIPR) to 1 s and 5 s long- and short-wavelength stimuli was measured. Pupil metrics included the 6 s and 30 s PIPR and early and late area under the curve.RESULTSSubjects spent 104.8 ± 46.6 min outdoors per day over the previous week. Morning melatonin concentration (6.9 ± 3.5 pg/ml) was significantly associated with time outdoors and objectively measured light exposure (P= .01 and .002, respectively). Pupil metrics were not significantly associated with light exposure or refractive error. PSQI scores indicated good sleep quality for emmetropes (score 4.2 ± 2.3) and poor sleep quality for myopes (5.6 ± 2.2,P= .04).CONCLUSIONSWe found that light exposure and time outdoors influenced morning melatonin concentration. No differences in melatonin or the ipRGC-driven pupil response were observed between refractive error groups, although myopes exhibited poor sleep quality compared to emmetropes. Findings suggest that a complex relationship between light exposure, ipRGCs, refractive error, and sleep exists.
Probabilistic Matching of Deidentified Data From a Trauma Registry and a Traumatic Brain Injury Model System Center
Authors: Kumar Raj G. , Wang Zhensheng , Kesinger Matthew R. , Newman Mark , Huynh Toan T. , Niemeier Janet P. , Sperry Jason L. , Wagner Amy K. 
Published: March 2018

Abstract
In a previous study, individuals from a single Traumatic Brain Injury Model Systems and trauma center were matched using a novel probabilistic matching algorithm. The Traumatic Brain Injury Model Systems is a multicenter prospective cohort study containing more than 14,000 participants with traumatic brain injury, following them from inpatient rehabilitation to the community over the remainder of their lifetime. The National Trauma Databank is the largest aggregation of trauma data in the United States, including more than 6 million records. Linking these two databases offers a broad range of opportunities to explore research questions not otherwise possible. Our objective was to refine and validate the previous protocol at another independent center. An algorithm generation and validation data set were created, and potential matches were blocked by age, sex, and year of injury; total probabilistic weight was calculated based on of 12 common data fields. Validity metrics were calculated using a minimum probabilistic weight of 3. The positive predictive value was 98.2% and 97.4% and sensitivity was 74.1% and 76.3%, in the algorithm generation and validation set, respectively. These metrics were similar to the previous study. Future work will apply the refined probabilistic matching algorithm to the Traumatic Brain Injury Model Systems and the National Trauma Databank to generate a merged data set for clinical traumatic brain injury research use.
A New Comorbidity in Female Patients With Ankylosing Spondylitis
Authors: Çağlayan Mehmet , Oktayoğlu Pelin , Ağaçayak Elif , Dagli Abdullah Zübeyir , Okçu Mehmet , Nas Kemal 
Published: March 2018

AimThe aim of this study was to investigate whether increased intra-abdominal pressure caused by pelvic inflammation and frequent use of the Valsalva maneuver increases the incidence of pelvic organ prolapse (POP) among female patients with ankylosing spondylitis (AS).MethodsThirty-nine patients diagnosed as having AS through the use of the modified New York criteria, 47 patients with chronic low-back pain (CLBP), and 38 healthy controls (HCs) were included in this study. All the patients and the HCs underwent thorough physical and gynecological examinations. Pelvic organ prolapse was graded blindly by a gynecologist. Presence or absence of cystocele (CS), rectocele (RC), and uterine prolapse (UP) was noted.ResultsThe incidences of CS, RC, and UD were significantly higher among the AS patients compared with the HCs (p= 0.001, 0.026, and 0002, respectively). The incidences of CS (p= 0.042) and UD (p= 0.017) were significantly higher among the AS patients compared with the CLBP patients.ConclusionsThe incidence of POP is higher among patients with AS compared with normal population. These patients should be questioned about the symptoms of POP and recommended, if necessary, regular gynecological examinations, as well as specific exercises including those targeting AS.
Evaluation of Learned Helplessness, Perceived Self-efficacy, and Functional Capacity in Patients With Fibromyalgia and Rheumatoid Arthritis
Authors: Moyano Sebastián , Scolnik Marina , Vergara Facundo , García María Victoria , Sabelli Mirtha Rosa , Rosa Javier Eduardo , Catoggio Luis José , Soriano Enrique Roberto 
Published: March 2018

Objectives
The aims of this study were to compare learned helplessness (LH) and perceived self-efficacy (SE) in patients with fibromyalgia (FM) and rheumatoid arthritis (RA) and to assess their correlation with functional disability, level of perceived pain, and fatigue.

Methods
This multicenter, cross-sectional study included consecutive patients (aged ≥18 years) with RA, according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria, and FM, according to 2010 American College of Rheumatology criteria. Learned helplessness was measured by the Rheumatology Attitude Index, Spanish version; SE with the Arthritis Self-efficacy Scale, Spanish version; functional capacity with the Health Assessment Questionnaire (HAQ), Argentine version; depression with Center for Epidemiological Studies–Depression Scale 7-item version and perceived pain and fatigue by the visual analog scale. Disease activity was measured by the Clinical Disease Activity Index (CDAI) and disease impact with the Fibromyalgia Impact Questionnaire (FIQ).

Results
A total of 215 patients, 100 with FM and 115 with RA, were included. Mean age was 59 (SD, 14) years and 58 (SD, 13) years for FM and RA, patients respectively. Whereas LH and depression were significantly higher, SE was significantly lower in FM patients. We found a positive correlation between LH and HAQ, pain, depression, fatigue, FIQ, and CDAI in FM and RA patients. We observed a negative correlation between SE and HAQ, pain, depression, fatigue, FIQ (FM), and CDAI (RA) in both groups.

Conclusions
Both LH and SE correlate significantly with functional capacity, perceived pain, disease activity, and disease impact in RA and FM patients. Learned helplessness was higher in patients with active disease or high disease impact, as opposed to those in remission or with low disease impact, and the reverse was true for SE. Patients with FM had significantly more LH, pain, fatigue, and depression and less SE compared with those with RA.
Resolution of Diplopia in Late Repair of Enophthalmos Following Facial Trauma
Authors: Liu Edward H. , Najarali Zainab , Farrokhyar Forough , Banfield Laura , McRae Mark 
Published: March 2018

Abstract
Posttraumatic enophthalmos due to isolated or complex orbital fractures can contribute to diplopia. Current evidence recommends early repair. However, little is known about the outcome of enophthalmos correction when repair occurs beyond 30 days after trauma. In this systematic review, the authors aim to evaluate the current evidence on functional outcomes after delayed repair of posttraumatic enophthalmos.
Two independent assessors undertook a systematic review of the literature using multiple databases. The authors’ inclusion criteria identified studies involving patients at least 14 years of age who had surgical correction of persistent enophthalmos 30 days after initial trauma. Each eligible paper was included after critical appraisal using validated guidelines. Data on preoperative and postoperative enophthalmos and diplopia in each study was extracted. The pattern of fracture was also noted.
The authors’ search for the medical databases yielded 1053 articles, of which 6 eligible papers were included. Meta-analysis was performed. In patients with complex injuries involving orbital and mid-facial fractures, diplopia resolution was calculated to be 53%, and enophthalmos was corrected in 83% of the patients. In patients with isolated orbital fractures, 53% had resolution of their diplopia, and enophthalmos was corrected in 88% of the patients.
Enophthalmos can be corrected to within 2 mm of the contralateral eye in both the isolated and complex orbital fractures in patients who present 30 days or greater after injury. Based on the studies reviewed, there is less predictability in diplopia resolution.
Lacrimal Apparatus Procurement in Face Transplantation
Authors: Hasan Asif , Maciver Colin , Toure Gaoussou , Meningaud Jean-Paul 
Published: March 2018

Abstract
The aesthetic outcome of a well-planned and executed vascularized composite tissue face allotransplant is unquestionable; however, complete functional restoration is necessary. The authors studied the possibility of restoring tear duct function in face transplant recipients. They also examined the technical specifics and feasibility of incorporating a lacrimal drainage apparatus into facial allografting. The authors performed a standardized face vascularized composite allograft on 4 hemi-faces (2 fresh cadavers). On one side of the face, a soft tissue myocutaneous alloflap was raised. They attempted to incorporate the nasolacrimal apparatus into the allograft to develop and describe an efficient harvest method. On the contralateral side, an osteocutaneous alloflap was raised with the midface and mandible. The authors describe 2 techniques to incorporate the lacrimal drainage system. The authors retrieved the graft in a consistent and replicable fashion within conventional alloflap retrieval times. The authors successfully incorporated the entire nasolacrimal drainage system into the conventional soft tissue-only myocutaneous alloflap by transforming it into a modified mini-osteomyocutaneous alloflap. They demonstrated that the contralateral conventional bi-maxillary osteocutaneous alloflap procedure, as an alternative comparative technique, provided another means to restore lacrimal drainage. In conclusion, surgically harvesting the nasolacrimal apparatus is technically feasible in vascularized composite tissue allotransplantation. Before translating this to a clinical setting, further dissections are necessary to explore the technical specifics of how to insert the harvested nasolacrimal apparatus into the recipient to restore a conduit for tear drainage. This study is the first step towards a fully functioning lacrimal drainage system in face transplant recipients.
Surgical Management of Mandibular Angle Fractures
Authors: An Wei , Ainiwaer Aisaiti , Wusiman Patiguli , Ali Gulibusitan , Moming Adili 
Published: March 2018

Purpose:The study proposed to determine the superiority between different fixation methods in the mandibular angle fractures (MAFs) and to evaluate best option for surgeon and patient.Methods:A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. The quality of studies was assessed, and the odds risk (OR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. Subgroup analyses by different fracture regions and different miniplate sizes were performed. Publication bias was measured by a funnel plot.Results:Twenty-one articles were enrolled in this review: 8 randomized controlled trials , 2 controlled clinical trials, and 11 retrospective studies. There were significant advantages for 3-dimensional (3D) miniplate (OR = 0.48,P = 0.003, 95% CI, 0.35–0.67) and 1 miniplate (OR 0.38, 95% CI 0.25–0.58,P < 0.00001). The cumulative OR for locking miniplate was 0.45, showing that the utilizing of locking mini-plate in management of MAFs decreases postoperative complications risk by 55% over the use of nonlocking mini-plate.Conclusions:The results of this review indicated that the use of 3D miniplate, locking plate, and 1 plate were more advanced to 2 miniplates technique in low incidence of postoperative complications in the treatment of MAFs.
A Novel Implementation of Magnetic Levitation to Quantify Leukocyte Size, Morphology, and Magnetic Properties to Identify Patients With Sepsis
Authors: Andersen Mikkel S. , Lu Shulin , Lopez Gregory J. , Lassen Annmarie T. , Shapiro Nathan I. , Ghiran Ionita C. 
Published: March 2018

ABSTRACTBackground:We have developed a novel, easily implementable methodology using magnetic levitation to quantify circulating leukocyte size, morphology, and magnetic properties, which may help in rapid, bedside screening for sepsis.Objective:Our objectives were to describe our methodological approach to leukocyte assessment, and to perform a pilot investigation to test the ability of magnetic levitation to identify and quantify changes in leukocyte size, shape, density, and/or paramagnetic properties in healthy controls and septic patients.Methods:This prospective, observational cohort study was performed in a 56,000/y visit emergency department (ED) and affiliated outpatient phlebotomy laboratory. Inclusion criteria were admittance to the hospital with suspected or confirmed infection for the septic group, and we enrolled the controls from ED/outpatient patients without infection or acute illness. The bench-top experiments were performed using magnetic levitation to visualize the leukocytes. We primary sought to compare septic patients with noninfected controls and secondary to assess the association with sepsis severity. Our covariates were area, length, width, roundness, and standard deviation (SD) of levitation height. We used unpairedttest and area under the curve (AUC) for the assessment of accuracy in distinguishing between septic and control patients.Results:We enrolled 39 noninfected controls and 22 septic patients. Our analyses of septic patients compared with controls showed: mean cell area in pixels (px) 562 ± 111 vs. 410 ± 45,P < 0.0001, AUC = 0.89 (0.80–0.98); length (px), 29 ± 2.5 vs. 25 ± 1.9,P < 0.0001, AUC = 0.90 (0.83–0.98); and width (px), 27 ± 2.4 vs. 23 ± 1.5,P < 0.0001, AUC = 0.92 (0.84–0.99). Cell roundness: 2.1 ± 1.0 vs. 2.2 ± 1.2,P = 0.8, AUC = 0.51. SD of the levitation height (px) was 72 ± 25 vs. 47 ± 16,P < 0.001, AUC = 0.80 (0.67–0.93).Conclusions:Septic patients had circulating leukocytes with especially increased size parameters, which distinguished sepsis from noninfected patients with promising high accuracy. This portal-device compatible technology shows promise as a potential bedside diagnostic.
Identifying Barriers to Preemptive Kidney Transplantation in a Living Donor Transplant Cohort
Authors: Helmick Ryan A. , Jay Colleen L. , Price Brittany A. , Dean Patrick G. , Stegall Mark D. 
Published: March 2018

Background
Despite substantial evidence demonstrating clear benefit, rates of preemptive kidney transplantation (PreKTx) remain low in the United States. Our goal was to identify barriers to PreKTx.

Methods
Using a telephone-administered questionnaire including questions about barriers, timing of referral, timing of education, we retrospectively studied first living donor kidney transplant recipients (2006-2010) at Mayo Clinic, Rochester, MN. Of 235 patients, 145 (62%) responded to the questionnaire (74 PreKTx and 71 non-PreKTx). We compared categorical data with Fisher exact test and median times with Wilcoxon rank sum test.

Results
Polycystic kidney disease (PCKD), longer median time between diagnosis and transplant, and time between education about transplant and transplant correlated with PreKTx (P < 0.01). The presence of at least 1 patient-identified barrier (lack of referral, financial barriers, medical barriers, no identified living donor and donor evaluation delays) was associated with non-PreKTx (0.034) though no single barrier predominated. Age, education level, insurance status and source of referral (primary care, nephrology, and nonphysician referral) were not associated with the rate of PreKTx. Univariate logistic regression identified white race, PCKD, and increased time from diagnosis as factors favoring PreKTx; PCKD and increased time remained significant factors after multivariate analysis.

Conclusions
Even among a patient population that is primarily white, educated, and has a spouse or first-degree relative donor, PreKTx rates remain concerningly low. Increased time between diagnosis or education and transplant are predictors of PreKTx. Greater emphasis on transplant education earlier in the stages of chronic kidney disease and community outreach from transplant centers may help to increase the rate of PreKTx.
Baseline Amnestic Severity Predicts Progression From Amnestic Mild Cognitive Impairment to Alzheimer Disease Dementia at 3 Years
Authors: Bradfield Nicholas I. , Ellis Kathryn A. , Savage Greg , Maruff Paul , Burnham Samantha , Darby David , Lautenschlager Nicola T. , Martins Ralph N. , Masters Colin L. , Rainey-Smith Stephanie R. , Robertson Joanne , Rowe Christopher , Woodward Michael , Ames David 
Published: March 2018

Background:
Given the long preclinical disease course of Alzheimer disease (AD) pathology, novel treatments may be more efficacious if administered before the emergence of dementia. Thus, accurate prediction of who will develop AD dementia is of key importance in selecting individuals for trials of treatment and may become crucial for future selection of patients for therapy.

Methods:
As part of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing, 901 individuals who did not have dementia were recruited. We assigned individuals according to Petersen criteria and Winblad criteria for Mild Cognitive Impairment (MCI) at baseline. We then stratified individuals with amnestic MCI into 2 groups according to the severity of their memory impairment on baseline neuropsychological assessment. Incident diagnosis of AD dementia was established by consensus of an expert panel at 36 months.

Results:
At 36 months, 725 (80.5%) participants were followed up, 54 (7.4%) of whom developed AD dementia. Subjects with amnestic MCI according to Petersen criteria were more likely to develop AD dementia [positive predictive value; PPV, 24.1%; 95% confidence interval (CI), 18.4-30.6] than healthy controls (PPV, 1.0%; 95% CI, 0.3-2.3). Winblad criteria were also effective, with multiple domain amnestic MCI being most accurate at predicting AD dementia (PPV, 47.3%; 95% CI, 33.7-61.2). Finally, more severe amnestic impairment below the median was useful for predicting the development of AD dementia in single domain amnestic MCI (PPV, 28.1%; 95% CI, 17.0-41.5) and in multiple domain amnestic MCI (PPV, 65.7%; 95% CI, 47.8-80.9).

Conclusions:
Memory impairment per se, impairment in multiple cognitive domains and severity of memory impairment were all associated with greater risk of developing AD dementia in this sample. Characterizing the severity of memory impairment may provide prognostic stratification within Petersen or Winblad taxonomies of amnestic MCI.
Nuisance Effects and the Limitations of Nuisance Regression in Dynamic Functional Connectivity fMRI
Authors: Nalci Alican , Rao Bhaskar D. , Liu Thomas T. 
Published: March 2018

AbstractIn resting-state fMRI, dynamic functional connectivity (DFC) measures are used to characterize temporal changes in the brain’s intrinsic functional connectivity. A widely used approach for DFC estimation is the computation of the sliding window correlation between blood oxygenation level dependent (BOLD) signals from different brain regions. Although the source of temporal fluctuations in DFC estimates remains largely unknown, there is growing evidence that they may reflect dynamic shifts between functional brain networks. At the same time, recent findings suggest that DFC estimates might be prone to the influence of nuisance factors such as the physiological modulation of the BOLD signal. Therefore, nuisance regression is used in many DFC studies to regress out the effects of nuisance terms prior to the computation of DFC estimates. In this work we examined the relationship between DFC estimates and nuisance factors. We found that DFC estimates were significantly correlated with temporal fluctuations in the magnitude (norm) of various nuisance regressors, with significant correlations observed in the majority (76%) of the cases examined. Significant correlations between the DFC estimates and nuisance regressor norms were found even when the underlying correlations between the nuisance and fMRI time courses were relatively small. We then show that nuisance regression does not eliminate the relationship between DFC estimates and nuisance norms, with significant correlations observed in the majority (71%) of the cases examined after nuisance regression. We present theoretical bounds on the difference between DFC estimates obtained before and after nuisance regression and relate these bounds to limitations in the efficacy of nuisance regression with regards to DFC estimates.