bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regenerating a monoblock to obturate root canalsvia a mineralising strategy
Authors: Zhang Le , Li Quan-Li , Cao Ying , Wang Yun 
Published: August 2018

AbstractTo develop a novel strategy for sealing and obturating dental root canals by tooth-like tissue regeneration, premolars with mature root apices were freshly collected, and root canals were prepared by following the clinical protocols in vitro. The teeth were immersed in supersaturated calcium and phosphate solution containing gallic acid and fluoride. At certain intervals, the dental roots were taken out, and their mineral precipitates were characterised by scanning electron microscopy, energy-dispersive spectroscopy mapping, X-ray diffraction and transmission electron microscopy. The cytocompatibility of the mineralizing products were evaluated with rabbit bone-marrow-derived mesenchymal stem cells in vitro. Results showed that the precipitates were mainly composed of fluoridated hydroxyapatite with ahexagonal prism morphology. Fluoridated hydroxyapatite initially nucleated and grew from the root canal dentine surface to the root canal centre. The fluoridated hydroxyapatite precipitate and root canal dentine intergraded together such that the interface became hardly distinguishable. The fluoridated hydroxyapatite precipitate grew into and obturated the dentinal tubules. In the root canal, the regenerated fluoridated hydroxyapatite densely packed and bundled together with a c-axis extension. After 7 days of mineralisation, the root canal was completely obturated, and the apical foramen was sealed. The mineralizing products had good biocompatibility with the cells, and the cells grew well on the mineralized surface. Biomimetic mineralisation strategy provides a novel means to regenerate tooth-like tissue to seal the root canal system permanently other than by passive synthetic material filling.
Incidence and Radiological Predictors of Concomitant Meniscal and Cruciate Ligament Injuries in Operative Tibial Plateau Fractures: A Prospective Diagnostic Study
Authors: Chang Hengrui , Zheng Zhanle , Shao Decheng , Yu Yiyang , Hou Zhiyong , Zhang Yingze 
Published: August 2018

AbstractThe aim of this prospective study was to determine the incidence of meniscal and cruciate ligament injuries in operative tibial plateau fractures detected using knee arthroscopy, and to identify the radiological predictors observed on CT images. From January 2016 to February 2017, a total of 102 closed tibial plateau fractures were enrolled in this prospective protocol. Each patient underwent arthroscopic examination following the tibial plateau internal fixation. Univariate analysis and multivariable logistic regression were used to assess the association between imaging parameters and soft-tissue injuries. The menisci were traumatically injured in 52.9% of subjects (54 of 102) and the cruciate ligaments injured in 22.5% (23 of 102). Significantly higher injury rates for bucket-handle meniscal tears were observed in Schatzker type VI fractures (P = 0.04). Greater risk of lateral meniscus injury was observed in patients with >6.3 mm of lateral joint depression. Greater risk of ACL injury when the volumetric lateral joint depression was ≤209.5 mm2 and/or with >5.7 mm lateral joint widening. Associated meniscal and ligament injuries were commonly seen among operative tibial plateau fractures. Preoperative CT measurements might help predict a higher risk of meniscus and ACL injury, providing guidance to the surgeon to look for and to be prepared to treat such injuries.
A Multicentric Brazilian Investigative Study of Copy Number Variations in Patients with Congenital Anomalies and Intellectual Disability
Authors: Ceroni J. R. M. , Dutra R. L. , Honjo R. S. , Llerena J. C. , Acosta A. X. , Medeiros P. F. V. , Galera M. F. , Zanardo É. A. , Piazzon F. B. , Dias A. T. , Novo-Filho G. M. , Montenegro M. M. , Madia F. A. R. , Bertola D. R. , de Melo J. B. , Kulikowski L. D. , Kim C. A. 
Published: August 2018

AbstractGenomic imbalances are the most common cause of congenital anomalies (CA) and intellectual disability (ID). The aims of this study were to identify copy number variations (CNVs) in 416 patients with CA and ID from 5 different genetics centers within 4 different states by using the Multiplex Ligation-dependent Probe Amplification (MLPA) technique and to apply the chromosomal microarray (CMA) methodology in selected cases. The samples were analyzed by MLPA kits P064, P036, P070 and P250. Positive results were found in 97/416 (23.3%) patients. CMA was applied in 14 selected cases. In 6/14 (42.85%) patients, CMA detected other copy number variations not detected by the MLPA studies. Although CMA is indispensable for genotype refinement, the technique is still unfeasible in some countries as a routine analysis due to economic and technical limitations. In these cases, clinical evaluation followed by karyotyping and MLPA analysis is a helpful and affordable solution for diagnostic purposes.
Neuropathology of Early Sudden Infant Death Syndrome—Hypoplasia of the Pontine Kolliker-Fuse Nucleus: A Possible Marker of Unexpected Collapse during Skin-to-Skin Care
Authors: Lavezzi Anna , Ferrero Stefano , Paradiso Beatrice , Chamitava Liliya , Piscioli Francesco , Pusiol Teresa 
Published: August 2018

Objective To find a possible pathogenetic mechanism of the early sudden infant death occurring in newborns during the skin-to-skin care (SSC), through the examination of neuronal centers regulating the vital activities.
Study Design This is an in-depth examination of the brain stem in 22 healthy term newborns, suddenly died in the first hour of life without the identification of a cause at autopsy (early sudden infant death syndrome [eSIDS]), 12 of them concomitantly with SSC, and 10 with age-matched controls died of known pathology.
Results Developmental alterations of neuronal structures of the brain stem were highlighted in 19 of the 22 eSIDS, but not in control. The hypoplasia of the pontine Kölliker-Fuse nucleus (KFN), an important respiratory center, was diagnosed at the histological examination, validated by morphometric quantifications, in 11 of the 12 eSIDS while they were placed on the mother's chest and in 2 of the 10 SSC unrelated neonatal deaths.
Conclusion The delayed development of the KFN could represent a specific finding of eSIDS occurring during SSC. Therefore, it is necessary to point out that the SSC represents a further risk factor that must be added to others already known for sudden infant death syndrome. Then this practice needs appropriate monitoring strategies of the infant's conditions.
Testosterone Administration Alters Hepatic Blood Flow Across Age: Systematic Review of Animal Experimental Studies
Authors: Nucci Ricardo , Tanasov Valéria , Krause Neto Walter , de Souza Romeu , Gama Eliane 
Published: August 2018

AbstractTestosterone levels decline gradually with advancing age. At this point, testosterone administration as a therapy has been largely used to improve different outcomes. However, testosterone induces dose-dependent negative effects on the structure and function of the liver across age. Therefore, the present study aimed to carry out a systematic review of the effects of testosterone administration on the hepatic structure of adult and aged animals. We have searched the PubMed, Google Scholar, Science Direct, Scielo and Lilacs databases for animal experimental studies on the effects of testosterone administration on the hepatic structure across age. After applying the inclusion and exclusion criteria, we included two articles in a systematic review and meta-analysis (regarding adult/aged rats). We have shown through a systematic review with meta-analysis that testosterone may cause chronic hepatic congestion. However, the present review had a small number of studies, which was considered a limitation. At this point, we encourage the development of more studies to elucidate the cellular and molecular mechanisms involved in hepatic injuries, as well as the hepatic metabolism of exogenous testosterone across age.
Differential and interacting effects of age and sleep restriction on daytime sleepiness and vigilance in adolescence: a longitudinal study
Authors: Campbell Ian G , Van Dongen Hans P A , Gainer Marcus , Karmouta Emmad , Feinberg Irwin 
Published: August 2018

AbstractStudy ObjectivesThere is contradictory evidence on whether sleep need decreases across adolescence. We investigated this question longitudinally with a dose-response design to test the effects of varied sleep durations on daytime sleepiness and on vigilance and to test whether these relations change with age across early and mid-adolescence.MethodsData from 76 participants who completed at least 2 years of the 3-year study are included in this report. Annually, participants ranging in age from 9.8 to 16.2 years completed three different time in bed (TIB) schedules each consisting of four consecutive nights of 7, 8.5, or 10 hours. Daytime sleepiness (multiple sleep latency test [MSLT]) and vigilance (psychomotor vigilance test [PVT]) were measured on the day following the fourth night of each TIB schedule.ResultsElectroencephalogram (EEG)-measured sleep durations changed linearly with TIB. MSLT-measured daytime sleepiness decreased with longer TIB and increased with age. The TIB and age effects interacted such that the TIB effect decreased with age. PVT performance improved with longer TIB and improved with age, but the benefit that increased TIB conferred on PVT performance did not change with age.ConclusionsThese results seem paradoxical because daytime sleepiness increased but vigilance improved with age. The significant age effect on the relation between TIB and sleepiness compared to the lack of an age effect on the relation between TIB and vigilance performance suggests different rates of maturation in underlying brain systems. We interpret these findings in relation to our model of adolescent brain development driven by synaptic elimination.
Cecal perforation
Authors: Czajka Gregory , Kreminski Halley 
Published: August 2018

ABSTRACT
Hydrocephalus can be the result of an infection, obstruction, impaired reabsorption of cerebrospinal fluid (CSF), or an abnormal increase in CSF. Ventriculoperitoneal (VP) shunting is the gold standard treatment for hydrocephalus despite its high rate of complications, including catheter obstruction and infection. Spontaneous cecal perforation by a VP shunt is extremely rare. Headache or subtle change in personality may indicate a VP shunt infection. Early recognition of the infection is critical for optimal patient outcomes.
Influence of Postoperative Intraocular Pressure on Graft Detachment After Descemet Membrane Endothelial Keratoplasty
Authors: Heinzelmann Sonja , Böhringer Daniel , Haverkamp Christian , Lapp Thabo , Eberwein Philipp , Reinhard Thomas , Maier Philip 
Published: August 2018

Purpose:
Descemet membrane endothelial keratoplasty (DMEK) seems to be the most promising technique for treating endothelium-related disorders of the cornea. However, graft detachment is a frequent complication. It often can be treated by rebubbling procedures. Unfortunately, this increases the risk of subsequent graft failure. It is therefore essential to define risk factors for graft detachment in DMEK. In this study, postoperative intraocular pressure (IOP) is investigated in this regard.

Methods:
In total, 1047 DMEK procedures in patients with Fuchs endothelial dystrophy or bullous keratopathy were reviewed. All rebubbling procedures were recorded as well as postoperative IOP values (first measure 2 hours postoperatively and highest and lowest value within 3 days after surgery), donor factors (donor age, organ culture time, and endothelial cell count), and whether DMEK surgery had been combined with cataract surgery (triple-DMEK). Incidence rates were estimated with the Kaplan–Meier method. Cox regression was used to assess statistical significance.

Results:
The overall rebubbling rate was 24% after 8 weeks. Relative dips in IOP may be associated with a higher risk for graft detachment (hazards ratio = 0.41; P < 0.001). Graft detachment was neither significantly influenced by donor factors, first or maximum IOP, nor by simultaneous cataract surgery (triple-DMEK).

Conclusions:
Avoiding dips in IOP may reduce the risk for graft detachment after DMEK. To prevent lowering of IOP values in the early postsurgical period, it may be advisable to achieve tight surgical wounds at the end of DMEK surgery and optimal filling of the anterior chamber with air and optionally with gas.
Bubble-free Gonioscopy
Authors: Kapetansky Frederick M. , Dusseau Nathaniel B. 
Published: August 2018

Purpose:
Accurate gonioscopy is necessary for the diagnosis and the treatment of glaucoma. The “gold standard” for indirect gonioscopy has been the Goldmann 3-mirror lens, requires an optical coupling agent (methylcellulose) between the cornea and under the surface of the goniolens. The design of an ideal lens would not only eliminate the need for gel, but could at the same time solve the problems associated with the trapping of an air bubble under the lens.

Materials and Methods:
This investigation involved a prototype 2-mirror goniolens with a radius of curvature of 8.4 mm and a 16 mm diameter area of corneal contact. A total of, 69 consecutive patients had bilateral keratometer measurements made. The prototype 2-mirror lens was applied to the anesthetized eye. The results of this examination were tabulated by one of the authors (F.M.K.); A=good fit without trapping of air, B=good fit but trapped bubble of air which could be expelled by the patient turning their eye towards the bubble, and C=total failure to expel the trapped bubble of air. Finally, if there were wrinkles in Descemet’s membrane, this was recorded.

Results:
A total of 64 patients were evaluated with a prototype 2-mirror lens. In total, 54/64 (84.38%) of eyes were successfully evaluated without trapping of an air bubble.

Conclusion:
Our stated goal of eliminating the need for gel as a coupling agent without trapping of an air bubble was successful in 54/64 eyes (84.38%). Our findings could spur development of newer bubble-free goniolenses for procedures such as laser trabeculoplasty.
Measuring Disability in Glaucoma
Authors: Sotimehin Ayodeji E. , Ramulu Pradeep Y. 
Published: August 2018

Background:
Glaucomatous visual field loss can have far-reaching and debilitating consequences on an individual, affecting one’s ability to perform many important tasks. Although assessment of glaucoma-related disability constitutes an important part of clinical care, there remains a lack of organized, detailed information on the most suitable methods to capture disability in glaucoma.

Purpose:
This review details the available methods to measure glaucoma-related disability and highlights important findings from studies utilizing these various methods.

Methods:
The literature was reviewed to identify papers evaluating disability in glaucoma and findings were summarized by research methodology used and area of impairment.

Results:
Identified methods for capturing glaucoma-related disability included qualitative descriptions, glaucoma-specific quality of life questionnaires, vision-specific questionnaires, general health questionnaires, functional domain-specific questionnaires, evaluation of task performance, event assessment (ie, falls and motor vehicle accidents), and real-world behavior (ie, daily physical activity). Findings using these methods show a strong relationship between glaucoma and/or glaucoma severity and difficulties with reading, driving, mobility, and other tasks such as prehension and facial recognition. In addition, glaucoma has financial and psychological implications on the patient, and can affect caregivers in some cases as well.

Conclusions:
A wide variety of research tools have been used to characterize the disability resulting from glaucoma. Together, these tools show that glaucoma affects many abilities which are important for independent living. Strengths and limitations of the various research techniques are discussed so that future studies may use the method(s) most suitable for answering the research question posed.
Residuum Muscle Activation During Gait in Individuals with Traditional and Osteomyoplastic Amputation
Authors: Kotamraju Bhanu Prasad , Commuri Sesh , Mai A. , Dionne Carol P. , Day Jonathan , Ertl William J.J. 
Published: August 2018

ABSTRACT

Introduction
In this case series, distal residuum muscle activation during self-paced, fast-paced, and load-carrying walking gaits was compared by traditional transtibial amputation (TTA) or transtibial osteomyoplastic amputation (TOA) approach.

Method
The activities of the residual muscles (tibialis anterior [TA] and gastrocnemius [GA]) were recorded during the three types of gait that are typically encountered during work-related activities.

Results
The study shows that there was substantial muscle activity in both the TA and the GA muscles of a TOA subject. On the other hand, the TA in TTA subjects did not show any appreciable activity during any of the gaits. Although the GA muscle in the intact lower limb was active in the late stance phase in both TOA and TTA subjects, this muscle was also active in the loading phase and in the early swing phase in both the groups. This GA activation occurs consistently with supporting the body weight during early stance and preparing the limb for the swing phase during the gait cycle.

Conclusions
The results of this study lay the foundation for future studies that investigate the effect of muscle activity on the health of the residual transtibial limb.
Serum Marker Score Based on Prognostic Nutrition Index, Carcinoembryonic Antigen, and Carbohydrate Antigen 19-9 Is Associated With Recurrence for Patients Undergoing Surgery for Pancreatic Ductal Adenocarcinoma
Authors: Nakagawa Shigeki , Yamashita Yo-ichi , Umezaki Naoki , Yamao Takanobu , Okabe Hirohisa , Imai Katsunori , Nitta Hidetoshi , Hashimoto Daisuke , Chikamoto Akira , Baba Hideo 
Published: August 2018

Objectives
The prognostic value of the prognostic nutrition index (PNI) in pancreatic ductal adenocarcinoma (PDAC) is still controversial. This study aimed to assess the correlation between PNI and the outcome for PDAC patients and to generate a new score from PNI and serum markers.

Methods
This study investigated 151 patients who underwent pancreatic resection for PDAC between April 2002 and June 2012. Disease-free survival (DFS), overall survival, and clinicopathological parameters were analyzed according to the PNI value.

Results
The low PNI patients had poorer 5-year DFS rate than high-PNI patients (10.7% and 34.8%, respectively). Multivariate analyses revealed that independent risk factors for poor DFS were high carcinoembryonic antigen (hazard ratio [HR], 1.53; P = 0.038), high carbohydrate antigen 19-9 (HR, 1.67; P = 0.017), positive lymph node metastasis (HR, 1.98; P = 0.017), R1 or 2 resection (HR, 3.50; P < 0.001), and low PNI (HR, 0.37 [high/low]; P = 0.029]. Scoring based on the formula −0.49 × (PNI) + 0.41 × (carcinoembryonic antigen) + 0.67 × (carbohydrate antigen 19-9) was significantly associated with poor DFS (P < 0.001) and overall survival (P = 0.0019).

Conclusions
Low PNI and serum marker score are significantly associated with poor DFS.
Bilateral Hypoglossal Nerve Palsy in an Adult Patient With Repaired Tetralogy of Fallot
Authors: Famoso Giorgia , Padroni Marina , Azzini Cristiano , De Vito Alessandro , Saletti Andrea , Casetta Ilaria 
Published: August 2018

Introduction:
Spontaneous cervical artery dissection (sCAD) is a major cause of ischemic stroke in young and middle-aged adults, but the occurrence of multiple sCADs could suggest the presence of an underlying arteriopathy. Bilateral hypoglossal nerve palsy caused by extracranial internal carotid artery dissections have been rarely described. We present the case of a 3-vessel sCAD in a patient with repaired tetralogy of Fallot (ToF).

Case Report:
A 50-year-old man was admitted to our stroke unit for a sudden onset of left cervical pain, mild left ptosis, dysarthria, and dysphagia. His medical history was remarkable for surgically repaired ToF. Neurological examination showed left Claude-Bernard-Horner syndrome and bilateral hypoglossal palsy. Diffusion-weighted magnetic resonance imaging excluded parenchymal lesions while magnetic resonance angiography showed a pattern of bilateral extracranial internal carotid and right vertebral dissection.

Conclusions:
This is the first case of multiple-vessel sCAD, and more associated with an unusual clinical presentation, in a patient with surgically repaired ToF, supporting the hypothesis that defective large artery elastogenesis plays a role in this congenital disorder, and suggesting the importance of continuous long-term vascular follow-up.
Investigation of the Video-EEG Findings and Clinical Data in Patients Diagnosed With Epilepsy and Psychosis
Authors: Mehdikhanova Lala , Vanli Yavuz Ebru N. , Çikrikçili Uğur , Baral Kulaksizoğlu Işin , Bebek Nerses , Gürses Candan , Gökyiğit Ayşen , Baykan Betül 
Published: August 2018

Background:
Studies on electrophysiological characteristics of patients with epilepsy and concomitant psychosis are limited. We aimed to investigate the clinical and video-electroencephalography (EEG) findings of patients with epilepsy-related psychosis (EP).

Materials and Methods:
Fifteen patients diagnosed with EP, assessed at the video-EEG monitoring unit and were under follow-up at both epilepsy and psychiatry clinics, were included. A total of 67 nonpsychotic epilepsy patients, investigated at the video-EEG monitoring unit were randomly selected as the control group and compared statistically with the EP group.

Results:
In medical history, patients with EP had experienced significantly higher level of status epilepticus (P=0.002) and perinatal cerebral injury (P=0.04), whereas drug-resistant epilepsy was detected at a lower level (P=0.015). With respect to seizure onset zone, the EP group had significantly more seizures of unknown foci, whereas the control group had mostly temporal lobe origin (P=0.0004). EEG findings showed that slow background activity was significantly common among patients with EP (P=0.009). Although only 5 of 15 patients with EP had been operated, 43 of 67 patients had undergone epilepsy surgery (P=0.04) in the control group. However, there was no significant difference between the 2 groups with respect to postoperative seizure control as per Engel classification.

Conclusions:
Although our sample size could be considered small, slowed EEG background activity, and the marked frequency of initial precipitant factors such as status epilepticus, perinatal cerebral injury, and detected neuronal autoantibodies suggested that EP is associated with more extensive involvement. EP is not a contraindication for epilepsy surgery, when appropriately investigated preoperatively.