bluuebunny/crossref_metadata_2025_split huggingface dataset:
RETRACTED: Can consumption of anthocyanin‐rich tomatoes reduce the risk of cardiovascular disease? (Experimental Biology 2014 Abstract Number 829.18)
Authors: Achterfeldt Sebastian , Martin Cathie , Kroon Paul 
Published: October 2018

The following abstract which was published originally in 2014 as part of the Experimental Biology 2014 meeting has been voluntarily retracted by the authors, except Sebastian Achterfeldt:THE FOLLOWING ABSTRACT HAS BEEN RETRACTEDAnthocyanins (ACN) are responsible for the red to dark purple colours in various fruits and vegetables. Epidemiological studies have shown an inverse relationship between consumption of ACN and risk of diseases, particularly cardiovascular diseases (CVD). Supplementation of animal diets with ACN‐rich foods and extracts has been shown to reduce atherosclerosis, improve vascular function and alter gene expression. However, although these studies have provided evidence that anthocyanin‐rich foods can protect against CVD, they do not prove that the anthocyanins are responsible. Therefore, we undertook a unique study using genetically modified anthocyanin‐rich purple tomatoes as the treatment and anthocyanin‐free red tomatoes as the control in a dietary intervention study.ApoE‐/‐ mice (n=20 per group) were fed different doses of purple tomatoes (0, 2.5, 5 or 10% w/w chow) with all groups receiving 10% total tomato. After 17 weeks of intervention, a number of markers of atherosclerosis, inflammation and gene expression were quantified. The data indicate that the anthocyanin‐supplemented diets caused significant reductions in the size of atherosclerotic lesions in the aortic arch, with reductions of up to approximately 40% compared to control for the group fed the highest dose of ACN‐rich tomatoes.These data show that consumption of anthocyanins within a complex plant food matrix causes reductions in the size of atherosclerotic plaques in a mouse model of human atherosclerosis. These findings support the notion that increasing anthocyanin consumption can reduce CVD risk.Grant Funding Source: Supported by EU FP7 (ATHENA‐245121) and BBSRC (UK).THE PRECEDING ABSTRACT HAS BEEN RETRACTEDThis was published in The FASEB Journal as an abstract only and there is no corresponding full article in the journal.
Art as Sanctuary: A Four-Year Mixed-Methods Evaluation of a Visual Art Course Addressing Uncertainty Through Reflection
Authors: Gowda Deepthiman , Dubroff Rachel , Willieme Anna , Swan-Sein Aubrie , Capello Carol 
Published: October 2018

Purpose
Engagement with visual art is a promising modality for addressing issues of uncertainty via reflective practice, one that is being increasingly used in health science education. An elective museum-based course for first-year medical students was created by two medical schools and led by an art educator experienced in medical education. The course, Observation and Uncertainty in Art and Medicine, sought to help students explore experiences of uncertainty and to develop reflective capacity through engagement with visual art.

Method
The course was run and evaluated from 2014 to 2017, with 47 students participating over the 4 years, with 12 students enrolled per year. Before and after the course, students were given the Groningen Reflection Ability Scale (GRAS) for reflective ability, the Tolerance for Ambiguity scale for ambiguity, and Best Intentions Questionnaire for personal bias awareness, and 35 students (74%) completed all of the scales. Focus group interviews and narrative postcourse evaluations were conducted, coded, and thematically analyzed.

Results
Statistically significant improvement was found in GRAS scores. Qualitative themes included student enhancement of observational skills, awareness of the subjectivity and uncertainty of perception, exploration of multiple points of view, and recognition of the course as a place for restoration and connection to classmates.

Conclusions
Incorporating visual art into medical education is an effective pedagogical method for addressing competencies central to training, including observation, reflection, and self-care.
Combining Scores Based on Compensatory and Noncompensatory Scoring Rules to Assess Resident Readiness for Unsupervised Practice: Implications From a National Primary Care Certification Examination in Japan
Authors: Onishi Hirotaka , Park Yoon Soo , Takayanagi Ryo , Fujinuma Yasuki 
Published: October 2018

Purpose
Competence decisions in health professions education require combining scores from multiple sources and identifying pass–fail decisions based on noncompensatory (required to pass all subcomponents) and compensatory scoring decisions. This study investigates consequences of combining scores, reliability, and implications for validity using a national examination with subcomponent assessments.

Method
National data were used from three years (2015, 2016, and 2017) of the Japan Primary Care Association Board Certification Examination, with four subcomponent assessments: Clinical Skills Assessment–Integrated Clinical Encounter (CSA-ICE), CSA–Communication and Interpersonal Skills (CSA-CIS), Multiple-Choice Questions (MCQ), and Portfolio. Generalizability theory was used to estimate variance components and reliability. Kane’s composite reliability and kappa decision consistency were used to examine the impact of using compensatory and noncompensatory scoring.

Results
Mean performance (n = 251) on the CSA-ICE, CSA-CIS, MCQ, and Portfolio subcomponent assessments were, respectively, 61% (SD = 11%), 67% (SD = 13%), 74% (SD = 8%), and 65% (SD = 9%); component-specific Φ-coefficient reliability ranged between, respectively, 0.57 and 0.67; 0.50 and 0.60; 0.65 and 0.76; and 0.87 and 0.89. Using a completely noncompensatory scoring approach on all four subcomponents, decision-consistency reliability was 0.33. Fully compensatory scoring yielded reliability of 0.86.

Conclusions
Assessing a range of abilities in making entrustment decisions requires considering the balance of assessment tools measuring distinct but related competencies. These results indicate that noncompensatory pass–fail decision making, which seems more congruent with competency-based education, may lead to much lower reliability than compensatory decision making when several assessment subcomponents are used.
Fatty Infiltration of Cervical Spine Extensor Musculature
Authors: Passias Peter G. , Segreto Frank A. , Bortz Cole A. , Horn Samantha R. , Frangella Nicholas J. , Diebo Bassel G. , Hockley Aaron , Wang Charles , Shepard Nicholas , Lafage Renaud , Lafage Virginie 
Published: October 2018

Study Design:
This is a retrospective review of a single surgeon cervical deformity (CD) database.

Objective:
Quantitatively describe the cervical extensor musculature in a CD population, and delineate associations between posterior musculature atrophy and progressive sagittal deformity.

Summary of Background Data:
While fatty infiltration (FI; ie, posterior musculature atrophy) of lumbar extensor musculature has been associated with pain and deformity, little is known of the relationship between FI, CD, cervical sagittal alignment, and functionality.

Methods:
CD patients [TS-CL>20 degrees, C2–C7 Cobb>10 degrees, CL>10 degrees, cervical sagittal vertical axis (cSVA)>4 cm, or chin-brow vertical angle>25 degrees] 18 years old and above, undergoing spinal fusion, with baseline T2-weighted magnetic resonance images were included. FI was assessed using dedicated imaging software at each intervertebral level from C2–C7. FI was gauged as a ratio of fat-free muscle cross-sectional area over total muscle cross-sectional area, with lower values indicating increasing FI. Influence of BL C2–C7 FI on patient-reported outcome measures (PROMs) and alignment was investigated. Multiple linear regression analysis (covariates: age, sex, body mass index, C2–C7 FI ratio) determined predictors of postoperative sagittal alignment and PROMs.

Results:
Thirty-eight patients were included (age: 56.6, sex: 73.7% female, body mass index: 30.1, Charlson Comorbidity Index 0.61). BL deformity presentation: TS–CL 27.4 degrees, CL 2.1 degrees, cSVA: 27.2 mm. Mean baseline C2–C7 FI ratio was 0.65±0.11. Worsening FI was associated with malaligned baseline cSVA (r
s=0.389, P=0.019), T1SS (r
s=0.340, P=0.062), and impaired gait (r
s=0.358, P=0.078). FI was not associated with BL PROMs (P>0.05). Following surgical intervention, regression models determined BL C2–C7 FI ratio as the strongest predictor of 1-year postoperative cSVA (β=−0.482, P=0.007, R
2=0.317). No associations between BL FI and postoperative PROMS or alignment parameters were observed (P>0.05).

Conclusions:
Patients with significant CD demonstrate alterations in the posterior extensor musculature of the cervical spine. Atrophic changes with FI of these muscle groups is associated with worsening CD and is an important predictor of postoperative sagittal alignment.

Level of Evidence:
Level III.
Treatment of Cervical Myelopathy
Authors: Gornet Matthew F. , McConnell Jeffrey R. , Riew K. Daniel , Lanman Todd H. , Burkus J. Kenneth , Hodges Scott D. , Dryer Randall F. , Copay Anne G. , Schranck Francine W. 
Published: October 2018

Study Design:
Analysis of 2- and 7-year outcomes from a clinical trial comparing 2-level cervical disk arthroplasty (CDA) to anterior cervical discectomy and fusion (ACDF) in 287 patients with radiculopathy alone, and 110 patients with myelopathy alone or myelopathy with radiculopathy.

Objective:
To compare the long-term safety and effectiveness of CDA for myelopathy versus radiculopathy.

Summary of Background Data:
CDA for myelopathy is safe and effective in short term.

Materials and Methods:
We analyzed Neck Disability Index (NDI), neck/arm pain, SF-36, neurological status, adverse events (AEs), and secondary surgeries at index and adjacent levels.

Results:
All groups improved significantly for NDI, neck/arm pain, and physical component summary (PCS) scores from preoperative to postoperative. CDA Myelopathy versus CDA Radiculopathy: 2- and 7-year improvements were not significantly different. The 7-year score improvements for CDA Myelopathy and CDA Radiculopathy were: NDI (37.8 vs. 35.8, P=0.352), neck pain (12.0 vs. 12.1, P=0.477), arm pain (11.6 vs. 9.6, P=0.480), and PCS (14.1 vs. 13.7, P=0.863). The 2 groups had similar proportions of patients who maintained or improved their neurological status (87.2% vs. 93.5%, P=0.218), similar rates of serious AEs (54.5% vs. 57.5%, P=0.291) and similar rates of secondary surgeries at index (3.7% vs. 4.4%, P=0.839) and adjacent levels (3.7% vs. 7.6%, P=0.367). CDA Myelopathy versus ACDF myelopathy: 2 and 7-year improvements were not significantly different. The 7-year CDA and ACDF score improvements were: NDI (37.8 vs. 31.1, P=0.147), neck pain (12.0 vs. 10.4, P=0.337), arm pain (11.6 vs. 11.4, P=0.791), and PCS (14.1 vs. 11.2, P=0.363). The 2 groups had statistically similar proportions who maintained or improved their neurological status (87.2% vs. 96.2%, P=0.409), statistically similar overall rates of secondary surgeries at the index levels (3.7% vs. 9.4%, P=0.374), and statistically similar rates of secondary surgeries at adjacent levels (3.7% vs. 15.4%, P=0.088). CDA group demonstrated lower rates of serious AEs than ACDF (54.5% vs. 65.9%, P=0.019).

Conclusions:
CDA for myelopathy is a safe and effective long-term treatment.
MicroRNA-18a Expression in Female Coronary Heart Disease and Regulatory Mechanism on Endothelial Cell by Targeting Estrogen Receptor
Authors: Yuan Liang , Tang Chunping , Li Dianfu , Yang Zhijian 
Published: October 2018

Abstract:
Coronary heart disease (CHD) is a kind of cardiovascular disease, which has been causing mortality around the world for decades. Because symptoms of CHD are different in female and male patients and these symptoms occur much later in female patients, CHD is very likely to be underdiagnosed in women. Thus, it is imperative to explore novel diagnostic method for CHD especially for women. Recently, microRNA-targeted therapy has attracted much attention as a novel therapeutic method. MicroRNAs have been proven as possible markers and targeted agents for diverse diseases. In this article, this study presented an overexpressed miR-18a signature in female CHD patients' peripheral blood. And a strong association of miR-18a with estrogen receptor (ER) expression level was observed. The effects of miR-18a on human umbilical vein endothelial cell proliferation and apoptosis were monitored. The modulatory ability and possible mechanism of miR-18a on ER expression and PI3K/Akt/mTOR pathway was explored by multiple methods. Our study suggested that miR-18a could regulate CHD development through targeting ER. This could provide important information for better understanding of CHD pathology and may offer a promising molecularly targeted method for CHD therapy.
QUANTITATIVE AND QUALITATIVE ANALYSIS OF THE THREE CAPILLARY PLEXUSES AND CHORIOCAPILLARIS IN PATIENTS WITH TYPE 1 AND TYPE 2 DIABETES MELLITUS WITHOUT CLINICAL SIGNS OF DIABETIC RETINOPATHY
Authors: Forte Raimondo , Haulani Hanan , Jürgens Ignasi 
Published: October 2018

Purpose:
To separately evaluate the three retinal capillary plexuses and the choriocapillaris in patients with diabetes mellitus (DM) Type 1 and Type 2, without clinical signs of diabetic retinopathy.

Methods:
The study was prospective and cross-sectional. Only patients with age ≤55 years were included. We used a swept-source optical coherence tomography angiography device (Triton; Topcon, Tokyo, Japan) to obtain both quantitative and qualitative analysis of the retinal capillary plexuses (superficial capillary plexus; middle capillary plexus; and deep capillary plexus) and the choriocapillaris.

Results:
We included 17 patients with DM Type 1 (age 34.52 ± 11.05 years, 29 eyes), 17 patients with DM Type 2 (age 48.76 ± 3.26 years, 32 eyes), and 23 healthy control subjects (age 41.82 ± 8.97 years, 43 eyes). When compared with controls, vessel density in the central 1 mm was reduced in both DM Type 1 and DM Type 2 groups in the superficial capillary plexus (P = 0.05 and P = 0.02, respectively), and in DM Type 2 in the deep capillary plexus (P = 0.03). Foveal avascular zone was increased in the middle capillary plexus and deep capillary plexus of DM Type 2 group compared with controls (P = 0.03 and P = 0.02, respectively). Choriocapillary voids were more frequent in DM Type 1 and DM Type 2 compared with controls (P = 0.003 and P < 0.001, respectively).

Conclusion:
Microvascular modifications are present in the three retinal capillary plexuses and the choriocapillaris in both DM Type 1 and DM Type 2 even in the absence of clinical signs of diabetic retinopathy.
PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH PHOSPHODIESTERASE-5 INHIBITOR THERAPY
Authors: Sebastiani Stefano , Pellegrini Marco , Giannaccare Giuseppe , Sarraf David 
Published: October 2018

Purpose:
To present an atypical case of paracentral acute middle maculopathy occurred upon awakening in the morning within hours after phosphodiesterase-5 (PDE-5) inhibitor consumption at bedtime.

Methods:
Multimodal retinal imaging findings, including fluorescein angiography, spectral domain optical coherence tomography, optical coherence tomography angiography, and microperimetry of a particular case of paracentral acute middle maculopathy lesion that follow the distribution of the cilioretinal artery.

Results:
A 52-year-old healthy man presented with an acute paracentral scotoma in his left eye upon awakening in the morning, after the use of a PDE-5 inhibitor pill the previous night. Spectral domain optical coherence tomography illustrated a hyperreflective band-like lesion at the level of the inner nuclear layer, consistent with a diagnosis of paracentral acute middle maculopathy, along the course of the cilioretinal artery that appeared normally perfused with fluorescein angiography. Optical coherence tomography angiography showed a perfusion deficit and capillary pruning of the retinal deep capillary plexus, with preserved intermediate capillary plexus, that colocalized with the paracentral scotoma confirmed with microperimetry.

Conclusion:
To our knowledge, this is the first report of paracentral acute middle maculopathy after the use of PDE-5 inhibitor. Nocturnal arterial hypotension exacerbated by the vasodilatory effect of the PDE-5 inhibitor may have caused transient cilioretinal artery hypo/nonperfusion and insufficiency. Paracentral acute middle maculopathy may represent the earliest form of ischemia in the central macular region, occurring after a milder vascular insult.
The Effect of Rebamipide Ophthalmic Solution on Cytokine and Mucin Secretion in Culture of Conjunctival Epithelial Cells From the Cu, Zn-Superoxide Dismutase-1 (SOD-1) Knock-Down Mouse
Authors: Ogawa Mamoru , Simsek Cem , Kojima Takashi , Nagata Taeko , Igarashi Ayako , Kawakita Tetsuya , Dogru Murat , Shimazaki Jun , Tsubota Kazuo 
Published: October 2018

Objectives:
To evaluate the in vitro effects of 1-mM rebamipide ophthalmic solution on the expression of inflammatory cytokines and MUC5AC in Cu, Zn-superoxide dismutase-1 (SOD-1) knock-down conjunctival epithelium.

Methods:
Conjunctival epithelium from C57BL/6 wild-type mice was cultured and treated with rebamipide ophthalmic solution. Using cytometric bead array, we examined the levels of interleukin-(IL)-6, IL-10, IL-17, monocyte chemoattractant protein-1, interferon-γ (INF-γ), tumor necrosis factor, and IL-12p70 in the culture supernatants. The culture supernatants were obtained from the culture medium of nontreated or SOD-1 knock-down conjunctival epithelium using small interfering RNA (siRNA). In addition, ELISA was performed to ascertain the MUC5AC concentration in the culture medium.

Results:
After rebamipide ophthalmic solution was applied, IL-6 concentration in the supernatants of conjunctival epithelial cells treated with and without siRNA showed a significant timewise decrease from 0 to 24 hr (963±42 to 0.07±0.05 pg/mL and 932±168 to 2.2±0.05 pg/mL, respectively) (P<0.001). Compared with baseline values, MUC5AC concentrations significantly increased 24 hr after rebamipide application to the conjunctival cultures—both with and without SOD-1 siRNA treatment (P<0.05 in both cases).

Conclusions:
Rebamipide seems to increase MUC5AC levels and suppress inflammation by decreasing IL-6 levels in mouse conjunctival epithelial cell cultures. SOD-1 siRNA-treated mouse conjunctival epithelial cell culture is a practical method for investigating changes in mucosa-associated mucins and proinflammatory cytokines in response to therapeutic interventions.
Ocular Surface Stem Cell Transplantation for Treatment of Keratitis–Ichthyosis–Deafness Syndrome
Authors: Cheung Albert Y. , Patel Sunny , Kurji Khaliq H. , Sarnicola Enrica , Eslani Medi , Govil Amit , Holland Edward J. 
Published: October 2018

Purpose:
To report our surgical experience with ocular surface stem cell transplantation (OSST) for limbal stem cell deficiency (LSCD) in the setting of keratitis–ichthyosis–deafness (KID) syndrome.

Methods:
Retrospective interventional case series.

Results:
We present 5 eyes of 3 patients with KID syndrome that developed LSCD and underwent OSST. Mean follow-up after OSST was 8.3 ± 4.3 years (range 3.4–11.4 years). Two eyes underwent living-related conjunctival limbal allograft (lr-CLAL), and 3 eyes were treated with keratolimbal allograft (KLAL). Four of the 5 eyes underwent subsequent keratoplasty. Both lr-CLAL eyes maintained a stable ocular surface at final follow-up. Conversely, all KLAL eyes developed a failed surface requiring repeat KLAL surgery. Because of multiple failed KLALs, 1 eye underwent placement of a keratoprosthesis.

Conclusions:
KID syndrome is a rare cause of LSCD. Although OSST can stabilize the surface, long-term treatment of KID syndrome can be challenging. An lr-CLAL may offer further benefit over a KLAL in these eyes because it is HLA- and ABO-matched tissue; it also helps to treat keratoconjunctivitis sicca, often a prominent feature of KID syndrome.
Correction of Recalcitrant Cicatricial Lower Lid Retraction and Entropion With Transverse Tarsotomy and Tarsoconjunctival Flap
Authors: Cho Raymond I. 
Published: October 2018

Purpose:
To describe a novel technique to correct cicatricial lower lid entropion and retraction using a transverse lower lid tarsotomy with an interposed tarsoconjunctival flap posterior lamellar spacer.

Methods:
Technique description and retrospective interventional case series.

Results:
Four patients underwent the procedure—two with complications following treatment of sinonasal carcinoma and two with complications following orbital fracture repair. All patients had failed prior posterior lamellar spacer grafts, including donor sclera, dermis-fat graft, and hard palate mucosa. Average time to flap takedown was 20 (11–28) days, with an average follow-up interval of 8.4 (6.2–11.5) months. All patients had resolution of lower lid entropion and significant improvement of lower lid retraction with an average of 2.8 mm (2.0–4.3) of elevation. There were no serious complications, and all patients reported significant improvement in ocular surface symptoms.

Conclusions:
Transverse tarsotomy combined with a tarsoconjunctival flap is effective for the correction of cicatricial lower lid retraction and entropion in eyelids that have failed surgery with traditional posterior lamellar spacer grafts.
Consumers' Association of Hospital Reputation With Healthcare Quality
Authors: Ziemba Justin B. , Arenberg Steven , Reustle Holly , Allaf Mohamad E. , Haldeman Dalal 
Published: October 2018

ABSTRACT
Why consumers consistently rank hospital reputation as one of the most important factors when selecting health care services remains unknown. We hypothesized that this is explained by consumers associating reputation with objective quality. We performed a cross-sectional, US population-based survey of consumers (N = 23,410) exploring this association. A Spearman rank order correlation was used to measure the strength of this relationship. Subgroups of consumers more likely to associate the two was explored with multivariable logistic regression. Consumers commonly agree (56%) that a hospital's reputation is the same as its quality of health care. Consumers also associate hospital reputation with the belief that they will be less like to suffer a complication (ρ = 0.509) or die (ρ = 0.441), although the strength of these relationships were modest (all p < 0.01). Consumers who were male (OR: 0.84), Hispanic (OR: 0.82), African American (OR: 0.86), married (OR: 0.85), self-reported as healthy (OR: 0.67), and had a recent hospitalization (OR: 0.70) were less likely to believe that reputation and quality were equivalent (all p < 0.01). This data suggests that consumers link the construct of hospital reputation with objective health care quality, but this pattern of behavior is of concern, particularly when reputation does not align with objective data.