bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated with the Development of Posterior Capsule Opacification Requiring Yttrium Aluminum Garnet Capsulotomy
Authors: Tokko Hassan A. , Hussain Farhan , Al-Awadi Ahmad , Mei Frank , Zeiter John H. , Kim Chaesik , Tannir Justin R. , Shukairy Aman , Juzych Mark S. , McDermott Mark L. , Nassiri Nariman , Hughes Bret A. 
Published: July 2019

SIGNIFICANCEDetermining risk factors for posterior capsule opacification will allow for further interventions to reduce the risk of development and thus additional procedures.PURPOSEThe purpose of this study was to investigate risk factors associated with development of clinically significant posterior capsule opacification requiring yttrium aluminum garnet (YAG) capsulotomy.METHODSMedical records of patients (≥18 years) who underwent cataract surgery between January 1, 2011, and March 31, 2014, at Kresge Eye Institute were reviewed. Three hundred eyes requiring YAG capsulotomy up to 3 years after cataract surgery were included in the YAG capsulotomy group. Three hundred eyes not requiring YAG capsulotomy up to 3 years after cataract surgery were selected via age-matched simple randomization (control group).RESULTSThe YAG capsulotomy group included patients with younger age (65.8 ± 11.3 vs. 70.1 ± 10.6 years,P< .001), more men (42.67 vs. 34.67%,P= .04), fewer patients with hypertension (73.00 vs. 83.00%,P< .001), and more patients with hydrophilic intraocular lenses (74.67 vs. 47.00%,P< .001). Logistic regression analysis demonstrated a negative association between YAG capsulotomy and age (coefficient, −0.04; 95% confidence interval [CI], 0.95 to 0.98;P< .001) and hydrophobic intraocular lenses (coefficient, −1.50; 95% CI, 0.15 to 0.33;P< .001), and a positive association with presence of glaucoma (coefficient, 0.88; 95% CI, 1.39 to 4.17;P= .002). Elapsed time to YAG capsulotomy was sooner in patients with a history of uveitis (95% CI, 5.10 to 9.70 months;P= .02) and insertion of hydrophilic intraocular lenses (95% CI, 18.67 to 21.57 months;P< .001).CONCLUSIONSResults of this study suggest that development of visually significant posterior capsule opacification is associated with younger age, glaucoma, and hydrophilic intraocular lenses, and it occurs earlier among those with hydrophilic intraocular lenses and a history of uveitis.
Conjunctival Redness Response to Corneal Stimulation
Authors: Alabi Emmanuel B. , Simpson Trefford L. 
Published: July 2019

SIGNIFICANCE
The conjunctiva is an integral component of the ocular surface, and its vasculature forms a terminal vascular bed of the human internal carotid artery. No research on the response of conjunctival vasculature to ocular surface stimulation exists; however, it is essential to understand the local physiological and pathological responses to such a stimulus.

PURPOSE
The purpose of this study was to characterize the ocular redness levels in healthy participants after the application of noxious corneal stimulation.

METHODS
A computerized Belmonte pneumatic esthesiometer was used to determine detection thresholds (using ascending method of limits) and to randomly deliver mechanical and chemical stimuli from levels of detection threshold to twice the threshold in 50% steps to the central cornea of 15 healthy subjects. For each suprathreshold stimulus, a spectrophotometer was used to measure ipsilateral and contralateral conjunctival redness before and after delivery of the corneal stimulus. Redness between the stimulated and unstimulated eyes was analyzed using dependent t tests. The effects of stimulus intensity and modality on conjunctival redness were analyzed using repeated-measures analysis of variance (ANOVA). Tukey honestly significant difference tests were used for all post hoc analyses. P ≤ .05 was considered statistically significant.

RESULTS
In mechanical and chemical stimulation experiments, the stimulated eye became redder than the unstimulated eye (all t tests, P > .05). On average, redness increased from baseline as the corneal stimulus intensity increased with corneal stimulation (ANOVA, P < .05). Chemical stimulation produced greater conjunctival redness than did mechanical stimulation at all stimulation levels (ANOVA, P < .05; all Tukey honestly significant difference tests, P < .05).

CONCLUSIONS
Stimulation of the central cornea by noxious mechanical and chemical stimuli evokes a dose-dependent autonomic conjunctival redness response. Chemical stimulation of the cornea seems to evoke a greater response compared with mechanical stimulation. This study serves as a basis for the characterization of the local stimulus-response neural circuitry relating nociceptive ocular surface stimuli to autonomic responses.
Effects of Different Body Postures on the Intraocular Pressure in Patients with Primary Angle-Closure Disease
Authors: Park Ji-Hye , Yoo Chungkwon , Yang Kyung-Sook , Kim Yong Yeon 
Published: July 2019

SIGNIFICANCE
Eyes with primary angle-closure disease showed higher intraocular pressure (IOP) in the recumbent postures including supine and lateral decubitus (LD) positions compared with the sitting position.

PURPOSE
The purpose of this study was to investigate the effects of different body postures on the IOP in eyes with primary angle-closure suspect (PACS), primary angle closure (PAC), or primary angle-closure glaucoma (PACG).

METHODS
This is a comparative case series of 31 patients with bilateral PAC disease, such as PACS, PAC, and PACG. The IOP was measured using Tonopen AVIA in sitting, supine, and right or left LD positions. Patients were instructed to rest their heads on the pillows in supine and LD positions. The eye on the lower side in the LD position was called dependent eye. The main outcome was the difference in IOP among different body postures.

RESULTS
Among the 62 eyes (31 patients), PACG, PAC, and PACS were noted in 44, 12, and 6 eyes, respectively. The IOP was not significantly different between the two eyes in sitting and supine positions, whereas the IOP was significantly higher in the dependent eye than in the nondependent eye in LD positions. Compared with that measured in the supine position, IOP differences of the dependent eye were higher than those of the nondependent eye when measured in LD position (right LD vs. supine, P = .02; left LD vs. supine, P = .01). In addition, when the study patients were divided into three groups according to their diagnosis, no significant differences were observed in the IOPs and IOP differences among the three groups.

CONCLUSIONS
Posture-induced IOP changes were comparable among eyes with PACS, PAC, and PACG.
“The Scalpel is Passed,” a Conversation With Dr Vincent J.M. DiMaio
Authors: Dana Suzanna 
Published: July 2019

Editor's Note
This is the first article in a new series of interviews with mentors in forensic pathology. These interviews will also be recorded, and the audio files will be available online through the journal's Web site, http://links.lww.com/FMP/A31.
Use of Intranasal Ketamine in Pediatric Patients in the Emergency Department
Authors: Guthrie Anne Marie , Baum Regan A. , Carter Craig , Dugan Adam , Jones Landon , Tackett Trei , Bailey Abby M. 
Published: July 2019

Objectives
Ketamine is a safe and widely used sedative and analgesic in the pediatric emergency department (ED). The use of intranasal (IN) ketamine in exchange for the administration of intravenous sedatives or analgesics for procedural sedation in pediatric patients is not commonplace. The goal of this study was to evaluate provider perceptions and patient outcomes at varying doses of IN ketamine for anxiolysis, agitation, or analgesia.

Methods
From January 2018 to May 2018, we performed a prospective survey and chart review of pediatric patients receiving IN ketamine. The primary outcome was to determine provider satisfaction with using IN ketamine. Secondary objectives included comparing outcomes stratified by dose, adverse events, assessing for treatment failure, and ED length of stay (LOS). As a secondary comparison, patients receiving IN ketamine whom otherwise would have required procedural sedation with intravenous sedatives or analgesics were placed into a subgroup. This subgroup of patients was compared with a cohort who received intravenous sedatives or analgesics for procedural sedation during a similar period the preceding year (January 2017 to June 2017).

Results
Of the 196 cases, 100% of the providers were comfortable using IN ketamine. The median overall provider satisfaction was 90 out of 100, the perception of patient comfort was 75 out of 100, and perceived patient comfort was maximized when using doses between 3 and 5 mg/kg. There were 15 (7.7%) patients who experienced ketamine treatment failure. Overall, the rate of adverse events was 6%, but were considered minor [nausea (n = 3; 1.5%), dizziness (n = 2; 1%), and drowsiness (n = 2; 1%)]. No patients required respiratory support or intubation. The mean LOS was 237.9 minutes, compared with those who underwent procedural sedation with an LOS of 332.4 minutes (P < 0.001).

Conclusions
This study demonstrates that IN ketamine was able to provide safe and successful analgesia and anxiolysis in pediatric patients in an ED setting. In addition, providers expressed a high degree of satisfaction with using IN ketamine (90 out of 100) in addition to a high degree of patient comfort during the procedure (75 out of 100). Intranasal ketamine provides an alternative to intravenous medication normally requiring more resource-intensive monitoring. Procedural sedations are resource and time intensive activities that increase ED LOS. Intranasal ketamine used for anxiolysis and analgesia offers the benefits of freeing up resources of staff and monitoring while enhancing overall throughput through a pediatric ED.
A Systematic Review and Meta-Analysis of the Pressure-Induced Vasodilation Phenomenon and Its Role in the Pathophysiology of Ulcers
Authors: Zwanenburg Pieter R. , Backer Sophia F. M. , Obdeijn Miryam C. , Lapid Oren , Gans Sarah L. , Boermeester Marja A. 
Published: July 2019

Background:
Physiologic studies show that tissue perfusion increases during moderate amounts of tissue compression. This is attributed to sensory nerves initiating a vasodilatory cascade referred to as pressure-induced vasodilation.

Methods:
PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies investigating perfusion during pressure exposure longer than 10 minutes. Retrieved studies were assessed using the Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies. Results were pooled with random effects models. The body of evidence was rated using the Office of Health Assessment and Translation approach.

Results:
Twenty-nine articles were included, of which 19 articles were included in meta-analyses. The evidence indicates that moderate amounts of tissue compression have the capacity to increase perfusion in healthy humans by 46 percent (95 percent CI, 30 to 62 percent). Using the Office of Health Assessment and Translation approach, the authors found a high level of confidence in the body of evidence. Pressure-induced vasodilation blockade was associated with increased pressure ulcer formation. Pressure-induced vasodilation was impaired by neuropathy and by the drugs diclofenac and amiloride.

Conclusions:
This systematic review and meta-analysis indicates that healthy humans have the capacity to increase local perfusion in response to mechanical stress resulting from tissue compression. Because pressure-induced vasodilation is mediated by sensory nerves, pressure-induced vasodilation emphasizes the importance of sensory innervation for durable tissue integrity. Pressure-induced vasodilation impairment seems to provide a complementary explanation for the susceptibility of neuropathic tissues to pressure-induced lesions.
Medically Unexplained Symptoms and Antecedent Sexual Abuse: An Observational Study of a Birth Cohort
Authors: Duncan Roderick , Mulder Roger , Wilkinson Sam H. , Horwood John 
Published: July 2019

ABSTRACT

Objective
Medically unexplained symptoms (MUS) are common and associated with high consumption of health care resources. Cross-sectional studies in selected and clinical populations show consistent linkages between history of childhood sexual abuse (CSA) and presentation with MUS and somatization. However, there are almost no well-controlled prospective studies in population samples.

Methods
Data were gathered in a longitudinal study of a New Zealand birth cohort born in 1977. Hospital e-record data for the period 2008–2015 (age, 30–38 years) were searched for a subsample of 408 study participants who were resident in one District Health Board region, and details of MUS contacts were recorded. Retrospective reports of CSA (<16 years) were obtained at ages 18 and 21 years. Associations between CSA and MUS were sequentially adjusted using logistic regression methods for both childhood confounders assessed before age 16 years and potential mediating mental health/family context up to age 30 years.

Results
Twenty (4.9%) participants were classified as having MUS, of whom 11 had a history of CSA. Severe CSA involving attempted/completed sexual penetration was strongly associated with risk of MUS (odds ratio = 11.6, 95% confidence interval = 4.3–31.7, p < .001). A substantial association remained after statistically adjusting for confounding and mediating mental health/family context (adjusted odds ratio = 5.1, 95% confidence interval = 1.2–21.3, p = .024). This strong association was specific to severe CSA (as opposed to childhood physical abuse) and to MUS rather than medically explained symptoms.

Conclusions
CSA involving attempted/completed penetration was strongly associated with attendance at secondary level care for MUS. Implications for prevention and treatment of MUS are discussed.
Social Role–Related Stress and Social Role–Related Reward as Related to Subsequent Subclinical Cardiovascular Disease in a Longitudinal Study of Midlife Women: The Study of Women's Health Across the Nation
Authors: Stewart Andrea Leigh , Barinas-Mitchell Emma , Matthews Karen A. , El Khoudary Samar R. , Magnani Jared W. , Jackson Elizabeth A. , Brooks Maria M. 
Published: July 2019

ABSTRACT

Objective
The purpose of this study was to determine if midlife social role quality, defined by the stress and rewards associated with four social roles, is related to later-life subclinical cardiovascular disease (SCVD) in a cohort of women transitioning through menopause.

Methods
The Study of Women's Health Across the Nation (SWAN) is a longitudinal cohort study of midlife women. Stress and reward from four social roles (spouse, parent, employee, caregiver) were assessed at seven early visits. Later-life SCVD was assessed via carotid ultrasound and brachial-ankle pulse wave velocity at two later visits. We tested whether ever reporting an “extremely” or “quite a bit” stressful role was related to SCVD. We also tested whether cumulative stress and reward, as well as baseline and change in stress and reward were related to SCVD, adjusting for demographics and cardiovascular risk factors.

Results
Among 1602 women, reporting a stressful role during midlife (between ages 47 and 52 years) was associated with later-life (age 61 years) carotid intima-media thickness, which was 21 μm thicker than never reporting a stressful role. No significant relationships between stressful roles and other SCVD measures were identified. Cumulative and baseline change models of stress and reward were not related to SCVD.

Conclusion
A stressful social role in midlife was associated with greater atherosclerotic burden in later-life in a cohort of women transitioning through menopause. Social role rewards were unrelated to better later-life SCVD. These findings extend the knowledge of stress and cardiovascular disease in women by using measures of stress and reward for multiple social roles over the years of midlife.
A Novel Technique for Short Nose Correction in Asians: M-Shaped Conchal Cartilage Combining With Septal Extension Graft
Authors: An Yang , Feng Ning , Chen Lujia , Yang Xin , Yang Xiao , Xia Youchen , Xue Hongyu , Li Dong 
Published: July 2019

Background:
Multiple techniques are available for short nose deformity correction. The septal extension graft represents the commonest method employed in Asians. However, a large number of surgeons hardly obtain esthetically satisfactory results since the majority of designs do not reflect the normally encountered surface anatomy of the nasal tip cartilage.

Objective:
The authors designed a novel technique, which combined the M-shaped conchal cartilage with the septal extension graft for overcoming the above shortcoming in Asians.

Methods:
Between February 2013 and March 2016, 33 patients presenting short nose deformity were surgically treated with the M-shaped conchal cartilage combined with the septal extension graft. The graft was an altered septal extension graft using the septal cartilage alongside the conchal cartilage. The harvested septal cartilage was located to the caudal septum and fixed with sutures. The conchal cartilage was trimmed into 2 strips, which were sutured together in an M-shape and firmly fixed in a bilateral manner to the caudal septal extension graft. Then, the alar cartilage was fixed with the M-shape graft. In all patients, nasal lengths, nasal tip projections, and nasolabial angles were assessed before and after surgery, respectively.

Results:
Nasal tip projections and nasal lengths showed remarkable increases, while columellar-labial angles were overtly decreased, in individuals surgically treated by the novel technique.

Conclusions:
This study presents a new method for correcting short nose deformity in Asians. The M-shaped conchal cartilage combined with the septal extension graft may effectively lengthen the nose while closely representing the actual surface of the esthetic nasal tip.
X-Linked IRAK1 Polymorphism is Associated with Sex-Related Differences in Polymorphonuclear Granulocyte and Monocyte Activation and Response Variabilities
Authors: Qin Yong , Peña Geber , Morcillo Patrick , Singh Sukhwinder , Mosenthal Anne C. , Livingston David H. , Spolarics Zoltan 
Published: July 2019

ABSTRACT
Common X-linked genetic polymorphisms are expected to alter cellular responses affecting males and females differently through sex-linked inheritance pattern as well as X chromosome (ChrX) mosaicism and associated ChrX skewing, which is unique to females. We tested this hypothesis in ex vivo lipopolysaccharide and phorbol ester-stimulated polymorphonuclear granulocytes (PMNs) and monocytes from healthy volunteers (n = 51). Observations were analyzed after stratification by sex alone or the presence of variant IRAK1 haplotype a common X-linked polymorphism with previously demonstrated major clinical impacts. Upon cell activation, CD11b, CD45, CD66b, CD63, and CD14 expression was markedly and similarly elevated in healthy males and females. By contrast, PMN and monocyte activation measured by CD11b, CD66b, and CD63 was increased in variant-IRAK1 subjects as compared with WT. Stratification by IRAK1 genotype and sex showed similar cell activation effect on variant-IRAK1 subjects and an intermediate degree of cell activation in heterozygous mosaic females. The increased membrane expression of these proteins in variant-IRAK1 subjects was associated with similar or increased intersubject but uniformly decreased intrasubject cell response variabilities as compared with WT. We also tested white blood cell ChrX skewing in the healthy cohort as well as in a sample of female trauma patients (n = 201). ChrX inactivation ratios were similar in IRAK1 WT, variant, and heterozygous healthy subjects. Trauma patients showed a trend of blunted ChrX skewing at admission in homozygous variant-IRAK1 and heterozygous mosaic-IRAK1 female subjects as compared with WT. Trauma-induced de novo ChrX skewing was also depressed in variant-IRAK1 and mosaic-IRAK1 female trauma patients as compared with WT. Our study indicates that augmented PMN and monocyte activation in variant-IRAK1 subjects is accompanied by decreased intrasubject cellular variability and blunted de novo ChrX skewing in response to trauma. A more pronounced cell activation of PMNs and monocytes accompanied by decreased response variabilities in variant-IRAK1 subjects may be a contributing mechanism affecting the course of sepsis and trauma and may also impact sex-based outcome differences due to its X-linked inheritance pattern and high prevalence.
The Prognostic Usefulness of the Lactate/Albumin Ratio for Predicting Clinical Outcomes in Out-of-Hospital Cardiac Arrest: a Prospective, Multicenter Observational Study (koCARC) Study
Authors: Kong Taeyoung , Chung Sung Phil , Lee Hye Sun , Kim Sinae , Lee Jihwan , Hwang Sung Oh , Shin Sang Do , Song Kyoung Jun , Cha Kyung Chul , You Je Sung 
Published: July 2019

ABSTRACT

Background and Purpose:
We aimed to evaluate the lactate/albumin ratio (LAR) to identify its significance as a prognostic marker for favorable neurologic outcome and survival in patients with return of spontaneous circulation after out-of-hospital cardiac arrest (OHCA). Based on the LAR and multiple parameters, we developed new nomograms and externally validated the tools.

Methods:
We conducted an observational study using a prospective, multicenter registry of out-of-cardiac arrest resuscitation provided by the Korean Cardiac Arrest Research Consortium registry from October 2015 to June 2017.

Results:
A total of 524 patients were included in this study. An increased LAR was significantly associated with decreased favorable neurologic outcomes (odds ratio [OR] 0.787; 95% confidence interval [CI], 0.630–0.983; P = 0.035) and survival at discharge (OR 0.744; 95% CI, 0.638–0.867; P < 0.001). The areas under the curve (AUCs) for predicting neurologic outcome and survival to discharge using the LAR were 0.824 (P < 0.001) and 0.781 (P < 0.001), respectively. An LAR value of more than the optimal cutoff values of 2.82 and 3.62 could significantly improve prediction of decreased favorable neurologic outcome and survival to discharge, respectively. We constructed nomograms based on the multivariate logistic model. The model for predicting favorable neurologic outcomes and survival discharge had AUCs of 0.927 (P < 0.001) and 0.872 (P < 0.001), respectively.

Conclusion:
The prognostic performance of the LAR was superior to a single measurement of lactate for predicting favorable neurologic outcomes and survival to discharge after OHCA. The newly developed nomograms can provide rapid prediction of probability of clinical outcomes.