bluuebunny/crossref_metadata_2025_split huggingface dataset:
VASOPROLIFERATIVE TUMORS IN INTERMEDIATE UVEITIS
Authors: Pichi Francesco , Neri Piergorgio , Agarwal Aniruddha , Invernizzi Alessandro , Choudhry Netan , Amer Radgonde , Lembo Andrea , Nucci Paolo , Thompson Ian , Sen H. Nida , Shields Carol L. 
Published: October 2019

Purpose:
To describe patients with intermediate uveitis complicated by vasoproliferative tumors (VPTs).

Methods:
Data were collected at seven Uveitis/Ocular Oncology centers on demographic, ophthalmic findings at baseline and at follow-up, and on imaging. The therapeutic intervention, final visual acuity, and duration of follow-up were recorded.

Results:
A total of 36 eyes from 34 patients (12 men, 22 women; mean age 35.3 ± 14.2 years) were included in this study. Visual acuity at presentation ranged from 20/40 to counting fingers. At the time of VPT diagnosis, intermediate uveitis was active in all eyes. The mean VPT thickness was 3.06 ± 0.86 mm. Local treatment to the VPT was provide in 22 eyes (61.1%) and no local treatment to the VPT in 14 eyes (38.9%). After the VPT was detected, systemic or local treatment for the inflammation was initiated and on follow-up FAs 94.4% of the eyes showed resolution of the vascular leakage. During follow-up of 35.8 months, the 22 VPTs treated locally had a reduction in the tumor thickness to 1.25 mm, whereas the 14 VPTs untreated remained stable (final mean tumor thickness 2.65 mm).

Conclusion:
The presence of active intermediate uveitis accompanied by VPTs suggests the need for an aggressive uveitis treatment.
Peripheral Hypertrophic Subepithelial Opacities of Corneal Grafts After Deep Anterior Lamellar Keratoplasty
Authors: Feizi Sepehr , Karjou Zahra , Masoudi Ali , Moshtaghion Seyed-Mohamadmehdi , Azari Amir A. 
Published: October 2019

Purpose:
To investigate possible underlying etiologies of the development of peripheral graft hypertrophic subepithelial opacities (PGHSO) and to evaluate the effects of these opacities on visual outcomes after deep anterior lamellar keratoplasty (DALK).

Methods:
This prospective, interventional case series enrolled 29 eyes with keratoconus that underwent DALK and developed PGHSO (group 1). The control group consisted of 32 eyes with keratoconus that underwent DALK during the same period and had a clear graft at the final examination (group 2). Possible underlying risk factors for the development of PGHSO were investigated, and postoperative refractive and topographic outcomes were compared between the 2 study groups.

Results:
Eyes of group 1 had well-defined elevated peripheral subepithelial opacities of the corneal graft, originating from the donor–recipient junction. The central 4-mm area of the graft was clear in all eyes of this group. Compared with the controls, group 1 had flatter grafts at postoperative month 1 and a longer time interval from surgery to initial suture removal. The 2 study groups were comparable in other investigated factors, including the severity of keratoconus, surgical technique, duration of topical steroid use, and donor quality. No significant differences were observed between the case and control groups in postoperative visual acuity and graft surface regularity.

Conclusions:
Graft flattening during the early postoperative period and prolonged time interval from surgery to initial suture removal might be factors predisposing to the development of PGHSO. This complication did not affect postoperative visual outcomes when the central 4-mm area of the graft remained clear.
Outcomes of Repeat Anterior Lamellar Keratoplasty
Authors: Woo Jyh Haur , Tan Yar Li , Htoon Hla Myint , Tan Donald Tiang Hwee , Mehta Jodhbir S. 
Published: October 2019

Purpose:
To describe the outcomes and complications of repeat anterior lamellar keratoplasty (ALK) after a failed primary ALK.

Methods:
This was a retrospective case series. Twenty-three eyes of 22 patients who underwent repeat ALK for optical indications from January 1, 1991, to December 31, 2017, were included. Clinical data were recorded from the Singapore Corneal Transplant Study database. Outcome measures were graft survival, best-corrected visual acuity (BCVA), and complications.

Results:
Of the 780 cases of ALK performed for optical indications during the study period, 23 cases (2.9%) underwent repeat ALK. Primary ALK comprised of 16 deep ALK and 7 automated lamellar therapeutic keratoplasty cases. After repeat ALK, 21 eyes had further dissection down to the descemetic or predescemetic plane, whereas 2 eyes had graft exchange for failed automated lamellar therapeutic keratoplasty. The graft survival of repeat ALK was 93.2%, 86.1%, and 78.3% at 1, 3, and 5 years, respectively. There were 4 cases of graft failure with a mean time to failure of 2.0 ± 1.7 years. After the repeat ALK procedure, 63.6% and 66.7% of eyes achieved a BCVA of LogMAR +0.3 (20/40) or better at 1 and 2 years, respectively. Five eyes (17.4%) had an intraoperative microperforation.

Conclusions:
In the case of a failed ALK graft for a range of optical indications, a repeat ALK procedure offers a viable and safe surgical option with good long-term graft survival and visual outcomes, while avoiding the various disadvantages of performing penetrating keratoplasty, especially the risk of allograft endothelial rejection.
Nurse practitioners leading the way: An exploratory study on the added value of nurse practitioners in outpatient care in the Netherlands
Authors: Boeijen Enzio R. K. , Peters Jeroen W. B. , van Vught Anneke J. A. H. 
Published: October 2019

ABSTRACT

Background:
Many Dutch nurse practitioners (NPs) work together with physicians and specialized nurses (SNs) in outpatient clinics, although the latter have questioned the added value of NPs in the outpatient clinic. Clarification of the distinction between and the added value of both nursing professions in relation to each other could lead to optimal use of the unique competencies of each type of nurse.

Purpose:
To explore NPs' perspectives on their added value in relation to SNs in the outpatient clinic.

Methodological orientation:
Data were analyzed by Braun and Clarke's thematic analysis. The CanMEDS competences were used to identify the NPs' comments about their practice.

Sample:
Twelve semi-structured interviews were conducted with NPs from two hospital settings.

Conclusions:
The added value of NPs was most evident in: nursing leadership, integrating care and cure and performing an expert level of nursing expertise, and competencies in science. To optimize their roles, NPs and SNs need to make all team members aware of their unique competences and promote role clarification.

Implications for practice:
This study provides barriers in barriers that influence optimal positioning of NPs within the interdisciplinary team, stresses the importance of discussion on the optimal skill mix within the interdisciplinary team, and describes the NPs' leadership role because this is the encompassing link between the main competencies of their practice. Addressing and overcoming these findings could improve the NPs' positioning and effective collaboration within (the outpatient clinic's) interprofessional teams.
Establishing nurse practitioner clinical practicums: Addressing fiscal realities
Authors: Delaney Kathleen R. , Swartwout Kathryn , Livesay Sarah L. , Bavis Margaret Perlia 
Published: October 2019

ABSTRACT
As demand expands for nurse practitioner clinical practicum sites, the supply of preceptors is decreasing. The traditional model of in-kind clinical training is losing its foothold for a variety of reasons. A looming question is how quickly a “pay to precept” norm will grow and what will be the costs. The pay for precepting movement is discussed including current trends, costs, and emerging compensation models. To adapt to this trend, alternative ways of drawing the precepting value proposition are suggested, particularly decreasing preceptor and site demands while increasing students' readiness to enter clinical practicum and tapping into faculty expertise to add value to the partnership. The authors provide suggestions on building a strategy for rethinking the structure of student precepting arrangements and compensation models.
Escalating interventional recanalization therapy in non-cirrhotic, non-malignant acute portal vein thrombosis
Authors: Gerwing Mirjam , Wilms Christian , Heinzow Hauke , Sporns Peter B. , Heindel Walter , Schmidt Hartmut , Wildgruber Moritz , Köhler Michael 
Published: October 2019

Objective:
To evaluate the effectiveness of interventional therapy in acute, non-malignant, non-cirrhotic portal vein thrombosis.

Methods:
We present a retrospective study of eight consecutive patients who presented with an acute non-malignant, non-cirrhotic portal vein thrombosis and were treated by mechanical recanalization using an escalating scheme including local aspiration, thrombolysis, rheolysis and the implantation of transjugular intrahepatic portosystemic shunt or other visceral stents.

Results:
Recanalization rates applying the escalating scheme were good, with a success rate of 75%. However, major complications occurred in 50% of patients, mostly due to bleeding at the percutaneous access site, and minor complications in 12.5% of patients.

Conclusion:
Interventional therapy is effective in acute portal vein thrombosis, but should only be performed at specialized centers and based on an individual treatment decision.
Flexor Tendon: Development, Healing, Adhesion Formation, and Contributing Growth Factors
Authors: Titan Ashley L. , Foster Deshka S. , Chang James , Longaker Michael T. 
Published: October 2019

Summary:Management of flexor tendon injuries of the hand remains a major clinical problem. Even with intricate repair, adhesion formation remains a common complication. Significant progress has been made to better understand the mechanisms of healing and adhesion formation. However, there has been slow progress in the clinical prevention and reversal of flexor tendon adhesions. The goal of this article is to discuss recent literature relating to tendon development, tendon healing, and adhesion formation to identify areas in need of further research. Additional research is needed to understand and compare the molecular, cellular, and genetic mechanisms involved in flexor tendon morphogenesis, postoperative healing, and mechanical loading. Such knowledge is critical to determine how to improve repair outcomes and identify new therapeutic strategies to promote tissue regeneration and prevent adhesion formation.
Bilateral DIEP Flap Breast Reconstruction to a Single Set of Internal Mammary Vessels: Technique, Safety, and Outcomes after 250 Flaps
Authors: Opsomer Dries , D’Arpa Salvatore , Benmeridja Lara , Stillaert Filip , Noel Warren , Van Landuyt Koenraad 
Published: October 2019

Background:
The deep inferior epigastric artery perforator (DIEP) flap is considered the gold standard in autologous breast reconstruction. In bilateral cases, both flaps are often anastomosed to the internal mammary vessels on either side of the sternum. The authors propose a method in which both flaps are anastomosed to only the right side internal mammary artery and vein.

Methods:
Between November of 2009 and March of 2018, 125 patients underwent bilateral DIEP flap breast reconstruction with this technique. One flap is perfused by the anterograde proximal internal mammary artery and the second one by the retrograde distal internal mammary artery after presternal tunneling. Patient demographics and operative details were reviewed retrospectively.

Results:
Two hundred fifty flaps were performed. One hundred fifty-two flaps were prophylactic or primary reconstructions (60.8 percent), 70 were secondary reconstructions (28 percent), and 28 were tertiary reconstructions (11.2 percent). Mean patient age was 46 years, and the mean body mass index was 25 kg/m2. Sixty patients underwent radiation therapy or chemotherapy (48 percent). The authors encountered one significant partial failure (0.4 percent) and nine complete flap failures (3.6 percent). The authors did not see a statistically significant predisposition for failure comparing the retrograde with the anterograde flow flaps, nor when comparing the tunneled with the nontunneled flaps.

Conclusions:
The authors’ results show that anastomosing both DIEP flaps to a single set of mammary vessels is safe and reliable. The authors conclude that the retrograde flow through the distal internal mammary artery is sufficient for free flap perfusion and that subcutaneous tunneling of a free flap pedicle does not predispose to flap failure.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Safety of Postoperative Opioid Alternatives in Plastic Surgery: A Systematic Review
Authors: O’Neill Rebecca C. , Hayes Kylie D. , Davison Steven P. 
Published: October 2019

Summary:
With the growing opioid epidemic, plastic surgeons are being encouraged to transition away from reliance on postoperative opioids. However, many plastic surgeons hesitate to use nonopioid analgesics such as nonsteroidal antiinflammatory drugs and local anesthetic blocks because of concerns about their safety, particularly bleeding. The goal of this systematic review is to assess the validity of risks associated with nonopioid analgesic alternatives. A comprehensive literature search of the PubMed and MEDLINE databases was conducted regarding the safety of opioid alternatives in plastic surgery. Inclusion and exclusion criteria yielded 34 relevant articles. A systematic review was performed because of the variation between study indications, interventions, and complications. Thirty-four articles were reviewed that analyzed the safety of ibuprofen, ketorolac, celecoxib, intravenous acetaminophen, ketamine, gabapentin, liposomal bupivacaine, and local and continuous nerve blocks after plastic surgery procedures. There were no articles that showed statistically significant bleeding associated with ibuprofen, celecoxib, or ketorolac. Similarly, acetaminophen administered intravenously, ketamine, gabapentin, and liposomal bupivacaine did not have any significant increased risk of adverse events. Nerve and infusion blocks have a low risk of pneumothorax. Limitations of this study include small sample sizes, different dosing and control groups, and more than one medication being studied. Larger studies of nonopioid analgesics would therefore be valuable and may strengthen the conclusions of this review. As a preliminary investigation, this review showed that several opioid alternatives have a potential role in postoperative analgesia. Plastic surgeons have the responsibility to lead the reduction of postoperative opioid use by further developing multimodal analgesia.
18F-FDG PET/CT of Multiorgan Sarcoid-Like Reaction During Anti–PD-1 Treatment for Melanoma
Authors: van Willigen Wouter W. , Gerritsen Winald R. , Aarntzen Erik H.J.G. 
Published: October 2019

Abstract
We report a case of a 50-year-old woman treated with anti–PD-1 inhibition for metastatic melanoma. During treatment, extensive and transient histopathologically confirmed sarcoid-like reaction was detected in multiple organ systems and at different time points using 18F-FDG PET/CT imaging. Immune-related adverse events during anti-PD-1/PD-L1 antibody treatment are increasingly being reported. This case report emphasizes the broad spectrum of possible presentations of sarcoid-like reaction detected by 18F-FDG PET/CT and its evolution in time. For the clinician, awareness of these immune-related adverse events helps to accurately interpret findings on imaging.
Polyarteritis Nodosa With Reversible FDG Accumulation in Vessels and Kidneys
Authors: Mino Nanami , Yamashita Hiroyuki , Takahashi Yuko , Kaneko Hiroshi 
Published: October 2019

AbstractA 59-year-old man presented with fever and lower extremity myalgia. Laboratory studies revealed elevated C-reactive protein.18F-FDG PET/CT demonstrated FDG uptake not only in the brachial arteries, femoral arteries, and their main ramifications, which were equivalent to small- to medium-sized arteries but also in the kidneys. Angiography revealed a renal aneurysm, confirming the diagnosis of polyarteritis nodosa. The increased FDG uptake in the vessels and kidneys resolved after 6 months of glucocorticoid treatment.
Identification of Distant Metastases From Recurrent Gliosarcoma Using Whole-Body 18F-FDG PET/CT
Authors: Unterrainer Marcus , Ruf Viktoria , Cyran Clemens C. , Brendel Matthias , Thon Niklas , Herms Jochen , Schüller Ulrich , Tonn Joerg-Christian , Bartenstein Peter , Albert Nathalie Lisa 
Published: October 2019

Abstract
A 51-year-old man presented with recurrent gliosarcoma and increasing cough over the last months. On 18F-FDG PET/CT, solid lung masses with high 18F-FDG uptake were present. A biopsy taken from a lung lesion indicated distant metastases from gliosarcoma. Gliosarcoma, a rare malignant central nervous system tumor, presents with extracranial metastases in only less than 10%. As highlighted by this case, 18F-FDG PET/CT can be used for whole-body staging in patients with metastatic brain tumor. Vice versa, highly 18F-FDG–avid lung lesions in patients with brain tumors should lead to distant metastases as differential diagnosis despite their rare occurrence.
A sorghum Practical Haplotype Graph facilitates genome-wide imputation and cost-effective genomic prediction
Authors: Jensen Sarah E. , Charles Jean Rigaud , Muleta Kebede , Bradbury Peter , Casstevens Terry , Deshpande Santosh P. , Gore Michael A. , Gupta Rajeev , Ilut Daniel C. , Johnson Lynn , Lozano Roberto , Miller Zachary , Ramu Punna , Rathore Abhishek , Romay M. Cinta , Upadhyaya Hari D. , Varshney Rajeev , Morris Geoffrey P. , Pressoir Gael , Buckler Edward S. , Ramstein Guillaume P. 
Published: October 2019

AbstractSuccessful management and utilization of increasingly large genomic datasets is essential for breeding programs to increase genetic gain and accelerate cultivar development. To help with data management and storage, we developed a sorghum Practical Haplotype Graph (PHG) pangenome database that stores all identified haplotypes and variant information for a given set of individuals. We developed two PHGs in sorghum, one with 24 individuals and another with 398 individuals, that reflect the diversity across genic regions of the sorghum genome. 24 founders of the Chibas sorghum breeding program were sequenced at low coverage (0.01x) and processed through the PHG to identify genome-wide variants. The PHG called SNPs with only 5.9% error at 0.01x coverage - only 3% lower than its accuracy when calling SNPs from 8x coverage sequence. Additionally, 207 progeny from the Chibas genomic selection (GS) training population were sequenced and processed through the PHG. Missing genotypes in the progeny were imputed from the parental haplotypes available in the PHG and used for genomic prediction. Mean prediction accuracies with PHG SNP calls range from 0.57-0.73 for different traits, and are similar to prediction accuracies obtained with genotyping-by-sequencing (GBS) or markers from sequencing targeted amplicons (rhAmpSeq). This study provides a proof of concept for using a sorghum PHG to call and impute SNPs from low-coverage sequence data and also shows that the PHG can unify genotype calls from different sequencing platforms. By reducing the amount of input sequence needed, the PHG has the potential to decrease the cost of genotyping for genomic selection, making GS more feasible and facilitating larger breeding populations that can capture maximum recombination. Our results demonstrate that the PHG is a useful research and breeding tool that can maintain variant information from a diverse group of taxa, store sequence data in a condensed but readily accessible format, unify genotypes from different genotyping methods, and provide a cost-effective option for genomic selection for any species.
Low E2F2 activity is associated with high genomic instability and PARPi resistance
Authors: Rennhack Jonathan P , Andrechek Eran R. 
Published: October 2019

AbstractThe E2F family, classically known for a central role in cell cycle, has a number of emerging roles in cancer including angiogenesis, metabolic reprogramming, metastasis and DNA repair. E2F1 specifically has been shown to be a critical mediator of DNA repair; however, little is known about DNA repair and other E2F family members. Here we present an integrative bioinformatic and high throughput drug screening study to define the role of E2F2 in maintaining genomic integrity in breast cancer. We utilizedin vitroE2F2 ChIP-chip and over expression data to identify transcriptional targets of E2F2. This data was integrated with gene expression from E2F2 knockout tumors in an MMTV-Neu background. Finally, this data was compared to human datasets to identify conserved roles of E2F2 in human breast cancer through the TCGA breast cancer, Cancer Cell Line Encyclopedia, and CancerRx datasets. Here we have computationally predicted that E2F2 transcriptionally regulates key mediators of DNA repair. Our gene expression data supports this hypothesis and low E2F2 activity is associated with a highly unstable tumor. In human breast cancer E2F2, status was also correlated with a patient’s response to PARP inhibition therapy. Taken together this manuscript defines a novel role of E2F2 in cancer progression beyond cell cycle and could be therapeutically relevant.Author SummaryThe E2F family of proteins have been known to regulate cell cycle and have recently been shown to have a number of roles in tumor progression. Here we use a combination of computational techniques and high-throughput drug screening data to establish a novel role of E2F2 in maintaining genomic integrity. We have shown that a number of direct and indirect target genes of E2F2 are involved in multiple classical DNA repair pathways. Importantly, this was shown to be unique to E2F2 and not present with other activator E2Fs like E2F1. We have also shown that E2F2 activity is positively correlated with PARP inhibitor sensitivity regardless of BRCA1/2 status. This is important due to the recent approval of PARP inhibitor therapy in the clinic. Based on our work E2F2 activity could serve as a novel biomarker of response and may identify a new cohort of patients which could benefit from PARPi therapy.