bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of a Venous Catheter as a Stent for Treatment of Acquired Punctal and Canalicular Stenosis
Authors: Meduri Alessandro , Inferrera Leandro , Tumminello Giuseppe , Frisina Rino , Forlini Matteo , Kaufman Stephen , Aragona Pasquale 
Published: July 2019

Purpose:
The aim of this study was to describe a simple technique to insert a venous catheter as a stent for the treatment of acquired punctal and canalicular stenosis.

Methods:
We performed this technique using a central venous catheter as a stent for the treatment of acquired punctal and canalicular stenosis.

Results:
The results show the easy availability of the material used for the intervention, its easy execution, and the low costs of materials. The goal of this technique is to have a lacrimal dot dilated and canalicular duct easy to irrigate.

Conclusion:
The use of a venous catheter as a stent for treatment of acquired punctal and canalicular stenosis seems to be simple, safe, repeatable, and noninvasive.
Computerized Tomography Radiomics Features Analysis for Evaluation of Perihematomal Edema in Basal Ganglia Hemorrhage
Authors: Yao Xiang , Liao Lishang , Han Yuxiao , Wei Ting , Wu Hai , Wang Yiying , Li Yanfei , Zhang Xinyuan , Ren Ke 
Published: July 2019

Abstract
To evaluate the edema area around basal ganglia hemorrhage by the application of computerized tomography (CT)-based radiomics as a prognostic factor and improve the diagnosis efficacy, a total of 120 patients with basal ganglia hemorrhage were analyzed retrospectively. The texture analysis software Mazda 3.3 was used to preprocess the CT images and manually sketch the region of interest to extract the texture features. The extracted texture features were selected by Fisher coefficient, POE+ACC and mutual information. The texture discriminant analysis uses the B11 module in the Mazda 3.3 software. The data were randomly divided into a training dataset (67%) and test dataset (33%). To further study the texture features, the training dataset can be divided into groups according to the median of GCS score, NIHSS score, and maximum diameter of hematoma. Random forest model, support vector machine model, and neural network model were built. AUC of the receiver operating characteristics curve was used to assess the performance of models with test dataset. Among all texture post-processing methods, the lowest error rate was 2.22% for the POE+ACC/nonlinear discriminant. For the maximum diameter of hematoma, GCS score, and NIHSS score group, the lowest error rate were 26.66%, 23.33%, and 30.00%, respectively. The values of AUCs were 0.87, 0.81, and 0.76, for random forest model, support vector machine model, and neural network model in the test dataset, respectively. Radiomic method with proper model may have a potential role in predicting the edema area around basal ganglia hemorrhage. It can be used as a secondary group in the diagnosis of edema area around basal ganglia hemorrhage.
Comparison of Three-Dimensional Surface Imaging Systems Using Landmark Analysis
Authors: Liberton Denise K. , Mishra Rashmi , Beach Margaret , Raznahan Armin , Gahl William A. , Manoli Irini , Lee Janice S. 
Published: July 2019

AbstractNumerous 3d imaging systems are now available commercially for the capture of facial shape data via landmarking or surface shape comparisons but it is not known whether these systems produce data of comparable quality. This study investigates the error associated with landmark coordinate data collected on facial surface images taken using three 3d imaging systems: the 3dMDface system (3dMD, Atlanta, GA), the Planmeca ProFace system (Planmeca, Roselle, IL), and the Vectra H1 handheld system (Canfield Scientific, Parsippany, NJ). This was a retrospective study involving 3d imaging data that used geometric morphometric analysis to assess overall shape differences as well as landmark-specific differences among the systems. Ten individuals evaluated at the NIDCR dental clinic on various protocols were imaged on all 3 systems. The subject pool consisted of syndromic and unaffected subjects, as disease status was irrelevant to the question of reproducibility and variability. Variation in landmark placement across systems was assessed by ANOVA, covariance matrix, and summary statistics. No overall shape or size differences were found among the systems. However, there was some landmark-specific variation and the 3dMD and Vectra systems were generally more similar to each other than either was to the Planmeca system. The data acquired by these 3 systems are comparable, although landmarks on the eyes and ears are noisy and most different among systems.
Olfactory Fossa and New Angle Measurements: Lateral Lamella-Cribriform Plate Angle
Authors: Asal Neşe , Bayar Muluk Nuray , Inal Mikail , Şahan Mehmet Hamdi , Doğan Adil , Arikan Osman Kürşat 
Published: July 2019

Objectives:
The authors investigated the olfactory fossa (OF) in patients with unilateral nasal septal deviation (NSD) and presented the lateral lamella-cribriform plate angle (LLCPA).

Methods:
Paranasal sinus computed tomography images of 300 adult subjects with unilateral NSD (111 males, 189 females) were evaluated retrospectively. Septal deviation angle (SDA), Keros Classification, OF depth and width, LLCPA; and orbital plate and cribriform plate (OPCP) distance were measured.

Results:
The OF depth values (ipsilateral, contralateral) were found as Keros III >Keros II >Keros I (P
adjusted <0.0175). The OF width values (ipsilateral) were detected as Keros I >Keros II and Keros I >Keros III (P
adjusted <0.0175). In patients with higher SDA values, ipsilateral OF depth values decreased (P <0.05). The LLCPA and OPCP values were higher in Keros I and lower in Keros III (P <0.05).

Conclusion:
In patients with lower LLCPA and OPCP, endoscopic sinus surgery will be more dangerous for trauma to lateral lamella and intracranial penetration.
Safety and Feasibility of Laparoscopic Pelvic Exenteration for Locally Advanced or Recurrent Colorectal Cancer
Authors: Ichihara Momoko , Uemura Mamoru , Ikeda Masataka , Miyake Masakazu , Kato Takeshi , Hamakawa Takuya , Maeda Sakae , Hama Naoki , Nishikawa Kazuhiro , Miyamoto Atsushi , Miyazaki Michihiko , Hirao Motohiro , Sekimoto Mitsugu 
Published: July 2019

Purpose:
Pelvic exenteration (PE) for locally advanced or recurrent colorectal cancer is often used to secure negative resection margins. The aim of this study was to evaluate the feasibility of laparoscopic PE.

Materials and Methods:
The clinical records of 24 patients (9, open; 15, laparoscopic) who underwent total or posterior PE for locally advanced or recurrent colorectal cancer between July 2012 and April 2016 at Osaka National Hospital were retrospectively reviewed. Operative factors were compared between the 2 groups.

Results:
The R0 resection rate was 100% in the laparoscopic group and 89% in the open group. The operative time and the incidence of postoperative complications were not significantly different between the 2 groups. The laparoscopic group showed less intraoperative blood loss (P=0.019), a lower C-reactive protein elevation on postoperative day 7 (P=0.025), and a shorter postoperative hospital stay (P=0.0009).

Conclusions:
Laparoscopic PE is a safe and feasible procedure to reduce postoperative stress.
Moving On: How Many Women Opt for Surgery After Pessary Use for Prolapse?
Authors: Patnam Radhika , Sripad Abhishek A. , Dengler Erin , Geller Elizabeth J. , Wu Jennifer M. 
Published: July 2019

Objective
Our primary objective was to evaluate the proportion of women who underwent surgery after successful pessary fitting for pelvic organ prolapse (POP). Our secondary objectives were to assess when surgery occurs and to evaluate factors associated with choosing surgery as compared to continuing with a pessary.

Methods
Our study population included women successfully fitted with a pessary for POP 1/1/12 and 12/31/16. We excluded non–English-speaking women and those who used pessary only as a bridge until surgery. We evaluated events occurring after a successful fitting, including whether women (1) continued pessary use, (2) underwent surgery, or (3) discontinued pessary without surgery. Our primary outcome was the proportion of women who opted for surgery after a successful pessary fitting for POP. We also assessed the median time to surgery and compared women who underwent surgery with those who continued with a pessary to assess variables associated with surgery.

Results
Of the 444 women with POP who were successfully fitted with a pessary and met inclusion criteria, 137 (31%) ultimately underwent surgery. The median time to surgery was 10 months (interquartile range, 4–18), with 59% having surgery within 1 year, and 89% within 2 years. In a logistic regression analysis controlling for age in decades, advanced POP stage, and Charlson Comorbidity Index, younger age remained significantly associated with surgery (odds ratio, 0.77, 95% confidence interval, 0.62–0.95; P = 0.02).

Conclusions
Among women successfully fitted with a pessary for POP, one third ultimately underwent surgery, with approximately 60% of these women undergoing surgery within the first year and 90% within 2 years.
Antimotility agents for the treatment of acute noninfectious diarrhea in critically ill patients: A practice management guideline from the Eastern Association for the Surgery of Trauma
Authors: Bugaev Nikolay , Bhattacharya Bishwajit , Chiu William C. , Como John J. , Cripps Michael W. , Ferrada Paula , Gelbard Rondi B. , Gondek Stephen , Kasotakis George , Kim Dennis , Mentzer Caleb , Robinson Bryce R. H. , Salcedo Edgardo S. , Yeh D. Dante 
Published: July 2019

BACKGROUND
Acute noninfectious diarrhea is a common phenomenon in intensive care unit patients. Multiple treatments are suggested but the most effective management is unknown. A working group of the Eastern Association for the Surgery of Trauma, aimed to evaluate the effectiveness of loperamide, diphenoxylate/atropine, and elemental diet on acute noninfectious diarrhea in critically ill adults and to develop recommendations applicable to daily clinical practice.

METHODS
The literature search identified 11 randomized controlled trials (RCT) appropriate for inclusion. The Grading of Recommendations Assessment, Development, and Evaluation methodology was applied to evaluate the effect of loperamide, diphenoxylate/atropine, and elemental diet on the resolution of noninfectious diarrhea in critically ill adults based on selected outcomes: improvement in clinical diarrhea, fecal frequency, time to the diarrhea resolution, and hospital length of stay.

RESULTS
The level of evidence was assessed as very low. Analyses of 10 RCTs showed that loperamide facilitates resolution of diarrhea. Diphenoxylate/atropine was evaluated in three RCTs and was as effective as loperamide and more effective than placebo. No studies evaluating elemental diet as an intervention in patients with diarrhea were found.

CONCLUSION
Loperamide and diphenoxylate/atropine are conditionally recommended to be used in critically ill patients with acute noninfectious diarrhea.

LEVEL OF EVIDENCE
Systematic Review/Guidelines, level III.
The Effects of an IL-21 Receptor Antagonist on the Alloimmune Response in a Humanized Mouse Skin Transplant Model
Authors: de Leur Kitty , Luk Franka , van den Bosch Thierry P.P. , Dieterich Marjolein , van der Laan Luc J.W. , Hendriks Rudi W. , Clahsen-van Groningen Marian C. , Issa Fadi , Baan Carla C. , Hoogduijn Martin J. 
Published: July 2019

Background.
Interleukin 21 (IL-21) is involved in regulating the expansion and effector function of a broad range of leukocytes, including T cells and B cells. In transplantation, the exact role of IL-21 in the process of allograft rejection is unknown. To further explore this, the aim of this study is to test the effect of an IL-21 receptor (IL-21R) blocking antibody on the early phase of allograft rejection in a humanized skin transplantation model in mice reconstituted with human T and B cells.

Methods.
Immunodeficient Balb/c IL2rγ−/−Rag2−/− mice were transplanted with human skin followed by adoptive transfer of human allogeneic splenocytes. Control animals were treated with a phosphate buffered saline vehicle while the other group was treated with a humanized anti-IL-21R antibody (αIL-21R).

Results.
In the phosphate buffered saline-treated animals, human skin allografts were infiltrated with lymphocytes and developed a thickened epidermis with increased expression of the inflammatory markers Keratin 17 (Ker17) and Ki67. In mice treated with αIL-21R, these signs of allograft reactivity were significantly reduced. Concordantly, STAT3 phosphorylation was inhibited in this group. Of note, treatment with αIL-21R attenuated the process of T and B cell reconstitution after adoptive cellular transfer.

Conclusions.
These findings demonstrate that blockade of IL-21 signaling can delay allograft rejection in a humanized skin transplantation model.
Education Strategies in Dialysis Centers Associated With Increased Transplant Wait-listing Rates
Authors: Waterman Amy D. , Peipert John D. , Xiao Huiling , Goalby Christina J. , Kawakita Satoru , Cui Yujie , Lentine Krista L. 
Published: July 2019

Background.
Transplant education in dialysis centers can increase access to kidney transplant; however, dialysis center transplant barriers are common, and limited research identifies the most effective transplant education approaches.

Methods.
We surveyed transplant educators in 1694 US dialysis centers about their transplant knowledge, use of 12 education practices, and 8 identified education barriers. Transplant wait-listing rates were calculated using US Renal Data System data.

Results.
Fifty-two percent of educators orally recommended transplant to patients, 31% had in-center transplant discussions with patients, 17% distributed print educational resources, and 3% used intensive education approaches. Distribution of print education (incident rate ratio: 1.021.151.30) and using >1 intensive education practice (1.001.111.23) within dialysis centers were associated with increased wait-listing rates. Several dialysis center characteristics were associated with reduced odds of using education strategies leading to increased wait-listing. Centers with greater percentages of uninsured patients (odds ratio [OR]: 0.960.970.99), in rural locations (OR: 0.660.790.95), with for-profit ownership (OR: 0.640.770.91), and with more patients older than 65 years (OR: 0.050.110.23) had lower odds of recommending transplant, while centers with a higher patient-to-staff ratio were more likely to do so (OR: 1.011.031.04). Language barriers (OR: 0.480.640.86) and having competing work priorities (OR: 0.400.530.70) reduced the odds of distributing print education. Providers with greater transplant knowledge were more likely to use >1 intensive educational strategy (OR: 1.011.271.60) while providers who reported competing work priorities (OR: 0.510.660.84) and poor communication with transplant centers (OR: 0.580.760.98) were less likely to do so.

Conclusions.
Educators should prioritize transplant education strategies shown to be associated with increasing wait-listing rates.
Is Preoperative Preparation Time a Barrier to Small Children Being Ready for Kidney Transplantation?
Authors: Feltran Luciana S. , Cunha Miriam F.M. , Perentel Simone M.R. de Melo , Hamamoto Fernando , Camargo Maria Fernanda C. , Komi Shirlei , Leão Jovelino Q.S. , Koch-Nogueira Paulo Cesar 
Published: July 2019

Background.
Small children are less frequently transplanted when compared with older. The objective of the present study was to compare the preparation time for transplantation in children of different weights and to identify factors associated with a delay in the workup of small children.

Methods.
We report on a retrospective cohort comprising all children referred for renal transplantation (RTx) workup between 2009 and 2017. The main outcome was transplantation workup time, defined as the time elapsed between the first consultation and when the child became ready for the surgery.

Results.
A total of 389 children (63.5% males) were selected, with a median weight of 18 kg (interquartile range, 11–32). Patients were categorized into 2 groups: group A (study group): ≤15 kg (n = 165) and group B (control group): >15 kg (n = 224). The probability of being ready for RTx was comparable between groups A and B. The cumulative incidence rate difference between groups is −0.05 (95% confidence interval, −0.03 to 0.02). The median time for RTx workup was 5.4 (2.4–9.4) in group A and 4.3 (2.2–9.0) months in group B (P = 0.451). Moreover, the presence of urinary tract malformation was associated with the need for longer transplantation workup time (P < 0.001).

Conclusions.
In children >7 kg, the workup time for transplantation is not related to body weight. In a specialized center, children weighing 7–15 kg became ready within the same timeframe as children weighing >15 kg, despite the smaller children had greater difficulty being nourished, dialyzed, and a greater need for surgical correction of the urinary tract pretransplant.
Association Between Living Kidney Donor Postdonation Hypertension and Recipient Graft Failure
Authors: Holscher Courtenay M. , Ishaque Tanveen , Haugen Christine E. , Jackson Kyle R. , Garonzik Wang Jacqueline M. , Yu Yifan , Al Ammary Fawaz , Segev Dorry L. , Massie Allan B. 
Published: July 2019

Background.
Recipients of kidneys from living donors who subsequently develop end-stage renal disease (ESRD) also have higher graft failure, suggesting the 2 donor kidneys share risk factors that could inform recipient outcomes. Given that donor ESRD is rare, an earlier and more common postdonation outcome could serve as a surrogate to individualize counseling and management for recipients. Hypertension is a frequent event before donor ESRD; thus, early postdonation hypertension might indicate higher risk of graft failure.

Methods.
We studied Scientific Registry of Transplant Recipients data to quantify the association between early postdonation hypertension and recipient graft failure using propensity score-weighted Cox proportional hazards regression. We also examined the association between postdonation systolic blood pressure and graft failure.

Results.
Of 37 901 recipients, 2.4% had a donor who developed hypertension within 2 years postdonation. Controlling for donor and recipient characteristics, recipients whose donors developed hypertension had no higher risk for graft failure (adjusted hazard ratio [aHR] 1.03, 95% confidence interval [CI] 0.85-1.25, P = 0.72). This was consistent among subgroups of recipients at higher risk for adverse outcomes due to hyperfiltration: African American recipients (aHR 1.10, 95% CI 0.70-1.73, P = 0.68) and those with ESRD caused by hypertension (aHR 1.10, 95% CI 0.65-1.85, P = 0.73) or diabetes (aHR 0.80, 95% CI 0.56-1.13, P = 0.20). However, graft failure was associated with postdonation systolic blood pressure (per 10 mm Hg, aHR 1.05, 95% CI 1.03-1.08, P < 0.001).

Conclusions.
Although postdonation systolic blood pressure is associated with graft failure, the reported diagnosis of hypertension as determined by the requirement for blood pressure treatment early postdonation did not portend a higher risk of recipient graft failure in the same way as eventual postdonation ESRD.
Oligonucleotide-based Preconditioning of DCD Cardiac Donors and Its Impact on Cardiac Viability
Authors: Kearns Mark J. , Miller Sally D. , Kong Hyejin J. , Sirounis Demetrios , Cheung Anson , Bashir Jamil , Seidman Michael A. , Boyd John H. 
Published: July 2019

Background.
While clinical donation after circulatory death (DCD) cardiac transplantation is being implemented with increasing frequency to address the supply/demand mismatch of donor grafts, no research to date has examined a strategy of donor preconditioning to optimize the viability of DCD hearts for transplantation. In our rat model of the DCD protocol, we investigate the impact of pretreating donors with phosphorothioate-linked cytosine and guanine rich oligodeoxynucleotides (CpG ODN) and their effects on cardiac function, injury, and a novel left ventricular (LV) mRNA biomarker panel.

Methods.
DCD rats were subjected to a withdrawal protocol, followed by 20 minutes of warm acirculatory standoff, representing a group of severely injured hearts as previously demonstrated. Beating heart controls and DCD rats were pretreated with vehicle or stimulatory CpG ODN (beating heart control and DCD stimulated with CpG ODN, BST and DST). Hearts were harvested for ex situ heart perfusion (ESHP), where LV function, histochemical injury, and differences in gene expression were characterized between groups.

Results.
Donor pretreatment with CpG ODN doubled the number of functional DCD hearts at ESHP. Pretreatment was associated with improved systolic and diastolic LV function, a reduction in histological injury, and markedly reduced elaboration of cardiac troponin-I in coronary effluent during ESHP. Pretreatment was also associated with a reduction in mRNA biomarkers associated with myocardial injury.

Conclusions.
A single dose of CpG ODN was associated with reduced biomarkers of cardiac injury and a 100% increase in cardiac viability in this rodent model of marginal DCD cardiac donation.
Geographic Disparities in Access to Simultaneous Pancreas and Kidney Transplant in the Pre- and Post-Pancreas Allocation System Eras
Authors: Concepcion Beatrice P. , Feurer Irene D. , Rega Scott A. , Niederhaus Silke , Odorico Jon , Forbes Rachel C. 
Published: July 2019

Background.
The 2014 pancreas allocation system (PAS) intended to decrease geographic variability in listing practices for simultaneous pancreas and kidney (SPK) transplant and define eligibility criteria for those with type 2 diabetes mellitus (T2DM). Our primary aims were to evaluate geographic disparities in access to SPK and assess T2DM SPK listings in the pre- and post-PAS eras.

Methods.
Adult listings for SPK and kidney transplant (pre-PAS, January 2010 to October 29, 2014; post-PAS, October 30, 2014, to June 2, 2017) were identified in the Scientific Registry of Transplant Recipients. Multivariable logistic regression models tested associations of geography and/or diabetes mellitus type on the likelihood of SPK versus kidney transplant listing pre- and post-PAS. Competing risk models tested the likelihood of SPK transplantation within 2 years of listing for SPK.

Results.
Among 41 205 listings (27 393 pre-PAS; 24 439 T2DM), univariate analysis showed reduced percentages for SPK post-PAS (22.1%–20.8%; P = 0.003). After adjusting for patient and center characteristics, geographic disparities declined slightly but persisted post-PAS (era by region interaction P < 0.001). The era by type of diabetes mellitus interaction effect was statistically significant (P = 0.039), reflecting that the proportions of SPK listings for T2DM increased in the post-PAS era (3.4%–3.9%; univariate P = 0.038), while those for type 1 diabetes mellitus remained statistically stable (47.9%–48.4%; univariate P = 0.571). Among people listed for SPK, geographic disparities in the cumulative incidence of transplantation within 2 years declined and the overall likelihood of transplantation increased in the post-PAS era (both P < 0.001).

Conclusions.
Geographic disparities in access to SPK declined slightly but persisted post-PAS. With new allocation change proposals and elimination of listing criteria for T2DM, further monitoring is warranted.