bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency
Authors: Frank-Ito Dennis O. , Carpenter David J. , Cheng Tracy , Avashia Yash J. , Brown David A. , Glener Adam , Allori Alexander , Marcus Jeffrey R. 
Published: May 2019

Background:
Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction relative to other conditions causing NAO. This preliminary study compares differences in NAO experienced by unilateral cleft lip nasal deformity (uCLND) subjects with noncleft subjects experiencing NAO.

Methods:
Computational modeling techniques based on patient-specific computed tomography images were used to quantify the nasal airway anatomy and airflow dynamics in 21 subjects: 5 healthy normal subjects; 8 noncleft NAO subjects; and 8 uCLND subjects. Outcomes reported include Nasal Obstruction Symptom Evaluation (NOSE) scores, cross-sectional area, and nasal resistance.

Results:
uCLND subjects had significantly larger cross-sectional area differences between the left and right nasal cavities at multiple cross sections compared with normal and NAO subjects. Median and interquartile range (IQR) NOSE scores between NAO and uCLND were 75 (IQR = 22.5) and 67.5 (IQR = 30), respectively. Airflow partition difference between both cavities were: median = 9.4%, IQR = 10.9% (normal); median = 31.9%, IQR = 25.0% (NAO); and median = 29.9%, IQR = 44.1% (uCLND). Median nasal resistance difference between left and right nasal cavities were 0.01 pa.s/ml (IQR = 0.03 pa.s/ml) for normal, 0.09 pa.s/ml (IQR = 0.16 pa.s/ml) for NAO and 0.08 pa.s/ml (IQR = 0.25 pa.s/ml) for uCLND subjects.

Conclusions:
uCLND subjects demonstrated significant asymmetry between both sides of the nasal cavity. Furthermore, there exists substantial disproportionality in flow partition difference and resistance difference between cleft and noncleft sides among uCLND subjects, suggesting that both sides may be dysfunctional.
The Effect of a Nurse-Led Cognitive Behavioral Protocol on Depressive Symptoms and Coping Strategies of Dementia Caregivers
Authors: PAN Yuqin , CHEN Ruyi 
Published: May 2019

ABSTRACT

Background
Family caregivers of patients with dementia (PWD) often experience depressive symptoms and use poor coping strategies. Cognitive behavioral interventions may enhance positive appraisals of caregiving-related issues and the utilization of active coping strategies among caregivers, which may help prevent caregiver depression. However, there is a shortage of primary, community-based mental health services in China, and little research has been conducted on the effect of nurse-led mental health programs in this population.

Purpose
This study explored the effect of a nurse-led cognitive behavioral intervention on depressive symptoms and coping strategies among family caregivers of PWD in China.

Methods
This randomized controlled trial used data from a sample of 112 caregivers screened from 276 potential participants in a city in southeastern China. The sample was randomly assigned to an intervention group (n = 56) and a control group (n = 56). The intervention group received five monthly in-home, nurse-led cognitive behavioral sessions and telephone consultations after each session. The control group received five monthly, short, general conversations with nurse interventionists at the participants' homes, in the hospital, or via telephone. Depressive symptoms, coping strategies, and the demographics of caregiving dyads were collected at Time 1 (baseline), Time 2 (the end of the 5-month intervention), and Time 3 (2-month follow-up). IBM SPSS Statistics Version 19.0 was used for data analysis.

Results
Eighty-two participants (intervention group: n = 47, control group: n = 35) completed the three evaluations. No significant group differences were found in baseline characteristics between the two groups. The general linear model repeated-measures analysis of variance indicated a significant difference in depressive symptoms and active coping between groups over time, with p < .001 for the interaction between depressive symptoms and groups and p < .01 for the interaction between active coping and groups. A similar result did not occur for passive coping. The t tests further supported a significant interventional effect on participants' depressive symptoms and active coping.

Conclusions/Implications for Practice
This nurse-led cognitive behavioral intervention was effective in decreasing depressive symptoms and improving active coping among study participants. The findings suggest the improvement of mental health services and social policies in China to support family caregivers of PWD.
Young age and tobacco use are predictors of lower medication adherence in inflammatory bowel disease
Authors: Bruna-Barranco Ignacio , Lué Alberto , Gargallo-Puyuelo Carla J. , Arroyo María T. , Alfambra Erika , Montero Jessica , Gomollón Fernando 
Published: May 2019

Background
Medication adherence is crucial in the management of patients with inflammatory bowel disease (IBD) because medication nonadherence in these patients is associated with an increased risk of flare-up, relapse, recurrence, loss of response to anti-tumour necrosis factor agents, morbidity and mortality, and poor quality of life. Data on risk factors are very controversial in the literature.

Aim
To assess the prevalence of medication nonadherence and to identify predictors of low medication adherence in Spanish patients with IBD.

Patients and methods
We carried out a cross-sectional study that included consecutive outpatients with IBD attending in our adult tertiary clinic in a 3-month period. Morisky 8-Item Medication Adherence Scale questionnaire as well as a survey of sociodemographic data were used.

Results
A total of 181 patients were evaluated. Almost half of the patients (46.4%) had high medication adherence, 30.9% had medium adherence, and 22.7% had low adherence. In relation to predictive factors of medication adherence, multivariate analysis showed that age was associated with high adherence [odds ratio (OR): 1.04; 95% confidence interval (CI): 1.01–1.06; P=0.002]. However, being a smoker and presence of Crohn’s disease were associated with low adherence (OR: 3.47; 95% CI: 1.36–8.90; P<0.01 and OR: 2.54; 95% CI: 1.12–5.79; P<0.05, respectively).

Conclusion
Only half of patients were high medication adherers. Young age, active smoking, and Crohn’s disease seems to be predictors of low medication adherence. On the basis of these data, efforts for reinforce medication adherence should be especially directed to young patients and smokers.
Noninvasive inflammatory markers for assessing liver fibrosis stage in autoimmune hepatitis patients
Authors: Yuan Xiaoling , Duan Sheng-Zhong , Cao Junying , Gao Nan , Xu Jie , Zhang Lanjing 
Published: May 2019

Objective
To examine the accuracy of noninvasive inflammatory markers in predicting liver fibrosis stage in patients with autoimmune hepatitis (AIH).

Patients and methods
We enrolled 55 patients with AIH and 60 healthy controls in this study, and divided them into three groups: F0 (control); F1–F3 (noncirrhotic fibrosis); and F4 (cirrhosis). The following markers were analyzed for all participants: lymphocyte-to-neutrophil ratio (LNR); lymphocyte-to-platelet ratio (LPR); lymphocyte-to-monocyte ratio (LMR); immunoglobulin-to-platelet ratio (IGPR); aminotransferase-to-platelet ratio index (APRI); aspartate aminotransferase-to-alanine aminotransferase ratio (AAR); and fibrosis-4 score (FIB-4). The predictive accuracy of these noninvasive markers was assessed using area under the receiver operating characteristic curve. Multivariate ordinal logistic regression models were used to analyze associations between the noninvasive markers and liver fibrosis stage.

Results
AAR, LPR, LMR, IGPR, APRI, and FIB-4 were linked to liver fibrosis-stage (P < 0.05), with correlation indices of − 0.219, 0.258, − 0.149, 0.647, 0.841, and 0.704, respectively, but not LNR (P = 0.093). area under the receiver operating characteristic curves of LPR, IGPR, AAR, LMR, APRI, and FIB-4 for detecting cirrhosis (F4 vs. F0–F3) were 0.936 (95% confidence interval: 0.870–1.000, P < 0.001), 0.939 (0.875–1.000, P < 0.001), 0.528 (0.319–0.738, P = 0.768), 0.555 (0.409–0.700, P = 0.568), 0.798 (0.694–0.902, P = 0.002), and 0.881 (0.796–0.967, P < 0.001). Our multivariate ordinal regression analysis showed that LPR and IGPR were associated independently with liver fibrosis stage, with a coefficient of 0.385 (95% confidence interval: 0.103–0.667, P = 0.007) and 14.903 (2.091–27.786, P = 0.023), respectively.

Conclusion
LPR and IGPR were associated independently with liver fibrosis stage in treatment-naive AIH, and were superior to APRI and FIB-4 in detecting cirrhosis.
Impact of occupational stress on irritable bowel syndrome pathophysiology and potential management in active duty noncombat Greek military personnel: a multicenter prospective survey
Authors: Papaefthymiou Apostolis , Doulberis Michael , Kountouras Jannis , Kolokytha Christina , Galanopoulos Michail , Liatsos Christos , Kyriakos Nikolaos , Giakoumis Marios , Papadomichelakis Michail , Polyzos Stergios A. , Kotronis Georgios , Katsinelos Panagiotis 
Published: May 2019

Introduction
Irritable bowel syndrome (IBS) is one of the gut–brain axis interaction disorders. It has global distribution with varying prevalence and particular financial and psychological consequences. IBS has been associated with stress and anxiety, conditions that are usually prevalent in the army. There are scarce data investigating the impact of IBS on noncombat active duty military without reports of Greek military or stress in the occupational environment.

Materials and methods
The main exclusion criteria in our noncombat military multicenter prospective survey were gastrointestinal pathologies, malignancies, hematochezia, recent infections and antibiotics prescription, and pregnancy. Questionnaires included a synthesis of baseline information, lifestyle, and diet, psychological and stress-investigating scales and the IBS diagnosis checklist. Hospital Anxiety and Depression Scale and Rome IV criteria were utilized.

Results
Among 1605 participants included finally, the prevalence of IBS was 8% and 131 cases were identified. Women were more vulnerable to IBS, although male sex was prevalent at a ratio of 3.5 : 1 (male:female) in the entire sample. The mean age of all participants was 23.85 years; most of the IBS patients were older than thirty. Abnormal anxiety scores and high levels of occupational stress were related to an IBS diagnosis.

Discussion
This prospective multicenter survey showed, for the first time, the potential impact of occupational stress on IBS in active duty noncombat Greek Military personnel. The diagnosis of IBS by questionnaire is a quick, affordable way that can upgrade, by its management, the quality of life and relieve from the military burden. Our results are comparable with previous studies, although large-scale epidemiological studies are required for the confirmation of a possible causative relationship.
Suprathreshold Motion Perception in Anisometropic Amblyopia: Interocular Speed Matching and the Pulfrich Effect
Authors: Maehara Goro , Araki Syunsuke , Yoneda Tsuyoshi , Thompson Benjamin , Miki Atsushi 
Published: May 2019

SIGNIFICANCE
Our results indicate that the difference in perceived luminance between the amblyopic and fellow eyes that is present under dichoptic viewing conditions does not affect the perceived speed of suprathreshold motion stimuli. This finding provides a new insight into suprathreshold perception in amblyopia.

PURPOSE
Interocular matching experiments indicate that dichoptically presented stimuli have a lower perceived luminance in amblyopic eyes relative to fellow eyes. This may be a consequence of interocular suppression. We investigated whether this effect extends to suprathreshold motion perception.

METHODS
Participants with amblyopia and control observers matched the perceived speed of dichoptically presented random-dot kinematograms and the perceived luminance of gray patches. Control participants also performed the speed matching task with a neutral density filter over one eye to simulate a perceived luminance reduction.

RESULTS
The amblyopia group exhibited lower perceived luminance in the amblyopic than in the fellow eye, as has previously been reported. However, interocular speed matching was veridical. For control observers, perceived speed was reduced in the eye with a neutral density filter relative to the nonfiltered eye. To assess whether the perceived luminance reduction in the amblyopic eye affected binocular function, we also measured the Pulfrich effect in the amblyopia group with equal luminance presented to each eye. No patients reported a spontaneous Pulfrich effect.

CONCLUSIONS
The results suggest that suprathreshold speed perception is intact in the amblyopic eye when both eyes are open.
Clinical Accuracy of the Nidek ARK-1 Autorefractor
Authors: Paudel Nabin , Adhikari Sameep , Thakur Ajit , Shrestha Bhairaja , Loughman James 
Published: May 2019

SIGNIFICANCE
Autorefractors are commonly used by eye care practitioners worldwide as a starting point for clinical prescribing and by researchers as an instrument to study development of refractive errors and accommodation. This study demonstrates that the Nidek ARK-1 provides a reasonable and repeatable estimate of refractive error.

PURPOSE
The purposes of this study were (a) to compare refraction measurements of the Nidek ARK-1 (2016 release) autorefractor with that of subjective refraction and retinoscopy performed by an experienced clinician and (b) to determine the intratest and intertest variability of autorefraction measures taken using the ARK-1 autorefractor.

METHODS
Sixty-seven adult patients aged 18 to 69 years underwent retinoscopy, subjective refraction, and ARK-1 autorefraction on a same day by a single clinician. A separate subset of 14 participants was invited for the repeatability and reproducibility study. Both eyes of each participant were included in the analysis.

RESULTS
A statistically significant (but not clinically significant) positive spherical difference was observed between the ARK-1 and subjective refraction (P = .003). Spherical equivalent refractive errors were statistically similar between the ARK-1 and subjective refraction (P = .20). A statistically and clinically significant difference was observed in the cylindrical component between the ARK and subjective refraction (P < .01). No statistically significant difference was observed between the ARK and subjective refraction in both the horizontal (J
0; P = .08) and oblique cylindrical vector (J
45; P = .96). Bland-Altman analysis revealed that the 95% limits of agreement were widest between the ARK and subjective refraction in all of the refractive components (−0.60 to 0.89 diopter for spherical component, −0.80 to 0.69 diopter for spherical equivalent, and −0.98 to 0.30 diopter for cylindrical component). The intertest and intratest variability of the ARK-1 was small.

CONCLUSIONS
The Nidek ARK-1 autorefractor is a useful clinical tool that provides a reasonable and repeatable estimation of refractive error in adults.
Impact of Septated First Dorsal Compartments on Symptomatic de Quervain Disease
Authors: Bernstein Derek T. , Gonzalez Mirtha A. , Hendrick Russell G. , Petersen Nancy J. , Nolla Jose M. , Netscher David T. 
Published: May 2019

Background:
The authors conducted this study to determine whether septation of the first dorsal compartment is more prevalent in de Quervain tenosynovitis, and whether this contributes to failure of corticosteroid injection therapy.

Methods:
A retrospective review of 79 consecutive patients (85 wrists) with symptomatic de Quervain tenosynovitis treated with surgical release was performed. The number of corticosteroid injections performed preoperatively and the presence of first dorsal compartment septation determined intraoperatively were recorded. Correlation between the number of steroid injections and the presence of septation was evaluated. In addition, 48 matched cadaver upper extremities (96 wrists) that had not previously undergone surgery for de Quervain disease were evaluated for the presence of first dorsal compartment septation. The prevalence of septation was compared between matched wrists and against the surgically treated clinical cohort.

Results:
In the clinical cohort, 61.2 percent of wrists contained a septated first dorsal compartment. There was no correlation between the presence of a septated first dorsal compartment and the number of steroid injections before surgical release. In the cadaver portion of the study, 72.9 percent of wrists contained septa. There was no significant difference in the prevalence of septated first dorsal compartments between groups.

Conclusions:
In the present study, the majority of wrists contained a septated first dorsal compartment, with no difference in the prevalence of septa between surgically treated patients and a cadaver sample that had not undergone prior surgical release. Furthermore, there was no correlation between the presence of septa and the number of preoperative corticosteroid injections administered.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Regeneration of a Pediatric Alveolar Cleft Model Using Three-Dimensionally Printed Bioceramic Scaffolds and Osteogenic Agents: Comparison of Dipyridamole and rhBMP-2
Authors: Lopez Christopher D. , Coelho Paulo G. , Witek Lukasz , Torroni Andrea , Greenberg Michael I. , Cuadrado Dean L. , Guarino Audrey M. , Bekisz Jonathan M. , Cronstein Bruce N. , Flores Roberto L. 
Published: May 2019

Background:
Alveolar clefts are traditionally treated with secondary bone grafting, but this is associated with morbidity and graft resorption. Although recombinant human bone morphogenetic protein-2 (rhBMP-2) is under investigation for alveolar cleft repair, safety concerns remain. Dipyridamole is an adenosine receptor indirect agonist with known osteogenic potential. This study compared dipyridamole to rhBMP-2 at alveolar cleft defects delivered using bioceramic scaffolds.

Methods:
Skeletally immature New Zealand White rabbits underwent unilateral, 3.5 × 3.5-mm alveolar resection adjacent to the growing suture. Five served as negative controls. The remaining defects were reconstructed with three-dimensionally printed bioceramic scaffolds coated with 1000 μm of dipyridamole (n = 6), 10,000 μm of dipyridamole (n = 7), or 0.2 mg/ml of rhBMP-2 (n = 5). At 8 weeks, new bone was quantified. Nondecalcified histologic evaluation was performed, and new bone was evaluated mechanically. Statistical analysis was performed using a generalized linear mixed model and the Wilcoxon rank sum test.

Results:
Negative controls did not heal, whereas new bone formation bridged all three-dimensionally printed bioceramic treatment groups. The 1000-μm dipyridamole scaffolds regenerated 28.03 ± 7.38 percent, 10,000-μm dipyridamole scaffolds regenerated 36.18 ± 6.83 percent (1000 μm versus 10,000 μm dipyridamole; p = 0.104), and rhBMP-2–coated scaffolds regenerated 37.17 ± 16.69 percent bone (p = 0.124 versus 1000 μm dipyridamole, and p = 0.938 versus 10,000 μm dipyridamole). On histology/electron microscopy, no changes in suture biology were evident for dipyridamole, whereas rhBMP-2 demonstrated early signs of suture fusion. Healing was highly cellular and vascularized across all groups. No statistical differences in mechanical properties were observed between either dipyridamole or rhBMP-2 compared with native bone.

Conclusion:
Dipyridamole generates new bone without osteolysis and early suture fusion associated with rhBMP-2 in skeletally immature bone defects.
64CuCl2 PET/CT in a Hyperfunctioning Parathyroid Gland
Authors: Evangelista Laura , Trevisan Michele , Sepulcri Matteo 
Published: May 2019

Abstract
We report a case of incidental 64CuCl2 uptake at PET/CT imaging in a 61-year-old man with a biochemical recurrence of prostate cancer. Parathyroid hormone was slightly elevated (92.4 pg/mL; reference range, 18.4–80.1 pg/mL); serum calcium was in reference range (9.5 mg/dL; reference range, 8.6–10.6 mg/dL), whereas serum phosphate was slightly low (2.6 mg/dL; reference range, 2.7–4.5 mg/dL). This case highlights the ability of 64CuCl2, similar to radiolabeled choline, to identify the presence of hyperfunctioning parathyroid glands in patients undergoing PET/CT examination.
Metastatic Extramammary Paget Disease of the Perianal Region
Authors: Mandava Anitha , Koppula Veeraiah , Yalamanchili Rohit , Ali Zakir 
Published: May 2019

Abstract
A 72-year-old man with history of itching for 8 months presented with an ill-defined, ulcerated, eczematous, thickened cutaneous lesion in the left perianal region. 18F-FDG PET/CT was performed, and neoplastic skin thickening with FDG uptake was seen at the left gluteal cleft. Hypermetabolic inguinal, retroperitoneal, and mediastinal lymph nodes, liver, and bone metastases were seen. Histopathology and immunohistochemistry of the perianal growth and left inguinal lymph node were positive for cytokeratin7 and gross cystic disease fluid protein and negative for cytokeratin 20 and CDX2, confirming the diagnosis of primary extramammary Paget disease with metastases.
18F-NaF Uptake in Calcified Uterine Leiomyoma
Authors: Kothekar Esha , Raynor William Y. , Werner Thomas J. , Alavi Abass , Baker Joshua F. 
Published: May 2019

Abstract
Uterine leiomyomas (fibroids) represent the most common benign pelvic tumors in women as well as the leading indication for hysterectomies in the United States. Risk factors for the development of fibroids include increasing age, hormonal changes, genetics, and race, among others. The lifetime risk of developing fibroids is greater than 80% among African American women, who also have the more severe form of this condition. We are presenting a case of incidental 18F-NaF uptake in the calcified uterine leiomyoma of a 52-year-old African American woman.
Focal Peritoneal Mesothelioma Demonstrated on FDG PET/CT
Authors: Xiao Jie , Yin Hongyan , Cheng Dengfeng , Shi Hongcheng , Xiu Yan 
Published: May 2019

Abstract
A 48-year-old woman was experiencing abdominal pain and melena for 3 months. Because of these symptoms combined with increased level of tumor marker CA125, possible abdominal malignancy was considered, and an FDG PET/CT was performed to assess occult tumor. The images revealed multiple hypermetabolic lesions along the peritoneal surface. Pathological examination after biopsy demonstrated low-grade epithelioid peritoneal mesothelioma.