bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Incision Size on Dry Eye Symptoms in the Small Incision Lenticule Extraction Procedure
Authors: Cetinkaya Servet , Gulmez Mehmet , Mestan Emine , Ucar Fikret , Ali Nermin 
Published: October 2018

Purpose:
To evaluate the influence of incision size on dry eye symptoms in the small incision lenticule extraction (SMILE) procedure.

Methods:
Ninety-four eyes of 47 patients with myopia and/or myopic astigmatism who had undergone the SMILE procedure were enrolled in this study. The patients were divided into 3 groups according to the incision size (2, 3, and 4 mm) applied during the SMILE procedure.

Results:
There were no significant differences among the groups in respect to age and sex (P values 0.251 and 0.974, respectively) and in respect to preoperative, postoperative first day, first week, first month, third month, and sixth month values of the Ocular Surface Disease Index score, tear break-up time, ST1, and staining grades.

Conclusions:
There was no difference in dry eye symptoms with 2-, 3-, and 4-mm incisions. In the learning period of SMILE surgery, larger incision sites can be used to make the procedure easier.
Two Femtosecond Laser LASIK Platforms: Comparison of Evolution of Visual Acuity, Flap Thickness, and Stromal Optical Density
Authors: Parafita-Fernández Alberto , García-Gonzalez Montserrat , Katsanos Andreas , Gros-Otero Juan , Teus Miguel 
Published: October 2018

Purpose:
To compare postoperative evolution of visual acuity, flap thickness, and stromal optical density during the first 3 months after femtosecond (FS) laser in situ keratomileusis surgery for correction of myopia using the iFS 150-kHz FS laser and LenSx FS laser platforms.

Methods:
This was a prospective case series. Thirty-nine eyes treated with the iFS 150-kHz FS laser versus 38 refraction-matched eyes treated with the LenSx FS laser platform were included. Visual outcomes, flap morphology, and optical density of the stroma (in both flap and residual stromal bed) were compared at 4 visits during a three-month follow-up period.

Results:
No significant differences were found in uncorrected distance visual acuity in any of the follow-up visits (1 day −0.02 vs. −0.03; 1 week −0.04 vs. −0.03; 1 month −0.04 vs. −0.04; 3 months −0.03 vs. −0.05 logarithm of the minimum angle of resolution). Flaps created with the iFS 150-kHz FS laser were closer to the intended thickness (110 μm) in every postoperative comparison (1 day 108.6 vs. 124.3; 1 week 107.6 vs. 123.6; 1 month 110.4 vs. 126.8; 3 months 116.2 vs. 126.5 μm; P < 0.0001). Dispersion of values, standard deviation, intraflap range, and differences in symmetric points were lower in the iFS 150-kHz FS laser group. Flap stromal optical density was significantly higher in the LenSx FS laser group at day 1 and week 1 (134.5 vs. 158.9 gray scale unit [GSU]; P < 0.0001 and 144.8 vs. 160.1 GSU; P = 0.011, respectively). Residual stromal bed optical density was higher in the LenSx FS laser group at all postoperative visits, and the differences reached significance at 1 week postoperatively (121.9 vs. 135.4 GSU; P = 0.03).

Conclusions:
Although both devices provided satisfactory visual outcomes, significant differences were detected in flap parameters. Flaps made with the iFS 150-kHz FS laser were thinner, more uniform, transparent, and accurate compared with those obtained with the LenSx FS laser.
Individualized Family-Centered Developmental Care
Authors: Lisanti Amy Jo , Vittner Dorothy , Medoff-Cooper Barbara , Fogel Jennifer , Wernovsky Gil , Butler Samantha 
Published: October 2018

Background
Infants born with critical congenital heart disease (cCHD) who require surgical intervention in the newborn period are often hospitalized in a cardiac intensive care unit (CICU). Cardiac surgery and the CICU environment are traumatic to infants and their families. Infants are exposed to overwhelming stress, which can result in increased pain, physiologic instability, behavioral disorganization, disrupted attachment, and altered brain development. Individualized Family-centered Developmental Care (IFDC) is a model that can address the unique needs and developmental challenges of infants with cCHD.

Purpose
The purpose of this article is to (1) clearly describe the uniqueness of the infant with cCHD, including the medical, neurological, and parental challenges, and (2) propose methods to apply IFDC to support recovery of infants with cCHD in the CICU.

Conclusions
The experiences in the CICU shape the developing brain and alter recovery and healing, thus adversely impacting development. Individualized Family-centered Developmental Care is a promising model of care that nurses can integrate into the CICU to promote neuroprotection and development. Nurses can effectively integrate IFDC into the CICU by understanding the unique characteristics of infants with cCHD and applying IFDC interventions that include both maturity and recovery perspectives.

Clinical Implications
The incorporation of IFDC interventions is essential for the infant with cCHD and should be a standard of care. Applying IFDC with a recovery perspective in all aspects of caregiving will provide opportunities for individualization of care and parent engagement, allowing infants in the CICU to recover from surgery while supporting both short- and long-term neurodevelopment.
Cochlear Implant Insertion Depth Prediction: A Temporal Bone Accuracy Study
Authors: Anschuetz Lukas , Weder Stefan , Mantokoudis Georgios , Kompis Martin , Caversaccio Marco , Wimmer Wilhelm 
Published: October 2018

Hypothesis:
The aim of this study was to present and validate the accuracy of a method to predict the required cochlear implant (CI) electrode array length for a specific angular insertion depth (AID).

Background:
The human cochlea exhibits remarkable interindividual morphological differences. The prediction of the required array length for a specific AID can help to improve the outcome of cochlear implant surgery.

Methods:
We estimated the linear insertion depth required for an angular insertion of 540 degrees using computed tomography images of 16 temporal bone specimens (eight Thiel fixed, eight formalin fixed). Free fitting electrode arrays were marked accordingly and inserted through a custom-made insertion guide tube. The achieved AIDs were assessed using postoperative micro-computed tomography scans.

Results:
In the Thiel specimens, the difference between the aimed depth of 540 degrees and achieved insertion depth was small (average 529 degrees, p = 0.076), with a mean prediction error of –11 degrees (maximum 30 degrees), indicating a small underestimation. By contrast, we observed early resistance during the insertions in the formalin specimens (average 409 degrees, p < 0.0001), resulting in a mean error of −131 degrees and bending of the electrode array in the cochlear basal turn in four of eight specimens.

Conclusion:
The equation presented in this study for calculating linear insertion depths can be helpful for the selection of adequate electrode array lengths in a clinical setting. The Thiel conservation is a highly suitable model for cadaveric electrode insertion studies. A free online calculator is available at http://www.hno.insel.ch/de/forschung/ci_estimator/.
A case report of a polytrauma patient with penetrating iron rods in thorax and head
Authors: Tang Xinpu , Chen Hongxu , Chen Chaoyue , Xu Jianguo 
Published: October 2018

Abstract

Introduction:
Impalement injury is an uncommon presentation, and penetrating chest injuries account for 1% to 13% of thoracic trauma hospital admissions. The vast majority of patients with penetrating thoracic trauma who survive to reach the hospital alive can be managed nonoperatively. Nevertheless, in 10% to 15% of cases, emergency operation is necessary due to the associated hemorrhagic shock and visceral injury.

Case presentation:
Here, we report on a 39-year-old male, a construction worker, who fell down from a height of a construction site, landing ventrally on a clump of iron rods with 4 projecting heavy metallic rods penetrating into his thorax and head (scalp pierced only). Emergency surgery was taken, and the patient had an uneventful successful outcome.

Conclusions:
After massive thoracic impalement, rapid transportation to a tertiary trauma center with the impaled objects in situ can improve the outcome. Video-assisted thoracic surgery (VATS) is recommended to remove the foreign body under direct vision and to reduce the incidence of missed, potentially fatal vascular or visceral injuries.
A 5-year follow-up of primary seminal vesicle adenocarcinoma
Authors: Yin Tiejun , Jiang Yueqiang 
Published: October 2018

Abstract

Rationale:
Primary seminal vesicle adenocarcinoma (PSVA) is an extremely rare malignancy that should be carefully differentiated from cancer originating in the prostate, colon or bladder. Without standard guidelines, radical resection is considered a mainstay treatment, providing the best prognosis. However, as manifestations of PSVA are not detected in early stages, the majority of cases of PSVA are diagnosed at late stages, contributing to poor prognosis.

Patient concerns:
We described the case of a PSVA patient confirmed by histopathology and immunohistochemistry (IHC) staining positive for carbohydrate antigen-125 (CA-125) and negative for prostate specific antigen (PSA).

Diagnosis:
Primary seminal vesicle adenocarcinoma.

Interventions:
Surgery was carried out at the beginning, however, residual tumor was verified; thus 3 cycles of chemotherapy with a regimen of paclitaxel and cis-platinum were performed, followed by radical pelvic radiotherapy with a dose of 60 Gray in 30 fractions; then, another 3 cycles of the same chemotherapy were carried out.

Outcomes:
At the moment, the patient is still under follow-up and has been disease-free for more than 5 years.

Lessons:
Our manuscript describes a patient with PSVA with long-term survival and supplies a successful management strategy for this malignancy.
Development in sunburn 2007–2015 and skin cancer projections 2007–2040 of campaign results in the Danish population
Authors: Køster Brian , Meyer Maria , Andersson Therese , Engholm Gerda , Dalum Peter 
Published: October 2018

Abstract
Exposure to ultraviolet radiation is the main risk factor for skin cancer. Denmark has one of the highest incidences of skin cancer in the world. In 2007, a long-term sun safety campaign was launched in Denmark. We have evaluated the effects on prevalence of sunburn and modeled the effects on future melanoma incidence.
Sunburn was evaluated by annual cross-sectional surveys representative for the Danish population on age, gender, and region. During 2007–2015, survey data were collected for 33.315 Danes. Cutaneous Melanoma incidences were modeled in the Prevent program, using population projections, historic incidence, sunburn exposure, and relative risk of sunburn on melanoma.
The prevalence of sunburn in Denmark was reduced with 1% annually during 2007 to 2015. The campaign is estimated to have reduced the number of skin cancer cases with 664 annually in 2040 and 14.326 totally during 2007 to 2040. If the campaign was terminated in 2015 and sunburn rates return to precampaign level there would be no annual reduction in 2040 while in total the reduction would be 4.024 cases for 2007 to 2040. A continuous campaign until 2040 would yield annual reductions of 2.121 cases by 2040 and a total of 29.729 cases for the entire period.
We have showed the value of prevention and the value of long-term planning in prevention campaigning. Sunburn use was reduced significantly during 2007–2015 and further reductions are possible. Consequently, we predict significant fewer skin cancer cases as anticipated.
Bone mineral loss and cognitive impairment
Authors: Kang Hyun Goo , Park Hyun Young , Ryu Han Uk , Suk Seung-Han 
Published: October 2018

Abstract
Low bone mineral density (BMD) is correlated with Alzheimer's disease and its severity, but the association remains unclear in adults (≥50 years) without a history of stroke or dementia.
We assessed BMD and cognitive function using the Mini-Mental Status Examination (MMSE) in 650 stroke- and dementia-free subjects (≥50 years) who were recruited for an early health check-up program between January 2009 and December 2010.
The mean age was 62.9 ± 8.0 years and mean MMSE score was 27.6 ± 3.6. A total of 361 subjects had reduced BMD: 197 (30.3%) had osteopenia and 154 (23.6%) had osteoporosis, based on criteria of world health organization. A total of 5.4% of the male subjects had osteoporosis, versus 19.8% of the female subjects. After adjusting for age, sex, education, and other possible confounding factors such as hypertension, diabetes mellitus, and smoking, the estimated odds ratio for cognitive impairment was 1.72 for the osteopenia group (95% confidence interval [CI] 1.09–2.14, P = .019) and 2.81 for the osteoporosis group (95% CI 1.78–4.45, P < .001).
Low BMD is correlated with cognitive impairment in community-dwelling adults aged 50 years and above without any medical history of stroke or dementia, especially in women. A community-based, early life, preventive osteoporosis education campaign might decrease the incidence of dementia.
A Morel-Lavallée lesion of the proximal calf in a young trauma patient
Authors: Kim Woo Jong , Lee Hong Seop , Won Sung Hun , Hong Yong Cheol , Lee Dhong Won , Lee Ji-Hye , Kim Chang Hyun 
Published: October 2018

Abstract

Rationale:
The Morel-Lavallée lesion (MLL) is a closed degloving injury developing when shear force acts between the muscle fascia and the subcutaneous layer. MLLs develop principally in the trochanteric area or the pelvis; lesions in the proximal calf are rare. Acute lesions can be treated conservatively, but chronic lesions are best treated surgically because of a high rate of recurrence. To the best of our knowledge, this is a rare case of successful treatment of an MLL in the proximal calf associated with tibio-fibular shaft fracture.

Patient concerns:
A 14-year-old male visited our emergency room after having been hit by a car. He exhibited direct trauma to the right lower leg and a distal tibio-fibular shaft fracture without an open wound. He underwent surgery to treat the fracture, which was immobilized with splint for 2 weeks post-operatively. At the 3-month follow-up, he complained of a painless, mobile, soft tissue mass in the posteromedial aspect of the proximal calf. Blood circulation was normal and we found no neurological abnormality in the distal region of the lower leg.

Diagnosis:
A plain radiograph of the right lower leg revealed a proximal, round, radiopaque soft tissue lesion. Ultrasonography revealed a homogeneous, hypoechoic fluid collection. Magnetic resonance imaging revealed fluid of homogeneous signal intensity between the subcutaneous layer and the underlying fascia of the gastrocnemius muscle.

Interventions:
Percutaneous drainage and intralesional steroid injection were performed on several occasions, but the lesion recurred every time. After 5 aspirations, we scheduled surgery. We radically excised the mass and sutured the superficial to the deep fascia to prevent shearing at the surgical plane.

Outcomes:
No complication or recurrence was noted at the 1-year follow-up.

Lesson:
An MLL in the proximal calf is an uncommon post-traumatic lesion and care must be taken to avoid misdiagnosis. If an MLL is suspected after imaging studies and physical examination, it is important to determine whether the lesion is acute or chronic and to plan treatment accordingly. Appropriate treatment should be given to patients to improve outcomes.
Lipoid pneumonitis in a patient with an accidental ingestion of kerosene successfully treated with bronchoscopic segmental lavage and systemic steroid
Authors: Kim Hyo-Jung , Lee Won Hyuk , Jeong Nari , Lee Jae Ha , Park Jin Han , Jang Hang Jea , Kim Hyun-Kuk 
Published: October 2018

Abstract

Rationale:
Standard treatment of lipoid pneumonitis remains unclear. This study reports a case of kerosene pneumonitis successfully treated with systemic steroid and segmental bronchoalveolar lavage (BAL).

Patient concerns:
A 30-year-old woman referred to our hospital because of worsening of respiratory symptoms and fever despite antibiotic therapy following accidental ingestion of kerosene. She had no underlying disease.

Diagnoses:
Chest CT scan showed necrotic consolidation, ground glass opacity (GGO), bronchial wall thickening in the right middle/lower lobe (RML/RLL) and right pleural effusion. The lipoid pneumonitis was confirmed by identification of a lipid laden macrophage in bronchoalveolar lavage fluid.

Interventions:
The patient was treated with systemic corticosteroid and segmental BAL.

Outcomes:
The patient's symptoms rapidly improved after treatment and she was discharged one week after admission. A follow-up CT scan a week after discharge revealed marked resolution of consolidation. No recurrence was reported for 8 months.

Lessons:
This is the first case of kerosene pneumonitis successfully treated with systemic steroid and bronchoscopic segmental lavage therapy in Korea. Very few cases have been reported worldwide.
Causative Agents of Drug-Induced Pancreatitis
Authors: Chung Eun Kyoung , Lee Ji Hyun , Jang Dong Kee , Lee Sang Hyub , Lee Jin Ho , Park Byung-Joo , Kwon Kyenghee , Lee Jun Kyu 
Published: October 2018

Objectives
The aim of this study was to analyze causes of drug-induced acute pancreatitis (DIAP) in Korea and factors associated with serious DIAP.

Methods
Case records of DIAP voluntarily reported to the Korea Adverse Event Reporting System from 2004 to 2013 were reviewed. When a patient took 2 or more drugs, each drug was identified as a potential cause. The seriousness of each case was determined based on the International Conference on Harmonization E2D Guideline. Logistic regression was performed to identify factors associated with the seriousness of DIAP.

Results
During the study period, 210 (0.05%) of 442,523 adverse event reports were (0.05%) DIAP. The most common causative medication of the DIAP cases with certain, probable/likely, and possible causality (n = 74) was l-asparaginase (n = 18), followed by azathioprine (n = 6), methylprednisolone (n = 6), and fenofibrate (n = 5). Serious events occurred in 43 cases (58%) with certain, probable/likely, and possible causality. They were significantly associated with the year of report (odds ratio, 0.572; P = 0.025) and the number of concurrently used medications (odds ratio, 2.659; P = 0.006).

Conclusions

l-Asparaginase is the most common cause of DIAP in Korea. Serious DIAP is more likely to occur in patients taking multiple medications.
Clinical Characteristics and Genetic Causes of Infantile Exocrine Pancreatic Insufficiency in Chinese Patients
Authors: Ye Ziqing , Zhou Ying , Huang Ying , Sun Hua , Wang Huijun , Wu Bingbing 
Published: October 2018

Objective
Infantile exocrine pancreatic insufficiency is a rare disease. We examined phenotypes and performed genetic sequencing in children with this disorder.

Methods
We enrolled 4 infants with exocrine pancreatic insufficiency. Patients were characterized by phenotypes and radiologic findings. Genetic sequencing was performed.

Results
Average age of disease onset was 2 months. Average (standard deviation [SD]) age at diagnosis was 11.9 (7.0) months. Patients presented with chronic steatorrhea and failure to thrive. Two had mild zinc deficiency. Imaging showed pancreatic lipomatosis and metaphyseal dysplasia among all patients. For these patients with similar phenotypes, genetic sequencing revealed that 2 patients had novel UBR1 mutations (c.[3043_3046delAAAG; c.3848 + 6T > C] and c.[1850-2A > T;c.4290T > G], reference sequence NM_174916), and another 2 patients had homozygous SBDS c.258 + 2T > C mutation and SBDS c.[258 + 2T > C;c.428C > T] mutations (reference sequence NM_016038.2). All patients received pancreatic enzyme replacement therapy.

Conclusions
Here we described 4 patients with infantile exocrine pancreatic insufficiency confirmed by laboratory tests and imaging. Whole-exome sequencing and Sanger sequencing showed that 2 patients had Johanson-Blizzard syndrome and 2 patients had Shwachman-Diamond syndrome. Genetic sequencing should be applied for definite diagnosis among these patients.
Impaired development of neocortical circuits contributes to the neurological alterations in DYRK1A haploinsufficiency syndrome
Authors: Arranz Juan , Balducci Elisa , Arató Krisztina , Sánchez-Elexpuru Gentzane , Najas Sònia , Parras Alberto , Rebollo Elena , Pijuan Isabel , Erb Ionas , Verde Gaetano , Sahun Ignasi , Barallobre Maria J. , Lucas José J. , Sánchez Marina p. , de la Luna Susana , Arbonés Maria L. 
Published: October 2018

ABSTRACTAutism spectrum disorders are early onset neurodevelopmental disorders characterized by deficits in social communication and restricted repetitive behaviors, yet they are quite heterogeneous in terms of their genetic basis and phenotypic manifestations. Recently, de novo pathogenic mutations in DYRK1A, a chromosome 21 gene associated to neuropathological traits of Down syndrome, have been identified in patients presenting a recognizable syndrome included in the autism spectrum. These mutations produce DYRK1A kinases with partial or complete absence of the catalytic domain, or they represent missense mutations located within this domain. Here, we undertook an extensive biochemical characterization of the DYRK1A missense mutations reported to date and show that most of them, but not all, result in enzymatically dead DYRK1A proteins. We also show that haploinsufficient Dyrk1a+/- mutant mice mirror the neurological traits associated with the human pathology, such as defective social interactions, stereotypic behaviors and epileptic activity. These mutant mice present altered proportions of excitatory and inhibitory neocortical neurons and synapses. Moreover, we provide evidence that alterations in the production of cortical excitatory neurons are contributing to these defects. Indeed, by the end of the neurogenic period, the expression of developmental regulated genes involved in neuron differentiation and/or activity is altered. Therefore, our data indicate that altered neocortical neurogenesis could critically affect the formation of cortical circuits, thereby contributing to the neuropathological changes in DYRK1A haploinsufficiency syndrome.
Individual variability in behavior and functional networks predicts vulnerability using a predator scent model of PTSD
Authors: Dopfel David , Perez Pablo D. , Verbitsky Alexander , Bravo-Rivera Hector , Ma Yuncong , Quirk Gregory J. , Zhang Nanyin 
Published: October 2018

AbstractOnly a minority of individuals who experience traumatic event(s) subsequently develop post-traumatic stress disorder (PTSD). However, whether differences in vulnerability to PTSD result from predisposition or a consequence of trauma exposure remains unclear. A major challenge in differentiating these possibilities is that clinical studies focus on individuals already exposed to traumatic experiences, and do not take into account pre-trauma conditions. Here using the predator scent model of PTSD in rats and a longitudinal design, we measured pre-trauma brain-wide neural circuit functional connectivity (FC), behavioral and corticosterone responses to trauma exposure, and post-trauma anxiety. Individual differences in freezing responses to predator scent exposure correlated with differences in pre-trauma FC in a set of neural circuits, especially in olfactory and stress-related systems, indicating that pre-existing function in these circuits could predispose animals to differential fearful responses to threats. Counterintuitively, rats with the lowest freezing showed more avoidance of the predator scent, a prolonged corticosterone response, and higher anxiety long after exposure. This study provides a comprehensive framework of pre-existing circuit function that determines threat response strategy, which might be directly related to the development of PTSD-like behaviors.