bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Endothelial Cell Count Up to Three Years After Implantation of Toric Implantable Collamer Lenses
Authors: Bohac Maja , Jagic Mateja , Biscevic Alma , Shijakova Violeta , Gabric Nikica , Patel Sudi 
Published: May 2019

Purpose:
To determine the temporal effect of toric implantable collamer lens (TICL) implantation and location on corneal endothelial cell density (ECD) over a period of 36 months after surgery.

Methods:
ECD [number of cells per square millimeter estimated using the Specular Microscope SP-1P (Topcon Europe Medical B.V., Netherlands)] data were collected from cases deemed suitable for the TICL (VTICMO, VTICM5; STAAR Surgical, Nidau, Switzerland). The preoperative refractive error (sphere and cylinder) ranged from −1.00 to −22.25 diopter sphere and from −0.50 to −5.50 diopter cylinder. ECD was evaluated at preoperative and all postoperative sessions.

Results:
Key findings were as follows: the mean ECD (±SD, 95% confidence interval) was 2720 cells/mm2 (±272, 2620–2820 cells/mm2) preoperatively, which was reduced to 2372 cells/mm2 (±325, 2250–2490 cells/mm2) at 36 months postoperatively (P < 0.001). Linear regression revealed the following significant correlations between the (1) log of the change in ECD (y1) and log of preoperative ECD (x1) at 2 years postoperatively, y1 = 2.513x1−6.2816 (n = 62, r= 0.3503, P = 0.005); (2) mean ECD (y2) and log time (in months, x2), y2= 2543.7−36.997x2−38.99x2
2 (r=−0.9654, n = 7, P = 0.0004); and (3) mean axial distance between the front surface of the crystalline lens and the TICL back surface (y3) and time postoperatively (in months, x3), y3 = 0.1035x3
2−5.2808x3 +473.18 (r = 0.8512, n = 7, P = 0.015).

Conclusions:
Expected ECD loss after TICL implantation by 2 years postoperatively is predictable. On average, over 3 years after implantation, there is (1) an initial rapid decline in ECD, followed by a gradual fall in the rate of cell loss, and (2) a gradual fall in the distance between the TICL and the crystalline lens by 2 years postoperatively, followed by a reversal by the third year.
Machine-learned analysis of the association of next-generation sequencing–based genotypes with persistent pain after breast cancer surgery
Authors: Kringel Dario , Kaunisto Mari A. , Kalso Eija , Lötsch Jörn 
Published: May 2019

Abstract
Cancer and its surgical treatment are among the most important triggering events for persistent pain, but additional factors need to be present for the clinical manifestation, such as variants in pain-relevant genes. In a cohort of 140 women undergoing breast cancer surgery, assigned based on a 3-year follow-up to either a persistent or nonpersistent pain phenotype, next-generation sequencing was performed for 77 genes selected for known functional involvement in persistent pain. Applying machine-learning and item categorization techniques, 21 variants in 13 different genes were found to be relevant to the assignment of a patient to either the persistent pain or the nonpersistent pain phenotype group. In descending order of importance for correct group assignment, the relevant genes comprised DRD1, FAAH, GCH1, GPR132, OPRM1, DRD3, RELN, GABRA5, NF1, COMT, TRPA1, ABHD6, and DRD4, of which one in the DRD4 gene was a novel discovery. Particularly relevant variants were found in the DRD1 and GPR132 genes, or in a cis-eCTL position of the OPRM1 gene. Supervised machine-learning–based classifiers, trained with 2/3 of the data, identified the correct pain phenotype group in the remaining 1/3 of the patients at accuracies and areas under the receiver operator characteristic curves of 65% to 72%. When using conservative classical statistical approaches, none of the variants passed α-corrected testing. The present data analysis approach, using machine learning and training artificial intelligences, provided biologically plausible results and outperformed classical approaches to genotype–phenotype association.
A Review of New and Emerging Techniques For Optical Diagnosis of Colonic Polyps
Authors: Glover Ben , Teare Julian , Patel Nisha 
Published: May 2019

Background and aims:
Endoscopic imaging is a rapidly progressing field and benefits from miniaturization of advanced imaging technologies, which may allow accurate real-time characterization of lesions. The concept of the “optical biopsy” to predict polyp histology has gained prominence in recent years and may become clinically applicable with the advent of new imaging technology. This review aims to discuss current evidence and examine the emerging technologies as applied to the optical diagnosis of colorectal polyps.

Methods:
A structured literature search and review has been carried out of the evidence for diagnostic accuracy of image-enhanced endoscopy and emerging endoscopic imaging technologies. The image-enhanced endoscopy techniques are reviewed, including their basic scientific principles and current evidence for effectiveness. These include the established image-enhancement technologies such as narrow-band imaging, i-scan, and Fuji intelligent chromoendoscopy. More recent technologies including optical enhancement, blue laser imaging, and linked color imaging are discussed. Adjunctive imaging techniques in current clinical use are discussed, such as autofluorescence imaging and endocytoscopy. The emerging advanced imaging techniques are reviewed, including confocal laser endomicroscopy, optical coherence tomography, and Raman spectroscopy.

Conclusions:
Large studies of the established image-enhancement techniques show some role for the optical diagnosis of polyp histology, although results have been mixed, and at present only the technique of narrow-band imaging is appropriate for the diagnosis of low-risk polyps when used by an expert operator. Other image-enhancement techniques will require further study to validate their accuracy but show potential to support the use of a “resect-and-discard” approach to low-risk polyps. New technologies show exciting potential for real-time diagnosis, but further clinical studies in humans have yet to be performed.
Years of Life and Productivity Loss Because of Adult Sudden Unexpected Death in the United States
Authors: Mirzaei Mojtaba , Joodi Golsa , Bogle Brittany , Chen Sarah , Simpson Ross J. 
Published: May 2019

Background:
Few studies have evaluated the years of life lost (YLL) and productivity loss due to sudden unexpected death (SUD). The burden of SUD on society is undetermined because of lack of population-based studies and comprehensive adjudication methods.

Objective:
We estimated YLL and productivity loss from SUD in working-age adults and compared it with the leading causes of death in the United States.

Methods:
We screened all out of hospital deaths among people aged 20–64 in Wake County, NC from 2013 to 2015 to adjudicate SUDs. We extrapolated Wake County incidence to estimate the age-standardized and sex-standardized rate of SUD in the United States. YLL was calculated based on the remaining life expectancy of the victims. Incorporating market and housekeeping value estimated the present value of lifetime productivity loss because of SUD.

Results:
SUD incidence rates in the US adults aged 20–64 were 49.3 (95% confidence interval, 41.2–58.3) and 21.7 (95% confidence interval, 16.5–27.8) per 100,000 among men and women, respectively. SUD resulted in the loss of 2 million years of life, accounting for 10.0% of YLL from all causes of death. Among natural causes of death, YLL from SUD was only lower than that from all cancers combined and heart disease. Lifetime productivity loss because of SUD was ~$51 billion, exceeding productivity loss from any individual cancer.

Conclusion:
SUD is an important source of YLL and productivity loss among adults aged 20–64. Such a high burden on society justifies prioritizing health policies and interventions toward preventing SUD.
Impact of Behavioral Feeding Intervention on Child Emotional and Behavioral Functioning, Parenting Stress, and Parent‐Child Attachment
Authors: Knight Rachel M. , Albright Jeremy J. , Huth‐Bocks Alissa , Morris Natalie K. , Mills Lauren , Klok Kaylin , Kallabat Nora , Drayton Amy K. 
Published: May 2019

ABSTRACTObjectives:Behavioral intervention is the only treatment for pediatric feeding problems with well documented empirical support. However, parents may be hesitant to pursue behavioral intervention because of concerns about possible negative side effects on child behavioral health and the parent‐child relationship. This study investigated associations between behavioral feeding treatment and parenting stress, internalizing and externalizing behavior problems in young children, and parent‐child attachment quality.Methods:Participants included 16 mother‐child dyads seeking treatment from a behavioral feeding clinic at a large Midwestern university medical center. Children were between the ages of 30 and 45 months (adjusted) at baseline. Caregivers completed the Child Behavior Checklist for ages 1.5 to 5 (CBCL/1.5–5), the Parenting Stress Index, 3rd Edition Short Form (PSI/SF), and mother‐child dyads participated in the Strange Situation procedure at baseline and again after 6 months. The treatment group (n = 12) began outpatient behavioral feeding intervention following the baseline evaluation, whereas the control group (n = 12) remained on the clinic waitlist until after the 6‐month follow‐up.Results:The treatment group demonstrated decreases in internalizing and externalizing child behavior problems and parenting stress compared with the control group. No significant differences were demonstrated in parent‐child attachment quality within or between groups.Conclusions:Behavioral feeding intervention had positive effects on perceptions of child emotional and behavioral functioning and maternal parenting stress. Intervention also did not impact the quality of the mother‐child attachment relationship. Further research with a larger sample size and additional observational measures of behavior is needed to support the replicability and generalizability of these results.
Autopsy Observation as Experiential Learning for Nurse Practitioner Students in an Online Advanced Pathophysiology Course
Authors: Keiser Megan M. , Murray-Wright Margaret 
Published: May 2019

Background
Many instructional classrooms now exist in the online environment, where it is difficult to integrate experiential teaching strategies. Autopsy-based education has been shown to be a valuable teaching tool for pathophysiology in a medical school curriculum.

Problem
There is a gap in the literature about the use of an autopsy observation in nurse practitioner (NP) education.

Approach
The purpose of this project was to develop and evaluate the effectiveness of an autopsy experience for NP students in an online advanced pathophysiology course.

Outcomes
Based on a review of course evaluations and reflective essays, the majority of students found this to be a valuable learning experience. The main barrier was locating a facility and scheduling the autopsy observation.

Conclusion
The benefits outweigh the barriers to providing experiential learning with an autopsy observation in an online pathophysiology course. As such, it should be considered in similar course offerings.
The prevalence of fracture extension in displaced femoral neck fractures in the elderly
Authors: Natsuhara Kyle Matsuo , Boutin Robert Downey , Lee Mark Andrew , Meehan John Patrick 
Published: May 2019

Abstract

Objective:
Arthroplasty is the common treatment for intracapsular femoral neck fractures in the elderly. Recent studies have shown that there may be more overall complications related to uncemented hemiarthroplasty compared to cemented, including more subsidence, intraoperative fractures, and postoperative fractures. Uncemented femoral components rely on a press fit, and the risk of these complications would be expected to increase in patients with unrecognized distal extension of femoral neck fractures. The purpose of this study is to determine the frequency of fracture extension of displaced femoral neck fractures in the elderly population.

Methods:
The electronic medical record database at our institution was retrospectively reviewed to search for consecutive reports from 2005 to 2015 of patients 65 years or older that sustained an intracapsular femoral neck fracture who had computed tomography (CT) examinations of the injury. Exclusion criteria were CTs that were not fine cut (<1.5 mm cuts) or occult femoral neck fractures that were seen only on magnetic resonance imaging. This resulted in 60 patients that were included in the study. Within this subset of patients, the CT scans were reassessed to look for extension of the fracture beyond the boundaries of the femoral neck. Of particular interest, were fracture lines that extended distal to the femoral neck, since these have the potential to affect the fit of an uncemented femoral stem. Data on subject age, gender, body mass index (BMI), and bone mineral density (BMD) were also collected, and it was determined if these demographics were predictive in patients having fracture extension. Treatment and follow-up data were collected for the patients as well.

Results:
Seven of 60 patients were identified to have fracture extension of intracapsular femoral neck fractures. The frequency of fracture extension of intracapsular femoral neck fractures distal to the femoral neck was 8.3% (5/60). All cases of fracture extension were nondisplaced or minimally displaced. 60% (3/5) of the distal fracture extensions were not diagnosed preoperatively by the radiologists or the treating orthopaedic surgeons. There was not a statistically significant difference when comparing age, gender, BMI, or BMD of the population group with distal fracture extension to that of the rest of the patient cohort.

Conclusions:
To our knowledge, this is the first study to report the frequency of fracture extension of displaced femoral neck fractures in the elderly population. The 8.3% rate of distal fracture extension in elderly femoral neck fractures may help explain the higher rate of subsidence, postoperative fracture and intraoperative fracture when applying uncemented hemiarthroplasty compared to cemented arthroplasty. It is important to be aware of the potential for this phenomenon.
Increased risk of deep venous thrombosis in patients with poor ankle dorsiflexion after lower limb immobilization
Authors: Aufwerber Susanna , Praxitelous Praxitelis , Edman Gunnar , Silbernagel Karin Grävare , Ackermann Paul W. 
Published: May 2019

Abstract

Objective:
Many trauma patients are at risk of pulmonary embolism due to unrecognized deep vein thrombosis (DVT). Restricted ankle dorsiflexion (AD) range of motion during leg immobilization is known to cause reduced venous blood flow. The aim of the present study was to assess whether AD at plaster cast removal is related to the incidence of DVT and to patient outcome.

Design:
Prospective observational cohort study.

Setting:
Level 1 Trauma Center.

Patients:
A total of 124 patients (97 men, 27 women; mean age 40.3 years) with plaster cast leg immobilization after surgical repair of Achilles tendon rupture were assessed.

Main outcome measures:
At 2 weeks postoperatively, assessments of AD and the incidence of DVT using compression duplex ultrasound were performed with observers blinded to patient grouping. Patients were dichotomized into 2 groups; poor or good AD, according to the mean AD, −7°. At 3- and 12 months patient-reported outcome was examined using validated questionnaires (ATRS and FAOS), and functional outcome using the heel-rise test.

Results:
Patients with poor AD sustained 42% DVTs, while patients with good AD exhibited a DVT-rate of 23% (P = .036). Logistic regression analysis corroborated this finding (OR = 2.62, P = .036; 95% CI = 1.06–6.44). AD was not linked to any long-term functional or patient-reported outcome.

Conclusions:
Reduced AD after plaster cast removal is associated with a higher risk of DVT. The results of this observational study warrant further prospective studies to confirm the effects of ankle dorsiflexion on the risk of developing venous thromboses.

Level of evidence: II
Cognitive Trajectory Phenotypes in Human Immunodeficiency Virus–Infected Patients
Authors: Dastgheyb Raha M. , Sacktor Ned , Franklin Donald , Letendre Scott , Marcotte Thomas , Heaton Robert , Grant Igor , McArthur Justin C. , Rubin Leah H. , Haughey Norman J. 
Published: May 2019

Objective:
The presentation of cognitive impairments in HIV-infected individuals has transformed since the introduction of antiretroviral therapies. Although the overall prevalence of cognitive impairments has not changed considerably, frank dementia is now infrequent, and milder forms of cognitive impairments predominate. Mechanistic insights to the underlying causes of these residual cognitive impairments have been elusive, in part due to the heterogenous etiology of cognitive dysfunction in this population. Here, we sought to categorize longitudinal change in HIV-infected patients based on the performance in specific cognitive domains.

Design:
This study consisted of 193 participants from the CHARTER cohort with detailed demographic, clinical, and neuropsychological testing data obtained from 2 study visits interspersed by ∼6 months. Cognitive testing assessed executive function, learning and delayed recall, working memory, verbal fluency, speed of information processing, and motor skills. Change scores were calculated for each domain between the 2 study visits. Dimension reduction and clustering was accomplished by principal component analysis of change scores and k-means clustering to identify cognitive domains that group together and groups of subjects with similar patterns of change.

Results:
We identified 4 distinct cognitive change phenotypes that included declines in: (1) verbal fluency, (2) executive function (3) learning and recall, and (4) motor function, with approximately equal numbers of participants in each phenotype.

Conclusions:
Each of the 4 cognitive change phenotypes identify deficits that imply perturbations in specific neural networks. Future studies will need to validate if cognitive change phenotypes are associated with alterations in associated neural pathways.
Structured Reporting in Ultrasound
Authors: O'Connor Stacy D. , Kulkarni Naveen M. , Griffin Michael O. , Baruah Dhiraj , Sudakoff Gary S. , Tolat Parag P. 
Published: May 2019

Abstract
Structured reporting of ultrasound examinations can add value throughout the imaging chain. Reports may be created in a more efficient manner, with increased accuracy and clarity. Communication with referring providers and patients may be improved. Patient care can be enhanced through improved adherence with guidelines and local best practices. Radiology departments may benefit from improved billing and quality reporting. Consistent discrete data can enable research and collaborations between institutions. This article will review the multifaceted impact of structuring ultrasound reports.
Applications of Bone Morphogenetic Protein-2: Alternative Therapies in Craniofacial Reconstruction
Authors: Fisher Mark , Yee Kristen , Alba Brandon , Tanna Neil , Bastidas Nicholas , Bradley James P. 
Published: May 2019

Abstract
Large defects of the craniofacial skeleton can be exceedingly difficult to reconstruct since autologous bone grafts are limited by donor site morbidity and alloplastic implants have low biocompatibility. Bone morphogenetic proteins (BMPs) in craniofacial reconstruction have been used with mixed outcomes and complication concerns; however, results for specific indications have been promising.
In alveolar clefts, cranial vault defects, mandibular defects, and rare Tessier craniofacial clefts, BMP-2 impregnated in collagen matrix was looked at as an alternative therapy for challenging cases. In cases where structural support was required, BMP-2 was used as part of a construct with bio-resorbable plates. Demineralized bone was added in certain cases.
The authors described specific indications, detailed surgical techniques, and a review of the current literature regarding the use of BMP-2 in craniofacial reconstruction. BMP-2 is a viable option for craniofacial reconstruction to decrease donor-site morbidity or when alternatives are contraindicated. It is not recommended for routine use or in the oncologic setting but should currently be reserved as an alternative therapy for complex cases with limited options.
Bone morphogenetic proteins are a promising, emerging option for complex craniofacial reconstruction. Future directions of BMP-2 therapies will become apparent as data from prospective randomized trials emerges.
Clinical Features of Chinese Sporadic Leber Hereditary Optic Neuropathy Caused by Rare Primary mtDNA Mutations
Authors: Cui Shilei , Yang Ling , Jiang Hanqiu , Peng Jingting , Shang Jun , Wang Jiawei , Zhang Xiaojun 
Published: May 2019

Objective:
The primary aim of this study was to describe clinical features of Chinese sporadic Leber hereditary optic neuropathy (LHON) caused by rare primary mitochondrial DNA (mtDNA) mutations.

Methods:
We characterized a Chinese patient cohort with rare primary mtDNA mutations at Beijing Tongren Hospital between 2015 and 2018. The clinical features of these patients were retrospectively recorded and analyzed.

Results:
Sixteen patients with LHON who had the selected rare primary mutations, including m.4171C>A (3 patients), m.10197G>A (1 patient), m.14459G>A (4 patients), and m.14502T>C (8 patients), were evaluated. The mean age at disease onset was 15 ± 6 years, and the male to female ratio was 15:1. Of 32 eyes of all patients, 75% (24/32) had a worst Snellen best-corrected visual acuity ≤0.1 (worse than 20/200), while 67% (2/3) who were carrying the m.4171C>A mutation experienced significant visual improvement. In addition, 40% (2/5) of patients with LHON carrying only m.14502T>C mutation had only mild visual impairment. Isolated manifestations of LHON was present in 94% (15/16) of all patients; 1 patient with the m.14459G>A mutation had LHON plus dystonia. Brain MRI T2 short tau inversion recovery sequences demonstrated optic atrophy in 62.5% (10/16); increased T2 signal in the optic nerve was found in 38% (6/16) of patients. The patient with LHON plus dystonia demonstrated optic atrophy and increased T2 signal in basal ganglia.

Conclusion:
Patients with LHON and rare primary mutations have diverse clinical phenotypes. Those with the m.4171C>A mutation are more likely to have a good visual prognosis, while the m.14502T>C mutation may play a synergistic role in disease onset. Increased signal in the optic nerve on MRI is not rare, and this feature should not exclude LHON as the potential cause for optic neuropathy.
Heterogeneous multi-scale framework for cancer systems models and clinical applications
Authors: Ghosh Alokendra , Radhakrishnan Ravi 
Published: May 2019

AbstractClinical Cancer models need to incorporate a wide variety of patient data and tumor heterogeneity which requires integration of multiple models. Due to differences in time and length scales of individual processes, such a model integration is a challenging task. Here we have developed an integrated framework combining ErbB receptor mediated Ras-MAPK and PI3K/AKT pathway with p53 mediated DNA damage response pathway. We have applied this in a clinical setting to predict patient specific response of different treatments in cancers of prostate, lung and kidney.