bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations in the Vascular Anatomy of the Right Colon and Implications for Right-Sided Colon Surgery
Authors: Kuzu Mehmet Ayhan , İsmail Erkin , Çelik Safa , Şahin Muhammed Feyzi , Güner Mehmet Ali , Hohenberger Werner , Açar Halil İbrahim 
Published: September 2019

BACKGROUND:
Knowledge of the normal pattern and variations of the blood supply of the right colon is crucial for better outcomes after colon surgery.

OBJECTIVE:
The purpose of this study was to describe the precise vascular anatomy of the right colon according to surgical perspective.

DESIGN:
Adult fresh cadavers were dissected between January 2013 and October 2015, focusing on the venous and arterial anatomy of the right side of the colon.

SETTINGS:
Macroscopic anatomical dissections were performed on 111 adult fresh cadavers with emphasis on the vascular anatomy of the right colon. The colic tributaries of the superior mesenteric artery and vein were documented in writing. Furthermore, the dissections were recorded with a video camera.

RESULTS:
The incidence of colic arteries arising from the superior mesenteric artery included ileocolic artery, 100%; right colic artery, 33.3%; middle colic artery, 100%; and accessory middle colic artery, 11,7%. All 111 cadavers had a single ileocolic vein, which drained into the superior mesenteric vein in 103 cases (92.8%), into the gastro-pancreatico-colic trunk in 7 cases (6.3%), and into the jejunal trunk in 1 case (0.9%). The drainage site of the ileocolic vein to the superior mesenteric vein varied, and in 9% of cases the ileocolic vein did not accompany the ileocolic artery. The gastro-pancreatico-colic trunk was detected in 87 cases (78.4%); with several forms of the origin of the respective branches, the gastropancreatic trunk was detected in 24 cases (21.6), and the classic gastrocolic trunk of Henle was not detected. Variations were found in the formation and drainage routes of other venous colic tributaries of the superior mesenteric vein.

LIMITATIONS:
This study is limited by its use of cadavers in that it is impossible to trace each vessel to its origin in live surgery.

CONCLUSIONS:
Surgeons must watch, observe, and bear in mind that vascular variations can occur. Awareness of these complex variations may improve the quality of surgery and may prevent devastating complications during right-sided colon resections.
Bilateral Posterior Tibial Nerve Stimulation in the Treatment of Rectal Evacuation Disorder: A Preliminary Report
Authors: Madbouly Khaled M. , Abbas Khaled S. , Emanuel Emad 
Published: September 2019

BACKGROUND:
Posterior tibial nerve stimulation influences both motor and sensory pathways, as well as the central nervous system. Stimulation of posterior tibial nerve roots (L4 to S3) could improve stool evacuation through S3 and/or S2 stimulation.

OBJECTIVE:
This study aimed to assess the efficiency of bilateral posterior tibial nerve stimulation in the treatment of rectal evacuation disorder without anatomic obstruction.

DESIGN:
This was a prospective case series studying the treatment of patients with obstructed defecation by posterior tibial nerve stimulation.

SETTING:
The study was conducted at a tertiary referral academic medical center.

PATIENTS:
Patients with rectal evacuation disorder without anatomic obstruction who were failing maximal conservative treatments were included.

INTERVENTION:
Thirty minutes of bilateral transcutaneous posterior tibial nerve stimulation was applied 3 times weekly for each patient for 6 consecutive weeks.

MAIN OUTCOME MEASURES:
The primary end point was the change in the modified obstructed defecation score. Secondary end points were changes in rectal sensitivity volumes (urge to defecate volume and maximal tolerable volume) and quality of life using the Patient Assessment of Constipation–Quality of Life questionnaire.

RESULTS:
Thirty-six patients (25 women) completed the trial. The mean age of patients was 57.2 years (SD = 14.4 y). No adverse events were reported. Symptomatic successful outcome was reported in 17 patients (47%) and modified obstructed defecation score decreased over 6 weeks (mean decrease = 10 points (95% CI, 8.7–11.3 points); p < 0.0001). Patients with successful outcome (responders) had relatively lower preoperative modified obstructed defecation score compared with patients with unsuccessful outcome (nonresponders). In the successful group, there were significant improvement after 6 weeks in both Patient Assessment of Constipation–Quality of Life score (mean improvement = 43.0 points (95% CI, 35.2–50.7 points); p < 0.0001) and rectal sensitivity (significant reductions in urge to defecate volume (from 258.1 ± 21.2 to 239.6 ± 15.3; p < 0.0001) and maximal tolerable volume (from 304.5 ± 24.8 to 286.8 ± 19.7; p < 0.0001)). No significant change in Patient Assessment of Constipation–Quality of Life or rectal sensitivity was observed in the nonresponders.

LIMITATIONS:
The study was designed just to proof the concept, but small sample size is a limitation. Another limitation is the short duration of study of only 6 weeks.

CONCLUSIONS:
Current data showed that bilateral transcutaneous posterior tibial nerve stimulation can improve symptoms in a considerable percentage of patients with obstructed defecation without anatomic obstruction. The procedure is more effective in patients with a less-modified obstructed defecation score. Additional studies are needed to discover the predictive factors for success.
Quantification of Erythema Associated With Continuous Versus Interrupted Nylon Sutures in Facial Surgery Repair: A Randomized Prospective Study
Authors: Majd Ali , Akbari Ardalan , Zloty David 
Published: September 2019

BACKGROUND
Patients are often concerned about the cosmetic appearance of scars following Mohs micrographic surgery (MMS), including residual erythema. However, few studies have compared the cosmetic outcomes between different suturing techniques.

OBJECTIVE
To compare the erythema intensity (EI) associated with interrupted sutures (IS) and continuous sutures (CS), and the degree of its reduction over time.

MATERIALS AND METHODS
Mohs micrographic surgery patients were randomized to have half of their defect repaired with IS and the other half with CS. Postoperatively, subjects were assessed at 1 week, 2 months, and 6 months and close-up photographs of their scars were taken. Computer-assisted image analysis was utilized to quantify the EI in each half-scar.

RESULTS
The average EI of IS was greater than that of CS by 9.3% at 1 week (p < .001) and 7.2% at 2 months (p < .021) but comparable at 6 months. These differences were clinically detectable, but EI differences resolved by 6 months in most cases. At 6 months, EI regressed by 33.5% in IS and 26.3% in CS.

CONCLUSION
Continuous sutures are associated with less erythema during early scar maturation but are comparable to IS at 6 months. These results may guide the choice of suturing technique to improve early cosmetic outcomes and overall patient satisfaction.
Placental Membrane Provides Improved Healing Efficacy and Lower Cost Versus a Tissue-Engineered Human Skin in the Treatment of Diabetic Foot Ulcerations
Authors: Glat Paul , Orgill Dennis P. , Galiano Robert , Armstrong David , Serena Thomas , DiDomenico Lawrence A. , Kaufman Jarrod , Carter Marissa J. , Jacobs Alan M. , Zelen Charles M. 
Published: September 2019

Background:
Aseptically processed dehydrated human amnion and chorion allograft (dHACA) (AmnioBand) has shown great promise in the treatment of recalcitrant diabetic foot ulcers (DFUs) when compared with standard wound care but has not yet been compared to any other tissue forms used in treating DFUs. The hypothesis was to conduct a randomized controlled trial in which dHACA was compared to one of the earliest and most commonly accepted tissue-engineered skin substitutes (TESS) (Apligraf) in the treatment of nonhealing DFUs over a period of 12 weeks to assess the superiority of healing.

Methods:
Following a 2-week screening period during which subjects with DFUs were treated with collagen alginate dressing, 60 subjects were randomized at 5 sites to receive either dHACA or TESS applied weekly, with weekly follow-up for up to 12 weeks.

Results:
The mean time to heal within 6-week time period for the dHACA group was 24 days (95% CI, 18.9–29.2) versus 39 days (95% CI, 36.4–41.9) for the TESS group; the mean time to heal at 12 weeks was 32 days (95% CI, 22.3–41.0) for dHACA-treated wounds versus 63 days (95% CI, 54.1–72.6) for TESS-treated wounds. The proportion of wounds healed at study completion (12 weeks) was 90% (27/30) for the dHACA group versus 40% (12/30) for the TESS group. The mean product cost for the dHACA group was significantly lower than that for the TESS group [dHACA: $2,200 (median: $1,300); TESS: $7,900 (median: $6,500)]. The mean wastage (%) at 12 weeks was also significantly lower for the dHACA group than that for the TESS group (36% vs 95%).

Conclusions:
It was concluded that aseptically processed dHACA heals diabetic foot wounds more reliably, statistically significantly faster than and at significantly lower cost than TESS.
Current Understanding of Religion, Spirituality, and Their Neurobiological Correlates
Authors: Rim James I. , Ojeda Jesse Caleb , Svob Connie , Kayser Jürgen , Drews Elisa , Kim Youkyung , Tenke Craig E. , Skipper Jamie , Weissman Myrna M. 
Published: September 2019

Abstract
Religion and spirituality (R/S) have been prominent aspects of most human cultures through the ages; however, scientific inquiry into this phenomenon has been limited. We conducted a systematic literature review of research on the neurobiological correlates of R/S, which resulted in 25 reports studying primarily R/S with electroencephalography, structural neuroimaging (MRI), and functional neuroimaging (fMRI, PET). These studies investigated a wide range of religions (e.g., Christianity, Buddhism, Islam) and R/S states and behaviors (e.g., resting state, prayer, judgments) and employed a wide range of methodologies, some of which (e.g., no control group, varying measures of religiosity, small sample sizes) raise concerns about the validity of the results. Despite these limitations, the findings of these studies collectively suggest that the experience of R/S has specific neurobiological correlates and that these correlates are distinct from non-R/S counterparts. The findings implicate several brain regions potentially associated with R/S development and behavior, including the medial frontal cortex, orbitofrontal cortex, precuneus, posterior cingulate cortex, default mode network, and caudate. This research may suggest future clinical applications and interventions related to R/S and various disorders, including mood, anxiety, psychotic, pain, and vertiginous disorders. Further studies with more rigorous study designs are warranted to elucidate the neurobiological mechanisms of R/S and their potential clinical applications.
Corneal Collagen Cross-Linking in Young Patients for Progressive Keratoconus
Authors: Barbisan Paulo Rodolfo Tagliari , Pinto Roberto Damian Pacheco , Gusmão Camillo Carneiro , de Castro Rosane Silvestre , Arieta Carlos Eduardo Leite 
Published: September 2019

Purpose:
The goal of this study was to compare the effect of early corneal collagen cross-linking (CXL) intervention (before 17 years of age) with that of late intervention (after 17 years of age) on the characteristics and progression of keratoconus.

Patients and Methods:
One hundred five eyes of 94 patients with keratoconus undergoing treatment with CXL were included. The patients were divided into 2 groups by age: group 1 (mean age of 13.8 yrs; range 10–16) and group 2 (mean age of 21.5 yrs; range 17–36). Eyes were evaluated regarding best-corrected visual acuity (BCVA), refractive error, corneal endothelial cell density, and central corneal thickness, as well as using slit-lamp biomicroscopy, Goldmann tonometry, and the keratometry (Kmax, Ksteep, and Kflat parameters) test before CXL and at 1, 3, 6, and 12 months thereafter.

Results:
The mean (SD) BCVA of group 1 was 0.45 (±0.25) before CXL and 0.56 (±0.29) 1 year after CXL (P = 0.030); mean (SD) Kmax, Ksteep, and Kflat were 58.47 (±7.2), 52.93 (±5.4), 47.22 (±4.2) before CXL respectively, and 58.21 (±7.7), 52.25 (±5.5), and 46.56 (±4.6) 1 year after CXL, respectively (P = 0.897, 0.481, and 0.491). The mean (SD) BCVA of group 2 was 0.50 (±0.30) before CXL and 0.56 (±0.32) 1 year thereafter (P = 0.346); mean (SD) Kmax, Ksteep, and Kflat were, respectively, 57.64 (±7.1), 54.02 (±6.2), and 48.60 (±4.1) before CXL and 56.46 (±8.0), 52.46 (±5.8), and 47.85 (±4.9) 1 year after CXL, respectively (P = 0.553, 0.258, and 0.640).

Conclusions:
The study showed no statistical differences between younger and older patients. These findings support the indication of CXL treatment in pediatric patients for early stabilization of the disease and better progress regarding BCVA and keratometry parameters.
Comparative Analysis of KGF-2 and bFGF in Prevention of Excessive Wound Healing and Scar Formation in a Corneal Alkali Burn Model
Authors: Cai JianQiu , Zhou Qingde , Wang Zhitao , Guo Ruide , Yang Rongshuai , Yang Xuanxin , Li Wenqing , Ahmad Naveed , Chen Qi , Hui Qi , Wang Xiaojie 
Published: September 2019

Purpose:
Basic fibroblast growth factor (bFGF) is an effective drug for corneal injury. However, the explicit role of bFGF in corneal scar formation still remains unclear. Keratinocyte growth factor-2 (KGF-2) is associated with the treatment of wound healing. We aimed to compare the efficacy of bFGF and KGF-2 in prevention of excessive wound healing and consequent scar formation in a rat alkali burn model, which provides important clues on the significance of KGF-2 to be developed as a new drug for such injuries.

Methods:
The epithelial defect area was evaluated using fluorescein sodium at a concentration of 0.5%. The therapeutic effect of KGF-2 and bFGF on proliferation of rabbit corneal fibroblasts (RCFs) was evaluated by methylthiazoletetrazolium. RCF migration assays were performed with a modified scratch method. Activation of mitogen-activated protein kinase (MAPK) was evaluated by Western blot with specific antibodies.

Results:
All corneal wounds treated with KGF-2 were found closed within 7 days; however, the wounds treated with bFGF or phosphate buffer saline (PBS) required 14 days to close. RCFs treated with KGF-2 or bFGF showed similar dose-dependent proliferation. The KGF-2 group significantly promoted cell migration compared with the bFGF group. The KGF-2 group showed less expression of α-smooth muscle actin (SMA) and numbers of myofibroblasts compared with the bFGF group. Our findings suggested identification of cascade reaction of extracellular regulated protein kinases (ERK)1/2 and p38 signals in KGF-2– and bFGF-induced proliferation and migration of RCFs. In addition, KGF-2 showed stronger effects during ERK1/2 and p38 phosphorylation in methylthiazoletetrazolium proliferation assay and scratch migration assay.

Conclusions:
KGF-2 exhibited better effects than bFGF in reepithelialization, acceleration of migration, and reduction of scar formation, which has potential to become a new drug to cure corneal injury.
The association between CKD-associated pruritus and quality of life in patients undergoing hemodialysis in Pakistan
Authors: Rehman Inayat Ur , Chan Kok Gan , Munib Syed , Lee Learn Han , Khan Tahir Mehmood 
Published: September 2019

Abstract
Chronic kidney disease (CKD)-associated pruritus is one of the most common symptoms found in patients who undergo dialysis for CKD, leading to a compromised quality of life. This study aimed to investigate the association between CKD-associated pruritus and the quality of life in patients undergoing hemodialysis in Pakistan.
A cross-sectional multicenter study was carried out from July 2016 to April 2017 in 2 tertiary care hospitals in Pakistan. Patients aged 18 years and above of both genders, undergoing hemodialysis, understood the Urdu language, and were willing to participate; were included.
Of 354 recruited patients with a response rate of 100%, majority (66.1%) of the patients were males. The median (intra-quartile range [IQR]) age of patients was 42.0 [34.0–50.0] years. The prevalence of pruritus was 74%. The median [IQR] score for pruritus was 10.0 (out of possible 25) [8.0–12.0]. Multivariate linear regression revealed a statistically significant association between CKD-associated pruritus with age of patients (β = 0.031; 95% confidence interval [CI] = 0.002–0.061; P = .038), duration of CKD (β = −0.013; 95% CI = −0.023 –−0.003; P = .014) and quality of life (β= −0.949; 95% CI = −1.450; −0.449). The median [IQR] score for health-related quality of life was 52.00 [43.00–58.00].
Prevalence of CKD-associated pruritus was reported to be 74% and it negatively affected the patient's quality of life. Patients with moderate to severe CKD-associated pruritus have poor quality of life. With an increase in intensity of pruritus, the QOL score decreased among the patients undergoing hemodialysis.
Excess weight loss is a vital strategy for controlling hypertension among multi-ethnic population in northwest China
Authors: Wang Lin , Heizhati Mulalibieke , Zhang Delian , Chang Guijuan , Yao Xiaoguang , Hong Jing , Kamilijiang Mayila , Li Mei , Li Nanfang 
Published: September 2019

Abstract
Hypertension is a common global health problem including China. This study aimed to assess the prevalence and awareness of hypertension, and evaluate risk factors associated with hypertension among multi-ethnic population in northwest China using a random sampling cross-sectional data.
A cross-sectional survey was conducted between 2014 and 2015 as part of a nationwide survey using stratified four-stage random sampling in Xinjiang. Hypertension was defined as mean systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥140/90 mm Hg and/or taking anti-hypertensive medication. In addition, the prevalence of hypertension (SBP ≥ 130 or DBP ≥ 80 mm Hg) was also estimated according to the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. Awareness of hypertension was based on self-report. An optimized risk score model was used to assess the risk and determine the predictive power of risk factors on hypertension.
Totally 6722 subjects aged ≥18 years were enrolled and prevalence of hypertension was 24.3%, while the prevalence of hypertension based on the 2017 ACC/AHA guideline was approximately twice as high as that based on 2010 Chinese guideline (37.6%). Among individuals with hypertension, 55.5% were aware of their condition. Six potential factors were estimated to be associated with increased risk of hypertension including age, ethnicity, marital status, body mass index (BMI), waistline circumference, and comorbidity. In the analyses of calculated risk score, BMI ≥ 28.0 corresponded to the highest risk score of 23 points. The area under the receiver operation curve for the multivariable prediction model was 0.803 (95%CI: 0.789–0.813).
There is a considerable prevalence of hypertension among Xinjiang adults, northwest China; awareness of hypertension is low. Excess weight loss may be a vital strategy for controlling hypertension, particularly if accompanied with other preventive measures in this region.
The valuation of concave-side thoracoplasty on the treatment of extremely severe scoliosis with severe pulmonary dysfunction on the base of halo-pelvic traction
Authors: Zhao Hehong , Hu Zhengjun , Zhao Deng , Wang Fei , Zhong Rui , Liang Yijian 
Published: September 2019

Abstract
Extremely severe scoliosis patients, especially main thoracic Cobb’ s angle >150°, often have severe thoracic deformity and pulmonary dysfunction, even the scoliosis is reduced by halo-pelvic traction, the improvement of pulmonary function is not satisfactory, the risk of spinal osteotomy in the next stage is still very high and left with obvious thoracic deformity. How to further improve the pulmonary function and appearance of these patients is a difficult problem to be solved.
Twenty extremely severe scoliosis patients with severe pulmonary dysfunction who underwent concave-side thoracoplasty in our hospital from September 2014 to September 2017 were included, data of thoracic volume and pulmonary function were collected before and after operation. The pulmonary function value reported was predicted forced vital capacity (FVC%), T-test was used to analyze the changes of the data by the statistical software SPSS21.0.
The 20 patient's averaged Cobb's angle of main thoracic was 163° ± 8° at admission and all of them with severe pulmonary dysfunction before concave-side thracoplasty. After operation, the thoracic volume of patients increased by 500.9 ± 222.9 mL, FVC% increased by 8.9% ± 7.5%. Both the difference has statistical significance (P < .01).
Concave-side thoracoplasty based on the halo-pelvic traction cannot only enlarge the volume of the concave thoracic cavity, lighten the compression of lung and further improve the pulmonary function of extremely severe scoliosis, but also can strengthen the correction of scoliosis and spinal rotation. Therefore, it is a safe and effective surgical approach.
Radiologic criteria to predict injury of the transverse atlantal ligament in unilateral sagittal split fractures of the C1 lateral mass
Authors: Park Heui-Jeon , Chang Dong-Gune , Park Jong-Beom , Kim Whoan Jeang , Song Kyung-Jin , Min Woo-Kie , Park Seung Chan 
Published: September 2019

Abstract
Unilateral sagittal split fracture (USSF) of the C1 lateral mass (LM) has been recently recognized as a rare variant of C1 atlas fracture. To date, there has been no study to investigate whether radiologic criteria can be applied to determine the presence or absence of transverse atlantal ligament (TAL) injury in USSF of the C1 LM.
Twenty six consecutive cases of USSF of the C1 LM were included in this study. According to Dickman classification, 16 cases were TAL injury, and 10 cases were TAL intact. Radiologic parameters were measured and compared between the 2 groups.
Total LM displacement (LMD) of the 2 sides (5.9 ± 2.0 mm vs 1.2 ± 2.0 mm), unilateral LMD of the fracture side (4.3 ± 1.2 mm vs 1.0 ± 1.1 mm), atlanto-dental interval (ADI) (2.0 ± 0.9 mm vs 1.5 ± 0.4 mm), and fracture gap (6.9 ± 2.7 mm vs 2.1 ± 1.1 mm) were statistically higher in the TAL injury group than the TAL intact group. However, basion-dental interval, clivus canal angle, and atlanto-occipital joint axis angle were not different between the 2 groups. Total LMD and unilateral LMD positively correlated with ADI and fracture gap. The incidence of fracture gap larger than 7 mm was statistically higher in the TAL injury group than the TAL intact group (81% vs 30%).
In conclusion, total LMD > 5.9 mm or unilateral LMD > 4.3 mm suggests the presence of TAL injury in USSF of the C1 LM. The possibility of diagnostic error for TAL injury can be further reduced in USSF of the C1 LM by considering the fracture gap larger than 7 mm.