bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal Bone CT Scan for Malleal Ligaments Assessment
Authors: Vaisbuch Yona , Hosseini Davood K. , Lanzman Bryan , Marcott Stephen C. , Ma Yifei , Song Yohan , Alyono Jennifer C. , Blevins Nikolas H. 
Published: October 2018

Objective:
To determine the feasibility of using temporal bone computed tomography (CT) scans to identify malleal ligaments and the prevalence of calcification in malleal ligaments.

Study Design:
Retrospective case review. CT scans were blindly and retrospectively reviewed by two physicians (a radiologist and a nonradiologist). Scans differed by slice thickness, and included both conventional CT and cone beam CT (CBCT).

Setting:
Ambulatory tertiary referral center.

Patients:
One hundred fifty-one temporal bone CT scans, obtained between the years 2014 and 2017, were initially screened, which included 302 ears. Patients with previous tympanomastoid surgery or middle ear opacification were excluded, leaving 187 ears in the study.

Intervention:
Diagnostic.

Main Outcome Measure:
Percentage of visible normal and calcified malleal ligaments.

Results:
Scans with submillimeter slice thickness were more likely to demonstrate all three malleal ligaments than those with 1 ml and larger slices (83.7% versus 50.0% for nonradiologist, p < 0.0001; 59.6 versus 34.8% for radiologist, p < 0.0001). Calcification was seen in 11.8% of ears reviewed. The ability to detect malleal ligaments with cone beam CT was 86.2%, while the rate with conventional CT was 71.1%, a difference that persisted when controlling for slice thickness. Interobserver agreement for the detection of malleal ligaments was 65% with a Cohen's kappa coefficient of κ = 0.27.

Conclusion:
Visualization of the malleal ligaments using CT scans is feasible in a majority of aerated ears. Detection of malleal ligaments improves with thinner slice thickness and cone-beam technique. Low interobserver agreement suggests the importance of experience and a need for standardized review.
Case Report of a New Coupler for Round Window Application of an Active Middle Ear Implant
Authors: Lenarz Thomas , Zimmermann Denise , Maier Hannes , Busch Susan 
Published: October 2018

Objectives:
To evaluate feasibility, surgical handling, audiological outcome, and coupling efficiency of a new coupler (custom-made device) for an active middle ear implant.

Patient:
Revision surgery after implantation of an active middle ear implant in a 66-year-old male patient with mixed hearing loss.

Intervention:
Prosthetic hearing rehabilitation with a new coupler for round window application.

Main Outcome and Results:
The patient obtained good speech perception in quiet (word recognition scores 80%; Freiburg monosyllables) and noise (−3.3 dB SNR; Oldenburg Sentence Test). The effective gain with the Hannover coupler improved at frequencies > 0.5 kHz compared with the values reported for other round window (RW)-coupling modalities.

Conclusion:
The coupler provides a feasible option for the RW application of the middle ear implant actuator. The spring concept of the coupler needs to be improved to further standardize RW-coupling and improve coupling efficiency at low frequencies (0.5 kHz).
Microstructural Alterations in the Brains of Adults With Prelingual Sensorineural Hearing Loss: a Diffusion Kurtosis Imaging Study
Authors: Zou Yan , Yang Yan , Fan Wenliang , Yu Qun , Wang Miao , Han Ping , Ma Hui 
Published: October 2018

Objective:
To investigate the alterations in microstructural gray matter (GM) and white matter (WM) in adults with prelingual sensorineural hearing loss (SNHL) using diffusion kurtosis imaging (DKI) and explore whether the clinical data are associated with the whole brain structure changes in SNHL subjects.

Study Design:
Prospective case study.

Setting:
Tertiary class A teaching hospital.

Patients:
Eighty adults with prelingual SNHL.

Intervention:
Diagnostic.

Main Outcome Measure:
DKI-derived metrics, including mean kurtosis, radial kurtosis, axial kurtosis, fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity were applied to explore the differences in GM and WM between the groups across the whole brain with voxel-based analysis.

Results:
Compared with the control group, adults with prelingual SNHL exhibited significantly decreased fractional anisotropy, mean kurtosis, radial kurtosis, and axial kurtosis in the bilateral superior temporal gyrus in both the GM and WM. No correlations were detected between these alterations and clinical data.

Conclusions:
These findings suggest that DKI can provide comprehensive characteristics to demonstrate reductions in the auditory cortical GM and hypomyelination of WM fibers in the auditory pathway caused by auditory deprivation early in life.
Tinnitus Impacts on Speech and Non-speech Stimuli
Authors: Omidvar Shaghayegh , Mahmoudian Saeid , Khabazkhoob Mehdi , Ahadi Mohsen , Jafari Zahra 
Published: October 2018

Objective:
To investigate how tinnitus affects the processing of speech and non-speech stimuli at the subcortical level.

Study Design:
Cross-sectional analytical study.

Setting:
Academic, tertiary referral center.

Patients:
Eighteen individuals with tinnitus and 20 controls without tinnitus matched based on their age and sex. All subjects had normal hearing sensitivity.

Intervention:
Diagnostic.

Main Outcome Measures:
The effect of tinnitus on the parameters of auditory brainstem responses (ABR) to non-speech (click-ABR), and speech (sABR) stimuli was investigated.

Results:
Latencies of click ABR in waves III, V, and Vn, as well as inter-peak latency (IPL) of I to V were significantly longer in individuals with tinnitus compared with the controls. Individuals with tinnitus demonstrated significantly longer latencies of all sABR waves than the control group. The tinnitus patients also exhibited a significant decrease in the slope of the V-A complex and reduced encoding of the first and higher formants. A significant difference was observed between the two groups in the spectral magnitudes, the first formant frequency range (F1) and a higher frequency region (HF).

Conclusions:
Our findings suggest that maladaptive neural plasticity resulting from tinnitus can be subcortically measured and affects timing processing of both speech and non-speech stimuli. The findings have been discussed based on models of maladaptive plasticity and the interference of tinnitus as an internal noise in synthesizing speech auditory stimuli.
The Viability of Percutaneous Bone-Anchored Hearing Systems in the HIV Population
Authors: Kuschke Silva , Honnet Simon , Scott Alex J. , Labuschagne Sherene , Pithey Sharon , Solomons Zane , Meyer Estie 
Published: October 2018

Objective:
To determine the viability of percutaneous bone-anchored hearing systems (BAHS), in terms of local soft tissue complications, in the HIV population.

Study Design:
Retrospective folder review.

Setting:
Two tertiary-level academic state hospitals in Cape Town, South Africa.

Patients:
Twenty patients, of which six (30%) were HIV-positive. All HIV-positive patients had CD4 counts greater than 200, and were on highly-active antiretroviral therapy (HAART).

Intervention:
Percutaneous BAHS implantation surgery was performed on all patients.

Main Outcome Measure:
Comparisons were made between HIV-positive and HIV-negative patients in terms of incidence of local soft tissue complications post-implantation.

Results:
Soft tissue complications occurred in 50% of patients, and most were easily managed with topical treatment. No significant differences were found when comparing incidence of local soft tissue complications between HIV-positive and HIV-negative patients (p = 0.314). Similarly, surgical technique did not influence soft tissue complication incidence (p = 0.143).

Conclusions:
No significant differences in incidence of local soft tissue complications after percutaneous BAHS implantation were found between HIV-positive and HIV-negative patients. In a resource-constrained country like South Africa, where cost and time management are vital, these results indicate that the use of percutaneous BAHS implantation is a viable option, even in HIV-positive patients.
Esophageal neuroendocrine carcinoma complicated with unexpected hyperprocalcitonin
Authors: Hu Qida , Jin Piaopiao , Zhao Xinyu , Wu Wangteng , Huang Bingfeng , Shao Shiyi , Que Risheng , Liang Tingbo 
Published: October 2018

Abstract

Rationale:
Neuroendocrine tumors (NETs) with hyperprocalcitonin are relatively rare with a low incidence rate.

Patient concerns:
An afebrile 63-year-old male with persistent low back pain unexpectedly presented with an extreme hyperprocalcitonin. Radiological assessment revealed thickening of the esophageal wall with vertebral bone destruction and liver lesions. Endoscopy showed an irregular-shaped esophageal lesion which turned out to be poorly-differentiated NETs.

Diagnosis:
Esophageal NETs with multiple metastases.

Interventions:
The patient was treated with chemotherapies, and was evaluated by procalcitonin level and radiology within follow-up.

Outcome:
The procalcitonin levels were altered in line with the therapeutic response and disease progression during the treatment course.

Lessons:
Increased procalcitonin occurs in several malignancies with neuroendocrine components, such as NETs of the digestive system.
Normal pregnancy induced glucose metabolic stress in a longitudinal cohort of healthy women
Authors: Wang Mu , Xia Wei , Li Han , Liu Fang , Li Yuanyuan , Sun Xiaojie , Lu Songfeng , Xu Shunqing 
Published: October 2018

Abstract
During normal pregnancy, mothers face a unique physiological challenge in the adaptation of glucose metabolism in preparation for the metabolic stress presented by fetal development. However, the responsible mechanism remains elusive. The purpose of this study is to investigate the mechanism of the metabolic stress of glucose metabolism in pregnant women using metabolomics method.
A Ultra Performance Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometer-based untargeted metabolomics study was performed to investigate the dynamic urinary signature of the intermediates of glucose metabolism in a longitudinal cohort of 232 healthy pregnant women in their first, second, and third trimesters.
Twelve glucose metabolic intermediates were screened out from hundreds of candidate metabolites using partial least squares discriminant analysis models. These 12 markers were mainly involved in the metabolic pathways of insulin resistance, glycolysis/gluconeogenesis, tricarboxylic acid cycle, nonabsorbable carbohydrate metabolism, and N-glycan biosynthesis. In particular, l-acetylcarnitine, a metabolite that is beneficial for the amelioration of insulin resistance, decreased in a time-dependent manner during normal pregnancy. Moreover, thiamine pyrophosphate, an intermediate product of glycolysis/gluconeogenesis, significantly increased in the second trimester, and argininosuccinic acid and oxalosuccinic acid, intermediates involved in the tricarboxylic acid cycle, significantly decreased in the third trimester, suggesting an increased glucose demand in the maternal body during fetal development.
These findings provide novel insight into the normal pregnancy-induced elevation of insulin resistance and glycolysis/gluconeogenesis, as well as the observed reduction in the aerobic oxidation of glucose.
Pain monitoring and management in a rehabilitation setting after total joint replacement
Authors: De Luca Maria Laura , Ciccarello Marcello , Martorana Manfredi , Infantino Davide , Letizia Mauro Giulia , Bonarelli Stefano , Benedetti Maria Grazia 
Published: October 2018

Abstract
Total hip replacement (THR) and, particularly, total knee replacement (TKR), are painful surgical procedures. Effective postoperative pain management leads to a better and earlier functional recovery and prevents chronic pain. Studies on the control of pain during the postoperative rehabilitation period are not common. The aim of this study is to present results of a perioperative anesthetic protocol, and a pain treatment protocol in use in the Orthopaedic and the Rehabilitation intensive units of our Hospital. 100 patients (50 THR and 50 TKR) were retrospectively included in this observational study. Numeric Rating Scale (NRS) for pain at rest registered in the clinical sheet was retrieved for all patients and analyzed with respect to the spinal anaesthesia given for the surgery, local analgesia, analgesia protocol adopted during the postoperative days in the Orthopaedic Unit, the antalgic treatment given during the stay within the Rehabilitation Unit, the postoperative consumption of rescue pain medication, and any collateral effect due to the analgesic therapy. Patients reached standard functional abilities (walking at least 50 meters and climbing/descending stairs) at a mean length of 8 days without medication-related complications. Mean NRS during the time of stay was 1.3 ± 0.3 for THR and 1.3 ± 0.2 for TKR) and maximum mean NRS was 1.8 ± 0.5 for TKR and 1.8 ± 0.6 for THR. The use of rescue therapy in the rehabilitation guard was correlated with the mean NRS pain and the maximum NRS pain. A very good control of pain with the perioperative anesthetic protocol and pain treatment protocol in use was obtained.
Everolimus-induced pulmonary toxicity
Authors: Dejust Sebastien , Morland David , Bruna-Muraille Claire , Eymard Jean-Christophe , Yazbek Gabriel , Savoye Aude-Marie , Papathanassiou Dimitri 
Published: October 2018

Abstract
The everolimus–exemestane combination is indicated in advanced breast cancer treatment and usually well tolerated. The objective of the study was to determine the frequency of everolimus lung side effects and investigate their imaging characteristics on positron emission tomography with 18F-fluoro-deoxy-glucose combined with computerized tomography (18F-FDG PET/CT).
Our single-center retrospective descriptive study systematically included all patients with metastatic breast cancer treated by this combination (n = 29 representing 57 18F-FDG PET/CT). Number of segments involved was quantified. Maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic target volume (MTV), and total lesion glycolysis (TLG) were measured. Severe pneumopathy was studied by subgroup analysis.
Pleuroparenchymal anomalies rate detected on 18F-FDG PET/CT was 62%. Alveolar-interstitial lesions were mainly observed (89%) and affected 2.8 segments (0.5–11.5) with a median of 2 segments. S7 and S10 were the most involved segments with SUVmax 3.9 (1.3–8.8) and SUVmean 2.2 (0.7–4.9). Statistically significant difference (P = .02) was found with number of segment involved to characterize severe pneumopathy (average of 6.3 segments [2.5–11.5] vs 1.9 segments [0.5–8] for interstitial lung disease) but not with SUVmax, SUVmean, MTV, TLG (P = .14, 0.22, 0.22, and 0.17, respectively).
The 18F-FDG PET/CT could highlight pulmonary everolimus side effects, with a typical imaging pattern: alveolar-interstitial opacities associated with moderate uptake, more or less extensive, mainly affecting the lower lobes. Rarely, a pseudotumoral aspect may be detected, corresponding to a pitfall. MTV or TLG showed a tendency to differentiate severe pneumopathy vs interstitial lung disease but no statistically significant differences was observed contrarily to the number of segments involved. Further studies are necessary to determine if the 18F-FDG PET/CT could early predict adverse effects of mTOR inhibitors.
Splenic cystic lymphangiomatosis in association with omental varices and portal hypertension
Authors: Hsu Wei-Fan , Yu Cheng-Ju , Yeh Chun-Chieh , Huang Wen-Hsin , Peng Cheng-Yuan 
Published: October 2018

Abstract

Rational:
Lymphangiomatosis is rare and benign, and slowly proliferating lymphatic vessels of unknown etiology and visceral lymphangiomatosis involving the spleen is rare. Since lymphangiomatosis may be asymptomatic or present as a sense of fullness, splenic cystic lymphangiomatosis is a disease of little concern.

Patient concerns:
A 34-year-old woman suffering from progressive epigastric fullness after oral intake for two weeks.

Diagnoses:
Physical examination showed a palpable mass which was more than 10 cm in size over the left hypochondrium. An abdominal computed tomography disclosed marked splenomegaly with multiple cystic lesions in the spleen, causing external compression with right-sided deviation of the adjacent organs and varices in the upper abdomen. Esophagogastroduodenoscopy revealed portal hypertensive gastropathy.

Interventions:
Conventional total splenectomy was performed in this patient because of an enlarged spleen and unknown etiology, preoperatively. Upon surgery, splenomegaly with polycystic content and varicose vessels over the omentum were noted. Autologous spleen transplantation was not performed because of limited orthotopic and vascularized spleen.

Outcomes:
The patient is doing well 18 months after splenectomy.

Lessons:
This was a rare case presenting with splenic cystic lymphangiomatosis in association with omental varices and portal hypertension. Splenic cystic lymphangiomatosis should be considered in the differential diagnosis of patients with a palpable painless mass over the left hypochondrium.
Early post-operative cognitive dysfunction after closed-loop versus manual target controlled-infusion of propofol and remifentanil in patients undergoing elective major non-cardiac surgery
Authors: Besch Guillaume , Vettoretti Lucie , Claveau Melanie , Boichut Nathalie , Mahr Nicolas , Bouhake Yannis , Liu Ngai , Chazot Thierry , Samain Emmanuel , Pili-Floury Sebastien 
Published: October 2018

Abstract

Introduction:
Post-operative cognitive dysfunction (POCD) is frequent in patients older than 60 years undergoing major non-cardiac surgery, and increases both morbidity and mortality. Anesthetic drugs may exert neurotoxic effects and contribute to the genesis of POCD. The hypothesis of the POCD-ELA trial was that closed-loop target-controlled infusion of propofol and remifentanil could reduce the occurrence of POCD by decreasing the risk of excessive depth of anesthesia and the dose of anesthetic drugs.

Methods and analysis:
We designed a single-center, single-blind, randomized, controlled, parallel trial and aim to include 204 patients aged >60 years undergoing elective major non-cardiac surgery. Patients will be randomized to receive closed-loop versus manual target-controlled infusion of propofol and remifentanil guided by bispectral index monitoring. Cognitive assessment will be performed the day before surgery (baseline) and within 72 hours after surgery, using a battery of validated neuropsychological tests. The primary outcome is the incidence of POCD within 72 hours after surgery. POCD is defined as a Z-score value > 1.96 for at least 2 different tests or a Z-score composite value >1.96. The calculation of the Z-score is based on data from an age-matched control population who did not undergo surgery or general anesthesia.

Ethics and dissemination:
This study was approved by the Ethics Committee (Comité de Protection des Personnes Est-II) and authorized by the French Health Products Agency (Agence Nationale de Sécurité des Médicaments, Saint-Denis, France). The University Hospital of Besancon is the trial sponsor and the holder of all data and publication rights. Results of the study will be submitted for publication in a peer-review international medical journal and for presentation in abstract (oral or poster) in international peer-reviewed congresses.

Registration:
The trial is registered with ClinicalTrials.gov (Identifier: NCT02841423, principal investigator: Prof Emmanuel Samain, date of registration: July 22, 2016). Last amendment of protocol: version 8.0 April 2018.
Efficacy and safety of PDE5 inhibitors in the treatment of diabetes mellitus erectile dysfunction
Authors: Li Xiao , Zhao Qi , Wang Jingshang , Wang Jisheng , Dai Hengheng , Li Haisong , Wang Bin 
Published: October 2018

Abstract

Introduction:
Diabetes mellitus erectile dysfunction (DMED) is a common complication of long-term hyperglycemia. With the increasing of diabetic patients, the number of DMED patients is gradually growing up, which has a serious impact on the quality of life of patients. PDE5 inhibitors have good clinical efficacy in DMED patients. This study is designed to evaluate the efficacy and safety of PDE5 inhibitors in DMED patients.

Methods and analysis:
We will systematically search all randomized controlled trials (RCTs) by electronic and manual search. Electronic retrieval of the database includes Pubmed, EMBASE, The Cochrane Library, the Chinese BioMedical Literature Database, the China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal database (VIP) and the Wanfang database. Manual search will retrieve gray literature, including dissertations, ongoing experiments, grey literature, conference and unpublished documents. We use the IIEF-5 scale as the primary outcome of DMED. We also need to pay attention to the following outcomes: the sexual satisfaction of patients and their partners, like IIEF Q3 Q4; SEP 2, 3; GAQ. More importantly, the adverse reactions of patients during medication will also be taken seriously. Two reviewers will independently read the articles, extract the data information, and give the assessment of risk of bias. Data analysis will be used the special software like RevMan (version 5.3.5), ENDNOTE X7 and STATA 13.

Results:
This study will provide a comprehensive assessment based on current evidence of PDE5 inhibitors for DMED, especially its impacts on International Index of Erectile Function, the sexual satisfaction of patients and their partners and safety.

Ethics and dissemination:
This systematic review will evaluate the efficacy and safety of PDE5 inhibitors on DMED. This review does not require ethical approval and will be reported in a peer-reviewed journal.

Trial registration number:
PROSPERO CRD42018095185.
The association of polymorphisms in promoter region of MMP2 and MMP9 with recurrent spontaneous abortion risk in Chinese population
Authors: Li Li , Liu Jia , Qin Shuang , Li Ruiman 
Published: October 2018

Abstract
This study aimed to reveal the genetic association between polymorphisms in promoter region of matrix metalloproteinase 2 (MMP2) and matrix metalloproteinase 9 (MMP9) and the risk of recurrent spontaneous abortion (RSA) in Chinese population.
A total of 129 RSA patients and 116 relative controls were selected and the genotyping of polymorphism was conducted by polymerase chain reaction with sequencing. Genotype distribution of polymorphism in the control group was tested the status of Hardy–Weinberg equilibrium and then, genotype frequencies were compared between the case and control groups by chi-squared test. Odds ratio (OR) with the corresponding 95% confidence interval (95% CI) was computed to express the risk of RSA caused by polymorphism. Moreover, the linkage disequilibrium of polymorphisms in MMP2 was analyzed by Haploview software.
CT genotype and T allele of rs243865 in MMP2 were significantly associated with the increased susceptibility to RSA in Chinese population (CT vs. CC: OR = 1.926, 95% CI = 1.101–3.368; T vs. C: OR = 1.751, 95% CI = 1.146–2.676). Similarly, CT genotype carriers of rs3918242 in MMP9 were obviously more in RSA patients than that of the controls (P = .037), which indicated it was associated with the risk of RSA occurrence (OR = 1.760, 95% CI = 1.034–2.995). So was T allele in RSA development (OR = 1.595, 95% CI = 1.061–2.398). Haplotypes C-T and T-C were also the risk factors of RSA (OR = 1.673, 95% CI = 1.103–2.536; OR = 2.171, 95% CI = 1.372–2.436).

MMP2 rs243865 and MMP9 rs3918242 polymorphisms are significantly associated with the risk of RSA in Chinese population.