bluuebunny/crossref_metadata_2025_split huggingface dataset:
Small-Incision Femtosecond Laser–Assisted Intracorneal Concave Lenticule Implantation in Patients With Keratoconus
Authors: Jin He , He Miao , Liu Hongshan , Zhong Xiaoying , Wu Junshu , Liu Liangping , Ding Hui , Zhang Chi , Zhong Xingwu 
Published: January 2019

Purpose:
To evaluate the feasibility and efficacy of small-incision femtosecond laser–assisted intracorneal concave lenticule implantation (SFII) and penetrating keratoplasty (PKP) in patients with progressive keratoconus.

Methods:
All the patients were clinically diagnosed with progressive keratoconus. Twenty patients underwent PKP (PKP group), and 11 patients underwent SFII (SFII group). Visual acuity, intraocular pressure, corneal topography, corneal visualization Scheimpflug technology, anterior segment optical coherence tomography, and in vivo confocal microscopy were analyzed.

Results:
Vision improved at 3 months postoperatively in the SFII group. In the PKP group, corrected distance visual acuity improved 1 week after surgery. Corneal topography showed a statistically significant decrease in the anterior K1 and K2. Corneal visualization Scheimpflug technology showed that changes in the biomechanical parameters of the SFII group were also statistically different from those of the PKP group. All the grafts from both groups were clearly visible by anterior segment optical coherence tomography observation. The central corneal thickness of both groups was stable during the 24-month study period. In vivo confocal microscopy showed a few dendritic cells in the subepithelial region in the SFII group. At 3 months after surgery, many dendritic cells and inflammatory cells were observed in the basal epithelium and stroma in the PKP group.

Conclusions:
Both SFII and PKP surgical procedures resulted in a stable corneal volume and improved visual acuity in this long-term study. SFII was less invasive and more efficient compared with PKP.
Postoperative Complications of Ab Interno Gelatin Microstent
Authors: Rooney David M. , Shadid Husam R. , Siegel Les I. , Watnick Richard L. , Lesser G. Robert , Obertynski Thomas , Siegel Marc J. , Citron Matthew E. , Hasbrook Madeline , Siegel Michael J. 
Published: January 2019

Purpose:
To report 4 previously undescribed postoperative complications in 4 cases of ab interno XEN45 Gel Stent (XEN) implantation following uncomplicated surgeries.

Patients and Methods:
A total of 51 consecutive XEN implantations performed between July 1, 2017 and April 30, 2018 were reviewed. All cases were performed by 7 experienced glaucoma surgeons affiliated with the William Beaumont Hospital, Department of Ophthalmology. Cases with postoperative complications were identified, and a literature review was performed on PubMed.gov between April 5, 2018 and June 2, 2018 to identify previously unreported XEN complications.

Results:
Case 1 consisted of an 86-year-old woman who suffered a suprachoroidal hemorrhage and associated rhegmatogenous retinal detachment following XEN implantation. One month after sclerotomy drainage and pars plana vitrectomy repair, an amputated XEN was found to have eroded through the conjunctiva. Case 2 consisted of a 68-year-old man with persistent elevated intraocular pressure due to recurrent Tenon’s capsule fibrosis who developed complete XEN retraction into the subconjunctival space. Cases 3 and 4 consisted of a 68-year-old man and a 78-year-old woman who developed occlusion of the microstent’s internal ostium by a partially detached Descemet’s membrane. Case 3 maintained normal intraocular pressure on timolol, whereas case 4 resulted in bleb failure, despite Nd:YAG laser lysis of the occluded XEN internal ostium.

Conclusions:
Although the XEN is a promising new surgical option for the management of primary open-angle glaucoma, it can present unique postoperative challenges that are still being elucidated. Timely intervention or prevention of these complications can be improved by early surgeon recognition and effective communication with comanaging ophthalmologists.
A Comparison of Deep Sclerectomy Trainer Versus Trainee Outcomes
Authors: Karaconji Tanya , Mercieca Karl , Romera Pau , McNaught Andrew , Anand Nitin 
Published: January 2019

Purpose:
The aim of this study was to compare the results of deep sclerectomy (DS) and combined deep sclerectomy with phacoemulsification (phaco-DS) performed by clinical fellows with those by an experienced glaucoma surgeon and DS trainer.

Patients and Methods:
This is a retrospective nonrandomized study of 266 eyes of 226 consecutive patients who had DS or phaco-DS between March 2014 and December 2016 which were included from a database of all glaucoma surgery performed in our department. A minimum of 9 months follow-up was required. The cases were recorded as to whether a fellow or consultant performed the entire procedure. Overall, 114 surgeries were performed by the consultant and 164 surgeries were performed by the fellow, in which 91 cases received no assistance from the consultant. Intraocular pressure (IOP) success criteria were: (A) IOP<22 mm Hg and/or 20% decrease from baseline off any glaucoma medications and (B) IOP<16 mm Hg and/or 30% drop from baseline off any glaucoma medications.

Results:
No statistically significant difference was noted by any criteria (P<0.05) between the 2 groups. The Kaplan-Meir IOP success rates at 2 years with criteria B (IOP<16 mm Hg without medications) were 64% for consultant, 76% for independent surgeries done by a fellow and 72% for surgeries with assistance from the consultant trainer (P=0.15). There were no significant differences between measured IOPs at any time after surgery. Intraoperative perforation of trabeculo-Descemet membrane was noted in 4 cases (3.5%) done by the consultant and 12 cases (7.3%) performed by fellows (Fisher exact P=0.19).

Conclusions:
IOP outcomes of DS and phaco-DS were not adversely affected if fellows performed surgery, whether under supervision or independently.
Spinal somatostatin-positive interneurons transmit chemical itch
Authors: Fatima Mahar , Ren Xiangyu , Pan Haili , Slade Hannah F.E. , Asmar Alyssa J. , Xiong Cynthia M. , Shi Angela , Xiong Ailin E. , Wang Lijing , Duan Bo 
Published: January 2019

Abstract
Recent studies have made significant progress in identifying distinct populations of peripheral neurons involved in itch transmission, whereas the cellular identity of spinal interneurons that contribute to itch processing is still a debate. Combining genetic and pharmacological ablation of spinal excitatory neuronal subtypes and behavioral assays, we demonstrate that spinal somatostatin-positive (SOM+) excitatory interneurons transmit pruritic sensation. We found that the ablation of spinal SOM+/Lbx1+ (SOMLbx1) neurons caused significant attenuation of scratching responses evoked by various chemical pruritogens (chemical itch). In an attempt to identify substrates of spinal itch neural circuit, we observed that spinal SOM+ neurons partially overlapped with neurons expressing natriuretic peptide receptor A (Npra), the receptor of peripheral itch transmitter B-type natriuretic peptide. Spinal SOM+ neurons, however, did not show any overlap with itch transmission neurons expressing gastrin-releasing peptide receptor in the dorsal spinal cord, and the gastrin-releasing peptide–triggered scratching responses were intact after ablating spinal SOM+ neurons. Dual ablation of SOMLbx1 and Npra+ neurons in the spinal cord reduced chemical itch responses to a greater extent than ablation of SOMLbx1 or Npra+ neurons alone, suggesting the existence of parallel spinal pathways transmitting chemical itch. Furthermore, we showed that SOM peptide modulated itch processing through disinhibition of somatostatin receptor 2A–positive inhibitory interneuron. Together, our findings reveal a novel spinal mechanism for sensory encoding of itch perception.
The serum protease network—one key to understand complex regional pain syndrome pathophysiology
Authors: König Simone , Bayer Malte , Dimova Violeta , Herrnberger Myriam , Escolano-Lozano Fabiola , Bednarik Josef , Vlckova Eva , Rittner Heike , Schlereth Tanja , Birklein Frank 
Published: January 2019

Abstract
Complex regional pain syndrome (CRPS) develops after fracture. The acute CRPS phenotype resembles exaggerated inflammation, which is explained by local and systemic activation of a proinflammatory network including peptides and cytokines. Epidemiologic data suggest that inactivation of the peptidase angiotensin-converting enzyme in patients treated for hypertension increases the odds to develop CRPS. This hint leads us to investigate the serum protease network activity in patients with CRPS vs respective controls. For this purpose, we developed a dabsyl-bradykinin (DBK)-based assay and used it to investigate patients with CRPS, as well as healthy and pain (painful diabetic neuropathy [dPNP]) controls. The major result is that the degradation of DBK to fragments 1-8 and 1-5 in healthy control and dPNP is shifted to higher values for DBK1-8 and lower values for DBK1-5 at 1 hour of incubation in patients with CRPS. Using this novel reporter peptide assay, we have been able to show that the resolving protease network for mediators such as BK might be different in patients with CRPS; having a look at the clinical signs, which resemble inflammation, this resolving protease network is probably less effective in CRPS.
Milk Thistle Treatment for Children and Adults with Trichotillomania
Authors: Grant Jon E. , Redden Sarah A. , Chamberlain Samuel R. 
Published: January 2019

Abstract

Background
Data on the pharmacological treatment of trichotillomania are limited. Milk thistle has antioxidant properties and showed promise in trichotillomania in a prior case report. The goal of the current study was to determine the efficacy and tolerability of silymarin in children and adults with trichotillomania.

Methods
Twenty individuals (19 [95.0%] women; 16 adults; mean age, 27.9 [11.5] years) with trichotillomania entered a 12-week, double-blind, placebo-controlled crossover study (6 weeks of milk thistle and 6 weeks of placebo with a 1-week wash-out in between). Dosing of milk thistle ranged from 150 mg twice a day to 300 mg twice a day. Subjects were assessed with the National Institute of Mental Health Trichotillomania Severity Scale (primary outcome), the Massachusetts General Hospital Hair Pulling Scale, Clinical Global Impression scale, and measures of depression, anxiety, and psychosocial functioning. Outcomes were examined using linear mixed models with a random intercept for subject and t tests.

Results
There were no statistically significant treatment type-by-time interactions for the main outcome measure, but significant effects were seen for secondary measures (eg, time spent pulling per day for the past week). From baseline to week 6, there was a significant decrease in Clinical Global Impression severity for the milk thistle group but not in the placebo group.

Conclusions
This trial failed to show that milk thistle was more effective than placebo on the main outcome measure, but milk thistle did demonstrate significant improvements on select secondary outcome measures. These findings may shed light on important neurochemical targets worthy of future investigation.
Fostering promotion and protection of the professional nurse practitioner role: A call to action
Authors: Berg Judith A. , Ruppert Susan D. 
Published: January 2019

ABSTRACT
The professional obligations to protect and promote nursing professional roles stem from the American Nurses Association Code of Ethics. Nurturing new generations of NPs to assume leadership role is foundational to succession planning and is critical to assuring NPs’ continued contributions to health care. Making professional role development a priority at various points in educational programs, modeling ways to contribute to the profession, and encouraging professional organization membership are a few of the suggestions presented for the academic environment. In clinical settings, NP meetings are opportunities to engage NPs in legislative and policy issues important to practice. Attaining employee benefits, such as conference attendance, can promote commitment; and precepting NP students forges professional bonds. Present and future generations of NPs must assume responsibility for protecting and promoting the role. Many threats to NPs’ scope of practice and other professional conundrums are ongoing. Instilling the values of protecting and promoting the NP role in students and colleagues and then identifying leaders to direct these efforts are essential to succession planning.
Electric-Acoustic Stimulation After Reimplantation: Hearing Preservation and Speech Perception
Authors: Thompson Nicholas J. , Dillon Margaret T. , Bucker Andrea L. , King English R. , Pillsbury Harold C. , Brown Kevin D. 
Published: January 2019

Objective:
Hearing preservation after cochlear implantation allows for fitting of acoustic and cochlear implant technologies in the same ear, known as Electric-Acoustic Stimulation (EAS). Cochlear implant recipients with EAS who experience an internal device failure face the additional risk of residual hearing loss during reimplantation. This report reviews the case of an EAS recipient with long-term hearing preservation and significant benefit who experienced a device failure and underwent cochlear reimplantation.

Patient:
Case study who presented with an internal device failure after nearly 10 years of hearing preservation and significant benefit with an EAS device.

Intervention:
Reimplantation with hearing preservation electrode array.

Main Outcome Measures:
Unaided residual hearing and aided speech perception with an EAS device using CNC words in quiet and CUNY sentences in noise.

Results:
Low-frequency thresholds were similar when comparing residual hearing pre- and post-reimplantation. The patient does not use the acoustic portion of the EAS device due to normal low-frequency hearing sensitivity—even after two cochlear implantation procedures. At the 3-month follow-up interval, the patient demonstrated restoration of aided speech perception performance with the EAS device.

Conclusions:
Hearing preservation can be maintained with long-term use of EAS devices. Those with preserved low-frequency hearing who experience a device failure may maintain hearing preservation after reimplantation. Normal low-frequency hearing thresholds were maintained in the present case, and the patient continued to listen with the EAS device without the acoustic component. EAS recipients may experience rapid restoration in speech perception after reimplantation in the presence of hearing preservation.
Linked-read Sequencing Analysis Reveals Tumor-specific Genome Variation Landscapes in Neurofibromatosis Type 2 (NF2) Patients
Authors: Roberts Daniel S. , Maurya Rahul , Takemon Yuka , Vitte Jeremie , Gong Liang , Zhao Juanjuan , Wong Chee-Hong , Slattery William , Peng Kevin A. , Lekovic Gregory , Schwartz Marc S. , Bulsara Ketan , Ngan Chew Yee , Giovannini Marco , Wei Chia-Lin 
Published: January 2019

Hypothesis:
We hypothesize that genomic variants including deletions, insertions, inversions, and tandem duplications beyond the changes in tumor suppressor NF2 gene affect gene expression of tumor-specific pathways in vestibular schwannomas (VS) patients with Neurofibromatosis type 2 (NF2), thus contributing to their clinical behavior.

Background:
Genomic variation could reconfigure transcription in NF2 transformation process. Therefore, genome-wide high-resolution characterization of structural variants (SV) landscapes in NF2 tumors can expand our understanding of the genes regulating the clinical phenotypes in NF2-associated VS.

Methods:
We performed whole-genome haplotype-specific structural variation analysis using synthetic linked reads generated through microfluidics-based barcoding of high molecular weight DNA followed by high-coverage Illumina paired-end whole-genome sequencing from 10 patients’ tumors of different growth rates and their matching blood samples.

Results:
NF2 tumor-specific deletions and large SVs were detected and can be classified based on their association with tumor growth rates. Through detailed annotation of these mutations, we uncover common alleles affected by these deletions and large SVs that can be associated with signaling pathways implicated in cell proliferation and tumorigenesis.

Conclusion:
The genomic variation landscape of NF2-related VS was investigated through whole-genome linked-read sequencing. Large SVs, in addition to deletions, were identified and may serve as modulators of clinical behavior.
Intraoperative Evaluation of Cochlear Implant Electrodes Using Mobile Cone-Beam Computed Tomography
Authors: Yamamoto Norio , Okano Takayuki , Yamazaki Hiroshi , Hiraumi Harukazu , Sakamoto Tatsunori , Ito Juichi , Omori Koichi 
Published: January 2019

Objective:
To evaluate the electrode status during cochlear implantation (CI) using mobile cone-beam CT (mCBCT).

Study Design:
Retrospective case review.

Setting:
Tertiary referral hospital.

Patients:
Fifty-seven patients (7 bilateral surgeries, 64 ears) who underwent CI and who received intraoperative mCBCT imaging.

Intervention:
CI and CBCT during surgery.

Main Outcome Measure:
Electrode location and angular insertion depth determined by intraoperative mCBCT images.

Results:
There were six cases with cochlear malformation where intraoperative mCBCT was useful to confirm electrode location. Of 58 ears with a normal cochlear morphology, perimodiolar, straight, and mid-scalar electrodes were used in 30 (cochleostomy; 14 advance off-stylet technique cases), 27 (26 round window [RW] insertion, 1 extended round window [ERW] insertion), and 1 (RW insertion) ears, respectively. Complete scala-tympani (ST) insertion was achieved in 35 ears (14 cochleostomy, 21 RW or ERW insertion). The complete ST-insertion rate was significantly higher with RW or ERW insertion than that for cochleostomy insertion (p = 0.03), although cochleostomy insertion using the advanced off-stylet technique had a similar rate to RW or ERW insertion. The angular insertion depth values (average ± standard deviation) for perimodiolar electrodes (354.4 ± 29.44 degrees) were significantly smaller than those for Flex24 (464.8 ± 43.09 degrees) and Flex28 (518.2 ± 61.91 degrees) electrodes (p < 0.05).

Conclusions:
Evaluation of CI electrodes using intraoperative mCBCT was comparable to that with fan-beam CT or c-arm-based CBCT. Considering the low radiation dose of mCBCT and its availability in any operation room, mCBCT is the better modality for evaluating cochlear implant electrode arrays.
Facial Rehabilitation as Noninvasive Treatment for Chronic Facial Nerve Paralysis
Authors: Karp Emily , Waselchuk Emily , Landis Cynthia , Fahnhorst Jill , Lindgren Bruce , Lyford-Pike Sofia 
Published: January 2019

Objectives:
This study aims to evaluate the effectiveness of facial rehabilitation (FR) in patients with chronic facial nerve paralysis (FNP) and describe factors that predict improved facial nerve function after FR in this patient population.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Around 241 patients were referred to a university hospital facial rehabilitation (FR) program for FNP between 1995 and 2016. Seventy-six patients met criteria, defined as diagnosis of FNP ≥12 months prior to initiation of FR.

Interventions:
Each received at least two sessions of directed FR by a single therapist. Techniques employed: neuromuscular retraining, stretching/massage, and active exercise.

Main Outcomes:
Variables affecting outcomes were analyzed to determine association with success of FR as measured by improvement in Facial Grading System (FGS) scale.

Results:
Onset of FNP to initiation of FR ranged 12 to 384 months (mean latency = 64.7 months). All patients, age 20 to 89, showed improvement in FGS after FR (mean, 16.54 points, SD 9.35). Positive predictors of FGS improvement after therapy (p-values < 0.05): increased the number of therapy sessions, right side of face being treated for FNP, lower starting FGS score. When controlling for these important variables, time from diagnosis to initiation of therapy was not significantly associated with improvement in FGS score.

Conclusion:
Facial rehabilitation was associated with improved FGS score regardless of patient age, gender, or latency to facial rehabilitation. As a noninvasive treatment option with positive outcomes, it should be offered to patients with facial nerve paralysis regardless of chronicity.
The evolution of genetic-based risk scores for lipids and cardiovascular disease
Authors: Dron Jacqueline S. , Hegele Robert A. 
Published: January 2019

Purpose of review
With improved next-generation sequencing technology, open-access genetic databases and increased awareness of complex trait genetics, we are entering a new era of risk assessment in which genetic-based risk scores (GRSs) will play a clinical role. We review the concepts underlying polygenic models of disease susceptibility and challenges in clinical implementation.

Recent findings
Polygenic risk scores are currently used in genetic research on dyslipidemias and cardiovascular disease (CVD). Although the underlying principles for constructing polygenic scores for lipids are established, the lack of consensus on which score to use is indicated by the large number — about 50 — that have been published. Recently, large-scale polygenic scores for CVD appear to afford superior risk prediction compared to small-scale scores. Despite the potential benefits of GRSs, certain biases towards ethnicity and sex need to be worked through.

Summary
We are on the verge of clinical application of GRSs to provide incremental information on dyslipidemia and CVD risk above and beyond traditional clinical variables. Additional work is required to develop a consensus of how such scores will be constructed and measured in a validated manner, as well as clinical indications for their use.
Prophylactic human papilloma virus vaccination in head and neck: indications and future perspectives
Authors: Wierzbicka Małgorzata , Berkhof Johannes Hans , Dikkers Frederik G. 
Published: January 2019

Purpose of review
To gain the evidence-based knowledge concerning the efficacy of HPV vaccination for oropharyngeal sites and to highlight the trials and strategies for vaccine administration in HPV-dependent head and neck diseases.

Recent findings
Vaccination can be provided in two injections. There is increasing anecdotal evidence that therapeutic vaccination is effective in treatment of recurrent respiratory papillomatosis.

Summary
The availability and broadening spectrum of HPV vaccines make possible the prevention of cervical and other HPV-dependent diseases. Vaccination is now included in the national immunization programs of most industrial countries and will be used, it is hoped, in developing countries within the next few years. In developing countries, few women are screened for cervical precancerous lesions, making immunization even more important. In affluent countries and matured societies, with high coverage of cervical screening, the focus of interest will shift to other HPV-related diseases. The HPV vaccination is effective in preventing oral infection with types targeted by the vaccines.
The devil is in the detail: current management of perioperative surgical complications after liver transplantation
Authors: Patel Priyal , DiNorcia Joseph 
Published: January 2019

Purpose of review
Despite advances in the field, perioperative morbidity is common after liver transplantation. This review examines the current literature to provide up-to-date management of common surgical complications associated with liver transplantation.

Recent findings
Research focuses on problems with anastomoses of the vena cava, portal vein, hepatic artery, and bile ducts. Interventional endoscopic and radiological techniques are used more frequently to avoid reoperation.

Summary
Advances in the management of perioperative surgical complications have focused on minimally invasive measures that successfully treat technical problems with implantation of liver allografts from both living and deceased donors.