bluuebunny/crossref_metadata_2025_split huggingface dataset:
FDG PET/CT in a Case of Dural Amyloidoma
Authors: Ran Pengcheng , Liu Yupin , Liang Xiang , Zhang Yu , Dong Aisheng 
Published: October 2018

Abstract
Dural amyloidoma is an unusual presentation of central nervous system amyloidosis. A 49-year-old woman presented with 1-month history of repeated episodes of vertigo. Precontrast MRI showed dural thickening over right frontal convexity with signal intensity similar to white matter. Postcontrast T1-weighted images showed remarkable enhancement of the lesion. Dural amyloidoma was confirmed by partial resection of the lesion. The patient underwent no further treatment. A follow-up FDG PET/CT showed increased FDG uptake of the residual dural amyloidoma. This case indicates dural amyloidoma should be included in the differential diagnosis of abnormal FDG uptake in dural lesions.
Diagnosing Polyps on Transvaginal Sonography
Authors: Fadl Shaimaa A. , Sabry Ahmed Saied , Hippe Daniel Scott , Al-Obaidli Amal , Yousef Reda Ramadan , Dubinsky Theodore J. 
Published: October 2018

Background
Endometrial polyps are localized overgrowth of glands, stroma, and blood vessels and reported in 13% to 50% of women with dysfunctional uterine bleeding. Transvaginal ultrasound (TVUS) is the initial noninvasive modality of choice for the evaluation of endometrial polyps. The addition of intrauterine contrast by adding saline during saline infusion sonohysterography (SIS) has been reported to improve diagnostic accuracy in detecting of endometrial polyps. Given all the technical advances in ultrasound instrumentation and technology over the last 10 years, we wanted to revisit the diagnostic accuracy and associated confidence level of TVUS and SIS for detecting endometrial polyps.

Objective
The aims of this study was to determine the diagnostic accuracy of TVUS in detecting endometrial polyps in patients with abnormal uterine bleeding or infertility and to determine if SIS is necessary when the level of confidence that a polyp is present is high.

Materials and Methods
A total of 144 patients who underwent both TVUS and SIS for the evaluation of abnormal uterine bleeding and infertility were retrospectively identified and independently reviewed by 2 blinded readers. Examinations were graded as polyps absent, equivocal for polyps, and polyps definitely present. Interreader agreement for TVUS grade was assessed using Cohen kappa. Hysteroscopy and histopathology were used as the reference standard for the final diagnosis. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated, and confidence intervals (CIs) were computed.

Results
From the combined assessments of both readers (288 reads), 24.7% were definitively positive for polyps, 47.2% were negative, and 28.1% were equivocal by TVUS. Interreader agreement was good with a kappa of 0.66 (95% CI, 0.56–0.76). Among the 108 reads where hysteroscopy/histopathology results were available, even when diagnostic confidence for the presence of polyps was high, TVUS had a PPV of 65.2% (95% CI, 42.1%–88.9%). This PPV was significantly lower than the corresponding PPV of SIS of 88.5% (95% CI, 77.4–100.0%; P = 0.021 for the difference).

Conclusion
Saline infusion sonohysterography has better diagnostic accuracy for the detection and exclusion of endometrial polyps than TVUS, even in cases where the diagnostic confidence for the presence of polyps is high. Saline infusion sonohysterography may still be needed to confirm a TVUS diagnosis for polyps to limit the number of negative hysteroscopies.
Comparison of Real-Time and Static Ultrasonography Diagnoses for Detecting Incidental Diffuse Thyroid Disease
Authors: Baek Hye Jin , Kim Dong Wook , Lee Yoo Jin , Ahn Hye Shin , Ryu Ji Hwa 
Published: October 2018

Abstract
This study aimed to compare diagnostic accuracy of real-time and static ultrasonography (US) for differentiating diffuse thyroid disease (DTD) from normal thyroid parenchyma (NTP). At 4 participating institutions, 203 patients underwent real-time thyroid US before thyroid surgery. For static US, the same radiologists retrospectively evaluated US findings on a picture archive and communication system after 4 weeks. In real-time and static US diagnoses, US category included no DTD, indeterminate, suspicious for DTD, and DTD. We investigated the diagnostic accuracy of real-time and static US with a receiver operating characteristic curve analysis using histopathologic results as the reference standard. Histopathologic results exhibited NTP (n = 139), Hashimoto thyroiditis (n = 24), non-Hashimoto lymphocytic thyroiditis (n = 33), and diffuse hyperplasia (n = 7). Of 203 patients, there were significant differences in echogenicity, echotexture, glandular margin, and vascularity of the thyroid gland and US category between NTP and DTD groups in both real-time and static US diagnoses (P < 0.001). The diagnostic indices of real-time and static US were highest when the cutoff criterion was chosen as 1 or more abnormal US features. In addition, US category was the only feature with a significant difference between DTD and NTP groups regardless of the practical experience. The receiver operating characteristic curve analysis showed that real-time US was superior to static US in the diagnostic accuracy; however, there was no significant difference (P = 0.09). In conclusion, real-time and static US can be helpful for detecting incidental DTD by using US classification based on abnormal US features.
Simultaneous Bilateral Microtia Reconstruction Using Single-Expanded Postauricular Flap Without Skin Grafting
Authors: Xing Wenshan , Wang Yue , Qian Jin , Wang Bingqing , Zhou Xu , Liu Tun , Zhang YongBiao , Zhang Qingguo 
Published: October 2018

Background
Auricular reconstruction in patients with congenital microtia permits craniofacial balance and harmony, especially in patients with bilateral microtia. However, published techniques usually require skin grafting, which can lead to color mismatch and visible scarring. Some surgeons prefer to reconstruct the auricle of each side separately, which prolongs the complete cycle of surgery and increases suffering of the patient. In this study, we introduce a modified technique using single expanded flaps without skin grafting to achieve simultaneous bilateral auricular reconstruction.

Methods
Between January 2012 and January 2017, a total of 54 patients with bilateral microtia underwent auricular reconstruction with expanded single flaps. Simultaneous bilateral auricular reconstruction was accomplished through 3 surgical stages. In the first stage, bilateral postauricular skin was expanded using 2 kidney-shaped tissue expanders. In the second stage, bilateral rib cartilage was harvested using minimal incisions, allowing 2 modified 3-layer frameworks to be fabricated. Each framework was then inserted into the pocket through the same incision with subsequent closure using 2-layer suture. In the third stage, the reconstructed ears were further trimmed, if necessary, and the lobules and tragus reconstructed. All the patients were followed up for 6 to 24 months.

Results
During follow-up, patients were satisfied with surgical outcome in terms of size, shape, location, detailing, and symmetry of the bilateral ears in more than 50 cases. Only 4 demonstrated postoperative complications. No skin necrosis, exposure of cartilage, or infection was observed or postoperative chest deformities.

Conclusions
Simultaneous bilateral auricular reconstruction using single expanded flaps combined with a modified 3-layer cartilage framework is an effective technique for patients with bilateral microtia.
Readability, Suitability, and Complexity of Online Resources for Lower Extremity Reconstruction
Authors: Hughes Christopher D. , Tran Bao Ngoc N. , Rinkinen Jacob , Lee Bernard T. , Iorio Matthew L. 
Published: October 2018

Background
Surgical options for lower extremity reconstruction frequently include a decision between autologous free flap reconstruction and amputation. Patients rely on health education materials for information before making treatment decisions. This study evaluates the quality of online health information for lower extremity reconstruction.

Methods
We identified the top 10 Web sites for “leg amputation” and “leg free flap reconstruction.” Three validated tools were used to evaluate literacy demand of materials, including (1) the Simple Measure of Gobbledygook for readability; (2) the Peter Mosenthal and Irwin Kirsch readability formula for complexity of nonprose materials such as list, graphs, charts; and (3) the Centers for Disease Control and Prevention's Clear Communication Index (Index). Differences in mean between the 2 groups were compared using Student t test.

Results
Average Simple Measure of Gobbledygook reading grades approximated 12th-grade level and were similar between the 2 groups. This is above the recommended level of sixth-grade health literature. Complexity scores for nonprose materials of these groups were within recommended range and corresponded to very low complexity at a fourth- to seventh-grade level. The Centers for Disease Control and Prevention index was higher for amputation literature compared with free flap reconstruction (70% vs 54%), but the difference was not statistically significant.

Conclusions
Overall, online health resources for lower extremity amputation and free flap reconstruction do not meet the standard for quality and accessible health information. Free flap reconstruction resources are scarce and complex. Patients facing decisions about extremity reconstruction may not have appropriate online health resources available to them to make informed decisions.
Temporal Trends Associated With the Rise in Alcoholic Liver Disease-related Liver Transplantation in the United States
Authors: Cholankeril George , Gadiparthi Chiranjeevi , Yoo Eric R. , Dennis Brittany B. , Li Andrew A. , Hu Menghan , Wong Katherine , Kim Donghee , Ahmed Aijaz 
Published: October 2018

Background
In the United States, alcoholic liver disease (ALD) has recently become the leading indication for liver transplantation.

Methods
Using the United Network for Organ Sharing registry, we examined temporal trends in adult liver transplant waitlist (WL) registrants and recipients with chronic liver disease (CLD) due to ALD from 2007 to 2016.

Results
From 2007 to 2016, ALD accounted for 20.4% (18 399) of all CLD WL additions. The age-standardized ALD WL addition rate was 0.459 per 100 000 US population in 2007; nearly doubled to 0.872 per 100 000 US population in 2016 and increased with an average annual percent change of 47.56% (95% confidence interval, 30.33% to 64.72%).The ALD WL addition rate increased over twofold among young (18-39 years) and middle-aged (40-59 years) adults during the study period. Young adult ALD WL additions presented with a higher severity of liver disease including Model for End-Stage Liver Disease score compared to middle aged and older adults (≥60 years). The number of annual ALD WL deaths readily rose from 2014 to 2016, despite an overall annual decline in all CLD WL deaths. Severe hepatic encephalopathy, low body mass index (<18.5) and diabetes mellitus were significant predictors for 1-year WL mortality.

Conclusions
Alcoholic liver disease–related WL registrations and liver transplantation have increased over the past decade with a disproportionate increase in young and middle-aged adults. These subpopulations within the ALD cohort need to be evaluated in future studies to improve our understanding of factors associated with these alarming trends.
The Transplant Index: A Novel Method to Predict Adult Liver Transplant Waitlist Outcomes
Authors: Kueht Michael , Bakhtiyar Syed Shahyan , Wu Jessie , Liu Hao , Chan Warren H. , Petrowsky Henrik , Riaz Irbaz B. , Cotton Ronald , Galvan Nhu Thao , O’Mahony Christine , Goss John , Rana Abbas 
Published: October 2018

Background.
The field of transplantation is shifting outcome priorities from 1-year survival to more comprehensive metrics including transplant rate and waitlist mortality. Identifying disenfranchised candidates (high waitlist death risk, low transplantation chance) can be a focus to improve outcomes.

Methods.
Given the waitlist outcomes (continued waiting, death, and transplantation), we aimed to identify factors predicting the likelihood candidates would undergo transplant or death by performing multivariate competing risk analyses of 121 198 candidates in the United Network for Organ Sharing database. We incorporated these probabilities (likelihood of transplantation and waitlist death) into the Transplant Index (TI) to identify disenfranchised candidates (high likelihood of death, low likelihood of transplantation).

Results.
Half of the patients had low incidences of death and transplantation within 90 days (TI-inactive). The remaining were stratified into 10 groups within a predictive index, the TI. Low TI groups (TI 10, 20, 30) had 90-day transplant rates of 50.8%, 41.6%, and 39.8% respectively, and their respective 90-day death rates were 22.8%, 15.1%, and 10.9%. High TI groups (TI 80, 90, >90) had 90-day transplantation rates of 53.7%, 64.3%, and 73.9%, respectively, and 90-day death rates of 5.9%, 6.5%, and 6.7% respectively. As TI increased, the likelihood of transplantation increased and that of death decreased. Low-TI groups represent the disenfranchised candidates.

Conclusions.
The TI identifies disenfranchised candidates on the adult liver transplant waitlist. This is the subgroup that would benefit the most from efforts to increase access to transplantation.
The Outcome of Allogeneic Hematopoietic Stem Cell Transplantation for Inherited Diseases Is Influenced by HLA Match, Year of Transplantation, and Immunized Female Donor
Authors: Ringden Olle , Remberger Mats , Gustafsson Britt , Moretti Gianluca , Mattsson Jonas , Winiarski Jacek , Sadeghi Behnam 
Published: October 2018

Background.
For many inborn errors of metabolism (IEM), allogeneic hematopoietic stem cell transplantation (HSCT) is the only cure.

Methods.
We report the outcome in 160 patients with inherited diseases, who were treated with HSCT in 3 decades. Median age was 3 years (range 0.1–63). Grafts were from matched related donors (MRDs, 56), matched unrelated donors (MUDs, 66), or HLA-mismatched donors (38).

Results.
Graft failure (GF) occurred in 26 patients (16%), severe acute graft-versus-host disease (GVHD) in 9 (6%), and chronic GVHD in 23 (12%). Ten-year survival was 64% before the year 2000 and 86% after that (P = 0.01). Ten-year survival for MRD grafts was 90%, as opposed to 79% for MUD grafts and 56% for HLA-mismatched grafts (P = 0.03). In multivariate analysis, GF was associated with having an HLA-mismatched donor (P < 0.05) or MUD (P = 0.015) and with reduced-intensity conditioning (P < 0.01). Death was associated with year of transplant (P = 0.015), having an HLA-mismatched donor (P < 0.001), and being a male recipient from an immune female donor (P = 0.05).

Conclusions.
The outcome after HSCT for IEM depends on HLA match, year and immune female donor.
Recommendations for Management and Treatment of Nonalcoholic Steatohepatitis
Authors: Ratziu Vlad , Ghabril Marwan , Romero-Gomez Manuel , Svegliati-Baroni Gianluca 
Published: October 2018

Abstract
The prevalence of nonalcoholic liver disease (NAFLD) is increasing worldwide in conjunction with the epidemic increase in obesity and metabolic risk factors. Consequently, NAFLD has become a leading indication for liver transplantation. Although genetic factors play an important role in the pathogenesis of NAFLD, detrimental lifestyle trends favoring a calorically unrestricted diet rich in carbohydrates and unsaturated fat, prolonged sedentary periods or limited physical activity have major metabolic implications. In aggregate these physiological dysregulations constitute the main risk factors for the metabolic syndrome and NAFLD. The cornerstone of the treatment of NAFLD, is lifestyle changes, including modifications to diet and physical activity, to reduce body weight and liver fat, however adherence is notoriously poor and the epidemic of NAFLD continues to grow unimpeded. In the face of this unmet clinical need, the pharmacologic therapy of NAFLD has been expanding as the varied mechanistic pathways of NAFLD are elucidated. Beyond these approaches to treating NAFLD, the prevention of other liver diseases is additionally important. Chief among these is alcoholic liver disease, and heavy use is detrimental irrespective of underlying NAFLD. However, the impact of mild to moderate alcohol use in patients with mild or nonadvanced forms NAFLD is undefined. This article summarizes the results of the International Liver Transplantation Society consensus meeting on NAFLD in liver transplantation. It describes the available evidence and provides consensus guidance on the lifestyle and pharmacologic therapies of NAFLD, and the consensus position on alcohol use in patients with NAFLD.
Risk Factors for Fellow Eye Involvement in Nonarteritic Anterior Ischemic Optic Neuropathy
Authors: Chang Melinda Y. , Keltner John L. 
Published: October 2018

Background:
Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in individuals older than 50 years. Demographic, ocular, and systemic risk factors for NAION have been identified, and we sought to determine which, if any, of these factors also increase risk of NAION in the fellow eye.

Methods:
We performed a retrospective chart review of patients with “ischemic optic neuropathy” (based on International Classification of Disease [ICD] codes) seen at a single eye center between 2007 and 2017. Patients who met diagnostic criteria for unilateral NAION without fellow eye optic neuropathy at diagnosis were included. Demographic information, ocular comorbidities, and systemic diagnoses were recorded, in addition to whether the fellow eye developed NAION during the follow-up period. Univariate and multivariate Cox proportional hazard regression were used to calculate hazard ratios (HRs) for fellow eye involvement.

Results:
Three hundred eighteen patients were identified by ICD codes, and 119 were included in the study. Twenty-nine (24%) patients developed NAION in the fellow eye over the mean follow-up period of 3.6 years (range: 1 month–11 years). Significant risk factors for fellow eye NAION included the presence of bilateral optic disc drusen (ODD, HR 2.78, 95% confidence interval [CI] 1.12–6.90, P = 0.02) and noncompliance with continuous positive airway pressure (CPAP) in patients with moderate-to-severe obstructive sleep apnea (HR 4.50, 95% CI 1.79–11.3, P = 0.0015).

Conclusions:
Bilateral ODD and noncompliance with CPAP when indicated are associated with increased risk of NAION in the fellow eye. Patients with these risk factors should be counseled on the potentially devastating visual consequences of bilateral NAION, and compliance with CPAP should be stressed when appropriate.
Developmental tuning of mineralization drives morphological diversity of gill cover bones in sculpins and their relatives
Authors: Cytrynbaum Eli G. , Small Clayton M. , Kwon Ronald Y. , Hung Boaz , Kent Danny , Yan Yi-lin , Knope Matthew L. , Bremiller Ruth A. , Desvignes Thomas , Kimmel Charles B. 
Published: October 2018

AbstractThe role of osteoblast placement in skeletal morphological variation is relatively wellunderstood, but alternative developmental mechanisms affecting bone shape remain largely unknown. Specifically, very little attention has been paid to variation in later mineralization stages of intramembranous ossification as a driver of morphological diversity. We discover the occurrence of specific, sometimes large regions of nonmineralized osteoid within bones that also contain mineralized tissue. We show through a variety of histological, molecular, and tomographic tests that this “extended” osteoid material is most likely nonmineralized bone matrix. This tissue type is a significant determinant of gill cover bone shape in the teleostean suborder Cottoidei. We demonstrate repeated evolution of extended osteoid in Cottoidei through ancestral state reconstruction and test for an association between its presence and habitat differences among species. Through measurement of extended osteoid at various stages of gill cover development in species across the phylogeny, we gain insight into possible evolutionary developmental origins of the trait. We conclude that this finetuned developmental regulation of bone matrix mineralization reflects heterochrony at multiple biological levels and is a novel mechanism for the evolution of diversity in skeletal morphology. This research lays the groundwork for a new model in which to study bone mineralization and evolutionary developmental processes, particularly as they may relate to adaptation during a prominent evolutionary radiation of fishes.
A bacteria-derived tail anchor localizes to peroxisomes in yeast and mammalian cells
Authors: Lutfullahoğlu-Bal Güleycan , Bengisu Seferoğlu Ayşe , Keskinb Abdurrahman , Akdoğan Emel , Dunna Cory D. 
Published: October 2018

ABSTRACTProkaryotes can provide new genetic information to eukaryotes by horizontal gene transfer (HGT), and such transfers are likely to have been particularly consequential at the dawn of eukaryogenesis. Since eukaryotes are highly compartmentalized, it is worthwhile to consider the mechanisms by which newly transferred proteins might reach diverse organellar destinations. Toward this goal, we have focused our attention upon the behavior of bacteria-derived tail anchors (TAs) expressed in the eukaryoteSaccharomyces cerevisiae. In this study, we report that a predicted membrane-associated domain of theEscherichia coliYgiM protein is specifically trafficked to peroxisomes in budding yeast, can be found at a pre-peroxisomal compartment (PPC) upon disruption of peroxisomal biogenesis, and can functionally replace an endogenous peroxisome-directed TA. Furthermore, the YgiM(TA) can also localize to peroxisomes in mammalian cells. Since the YgiM(TA) plays no endogenous role in peroxisomal function or assembly, this domain is likely to serve as an excellent tool toward illumination of the mechanisms by which TAs can travel to peroxisomes. Moreover, our findings emphasize the ease with which bacteria-derived sequences might target to organelles in eukaryotic cells following HGT, and we discuss the importance of flexible recognition of organelle targeting information during and after eukaryogenesis.