bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcomes of Descemet Stripping Endothelial Keratoplasty in Eyes With Glaucoma Drainage Devices
Authors: Kang Joann J. , Ritterband David C. , Atallah Richard T. , Liebmann Jeffrey M. , Seedor John A. 
Published: May 2019

Precis:
In this retrospective case series of 85 eyes, 31.8% developed graft failure and graft survival was 50% at 3 years. The presence of an aqueous shunt has a significantly adverse effect on long-term graft survival.

Purpose:
To report visual outcomes and complications of Descemet stripping endothelial keratoplasty (DSEK) in eyes with glaucoma drainage devices (GDD).

Materials and Methods:
A retrospective chart review was conducted of 122 procedures of 85 eyes of 83 patients who underwent DSEK and had prior or concurrent GDD implantation. Mean follow-up was 36.5±31.4 months. Patients with postoperative follow-up of <3 months were excluded from analysis. Outcome measures examined included visual acuity, donor dislocation rate, intraocular pressure (IOP), and graft survival.

Results:
The mean logMAR vision improved to 1.07 postoperatively from 1.43 preoperatively, with 61% of eyes experiencing improved visual acuity. Graft dislocation occurred in 27 (31.8%) eyes and required repeat injection of air in the anterior chamber. Primary graft failure occurred in 2 (2.4%) eyes, whereas secondary graft failure occurred in 27 (31.8%) of eyes, with an average time of 24.3 months for development. Estimated survival rates at 1, 2, and 3 years were 89%, 78%, and 50%, respectively. Escalation of IOP occurred in 21 (24.7%) eyes postoperatively, where 14 eyes underwent medical therapy and 7 eyes required surgical intervention/laser for IOP control.

Conclusions:
DSEK after GDD is a viable alternative to treat endothelial dysfunction, with the majority of patients achieving visual improvement. However, aqueous shunt implantation has a significantly adverse effect on long-term graft survival and close follow-up is warranted.
Ocular Cosmetics: Public Safety Problem or Harmless Products?
Authors: Janetos Timothy M. , Thyparampil Preeti 
Published: May 2019

Purpose:
This perspective explores the safety profile of ocular cosmetics and explores the role ophthalmologists can play in mitigating potential ocular harm from unsafe products.

Methods:
N/A.

Results:
Cosmetics and personal care products represent a large industry that is currently unregulated in any meaningful way. Products intended for use around the eyes carry a risk of serious side effects including contact dermatitis and bacterial infection. Currently, legislation has been proposed to change regulation to provide more meaningful oversight of cosmetics.

Conclusions:
Ophthalmologists are often the first to recognize patterns in harmful products intended for use around the eye and can help mitigate potential future ocular harm by reporting adverse events to the Food and Drug Administration and by advocating for cosmetic regulation change.
Obesity Affects the Association of Bioelectrical Impedance Phase Angle With Mortality in People Living With HIV
Authors: Cogliandro Viola , Yester Donna , Westfall Andrew O. , Raper James L. , Saag Michael S. , Henostroza German , Overton E. Turner , Willig Amanda L. 
Published: May 2019

Abstract
Bioelectrical impedance analysis phase angle (BIA-PA) is a valid indicator of mortality risk in people living with HIV; however, it is not known whether BIA-PA is valid for people living with HIV who are overweight or obese. We assessed whether BIA-PA differentially predicted mortality by body mass index category in participants receiving clinical care at a single site between 2000 and 2012. Change in BIA-PA from the highest versus last available phase angle was assessed using multivariate logistic regression models. Eight hundred ninety participants were included in the final analyses, with 102 deaths recorded during the study period. Decline in BIA-PA was associated with mortality in underweight and normal weight participants but not in overweight or obese participants. Additional investigation is warranted to determine the appropriate clinical BIA-PA equations and parameters to identify overweight and obese patients with increased mortality risk.
Clinicopathological features and surgical outcomes of resected functional pancreatic neuroendocrine tumors: a single institution experience
Authors: Javed Ammar A. , Hasanain Alina , Haider Aleezay , Jones George , Javed Zunaira N. , Soares Kevin , Burkhart Richard A. , Cameron John L. , Weiss Matthew J. , Wolfgang Christopher L. , He Jin 
Published: May 2019

Abstract

Background:
Functional pancreatic neuroendocrine tumors (f-PanNETs) are rare tumors of the pancreas that are associated with excess hormone production. A majority of literature available on these tumors is limited to case reports and small series and discusses a particular subtype. Here, we report the clinicopathological features and outcomes of all f-PanNETs from a high-volume pancreatectomy center.

Methods:
A prospectively maintained database was used to identify patients who underwent resection for f-PanNETs between January 1995 and December 2015. Patients were stratified by the type of f-PanNET, and their clinicopathological features and outcomes were analyzed and reported.

Results:
We identified 69 patients with a mean age of 52 ± 16 years, and the majority were female (62%). The most common type of f-PanNET were insulinomas (70%) followed by gastrinomas (15%), and vasoactive intestinal peptidomas (VIPomas) (10%). There was considerable heterogeneity in the presenting symptoms. Patients with insulinomas presented with smaller tumors compared to the other subtypes. Nodal disease was most frequent in patients with VIPomas (71%), and gastrinomas (50%). The median overall survival (OS) was 7.4 years. Elevated Ki-67 and age >65 years were associated with poorer OS. Recurrence was observed in 8 patients (12%) and was most frequent in patients with VIPomas. Recurrence was associated with a poorer OS (P = .012).

Conclusion:
f-PanNETs are exceedingly rare and present with a wide variety of symptoms, histopathological findings, and outcomes. Surgical resection can help achieve good long-term survival.
In Vivo Real-time Remote Cochlear Implant Capacitive Impedance Measurements: A Glimpse Into the Implanted Inner Ear
Authors: Di Lella Federico Alberto , De Marco Diego , Fernández Florencia , Parreño Matías , Boccio Carlos Mario 
Published: May 2019

Objectives:
To propose a remote, real-time, safe, and easy systematic method to determine electrode electric impedance components: access resistance, polarization capacitance, and polarization resistance.

Patients:
Patients who received a cochlear implant and had normal cochlear anatomy and complete array insertion were recruited. A total of four adult patients were included and separated in two groups according to implantation time.

Intervention:
Cochlear implant electrical impedance and its components were measured in all patients by using a novel diagnostic tool: a custom made software running in the patient's computer. Data is transmitted in real time to the investigator. Various stimulation and measuring strategies were used to obtain specific information in each cochlear region.

Main Outcome Measures:
Access resistance, polarization capacitance, and resistance of each patient were measured. Measurement success rate and required time for the patient were recorded.

Results:
Access resistance, polarization capacitance, and resistance were obtained in different modes, thus in every specific region of the cochlea. All measurements were successful. Each measurement took approximately 7 minutes and was transmitted in real time to the investigators.

Conclusion:
Routine use of this tool may allow constant assessment of cochlear health and could be eventually used to monitor the effect of drugs in the inner ear. This methodology provides an in vivo “electrical view” of the inside of the implanted cochlea.
Effects of Second-Hand Smoke on Pancreatitis in Children
Authors: Ballengee Cortney R. , Brooks Peter , Leong Traci , Geem Duke , Freeman A. Jay 
Published: May 2019

Objectives
Pediatric pancreatitis incidence is increasing, but little is known about risk factors. Smoking increases the risk for adult pancreatitis and has been shown to affect CFTR function in vitro. Therefore, we evaluated passive smoke exposure effects on disease outcomes in children with various pancreatitis etiologies.

Methods
We conducted a 5-year retrospective chart review of patients admitted for pancreatitis to Children's Healthcare of Atlanta. Demographic data, etiology of pancreatitis, and number of hospitalizations with length of stay (LOS) were compared with smoking exposure, obtained through telephone query.

Results
Of the 134 subjects admitted for pancreatitis, 90 reported no smoke exposure (none), 33 reported outdoor smoke exposure (outside), and 11 reported exposure to indoor smoking (inside). Average hospital admissions (P = 0.038) and LOS (P = 0.004) were significantly higher among subjects with inside smoke exposure compared with those with outdoor or no exposure. Average hospital admissions were significantly higher in subjects with CFTR mutations compared with those with nongenetic or other genetic etiologies (P ≤ 0.001).

Conclusions
Second-hand smoke exposure may increase hospital admission rates and LOS for pediatric pancreatitis. Children with an identifiable CFTR mutation may have increased risk for hospital admissions compared with those who do not.
Enhanced Protein Diet for Preterm Infants
Authors: Atchley Courtney B. , Cloud Ann , Thompson David , Blunt Michelle H. , Satnes Kelli J. , Szyld Edgardo , Ernst Kimberly D. 
Published: May 2019

ABSTRACTObjective:To evaluate dietary protein's effect on fat accretion and weight gain in hospitalized preterm infants.Methods:Prospective, randomized, double‐blind, controlled trial of 36 infants born at <32 weeks, hospitalized in a tertiary neonatal intensive care unit. After achieving full enteral volume, infants were randomized to either an enhanced protein diet (EPD) (protein‐energy ratio [PER] 4 g/100 calories) or a standard protein diet (SPD) (PER 3 g/100 calories). Macronutrients were calculated using published values for formula, donor milk bank analysis, or weekly analysis of a 24‐hour pooled maternal milk sample. Human milk fortifier and/or liquid protein were used to achieve the target PER until discharge or a maximum of 4 weeks. Body composition was measured weekly using air displacement plethysmography. The principal outcomes, rates of weight gain and fat accretion, were compared between groups in linear mixed models.Results:Thirty‐three infants received approximately 17 days of the study diet. Relative weight gain was 21.6 g · kg−1 · day−1 (95% confidence interval [CI] 19.5–23.8) for the EPD group (n = 16) versus 19.1 g · kg−1 · day−1 (95% CI 17.0–21.2) for the SPD group (n = 17), P = 0.095. Baseline percent fat mass (FM) in the EPD group was 5.15% (95% CI 3.58%–6.72%) compared with 7.29% (95% CI 5.73%–8.84%) in the SPD group, P = 0.0517. Percent FM increased 0.398%/day (95% CI 0.308–0.488) for the EPD group versus 0.284%/day (95% CI 0.190–0.379) for the SPD group (P = 0.0878).Conclusions:Preterm infants with a lower baseline FM percentage who received an EPD demonstrated a more pronounced catch‐up percentage of fat accretion.
Atypical Presentations of Exertional Collapse
Authors: Newman Caroline , Fields Karl B. 
Published: May 2019

Abstract
Exertional collapse associated with sickle trait (ECAST) is an underrecognized cause of exertional collapse triggered by complex mechanisms involving acidosis, rhabdomyolysis, and arrhythmias, all of which create sickling, vaso-occlusive problems, and ultimately end organ failure. Three cases are described in young athletes, as well as 12 other examples of ECAST noted in case reports and news sources. Exertional collapse associated with sickle trait can be differentiated from other common causes of collapse (exertional heat syndrome, acute cardiac events, and asthma) because it is a conscious collapse without neurological changes, occurs early in workout with only mildly elevated body temperature, and involves muscle pain and weakness but not cramping. Aggressive early management and transport to care facilities can reverse ECAST in certain cases. This article discusses tips for early recognition, initial treatment in the emergency department, and precautions that can be taken to prevent sickling collapse in athletes with sickle cell trait (SCT).
Treatment of Glenohumeral Subluxation
Authors: Cole Andrew , Cox Talitha 
Published: May 2019

Objective
The aim of this review was to identify treatment strategies in the research literature to inform all health professionals on best practice strategies when addressing glenohumeral subluxation.

Design
Articles were identified by searching electronic databases. Two reviewers independently appraised the methodological quality of the selected studies. Discrepancies were resolved after corroboration of results.

Results
Research literature pertaining to five major treatment strategies was found (n = 40 peer-reviewed publications), spanning evidence levels I–V. The greatest number of studies concerned neuromuscular electrical stimulation (n = 19), five of which were level I studies, followed by manual preventive strategies, such as slings (n = 20), three of which were level I studies.

Conclusions
These findings indicate that the most high-quality research supports using neuromuscular electrical stimulation or manual preventive studies, although no studies used direct comparison methods to ascertain relative merits of each type of intervention when compared with others. No evidence suggested that harm was done by using neuromuscular electrical stimulation or manual preventive methods. This literature review suggests that the identified treatment strategies should be considered by clinicians as the treatment of choice for GHS. No literature was identified that reviewed treatment strategies in a pediatric population; however, the authors considerations for treatment in the pediatric population were included.
Mirror Image Based Three-Dimensional Virtual Surgical Planning and Three-Dimensional Printing Guide System for the Reconstruction of Wide Maxilla Defect Using the Deep Circumflex Iliac Artery Free Flap
Authors: Jang Wan-Hee , Lee Jake Minki , Jang Sam , Kim Hee-Dong , Ahn Kang-Min , Lee Jee-Ho 
Published: May 2019

Abstract
A patient was diagnosed with squamous cell carcinoma of the maxillary sinus and consequently underwent a unilateral total maxillectomy and reconstruction using an anterolateral thigh (ALT) free flap. Soft tissue transplantation without a bone graft at the large maxillary defect site caused a midfacial collapse, which worsened, especially after radiotherapy. The 3-dimensional positioning of the composite flap for wide maxillary reconstruction is aesthetically important. To achieve ideal symmetry and aesthetics, a mirror image was created using the normal contralateral side. Through computer simulation, the function and symmetry of the virtually reconstructed maxilla was evaluated, and the surgical guide was made using a 3D printing system. Based on the prepared surgical guide, a deep circumflex iliac artery (DCIA) free flap was harvested, and its implementation in the reconstruction ultimately led to satisfactory results. Utilization of mirror image based virtual surgical planning and a 3D printing guide is a significantly effective method for maxilla reconstruction with DCIA flaps.
Liver Transplantation Using Uncontrolled Donors After Circulatory Death: A 10-year Single-center Experience
Authors: Jiménez-Romero Carlos , Manrique Alejandro , Calvo Jorge , Caso Óscar , Marcacuzco Alberto , García-Sesma Álvaro , Abradelo Manuel , Nutu Anisa , García-Conde María , San Juan Rafael , Justo Iago 
Published: May 2019

Background.
One method for increasing the donor pool for orthotopic liver transplantations (OLTs) is to use uncontrolled donation after circulation death (uDCDs).

Methods.
From January 2006 to December 2016, we performed 75 OLTs using uDCD livers. The control group comprised a sample of 265 OLTs using livers of donations after brain death (DBDs). A comparative study was performed.

Results.
Of 256 potential uDCD donors cannulated, 75 (29.3%) livers were accepted for OLT. The amount of hemoderivatives transfused was significantly higher in the uDCD group. The rate of primary nonfunction was also significantly higher (P = 0.031) in uDCD recipients (8%) than DBD recipients (1.5%). The overall rate of biliary complications was significantly higher (P = 0.001) in uDCD recipients (23 cases, 30.6%) than DBD recipients (28 cases, 10.6%). In the uDCD group, 1-, 3-, and 5-year patient survival rates were 82.7%, 73%, and 71.5%, respectively; in the DBD group, they were 89%, 83.7%, and 78.8%, respectively (P = 0.180). In the uDCD group, 1-, 3-, and 5-year graft survival rates were 73.3%, 65.1%, and 63.6%, respectively; in the DBD group, they were 87.1%, 81.9%, and 76.5%, respectively (P = 0.013). Multivariate analysis showed that independent risk factors for patient and graft survival were intraoperative transfusion of >6 units of packed red blood cell concentrates and recipients who were older than 60 years.

Conclusions.
Although graft survival is significantly lower using uDCD livers, 5-year patient survival in recipients of DBD and uDCD livers is similar. After careful selection, the livers of uDCD can be selectively used for OLT.
Discriminative Ability of Montreal Cognitive Assessment Subtests and Items in Racial and Ethnic Minority Groups
Authors: Milani Sadaf Arefi , Marsiske Michael , Striley Catherine W. 
Published: May 2019

Introduction:
The Montreal Cognitive Assessment (MoCA) is a popular screening tool for Mild Cognitive Impairment (MCI). The psychometric properties of the MoCA have not been widely examined in minority groups. We aimed to analyze the discriminate ability of subtests and items by race and ethnicity given gold-standard clinical diagnosis of cognitive status.

Methods:
We analyzed data from the National Alzheimer Coordinating Center Uniform Data Set March 2018 data freeze. Stepwise regression was used to determine which subtests predicted cognitive status (normal cognition, MCI, or dementia), by race/ethnicity. Item discrimination and difficulty was calculated by race/ethnicity and cognitive status.

Results:
In our sample (n=3895), with an average age of 69.7, 80.7% were non-Hispanic white, 15.0% were non-Hispanic black, and 4.2% were Hispanic. Among non-Hispanic whites all subtests, education, and age predicted clinician diagnosis, while visuospatial/executive, attention, language, delayed recall, and orientation subtests were predictive among non-Hispanic blacks and visuospatial/executive, delayed recall, and orientation subtests and education were predictive among Hispanics. Item discrimination and difficulty varied by race/ethnicity and cognitive status.

Conclusions:
By understanding the psychometric properties of MoCA subtests, we can focus on subtests that have higher discrimination and more diagnostic utility. Subtests should be further evaluated for use in screening of minority individuals.
Patient Stakeholder Versus Physician Preferences Regarding Amyloid PET Testing
Authors: Armstrong Melissa J. , Gronseth Gary S. , Day Gregory S. , Rheaume Carol , Alliance Slande , Mullins C.D. 
Published: May 2019

Background:
Patient and caregiver perspectives on amyloid positron emission tomography (PET) use are largely unexplored, particularly as compared with clinician views.

Methods:
We surveyed clinicians, patients, caregivers, and dementia advocates on topics relating to an evidence-based guideline on amyloid PET use. Topic importance was rated on a 9-point scale. Patient stakeholder and clinician views were compared using the Mann-Whitney U test.

Results:
Patient representatives (n=107) rated all survey topics as equal to or more important than clinicians (n=114) except 1 item discussing potential harms of false-positive diagnoses. Differences between patient representative and clinician populations were greatest when comparing the competing values of false-positive and false-negative diagnoses and the value of testing asymptomatic individuals.

Conclusions:
Patients and caregivers emphasized the importance of having a dementia diagnosis and placed more value on testing and outcomes for asymptomatic populations than clinicians. This underscores the importance of research investigating the effect of amyloid PET results on asymptomatic individuals and the need for amyloid PET ordering and disclosure standards.
Recent developments in imaging of epilepsy
Authors: Wiest Roland , Beisteiner Roland 
Published: May 2019

Purpose of reviewImaging constitutes one of the key pillars in the diagnostic workup after a first seizure as well as for the presurgical workup in epilepsy. The role of imaging in emergency situations, mainly to support the adequate diagnosis, as well as its role in planning of noninvasive image-guided therapies is less well established. Here, we provide an overview on peri-ictal imaging findings to support differential diagnosis in emergency situations and describe recent attempts toward minimal invasive therapy in the treatment of epilepsy and its comorbidities based on a combination of imaging techniques with ultrasound.Recent findingsPeri-ictal perfusion changes can differentiate ictal stroke mimics from acute ischemic stroke if focal areas of increased perfusion are depicted by computed tomography or MRI. Postictal perfusion patterns in patients with persisting neurological symptoms are frequently normal and do not reach enough diagnostic sensitivity to differentiate between stroke and its mimics. Noninvasive magnetic resonance-techniques as arterial spin labeling may provide a higher sensitivity, especially in combination with diffusion-weighted and susceptibility-weighted MRI. Imaging guided focused ultrasound (FUS) bears the potential to ablate epileptogenic tissue and allows suppression of epileptic activity. Imaging guided blood–brain-barrier opening with FUS offers new options for local drug administration.SummaryMRI should be considered the method of choice in the differential diagnosis of peri-ictal imaging findings and their differential diagnosis. A combination of various MRI techniques with FUS opens new avenues for treatment of epilepsy.
Spaniel: analysis and interactive sharing of Spatial Transcriptomics data
Authors: Queen Rachel , Cheung Kathleen , Lisgo Steven , Coxhead Jonathan , Cockell Simon 
Published: May 2019

AbstractSpatial Transcriptomics allows the sequencing of the complete transcriptomes from barcoded regions of intact tissue. The technology has the potential to answer a wide range of biological questions concerning cellular function, but analysis of the data presents a number of challenges which are not met by existing analysis tools. Here we present Spaniel, an R package providing a framework for analysing and sharing Spatial Transcriptomics data.