bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Age and Hearing Loss on the Recognition of Emotions in Speech
Authors: Christensen Julie A. , Sis Jenni , Kulkarni Aditya M. , Chatterjee Monita 
Published: January 2019

Objectives:
Emotional communication is a cornerstone of social cognition and informs human interaction. Previous studies have shown deficits in facial and vocal emotion recognition in older adults, particularly for negative emotions. However, few studies have examined combined effects of aging and hearing loss on vocal emotion recognition by adults. The objective of this study was to compare vocal emotion recognition in adults with hearing loss relative to age-matched peers with normal hearing. We hypothesized that age would play a role in emotion recognition and that listeners with hearing loss would show deficits across the age range.

Design:
Thirty-two adults (22 to 74 years of age) with mild to severe, symmetrical sensorineural hearing loss, amplified with bilateral hearing aids and 30 adults (21 to 75 years of age) with normal hearing, participated in the study. Stimuli consisted of sentences spoken by 2 talkers, 1 male, 1 female, in 5 emotions (angry, happy, neutral, sad, and scared) in an adult-directed manner. The task involved a single-interval, five-alternative forced-choice paradigm, in which the participants listened to individual sentences and indicated which of the five emotions was targeted in each sentence. Reaction time was recorded as an indirect measure of cognitive load.

Results:
Results showed significant effects of age. Older listeners had reduced accuracy, increased reaction times, and reduced d’ values. Normal hearing listeners showed an Age by Talker interaction where older listeners had more difficulty identifying male vocal emotion. Listeners with hearing loss showed reduced accuracy, increased reaction times, and lower d’ values compared with age-matched normal-hearing listeners. Within the group with hearing loss, age and talker effects were significant, and low-frequency pure-tone averages showed a marginally significant effect. Contrary to other studies, once hearing thresholds were taken into account, no effects of listener sex were observed, nor were there effects of individual emotions on accuracy. However, reaction times and d’ values showed significant differences between individual emotions.

Conclusions:
The results of this study confirm existing findings in the literature showing that older adults show significant deficits in voice emotion recognition compared with their normally hearing peers, and that among listeners with normal hearing, age-related changes in hearing do not predict this age-related deficit. The present results also add to the literature by showing that hearing impairment contributes additionally to deficits in vocal emotion recognition, separate from deficits related to age. These effects of age and hearing loss appear to be quite robust, being evident in reduced accuracy scores and d’ measures, as well as in reaction time measures.
Comparison of the Inflammatory Infiltrates in Tumoral Melanosis, Regressing Nevi, and Regressing Melanoma
Authors: George Eva Vertes , Kalen Jessica E. , Kapil Jyoti P. , Motaparthi Kiran 
Published: January 2019

Background:
Tumoral melanosis (TM) is a histologic diagnosis characterized by abundant pigment-laden macrophages in the dermis. It is generally thought to represent a regressed melanoma, although it has also been reported after benign pigmented lesions as well. Determining the antecedent lesion in cases of TM is of clinical importance to accurately guide therapy and prognostication. Comparing the histopathologic and immunohistochemical (IHC) characteristics of TM, halo nevi (HN), and regressing melanoma (RM) may help predict the antecedent lesion in cases of TM.

Methods:
Cases of TM, HN, and RM were selected and assessed for histopathologic (preservation of junctional melanocytic component, depth and width, solar elastosis, fibrosis, and preservation of rete ridge architecture) and IHC (SOX-10, CD138, and PD-1) parameters. PD-L1 immunostaining was also evaluated in cases of HN and RM.

Results:
Severe solar elastosis, fibrosis, and marked rete ridge effacement were more frequent in RM than in HN. By contrast, numerous plasma cells, clusters of lymphocytes expressing PD-1, and >50% PD-L1 expression in melanocytes were more common in HN than in RM. However, the association of these variables did not reach statistical significance.

Discussion:
Although studies with higher statistical power are needed, this study serves as an initial investigation to characterize the histopathologic and IHC characteristics, which may help better understand TM and its precursor lesions.
Cutaneous B-Cell Lymphoblastic Lymphoma
Authors: Amarasekera Dilru , Connolly Deirdre , Gochoco Ashley , Yang Sherry , Grosso Dolores , Flomenberg Neal , Shi Wenyin , Alpdogan Seyfettin Onder , Duffy Robert , Sahu Joya 
Published: January 2019

Abstract:
B-cell lymphoblastic lymphoma (B-LBL) is a malignant neoplasm of immature B cells that accounts for only 10% of all cases of lymphoblastic lymphoma. Most commonly, B-LBL presents as bony lesions, but in rare cases, the disease manifests cutaneously. We present a case of simultaneous cutaneous and systemic presentation of B-LBL in an otherwise healthy 28-year-old man in which the lymphoblastic infiltrate stained positive for CD79a, Tdt, CD10, and CD20. A diagnosis of cutaneous B-LBL was made, and systemic work-up revealed widespread involvement of the skin, bone, and lymph nodes. Review of all currently described cases of cutaneous B-LBL with or without systemic involvement revealed that the most frequently positive tumor markers were CD79a (92.3%), Tdt (90.6%), and CD10 (83.3%). Systemic involvement of B-LBL was found in nearly half of all cases with cutaneous presentation.
In Vitro Evaluation of Preinjection Aspiration for Hyaluronic Fillers as a Safety Checkpoint
Authors: Torbeck Richard L. , Schwarcz Robert , Hazan Ezra , Wang Jordan V. , Farberg Aaron S. , Khorasani Hooman 
Published: January 2019

BACKGROUND
Hyaluronic acid (HA) fillers have increased in popularity. Although complications are rare, knowledge regarding their prevention and management are crucial. The utility of preinjection aspiration has become controversial.

OBJECTIVE
Our study investigated the utility of preinjection aspiration as a safety checkpoint for HA fillers through comparison of physiochemical and rheological properties in an in vitro model.

MATERIALS AND METHODS
Whole blood was drawn from vacutainers using syringes containing 10 commonly used HA fillers. Each HA filler was examined with the plunger pulled back at volumes of 0.2 and 0.5 cc. The time required to visualize a flash was recorded. Data were compared using physiochemical and rheological properties, pullback volumes, and needle gauges.

RESULTS
Using a multivariable regression model, HA concentration, elastic modulus (G′), viscous modulus (G″), and complex modulus (G*) had significant relationships with time to flash, whereas needle gauge and pullback volume did not. However, when comparing pullback volume using an appropriate paired analysis, 0.5 cc pullback volume had a significantly decreased mean time to flash than 0.2 cc.

CONCLUSION
Preinjection aspiration may have utility as a safety checkpoint for HA fillers. Practitioners may have to adjust pullback volume and waiting time to visualize the flash based on physiochemical and rheological properties.
LONG-TERM VISUAL RECOVERY IN BILATERAL HANDHELD LASER POINTER–INDUCED MACULOPATHY
Authors: Chen Xuejing , Dajani Omar A. W. , Alibhai Agha Yasin , Duker Jay S. , Baumal Caroline R. 
Published: January 2019

Purpose:
To describe the long-term visual, clinical, and optical coherence tomography (OCT) recovery after 4 years in a patient who incurred severe bilateral handheld laser pointer damage.

Methods:
The findings on clinical examination, color fundus photography, and spectral domain OCT at presentation followed by sequential time points over 4 years are presented.

Results:
A 9-year-old healthy boy presented with bilateral reduced vision to count fingers in each eye with yellow irregular lesions. After extensive evaluation, he admitted to multiple, prolonged episodes of staring at a handheld red laser pointer reflected in a mirror. Initial visual acuity was count fingers bilaterally. Clinical examination revealed bilateral yellow streaks radiating from the fovea without hemorrhages or fluid and retinal pigment epithelium pigmentary mottling. Spectral domain OCT showed disruption of the foveal outer retina extending from the outer plexiform layer to the retinal pigment epithelium spanning 896 μm in the right eye and 564 μm in the left eye. Six months after injury, vision had only minimally improved to 20/200 with resolution of outer plexiform layer and outer nuclear layer opacification on OCT. Over the ensuing 4 years, visual acuity slowly recovered to 20/30 in each eye and the regions of outer retinal disruption progressively reduced in size to 295 μm in the right eye and 115 μm in the left eye.

Conclusion:
This case illustrates gradual vision and anatomical improvement over 4 years despite initial poor vision after severe laser pointer macular damage. Visual recovery may be related to patient and exposure factors as well as initial OCT features where an intact Bruch membrane can provide a scaffold for photoreceptors to recover, thereby reducing the outer retinal defect.
Retinoscopy as a Screening Tool for Keratoconus
Authors: Al-Mahrouqi Haitham , Oraba Saif Bani , Al-Habsi Shihab , Mundemkattil Noufal , Babu Jithin , Panchatcharam Sathiya M. , Al-Saidi Rashid , Al-Raisi Abdulatif 
Published: January 2019

Purpose:
To investigate the validity and reliability of retinoscopy in screening for keratoconus using the rotating Pentacam Scheimpflug camera as the gold standard comparison.

Methods:
Patients between the ages of 10 and 30 years who were referred to the outpatient clinic with keratoconus, keratoconus suspect, reduced vision, eye discomfort or frequent change of glasses, or for refraction or refractive surgery, were screened by two independent and masked retinoscopists for the presence of scissoring reflex. Patients then underwent vision testing, slit lamp examination, and Pentacam imaging. A diagnosis of keratoconus by Pentacam was made if the final D index in the Belin and Ambrósio Display was ≥2.69. The results of retinoscopy and Pentacam examinations were compared to assess the validity and reliability of the test.

Results:
A total of 123 patients (67 male patients and 45 female patients) with a mean age of 21 years ±5.6 (range 10–30 years) comprising 245 eyes were included. There were 87 eyes with keratoconus, and using the Amsler–Krumeich classification, 67.8%, 26.4%, 2.3%, and 3.4% of the eyes had stage I, II, III, and IV, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of retinoscopy were 97.7%, 79.9%, 70.8%, and 98.4%, respectively. The area under the curve was 0.88 (95% confidence interval, 0.83–0.92). There was excellent agreement between the 2 retinoscopists (Cohen's kappa value 0.84).

Conclusions:
Retinoscopy appears to be a very sensitive and reliable test for detecting keratoconus including early disease. Such a test may be implemented in population-based screening programs for keratoconus.
Cytomegalovirus Corneal Endotheliitis After Descemet Membrane Endothelial Keratoplasty
Authors: Tan Tien-En , Tan Donald Tiang Hwee 
Published: January 2019

Purpose:
To describe 4 cases of cytomegalovirus (CMV) corneal endotheliitis occurring after Descemet membrane endothelial keratoplasty (DMEK).

Methods:
This is a retrospective, interventional case series. Case records of 4 patients (one eye each) diagnosed with CMV corneal endotheliitis after DMEK were reviewed retrospectively. Presenting clinical features, treatment, and outcomes were examined.

Results:
Patients' age ranged from 68 to 77 years. Three patients underwent DMEK for failed corneal grafts and 1 for pseudophakic bullous keratopathy. Time from DMEK to presentation ranged from 5 to 15 weeks. Presenting features included corneal edema, pigmented keratic precipitates, mild anterior chamber inflammation, and raised intraocular pressure. Two cases were initially misdiagnosed as graft rejection and treated with corticosteroids. Both worsened, and delayed diagnoses of CMV corneal endotheliitis were made. The two other cases were diagnosed correctly at initial presentation. All cases were confirmed by anterior chamber paracentesis and polymerase chain reaction testing for CMV. All cases were treated initially with topical ganciclovir gel and oral valganciclovir. Three cases showed clinical resolution. Final corrected visual acuity ranged from 20/25 to 20/40. One case failed to respond to topical ganciclovir gel, oral valganciclovir, and intravenous ganciclovir and foscarnet. This patient declined further systemic treatment and was maintained on topical ganciclovir only but subsequently showed spontaneous resolution 3 months later.

Conclusion:
CMV corneal endotheliitis may occur after DMEK and can closely mimic graft rejection. Polymerase chain reaction testing of aqueous humor is advised for suspect cases. A high index of suspicion is important for prompt diagnosis and initiation of appropriate antiviral treatment.
Comparison of Graft Thickness Measured by an Eye Bank With Graft Thickness Measured After Descemet Stripping Automated Endothelial Keratoplasty
Authors: Feizi Sepehr , Delfazayebaher Siamak , Masoudi Ali , Babamohamadi Zahra , Javadi Mohammad Ali 
Published: January 2019

Purpose:
To compare donor lenticule thickness reported by the eye bank with lenticule thickness measured at 6 months after Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods:
This prospective, interventional case series enrolled 30 eyes from 30 patients who underwent DSAEK using precut eye bank tissue. Preoperative thickness measurements of the donor lenticules were taken centrally and at pericentral and peripheral graft areas using an anterior segment optical coherence tomography system. The same measurements were repeated 6 months postoperatively. The preoperative and postoperative values were compared, and the relationships between these measurements were investigated using Pearson correlation coefficients.

Results:
The mean donor age was 47.7 ± 10.7 years. The mean preoperative endothelial cell density was 3017 ± 361 cells/mm2, which decreased to 1645 ± 482 cells/mm2 postoperatively (P < 0.001). The graft thickness of the precut tissue, as reported by the eye bank, was 136.8 ± 24.9 μm at the center, 149.4 ± 27.3 μm at the pericentral area, and 198.4 ± 32.8 μm at the periphery. The corresponding postoperative values were 119.2 ± 29.8 μm (P = 0.004), 124.5 ± 34.6 μm (P = 0.002), and 156.3 ± 45.4 μm (P < 0.001), respectively. The graft thickness measured by the eye bank was significantly associated with that measured in vivo at 6 months at the central (r = 0.63, P = 0.001) and pericentral (r = 0.50, P = 0.009) graft areas. However, the correlation between preoperative and postoperative peripheral graft thickness was insignificant (P = 0.14).

Conclusion:
Compared with preoperative values, central, pericentral, and peripheral graft thicknesses were reduced by 10.4%, 14.2%, and 18.4%, respectively, 6 months after DSAEK. Postoperative graft thinning was greater at the periphery compared with the central and pericentral areas.
Reduction of Acanthamoeba Cyst Density Associated With Treatment Detected by In Vivo Confocal Microscopy in Acanthamoeba Keratitis
Authors: Wang Ye Elaine , Tepelus Tudor Cosmin , Gui Wei , Irvine John A. , Lee Olivia L. , Hsu Hugo Y. 
Published: January 2019

Purpose:
Acanthamoeba keratitis (AK) is a severe vision-threatening ocular infection that is frequently a diagnostic challenge. Treatment course is lengthy and often not fully effective. Contact lens wear has been recognized as the prime risk factor for AK. In vivo confocal microscopy (IVCM) is a noninvasive imaging modality that allows direct visualization of potential causative pathogens in real time with an established utility in the diagnosis of AK. In this study, we aim to assess the utility of IVCM in monitoring disease progression in contact lens wearers with culture-confirmed keratitis.

Methods:
Fourteen eyes from 11 patients with culture-confirmed AK were included in this retrospective study. IVCM was performed during the patient's initial visit and all follow-up visits. All available confocal sequences were reviewed and graded in a masked fashion. Density of Acanthamoeba cyst infiltration and changes in the cyst density as a percentage of baseline cyst density measured at each patient's initial visit were calculated. A univariate regression analysis was performed to assess the association between treatment and changes in cyst density per month of treatment.

Results:
Acanthamoeba cysts were identified by IVCM in all of these culture-confirmed cases of keratitis. Mean cyst density in the central cornea at presentation was 99 ± 64.9 cells per square millimeter (range, 38–255/mm2). Cyst density in our study population significantly decreased by approximately 5.3% with each month of antiamebic treatment (P = 0.001; R
2 = 0.41).

Conclusions:
Reduction in Acanthamoeba cyst density with treatment can be monitored by IVCM, which in turn can be used clinically in prognostication and disease monitoring of AK.
Secondary Intraocular Lens Implantation After Simultaneous Penetrating Keratoplasty and Cataract Extraction for Coexisting Corneal and Lens Opacities
Authors: Solaiman Kamal A. M. , El-Haig Wael M. , Bor'i Ashraf , Khalil Ahmad S. , Awad Ahmed M. B. , Al-Bialy Hani A. , Ibrahim Basem M. 
Published: January 2019

Purpose:To report the results of a new approach to the 2-stage surgical management of coexisting visually significant corneal opacities and cataract.Methods:A retrospective analysis of eyes with corneal opacities and cataract that were surgically treated with simultaneous penetrating keratoplasty and cataract surgery, followed by secondary intraocular lens (IOL) implantation after removal of corneal sutures, was conducted. The parameters used for assessment were the following: mean percentage of graft endothelial cell loss after IOL implantation, deviation of the postoperative mean spherical equivalent from the target refraction, and mean uncorrected distance visual acuity (UDVA).Results:Twenty-nine eyes were included in the study. The mean baseline UDVA was 1.94 ± 0.46, and the mean baseline best-corrected distance visual acuity was 1.56 ± 0.42. The mean interval between the 2 surgical interventions was 13.3 ± 2.2 months. Just before secondary IOL implantation, the mean endothelial cell density was 2198 ± 311 cells. The mean percentage of corneal endothelial cell loss was 7.3% at 6 months after IOL implantation (P= 0.16). Before IOL implantation, the mean spherical equivalent was +11.75 ± 3.38 D. After IOL implantation, the mean spherical equivalent improved to −0.19 ± 0.93 D (P= 0.003) at 6 months. The mean UDVA improved to 0.34 ± 0.18 (P= 0.017), whereas the mean corrected distance visual acuity improved to 0.18 ± 0.29 at 6 months (P= 0.016). All grafted corneas maintained their clarity until the final follow-up visit.Conclusions:Postponing IOL implantation some months after simultaneous penetrating keratoplasty and cataract extraction has a negligible effect on the corneal graft endothelium and achieves near postoperative target refraction with significant improvement in UDVA.
Empowerment as a Predictor of HIV Testing Among Married Women in Nepal
Authors: Thapa Roshna , Yang Youngran , Kang Jeong Hee , Nho Ju-Hee 
Published: January 2019

Abstract
We examined the association of women empowerment and HIV testing in Nepalese women. Data from the 2012 Nepal Demographic and Health Survey provided a sample of 6,579 females ages 15–49 years. Women empowerment subcategories included participation in decision making, attitudes about safer sex negotiation, and sexual autonomy. Only 454 participants (6.9%) had been tested for HIV. Of note, 41.3% had high participation in decision making, 84.5% showed positive attitudes about safer sex negotiation, and 71.8% scored high in sexual autonomy. After adjusting potential confounders, the odds of being tested were higher for women with positive attitudes about safer sex negotiation (adjusted odds ratio = 1.444, 95% confidence interval: 1.006–2.072, p = .046) and high sexual autonomy (adjusted odds ratio = 3.138, 95% confidence interval: 1.375–7.164, p = .007). Age, education, and wealth were independent factors determining the women's HIV testing approach. Our study can be a guide for interventions and policies to empower women and encourage HIV testing in Nepal.
Novel tyrosine kinase inhibitors for patients with inadequate response in chronic myeloid leukemia
Authors: Mauro Michael J. 
Published: January 2019

Purpose of review
The purpose of this review is to summarize treatment expectations and response milestones, to conceptualize the approach to defining inadequate response to therapy and critically appraise current available strategies, as well to highlight novel agents under development to address unmet needs in chronic myeloid leukemia (CML) therapy.

Recent findings
Given excess risk with currently available highly potent ABL1 (Abelson murine leukemia viral oncogene homolog 1) inhibitors, a number of alternate, highly potent compounds have entered the clinic to address select resistance such as the T315I mutation with the promise of greater selectivity and better adverse event profile. In addition, alternate approaches to ABL1 inhibition, targeting the myristoyl pocket of ABL1, are showing promising early results and are moving into later phase trials.

Summary
CML is a highly treatable form of leukemia with multiple orally available small molecule inhibitors of the activated BCR-ABL1 (breakpoint cluster region-ABL1) kinase. Despite such an array of therapy options, inadequate response to therapy remains a challenge with a substantial minority of patients facing tyrosine kinase inhibitor (TKI) resistance, intolerance, or both. Unmet needs in Ph+ leukemia include highly selective resistant disease, multi-TKI resistant CML, and advanced phase disease.
Atypical Mandibular Angle Fracture
Authors: Junior Wanderley da Silva Félix , Fanderuff Marina , Reis Thiago Vinicius Rodrigues , Rebellato Nelson Luis Barbosa , Scariot Rafaela , Klüppel Leandro Eduardo 
Published: January 2019

Abstract
The mandibular fracture takes the second position among facial bones fractures, with significant increase of cases in the last years. The aim of this paper is to report a clinical case of a patient with facial trauma due to an automotive accident, resulting in an atypical fracture in a unilateral mandibular angle. In the image examinations an atypical favorable fracture in the right mandibular angle region involving the apex of the erupted 48 tooth was found. The fracture line started in the posterior region of mandibular ramus, below mandibular condyle, and spread out until inferior border of the mandible in premolar region. Despite the atypical design of the mandibular angle fracture described in this paper, the treatment showed satisfactory results, without any aesthetic or functional changes for the patient.
A Novel Application of Virtual Surgical Planning to Facial Feminization Surgery
Authors: Mandelbaum Max , Lakhiani Chrisovalantis , Chao Jerry W. 
Published: January 2019

Abstract
Feminization of the frontonasal-orbital complex is a critical aspect in surgical management of gender dysphoria. Here, we describe our utilization of a prefabricated cutting guide to facilitate frontal sinus setback.