bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior Amorphous Corneal Dystrophy Associated With Keratoglobus: A Case Report
Authors: Fay Jonathan , Herzlich Alexandra A. , Florakis George J. 
Published: September 2017

Purpose:
Posterior amorphous corneal dystrophy (PACD) is a rare disorder characterized by sheet-like opacification of the posterior corneal stroma, corneal thinning, and decreased corneal curvature. It is not known to be associated with progressive corneal ectasia. In this report, we examine the course of a patient with PACD who developed bilateral keratoglobus-type corneal ectasia.

Methods:
The clinical history of a single patient is reviewed from birth through age 15. Visual acuity, refraction, ultrasound pachymetry, anterior segment optical coherence tomography, corneal topography, and corneal tomography are presented.

Results:
The patient was noted to have bilateral cloudy corneas at birth. Congenital infection, metabolic disease, and glaucoma were ruled out. Anterior segment optical coherence tomography demonstrated posterior stromal opacification typical of PACD. Over time, the patient progressed from best uncorrected visual acuity of 20/20-2 OD and 20/25-3 OS to PROSE lens-corrected visual acuity of 20/30-3 OD and 20/30-3 OS. Central corneal thinness progressed from 491 to 408 μm in the right eye and from 505 to 389 μm in the left eye. Steepening in corneal axial/sagittal curvature developed in both eyes beginning inferiorly then involving the corneas diffusely.

Conclusions:
In this case report, we illustrate progressive corneal ectasia in a patient with PACD. Although both conditions may represent changes in the structure and integrity of corneal collagen, whether an association exists between the 2 conditions is unknown.
“Bubble-in-the-Roll” Technique Using the Endoject DMEK Injector: Influence of the Air Bubble on Endothelial Cell Loss
Authors: Akbaba Yasemin , Weller Julia M. , Rössler Kathrin , Armitage W. John , Schlötzer-Schrehardt Ursula , Kruse Friedrich E. , Tourtas Theofilos 
Published: September 2017

Purpose:
To evaluate the impact of the air bubble on endothelial cell loss using the “bubble-in-the-roll” technique during Descemet membrane endothelial keratoplasty (DMEK).

Methods:
Twenty DMEK grafts not suitable for transplantation were manually prepared from organ-cultured corneoscleral discs and injected into culture media using the Endoject DMEK injector (Medicel AG, Wolfhalden, Switzerland). Based on the injection method, the grafts were divided into 2 groups: In group A (n = 10), a small air bubble was placed inside the graft roll while it was in the injector. In group B (n = 10), the grafts were injected without an air bubble inside the graft roll. Main outcome measures included endothelial cell density (ECD) after graft stripping and graft injection.

Results:
There were no statistically significant differences between groups A and B in donor age, storage duration, and donor ECD. ECD decreased from 1929 ± 145 cells/mm2 to 1796 ± 303 cells/mm2 after graft stripping in group A and from 1801 ± 226 cells/mm2 to 1709 ± 290 cells/mm2 in group B. ECD after graft injection further decreased to 1683 ± 291 cells/mm2 in group A and to 1651 ± 292 cells/mm2 in group B. Endothelial cell loss after graft stripping and graft injection was not statistically significant between groups A and B (P = 0.29 and P = 1, respectively).

Conclusions:
The bubble-in-the-roll technique for injection and unfolding of the graft is a safe method for graft delivery into the anterior chamber guaranteeing orientation of the graft without harming the endothelium.
Meibomian Gland Dysfunction Associated With Periocular Radiotherapy
Authors: Woo Young Jun , Ko JaeSang , Ji Yong Woo , Kim Tae-im , Yoon Jin Sook 
Published: September 2017

Purpose:
To investigate the influence of periocular radiotherapy on meibomian glands.

Methods:
We evaluated 28 patients (40 eyes) who received radiotherapy (RT group) for conjunctival or orbital lymphoma and 30 age-matched control subjects (60 eyes). Subjects underwent slit-lamp examination of the eyelids, Schirmer test, meibography, and evaluation of tear film breakup time (TBUT), Ocular Surface Disease Index (OSDI) scores, meibomian glands evaluation (meiboscore, meibum expressibility, and lid margin abnormality scores), and tear film lipid layer thickness using an ocular surface interferometer. These parameters were compared between subjects in the RT and control groups.

Results:
Meiboscores as well as meibum expressibility and OSDI scores in the RT group were significantly higher compared with those in the control group (1.6 ± 0.9 vs. 0.4 ± 0.6, 1.6 ± 1.0 vs. 0.2 ± 0.4, and 48.1 ± 21.4 vs. 6.2 ± 4.4, respectively, P < 0.001, all), whereas the Schirmer value (9.2 ± 5.1 vs. 12.3 ± 5.2, P = 0.004), TBUT (4.2 ± 2.5 vs. 6.4 ± 2.6, P = 0.001), and lipid layer thickness (61.0 ± 29.3 vs. 85.2 ± 20.0, P < 0.001) in the RT group were lower compared with those in the control group. The percentage of meibomian gland dropout was significantly correlated with age (P = 0.025) and total radiation dose (P = 0.012), regardless of the target location of irradiation. Even low-dose irradiated eyes (<30 Gy) exhibited significantly higher meiboscores (P < 0.001) and shorter TBUT (P = 0.005) compared with control eyes.

Conclusions:
Eyes that received periocular radiotherapy exhibited relatively high tear film instability induced by meibomian gland dysfunction, contributing to the high severity of dry eye symptoms.
Predictors of Pancreatic Cancer–Associated Weight Loss and Nutritional Interventions
Authors: Nemer Laura , Krishna Somashekar G. , Shah Zarine K. , Conwell Darwin L. , Cruz-Monserrate Zobeida , Dillhoff Mary , Guttridge Denis C. , Hinton Alice , Manilchuk Andrei , Pawlik Timothy M. , Schmidt Carl R. , Talbert Erin E. , Bekaii-Saab Tanios , Hart Phil A. 
Published: September 2017

Objectives
Pancreatic ductal adenocarcinoma (PDAC) is often accompanied by weight loss. We sought to characterize factors associated with weight loss and observed nutritional interventions, as well as define the effect of weight loss on survival.

Methods
Consecutive subjects diagnosed with PDAC (N = 123) were retrospectively evaluated. Univariate analysis was used to compare subjects with and without substantial (>5%) weight loss. Multivariate logistic regression was performed to identify factors associated with weight loss, and survival analyses were performed using Kaplan-Meier curves and Cox survival models.

Results
Substantial weight loss at diagnosis was present in 71.5% of subjects and was independently associated with higher baseline body mass index, longer symptom duration, and increased tumor size. Recommendations for nutrition consultation and pancreatic enzyme replacement therapy occurred in 27.6% and 36.9% of subjects, respectively. Weight loss (>5%) was not associated with worse survival on multivariate analysis (hazard ratio, 1.32; 95% confidence interval, 0.76–2.30), unless a higher threshold (>10%) was used (hazard ratio, 1.77; 95% confidence interval, 1.09–2.87).

Conclusions
Despite the high prevalence of weight loss at PDAC diagnosis, there are low observed rates of nutritional interventions. Weight loss based on current criteria for cancer cachexia is not associated with poor survival in PDAC.
Diagnosing Chronic Pancreatitis
Authors: Issa Yama , van Santvoort Hjalmar C. , van Dieren Susan , Besselink Marc G. , Boermeester Marja A. , Ahmed Ali Usama 
Published: September 2017

Objectives
This study aims to compare the M-ANNHEIM, Büchler, and Lüneburg diagnostic tools for chronic pancreatitis (CP).

Methods
A cross-sectional analysis of the development of CP was performed in a prospectively collected multicenter cohort including 669 patients after a first episode of acute pancreatitis. We compared the individual components of the M-ANNHEIM, Büchler, and Lüneburg tools, the agreement between tools, and estimated diagnostic accuracy using Bayesian latent-class analysis.

Results
A total of 669 patients with acute pancreatitis followed-up for a median period of 57 (interquartile range, 42–70) months were included. Chronic pancreatitis was diagnosed in 50 patients (7%), 59 patients (9%), and 61 patients (9%) by the M-ANNHEIM, Lüneburg, and Büchler tools, respectively. The overall agreement between these tools was substantial (κ = 0.75). Differences between the tools regarding the following criteria led to significant changes in the total number of diagnoses of CP: abdominal pain, recurrent pancreatitis, moderate to marked ductal lesions, endocrine and exocrine insufficiency, pancreatic calcifications, and pancreatic pseudocysts. The Büchler tool had the highest sensitivity (94%), followed by the M-ANNHEIM (87%), and finally the Lüneburg tool (81%).

Conclusions
Differences between diagnostic tools for CP are mainly attributed to presence of clinical symptoms, endocrine insufficiency, and certain morphological complications.
Carcinosarcoma of the Pancreas
Authors: Ruess Dietrich A. , Kayser Claudia , Neubauer Jakob , Fichtner-Feigl Stefan , Hopt Ulrich T. , Wittel Uwe A. 
Published: September 2017

Abstract
Carcinosarcomas are rare biphasic neoplasms with distinct malignant epithelial and mesenchymal components. Most commonly, carcinosarcomas arise in the uterus as malignant mixed müllerian tumors, but also infrequently appear in other organs such as the ovaries and breast, the prostate and urinary tract, the lungs, or in the gastrointestinal system, among others. Pancreatic carcinosarcomas are exceedingly rare; only a few cases are reported in the English literature. Their pathogenesis remains to be fully clarified. We present here the case of a pancreatic carcinosarcoma with evidence for monoclonality via determination of Kras mutational status after microdissection and suggest a common origin of the 2 tumor components. Comprehensive review of the available literature allows the conclusion that most pancreatic carcinosarcomas appear to be of monoclonal origin and seem to have arisen from a carcinoma via metaplastic transformation of 1 part or subclone of the tumor, probably by epithelial-mesenchymal transition. All reported patients were treated with surgery. Adjuvant therapy, if administered, consisted predominantly of gemcitabine. Prognosis for this neoplasm occurs to be similar or even worse compared with classic pancreatic ductal adenocarcinoma. Despite the lack of evidence-based recommendations for its treatment, resection should be performed, if possible.
A Normal Preoperative Lipase Serum Level Is an Easy and Objective Risk Factor of Pancreatic Fistula After Pancreaticoduodenectomy
Authors: Gagnière Johan , Abjean Adeline , Franz Martin , Aumont Ophélie , Pereira Bruno , Dupré Aurélien , Veziant Julie , Le Roy Bertrand , Boyer Louis , Pezet Denis , Buc Emmanuel 
Published: September 2017

Objectives
The evaluation of the risk of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy is crucial to optimize perioperative strategies. Many risk factors of POPF have been identified and were included in scores. Performances of these scores have to be improved because of the use of subjective and/or intraoperative factors. We tried to identify new risk factors of POPF that could improve the performance of validated scores.

Methods
We analyzed data from a prospective database of 191 consecutive patients who underwent a pancreaticoduodenectomy. Recorded data included a comprehensive inventory of pre-, intra- and postoperative clinical, biological and radiological data.

Results
The rate of POPF was significantly increased in patients with a normal preoperative lipase serum level (LSL) (29.8% vs 6.8%; P = 0.001). After multivariate analysis, a normal preoperative LSL was a strong independent risk factor of both POPF (odds ratio, 7.06; P = 0.001) and clinically relevant POPF (odds ratio, 3.11; P = 0.036). The addition of the normality of the preoperative LSL to the Fistula Risk Score significantly improved its performance (P < 0.001).

Conclusions
A normal preoperative LSL was a strong, easy, and objective preoperative risk factor of POPF. Its addition to the Fistula Risk Score improved its performance and allows a more accurate evaluation of the risk of POPF.
Bile Acid Synthesis Disorders in Arabs: A 10-year Screening Study
Authors: Al-Hussaini Abdulrahman A. , Setchell Kenneth D.R. , AlSaleem Badr , Heubi James E. , Lone Khurram , Davit-Spraul Anne , Jacquemin Emmanuel 
Published: September 2017

ABSTRACT

Objectives:
Early diagnosis of bile acid synthesis disorders (BASDs) is important because, untreated, these conditions can be fatal. Our objectives were to screen children with cholestasis or unexplained liver disease for BASD and in those with confirmed BASD to evaluate the effectiveness of cholic acid therapy.

Methods:
A routine serum total bile acid measurement was performed on children with cholestasis, liver cirrhosis, and liver failure. Patients were screened for BASD by fast atom bombardment ionization-mass spectrometry (FAB-MS) analysis of urine, and molecular analysis confirmed diagnosis. Treatment response to oral cholic acid (10–15 mg/kg bw/day) was assessed from liver function tests and fat-soluble vitamin levels. FAB-MS analysis of urine was used to monitor compliance and biochemical response.

Results:
Between 2007 and 2016, 626 patients were evaluated; 450 with infantile cholestasis. Fifteen cases of BASD were diagnosed: 12 presented with infantile cholestasis (2.7%, 7 boys), an 8-year-old boy presented with cirrhosis, and two 18-month-old boys presented with hepatomegaly and rickets. Eleven were caused by 3β-hydroxy-Δ5-C27-steroid oxidoreductase dehydrogenase deficiency, 3 from Δ4-3-oxosteroid 5β-reductase deficiency, and 1 had Zellweger spectrum disorder. In all but 1, serum total bile acids were normal or low. With cholic acid therapy, 10 are alive and healthy with their native liver. Liver failure developed in 3 infants despite therapy; 2 died and 1 underwent liver transplantation.

Conclusions:
BASDs are rare but treatable causes of metabolic liver disease in Saudi Arabia. BASD should be considered in infants with cholestasis and low or normal serum total bile acid concentrations.
Efficacy of a Clinic-Based Safer Sex Program for Human Immunodeficiency Virus–Uninfected and Human Immunodeficiency Virus–Infected Young Black Men Who Have Sex With Men: A Randomized Controlled Trial
Authors: Crosby Richard A. , Mena Leandro , Salazar Laura F. , Hardin James W. , Brown Tim , Vickers Smith Rachel 
Published: September 2017

Objective
To test the efficacy of a single-session, clinic-based intervention designed to promote condom use among young black men who have sex with men (YBMSM).

Methods
Six hundred YBMSM were enrolled in a randomized controlled trial, using a 12-month observation period. An intent-to-treat analysis was performed, with multiple imputation for missing data.

Results
Compared with the reference group, human immunodeficiency virus (HIV)–infected men in the intervention group had 64% greater odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 1.64; 95% confidence interval, 1.23–2.17, P = 0.001). Also, compared with the reference group, HIV-uninfected men in the intervention group had more than twice the odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 2.14; 95% confidence interval, 1.74–2.63, P < 0.001). Significant intervention effects relative to incident sexually transmitted diseases were not observed.

Conclusions
A single-session, clinic-based, intervention may help protect HIV-uninfected YBMSM against HIV acquisition and HIV-infected YBMSM from transmitting the virus to insertive partners.
Neurosyphilis: Knowledge Gaps and Controversies
Authors: Tuddenham Susan , Ghanem Khalil G. 
Published: September 2017

Abstract
After reaching a nadir at the turn of the century, syphilis rates in the United States have increased since 2000. Treponema pallidum may disseminate to the central nervous system within hours to days after inoculation. In this review, we focus on knowledge gaps and areas of controversy in neurosyphilis epidemiology, diagnosis, and management. Modern estimates of the prevalence of neurosyphilis are hindered by the lack of consistent reporting data and are based on relatively small retrospective cohort studies. The various diagnostic modalities for neurosyphilis have significant limitations. Although several novel biomarkers for neurosyphilis have been evaluated, none to date have found a place in clinical practice. The role of a cerebrospinal fluid examination in patients without neurological symptoms continues to be an area of controversy, whereas the data for the use of antibiotic regimens other than intravenous aqueous or intramuscular procaine penicillin for the treatment of neurosyphilis are limited. As syphilis incidence continues to increase unabated in many countries around the world, it is critical to address these gaps of knowledge.
Cryotherapy Reduces Progression of Cervical Intraepithelial Neoplasia Grade 1 in South African HIV-Infected Women: A Randomized, Controlled Trial
Authors: Firnhaber Cynthia , Swarts Avril , Goeieman Bridgette , Rakhombe Ntombi , Mulongo Masangu , Williamson Anna-Lise , Michelow Pam , Ramotshela Sibongile , Faesen Mark , Levin Simon , Wilkin Timothy 
Published: September 2017

Background:
HIV-infected women are at an increased risk of cervical cancer, especially in resource-limited countries. Cervical cancer prevention strategies focus treating cervical high-grade squamous intraepithelial lesions (HSIL). The management of low-grade squamous intraepithelial lesions (LSIL) in HIV-infected women is unknown.

Setting:
HIV treatment clinic in Johannesburg, South Africa.

Methods:
We randomized HIV-infected women with histologic cervical LSIL to cervical cryotherapy vs. no treatment (standard of care). Cervical high-risk human papillomavirus testing (hrHPV) was performed at baseline. All women underwent cervical cytology and colposcopic biopsies 12 months after enrollment. The primary end point was HSIL on histology at month 12. Chi-square was used to compare arms.

Results:
Overall, 220 HIV-infected women were randomized to cryotherapy (n = 112) or no treatment (n = 108). Median age was 38 years, 94% were receiving antiretroviral therapy; median CD4 was 499 cells per cubic millimeter, and 59% were hrHPV positive. Cryotherapy reduced progression to HSIL: 2/99 (2%) in the cryotherapy arm and 15/103 (15%) in the no treatment arm developed HSIL, 86% reduction (95% confidence interval: 41% to 97%; P = 0.002). Among 17 HSIL end points, 16 were hrHPV+ at baseline. When restricting the analysis to hrHPV+ women, HSIL occurred in 2/61 (3%) in the cryotherapy arm vs. 14/54 (26%) in the no treatment arm, 87% reduction (95% confidence interval: 47% to 97%; P = 0.0004). Participants in the cryotherapy arm experienced greater regression to normal histology and improved cytologic outcomes.

Conclusions:
Treatment of cervical LSIL with cryotherapy decreased progression to HSIL among HIV-infected women especially if hrHPV positive. These results support treatment of LSIL in human papillomavirus test-and-treat approaches for cervical cancer prevention in resource-constrained settings.
Analysis of bacterial genomes from an evolution experiment with horizontal gene transfer shows that recombination can sometimes overwhelm selection
Authors: Maddamsetti Rohan , Lenski Richard E. 
Published: September 2017

AbstractWe analyzed genomes from an experiment in whichEscherichia coliK-12 Hfr donors were periodically introduced into 12 evolving populations ofE. coliB. Previous work showed that recombination did not increase adaptation, despite increasing variation relative to asexual controls. The effects of recombination were highly variable: one lineage was mostly derived from the donors, while another acquired almost no donor DNA. In most lineages, some regions showed repeated introgression and others almost none. Regions with high introgression tended to be near the donors origin of transfer sites. To determine whether introgressed alleles imposed a genetic load, we extended the experiment for 200 generations without recombination and sequenced whole-population samples. Beneficial alleles in the recipient populations were occasionally driven extinct by maladaptive donor-derived alleles. On balance, our analyses indicate that the plasmid-mediated recombination was sufficiently frequent to drive donor alleles to fixation without providing much, if any, selective advantage.
Evaluation of Convolutionary Neural Networks Modeling of DNA Sequences using Ordinal versus one-hot Encoding Method
Authors: Choong Allen Chieng Hoon , Lee Nung Kion 
Published: September 2017

AbstractConvolutionary neural network (CNN) is a popular choice for supervised DNA motif prediction due to its excellent performances. To employ CNN, the input DNA sequences are required to be encoded as numerical values and represented as either vectors or multi-dimensional matrices. This paper evaluates a simple and more compact ordinal encoding method versus the popular one-hot encoding for DNA sequences. We compare the performances of both encoding methods using three sets of datasets enriched with DNA motifs. We found that the ordinal encoding performs comparable to the one-hot method but with significant reduction in training time. In addition, the one-hot encoding performances are rather consistent across various datasets but would require suitable CNN configuration to perform well. The ordinal encoding with matrix representation performs best in some of the evaluated datasets. This study implies that the performances of CNN for DNA motif discovery depends on the suitable design of the sequence encoding and representation. The good performances of the ordinal encoding method demonstrates that there are still rooms for improvement for the one-hot encoding method.