bluuebunny/crossref_metadata_2025_split huggingface dataset:
FOVEAL AVASCULAR ZONE AREA ANALYSIS USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY BEFORE AND AFTER IDIOPATHIC EPIRETINAL MEMBRANE SURGERY
Authors: Kitagawa Yorihisa , Shimada Hiroyuki , Shinojima Ari , Nakashizuka Hiroyuki 
Published: December 2017

Purpose:
To determine the size of the foveal avascular zone (FAZ) by optical coherence tomography angiography before and after idiopathic epiretinal membrane surgery.

Methods:
Thirteen consecutive patients (13 eyes) with unilateral epiretinal membrane were studied retrospectively. Optical coherence tomography angiography was used to measure the FAZ area within 3 mm2 × 3 mm2 scans of the superficial (superficial FAZ) and deep plexus layers (deep FAZ) before and 6 months after vitrectomy. The unaffected fellow eyes were used as controls.

Results:
The mean superficial and deep FAZ areas at 6 months after vitrectomy (0.080 ± 0.038 and 0.113 ± 0.045 mm2, respectively) were significantly (P < 0.0001, P = 0.0035) larger than the corresponding mean preoperative FAZ areas (0.056 ± 0.030 and 0.082 ± 0.035 mm2). However, the areas of FAZ expansion were small (0.024 ± 0.013 and 0.031 ± 0.031 mm2). The mean postoperative superficial and deep FAZ areas were significantly (P < 0.0001, P < 0.0001) smaller than those of fellow eyes (0.295 ± 0.108 and 0.410 ± 0.142 mm2). Multiple regression analysis showed that preoperative FAZ area had the highest correlation with postoperative FAZ area (P < 0.05).

Conclusion:
This study showed horizontal contraction of the FAZ area in eyes with epiretinal membrane. Because preoperative FAZ area correlates with postoperative FAZ area, FAZ area may be a useful parameter for determining timing of surgery for epiretinal membrane.
Three-Dimensional Printing of Life-Like Models for Simulation and Training of Minimally Invasive Cardiac Surgery
Authors: Yamada Toshiyuki , Osaka Motohiko , Uchimuro Tomoya , Yoon Ryogen , Morikawa Toshiaki , Sugimoto Maki , Suda Hisao , Shimizu Hideyuki 
Published: December 2017

Objective As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. Methods Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity. A polyvinyl alcohol model material with a texture and physical properties similar to those of heart tissue was initially used in mitral valve replicas to simulate surgical procedures. To develop this material, we mechanically investigated the composition of each part of the porcine heart. Results We investigated the elastic modulus and breaking strength of the porcine heart. Based on investigation results, the cardiac model was set at rupture strength 20 MPa, elastic modulus 0.17 MPa, and moisture content 85%. This provided a biotexture and feeling exactly like a patient heart. Computed tomography scans confirmed that the model shape was nearly the same as that of a human heart. We simulated minimally invasive mitral valve repair, including ring annuloplasty, chordal reconstruction, resection and suture, and edge-to-edge repair. Full surgery simulations using this model used minimally invasive cardiac surgery tools including a robot. Conclusions This life-like model can be used as a standard simulator to train younger, less experienced surgeons to practice minimally invasive cardiac surgery procedures and may help develop new operative tools.
The Need for Consistent Predictors of Success for Surgical Ablation of Atrial Fibrillation
Authors: Ad Niv , Holmes Sari Diana , Patel Jay , Je Hyung Gon , Shuman Deborah J. 
Published: December 2017

Objective As with any medical therapy, identification of consistent and reliable outcome predictors is essential to understanding the efficacy of surgical ablation for atrial fibrillation. We originally intended to conduct a meta-analysis on atrial fibrillation surgical ablation to identify clinical factors that are most often associated with success. However, these studies are greatly heterogeneous. We conducted a systematic review to identify trends in outcome predictors and to provide recommendations for more uniform data analysis and reporting. Methods Relevant studies published between January 2005 and September 2013 were identified. To minimize heterogeneity, data were extracted only from multivariate analyses of outcome predictors. The initial approach for meta-analytic analyses was abandoned for a systematic review approach. Results From 604 initial citations, 19 studies with 5200 patients were included in the review. Systematic review of multivariable atrial fibrillation recurrence rates after surgical ablation revealed that studies were statistically heterogeneous, but atrial fibrillation recurrence after surgical ablation in mid-term follow-up was most often predicted by left atrium size, duration of atrial fibrillation, fine-wave atrial fibrillation, age of patient, and atrial fibrillation type. Conclusions The innate heterogeneity of published data precludes a meta-analysis for predictors of surgical ablation success. Of the few published studies that allow comparison, the most consistent predictors of failure were enlarged left atrium and long atrial fibrillation duration. These results underscore the need for consistent and reliable outcome predictors. We strongly recommend the development of a standardized system of measurement for consistent clinical parameters that can be used in outcome analyses for surgical ablation of atrial fibrillation.
Lithium + Colchicine
Authors: Mooney John J. , Brady Roscoe O. 
Published: December 2017

Abstract

Purpose
Rosenblat and McIntyre (Acta Psychiatr Scand. 2015;132: 180–191) propose that immune disorders are important mediators between bipolar disorders and medical comorbidities. Rosenblat et al (Bipolar Disord. 2016;18:89–101) present a meta-analysis showing that adjunctive anti-inflammatory agents could evoke moderate antidepressant responses in bipolar disorders. We propose using the anti-inflammatory drug colchicine to improve the long-term safety and efficacy of lithium treatment for bipolar disorders.

Methods
This report is based on searches of the PubMed and Web of Science databases.

Results
Bipolar disorders are associated with significant medical comorbidities such as hypertension, overweight/obesity, diabetes mellitus, metabolic syndrome, and arteriosclerosis, accompanied by enhanced release of pro-inflammatory markers during changes in mood state. During lithium therapy, granulocyte-colony stimulating factor, CD34+ hematopoietic stem/progenitor cells, and neutrophil elastase enter the circulation with activated neutrophils to promote the extravascular migration of activated neutrophils and enhance tissue inflammation. Concurrent treatment with lithium and low-dose colchicine could facilitate the responsiveness of bipolar patients to lithium by reducing leukocyte tissue emigration, the release of neutrophil elastase, and the release of leukocyte pro-inflammatory cytokines such as IL-1β that are regulated by the NLRP3 inflammasome assembly complex.

Conclusions
Concurrent therapy with lithium and low-dose colchicine could reduce complications involving leukocyte-mediated inflammatory states in bipolar patients and promote patient acceptance and responsiveness to lithium therapy.
Attitude of Nursing Students Toward Scientific Research: A Cross-Sectional Study in Turkey
Authors: ÜNVER Seher , SEMERCI Remziye , ÖZKAN Zeynep Kizilcik , AVCIBAŞI İlker 
Published: December 2017

ABSTRACT

Background:
Nursing, a social applied science, is a dynamic profession. Professional nurses must be curious, investigative, and open to learning as well as practice critical and analytic thinking to sustain their professionalism.

Purpose:
The aim of this study was to determine the attitudes of nursing students toward scientific research.

Methods:
A descriptive and cross-sectional study design was used. This study was conducted at a nursing department of a university in Turkey. A sample of 375 nursing students participated. Data were collected using the “Personal Information Form” and “Attitude Scale towards Scientific Studies.” Standard descriptive statistical methods, correlation, Mann–Whitney U, Kruskal–Wallis, and post hoc Bonferroni were used in data analysis.

Results:
Nearly all (90.1%) of the participants were female, and 33.9% were sophomore (second-year) students. Junior (third-year) students held the most positive attitudes toward research, as compared with the participants in other academic years. Participants who had participated in scientific activities held more positive attitudes toward research than those who had not. Participants who had prior experience doing scientific research showed more positive attitudes toward research and researchers than those without this experience. Being older, having scientific research experience, following the continuous broadcasts related to nursing, and participating in scientific activities all significantly influenced attitude toward research (p < .05).

Conclusions/Implications for Practice:
Although nursing students who participated in this study exhibited generally positive attitudes toward scientific research, they had relatively little experience participating in scientific activities. Therefore, to foster a positive scientific research culture among undergraduate students, grants should be provided that encourage wider participation in scientific activities and offer opportunities for undergraduate students to do scientific research.
Significant Effect of Acupressure in Elevating Blood Stem Cell Factor During Chemotherapy in Patients With Gynecologic Cancer
Authors: SHIH Ya-Wen , YANG Shun-Fa , CHIEN Ming-Hsien , CHANG Ching-Wen , CHANG Vincent H. S. , TSAI Hsiu-Ting 
Published: December 2017

ABSTRACTBackground:Chemotherapy is used mainly to treat and control the progression of gynecological cancer. Bone marrow suppression, one of the adverse side effects of chemotherapy, may decrease immune function, increasing the risk of serious, fatal infections.Purpose:The aims of this study were to evaluate the effectiveness of noninvasive acupressure in preventing and diminishing chemotherapy-induced myelosuppression in patients with gynecologic cancer and to determine whether this effect is associated with the regulation of the expressions of granulocyte-macrophage colony-stimulating factor and stem cell factor (SCF).Methods:In total, 28 women with gynecological cancer were randomly assigned either to the experimental group (n= 10) or to the control group (n= 18). The experimental group received acupressure of 5-minute duration to the Hegu (LI4), Quchi (LI11), Xuehai (SP10), Sanyinjiao (SP6), Taixi (K3), Zusanli (ST36), Taichong (LR3), and Baihui (GV20) points, respectively, three times per day for 6 weeks. The control group did not receive the acupressure intervention. The blood count, including white blood cells, platelets, and hemoglobin, and serum levels for SCF and granulocyte-macrophage colony-stimulating factor were assessed before (pretest) and 6 weeks after (posttest) the participants’ first course of chemotherapy.Results:At posttest, blood hemoglobin had significantly decreased from (mean ±SD) 11.6 ± 2.2 to 10.8 ±1.6 mg/dl (p= .03) in the control group. However, no significant pretest–posttest difference in hemoglobin concentration (11.4 ± 1.0 vs. 10.9 ± 1.1 mg/dl) was detected in the experimental group. Levels of SCF increased significantly between pretest and posttest in both the control group (from 1196.10 ± 293.17 to 1325.05 ± 253.77 ng/ml;p= .01) and the acupressure group (from 1046.78 ± 469.52 to 1387.06 ± 310.00 ng/ml;p= .007). In addition, a borderline difference (p= .05) in mean pretest–posttest SCF increase was found between the acupressure group (340.28 ± 255.46 ng/ml) and the control group (128.94 ± 250.64 ng/ml). Finally, a significant time-dependent interactive effect was found between acupressure and the increased blood level of SCF at posttest (β = 211.34,p= .02).Conclusions/Implications for Practice:The findings support that acupressure on specific acupoints increases blood SCF levels significantly, which may help protect chemotherapy patients from experiencing reduced hemoglobin levels and may relieve chemotherapy-induced myelosuppression in patients with gynecologic cancer. This noninvasive approach is suggested for practical implementation in patients undergoing a course of chemotherapy.
Knowledge of the Warning Signs of Foot Ulcer Deterioration Among Patients With Diabetes
Authors: CHIN Yen-Fan , YEH Jiun-Ting , YU Hsing-Yi , WENG Li-Chueh 
Published: December 2017

ABSTRACT

Background:
Seeking treatment in a timely manner may prevent lower limb amputation subsequent to diabetic foot ulcers. Knowledge regarding the warning signs is one importantfactor that is related to the timely treatment seeking of patients with diabetic foot ulcers. However, there is no previousresearch on which aspects of such knowledge that patients with diabetes are lacking.

Purpose:
The aims of this study were to test the psychometric properties of a questionnaire that was designed to assess the knowledge of the warning signs of diabetic foot ulcer deterioration and to determine the knowledge of these warning signs among patients with a history of diabetic foot ulcers.

Methods:
A cross-sectional study design was used. Patients with a history of diabetic foot ulcers were recruited using convenience sampling (N = 385). Data were analyzed using Spearman’s rank correlation and the Mann–Whitney U test.

Results:
The questionnaire showed good known-group validity, satisfied internal consistency (Kuder-Richardson Formula 20 = .82), and exhibited acceptable 2-week test–retest reliability (Spearman’s rho coefficient = .75). More than 30% of the participants were unaware of the warning signs of peripheral vascular insufficiency and severe infection. Of the participants, 75.8% felt that the time to seek medical treatment of diabetic foot ulcers was when they experienced wound deterioration. Those who held this opinion had significantly less knowledge regarding the warning signs of diabetic foot ulcer deterioration than did those who had not. Other factors that were significantly associated with less knowledge included being older, having less education, not having an existing foot ulcer, having no foot ulcer treatment history, and never having received education regarding foot ulcers.

Conclusions/Implications for Practice:
The questionnaire showed adequate validity and reliability and thus may be used by healthcare practitioners and researchers to assess the knowledge of at-risk patients regarding the warning signs of diabetic foot ulcer deterioration. Patient education regarding the importance of timely treatment seeking and warning signs should be promoted.
Celiac disease is uncommon in irritable bowel syndrome in the USA
Authors: Almazar Ann E. , Talley Nicholas J. , Larson Joseph J. , Atkinson Elizabeth J. , Murray Joseph A. , Saito Yuri A. 
Published: December 2017

Background and aimsRoutine serologic testing for celiac disease (CD) may be useful in irritable bowel syndrome (IBS) patients, but this is controversial. We aimed to compare the prevalence of unrecognized CD in a large cohort of patients with and without IBS.Participants and methodsThis is a family case–control IBS study conducted at a single US academic medical center. Stored serum and DNA were available. Tissue transglutaminase (TTg) immunoglobulin A was performed, followed by indirect immunofluorescence testing for endomysial antibodies with positive or weakly positive TTg results. Individuals were considered to have CD if both results were positive.χ2and Fisher’s exact tests were used to compare prevalence between the two groups.ResultsSerum samples were studied from 533 cases and 531 controls. In all, 80% of participants were female, with a median age of 50 years; 65% of cases and 0% controls met the Rome criteria for IBS. Previous serological testing for CD had occurred in 142 (27%) cases and 13 (2%) controls, but none had CD on subsequent testing. Six (1.1%) cases versus five (0.9%) controls had positive or weakly positive TTg test. Six cases (1.1%) versus three (0.6%) controls were confirmed to have CD by endomysial antibody (P=0.51).ConclusionNo difference in the prevalence of CD between patients with IBS and patients without IBS at a tertiary medical center was observed. Our findings do not support routine celiac serologic or genetic testing in patients with IBS in all US populations.
Evidence-Based Management of Drains Following Pancreatic Resection
Authors: Villafane-Ferriol Nicole , Shah Rohan M. , Mohammed Somala , Van Buren George , Barakat Omar , Massarweh Nader N. , Tran Cao Hop S. , Silberfein Eric J. , Hsu Cary , Fisher William E. 
Published: December 2017

Abstract
Many pancreatic surgeons continue to use intraperitoneal drains, but others have limited or avoided their use, believing this improves outcomes. We conducted a systematic review and meta-analysis of the literature assessing outcomes in pancreatectomy without drains, selective drainage, and early drain removal. We searched PubMed, Embase, and the Cochrane Library databases and conducted a systematic review of randomized and nonrandomized studies comparing routine intra-abdominal drainage versus no drainage, selective drain use, and early versus late drain removal after pancreatectomy, with major complications as the primary outcome. A meta-analysis of the literature assessing routine use of drains was conducted using the random-effects model. A total of 461 articles met search criteria from PubMed (168 articles), Embase (263 articles), and the Cochrane Library (30 articles). After case reports and articles without primary data on complications were excluded, 14 studies were identified for systematic review. Definitive evidence-based recommendations cannot be made regarding the management of drains following pancreatectomy because of limitations in the available literature. Based on available evidence, the most conservative approach, pending further data, is routine placement of a drain and early removal unless the patient's clinical course or drain fluid amylase concentration suggests a developing fistula.
Fetal Anemia Causing Hydrops Fetalis From an Alpha-Globin Variant: Homozygous Hemoglobin Constant Spring
Authors: Komvilaisak Patcharee , Komvilaisak Ratana , Jetsrisuparb Arunee , Wiangnon Surapon , Jirapradittha Junya , Kiatchoosakun Pakaphan , Fucharoen Goonapa 
Published: December 2017

Background:Fetal anemia is often assumed to be due to red cell alloimmunization and Parvovirus infection, and can lead to hydrops fetalis and death in utero. Other causes, such as mutations of hemoglobin alpha, are less commonly considered.Methods:We report 7 cases with fetal anemia causing hydrops fetalis. Serial Doppler ultrasound for measurement peak systolic velocity (PSV) of middle cerebral artery (MCA) was used for evaluation of fetal anemia. Fetal anemia is suggested if the MCA/PSV ratio is >1.5 multiple of median. Cordocentesis was performed subsequently to find the cause of fetal anemia and check fetal hemoglobin for consideration of intrauterine infusion. Investigations for fetal anemia include complete blood count, blood morphology, and blood group of mother and fetus, reticulocyte counts, red cell indices, screening for thalassemia, hemoglobin typing, acid elution test, parvovirus B 19 serology, and TORCH titer (toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, human immunodeficiency virus, and syphilis). Intrauterine infusion, using irradiated prestorage filtered red cell with hematocrit level of 80%, is indicated if fetal hemoglobin is <10 g/dL.Result:Seven cases with fetal anemia were prenatally diagnosed from gestational ages 20 to 34 weeks. Initial hematocrit in these cases varied from 9% to 17.2%. In each case, causes of anemia were determined using the investigations listed above. All cases underwent uneventfully up to 3 intrauterine transfusions. DNA study for thalassemia demonstrated homozygous Constant Spring (CS) in 5 cases, homozygous CS with heterozygous E in 1 case, and compound heterozygous CS and Pakse in 1 case. The perinatal outcomes were normal term in 5 cases, preterm in 2 cases. Low birth weight was determined in 2 cases. The screening for thalassemia major, including the osmotic fragility and dichlorophenol indophenol precipitation test (DCIP), is not helpful for detecting hemoglobin variants such as Constant Spring or Pakse.Summary:This study emphasizes homozygous Constant Spring and compound heterozygous CS and Pakse as a cause of hydrops fetalis. Proper management for the fetus after diagnosis can lead to a good fetal outcome. Prevention control programs should include screening of parents for the heterozygous state.
Prevention of HIV-1 Transmission Through Breastfeeding: Efficacy and Safety of Maternal Antiretroviral Therapy Versus Infant Nevirapine Prophylaxis for Duration of Breastfeeding in HIV-1-Infected Women With High CD4 Cell Count (IMPAACT PROMISE): A Randomized, Open-Label, Clinical Trial
Authors: Flynn Patricia M. , Taha Taha E. , Cababasay Mae , Fowler Mary Glenn , Mofenson Lynne M. , Owor Maxensia , Fiscus Susan , Stranix-Chibanda Lynda , Coutsoudis Anna , Gnanashanmugam Devasena , Chakhtoura Nahida , McCarthy Katie , Mukuzunga Cornelius , Makanani Bonus , Moodley Dhayendre , Nematadzira Teacler , Kusakara Bangini , Patil Sandesh , Vhembo Tichaona , Bobat Raziya , Mmbaga Blandina T. , Masenya Maysseb , Nyati Mandisa , Theron Gerhard , Mulenga Helen , Butler Kevin , Shapiro David E. ,   the PROMISE Study Team
Published: December 2017

Background:
No randomized trial has directly compared the efficacy of prolonged infant antiretroviral prophylaxis versus maternal antiretroviral therapy (mART) for prevention of mother-to-child transmission throughout the breastfeeding period.

Setting:
Fourteen sites in Sub-Saharan Africa and India.

Methods:
A randomized, open-label strategy trial was conducted in HIV-1–infected women with CD4 counts ≥350 cells/mm3 (or ≥country-specific ART threshold if higher) and their breastfeeding HIV-1–uninfected newborns. Randomization at 6–14 days postpartum was to mART or infant nevirapine (iNVP) prophylaxis continued until 18 months after delivery or breastfeeding cessation, infant HIV-1 infection, or toxicity, whichever occurred first. The primary efficacy outcome was confirmed infant HIV-1 infection. Efficacy analyses included all randomized mother–infant pairs except those with infant HIV-1 infection at entry.

Results:
Between June 2011 and October 2014, 2431 mother–infant pairs were enrolled; 97% of women were World Health Organization Clinical Stage I, median screening CD4 count 686 cells/mm3. Median infant gestational age/birth weight was 39 weeks/2.9 kilograms. Seven of 1219 (0.57%) and 7 of 1211 (0.58%) analyzed infants in the mART and iNVP arms, respectively, were HIV-infected (hazard ratio 1.0, 96% repeated confidence interval 0.3–3.1); infant HIV-free survival was high (97.1%, mART and 97.7%, iNVP, at 24 months). There were no significant differences between arms in median time to breastfeeding cessation (16 months) or incidence of severe, life-threatening, or fatal adverse events for mothers or infants (14 and 42 per 100 person-years, respectively).

Conclusions:
Both mART and iNVP prophylaxis strategies were safe and associated with very low breastfeeding HIV-1 transmission and high infant HIV-1–free survival at 24 months.