bluuebunny/crossref_metadata_2025_split huggingface dataset:
SIGNIFICANT REDUCTION OF BOTH PERIPAPILLARY AND SUBFOVEAL CHOROIDAL THICKNESS AFTER PANRETINAL PHOTOCOAGULATION IN PATIENTS WITH TYPE 2 DIABETES
Authors: Kang Hae Min , Lee Na Eun , Choi Jeong Hoon , Koh Hyoung Jun , Lee Sung Chul 
Published: August 2017

Purpose:
To evaluate changes in peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) after panretinal photocoagulation (PRP) for diabetic retinopathy.

Methods:
This retrospective interventional study included 59 treatment-naive eyes of 33 patients who underwent PRP and completed ≥12 months of follow-up. Peripapillary choroidal thickness and SFCT were measured at baseline and 1, 3, 6, and 12 months post-PRP. Differences between baseline and 12 months (ΔSFCT and ΔPCT) and percentage changes (ΔSFCT or ΔPCT/baseline × 100%) were determined.

Results:
Mean SFCT was 287.7 ± 76.7 μm (139.0–469.0 μm) at baseline and 225.8 ± 62.0 μm (102.5–379.5 μm) 12 months post-PRP (P < 0.001). Mean PCT was 161.2 ± 16.5 μm (75.3–308.1 μm) at baseline and 128.4 ± 41.8 μm (73.0–212.9 μm) 12 months post-PRP (P < 0.001). ΔSFCT was −61.3 ± 28.7 μm (−139.5 to −17.0 μm), and %SFCT was 21.2 ± 7.2% (6.8% to 36.1%). ΔPCT was −36.4 ± 23.2 μm (−149.1 to 5.4 μm), and %PCT was 22.4 ± 12.0% (2.5% to 62.6%). Diabetic retinopathy severity was the only factor significantly correlated with %SFCT (β = 0.500, P = 0.004) and %PCT (β = 0.152, P = 0.024).

Conclusion:
Both PCT and SFCT reduced significantly after PRP. Diabetic retinopathy severity was significantly correlated with post-PRP changes of peripapillary and SFCT.
Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury
Authors: Mauck Matthew C. , Smith Jennifer , Shupp Jeffrey W. , Weaver Mark A. , Liu Andrea , Bortsov Andrey V. , Lateef Bilal , Jones Samuel W. , Williams Felicia , Hwang James , Karlnoski Rachel , Smith David J. , Cairns Bruce A. , McLean Samuel A. 
Published: August 2017

Abstract
More than half of individuals experiencing major thermal burn injury (MThBI) receive an autologous skin graft (autograft), in which skin is removed from a healthy “donor” site and transplanted to the burn site. Persistent pain and itch at the graft site are major causes of suffering and disability in MThBI survivors. African Americans have a higher risk of MThBI, and in other clinical settings African Americans experience a greater burden of pain and itch relative to European Americans. However, to our knowledge, ethnic differences in skin graft site pain and itch outcomes after MThBI have not been assessed. We evaluated skin graft site pain and itch severity (0-10 Numeric Rating Scale [NRS]) over 1 year in a prospective multicenter cohort sample of African Americans and European Americans. In adjusted linear mixed models, African Americans experienced a slower rate of pain resolution in the acute phase of recovery (β = −0.05 vs −0.08 NRS points per day, P < 0.001), which resulted in a higher pain severity in the persistent phase of recovery (NRS mean difference = 1.21, 95% confidence interval [0.12-2.29]), although not statistically significant after correction for multiple comparisons. African Americans also experience greater itch severity in 6 weeks to 12 months after burn injury compared with European Americans (NRS mean difference = 1.86 [0.80-2.93]), which results from a faster rate of itch development in African Americans in the acute recovery phase after burn injury. Future studies may improve outcomes in African Americans and lead to new pathogenic insights that benefit all burn injury survivors.
Anatomical Relationship of the Middle Cranial Fossa Dura to Surface Landmarks of the Temporal Bone
Authors: Alhussaini Mohamed A. , Mattingly Jameson K. , Cass Stephen P. 
Published: August 2017

Hypothesis:
The suprameatal crest and temporal line provides a reliable landmark to the middle fossa dura.

Background:
Surface anatomy of the temporal bone is used to guide mastoid surgery, but studies investigating these landmarks are limited. The aim of this study was to examine the anatomical relationship of the middle fossa dura to the temporal line.

Methods:
Thirty-two fresh hemicephalic temporal bones were prepared by drawing four lines along the mastoid including the suprameatal crest and temporal line (line 2), one line 5 mm superior to line 2 (line 1), and one 5 mm inferior to line 2 (line 3), and at Reid's base line (line 4). Four points were marked along these lines anterior to posterior 3 mm apart. A 1 mm bur was used to drill perpendicular to these points to examine the relationship to the middle fossa dura.

Results:
The dura was found inferior to line 2 in 6.3% at point 1, 6.3% at point 2, 9.4% at point 3, and 18.8% at point 4. The dura in line 1 was found inferior to point 1 in 52.1%, point 2 in 46.9%, point 3 in 56.3%, and point 4 in 62.5%. Only one specimen (3.1%) had dura lying inferior to line 3. No specimens were inferior line 4 at any point.

Conclusion:
The dura of the middle fossa lies superior the temporal line in >80% of specimens and at least 5 mm superior in nearly half. This indicates the temporal line or a line slightly inferior to this is reliably inferior the middle fossa dura.
Surgery With or Without Postoperative Radiation Therapy for Early-stage External Auditory Canal Squamous Cell Carcinoma: A Meta-analysis
Authors: Oya Ryohei , Takenaka Yukinori , Takemura Kazuya , Ashida Naoki , Shimizu Kotaro , Kitamura Takahiro , Yamamoto Yoshifumi , Uno Atsuhiko 
Published: August 2017

Objective:
External auditory canal squamous cell carcinoma (EACSCC) is a rare disease with no standard treatment supported by high-level evidence. The aim of this study was to investigate EACSCC prognoses according to treatment modality and thus determine the optimal intervention for early-stage disease.

Data Sources:
PubMed, Scopus, and Ichushi-Web searches of the English and Japanese-language literature published between January 1, 2006 and December 31, 2016 were performed using the key words “external auditory canal cancer” and “temporal bone cancer.”

Study Selection:
Articles related to EACSCC that include the 5-year overall survival rate or individual patient data for histological types, follow-up periods, and final outcomes were enrolled.

Data Extraction:
Sex, age, Moody's modified Pittsburgh stage, type of treatment modality, type of operation, follow-up period, and 5-year survival rates were extracted.

Data Synthesis:
Twenty articles were used for the aggregate meta-analysis using a random-effects model, and 18 articles that reported 99 patients with early-stage EACSCC were used for the individual patient data meta-analysis.

Conclusion:
The 5-year overall survival rate of early-stage EACSCC was 77%. Postoperative radiation therapy (PORT) was performed in 45% of stage I patients and 68% of stage II patients. Survival analysis of all patients showed no differences between the surgery-only and PORT groups; however, PORT exhibited a better prognosis than surgery alone among patients with stage I disease (p = 0.003, log-rank test). This result indicated that PORT can be the standard therapy for stages I and II EACSCC.
The First Reported Case of Primary Intestinal-type Adenocarcinoma of the Middle Ear and Review of the Literature
Authors: Nader Marc-Elie , Bell Diana , Ginsberg Lawrence , DeMonte Franco , Gunn G. Brandon , Gidley Paul W. 
Published: August 2017

Objective:
Adenocarcinoma of the middle ear is a rare entity that must be distinguished from other adenomatous tumors of the temporal bone. We present the first patient of an intestinal-type adenocarcinoma originating from the middle ear.

Patients:
A 58-year-old woman presented with an 8-year history of left otorrhea. Her middle ear effusions were quite thick and gummy. She underwent eight sets of pressure-equalization tubes within 3 years. In 2011, her physical examination identified a middle ear mass, and she underwent mastoidectomy. A middle ear adenoma was resected. She underwent an additional three mastoidectomies for recurrence, with pathology from the 4th mastoidectomy revealing a diagnosis of adenocarcinoma. Imaging, at that time, showed an extensive temporal bone and Eustachian tube tumor.

Interventions:
She underwent a left subtotal temporal bone resection, parotidectomy, infratemporal fossa resection, dural resection, and microvascular free flap reconstruction followed by postoperative proton beam radiotherapy.

Main Outcome Measures:
The final pathology report revealed intestinal-type adenocarcinoma.

Results:
Treatment was successful and the patient remains disease free 4 years later.

Conclusion:
This is the first report of an intestinal-type adenocarcinoma of the middle ear and temporal bone. This patient also illustrates the difficulty of accurate histologic diagnosis of adenomatous tumors of the middle ear.
Patulous Eustachian Tube Dysfunction: Patient Demographics and Comorbidities
Authors: Ward Bryan K. , Ashry Yehia , Poe Dennis S. 
Published: August 2017

Objective:
The objective is to describe a large cohort of patients presenting with patulous Eustachian tube (pET) dysfunction.

Study Design:
Retrospective patient series.

Setting:
Tertiary referral center.

Patients:
All outpatient visits (2004–2016) that were assigned ICD9 code (381.7-Patulous Eustachian tube) were screened. Only patients with observed tympanic membrane movements during ipsilateral nasal breathing or acoustic reflex decay testing demonstrating transmitted nasal breathing were included (n = 190, n = 239 ears).

Main Outcome Measures:
Demographics and nasopharyngoscopy/otomicroscopy findings by comorbidities.

Results:
The majority (54%) was female and mean age of symptom onset was 38.0 (SD 20.0) years. Common symptoms included voice autophony (93%), breath autophony (92%), aural fullness (57%), pulsatile tinnitus (17%), and crackling or rumbling sounds (14%). Symptoms increased in frequency and duration with time (65%), were exacerbated with exercise (27%), and improved with placing the head in a dependent position (65%), sniffing (28%), upper respiratory infection (8%), and ipsilateral internal jugular vein compression (12%). In 52% pET was bilateral. Common comorbidities include environmental allergy (49%), weight loss (35%), laryngopharyngeal reflux (33%), anxiety (31%), autoimmunity (13%), and neuromuscular disease (8%). Allergy and anxiety patients were younger and more likely to have tonic contraction of the tensor veli palatini on exam (p < 0.05, χ
2). Allergy patients also had relief with sniffing and tympanic membrane retraction (p < 0.01, χ
2). Weight loss patients reported mean loss of 19.7 kg (SD 23.1), and were older, more rapidly diagnosed, and more likely to have persistent symptoms (p < 0.05). Initially, all patients were treated medically, with 47% eventually electing surgical intervention.

Conclusion:
pET is progressive, often bilateral, and possibly underdiagnosed. In this large series of pET, in addition to weight loss and chronic medical conditions, allergy and stress/anxiety were identified as novel risk factors. Most patients can be treated medically.
Duration of Eligibility Prior to Cochlear Implantation: Have We Made Any Progress?
Authors: Appelbaum Eric N. , Yoo Shannon S. , Perera Robert A. , Coelho Daniel H. 
Published: August 2017

Objective:
The objective is to determine if eligibility (as defined as the duration of severe to profound hearing loss before cochlear implantation [CI]) has changed over the 30 years since Food and Drug Administration approval.

Data Sources:
English-language, peer-reviewed articles, theses, and trial data available through PubMed and Cochrane Library databases up until and including May 31, 2016.

Study Selection:
One thousand six unique articles were identified. Prospective studies that reported duration of severe/profound hearing loss before CI in adult patients were included. Retrospective studies, reviews, meta-analyses, articles reporting pediatric or mixed data, hybrid/electroacoustic CI, and articles from centers outside the United States were excluded. Seventy-one studies met inclusion criteria and were included for analysis.

Data Extraction:
Contributing authors independently reviewed included studies for data validity and applicability.

Data Synthesis:
Metaregression was used to assess the relationship between the year of publication and duration of hearing loss. To account for a possible age effect, a second model was estimated including mean age at the time of study as a covariate.

Conclusion:
A positive association between study year and the duration of hearing loss before implantation was found showing a 0.28-year increase in the duration of hearing loss for every increasing study year. Contrary to conventional assumption, duration of eligibility for CI appears to be increasing. Though the reasons for this are not clear, current strategies to increase both awareness and access to CI seem to be falling short.
Celecoxib-induced Liver Injury
Authors: Mukthinuthalapati Pavan K. , Fontana Robert J. , Vuppalanchi Raj , Chalasani Naga , Ghabril Marwan 
Published: August 2017

Background:
Celecoxib is a widely prescribed nonsteroidal anti-inflammatory drug, and has been associated with rare instances of idiosyncratic drug-induced liver injury (DILI). The aim of this study is to describe and analyze the salient features of published cases of celecoxib DILI.

Materials and Methods:
A literature search using common terms for liver injury cross-referenced with celecoxib was undertaken from the year 2000 through June 2016. Identified cases were analyzed with respect to reported demographic and clinical data with descriptive.

Results:
Celecoxib DILI was reported in 18 patients with a median age of 54 years (range, 29 to 84) and 15 (88%) were female. The median daily dose was 200 mg (range, 200 to 533), and median duration and latency were 13 days (1 to 730) and 17 days (2 to 730), respectively. In 15 (83%) cases, DILI occurred after relatively short treatment duration, median of 12 days (1 to 42). Rash and immunoallergic features were noted in these patients, with peripheral or histologic findings of eosinophilia in 6 (40%). In 3 cases, DILI occurred after prolonged exposure (range, 152 to 730 d), none with immunoallergic features. The pattern of liver injury included hepatocellular (6), mixed (5), and cholestatic (4), and was unknown in 3 cases. Clinical outcomes included 2 (11%) requiring liver transplantation, 4 (22%) with chronic liver injury and recovery in 12 (67%) cases.

Conclusions:
Women are overrepresented in published reports of celecoxib DILI. Latency was short (<3 mo) in most patients but some subjects may present with DILI following prolonged celecoxib use. Although rare, celecoxib-DILI can have potentially life threatening consequences.
Using Skin Gene Markers for Estimating Early Postmortem Interval at Different Temperatures
Authors: Ali Mona Mohamed , Ibrahim Samah Fathy , Fayed Amel Ahmed 
Published: August 2017

Abstract
Many researches document long-term RNA persistence in a variety of tissues and its applicability in estimating the postmortem interval (PMI). Skin-specific mRNA marker, late cornified envelope 1C (LCE1C), was used to identified skin samples. Before using the LCE1C in criminal casework, its persistence and applicability for estimating PMI in different temperatures were tested. Twelve skin samples were collected from 6 patients, and 6 samples were kept at 24°C and others were kept at 40°C for 5 days. The expression levels of LCE1C mRNA are serially detected and quantified using real-time polymerase chain reaction. The expression levels of LCE1C were decreased with increasing the time interval in time-dependent manner, whereas changing the surrounding temperatures did not show any statistical significance. These results could suggest using LCE1C in estimation of PMI. Moreover, these encourage investigators and crime laboratories to know environmental conditions before interpreting the results.
An Intensive, Simulation-Based Communication Course for Pediatric Critical Care Medicine Fellows
Authors: Johnson Erin M. , Hamilton Melinda F. , Watson R. Scott , Claxton Rene , Barnett Michael , Thompson Ann E. , Arnold Robert 
Published: August 2017

Objective:
Effective communication among providers, families, and patients is essential in critical care but is often inadequate in the PICU. To address the lack of communication education pediatric critical care medicine fellows receive, the Children’s Hospital of Pittsburgh PICU developed a simulation-based communication course, Pediatric Critical Care Communication course. Pediatric critical care medicine trainees have limited prior training in communication and will have increased confidence in their communication skills after participating in the Pediatric Critical Care Communication course.

Design:
Pediatric Critical Care Communication is a 3-day course taken once during fellowship featuring simulation with actors portraying family members.

Setting:
Off-site conference space as part of a pediatric critical care medicine educational curriculum.

Subjects:
Pediatric Critical Care Medicine Fellows.

Interventions:
Didactic sessions and interactive simulation scenarios.

Measurements and Main Results:
Prior to and after the course, fellows complete an anonymous survey asking about 1) prior instruction in communication, 2) preparedness for difficult conversations, 3) attitudes about end-of-life care, and 4) course satisfaction. We compared pre- and postcourse surveys using paired Student t test. Most of the 38 fellows who participated over 4 years had no prior communication training in conducting a care conference (70%), providing bad news (57%), or discussing end-of-life options (75%). Across all four iterations of the course, fellows after the course reported increased confidence across many topics of communication, including giving bad news, conducting a family conference, eliciting both a family’s emotional reaction to their child’s illness and their concerns at the end of a child’s life, discussing a child’s code status, and discussing religious issues. Specifically, fellows in 2014 reported significant increases in self-perceived preparedness to provide empathic communication to families regarding many aspects of discussing critical care, end-of-life care, and religious issues with patients’ families (p < 0.05). The majority of fellows (90%) recommended that the course be required in pediatric critical care medicine fellowship.

Conclusions:
The Pediatric Critical Care Communication course increased fellow confidence in having difficult discussions common in the PICU. Fellows highly recommend it as part of PICU education. Further work should focus on the course’s impact on family satisfaction with fellow communication.
Ventilation variability of Labrador Sea Water and its impact on oxygen and anthropogenic carbon: a review
Authors: Rhein Monika , Steinfeldt Reiner , Kieke Dagmar , Stendardo Ilaria , Yashayaev Igor 
Published: August 2017

Ventilation of Labrador Sea Water (LSW) receives ample attention because of its potential relation to the strength of the Atlantic Meridional Overturning Circulation (AMOC). Here, we provide an overview of the changes of LSW from observations in the Labrador Sea and from the southern boundary of the subpolar gyre at 47° N. A strong winter-time atmospheric cooling over the Labrador Sea led to intense and deep convection, producing a thick and dense LSW layer as, for instance, in the early to mid-1990s. The weaker convection in the following years mostly ventilated less dense LSW vintages and also reduced the supply of oxygen. As a further consequence, the rate of uptake of anthropogenic carbon by LSW decreased between the two time periods 1996–1999 and 2007–2010 in the western subpolar North Atlantic. In the eastern basins, the rate of increase in anthropogenic carbon became greater due to the delayed advection of LSW that was ventilated in previous years. Starting in winter 2013/2014 and prevailing at least into winter 2015/2016, production of denser and more voluminous LSW resumed. Increasing oxygen signals have already been found in the western boundary current at 47° N. On decadal and shorter time scales, anomalous cold atmospheric conditions over the Labrador Sea lead to an intensification of convection. On multi-decadal time scales, the ‘cold blob’ in the subpolar North Atlantic projected by climate models in the next 100 years is linked to a weaker AMOC and weaker convection (and thus deoxygenation) in the Labrador Sea.
This article is part of the themed issue ‘Ocean ventilation and deoxygenation in a warming world’.
High-latitude ocean ventilation and its role in Earth's climate transitions
Authors: Naveira Garabato Alberto C. , MacGilchrist Graeme A.  , Brown Peter J. , Evans D. Gwyn , Meijers Andrew J. S. , Zika Jan D. 
Published: August 2017

The processes regulating ocean ventilation at high latitudes are re-examined based on a range of observations spanning all scales of ocean circulation, from the centimetre scales of turbulence to the basin scales of gyres. It is argued that high-latitude ocean ventilation is controlled by mechanisms that differ in fundamental ways from those that set the overturning circulation. This is contrary to the assumption of broad equivalence between the two that is commonly adopted in interpreting the role of the high-latitude oceans in Earth's climate transitions. Illustrations of how recognizing this distinction may change our view of the ocean's role in the climate system are offered.This article is part of the themed issue ‘Ocean ventilation and deoxygenation in a warming world’.
Intron-containing RNA from the HIV-1 provirus activates type I interferon and inflammatory cytokines
Authors: McCauley Sean Matthew , Kim Kyusik , Nowosielska Anetta , Dauphin Ann , Yurkovetskiy Leonid , Diehl William Edward , Luban Jeremy 
Published: August 2017

ABSTRACTHIV-1-infected people who take drugs that suppress viremia to undetectable levels are protected from developing AIDS. Nonetheless, these individuals have chronic inflammation associated with heightened risk of cardiovascular pathology. HIV-1 establishes proviruses in long-lived CD4+memory T cells, and perhaps other cell types, that preclude elimination of the virus even after years of continuous antiviral therapy. Though the majority of proviruses that persist during antiviral therapy are defective for production of infectious virions, many are expressed, raising the possibility that the HIV-1provirus or its transcripts contribute to ongoing inflammation. Here we found that the HIV-1 provirus activated innate immune signaling in isolated dendritic cells, macrophages, and CD4+T cells. Immune activation required transcription from the HIV-1 provirus and expression of CRM1-dependent, Rev-dependent, RRE-containing, unspliced HIV-1 RNA. Ifrevwas providedin trans, all HIV-1 coding sequences were dispensable for activation except thosecis-acting sequences required for replication or splicing. These results indicate that the complex, post-transcriptional regulation intrinsic to HIV-1 RNA is detected by the innate immune system as a danger signal, and that drugs which disrupt HIV-1 transcription or HIV-1 RNA metabolism would add qualitative benefit to current antiviral drug regimens.