bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tear Cytokines as Biomarkers for Acute Ocular Graft-Versus-Host Disease
Authors: Qiu Yuan , Hu Bohao , Peng Rong-mei , Huang Jing-Feng , Hong Jing 
Published: February 2022

Purpose:
The purpose of this study was to analyze tear cytokine and complement levels in patients diagnosed with acute ocular graft-versus-host disease (oGVHD) and examine the consistency of these levels with the severity of clinical manifestations.

Methods:
Ten patients with acute oGVHD (20 eyes) were enrolled for the assessment of tear cytokine levels and ocular surface parameters, and 18 healthy people (36 eyes) were selected as the control group. The tear cytokine and complement levels were measured using microsphere-based immunoassay analysis.

Results:
The main clinical manifestations of acute oGVHD include eye redness, a large amount of purulent exudate, eye pain, and even false membranes. The levels of intercellular cell adhesion molecule-1, interleukin 6 (IL-6), interleukin 1 beta (IL-1β), interleukin 8, epidermal growth factor (EGF), interleukin 7 (IL-7), B-cell activating factor, granulocyte-macrophage colony-stimulating factor (GM-CSF), and complement in patients with acute oGVHD showed significant differences compared with those in normal people. Furthermore, the levels of IL-6, IL-1β, EGF, GM-CSF, IL-7, and C3a showed a stronger correlation with ocular surface parameters.

Conclusions:
Our study was the first to enroll patients with acute oGVHD to assess tear cytokine levels as a method contributing to the diagnosis of acute oGVHD. In addition, it has been demonstrated that certain tear cytokines, including intercellular cell adhesion molecule-1, IL-6, IL-1β, interleukin 8, B-cell activating factor, GM-CSF, IL-7, EGF, and complement, may be new diagnostic biomarkers for acute oGVHD.
Endolymphatic Hydrops Magnetic Resonance Imaging in Menire's Disease Patients on a Vertigo Attack
Authors: Chen Wei , Geng Yue , Niu Yue , Lin Mengyan , Lin Naier , Sha Yan 
Published: February 2022

Objective:
To investigate the characteristics of endolymphatic hydrops (EH) in Menire's disease (MD) patient on a vertigo attack.

Study Design:
Prospective study.

Setting:
Tertiary referral center.

Patients:
Thirty-six MD patients underwent the enhanced magnetic resonance imaging (MRI) examinations of the inner ear on a vertigo attack were enrolled.

Main Outcome Measures:
All patients met the diagnostic criteria for MD and underwent intravenous gadolinium injection 4 hours before the MRI examinations. The MRI examinations were performed in MD patients on a vertigo attack.

Results:
Various degrees of vestibular EH appeared in almost all affected ears (2 ears had no EH, 11 ears had mild EH, 26 ears had significant EH). The positive rate of vestibular EH was 37/39 (94.9%). Cochlear EH occurred in 29 ears among 39 affected ears (17 ears had mild EH, 12 ears had significant EH).

Conclusion:
MRI with intravenous gadolinium injection can provide a better assessment of EH in MD patient on a vertigo attack. Vestibular EH seems to be closely related with the vertigo attacks in MD patients, which needs further study.
Predictors of Recurrence After Sub-total or Near-total Resection of Vestibular Schwannoma: Importance of Tumor Volume and Ventral Extension
Authors: Manzoor Nauman F. , Nassiri Ashley M. , Sherry Alexander D. , Dang Sabina , Yancey Kristen L. , Monsour Meredith , Perkins Elizabeth L. , Khattab Mohamed H. , Thompson Reid C. , O’Malley Matthew R. , Bennett Marc L. , Rivas Alejandro C. , Haynes David S. 
Published: February 2022

Objective:
To evaluate the predictors of remnant tumor regrowth and need for salvage therapy after less than gross total resection (GTR) of vestibular schwannoma (VS).

Study Design:
Retrospective chart review.

Setting:
Tertiary neurotologic referral center.

Patients:
Patients who underwent VS resection between 2008 and 2019 either with GTR, near total resection (NTR), and subtotal resection (STR).

Interventions:
Microsurgical resection, salvage radiosurgery.

Main Outcome Measures:
Regrowth free interval, salvage free interval, tumor doubling rate.

Results:
Three hundred eighty five cases (GTR = 236, NTR = 77, and STR = 71) from 2008 to 2019 were included. STR cohort had much larger and complex tumors with significant differences in tumor volume, ventral extension and brainstem compression (p
< 0.001). On single predictor analysis, tumor volume, ventral extension, brainstem compression as well as STR strategy was associated with significant increased risk of regrowth and need for salvage therapy. Multivariate analysis revealed STR strategy as significant predictor of regrowth (hazard ratio 3.79, p
< 0.0005). Absolute remnant volume and extent of resection (EOR) did not predict regrowth. A small proportion of cases (NTR = 4%, STR = 15%) eventually needed salvage radiosurgery with excellent ultimate local tumor control with no known recurrence to date.

Conclusions:
Conservative surgical strategy employing NTR or STR can be employed safely in large and complex VS. While there is increased risk of regrowth in the STR cohort, excellent local control can be achieved with appropriate use of salvage radiosurgery. No disceret radiologic or operative predictors of regrowth were identified.
Pars plana vitrectomy surgery for kyrieleis plaques with retinal detachment
Authors: Yang Jianjun , Pan Hanying 
Published: February 2022

Abstract

Introduction:
Kyrieleis plaques complicated by retinal detachment are rare. To date, there has been no pathological diagnosis of Kyrieleis plaques.

Patient concerns:
A 39-year-old male patient had blurred vision in his left eye, which was previously healthy.

Diagnosis:
We considered the clinical picture of kyrieleis plaques complicated by retinal detachment.

Interventions:
Pars Plana vitrectomy surgery was performed

Outcomes:
Retinal detachment recovered partially and after one year of follow-up, he had good vision in his left eye.

Conclusion:
Viral infection is a possible cause of Kyrieleis plaques. Endothelial cells of retinal arteries may be involved in this process. Pars Plana Vitrectomy can be a good method to treat Kyrieleis plaques complicated by retinal detachment.
Evolution of International Pediatric Endoscopic Practice Changes During the Coronavirus Disease 2019 Pandemic
Authors: Ruan Wenly , Fishman Douglas S. , Lerner Diana G. , Furlano Raoul I. , Thomson Mike , Walsh Catharine M. 
Published: February 2022

ABSTRACTObjectives:The coronavirus disease 2019 (COVID‐19) pandemic has drastically altered endoscopic practices. We initially reported the international impact of COVID‐19 on pediatric endoscopic practice. This follow‐up study aimed to assess changes 7 months following the initial survey to delineate practice change patterns as the pandemic evolved.Methods:Pediatric gastroenterologists who responded to the initial survey were re‐surveyed seven months later using Research Electronic Data Capture (REDCap). The survey recorded information on changes in pediatric endoscopic practice patterns, including COVID‐19 screening and testing processes and personal protective equipment (PPE) utilization. Additionally, endoscopists’ risk tolerance of COVID‐19 transmission was evaluated.Results:Seventy‐five unique institutions from 21 countries completed surveys from the 145 initial responses (51.7% response rate). Procedural volumes increased at most institutions (70.7%) and most were performing previously postponed cases (90.7%). Ninety‐seven percent of institutions were performing pre‐endoscopy screening with 78.7% testing all patients. Many institutions (34.7%) have performed procedures on COVID‐19 positive patients. There was significantly less PPE reuse (P < 0.05) and fewer institutions recommending full PPE for all endoscopies (43.2% vs 59.2%, P = 0.013). Overall, pediatric endoscopists’ risk tolerance of COVID‐19 transmission is low.Conclusions:This is the first survey to highlight the evolution of pediatric endoscopic practices related to the COVID‐19 pandemic, underscoring the need for ongoing pandemic‐related guidance for pediatric endoscopic practice.
Life Events, Barriers to Care, and Outcomes Among Minority Women Experiencing Depression
Authors: Tieu Lina , Walton Quenette L. , Sherbourne Cathy D. , Miranda Jeanne M. , Wells Kenneth B. , Tang Lingqi , Williams Pluscedia , Anderson Gera L. , Booker-Vaughns Juanita , Pulido Esmeralda , Carr Themba , Heller S. Megan , Bromley Elizabeth 
Published: February 2022

Abstract
The long-term course of depression is not well-understood among minority women. We assessed depression trajectory, barriers to depression care, and life difficulties among minority women accessing health and social service programs as part of the Community Partners in Care study. Data include surveys (N = 339) and interviews (n = 58) administered at 3-year follow-up with African American and Latina women with improved versus persistent depression. The majority of the sample reported persistent depression (224/339, 66.1%), ≥1 barrier to mental health care (226/339, 72.4%), and multiple life difficulties (mean, 2.7; SD, 2.3). Many barriers to care (i.e., related to stigma and care experience, finances, and logistics) and life difficulties (i.e., related to finances, trauma, and relationships) were more common among individuals reporting persistent depression. Results suggest the importance of past experiences with depression treatment, ongoing barriers to care, and negative life events as contributors to inequities in depression outcomes experienced by minority women.
Instrumented Gait Analysis (IGA) for Management of Children With Cerebral Palsy: A Needs Assessment Survey
Authors: Godwin Ellen M. , Salem Yasser , States Rebecca A. , Krzak Joseph J. , McMulkin Mark , Bodkin-Winter Amy 
Published: February 2022

Purpose:
This needs assessment survey identifies the priorities of the clinical and research communities involved with the use of instrumented gait analysis (IGA) for a clinical practice guideline on IGA use with children with cerebral palsy (CP).

Methods:
Thirteen Likert scale questions asked about the importance of topics related to IGA. Other questions addressed respondents' demographics, experience with IGA, patient populations, and gait laboratory characteristics. Several open-ended questions were included and analyzed.

Results:
The survey was completed by 43 physical therapists and 53 non–physical therapists involved with IGA. More than 90% rated the following as critically or highly important: reliability and validity of IGA to identify gait pathology (94%); ability to longitudinally track gait pathology (93%); use in planning interventions (93%); use in evaluating outcomes (93%); and definition of IGA (90%).

Conclusions and Recommendations for Clinical Practice:
This needs assessment survey identified the topic priorities of clinicians and practitioners who use IGA for the management of children with CP. These results will guide the development of a clinical practice guideline on the use of IGA for the management of CP.
Skeletal and Dental Outcomes after Facial Allotransplantation: The Cleveland Clinic Experience and Systematic Review of the Literature
Authors: Coombs Demetrius M. , Bassiri Gharb Bahar , Tuncer Fatma B. , Djohan Risal S. , Gastman Brian R. , Bernard Steven L. , Schwarz Graham S. , Gurunian Raffi , Siemionow Maria Z. , Papay Frank A. , Rampazzo Antonio 
Published: February 2022

Background:
Most of the literature surrounding face transplantation focuses on technique, immunology, and psychology. Dental and skeletal outcomes remain persistently underreported. This study critically examined the worldwide face transplant experience to evaluate such outcomes.

Methods:
A systematic review of all composite allografts containing midface and/or mandible was performed. Dental and skeletal complications were recorded. Formal imaging and photographs available in the literature were analyzed using skeletal measurements, soft-tissue cephalometrics, and the Angle classification. Outcomes of our face transplant patients, including condylar assessment and airway volume measurements, is also presented.

Results:
Twenty-five patients received allografts containing midface (n = 7) or mandible (n = 2), whereas 16 contained a double-jaw. All midface-only transplants developed skeletal deformity; 57 percent developed a palatal fistula. Both partial and full arch transplantation patients developed skeletal deformity. Among double-jaw transplants, 69 percent developed palatal fistula or floor-of-mouth dehiscence, 66 percent developed malocclusion, 50 percent developed trismus, and 31 percent required corrective orthognathic surgery. In 40 percent of patients, malocclusion recurred after corrective orthognathic surgery. Forty percent of all patients developed dental cavities or periodontal disease. All of our patients received midface and/or mandible. One patient required corrective orthognathic surgery. Midfacial segments showed clockwise rotation. Airway volumes decreased over time.

Conclusions:
Skeletal and dental complications remain extremely common after facial allotransplantation involving either single- or double-jaw composites. Corrective orthognathic surgery and dental extraction is often necessitated. These data will aid face transplant teams during surgical planning and preoperative counseling.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Persistent HIV transcription and variable antiretroviral drug penetration in lymph nodes during plasma viral suppression
Authors: Fletcher Courtney V. , Kroon Eugène , Schacker Timothy , Pinyakorn Suteeraporn , Chomont Nicolas , Chottanapund Suthat , Prueksakaew Peeriya , Benjapornpong Khunthalee , Buranapraditkun Supranee , Phanuphak Nittaya , Ananworanich Jintanat , Vasan Sandhya , Hsu Denise 
Published: February 2022

Objective:
The ability of antiretroviral drugs to penetrate and suppress viral replication in tissue reservoir sites is critical for HIV remission. We evaluated antiretroviral concentrations in lymph nodes and their impact on HIV transcription.

Methods:
Participants of the RV254/SEARCH010 Acute HIV Infection Cohort in Thailand were enrolled. Group 1 (n
= 6) initiated and continued antiretrovirals with two nucleoside reverse transcriptase inhibitors (NRTIs), dolutegravir (DTG) and mar- aviroc (MVC). Group 2 (n = 12) initiated antiretrovirals with two NRTIs as well as efavirenz and were switched to two NRTIs as well as DTG. Antiretroviral concentrations were measured by mass spectroscopy. HIV RNA+ and DNA+ cells were measured by in-situ hybridization.

Results:
All participants were MSM. At lymph node biopsy, all had plasma HIV RNA less than 20 copies/ml. Group 2 had longer durations of antiretroviral and DTG use (medians of 135 and 63 weeks, respectively) compared with Group 1 (median 44 weeks for both). TFV-DP, 3TC-TP, DTG and MVC were quantifiable in all lymph node samples from participants receiving those drugs versus carbovir-triphosphate (CBV-TP) in four out of 14. Median ratios of lymph node to peripheral blood concentrations were DTG, 0.014; MVC, 6.9; CBV-TP, 0.38; 3TC-TP, 0.32; and TFV-DP, 3.78. Median inhibitory quotients [ratios of lymph node concentrations to in-vitro inhibitory levels (IC50-or-90)] were DTG, 0.8; MVC, 38.8; CBV-TP, 0.5; 3TC- TP, 4.1; and TFV-DP, 1.8. Ongoing viral transcription was detected in lymph node of all participants. Median lymph node RNA+ cells were 71 350 versus 99 750 cells/g for Groups 1 and 2, respectively (P = 0.111).

Conclusion:
MVC has enhanced lymph node penetration and thereby may contribute to more complete viral suppression in the lymph node.
Whole-Body Magnetic Resonance Imaging in the Large Population-Based German National Cohort Study
Authors: Schuppert Christopher , Krüchten Ricarda von , Hirsch Jochen G. , Rospleszcz Susanne , Hoinkiss Daniel C. , Selder Sonja , Köhn Alexander , Stackelberg Oyunbileg von , Peters Annette , Völzke Henry , Kröncke Thomas , Niendorf Thoralf , Forsting Michael , Hosten Norbert , Hendel Thomas , Pischon Tobias , Jöckel Karl-Heinz , Kaaks Rudolf , Bamberg Fabian , Kauczor Hans-Ulrich , Günther Matthias , Schlett Christopher L. ,   for The German National Cohort MRI Study Investigators
Published: February 2022

Background
Reproducible image quality is of high relevance for large cohort studies and can be challenging for magnetic resonance imaging (MRI). Automated image quality assessment may contribute to conducting radiologic studies effectively.

Purpose
The aims of this study were to assess protocol repetition frequency in population-based whole-body MRI along with its effect on examination time and to examine the applicability of automated image quality assessment for predicting decision-making regarding repeated acquisitions.

Materials and Methods
All participants enrolled in the prospective, multicenter German National Cohort (NAKO) study who underwent whole-body MRI at 1 of 5 sites from 2014 to 2016 were included in this analysis (n = 11,347). A standardized examination program of 12 protocols was used. Acquisitions were carried out by certified radiologic technologists, who were authorized to repeat protocols based on their visual perception of image quality. Eleven image quality parameters were derived fully automatically from the acquired images, and their discrimination ability regarding baseline acquisitions and repetitions was tested.

Results
At least 1 protocol was repeated in 12% (n = 1359) of participants, and more than 1 protocol in 1.6% (n = 181). The repetition frequency differed across protocols (P < 0.001), imaging sites (P < 0.001), and over the study period (P < 0.001). The mean total scan time was 62.6 minutes in participants without and 67.4 minutes in participants with protocol repetitions (mean difference, 4.8 minutes; 95% confidence interval, 4.5–5.2 minutes). Ten of the automatically derived image quality parameters were individually retrospectively predictive for the repetition of particular protocols; for instance, “signal-to-noise ratio” alone provided an area under the curve of 0.65 (P < 0.001) for repetition of the Cardio Cine SSFP SAX protocol. Combinations generally improved prediction ability, as exemplified by “image sharpness” plus “foreground ratio” yielding an area under the curve of 0.89 (P < 0.001) for repetition of the Neuro T1w 3D MPRAGE protocol, versus 0.85 (P < 0.001) and 0.68 (P < 0.001) as individual parameters.

Conclusions
Magnetic resonance imaging protocol repetitions were necessary in approximately 12% of scans even in the highly standardized setting of a large cohort study. Automated image quality assessment shows predictive value for the technologists' decision to perform protocol repetitions and has the potential to improve imaging efficiency.
Removal of Fracture Fragments in Intracapsular Condylar Fractures: An Alternative Treatment Option
Authors: Cui Meng-Juan , Yang Rui-Cong , Zhou Hai-Hua , Lv Kun , Yang Rong-Tao , Li Zhi , Li Zu-Bing 
Published: February 2022

Objective:
This study aimed to explore bone remodeling after condylar fracture fragments have been removed from patients with intracapsular condylar fractures. it also evaluated whether condyle fracture removal can be used alternatively when the authors treat patients with comminuted or small pieces of fracture or in extremely difficult operations.

Methods:
Records of patients who sustained intracapsular condylar fractures and treated by removal of fragments for the period of February 2013 to September 2019 were retrieved. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fracture, treatment methods and time of review were recorded and analyzed. Image dates of pre- and post-treatment (including the time of review) were also recorded.

Results:
The data of a total of 103 patients ranging from 5 to 84 years old were retrieved during this study. A total of 135 sides of condylar fragments were removed. Almost all of the patients with comminuted condyle head fracture or type A fracture presented apparent shortening of the ramus height, and none of them showed osteogenesis (or new bone formation) during their follow-up. Present study only observed osteogenesis in few patients who sustained type B/C intracapsular condylar fractures during their follow-up. The younger the patient was, the longer the follow-up time was, and the higher the possibility of new bone formation was. No correlation was found between the amount of osteogenesis and follow-up time, the amount of osteogenesis was generally small, and no patient could form a new condyle head similar to the normal (or original) condyle head. Condylar hypertrophy only occurred in children. Four patients developed temporomandibular joint ankylosis.

Conclusions:
Removal of fracture fragments is an alternative treatment option for patients who sustained comminuted or small pieces of fracture or in extremely difficult operations.
Anisakiasis in Palatine Tonsil
Authors: Cha Eun Joo , Kim Jung Soo , Heo Sung Jae 
Published: February 2022

Abstract:
Anisakiasis is a parasitic infection caused by ingesting raw or undercooked fish and seafood infected with Anisakis larvae. Anisakis genus is mostly found in the mucosal or submucosal layer of the stomach and intestine. However, the reports of anisakiasis in tonsils are highly uncommon. A 54-year-old woman with clinical features of sore throat and foreign-body sensation for 10 days after eating raw and undercooked fish. A wriggling worm was noted beneath the mucosa of the right palatine tonsil upon endoscopic examination. The worm was immediately removed completely and histological examination revealed anisakiasis. Reports of anisakia-sis in the tonsils are scarce, but it should be considered at the initial physical examination of patients who visit the hospital for sore throat after eating raw fish. We report a case of anisakiasis in the palatine tonsils, which to date has been rarely reported in the literature.
Association between Surgery, Anesthesia, and Obstetric Workforce and Emergent Surgical and Obstetric Mortality among United States Hospital Referral Regions
Authors: Truche Paul , Semco Robert S. , Hansen Nathaniel F. , Uribe-Leitz Tarsicio , Roa Lina , Allar Benjamin G. , Layman Ilan B. , Bergmark Regan W. , Williams Wendy , Riviello Robert , McClain Craig D. , Jarman Molly P. , Cooper Zara , Meara John G. , Ortega Gezzer 
Published: February 2022

Objective:To determine the association between SAO workforce and mortality from emergent surgical and obstetric conditions within US HR Rs.Background:SAO workforce per capita has been identified as a core metric of surgical capacity by the Lancet Commission on Global Surgery, but its utility has not been assessed at the subnational level for a high-income country.Methods:The number of practicing surgeons, anesthesiologists, and obstetricians per capita was estimated for all HRRs using the US Health Resources & Services Administration Area Health Resource File Database. Deaths due to emergent general surgical and obstetric conditions were determined from the Center for Disease Control and Prevention WONDER database. We utilized B-spline quantile regression to model the relationship between SAO workforce and emergent surgical mortality at different quantiles of mortality and calculated the expected change in mortality associated with increases in SAO workforce.Results:The median SAO workforce across all HRRs was 74.2 per 100,000 population (interquartile range 33.3-241.0). All HRRs met the Lancet Commission on Global Surgery lower target of 20 SAO per 100,000, and 97.7% met the upper target of 40 per 100,000. Nearly 2.8 million Americans lived in HRRs with fewer than 40 SAO per 100,000. Increases in SAO workforce were associated with decreases in surgical mortality in HRRs with high mortality, with minimal additional decreases in mortality above 60 to 80 SAO per 100,000.Conclusions:Increasing SAO workforce capacity may reduce emergent surgical and obstetric mortality in regions with high surgical mortality but diminishing returns may be seen above 60 to 80 SAO per 100,000. Trial Registration: N/A