bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolonged Insertion Time Reduces Translocation Rate of a Precurved Electrode Array in Cochlear Implantation
Authors: van der Jagt Annerie M. A. , Briaire Jeroen J. , Boehringer Stefan , Verbist Berit M. , Frijns Johan H. M. 
Published: February 2022

Hypothesis:
Insertion speed during cochlear implantation determines the risk of cochlear trauma. By slowing down insertion speed tactile feedback is improved. This is highly conducive to control the course of the electrode array along the cochlear contour and prevent translocation from the scala tympani to the scala vestibuli.

Background:
Limiting insertion trauma is a dedicated goal in cochlear implantation to maintain the most favorable situation for electrical stimulation of the remaining stimulable neural components of the cochlea. Surgical technique is one of the potential influencers on translocation behavior of the electrode array.

Methods:
The intrascalar position of 226 patients, all implanted with a precurved electrode array, aiming a mid-scalar position, was evaluated. One group (n = 113) represented implantation with an insertion time less than 25 seconds (fast insertion) and the other group (n = 113) was implanted in 25 or more seconds (slow insertion). A logistic regression analysis studied the effect of insertion speed on insertion trauma, controlled for surgical approach, cochlear size, and angular insertion depth. Furthermore, the effect of translocation on speech performance was evaluated using a linear mixed model.

Results:
The translocation rate within the fast and slow insertion groups were respectively 27 and 10%. A logistic regression analysis showed that the odds of dislocation increases by 2.527 times with a fast insertion, controlled for surgical approach, cochlear size, and angular insertion depth (95% CI = 1.135, 5.625). We failed to find a difference in speech recognition between patients with and without translocated electrode arrays.

Conclusion:
Slowing down insertion speed till 25 seconds or longer reduces the incidence of translocation.
Cochlear Implantation in Neurofibromatosis Type 2: Experience From the UK Neurofibromatosis Type 2 Service
Authors: Smith Matthew E. , Edmiston Rachel , Trudel Mathieu , Freeman Simon , Stapleton Emma , Axon Patrick , Donnelly Neil , Tysome James R. , Bance Manohar , Obholzer Rupert , Jiang Dan , Mackeith Samuel , Ramsden James , O’Driscoll Martin , Mawman Deborah , Buttimore Juliette , Nunn Terry , Humphries Jane , Evans Dafydd Gareth , Lloyd Simon K.W. 
Published: February 2022

Objective:
To review the outcomes of cochlear implants (CI) in patients with neurofibromatosis type 2 (NF2) in a large cohort, and identify factors associated with poor hearing benefit.

Study Design:
Fifteen-year retrospective national observational case series.

Setting:
United Kingdom regional NF2 multidisciplinary teams.

Patients:
Consecutive patients with NF2 receiving a CI.

Interventions:
CI for hearing rehabilitation.

Main outcome measures:
1) Audiometric performance at 9 to 12 months after implantation using City University of New York (CUNY) sentence recognition score, and Bamford- Kowal-Bench (BKB) word recognition score in quiet (BKBq), and in noise (BKBn). 2) CI use at most recent review.

Results:
Sixty four consecutive patients, median age 43 years, were included. Nine to 12 months mean audiometric scores were: CUNY 60.9%, BKBq 45.8%, BKBn 41.6%. There was no difference in audiometric outcomes between VS treatment modalities. At most recent review (median 3.6 years from implantation), 84.9% with device in situ/available data were full or part-time users. Between 9 and 12 months and most recent review there was an interval reduction in mean audiometric scores: CUNY −12.9%, BKBq −3.3%, BKBn −4.9%. Larger tumor size and shorter duration of profound hearing loss were the only variables associated with poorer audiometric scores. Tumor growth at the time of surgery was the only variable associated with CI non-use. Individual patient response was highly variable.

Conclusions:
CI can provide significant and sustained auditory benefits to patients with NF2 independent of tumor treatment modality, with the majority of those implanted becoming at least part-time users. Larger datasets are required to reliably assess the role of independent variables.
Etiology, pathological characteristics, and clinical management of black pleural effusion
Authors: Yousaf Zohaib , Ata Fateen , Chaudhary Haseeb , Krause Florian , Illigens Ben Min-Woo , Siepmann Timo 
Published: February 2022

Abstract

Background:
Pleural effusion is characterized by excessive fluid collection in the pleural cavity. Black pleural effusion (BPE) is a rare entity with only limited scientific data. We aimed to review the current literature on black pleural effusion to characterize demographics, etiology, clinical presentation, pathological findings, available treatment strategies, and prognosis of this rare condition.

Methods:
We performed a systematic review of case reports and series and synthesized data on demographics, manifestations, management, and outcomes of patients with BPE. We searched Cochrane Library, PubMed, SCOPUS, and Google Scholar for any date until January 10, 2021. All studies (n = 31) that reported black pleural effusion in patients were added to the review. Prospective Register of Systematic Reviews registration number: CRD42020213839. Summary and descriptive analysis was performed on Jamovi version 1.2.

Results:
The mean age of 32 patients with BPE was 53 years, with male predominance (69%). The commonest risk factor was smoking (n = 9) followed by alcohol intake (n = 8). Dyspnea was the commonest symptom (n = 24, 75%). Pleural fluid was mostly exudative (n = 21). The commonest associated diagnosis was malignancy (n = 14), with 50% secondary to metastatic melanoma. The commonest intervention was therapeutic thoracocentesis (n = 25, 78%), and the effusion recurred in half of the cases where recurrence was reported (n = 13). In our review, we found the mortality rate to be at 20.8% (n = 20.8%). 58.3% of the patients were successfully treated and discharged home (n = 14).

Conclusion:
Although rare, BPE appears to be a relevant symptom as it seems to be frequently associated with modifiable risk factors and underlying malignancy. Our systematic review substantiates a vital research gap as observational research is imperative to characterize BPE further and form a basis for designing tailored diagnostic, preventive, and therapeutic strategies for BPE.
Impact of endoscopic ultrasonography on the accuracy of T staging in esophageal cancer and factors associated with its accuracy
Authors: Wang Mingbo , Zhu Yonggang , Li Zhenhua , Su Peng , Gao Wenda , Huang Chao , Tian Ziqiang 
Published: February 2022

Abstract
The sensitivity and specificity of endoscopic ultrasound (EUS) for esophageal cancer are variable. The aim of the present study was to determine the accuracy of EUS for the T staging of esophageal cancer and to explore the factors that affect the accuracy.
This was a retrospective study of patients with esophageal cancer who underwent EUS between January 2018 and September 2019 at the author's hospital. All patients underwent EUS, surgery, and pathological examination. The diagnostic value of ultrasound-based T (uT) staging was evaluated using the pathological T (pT) staging as the gold standard.
Finally, 169 patients were included. Among the 169 patients, 37 were overstaged by EUS, 33 were understaged, and 99 were correctly staged. The overall accuracy of EUS was 58.6%. Sensitivity was low, at 0% to 70.8% depending upon the pT stage, but specificity was higher, at 71.0% to 100.0%, also depending upon the pT stage. The multivariable analysis revealed that highly differentiated tumors (odds ratio = 9.167, P = .041) and pT stage ≥T2 (odds ratio = 2.932, P = .004) were independent factors of accurate uT stage.
The staging of esophageal cancer using EUS has low sensitivity but high specificity. Highly differentiated tumors and pT stage ≥2 tumors were associated with the accuracy of uT staging.
Real-world comparison of mono and dual combination therapies of metformin, sulfonylurea, and dipeptidyl peptidase-4 inhibitors using a common data model
Authors: Lee Kyung Ae , Jin Heung Yong , Kim Yu Ji , Kim Sang Soo , Cho Eun-Hee , Park Tae Sun 
Published: February 2022

Abstract
The comparative effectiveness of oral hypoglycemic agents on glycemic control and chronic complications in clinical practice is unknown in Korea. This study aimed to compare glycemic control and the incidence of hypoglycemia and chronic complications among adult patients with type 2 diabetes prescribed metformin, dipeptidyl peptidase-4 inhibitors (DPP4I), and sulfonylurea (SU) as monotherapy or dual combination therapy.
We retrospectively analyzed propensity-matched cohort data from 3 national university hospitals in Korea. All electronic health records were transformed into a unified Observational Medical Outcomes Partnership Common Data Model and analyzed using ATLAS, an open-source analytical tool, and R software. Glycemic control was assessed as the first observation of a reduction in glycosylated hemoglobin (HbA1c) level below 7% after prescription of the drug. Differences in the incidence of chronic complications were compared based on the first observation of each complication. Glycemic control and chronic complications were evaluated in patients who maintained the same prescription for at least 3 and 12 months, respectively.
Patients who received metformin had lower hazard of reaching HbA1c levels below 7% as compared with those who received SU, and had higher hazard compared with those who received DPP4I (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.75–0.98; and HR, 1.68; 95% CI, 1.42–1.99, respectively). The incidence of hypoglycemia was significantly higher in the SU group than in the metformin and DPP4I groups (metformin vs SU; HR, 0.30; 95% CI, 0.21–0.43; SU vs DPP4I; HR, 4.42; 95% CI, 2.35–8.31). Metformin + DPP4I had similar hazard of reaching HbA1c levels below 7% compared with metformin + SU (HR, 1.19; 95% CI, 0.99–1.43) and the incidence of hypoglycemia was significantly lower in the metformin + DPP4I group (HR 0.13; 95% CI 0.05–0.30). There was no significant difference in the analysis of the occurrence of chronic complications.
SU followed by metformin was effective, and both drugs showed an increased hazard of reaching HbA1c levels below 7% compared with DPP4I. Metformin + DPP4I is comparatively effective for HbA1c level reduction below 7% compared with metformin + SU. Hypoglycemia was high in the SU-containing therapy.
Mechanical model of steady-state and inflammatory conditions in patients with relapsing polychondritis
Authors: Shimizu Jun , Suzuki Noboru 
Published: February 2022

Abstract
Relapsing polychondritis (RP) is a multisystem inflammatory disorder, considered to associate with immune aberration.
Increased T helper type-1 cell-related cytokines were reported in RP patients. mRNA expressions of a regulatory T cell cytokine interleukin (IL)-10 increased, whereas pro-inflammatory cytokines IL1β and IL6 mRNA expressions decreased in freshly isolated peripheral blood mononuclear cells of RP patients compared with those in healthy individuals. Upon in vitro stimulation with mitogen, IL10 mRNA expressions decreased, and IL1β and IL6 mRNA expressions increased in RP patients.
This short-time dynamic change of gene expressions from anti-inflammatory to pro-inflammatory features of immune cells may be associated with the “relapsing” disease course of patients with RP. IL1β mRNA expressions of peripheral blood mononuclear cells exhibited positive correlations with serum matrix metalloproteinase (MMP)-3 concentrations in patients with respiratory involvement. Such positive correlation was not found in those without respiratory involvement.
In a metagenomic analysis, an altered composition of gut microbes was found, suggesting that microbe metabolites such as short-chain fatty acids may affect T cell responses of the patients.
In this review, the relationships among RP-related inflammatory molecules were summarized. The data support a hypothesis that the immune conditions are different between steady-state and inflammation in RP patients.
Asymptomatic gastric tuberculosis in the gastric body mimicking an isolated microscopic erosion
Authors: Zhang Wenguang , Song Fusheng , Zhang Zhimei , Yang Jun , Zhao Linlin 
Published: February 2022

Abstract

Introduction:
Gastric tuberculosis is rarely seen in clinical practice, which occurs mostly secondary to lung tuberculosis, intestinal tuberculosis, and other common tuberculosis. Gastric tuberculosis rarely presents as a single microscopic superficial erosion. We recently diagnosed such a case, hence reporting it herein.

Patient concerns:
A 40-year-old female patient was admitted with a chief complaint of painful enlarged cervical lymph nodes. She had no other symptoms or any previous history of remarkable diseases.

Diagnosis:
Physical examination found multiple enlarged cervical lymph nodes. Computer tomography revealed multiple circular well-defined soft tissue masses in the bilateral carotid sheath spaces. A cervical lymph node biopsy showed caseous necrosis with infiltration of neutrophils and lymphocytes, and most importantly, mycobacteria through staining for acid fast bacilli. Routine gastroscopy showed a 0.5 cm × 0.5 cm well-defined erosion on the large curvature of the gastric body. Gastric biopsy revealed chronic granulomatous inflammation with mycobacteria through staining for acid fast bacilli. The patient was diagnosed as having cervical lymph node tuberculosis and gastric tuberculosis.

Interventions and outcomes:
She received 6 months of standard anti-tuberculosis therapy. The enlarged cervical lymph nodes shrank in size and the pain was relieved.

Conclusions:
Gastroscopy should be performed to look for gastric tuberculosis if the patient presents primary tuberculosis in other organs/tissues such as cervical lymph nodes. If any small erosion is found, a biopsy is justified for checking the possibility of gastric tuberculosis.
Comparison of cyclophosphamide and calcineurin inhibitors for idiopathic membranous nephropathy
Authors: Li Kang , Yu Yanqiu , Gao Yuan , Gao Junjie 
Published: February 2022

Abstract

Background:
Idiopathic membranous nephropathy (IMN) is one of the leading causes of nephrotic syndrome in adults. We performed a protocol for systematic review and meta-analysis to compare the efficacy and safety of cyclophosphamide (CTX) with calcineurin inhibitors (CNIs) in the treatment of IMN.

Methods:
PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and 3 Chinese databases (WanFang Data, Chongqing VIP and China National Knowledge Infrastructure) were searched from inception through January 2022 to identify randomized controlled trials that compared CTX with CNIs for patients with IMN. Systematic review and meta-analysis of the data will be performed in RevMan software (version 5.3) according to the preferred reporting items of systematic reviews and meta-analysis guidelines. Two authors independently performed the literature searching, data extraction, and quality evaluation. Risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized controlled trials.

Results:
The results will be submitted to a peer-reviewed journal once completed.

Conclusion:
The conclusion of our research will provide evidence to help physicians to decide between CTX and CNIs therapy regimens for IMN patients.

Open Science Framework registration number:
10.17605/OSF.IO/G584K
Colonic Function Investigations in Children
Authors: Rybak Anna , Martinelli Massimo , Thapar Nikhil , Van Wijk Michiel P. , Vandenplas Yvan , Salvatore Silvia , Staiano Annamaria , Benninga Mark A. , Borrelli Osvaldo 
Published: February 2022

ABSTRACTDisorders of colonic motility, most often presenting as constipation, comprise one of the commonest causes of outpatient visits in pediatric gastroenterology. This review, discussed and created by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Motility Working Group, is a practical guide, which highlights the recent advances in pediatric colonic motility testing including indications, technical principles of the tests, patient preparation, performance and basis of the results’ analysis of the tests. classical methods, such as colonic transit time (cTT) with radiopaque markers and colonic scintigraphy, as well as manometry and novel techniques, such as wireless motility capsule and electromagnetic capsule tracking systems are discussed.
Endoluminal Functional Lumen Imaging Probe Is Safe in Children Under Five Years Old
Authors: Hoskins Brett , Almazan Erik , Mogul Douglas , Ng Kenneth 
Published: February 2022

ABSTRACTBackground:Endoluminal functional lumen imaging probe (EndoFLIP) is a minimally invasive, novel device that uses high‐resolution impedance planimetry to measure important parameters of the gastrointestinal lumen that aid in the diagnosis of esophageal disorders. EndoFLiP is approved by the US Food and Drug Administration (FDA) for children 5 years and older. We sought to compare its safety and luminal characteristics between children under 5 years of age with children 5 years and older.Methods:A single‐center retrospective review was performed to identify all patients < 21 years of age who underwent esophagogastroduodenoscopy (EGD) with EndoFLIP between October 2017 and November 2020. Results: Sixty‐seven EGDs with EndoFLIP were performed in 56 patients, including 14 that were done in children < 5 years and 53 in children ≥5years. The median age in the < 5‐year group was 1.7years (interquartile range [IQR], 0.9–4.4) and the youngest patient was 1 month old. The median age in ≥5‐year group was 14.3 years (IQR, 8.2–16.2). Median procedure times were similar (32 minutes [IQR, 25–48] for the < 5‐year group; 28 minutes [IQR, 20–33] for ≥5‐year group; P = 0.08). There were no adverse events or unplanned hospitalizations in either group. At 30 mL inflation, the pressure of the lower esophageal sphincter (LES) was statistically different between the 2 groups (P = 0.02).Conclusion:EndoFLIP appears to be safe for use in our small cohort of children < 5 years of age and may be an important tool in the management of esophageal disorders in this age group. There was no difference in procedure time between our 2 age groups and there were no procedure‐related complications.
Evaluation of the Melbourne Rapid Fields Test Procedure
Authors: Harris Paul Alan , Johnson Chris A. , Chen Yuan , Fann Hannah , Gafford Gabrielle , Kim Ye Ji , Mezgebu Ellilta D. 
Published: February 2022

SIGNIFICANCE
Both the Melbourne Rapid Fields (MRF) tablet and home versions are easy-to-use, portable, and low-cost and accurate methods of evaluating visual fields.

PURPOSE
This study aimed to investigate the clinical capabilities of the MRF perimetry test by comparing it with the Humphrey Field Analyzer (HFA), determine MRF consistency, assess the influence of refractive error, ascertain ambient illumination effects, and evaluate the consistency between the tablet and Internet Web site versions of the MRF.

METHODS
Forty healthy young participants with normal visual function (33 female, 7 male; average age, 24 years) underwent two MRF office-based tablet, two HFA tests, and two MRF Web site–based tests, one in our laboratory and one at home on their own computer using the 24-2 test pattern each time. An additional six healthy participants with normal visual function performed the 24-2 test with varying amounts of blur.

RESULTS
The average individual sensitivity values of MRF and HFA were within 4.02 dB (right eye) and 4.15 dB (left eye). The dynamic range of the MRF was smaller (30 dB) than that of the HFA. When sensitivity values greater than 30 dB were excluded, the sensitivity differences were within 2.2 dB (right eye) and 2.46 dB (left eye) of each other. Only a small number of cases produced reliability values (false positives, false negatives, fixation losses) that were outside of normal limits. There was a high correlation between test results obtained with the tablet version of the MRF test when compared with the Internet-based Web site version.

CONCLUSIONS
Quantitative visual field testing and perimetric screening procedures can be performed effectively and can provide results that are comparable with bowl perimeter test results.
Asymmetric Peripheral Refraction Profile in Myopes along the Horizontal Meridian
Authors: Yelagondula Vijay Kumar , Achanta Divya Sree Ramya , Panigrahi Swathi , Panthadi Sahithi Kusuma , Verkicharla Pavan Kumar 
Published: February 2022

SIGNIFICANCE
The investigation of peripheral refraction profiles in Indian myopes showed relative peripheral hyperopic refraction in temporal retina and possible dominant role of hyperopic defocus signals from temporal retina in the development of myopia.

PURPOSE
Considering that the peripheral refraction profiles were extensively reported to be associated with the central refractive error and vary among different ethnicities, we investigated the peripheral refraction profiles in Indians.

METHODS
A total of 161 participants aged between 18 and 33 years were included in the study. All of the eligible participants underwent a comprehensive eye examination. Central and peripheral refractions were determined using an open-field autorefractor in 10° intervals up to ±30° in the horizontal meridian, and in 5° intervals up to ±15° in the vertical meridian. Axial length and central corneal radius were measured using a non-contact optical biometer. Peripheral refraction was compared between the different refractive error groups and myopic subgroups.

RESULTS
Myopes showed a significant asymmetrical peripheral refraction profile along horizontal meridian with relative peripheral myopia at nasal 30° and relative peripheral hyperopia at temporal 30° (mean ± standard error at N30°: −0.37 ± 0.13 D vs. T30°: +0.56 ± 0.11 D, P < .05). Emmetropes and hyperopes showed relative peripheral myopia both in nasal and temporal eccentricities. Relative peripheral refraction was significantly different between the refractive groups and myopic subgroups along the temporal retinal eccentricities only (P < .05). Along the vertical meridian, relative peripheral myopia was seen among the three refractive error groups (P < .05). J
0 and J
45 significantly changed with retinal eccentricity along both the meridians in all the refractive error groups (P < .05).

CONCLUSIONS
Myopes showed an asymmetric type of peripheral refraction with relative hyperopic defocus in temporal retina and myopic defocus in the nasal retina. Possible role of retinal hyperopic defocus along temporal retina in myopiogenesis needs to be explored.