bluuebunny/crossref_metadata_2025 huggingface dataset:
WIDEFIELD SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS IN WAGNER SYNDROME
Authors: Bleicher Isaac D. , Garg Itika , Hoyek Sandra , Place Emily , Miller John B. , Patel Nimesh A.
Published: August 2022

Purpose:

To describe novel clinical and angiographic findings in Wagner syndrome.

Methods:

A retrospective case series of three related patients with Wagner syndrome. Patients underwent standard optical coherence tomography (OCT), B-scan ultrasonography, and fluorescein angiography in addition to wide field swept-source OCT angiography (WF SS-OCTA) (PLEX Elite 9000, Carl Zeiss Meditec Inc). Patients underwent genetic testing for a panel of hereditary vitreoretinopathies.

Results:

Three related patients with Wagner syndrome were identified. All were found to have prominent vitreous strands, abnormal vitreoretinal adhesions, peripheral retinal holes, and varying degrees of myopia. A mid-peripheral tractional ridge was identified in all six eyes. All patients were positive for a known pathologic intron variant in the VCAN gene (4004-5T-A). Wide field swept-source OCT angiography (12 mm × 12 mm) was performed in two patients and demonstrated perivascular capillary loss in the superficial capillary plexus along the arcades bilaterally. One patient demonstrated associated retinal atrophy within the area of capillary loss. The capillary loss extended beyond the margin of retinal atrophy.

Conclusion:

The unusual finding of a mid-peripheral tractional ridge of the retina associated with myopia led to a genetic diagnosis of Wagner syndrome. Widefield swept-source OCT angiography demonstrated a novel feature of perivascular loss of the superficial retinal capillary plexus. This result suggests that vitreous traction may cause localized microvasculature dysfunction and subsequent retinal atrophy in Wagner syndrome. This is the first known evaluation of Wagner syndrome using OCT angiography.
RIDGE-SHAPED PERIPAPILLA
Authors: Wakabayashi Taku , Yonekawa Yoshihiro , Ohno-Matsui Kyoko , Cohen Salomon Y. , Rowland Christina , Pulido Jose S.
Published: August 2022

Purpose:

To report a case of peripapillary subretinal fluid associated with a ridge-shaped morphology surrounding the optic disk, which we termed ridge-shaped peripapilla.

Methods:

Case report.

Results:

A 6-year-old girl with mild-to-moderate myopia was referred for an abnormal fundus appearance of the left eye. Fundus examination of the left eye showed a vertical whitish elevation just temporal to the disk with pigment clumping. Spectral domain optical coherence tomography of the left eye showed an elevation of the fundus at the temporal edge of the disk with thinning of the choroid overlying the thickened scleral protrusion and a serous subretinal fluid. Fluorescein angiography of the left eye showed a hyperfluorescent area without leakage at the temporal edge of the disk, indicative of retinal pigment epithelium atrophy. There was no sign of choroidal neovascularization. Based on the fluorescein angiography and optical coherence tomography findings, the protrusion of the sclera seemed to result in overlying choroidal thinning with choroidal blood flow disturbances, and consequent retinal pigment epithelium atrophy, leading to the subretinal fluid.

Conclusion:

This case highlights an unusual presentation of ridge-shaped peripapilla, characterized by inward convexity of the peripapillary area with a ridge-shaped morphology and localized thickening of the peripapillary sclera, in eyes with myopia.
NEODYMIUM-DOPED YTTRIUM ALUMINUM GARNET LASER ABLATION OF INTERNAL LIMITING MEMBRANE TO TREAT MYOPIC MACULAR RETINOSCHISIS: CASE SERIES
Authors: Takahashi Hiroyuki , Uramoto Kengo , Ohno-Matsui Kyoko
Published: August 2022

Purpose:

To evaluate the efficacy and safety of neodymium-doped yttrium aluminum garnet laser ablation of the internal limiting membrane (ILM) to treat myopic macular retinoschisis.

Methods:

Four patients with myopic myopic macular retinoschisis that extended out of the macular area were studied. All patients underwent yttrium aluminum garnet laser ablation of the detached ILM in the paramacular area, and the eyes were examined by ultra-widefield optical coherence tomography at the baseline and 6 months after the treatment. The measured outcomes were the foveal retinal thickness and the best-corrected visual acuity.

Results:

Neodymium-doped yttrium aluminum garnet laser was applied to the paramacular ILM in all four eyes. In each eye, the procedure failed to disrupt the ILM, and no significant changes were observed in foveal retinal thickness or best-corrected visual acuity subsequently. No serious adverse event occurred in all eyes. A transient intraretinal hemorrhage developed at the site of the application in two eyes but resolved within a week after the treatment.

Conclusion:

Neodymium-doped yttrium aluminum garnet laser was applied to ILM in the peripheral macula in eyes with myopic macular retinoschisis. However, the lack of a reduction of the foveal thickness and improvement of the best-corrected visual acuity indicate that accurate focusing system is needed to treat eyes with myopic macular retinoschisis.
RETINAL MANIFESTATIONS OF WALKER–WARBURG SYNDROME IN TWO SIBLINGS WITH RXYLT1 MUTATIONS
Authors: Jung Eric E. , Nagiel Aaron
Published: August 2022

Purpose:

We report two siblings with genetically confirmed Walker–Warburg syndrome (WWS), studied with multimodal imaging, who presented with different retinal manifestations.

Methods:

This is a retrospective report of two WWS cases with ultra-widefield fundus photography, fluorescein angiography, and ultrasound. Molecular diagnosis was achieved using panel testing and targeted variant testing.

Results:

Two siblings, one male and one female, born 17 months apart with a diagnosis of WWS underwent retinal examination with imaging. The 3-month-old female infant exhibited microphthalmia, persistent hyaloidal arteries, and retrolental membranes with total tractional retinal detachments on ultrasound in both eyes. The 22-day-old male newborn exhibited persistent hyaloidal arteries and extensive peripheral avascular retina on angiography in both eyes. Both were found to be positive for the same two pathogenic variants in the RXYLT1/TMEM5 gene, which accounts for approximately 9% of cases of genetically confirmed WWS.

Conclusion:

Siblings with genetically confirmed WWS can have variable presentations despite identical genotype. This highlights the phenotypic disease spectrum of WWS, which may be similar to that seen in familial exudative vitreoretinopathy.
PRIMARY OCCLUSIVE PANVASCULITIS WITH SEGMENTAL PERIARTERIAL PLAQUES
Authors: Ngo Wei Kiong , Spaide Richard F.
Published: August 2022

Purpose:

The purpose of this study was to describe a new clinical entity of bilateral occlusive panvasculitis with segmental periarterial plaques and its clinical course in two patients.

Methods:

This was a retrospective chart review.

Results:

Two patients with no medical history of any systemic inflammatory diseases presented with bilateral segmental periarterial plaques (Kyrieleis plaques), cotton wool spots, and microaneurysms. Segmental leakage, staining, and vascular occlusions involved the arterioles, venules, and capillaries. Leakage from the superficial capillary plexus in some areas bordering deep capillary plexus nonperfusion was observed. Both had recurrent episodes of vascular occlusions, normal brain MRI, and audiology tests. Complete workup including serology for infections, inflammatory markers, and antibody titers was unremarkable. They were started on with corticosteroids and immunosuppressant, and there were no further vascular occlusions. Both developed neovascularization adjacent to the areas of capillary nonperfusion. The second patient also developed vitreomacular traction and cystoid macular edema. He required intravitreal anti-VEGF injection, sector laser photocoagulation, and underwent a vitrectomy with membrane peeling. At the last visit, the visual acuity was 20/30 in both eyes for the first patient and 20/20 in the right eye and 20/40 in the left eye for the second patient, 12 and 6.5 years after initial presentation, respectively.

Conclusion:

Both patients presented with findings of bilateral panvasculitis with prominent segmental periarterial plaques and had repeated episodes of vascular occlusions before corticosteroid and immunosuppressants treatment, after which no additional occlusions were observed. We propose that the constellation of findings constitutes a novel clinical entity, occlusive panvasculitis with segmental periarterial plaques.
HYPERACUTE PSEUDOPHAKIC MACULAR EDEMA VANISHING WITHIN 72 HOURS: A CASE SERIES
Authors: Mori Tommaso , Cutrupi Francesco , Surico Pier Luigi , Sgrulletta Roberto , Di Zazzo Antonio , Coassin Marco
Published: August 2022

Purpose:

To report three cases of massive pseudophakic macular edema occurring the day after uneventful cataract surgery and resolving in 24 to 72 hours.

Methods:

Observational case series.

Results:

A 68-year-old woman affected by systemic lupus erythematosus and antiphospholipid syndrome displayed massive macular edema on optical coherence tomography scan one day after uneventful cataract surgery. Routine postoperative topical eye drops (chloramphenicol/betamethasone 4 times a day and bromfenac 2 times a day) were continued without additional medications. Three days later, optical coherence tomography showed a completely recovered, normal fovea. Two similar cases were documented. A 73-year-old man and a 53-year-old man underwent cataract surgery and started the mentioned topical postoperative therapy. Severe macular edema was diagnosed the day after surgery and resolved in 24 and 48 hours, respectively.

Conclusion:

Massive macular edema may occur immediately after uncomplicated cataract and then disappear within 1 to 3 days, without invasive therapies. This is a very significant event that may follow cataract surgery, and that was previously unreported.
LISDEXAMFETAMINE (VYVANSE) USE ASSOCIATED WITH BRANCH RETINAL ARTERY OCCLUSION
Authors: Blair Kyle , Czyz Craig , Smithers Joshua , Yassall Anthony
Published: August 2022

Background/Purpose:

Branch retinal artery occlusions (BRAO) are primarily associated with the aging population and are rare in young adults. The etiology of BRAO includes embolic or nonembolic sources. Lisdexamfetamine has been associated with vasospastic ischemic events in multiple areas of the body. However, there are currently no reported cases of BRAO associated with lisdexamfetamine use. Here, we present a case that suggests a correlation between lisdexamfetamine use and a nonembolic BRAO in a young adult man.

Methods/Results:

A 32-year-old man presented with sudden left eye blurred vision 17 days after beginning lisdexamfetamine. Fundus examination confirmed the BRAO diagnosis. Following evaluation by a retina specialist, vasospasm was considered the most likely cause for the BRAO. Other possible etiologies were unlikely due to diagnostic testing.

Conclusion:

The temporal association between lisdexamfetamine and BRAO symptom onset suggests vasospastic occlusion. Lisdexamfetamine-associated adverse events should be considered as a possible etiology for BRAO.
RETINAL VASCULAR DISEASE IN LIMB-GIRDLE MUSCULAR DYSTROPHY
Authors: Shaheen Abdulla R. , Yannuzzi Nicolas A. , Kennedy Thomas , Yannuzzi Lawrence A.
Published: August 2022

Purpose:

To report bilateral retinal vascular occlusive disease in limb-girdle muscular dystrophy (LGMD).

Methods:

Case report.

Results:

A 34-year-old Asian woman was referred for evaluation and management of central retinal vein occlusion. Ultra-wide-field fluorescein angiography showed resolving initial peripheral retinal vein occlusion in one eye and peripheral venular segmental staining in the fellow asymmetric eye. Genetic testing established the diagnosis of LGMD.

Conclusion:

Similar to other forms of muscular dystrophy, LGMD is caused by genetic abnormalities in sarcolemma proteins, a key structural component that connects the intracellular cytoskeleton of a myofiber to the extracellular matrix. Like other muscular dystrophies, LGMD may be associated with retinal vascular abnormalities noted. In this case, retinal vascular smooth muscle dysfunction was seen in LGMD, analogous to reported vascular abnormalities in other muscular dystrophies such as facioscapulohumeral dystrophy and Duchenne muscular dystrophy.
INTRARETINAL HUMAN AMNIOTIC MEMBRANE AFTER MACULAR HOLE REPAIR
Authors: Baradad-Jurjo María Carmen , Vela Segarra José Ignacio , Díaz-Cascajosa Jesús , Vilimelis Jaume Crespí , Bassaganyas Francisca
Published: August 2022

Purpose:

To describe a unique complication of macular hole repair surgery using a subretinal human amniotic membrane plug.

Methods:

Retrospective, interventional case report.

Results:

A 71-year-old man presented with a chronic full-thickness macular hole in his left eye. Conventional 23-gauge pars plana vitrectomy with internal limiting membrane peeling and implantation of a subretinal human amniotic membrane plug was performed. In the postoperative period, centripetal growth of external retinal layers was observed under the plug. Six months after the surgery, the human amniotic membrane plug was completely integrated into the retina.

Conclusion:

This is the first reported case of intraretinal integration of a human amniotic membrane plug after macular hole repair surgery.
MULTIPLE EVANESCENT WHITE DOT SYNDROME FROM A PATIENT'S PERSPECTIVE
Authors: Bograd Alexandra , Munk Marion R.
Published: August 2022

Purpose:

Multiple evanescent white dot syndrome is a self-limiting inflammatory condition of the outer retina. Only little information is available how patients experience their symptoms.

Method:

We report a case of a 28-year-old male graphic designer with multiple evanescent white dot syndrome, who precisely illustrated the development and course of the characteristic symptoms while looking at the ceiling, at a face and on his phone.

Result:

At onset, the scotoma was sparking/shiny and appeared on the temporal field of view, consistent with an enlarged blind spot. Over the course of the disease, the scotoma decreased in intensity and moved superiorly and nasally until it completely faded.

Conclusion:

Illustrations from a patient's perspective over the course of the disease can be beneficial for physicians and other multiple evanescent white dot syndrome patients for a better understanding and monitoring of their disease.
Management of an atypical case of post-operative endophthalmitis presenting as angle-closure glaucoma
Authors: Liao Albert , Xu Lucy T. , Yeh Steven , Yan Jiong
Published: August 2022

Background/Purpose:

To report an atypical presentation of postoperative endophthalmitis after cataract surgery that initially presented as angle-closure glaucoma and to discuss challenges with the case management due to the unusual presentation and patient non-compliance.

Methods:

Observational case report. B-scan ultrasound and ultrasound biomicroscopy.

Results:

A 69-year-old Caucasian male with a 1-week history of uncomplicated cataract surgery was referred to our glaucoma clinic due to vision loss and concern for angle closure glaucoma. Anterior segment exam showed 360 degrees of flat anterior chamber (AC) with no hypopyon. A diagnosis of postoperative endophthalmitis was established when a B-scan ultrasound showed dense vitreous opacities. The patient underwent a pars plana vitrectomy (PPV), AC reformation, peripheral iridectomy, and intravitreal injection of antibiotics for treatment of endophthalmitis in the presence of an angle-closure glaucoma with good visual recovery.

Conclusion:

A low threshold for suspicion of endophthalmitis is needed after any routine intraocular procedure. An atypical presentation may masquerade as another pathology that delays the true diagnosis and treatment. Timely intervention in postoperative endophthalmitis is crucial in preserving vision.
Whom Do Incentive Program Physicians Serve? New Measures for Assessing Program Reach
Authors: Quigley Leo
Published: August 2022

One approach to ameliorating health workforce maldistribution is incentivizing health professionals, including physicians, to locate in underserved areas. However, eligibility for programs typically relies on large geographic areas whereas it is subpopulations within underserved areas who are typically at risk. New measures introduced in this article capture data on the patients actually served by incentive program physicians. A pilot study of one state's J-1 Visa Waiver and loan repayment programs validated the new measures of medical need, low income, rural location, and population-to-provider ratios of provider location, providing a nuanced picture of the groups actually served by incentive program physicians.
Improving Quality and Safety for Patients After Hospital Discharge
Authors: Bourgoin Angel , Balaban Richard , Hochman Michael , Greenwald Jeffrey L. , Saluja Sonali , Palen Ted E. , Perfetto Deborah , Hogan Eileen M. , Maxwell James
Published: August 2022

To understand current and idealized primary care–based care transition workflow processes for hospitalized patients, we conducted 133 interviews with staff at 9 primary care sites; community agency staff (n = 18); recently discharged patients (n = 33); and primary care thought leaders (n = 9). Current postdischarge workflows in primary care vary widely across settings, are often implemented inconsistently, and rarely involve communications with the patient or inpatient team during hospitalization. Based on these findings, we propose 5 principles for primary care practices to facilitate active involvement in postdischarge care, beginning during the hospital admission and extending until after the initial postdischarge primary care visit.
To What Extent Are ACO and PCMH Models Advancing the Triple Aim Objective? Implications and Considerations for Primary Care Medical Practices
Authors: Cantiello John
Published: August 2022

Accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) have emerged to advance the health care system by achieving the Triple Aim of improving population health, reducing costs, and enhancing the patient experience. This review examines evidence regarding the relationship between these innovative care models and care outcomes, costs, and patient experiences. The 28 articles summarized in this review show that ACO and PCMH models play an important role in achieving the Triple Aim, when compared with conventional care models. However, there can be drawbacks associated with model implementation. The long-term success of these models still merits further investigation.
Pay-for-Performance in the Massachusetts Medicaid Delivery System Transformation Initiative
Authors: Sefton Laura , Tierney Laxmi
Published: August 2022

Pay-for-performance (P4P) is among the alternative payment models (APMs) that are designed to incentivize enhancements to healthcare efficiency and quality. Massachusetts' Office of Medicaid implemented a delivery system transformation initiative (DSTI) through an 1115(a) Demonstration Waiver to support and incentivize seven safety net hospitals to implement clinical care changes and transition to risk-based APMs. Comparative case study design was used to describe achievement of hospital-specific clinical and operational measures. Qualifying hospitals implemented 47 projects across three categories: (1) development of a fully integrated delivery system, (2) health outcomes and quality, and (3) ability to respond to statewide transformation to value-based purchasing and to accept alternatives to fee-for-service payments that promote system sustainability. Projects commonly focused on care transitions improvements, physical and behavioral healthcare integration, and chronic disease care management interventions. Collectively, the hospitals met all or most of 60 population-focused improvement measures and 10 common measures' targets, indicative of the progress. Some hospitals achieved substantial positive gains; however, missed targets suggest substantial organizational and workflow changes over a longer timeframe as well as consistent patient engagement may be necessary. Overall, the P4P structure of DSTI was effective in encouraging organizational change and supporting the transition of these hospitals towards APMs.
Applications of cardiac biomarkers in chronic kidney disease
Authors: Kula Alexander , Bansal Nisha
Published: August 2022

Purpose of review

Cardiovascular disease is the leading cause of death in individuals with chronic kidney disease (CKD). The mechanisms connecting CKD and cardiovascular disease are complex, and serum biomarkers can help improve our understanding. Nt-proBNP and troponin have documented success as biomarkers to diagnose and provide mechanistic insights in non-CKD populations. The purpose of this review is to summarize evidence suggesting efficacy and potential for clinical application of Nt-proBNP and troponin in individuals with CKD.

Recent findings

Our understanding of how Nt-proBNP and Troponin should be interpreted in those with CKD is evolving. Although both biomarkers are in part cleared by the kidney, elevated levels predominantly reflect cardiovascular disease. Both Nt-proBNP and troponin are associated with risk for future cardiovascular events in CKD. Determining CKD-specific cutoffs and using biomarkers to guide therapy remains under active investigation.

Of the many serum biomarkers under investigation, Nt-proBNP and troponin best meet the criteria for effective biomarkers in CKD. Assays are widely available and proven to be accurate in CKD populations. Nt-proBNP and troponin deserve special focus in ongoing research of cardiovascular risk reduction in CKD, especially to identify patients at the highest risk, suggest targetable mechanisms and assess treatment efficacy.
Machine learning for risk stratification in kidney disease
Authors: Gulamali Faris F. , Sawant Ashwin S. , Nadkarni Girish N.
Published: August 2022

Purpose of review

Risk stratification for chronic kidney is becoming increasingly important as a clinical tool for both treatment and prevention measures. The goal of this review is to identify how machine learning tools contribute and facilitate risk stratification in the clinical setting.

Recent findings

The two key machine learning paradigms to predictively stratify kidney disease risk are genomics-based and electronic health record based approaches. These methods can provide both quantitative information such as relative risk and qualitative information such as characterizing risk by subphenotype.

The four key methods to stratify chronic kidney disease risk are genomics, multiomics, supervised and unsupervised machine learning methods. Polygenic risk scores utilize whole genome sequencing data to generate an individual's relative risk compared with the population. Multiomic methods integrate information from multiple biomarkers to generate trajectories and prognostic different outcomes. Supervised machine learning methods can directly utilize the growing compendia of electronic health records such as laboratory results and notes to generate direct risk predictions, while unsupervised machine learning methods can cluster individuals with chronic kidney disease into subphenotypes with differing approaches to care.
Lack of a coherent theory limits the diagnostic and prognostic value of the (central) auditory processing disorder: a theoretical and clinical perspective
Authors: Cacace Anthony T. , Enayati Zakaria
Published: August 2022

Purpose of review

To consider pertinent issues towards developing a coherent theory of the auditory processing disorder (APD). By identifying the conceptual and methodological shortcomings that have thwarted development in this area for decades, we propose solutions to achieve a veridical endpoint to advance the field.

Recent findings

Concerted efforts in the theoretical, experimental, and clinical domains have focused on validating the APD by demonstrating the “modality specificity” of the deficit. The importance of this conceptual framework is the delineation of auditory-perceptual dysfunctions from more generalized “supramodal” deficits, like those related to attention, memory, and language. Because contemporary schemata have limited the assessment of APD to auditory tasks alone (unimodaltesting), functional dissociations cannot be established, indeterminate diagnoses are problematic, and progress remains unduly constrained. The use of matched tasks in multiple sensory modalities is advocated as a diagnostic imperative to remedy this deficiency.

Themes covered by this review include the need to develop a coherent theory of APD, to identify and limit factors which confound a valid diagnosis, and to validate the diagnosis by demonstrating the “modality specificity” of the deficit. Without an obligatory theoretical designation, the APD will remain as an obscure and controversial entity, limited to indeterminate test results and misdiagnoses.
Cochlear implantation in systemic autoimmune disease
Authors: Goh Xueying , Muzaffar Jameel , Bance Manohar
Published: August 2022

Purpose of review

Autoimmune inner ear disease (AIED) is a rare, but likely underrecognized cause of hearing loss. However, hearing loss is common in systemic autoimmune disease and it is important for the clinician to be familiar with the spectrum of disease. In this article, we will review the developments in diagnosis and management of AIED, with a focus on the outcomes and potential pitfalls of cochlear implantation.

Recent findings

Hearing loss in AIED tends to be progressive and bilateral, but up to 40% can present as sudden hearing loss and one-third can present unilaterally. HSP-70 serology may help with diagnosis and may predict steroid response. Cochlear implantation provides excellent hearing and quality of life outcomes in patients deafened by AIED. Intracochlear fibrosis/ossification is found intraoperatively in the majority (54%) of patients undergoing cochlear implantation. A large percentage (32%) of patients has fluctuating impedances postimplantation, which may interfere with implant performance and mapping.

Diagnosis of AIED is largely clinical, and a strong index of suspicion is required. Multidisciplinary care is crucial for optimal management. Cochlear implant outcomes are generally excellent, but the clinician needs to be cognizant of the pitfalls of encountering intracochlear fibrosis intraoperatively and likelihood of implant performance fluctuation related to ongoing inflammation in the cochlea.
The remaining obstacles for a totally implantable cochlear implant
Authors: Trudel Mathieu , Morris David P.
Published: August 2022

Purpose of the review

For years, the development of a totally implantable cochlear implant (TICI) has faced several technical challenges hindering any prototypes from reaching full commercialization. This article aims to review the necessary specifications for a viable TICI. An overview of the remaining challenges when designing TICIs will be provided, focusing on energy supply and implantable microphones.

Recent findings

The literature review highlights how research efforts to generate sufficient power to supply a fully implantable CI could take advantage of microelectromechanical systems (MEMS)-based energy harvesters incorporating piezoelectric materials. Using one of the various energy sources in the vicinity of the temporal bone would allow the development of a self-sufficient implant, overcoming the limitations of electrochemical batteries. Middle ear implantable microphones could also use similar fabrication techniques and transduction mechanisms to meet the sensor requirements for a TICI.

Recent breakthroughs in power supply using MEMS-based energy harvesting technologies and piezoelectric implantable microphones may make TICIs become a more practical reality in the foreseeable future. Once available, TICIs will have major impact on our patients’ quality of life and may help to make hearing rehabilitation a more appealing option to a greater proportion of those who fulfill our candidacy criteria.
Anterior cervical spine surgery and dysphagia
Authors: Nachalon Yuval
Published: August 2022

Purpose of review

The purpose of this review is to summarize current evidence regarding dysphagia in anterior cervical spine surgeries (ACSS) and to present recent advances in evaluation and surgical technique.

Recent findings

Various risk factors for dysphagia have been identified, and they include female sex, smoking history, prior surgery and cervical lordotic angle. EAT-10 is a validated tool for the assessment of individuals with dysphagia post-ACSS. Local intraoperative corticosteroid application significantly reduced the incidence and magnitude of dysphagia in four out of five studies that were reviewed. Individuals who had undergone cervical disc replacement (CDR) and revision surgery by a zero-profile anchored spacer (ROI-C) device experienced less dysphagia than those who had anterior cervical discectomy with fusion (ACDF). Videofluoroscopic swallow study (VFSS) after ACSS demonstrated pharyngeal weakness and increased posterior pharyngeal wall thickness, while no other abnormality was found.

Different technique variations can reduce dysphagia severity in individuals undergoing ACSS. Surgeons are encouraged to continue performing randomized control studies to assist in choosing the most favourable technique for the patient.
The association between self-efficacy and completion of first-line treatment among newly referred patients with lung cancer
Authors: Kjaer Trille K. , Hansen Nina H. G. , Levinsen Anne Katrine G. , Carlsen Signe , Mellemgaard Anders , Oksen Marianne S. , Andersen Ingelise , Dalton Susanne O.
Published: August 2022

Background:

Clinical factors have an impact on the planning and completion of lung cancer treatment, but it is not well documented how psychological factors such as self-efficacy, that is, a person's belief in his or her own ability to respond to and control challenges in life, might affect completion of lung cancer treatment. We explored the association between general self-efficacy and completion of planned first-line treatment among newly referred patients with lung cancer.

Methods:

A total of 137 patients with lung cancer newly referred to the Oncology Department at Herlev University Hospital, Denmark, participated in this study. Data were prospectively collected through questionnaires and medical records. The Generalized Self-Efficacy Scale was used to assess self-efficacy at the time of diagnosis. Logistic regression models were used to analyze the association between self-efficacy and completion of planned first-line treatment with adjustment for age, sex, education, marital status, disease stage, and comorbidity.

Results:

Patients with high self-efficacy had significantly higher odds for completing first-line treatment (odds ratio 1.10; 95% confidence interval: 1.03–1.19) after adjustments.

Conclusions:

Patients who reported having higher self-efficacy were more likely to complete first-line treatment than patients with lower self-efficacy. This finding suggests that taking patients' psychological resources into account when planning for treatment may have potential to improve treatment for vulnerable patients with lung cancer. However, more studies are needed to confirm our findings.
Anatomy and Sonographic Examination for Lateral Epicondylitis: EURO-MUSCULUS/USPRM* Approach
Authors: Ricci Vincenzo , Cocco Giulio , Mezian Kamal , Chang Ke-Vin , Naňka Ondřej , Tamborrini Giorgio , Kara Murat , Özçakar Levent
Published: August 2022

Objective

To define a standardized comprehensive sonographic approach for evaluating the different histo-anatomical compartments of the lateral elbow.

Design

Using high-frequency US probes, we tried to match the anatomical features of the lateral elbow and its different sonographic patterns in patients with the diagnosis of lateral epicondylitis. Moreover, high-sensitive color/power Doppler assessments have also been performed to evaluate the microcirculation.

Results

Modern US equipment appears to provide an extremely detailed sonographic assessment of the different anatomical layers located in the lateral compartment of the elbow. Moreover, high-sensitive color/power Doppler imaging allows for clear visualization of the perfusion patterns in pathological conditions.

Conclusion

In clinical practice, high-frequency B-mode and high-sensitive color/power Doppler imaging can be integrated with the clinical findings to better define the pain generator(s) for optimizing the management of patients with lateral epicondylitis.
Facial Feminization Surgery: Part 1 of the Plastic Surgeon's Perspective of Gender-Affirming Surgery
Authors: Gibstein Alexander R. , Jabori Sinan K. , Danker Sara
Published: August 2022

The perceived feminine face is distinctly unique from the perceived masculine face. Facial feminization surgery (FFS) includes a range of surgical procedures designed to change characteristically masculine facial features into feminine ones. FFS encompasses a set of bone and soft-tissue reconstructive procedures including, but not limited to, forehead contouring with or without frontal sinus setback, hairline adjustment, brow lift, rhinoplasty, lip lift, mandibular shaping, genioplasty, and “tracheal” shave, and fat grafting. Some patients choose to undergo one, all, or groupings of the procedures. The surgical decision is tailored to the individual and based on clinical opinion, patient desire, and insurance status or means to pay. FFS improves patient quality of life, has good general aesthetic outcomes, and improves feminine gender appearance (Morrison et al., 2020).
Understanding the effects of Universal Test and Treat on longitudinal HIV care continuum outcomes among South African youth: a retrospective cohort study
Authors: Filiatreau Lindsey M. , Edwards Jessie K. , Masilela Nkosinathi , Gómez-Olivé F. Xavier , Haberland Nicole , Pence Brian W. , Maselko Joanna , Muessig Kathryn E. , Kabudula Chodziwadziwa Whiteson , Dufour Mi-Suk Kang , Lippman Sheri A. , Kahn Kathleen , Pettifor Audrey
Published: August 2022

Introduction

Little is known about when youth living with HIV (YLHIV) are most susceptible to disengagement from HIV care. The longitudinal HIV care continuum is an underutilized tool that can provide a holistic understanding of population-level HIV care trajectories and be used to compare treatment outcomes across groups. We aimed to explore effects of the Universal Test and Treat policy (UTT) on longitudinal care outcomes among South African youth living with HIV (YLHIV) and identify temporally precise opportunities for re-engaging this priority population.

Methods

Using medical record and census data, we conducted a retrospective cohort study among youth aged 18-24 newly diagnosed with HIV between August 2015 and December 2018 in nine health care facilities in rural South Africa. We used weighted Fine and Grey sub-distribution proportional hazards models to characterize longitudinal care continuum outcomes in the population overall and stratified by treatment era of diagnosis. We estimated the proportion of individuals in each stage of the continuum over time and the mean time spent in each stage in the first year following diagnosis. Estimates for the two groups were compared using differences (diagnosis pre-UTT=referent).

Results

A total of 420 YLHIV were included. By the end of the first year following diagnosis, just 23% of individuals had no 90-or-more-day lapse in care and were virally suppressed. Those diagnosed in the UTT era spent less time as ART-naïve (mean difference=-19.3 days; 95% CI: - 27.7, -10.9) and more time virally suppressed (mean difference=17.7; 95% CI: 1.0, 34.4) compared to those diagnosed pre-UTT adoption. Most individuals who were diagnosed in the UTT era and experienced a 90-or-more-day lapse in care disengaged between diagnosis and linkage to care or ART initiation and viral suppression.

Conclusions

Implementation of UTT yielded modest improvements in time spent on ART and virally suppressed among South African YLHIV. However, meeting UNAIDS’ 95-95-95 targets remains a challenge in this priority population. Retention in care and re-engagement interventions that can be implemented between diagnosis and linkage to care (e.g., longitudinal counseling following diagnosis) or ART initiation and viral suppression may be particularly important to improving treatment outcomes among South African YLHIV.
Pupil-linked phasic arousal relates to the reduction of response inhibition: inferences from a simultaneous pupillometry and EEG-fMRI study
Authors: Hong Linbi , He Hengda , Sajda Paul
Published: August 2022

Attention reorienting is a critical cognitive function which drives how we respond to novel and unexpected stimuli. In recent years, arousal has been linked to attention reorienting. The timing and spatial organization of the interactions between the arousal and reorienting systems, however, remain only partially revealed. Here, we investigate the dynamics between the two systems through simultaneous recordings of pupillometry, EEG, and fMRI of healthy human subjects while they performed an auditory target detection task. We used pupil diameter and activity in the noradrenergic locus coeruleus to infer arousal, and found these measures linked to distinct cortical activity at various temporal stages of the reorienting response. Specifically, our results provide the first demonstration in humans of how phasic pupil-linked arousal relates to the reduction of response inhibition, an inference which otherwise would remain hidden without the help of simultaneous multi-modal acquisitions.
Multiplex genome engineering in Clostridium beijerinckii NCIMB 8052 using CRISPR-Cas12a
Authors: Patinios Constantinos , de Vries Stijn T. , Diallo Mamou , Lanza Lucrezia , Verbrugge Pepijn L. J. V. Q. , López-Contreras Ana M. , van der Oost John , Weusthuis Ruud A. , Kengen Servé W. M.
Published: August 2022

Clostridium species are re-emerging as biotechnological workhorses for industrial acetone-butanol-ethanol production. This re-emergence is largely due to advances in fermentation technologies but also due to advances in genome engineering and re-programming of the native metabolism. Several genome engineering techniques have been developed including the development of several CRISPR-Cas tools. Here, we expanded the CRISPR-Cas toolbox and developed a CRISPR-Cas12a genome engineering tool in Clostridium beijerinckii NCIMB 8052. By controlling the expression of FnCas12a with the strict xylose-inducible promoter, we achieved efficient (25-100%) single-gene knockout of five C. beijerinckii NCIMB 8052 genes (Spo0A, Upp, Cbei_1291, Cbei_3238, Cbei_3832). Moreover, we achieved multiplex genome engineering by simultaneously knocking out the Spo0A and Upp genes in a single step with an efficiency of 18%. Finally, we showed that the spacer sequence and position in the CRISPR array can affect the editing efficiency outcome.
Effects of Aging on Cortical Representations of Continuous Speech
Authors: Karunathilake I.M Dushyanthi , Dunlap Jason L. , Perera Janani , Presacco Alessandro , Decruy Lien , Anderson Samira , Kuchinsky Stefanie E. , Simon Jonathan Z.
Published: August 2022

Understanding speech in a noisy environment is crucial in day-to-day interactions, and yet becomes more challenging with age, even for healthy aging. Age-related changes in the neural mechanisms that enable speech-in-noise listening have been investigated previously; however, the extent to which age affects the timing and fidelity of encoding of target and interfering speech streams are not well understood. Using magnetoencephalography (MEG), we investigated how continuous speech is represented in auditory cortex in the presence of interfering speech, in younger and older adults. Cortical representations were obtained from neural responses that time-locked to the speech envelopes using speech envelope reconstruction and temporal response functions (TRFs). TRFs showed three prominent peaks corresponding to auditory cortical processing stages: early (∼50 ms), middle (∼100 ms) and late (∼200 ms). Older adults showed exaggerated speech envelope representations compared to younger adults. Temporal analysis revealed both that the age-related exaggeration starts as early as ∼50 ms, and that older adults needed a substantially longer integration time window to achieve their better reconstruction of the speech envelope. As expected, with increased speech masking, envelope reconstruction for the attended talker decreased and all three TRF peaks were delayed, with aging contributing additionally to the reduction. Interestingly, for older adults the late peak was delayed, suggesting that this late peak may receive contributions from multiple sources. Together these results suggest that there are several mechanisms at play compensating for age-related temporal processing deficits at several stages, but which are not able to fully reestablish unimpaired speech perception.

NEW & NOTEWORTHY

We observed age-related changes in cortical temporal processing of continuous speech that may be related to older adults’ difficulty understanding speech in noise. These changes occur in both timing and strength of the speech representations at different cortical processing stages, and depend on both noise condition and selective attention. Critically, their dependency on noise condition changes dramatically among the early, middle, and late cortical processing stages, underscoring how aging differentially affects these stages.
Evaluation of salinity tolerance of lowland rice genotypes at the reproductive stage
Authors: Rafaliarivony Safidimanjato , Ranarijaona Hery Lisy Tiana , Rasoafalimanana Mbolarinosy , Radanielina Tendro , Wissuwa Matthias
Published: August 2022

Salinity is an abiotic stress considered as the most widespread soil problem next to drought in rice growing areas of the world. To facilitate agricultural production on salt-affected soil, water and soil management is the most common practice, but this approach is increasingly problematic because water is becoming scarce. Therefore, developing tolerant varieties would the best solution to this problem. The present study evaluated salinity tolerance of 72 lowland rice genotypes at the reproductive stage. Experiments were conducted in irrigated fields at Marovoay, Madagascar, under low and moderately high salinity with electric conductivities of 2 dSm-1 and 4 dSm-1, respectively. A subsequent validation experiment was conducted in a pot experiment at three levels of salinity corresponding to 0, 4 and 8 dSm-1. Plant height, panicle number, panicle length, panicle fertility, spikelet fertility, straw weight and grain yield were measured together with a visual score of salt injury. Field salinity strongly reduced panicle number and spikelet fertility, reducing grain yield to less than 10 g m-2 in sensitive genotypes compared to more than 60 g m-2 in tolerant genotypes. The field experiment classified 20% of genotypes as tolerant, 50% as intermediate and 30% as sensitive to salinity. Four genotypes IR55179, MTM13_1, MTM13_3, MTM13_5, were re-confirmed as highly tolerant in the pot experiment. Higher spikelet and panicle fertility in tolerant genotypes contributed to their superior grain yield under salinity stress whereas these traits were particularly reduced in the sensitive local varieties. Genotypes with tolerance to salinity at the reproductive stage identified here could be used as donors to improve grain yield of local sensitive varieties, possibly using spikelet and panicle fertility as selection criteria for screening breeding lines at the reproductive stage.
Data-Driven Predictions of Potential Leishmania Vectors in Latin America
Authors: Vadmal Gowri M. , Glidden Caroline K. , Han Barbara A. , Carvalho Bruno , Castellanos Adrian A. , Mordecai Erin A.
Published: August 2022

The incidence of vector-borne diseases is rising as deforestation, climate change, and globalization bring humans in contact with arthropods that can transmit pathogens. In particular, incidence of American Cutaneous Leishmaniasis (ACL), a parasitic disease transmitted by sandflies, is increasing as previously intact habitats are cleared for agriculture and urban areas, potentially bringing people into contact with vectors and reservoir hosts. Previous evidence has identified dozens of sandfly species that have been infected with and/or transmit Leishmania parasites. However, there is an incomplete understanding of which sandfly species transmit the parasite, complicating efforts to limit disease spread. Here, we apply machine learning models (boosted regression trees) to leverage biological and geographical traits of known sandfly vectors to predict potential vectors. Additionally, we generate trait profiles of confirmed vectors and identify important factors in transmission. Our model performed well with an average out of sample accuracy of 86%. The models predict that synanthropic sandflies living in areas with greater canopy height, less human modification, and within an optimal range of rainfall are more likely to be Leishmania vectors. We also observed that generalist sandflies that are able to inhabit many different ecoregions are more likely to transmit the parasite. Our results suggest that Psychodopygus amazonensis and Nyssomia antunesi are unidentified potential vectors, and should be the focus of sampling and research efforts. Overall, we found that our machine learning approach provides valuable information for Leishmania surveillance and management in an otherwise complex and data sparse system.

Author Summary

American Cutaneous Leishmaniasis (ACL) is a neglected parasitic disease transmitted by sandflies in Latin America. There is an incomplete understanding of which sandfly species transmit the parasite, complicating efforts to limit disease spread. In this study, the authors created a database of sandfly traits, then used predictive models to determine important factors in disease transmission and how different climate and environmental variables affect ACL transmission. The models suggest that transmission occurs at the interface between domestic habitats and well-preserved forests. The authors also generate predictions of which sandflies might be transmitting the parasite that are not known vectors at the time, specifically Psychodopygus amazonensis and Nyssomia antunesi. This new knowledge can lead to a better understanding of the system of transmission, and can point to possible hotspots of the disease. The analysis can also help direct researchers to areas of interest for sampling studies, as well as specific sandflies to focus their effort on.
Effective Matrix Designs for COVID-19 Group Testing
Authors: Brust David , Brust Johannes J.
Published: August 2022

Background

Grouping samples with low prevalence of positives into pools and testing these pools can achieve considerable savings in testing resources compared with individual testing in the context of COVID-19. We review published pooling matrices, which encode the assignment of samples into pools and describe decoding algorithms, which decode individual samples from pools. Based on the findings we propose new one-round pooling designs with high compression that can efficiently be decoded by combinatorial algorithms. This expands the admissible parameter space for the construction of pooling matrices compared to current methods.

Results

By arranging samples in a grid and using polynomials to construct pools, we develop direct formulas for an Algorithm (Polynomial Pools (PP)) to generate assignments of samples into tests. Designs from PP guarantee to correctly decode all samples with up to a specified number of positive samples. PP includes recent combinatorial methods for COVID-19, and enables new constructions that can result in more effective designs.

Conclusion

For low prevalences of COVID-19, group tests can save resources when compared to individual testing. Constructions from the recent literature on combinatorial methods have gaps with respect to the possibilities of designs. We develop a method (PP), which includes previous constructions and enables new designs that can be advantageous in various situations.