bluuebunny/crossref_metadata_2025 huggingface dataset:
The Promise of Property: Legal Optimism and Collective Efficacy in Chicago’s Urban Agriculture District
Authors: Ela Nate
Published: August 2020

This article explains how and why community organizers in Chicago’s Englewood neighborhood have found promise in the opportunities that property law provides for addressing community problems. Drawing on interviews and ethnographic fieldwork, it examines the creation of neighborhood institutions for Chicago’s first urban agriculture district. These institutions have been informed by memories of slavery and sharecropping, and of the role played by food production and economic cooperation in struggles for African American self-determination. To keep ownership, use, and benefits of urban farmland local, organizers in Englewood founded a community land trust as a way to cultivate a sense of community ownership and control, and as a way to chip away at the alienation that blocks residents from addressing local problems. Prior studies have linked collective efficacy and residents’ individual sense of ownership; the experience in Englewood points to how collective efficacy could also be fostered by institutions that demonstrate collective, African-American ownership of community resources. The article discusses why organizers and residents in race-class subjugated communities may find promise in the sense of sovereignty and legal agency afforded by property.
Evaluation of the changes in composition of pork chops during cooking
Authors: Gaffield Katelyn N , Schunke Emily D , Lowell Jessica E , Dilger Anna C , Harsh Bailey N
Published: August 2020

The objective was to determine the change in extractable lipid concentration during cooking of boneless pork chops to different endpoint temperatures. Pork loins (152 total) were used and three consecutive chops were cut from each loin. Chop 1 was evaluated raw (not cooked) for intramuscular fat (IMF) percentage. Raw IMF percentages were used to categorize the remaining two chops, from each loin, into low, average, and high marbling bins. The low bin included ≤3% IMF, the average bin included 3–4% IMF, and the high bin included ≥4% IMF. Chop 2 was cooked to 63 °C and chop 3 was cooked to 71 °C to evaluate cook loss, Warner–Bratzler shear force (WBSF), and IMF percentage. When cooked to either 63 or 71 °C, high IMF chops maintained greater (P < 0.001) IMF percentage than average and low IMF chops. Additionally, average IMF chops maintained greater (P < 0.001) IMF percentage than low chops, regardless of endpoint cooking temperature. The three marbling categories did not differ in cook loss (P = 0.28) or WBSF (P = 0.23) when chops were cooked to either 63 or 71 °C. However, both WBSF (2.76 kg) and cook loss (18.72%) were decreased (P < 0.001) in chops cooked to 63 °C compared with chops cooked to 71 °C (3.08 kg, 23.45%). Overall, differences in IMF percentages persisted even after cooking. Furthermore, IMF percentage of pork chops did not affect tenderness.
Harnessing technology and portability to conduct molecular epidemiology of endemic pathogens in resource-limited settings
Authors: Faust Christina L , Brunker Kirstyn , Ajambo Diana , Ryan Mary , Moses Arinaitwe , Rowel Candia , Wangoola Robert Mandela , Wampande Eddie M , Guma Andrew , Adriko Moses , Lamberton Poppy H L , Tukahebwa Edridah M , Mugenyi Albert , Waiswa Charles
Published: August 2020

Improvements in genetic and genomic technology have enabled field-deployable molecular laboratories and these have been deployed in a variety of epidemics that capture headlines. In this editorial, we highlight the importance of building physical and personnel capacity in low and middle income countries to deploy these technologies to improve diagnostics, understand transmission dynamics and provide feedback to endemic communities on actionable timelines. We describe our experiences with molecular field research on schistosomiasis, trypanosomiasis and rabies and urge the wider tropical medicine community to embrace these methods and help build capacity to benefit communities affected by endemic infectious diseases.
Maternal Surgery During Pregnancy Has a Transient Adverse Effect on the Developing Fetal Rabbit Brain
Authors: Van der Veeken L. , Van der Merwe J. , Devroe S. , Inversetti A. , Galgano A. , Bleeser T. , Meeusen R. , Rex S. , Deprest J.
Published: August 2020

(Am J Obstet Gynecol. 2019;221:355.e1–355.e19)

Approximately 0.2% to 2% of pregnant women in the United States and Europe undergo nonobstetric surgery each year. These procedures are often performed under general anesthesia (GA). Clinicians, researchers, and organizations have expressed concern about the potential adverse effects of anesthesia on the developing brain of an infant or fetus. Previous clinical research studies have indicated varying conclusions, but there is a general consensus that the developing brain is most vulnerable when the brain is at peak growth, beginning mid-gestation, and continues after delivery. While earlier animal studies have explored the effects of neonatal anesthesia only, little research has explored the effects of GA administered for surgery, as well as the effect of surgery itself during pregnancy. This study investigated whether the combination of maternal anesthesia and surgery, using a rabbit model, would lead to poorer neurological outcomes at birth, as well as behavioral and cognitive debilitation in the time after delivery.
Effect of an Exercise Programme for Reducing Abdominal Fat on Overactive Bladder Symptoms in Young Overweight Women
Authors: Hagovska Magdaléna , Švihra Ján , Buková Alena , Dračková Dana , Horbacz Agata , Nagyová Iveta
Published: August 2020

(Abstracted from Int Urogynecol J 2020;31:895–902)

Overactive bladder (OAB) occurs in 5% to 10% of young women aged 18 to 35 years. Well-known associations include being overweight and obesity.
Factors Associated With Subchorionic Hematoma Formation in Pregnancies Achieved Via Assisted Reproductive Technologies
Authors: West Brady T. , Kavoussi Parviz K. , Odenwald Kate C. , London Krista , Hunn Caitlin L. , Chen Shu-Hung , Wininger John David , Gilkey Melissa S. , Kavoussi Keikhosrow M. , Kavoussi Shahryar K.
Published: August 2020

(Abstracted from J Assist Reprod Genet 2020;37:305–309)

Subchorionic hematoma (SCH) has been reported to be more frequent among singleton in vitro fertilization (IVF) pregnancies than singleton non-IVF pregnancies. This increased prevalence may be due to controlled ovarian hyperstimulation (COH) predisposing the endometrial environment to SCH.
Maternal Alcohol-Use Disorder and Child Outcomes
Authors: O'Leary Colleen , Lawrence David , Hafekost Katherine , Zubrick Stephen R. , Bower Carol
Published: August 2020

(Abstracted from Pediatrics 2020;145(3):e20191574)

Heavy maternal alcohol use has been shown to increase the risk of negative child outcomes. These poor outcomes have been attributed to both the biological effects of alcohol exposure in utero and social or environmental factors.
Medical Education in the United States and Canada, 2020
Authors: McOwen Katherine S. , Whelan Alison J. , Farmakidis Anne L.
Published: August 2020

For the third time this century, the Association of American Medical Colleges has coordinated a collection of reports from their member medical schools that collectively reflect the state of medical education in the United States and Canada. This introduction to the September 2020 supplement to Academic Medicine provides an overview of the collection, with 145 out of 171 eligible medical schools participating in the project. The authors observe trends and similarities across the reports from participating schools, structuring the introduction to mirror the main questions posed to the schools: highlights of each school’s medical education program, curriculum description, curricular governance, education staff, faculty development and support in medical education, regional medical campuses, and initiatives in progress. Key findings from the authors include expansion of student enrichment tracks, early clinical encounters, focus on wellness, expansion in competency-based medical education, and continued evolution of approaches to assessment. The authors note that this supplement was produced before COVID-19, and although it robustly chronicles the prepandemic state of medical education, medical education has already evolved and will continue to do so. This view offers important opportunities to observe and study changes in the curricula.
Current understanding of the fascial plane blocks for analgesia of the chest wall: techniques and indications update for 2020
Authors: Warfield Dennis J. , Barre Shane , Adhikary Sanjib Das
Published: August 2020

Purpose of review

Thoracic myofascial plane blocks have gained popularity because of their ease of performance and relative safety. This review highlights current research demonstrating the efficacy of these blocks for specific surgical procedures and provides a brief description of how these techniques are performed.

Recent findings

Fascial plane blocks of the thorax and chest wall have been shown to be beneficial in providing perioperative analgesia for a variety of surgical procedures. Studies discussed in this review compare thoracic fascial plane blocks to systemic analgesia alone, contrast these novel methods of pain control to more traditional techniques, such as paravertebral nerve blocks and epidural anesthesia, and attempt to determine, which fascial plane blocks provide optimal postsurgical analgesia.

Thoracic fascial plane blocks provide the anesthesiologist a number of techniques to address postsurgical pain. The relative ease of performance and safety profile of these blocks make them an appealing option for pain control for many patients undergoing thoracic or chest wall surgery. Further research is needed to not only define additional indications for each of these blocks, but also explore optimal dosing including the use of continuous catheter techniques.
Diaphragm-sparing brachial plexus blocks: a focused review of current evidence and their role during the COVID-19 pandemic
Authors: Cubillos Javier , Girón-Arango Laura , Muñoz-Leyva Felipe
Published: August 2020

Purpose of review

Given that COVID-19 can severely impair lung function, regional anesthesia techniques avoiding phrenic nerve paralysis are relevant in the anesthetic management of suspected/confirmed COVID-19 patients requiring shoulder and clavicle surgical procedures. The objective of this review is to provide an overview of recently published studies examining ultrasound-guided diaphragm-sparing regional anesthesia techniques for the brachial plexus (BP) to favor their preferent use in patients at risk of respiratory function compromise.

Recent findings

In the last 18 months, study findings on various diaphragm-sparing regional anesthesia techniques have demonstrated comparable block analgesic effectivity with a variable extent of phrenic nerve paralysis. The impact of hemi-diaphragmatic function impairment on clinical outcomes is yet to be established.

Existing diaphragm-sparing brachial plexus regional anesthesia techniques used for shoulder and clavicle surgery may help minimize pulmonary complications by preserving lung function, especially in patients prone to respiratory compromise. Used as an anesthetic technique, they can reduce the risk of exposure of healthcare teams to aerosol-generating medical procedures (AGMPs), albeit posing an increased risk for hemi-diaphragmatic paralysis. Reducing the incidence of phrenic nerve involvement and obtaining opioid-sparing analgesia without jeopardizing efficacy should be prioritized goals of regional anesthesia practice during the COVID-19 pandemic.
Has the future arrived? Liposomal bupivacaine versus perineural catheters and additives for interscalene brachial plexus block
Authors: Orebaugh Steven L. , Dewasurendra Anu
Published: August 2020

Purpose of review

Single injection interscalene block (ISB) provides effective analgesia for shoulder surgery. However, the duration of these is limited. This review summarizes the effectiveness of three potential means of extending the duration of analgesia: perineural infusion of local anesthetic agents, addition of adjuvant drugs to local anesthetics in single-injection nerve block, and utilization of liposomal bupivacaine in the surgical field or in the block itself.

Recent findings

Perineural infusion of local anesthetics with interscalene catheters provides superior pain relief with reduction of postoperative opioids. Both dexmedetomidine and dexamethasone effectively extend the duration of single injection ISB. Liposomal bupivacaine holds promise when injected perineurally in ISB, either as a sole agent or when mixed with standard bupivacaine.

Interscalene catheters, adjunctive drugs added to local anesthetics in single-injection interscalene brachial plexus blocks, or liposomal bupivacaine may be used to effectively prolong the duration of analgesia for shoulder surgery patients.
How Do Audiologists Respond to Emotional and Psychological Concerns Raised in the Audiology Setting? Three Case Vignettes
Authors: Bennett Rebecca J. , Meyer Carly J. , Ryan Brooke J. , Eikelboom Robert H.
Published: August 2020

Objectives:

Emotional and psychological well-being are essential to overall health, but there is little research showing how to approach emotional and psychological concerns in the audiological setting. This study investigated audiologists’ self-reported clinical behaviors in response to emotional and psychological concerns and/or symptoms raised by audiology clients.

Design:

A sample of 83 Australia-based audiologists completed a survey including vignettes presenting older adults with hearing loss and experiencing symptoms consistent with either depression or grief. Content analysis was used to explore: (1) audiologists’ self-reported usual response when clients present with emotional and psychological concerns and/or symptoms in the audiological setting; (2) audiologists’ ability to identify and describe psychological symptoms; and (3) audiologists’ self-reported clinical behaviors relating to client referral for psychological support.

Results:

When asked to describe their usual clinical course of action in response to the vignettes, over one half the audiologists described actions that address the clients concerns related to psychological well-being. Where audiologists described how they would provide psychological support, they described modifications to the audiological rehabilitation program including involving significant others in the rehabilitation process, recommending additional support outside of the audiology setting (such as General Practitioner or psychologists), and providing emotional support and counseling. When prompted, the majority of participants recognized the two cases with depression as having a mental health condition; however, 48% of participants indicated the control case as also having a mental health condition. When asked directly, the majority of audiologists indicated that they would refer the three vignettes for specialist support; however, less than one third described referral to a General Practitioner and less than 5% described referral to a mental health professional as their normal course of action in the open response item. Twenty-five different professions/people were reported as potential sources for referral.

Conclusion:

These findings support the need for further training and/or resources for audiologists to enable them to appropriately detect, describe and refer for emotional and psychological concerns and/or symptoms raised by clients’ in the audiology setting.
Prevalence and Impact of Hyponatremia in Patients With Coronavirus Disease 2019 in New York City
Authors: Frontera Jennifer A. , Valdes Eduard , Huang Joshua , Lewis Ariane , Lord Aaron S. , Zhou Ting , Kahn D. Ethan , Melmed Kara , Czeisler Barry M. , Yaghi Shadi , Scher Erica , Wisniewski Thomas , Balcer Laura , Hammer Elizabeth
Published: August 2020

Objectives:

Hyponatremia occurs in up to 30% of patients with pneumonia and is associated with increased morbidity and mortality. The prevalence of hyponatremia associated with coronavirus disease 2019 and the impact on outcome is unknown. We aimed to identify the prevalence, predictors, and impact on outcome of mild, moderate, and severe admission hyponatremia compared with normonatremia among coronavirus disease 2019 patients.

Design:

Retrospective, multicenter, observational cohort study.

Setting:

Four New York City hospitals that are part of the same health network.

Patients:

Hospitalized, laboratory-confirmed adult coronavirus disease 2019 patients admitted between March 1, 2020, and May 13, 2020.

Interventions:

None.

Measurements and Main Results:

Hyponatremia was categorized as mild (sodium: 130–134 mmol/L), moderate (sodium: 121–129 mmol/L), or severe (sodium: ≤ 120 mmol/L) versus normonatremia (135–145 mmol/L). The primary outcome was the association of increasing severity of hyponatremia and in-hospital mortality assessed using multivariable logistic regression analysis. Secondary outcomes included encephalopathy, acute renal failure, mechanical ventilation, and discharge home compared across sodium levels using Kruskal-Wallis and chi-square tests. In exploratory analysis, the association of sodium levels and interleukin-6 levels (which has been linked to nonosmotic release of vasopressin) was assessed. Among 4,645 patient encounters, hyponatremia (sodium < 135 mmol/L) occurred in 1,373 (30%) and 374 of 1,373 (27%) required invasive mechanical ventilation. Mild, moderate, and severe hyponatremia occurred in 1,032 (22%), 305 (7%), and 36 (1%) patients, respectively. Each level of worsening hyponatremia conferred 43% increased odds of in-hospital death after adjusting for age, gender, race, body mass index, past medical history, admission laboratory abnormalities, admission Sequential Organ Failure Assessment score, renal failure, encephalopathy, and mechanical ventilation (adjusted odds ratio, 1.43; 95% CI, 1.08–1.88; p = 0.012). Increasing severity of hyponatremia was associated with encephalopathy, mechanical ventilation, and decreased probability of discharge home (all p < 0.001). Higher interleukin-6 levels correlated with lower sodium levels (p = 0.017).

Conclusions:

Hyponatremia occurred in nearly a third of coronavirus disease 2019 patients, was an independent predictor of in-hospital mortality, and was associated with increased risk of encephalopathy and mechanical ventilation.
Neonatal sepsis: within and beyond China
Authors: Dong Ying , Basmaci Romain , Titomanlio Luigi , Sun Bo , Mercier Jean-Christophe
Published: August 2020

Sepsis remains a significant cause of neonatal morbidity and mortality in China. A better understanding of neonatal sepsis in China as compared with other industrialized and non-industrialized countries may help optimize neonatal health care both regionally and globally. Literature cited in this review was retrieved from PubMed using the keywords “neonatal sepsis,” “early-onset (EOS)” and “late-onset (LOS)” in English, with the focus set on population-based studies. This review provides an updated summary regarding the epidemiology, pathogen profile, infectious work-up, and empirical treatment of neonatal sepsis within and beyond China. The incidence of neonatal EOS and the proportion of Group B Streptococcus (GBS) within pathogens causing EOS in China seem to differ from those in developed countries, possibly due to different population characteristics and intrapartum/postnatal health care strategies. Whether to adopt GBS screening and intrapartum antibiotic prophylaxis in China remains highly debatable. The pathogen profile of LOS in China was shown to be similar to other countries. However, viruses as potential pathogens of neonatal LOS have been underappreciated. Growing antimicrobial resistance in China reflects limitations in adapting antibiotic regimen to local microbial profile and timely cessation of treatment in non-proven bacterial infections. This review stresses that the local epidemiology of neonatal sepsis should be closely monitored in each institution. A prompt and adequate infectious work-up is critically important in diagnosing neonatal sepsis. Adequate and appropriate antibiotic strategies must be overemphasized to prevent the emergence of multi-resistant bacteria in China.
Clinical outcomes and secondary glaucoma after gamma-knife radiosurgery and Ruthenium-106 brachytherapy for uveal melanoma: a single institution experience
Authors: Mazzini Cinzia , Pieretti Giulia , Vicini Giulio , Nicolosi Cristina , Scoccianti Silvia , Pertici Maurizio , Greto Daniela , Desideri Isacco , Bordi Lorenzo , Pecchioli Guido , Virgili Gianni
Published: August 2020

We retrospectively analyzed data from records of 48 patients (48 eyes) treated with gamma-knife (n = 18) or Ruthenium-106 brachytherapy (n = 30) for uveal melanoma, in our Ocular Oncology Unit between December 2013 and September 2019, with the aim to evaluate treatment outcomes, and incidence and risk factors for secondary glaucoma. Patients demographics and tumor characteristics at diagnosis were recorded. Follow-up data were collected regarding local tumor control, treatment complications, enucleation need, metastases occurrence and survival status. The median follow-up period was 33.7 months in the gamma-knife group and 26.2 months in the brachytherapy group. The mean tumor thickness, the largest basal diameter and the tumor volume were significantly higher in the gamma-knife group than in the brachytherapy group. The local tumor control rate was 100% in the brachytherapy group and 77.8% in the gamma-knife group. In the gamma-knife group, six patients were enucleated, no patient treated with brachytherapy underwent enucleation. The overall survival rate was 96.7% in the brachytherapy group and 94.44% in the gamma-knife group. Secondary glaucoma occurred in 10 patients after gamma-knife and in one patient after brachytherapy: it should be emphasized that larger lesions were treated with gamma-knife, whereas smaller tumors were selected for brachytherapy. We found a significative correlation of tumor thickness (P value = 0.043) and volume (P value = 0.040) with secondary glaucoma occurrence after gamma-knife treatment. Moreover, secondary glaucoma significantly correlated with radiation retinopathy in the gamma-knife group (P value = 0.009). This study shows preliminary clinical results that could be useful for further studies with more patients and longer follow-up.
What Is in the Literature
Authors: Bromberg Mark B.
Published: August 2020

What is in the Literature focuses on peripheral neuropathies with new and practical information related to the diagnosis, treatment, and management. Diagnostic and treatment guidelines are available for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) but not all clinicians follow them resulting in erroneous diagnoses and prolonged treatment. Secondary axonal loss in CIDP causes increased connective tissue in muscle. Antibodies to proteins at the node of Ranvier are found in a small percentage of patients with CIDP. The differential diagnosis for CIDP-like neuropathies includes amyloid neuropathy and POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) and amyloidosis. Upper limits for cerebral spinal fluid protein are 0.45 g/L and cell count <10/µL, but both may be too low. Hyperactive reflexes may occur in Guillain–Barré syndrome and should not exclude the diagnosis. In severely affected Guillain–Barré syndrome patients, a second dose of intravenous immune globulin within 4 weeks of onset is not likely to be effective.
Longitudinal Analysis of Disease Burden in Refractory and Nonrefractory Generalized Myasthenia Gravis in the United States
Authors: Harris Linda , Allman Phillip H. , Sheffield Reinee , Cutter Gary
Published: August 2020

Objective:

To compare temporal trends in clinical and health care resource utilization (HRU) outcomes in people with refractory and nonrefractory generalized myasthenia gravis (gMG).

Methods:

A retrospective analysis of data from adults with gMG in the Myasthenia Gravis Foundation of America Patient Registry. gMG status (ever-refractory or always nonrefractory) and clinical (Myasthenia Gravis—Activities of Daily Living [MG-ADL] scores, exacerbations) and HRU outcomes were determined from questionnaires self-completed 6-monthly for up to 4 years. The probability of each outcome was compared for the 2 groups over time.

Results:

The mean MG-ADL score and the probability of experiencing each outcome were significantly greater in the ever-refractory versus nonrefractory groups during each year of follow-up. Between-group differences in time trends were statistically significant for intensive care and feeding-tube use.

Conclusions:

People who have ever had refractory gMG may have worse functional status, more exacerbations, and higher HRU than people with consistently nonrefractory disease.
COVID-19
Authors: Leap Jennifer , Villgran Vipin , Cheema Tariq
Published: August 2020

COVID-19 is caused by the coronavirus known as SARS-CoV2. This virus may lead to asymptomatic cases, mild illness, or acute respiratory distress syndrome. Here we describe the epidemiology, pathophysiology, transmission, and symptoms of the virus.
Leading Through the Unknown
Authors: Coe Paula F. , Graper Lisa L. , Zangerle Claire M.
Published: August 2020

This article provides a road map to swiftly operationalize the structure and process for organizational readiness in response to the COVID-19 pandemic. The pandemic forced network leaders to face an unprecedented public health crisis while navigating circumstances driven by a widely impactful disease with minimal empirical evidence regarding disease spread, containment, and treatment. Key leaders across the enterprise planned, executed, and continually refined a strategy against the pandemic surge. Mission-driven decisions, communication, and actions were critical in connecting and informing the stakeholders about the evolving and uncertain conditions. In partnership with internal and external stakeholders, the use of data, technology, and innovation provided new opportunities to transform existing care and business models into adaptable prototypes for mitigating risks and informing tactical steps. Execution of testing sites, building a command center, and increasing bed capacity infused daily operations. Creating innovative processes, including working with private industry to secure resources and pioneering solutions, is the result of leveraging talented teams to produce solutions. Trustful partnerships among enterprise leaders and their constituents stemmed from a common, shared vision. Utilizing systems thinking led to optimizing a response and preparedness plan for now and for future pandemics.
COVID-19
Authors: Hardt DiCuccio Margaret , Reynolds Colleen , Snyder Amy , Cianci Nolan
Published: August 2020

The COVID-19 pandemic presented an unprecedented opportunity to test the emergency management plan of one large urban teaching hospital. In this article, a detailed description of the hospital's surge planning process with lessons learned has been provided.
Safety of Oral Midazolam as a Perioperative Anxiolytic for Outpatient Dermatologic Procedures
Authors: Bezalel Spencer A. , Brewer Jerry D. , Baum Christian L. , Arpey Christopher J. , Roenigk Randall K. , Otley Clark C.
Published: August 2020

BACKGROUND

Perioperative anxiety can negatively impact patient satisfaction and can complicate outpatient dermatologic procedures.

OBJECTIVE

Evaluate adverse events associated with oral midazolam as a perioperative anxiolytic during dermatologic surgery and assess whether an enhanced monitoring approach is associated with an increased detection rate.

MATERIALS AND METHODS

Five hundred cases (250 before and after change in monitoring) where patients were administered oral midazolam between July 2015 and May 2017 were retrospectively reviewed. The number of procedures, type of procedures, dose in milligrams, number of doses, major and minor adverse events, and vital signs were recorded.

RESULTS

The difference in number of treatment sites, types of procedures, and total dose administered was not significant. There were minor but significant differences in the mean change in blood pressure, heart rate, respiratory rate, and Richmond Agitation and Sedation Scale score before and after the procedure but not oxygen saturation. These vital sign changes were not clinically significant. There were zero major adverse events in both groups. There were 2 patients who became transiently hypoxic.

CONCLUSION

Oral midazolam administration was not associated with major adverse events including in the more intensively monitored group. This supports its use as an anxiolytic for outpatient dermatologic procedures.
MiR-455-5p Attenuates Cerebral Ischemic Reperfusion Injury by Targeting FLT3
Authors: Chen Jinjing , Zhu Chunran , Jia Weijian , Wang Jing , Gu Liang
Published: August 2020

Cerebral ischemia–reperfusion (I/R) injury is a terrible disease which results in the dysfunction and structural damage of brain tissues. Growing evidence implies that miR-455-5p is implicated in the regulation of pathogenesis of several diseases. The aim of this study is to reveal the role of miR-455-5p in cerebral I/R injury and the regulatory mechanism. We established a vitro model by inducing SH-SY5Y and PC-12 cells with oxygen-glucose deprivation and reoxygenation. The experimental cerebral I/R rat model was established by middle cerebral artery occlusion operation. The findings indicated that miR-455-5p expression was downregulated in oxygen-glucose deprivation and reoxygenation induced cells and I/R rat model. In addition, miR-455-5p upregulation inhibited SH-SY5Y cell apoptosis and cerebral damage, whereas miR-455-5p silencing promoted SH-SY5Y cell apoptosis and cerebral damage. Mechanistically, luciferase reporter assay corroborated that miR-455-5p could bind with feline mcDonough sarcoma-like tyrosine kinase 3 (FLT3) mRNA. However, the role of FLT3 in cerebral I/R injury was rarely investigated. Real-time polymerase chain reaction revealed that FTL3 expression was negatively regulated by miR-455-5p. FTL3 upregulation reversed the inhibitory effects of miR-455-5p upregulation on PC-12 and SH-SY5Y cell apoptosis. Therefore, our study verified that miR-455-5p improved cerebral I/R injury by targeting FLT3, which suggests a potential new target for the prevention of cerebral I/R injury.
Determination of Organically Bound Tritium (OBT) Concentration in Fish by Thermal Oxidation and Liquid Scintillation Counting Method
Authors: Nayak S. Rashmi , D’Souza Renita S. , Purushotham Mohan M. , Seraje Bharath , Blangat Dileep N. , Mana Ravi P. , Naregundi Karunakara
Published: August 2020

Effluents containing tritium (3H) dispersed into the fresh water or marine environment from nuclear facilities can be taken up by biota. Aquatic and marine organisms are among the important pathways through which tritium can enter into the human body, and hence, assessment of the extent of pollution of these ecosystems is very important for radiation dose assessments. Tritium present in environmental matrices can be classified as tissue-free water tritium (TFWT) and organically bound tritium (OBT). Optimization of a method for the determination of OBT in fish, based on thermal oxidation of the sample, is discussed. Samples were subjected to thermal oxidation in a pyrolyser system, and the water produced from the combustion was analyzed by liquid scintillation spectrometry. Results show that a maximum of ~2 g of processed fish sample can be combusted efficiently in the pyrolyser. Using this method, a recovery of 84% was achieved, and minimum detectable activity (MDA) for the method was determined to be 8.5 Bq kg−1 (sample weight = 2 g, counting time = 30,000 s, and detection efficiency = 20%).
Can SUVmax of 68Ga-labeled PSMA Ligand and 18F-choline PET/CT Be Used to Predict the Radiation Dose in Prostate Cancer Patients?
Authors: Khansa Zeinab , Neaimeh Nemer , Korek Mahmoud , Haidar Mohamad
Published: August 2020

Gallium-68 (68Ga)-PSMA and 18F-Choline are two radionuclides that have already shown high potential for the detection of prostate cancer. The comparison between these two radionuclides has several advantages in radiation protection. The aim of this prospective study was to identify which of these two radionuclides can help in predicting the equivalent dose using the maximum standard uptake value (SUVmax) of normal organs, the kidneys. Two groups of 40 patients (total n = 80) who underwent PET/CT using 68Ga or 18F for diagnosis of prostate cancer between April 2018 and December 2018 at the American University of Beirut Medical Center were included. First, the dose rates were measured after 1 h of radionuclide uptake at 1 m distance with background of 0.015 μSv h−1. Then, SUVmax for kidneys were determined from images obtained with PET/CT 1 h after injection of both radionuclides. The ratios of the equivalent doses to the SUVmax for kidneys were compared for both 68Ga-PSMA and 18F-Choline. There is a positive moderate relationship between the SUVmax for kidneys and the 68Ga dose rate after 1 h of injection at 1 m distance from the abdomen (p-value = 0.023 < 0.05). This relationship is statistically significant. However, there is a very low negative relationship between the SUVmax kidney and 18F dose rate after 1 h of injection at 1 m distance from the abdomen (p-value = 0.93 > 0.05). This relationship is not statistically significant. This leads to the suggestion that we can predict the equivalent dose due to 68Ga by indicating the SUVmax from the PET/CT images.
COMPARISON OF SCLERAL FIXATION OF INTRAOCULAR LENS
Authors: Jang Kyu Hwan , Kong Mingui , Moon Byung Gil , Son Gisung
Published: August 2020

Purpose:

To compare the clinical outcomes of sutured scleral and sutureless intrascleral fixations of the intraocular lens.

Methods:

Medical records of patients who underwent sutureless intrascleral fixation (sutureless group) and the conventional sutured scleral fixation (sutured group) were retrospectively reviewed. Patient demographics and the clinical outcomes of the two techniques were compared before and 1, 3, and 6 months after surgery.

Results:

Seventy patients were followed up for 6 months after the surgery: 25 patients in the sutureless group (25 eyes) and 45 in the sutured group (45 eyes). Surgery time was shorter in the sutureless group than that in the sutured group (73.00 ± 15.68 vs. 107.39 ± 25.30 minutes, P < 0.001). The visual acuity gradually improved throughout the postoperative period in both groups, and a faster visual acuity recovery was observed in the sutureless group. The cylindrical error at 6 months after the surgery was significantly lower in the sutureless group than that in the sutured group (−1.33 ± 0.55 vs. −2.29 ± 1.19 diopter, P < 0.001).

Conclusion:

Sutureless intrascleral fixation is an effective and reliable surgical technique that provides more favorable visual and refractive outcomes than the conventional sutured scleral fixation method.
DEEP PHENOTYPING AND FURTHER INSIGHTS INTO ITM2B-RELATED RETINAL DYSTROPHY
Authors: Nassisi Marco , Wohlschlegel Juliette , Liu Bingqian , Letellier Camille , Michiels Christelle , Aubois Anne , Mohand-Said Saddek , Habas Christophe , Sahel José-Alain , Zeitz Christina , Audo Isabelle
Published: August 2020

Purpose:

To reappraise the presentation and the course of ITM2B-related retinal dystrophy and give further insights into ITM2B expression in the retina.

Methods:

The clinical data of nine subjects with ITM2B-related retinal dystrophy were retrospectively reviewed. The genetic mutation was assessed for its influence on splicing in cultured fibroblasts. The cellular expression of ITM2B within the inner retina was investigated in wild-type mice through mRNA in situ hybridization.

Results:

All patients complained of decreased vision and mild photophobia around their twenties–thirties. The peculiar feature was the hyperreflective material on optical coherence tomography within the inner retina and the central outer nuclear layer with thinning of the retinal nerve fiber layer. Although retinal imaging revealed very mild or no changes over the years, the visual acuity slowly decreased with about one Early Treatment Diabetic Retinopathy Study letter per year. Finally, full-field electroretinography showed a mildly progressive inner retinal and cone dysfunction. ITM2B mRNA is expressed in all cellular types of the inner retina. Disease mechanism most likely involves mutant protein misfolding and/or modified protein interaction rather than misplicing.

Conclusion:

ITM2B-related retinal dystrophy is a peculiar, rare, slowly progressive retinal degeneration. Functional examinations (full-field electroretinography and visual acuity) seem more accurate in monitoring the progression in these patients because imaging tends to be stable over the years.
CHARACTERISTICS OF PERIPAPILLARY INTRACHOROIDAL CAVITATION IN HIGHLY MYOPIC EYES
Authors: Liu Ran , Li Zhixi , Xiao Ou , Zhang Jian , Guo Xinxing , Loong Lee Jonathan Tak , Wang Decai , Lee Peiying , Jong Monica , Sankaridurg Padmaja , He Mingguang
Published: August 2020

Purpose:

To characterize peripapillary intrachoroidal cavitation (PICC) in highly myopic participants and its associated risk factors.

Methods:

This observational, cross-sectional study recruited 890 Chinese participants with bilateral high myopia, defined as ≤−6.00 diopters spherical power. Fundus photography and spectral-domain optical coherence tomography were used to determine the presence of PICC, defined as a yellow–orange lesion adjacent to the disc border with a corresponding intrachoroidal hyporeflective space.

Results:

Among 890 participants, 884 right eyes were included for analysis. The rate of PICC was 3.6% (32 eyes). Peripapillary intrachoroidal cavitation was observed in two eyes without myopic retinal lesions, nine eyes with tessellated fundus only, 16 eyes with diffuse chorioretinal atrophy, and five eyes with patchy chorioretinal atrophy. The most commonly affected area was inferior disc border (87.5%), followed by multiple (9.4%) and superior (3.1%) disc borders. The multiple linear logistic regression model showed that older age, more myopic spherical equivalent, and longer axial length were associated with the presence of PICC.

Conclusion:

Peripapillary intrachoroidal cavitation was present in 3.6% of highly myopic eyes. It was more common in eyes with a higher myopic maculopathy category. Older age, more myopic spherical equivalent, and longer axial length were risk factors for the presence of PICC.
Safety of KPI-121 Ophthalmic Suspension 0.25% in Patients With Dry Eye Disease: A Pooled Analysis of 4 Multicenter, Randomized, Vehicle-Controlled Studies
Authors: Korenfeld Michael , Nichols Kelly K. , Goldberg Damien , Evans David , Sall Ken , Foulks Gary , Coultas Susan , Brazzell Kim
Published: August 2020

Purpose:

The safety of KPI-121 0.25%, an ophthalmic nanoparticle suspension of loteprednol etabonate, was evaluated in subjects with dry eye disease (DED) in one phase 2 and three phase 3 randomized trials of similar design.

Methods:

Adults with DED received KPI-121 0.25% or vehicle drops 4 times daily (QID) for ≥2 weeks; 1430 subjects received KPI-121 0.25% and 1438 subjects received vehicle drops. Main safety assessments were adverse events (AEs) and intraocular pressure (IOP). As a common side effect associated with the use of ocular corticosteroids is elevated IOP, subjects with a history of or current diagnosis of glaucoma were excluded.

Results:

Instillation site pain was the most common AE, reported by 5.2% of subjects in the KPI-121 0.25% group and 4.4% of subjects in the vehicle group; other AEs were reported by ≤0.8% of subjects in the KPI-121 group. IOP elevations, a side effect associated with the use of ophthalmic corticosteroids, were observed with low incidence: 0.6% and 0.2% of subjects in the KPI-121 and vehicle groups, respectively. An IOP elevation was defined as an increase from baseline of >5 mm Hg that resulted in an IOP of ≥21 mm Hg in either eye during use of the study product.

Conclusions:

KPI-121 ophthalmic suspension 0.25% seemed to be safe and well tolerated when dosed QID for 2 to 4 weeks in those DED subjects included in the 4 trials.
Varied Presentations of Posterior Keratoconus: A Clinical Case Series
Authors: Ganesan Niruban , Narayana Shivananda , Kasturi Nirupama , Kaliaperumal Subashini , Srinivasan Renuka , Vallinayagam Muthukrishnan
Published: August 2020

Purpose:

To describe the varied presentations of posterior keratoconus.

Methods:

This is a 3-year institute-based retrospective study report from June 2015 to June 2018 that describes 13 eyes of 12 patients with varied presentations of posterior keratoconus, evaluating tomographic changes using Scheimpflug corneal tomography and anterior segment optical coherence tomography. Slit-lamp examination revealed circumscribed nebular corneal opacity with posterior corneal depression.

Results:

Eleven patients had unilateral and one had a bilateral presentation. Five patients presented in the first and second decade with a nebular opacity and circumscribed excavation of the posterior cornea. One patient was a 12-year-old girl who presented with systemic manifestations. Seven others were middle-aged adults with superior, central, or peripheral excavation. Two patients had microcornea.

Conclusions:

This is the largest case series on posterior keratoconus, depicting its varied features. Diagnosis of this uncommon condition requires a high index of suspicion, meticulous slit-lamp examination, and systemic evaluation to rule out other associated anomalies. We report a patient of unilateral posterior keratoconus with systemic associations, second such case in the literature.
Nivolumab-Induced Ulcerative Keratitis—A Case Report
Authors: Losonczy Gergely , Gijs Marlies , Nuijts Rudy M.M.A.
Published: August 2020

Purpose:

To describe a case of nivolumab-induced ulcerative keratitis rapidly recovering on topical steroid treatment and to determine changes in cytokine levels in the tear fluid caused by nivolumab.

Methods:

We report a 34-year-old man receiving nivolumab for metastasized melanoma with severe dry eye symptoms and a persistent corneal epithelial defect. Levels of cytokine and matrix metalloproteinase in tear fluid were measured by multiplex immunoassays.

Results:

The corneal epithelial defect failed to recover for antiviral and lubrication therapy but resolved within 48 hours after topical steroid therapy was initiated. No recurrence of corneal ulceration was observed with intermittent topical steroid therapy during the remaining period of nivolumab treatment. No Sjögren disease-related autoantibodies were detected in the patient's serum. The levels of inflammatory cytokines and matrix metalloproteinases in the tear fluid were markedly elevated after nivolumab treatment.

Conclusions:

Our observations suggest that nivolumab treatment induces a local autoimmune ocular surface disorder resulting in corneal ulceration that promptly resolves using steroid eye drops. The integrity of the corneal epithelial layer can be sustained using intermittent topical steroid therapy in patients receiving nivolumab.
Dupilumab-Associated Ocular Surface Disease: Clinical Characteristics, Treatment, and Follow-Up
Authors: Bohner Austin , Topham Christina , Strunck Jennifer , Haynes Dylan , Brazil Molly , Clements John , Simpson Eric , Chamberlain Winston
Published: August 2020

Purpose:

A consecutive case series of patients with dupilumab-associated ocular surface disease (DAOSD) that describes common ocular symptoms and signs, proposes a symptom disease severity grading system, and describes treatment strategies of DAOSD patients was evaluated.

Methods:

A retrospective chart review of patients with concomitant dupilumab-treated atopic dermatitis and DAOSD with ophthalmic evaluation between January 2014 and May 2019 was conducted.

Results:

Twenty-nine patients (mean age 46 years, M/F: 12/17) with 57 ophthalmic exams were identified. The most common ocular symptoms included irritation/pain (n = 28, 97%), redness (n = 24, 83%), pruritus (n = 18, 62%), discharge (n = 18, 62%), and light sensitivity (n = 6, 21%). The most frequent signs included conjunctival injection (n = 18, 62%), superficial punctate keratitis (n = 16, 55%), and papillary reaction (n = 8, 28%). Topical corticosteroids (TCS) (n = 23, 79%), tacrolimus (n = 6, 21%), and artificial tears (n = 7, 24%) were the most commonly used therapies. Of those with follow-up documentation (n = 21), 20 were noted to have partial or complete response with TCS based on symptoms and reduction of signs. Using our proposed symptom-based grading scale, scaled 1 to 5 based on the presence of common symptoms listed above, 66% (n = 19) requiring topical immunomodulating therapy were found in the ‘severe’ group (≥3 symptoms) and 17% (n = 5) were found in the ‘mild’ group (≤2 symptoms).

Conclusions:

This study provides insight into the commonly presenting ocular signs and symptoms associated with DAOSD and highlights the efficacy of TCS and other immunomodulators in improving symptoms associated with DAOSD. Based on our findings, we propose a symptom-based grading system that can guide nonophthalmic physicians regarding ophthalmology consult.
Safety and Efficacy of Corneal Minimized-Volume Ablation With Accelerated Cross-Linking in Improving Visual Function for Keratoconus
Authors: Yang Xiaonan , Liu Quan , Feng Qiting , Lin Haiqin
Published: August 2020

Purpose:

To evaluate the safety and efficacy of corneal minimized-volume ablation with accelerated cross-linking in improving visual function in keratoconus eyes.

Methods:

Through a pilot study, 25 eyes of 25 consecutive patients with keratoconus grade I–III were recruited that underwent corneal transepithelial photorefractive keratectomy with “minimized volume” ablation profile and accelerated corneal cross-linking in the same session. Corrected and uncorrected distance visual acuities, manifest refraction, corneal curvature and higher-order aberrations, endothelial cells, and the ocular modulation transfer function were assessed preoperatively and postoperatively, with a minimum follow-up of 6 months. A P value < 0.05 was the threshold of statistical significance.

Results:

At 8.2 ± 3.6 months postoperatively, the mean corrected and uncorrected distance visual acuities (LogMAR) were 0.07 ± 0.15 and 0.45 ± 0.39, significantly improving from the baseline of 0.24 ± 0.24 (P
8m-before = 0.005) and 1.12 ± 0.33 (P
8m-before < 0.001), respectively. Spherical equivalent was −2.80 ± 2.72 diopters (D), significantly decreasing from the baseline of −6.61 ± 3.06 D (P
8m-before < 0.001), whereas the attempted corrected spherical equivalent was−2.30 ± 1.22 D. Meanwhile, a significant reduction was found in higher-order aberration, along with the postoperative improvement in ocular modulation transfer function. Corneal surface morphological parameters were found with significant decreases postoperatively (index of surface variance: P
8m-before = 0.003; index of vertical asymmetry: P
8m-before = 0.005; keratoconus index: P
8m-before = 0.004; center keratoconus index: P
8m-before = 0.003; and index of height decentration: P
8m-before < 0.001). Nevertheless, no significant change was found in posterior corneal curvature or endothelial cell density between pre- and post-operative periods.

Conclusions:

Corneal minimized-volume ablation with accelerated cross-linking was an effective and safe option for correction of mild refractive error, leading to significant improvement of visual function in patients with keratoconus.