bluuebunny/crossref_metadata_2025 huggingface dataset:
Infrarenal aortic reconstruction using autologous femoral vein for a mycotic aneurysm caused by Streptococcus equi
Authors: Ghaly Paul , Di Mascio Delfino , Vicaretti Mauro
Published: August 2021

A common source of infection in equine, Streptococcus equi, is an uncommon pathogen in humans, rarely identified as the cause for mycotic aortic aneurysms. Typically associated with consumption of unpasteurized milk or contact with horses, S. equi can result in severe bacteremia, endocarditis and meningitis. We describe the presentation and successful management of a 69-year-old retired equestrian who underwent infrarenal aortic resection and reconstruction using autologous right femoral vein for a S. equi mycotic aneurysm.
Longitudinal Associations of PROMIS-29 Anxiety and Depression Symptoms With Low Back Pain Impact in a Sample of U.S. Military Service Members
Authors: Dunbar Michael S , Rodriguez Anthony , Edelen Maria O , Hays Ron D , Coulter Ian D , Siconolfi Daniel , Herman Patricia M
Published: August 2021

Introduction

The Impact Stratification Score (ISS) is a measure of the impact of chronic low back pain (LBP) consisting of nine Patient-Reported Outcomes Measurement Information System (PROMIS-29) items, but no studies have examined the ISS or its association with psychological symptoms in military samples. This study examines longitudinal associations between psychological symptoms and the ISS among military service members.

Material and Methods

The study involved secondary data analysis of a sample of active duty U.S. military service members aged 18-50 years with LBP (n = 733). Participants completed the PROMIS-29 at three time points during treatment: baseline (time 1, T1), week 6 of treatment (time 2, T2), and week 12 of treatment (time 3, T3). The impact of LBP was quantified using the ISS (ranging from 8 = least impact to 50 = greatest impact). Psychological symptoms were assessed as PROMIS-29 anxiety and depression scores. Separate autoregressive cross-lagged models examined reciprocal associations of ISSs with anxiety, depression, and emotional distress scores from T1 to T3.

Results

Within each time point, the ISS was significantly and positively correlated with anxiety and depression. In autoregressive cross-lagged models, anxiety and depression predicted the ISS at the next time point and associations were similar in magnitude (e.g., anxiety T2 to ISS T3: β = 0.12, P < .001; depression T2 to ISS T3: β = 0.12, P <.001). The ISS did not predict future depression or emotional distress scores at any time point, but the ISS at T2 was significantly, positively associated with anxiety scores at T3 (β = 0.07, P = .04).

Conclusion

Psychological symptoms consistently and prospectively predict the impact of LBP as measured by the ISS among service members undergoing pain treatment. The ISS may also be associated with future anxiety but not depression. PROMIS-29 anxiety and depression items may be useful adjunctive measures to consider when using the ISS to support LBP treatment planning and monitoring with service members.
The picasso map-making code: application to a simulation of the QUIJOTE northern sky survey
Authors: Guidi F , Rubiño-Martín J A , Pelaez-Santos A E , Génova-Santos R T , Ashdown M , Barreiro R B , Bilbao-Ahedo J D , Harper S E , Watson R A
Published: August 2021

Map-making is an important step for the data analysis of cosmic microwave background (CMB) experiments. It consists of converting the data, which are typically a long, complex, and noisy collection of measurements, into a map, which is an image of the observed sky. We present in this paper a new map-making code named picasso (Polarization and Intensity CArtographer for Scanned Sky Observations), which was implemented to construct intensity and polarization maps from the Multi Frequency Instrument (MFI) of the QUIJOTE (Q-U-I Joint TEnerife) CMB polarization experiment. picasso is based on the destriping algorithm, and is suited to address specific issues of ground-based microwave observations, with a technique that allows the fit of a template function in the time domain, during the map-making step. This paper describes the picasso code, validating it with simulations and assessing its performance. For this purpose, we produced realistic simulations of the QUIJOTE-MFI survey of the northern sky (approximately ∼20 000 deg2), and analysed the reconstructed maps with picasso, using real and harmonic space statistics. We show that, for this sky area, picasso is able to reconstruct, with high fidelity, the injected signal, recovering all the scales with ℓ > 10 in TT, EE, and BB. The signal error is better than 0.001 per cent at 20 < ℓ < 200. Finally, we validated some of the methods that will be applied to the real wide-survey data, like the detection of the CMB anisotropies via cross-correlation analyses. Despite that the implementation of picasso is specific for QUIJOTE-MFI data, it could be adapted to other experiments.
A model for line absorption and emission from turbulent mixing layers
Authors: Tan Brent , Oh S Peng
Published: August 2021

Turbulent mixing layers (TMLs) are ubiquitous in multiphase gas. They can potentially explain observations of high ions such as O vi, which have significant observed column densities despite short cooling times. Previously, we showed that global mass, momentum, and energy transfer between phases mediated by TMLs is not sensitive to details of thermal conduction or numerical resolution. By contrast, we show here that observables such as temperature distributions, column densities, and line ratios are sensitive to such considerations. We explain the reason for this difference. We develop a prescription for applying a simple 1D conductive-cooling front model which quantitatively reproduces 3D hydrodynamic simulation results for column densities and line ratios, even when the TML has a complex fractal structure. This enables subgrid absorption and emission line predictions in large scale simulations. The predicted line ratios are in good agreement with observations, while observed column densities require numerous mixing layers to be pierced along a line of sight.
Exceptional variation in the appearance of Common Murre eggs reveals their potential as identity signals
Authors: Birkhead Tim R , Thompson Jamie E , Cox Amelia R , Montgomerie Robert D
Published: August 2021

We studied the ground colors and maculations of 161 Common Murre (Uria aalge) eggs laid by 43 females in 3 small breeding groups on the cliffs of Skomer Island, Wales, in 2016–2018. Both the colors and maculations varied much more among than within females, providing quantitative evidence for the egg traits that might facilitate the parents’ ability to identify their own eggs on the crowded breeding ledges where the density is typically ~20 eggs m–2. Ground colors had a trimodal distribution of hue values (whitish to pale brown, pale blue, or vivid blue-green) and maculations ranged from none to complex squiggles and blotches. The eggs laid by each female in different years were similar to one another, and replacement eggs laid by females within years were also more similar to their first egg than to other eggs in the same breeding group. Egg appearance did not differ among the 3 breeding groups that we studied. Our findings thus support anecdotal observations that, within and between years, female Common Murres lay eggs that have similar ground colors and maculations. We do not, however, find evidence that there is much difference among the eggs laid in different parts of a colony.
Identifying trajectories of radiographic spinal disease in ankylosing spondylitis: a 15-year follow-up study of the PSOAS cohort
Authors: Hwang Mark C , Lee MinJae , Gensler Lianne S , Brown Matthew A , Tahanan Amirali , Rahbar Mohammad H , Hunter Theresa , Shan Mingyan , Ishimori Mariko L , Reveille John D , Weisman Michael H , Learch Thomas J
Published: August 2021

Objectives

Little is known with certainty about the natural history of spinal disease progression in ankylosing spondylitis (AS). Our objective was to discover if there were distinct patterns of change in vertebral involvement over time and to study associated clinical factors.

Methods

Data were analysed from the Prospective Study of Outcomes in Ankylosing Spondylitis (PSOAS) observational cohort. All patients met modified New York Criteria for AS and had ≥2 sets of radiographs scored by modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by two independent readers between 2002 and 2017. Group-based trajectory modelling (GBTM) was used to classify patients into distinct groups of longitudinal mSASSS considering sociodemographic and clinical covariables. The optimal trajectory model and number of trajectories was selected using Nagin’s Bayesian information criterion (BIC).

Results

A total of 561 patients with 1618 radiographs were analysed. The optimum number of trajectory groups identified was four (BIC −4062). These groups were subsequently categorized as: non-progressors (204 patients), late-progressors (147 patients), early-progressors (107 patients) and rapid-progressors (103 patients). Baseline predictors associated with higher spinal disease burden groups included: baseline mSASSS, male gender, longer disease duration, elevated CRP and smoking history. In addition, time-varying anti-TNF use per year was associated with decreased mSASSS progression only in the rapid-progressor group.

Conclusions

GBTM identified four distinct patterns of spinal disease progression in the PSOAS cohort. Male gender, longer disease duration, elevated CRP and smoking were associated with higher spinal disease groups. Independent confirmation in other AS cohorts is needed to confirm these radiographic patterns.
Retinal degeneration in mice lacking the cyclic nucleotide‐gated channel subunit CNGA1
Authors: Liu Yang , Wang Yafang , Xiao Yushu , Li Xiaomeng , Ruan Shang , Luo Xueting , Wan Xiaoling , Wang Fenghua , Sun Xiaodong
Published: August 2021

Cyclic nucleotide‐gated (CNG) channels are important mediators in the transduction pathways of rod and cone photoreceptors. Native CNG channels are heterotetramers composed of homologous A and B subunits. Biallelic mutations in CNGA1 or CNGB1 genes result in autosomal recessive retinitis pigmentosa (RP). To investigate the pathogenic mechanism of CNG channel‐associated retinal degeneration, we developed a mouse model of CNGA1 knock‐out using CRISPR/Cas9 technology. We observed progressive retinal thinning and a concomitant functional deficit in vivo as typical phenotypes for RP. Immunofluorescence and TUNEL staining showed progressive degeneration in rods and cones. Moreover, microglial activation and oxidative stress damage occurred in parallel. RNA‐sequencing analysis of the retinae suggested down‐regulated synaptic transmission and phototransduction as early as 9 days postnatal, possibly inducing later photoreceptor degeneration. In addition, the down‐regulated PI3K‐AKT‐mTOR pathway indicated upregulation of autophagic process, and chaperone‐mediated autophagy was further shown to coincide with the time course of photoreceptor death. Taken together, our studies add to a growing body of research exploring the mechanisms of photoreceptor death during RP progression and provide a novel CNGA1 knockout mouse model for potential development of therapies.
Nanoparticles in allergen immunotherapy
Authors: Longo Alessandra , Longo Valeria , Colombo Paolo
Published: August 2021

Purpose of review

Allergen immunotherapy is the only recognized causal treatment for allergic disease that modulates the immune system toward a tolerogenic or desensitized state. Allergens or their derivative preparations are formulated with adjuvants of different origin and having diverse immunological functions, such as prolonged tissue release and specific immunomodulatory properties. In the last 2 decades, thanks to developments in the field of nanotechnology, more biosafe nanoscale materials have become available for use as pharmaceutical adjuvants in medical research.

Recent findings

Nanomaterials possess unique and versatile properties which can be employed to develop drug carriers with safer profiles, better stability in physiological conditions and immunomodulatory properties. Nanoparticles can have an adjuvant effect per se or also when they are packed in structures whose physical–chemical properties can be handled in a way that also influences its release dynamics. In particular, it has been suggested that nanoparticle preparations can be put in complexes or loaded with allergens or allergenic extracts, opening the way to innovative paradigms.

In this review, we analyze allergen/nanoparticle properties in terms of cytotoxicity, stability and immunogenic reaction in in-vitro and animal systems.
Sedation/analgesia techniques for nonoperating room anesthesia: new drugs and devices
Authors: Finlay Janna E. , Leslie Kate
Published: August 2021

Purpose of review

The purpose of this article is to review new drugs and devices for nonoperating room anesthesia (NORA).

Recent findings

Remimazolam is an ultra-short-acting, water-soluble intravenous benzodiazepine with a fast onset and offset that has been approved recently for use in procedural sedation. Phase III trials have established the effectiveness of remimazolam sedation compared with placebo and midazolam in gastrointestinal endoscopy and bronchoscopy. More research is required investigating remimazolam in real-world NORA settings, including comparisons with propofol sedation. Oliceridine is a μ-agonist with selectivity for the G protein pathway and low potency for β-arrestin recruitment. As such it may be associated with less nausea, vomiting and respiratory depression than traditional opioids used. Although no studies have been published about oliceridine use in NORA to date, results from surgical studies indicate a potential place in nonoperating room practice. Research continues into alternative methods of drug delivery, such as patient-controlled sedation but no new devices are described.

Further studies are required before these new drugs and devices are embraced in NORA.
Secondary Traumatic Stress and Vigor Among Neonatal Intensive Care Unit Personnel
Authors: Nissanholtz Gannot Rachel , Hamama Raz Yaira , Stein Iris , Hochwald Ori
Published: August 2021

Background:

The demanding and highly stressful work environment of the neonatal intensive care unit (NICU) has led to the identification of a possible psychological stress reaction among NICU nurses and physicians, termed secondary traumatic stress (STS).

Purpose:

The current study aimed to explore the association between vigor at work (as an energy resource) and STS, while considering their association with the professional role (nurses/physicians—as a condition resource) as well as with coping flexibility (as a personal resource).

Methods:

In this cross-sectional study physicians and nurses working in NICUs across Israel completed a questionnaire comprising sections on demographics and professional characteristics, self-rated health, STS, coping flexibility, and vigor.

Results:

Of 280 physicians and nurses approached, 70% (195) completed the questionnaire. No significant differences between nurses and physicians were found in STS adjusted for gender, being in a committed relationship, and seniority in the NICU. Vigor was negatively correlated with STS—both in the entire sample and for each professional role alone. Coping flexibility was a statistically significant moderator between vigor and STS, whereas the interaction between vigor and professional role was not significant. Specifically, the negative relationship between vigor and STS was significant when coping flexibility was more than 10.10 (61% of the participants) but not significant at lower values.

Implications for Practice and Research:

The understanding of the relationship between vigor and STS, with coping flexibility as its moderator, encourages an intervention aimed at reducing stress by increasing these resources.
Biomarkers in systemic sclerosis: mechanistic insights into pathogenesis and treatment
Authors: Arron Joseph R.
Published: August 2021

Purpose of review

Systemic sclerosis (SSc) is heterogenous on molecular, cellular, tissue, and clinical levels. Although many biomarkers have been described in clinical studies, few have been rigorously mapped to specific molecular pathways, tissue pathologies, and clinical manifestations. A focused assessment of peripheral blood levels of C–C Motif Chemokine Ligand-18 (CCL18) and periostin illustrates how biomarkers can link molecular mediators to clinical outcomes.

Recent findings

CCL18 is produced by pulmonary macrophages in response to type 2 cytokines and IL6. Elevated serum CCL18 is associated with interstitial lung disease (ILD) in SSc patients and is prognostic for ILD progression. It is pharmacologically modulated by IL6 inhibition, and associated with stabilization of lung function decline but not with improvements in skin fibrosis. Periostin is produced by dermal fibroblasts in SSc in response to type 2 cytokines and transforming growth factor-beta. Elevated serum periostin is associated with cutaneous disease in SSc patients but not ILD. Other cell- and tissue-specific biomarkers detectable in peripheral blood and informative with respect to SSc pathogenesis include KL-6 and SP-D in lung epithelium, osteopontin in lung macrophages, and cartilage oligomeric matrix protein in dermal fibroblasts.

Blood biomarkers related to specific molecular mediators, cell types, and tissues of origin can help to link therapeutic targets to treatable traits in SSc.
Urinary Bladder Matrix Grafting: A Simple and Effective Alternative to Flap Coverage for Wounds in High-Risk Orthopaedic Trauma Patients
Authors: Parry Joshua A. , Shannon Steven F. , Strage Katya E. , Hadeed Michael M. , Heare Austin , Stacey Stephen , Hammerberg E. Mark , Mauffrey Cyril
Published: August 2021

Complex traumatic and/or infected wounds and their sequelae are a significant burden for high-volume trauma centers. Local or free flap coverage options are well described; however, they may be high risk in poor hosts with multiple comorbidities and active infections. In addition, flap coverage can result in delays in wound coverage depending on specialist availability. Porcine urinary bladder matrix grafting has been shown to be a simple definitive wound coverage option that can be performed without delay in multiple patient populations for wounds that would otherwise require flap coverage. The purpose of this article was to describe a technique for urinary bladder matrix grafting and report on a series of orthopaedic trauma patients treated with this technique.
Lymphoid-biased hematopoietic stem cells and myeloid-biased hematopoietic progenitor cells have radioprotection activity
Authors: Zhang Shanshan , O’Neill Aled , Xie Miner , Wu Peng , Wang Xiaofang , Bai Haitao , Dong Fang , Wang Jinhong , Zhang Qingyun , Suda Toshio , Ema Hideo
Published: August 2021

Radioprotection was previously considered as a function of hematopoietic stem cells (HSCs). However, recent studies have reported its activity in hematopoietic progenitor cells (HPCs). To address this issue, we compared the radioprotection activity in 2 subsets of HSCs (nHSC1 and 2 populations) and 4 subsets of HPCs (nHPC1–4 populations) of the mouse bone marrow, in relation to their in vitro and in vivo colony-forming activity. Significant radioprotection activity was detected in the nHSC2 population enriched in lymphoid-biased HSCs. Moderate radioprotection activity was detected in nHPC1 and 2 populations enriched in myeloid-biased HPCs. Low radioprotection activity was detected in the nHSC1 enriched in myeloid-biased HSCs. No radioprotection activity was detected in the nHPC3 and 4 populations that included MPP4 (LMPP). Single-cell colony assay combined with flow cytometry analysis showed that the nHSC1, nHSC2, nHPC1, and nHPC2 populations had the neutrophils/macrophages/erythroblasts/megakaryocytes (nmEMk) differentiation potential whereas the nHPC3 and 4 populations had only the nm differentiation potential. Varying day 12 spleen colony-forming units (day 12 CFU-S) were detected in the nHSC1, nHSC2, and nHPC1–3 populations, but very few in the nHPC4 population. These data suggested that nmEMk differentiation potential and day 12 CFU-S activity are partially associated with radioprotection activity. Reconstitution analysis showed that sufficient myeloid reconstitution around 12 to 14 days after transplantation was critical for radioprotection. This study implied that radioprotection is specific to neither HSC nor HPC populations, and that lymphoid-biased HSCs and myeloid-biased HPCs as populations play a major role in radioprotection.
Percutaneous Arthroscopic Assisted Fixation of a Tibial Plafond Impaction Fracture Fixation: Surgical Technique and Case Report
Authors: Newman Michael , Goriainov Vitali , Marsland Daniel
Published: August 2021

Tibial plafond fractures are high energy injuries caused by axial loading. Despite evolving equipment and surgical techniques, the prognosis remains relatively poor for individuals who sustain this type of injury, with reduced functional outcomes and early posttraumatic osteoarthritis. We present a case of a tibial plafond fracture treated percutaneously with arthroscopic assisted reduction, bone grafting and fixation, without the requirement for an external fixator, and with a successful outcome at 1-year follow up.

Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
Open questions and controversies in the systemic treatment of breast cancer
Authors: Barrios Carlos Henrique , Reinert Tomás
Published: August 2021

Purpose of review

Personalized therapy has revolutionized our approach to breast cancer (BC). Patient selection strategies and new biomarkers are the basis for increasingly complex diagnostic and therapeutic algorithms. In this short review, we discuss recent developments in breast oncology, focusing on controversial topics with relevance for clinical practice.

Recent findings

The use of gene expression signatures to guide adjuvant therapy in hormone receptor-positive tumors and personalized strategies for systemic treatment of early stage HER2-positive disease represent significant advances. Additionally, the current role of platinum salts, immune checkpoint inhibitors, and CDK4/6 inhibitors in the (neo)adjuvant treatment remains controversial, with several ongoing randomized clinical trials exploring their use. In the metastatic disease setting, we identify important unmet needs such as the development of predictive biomarkers and the definition of the ideal sequencing algorithm with the incorporation of innovative agents in all subtypes of BC.

Advances in understanding the molecular biology and heterogeneity of BC have led to the development of new biomarkers and therapeutic agents that significantly impact current and future clinical practice.
Postoperative Outcomes of Local Skin Flaps Used in Oncologic Reconstructive Surgery of the Nasal Ala: A Systematic Review
Authors: Nicholas Mathew N. , Liu Annie , Jia Jocelyn , Chan Airiss R. , Eisen Daniel B.
Published: August 2021

BACKGROUND

Despite numerous options for nasal ala reconstruction, advantages and disadvantages of each method are unclear.

OBJECTIVE

To summarize reported outcomes of local flaps without the use of grafts for nasal ala oncologic reconstructive surgery.

METHODS

A nasal ala-specific protocol was adapted from a previous head- and neck-specific PROSPERO submission (CRD42017071596). The search was conducted in MEDLINE, EMBASE, and CENTRAL on December 23, 2017 and updated on May 10, 2019. Two reviewers screened 9,313 results from head and neck literature. Study bias was evaluated with the ROBINS-I tool.

RESULTS

Subunit-based categorization of included studies identified 12 nasal ala-specific publications. Complications (flap necrosis, hematoma, wound infections, trapdoor deformities, and dehiscence), functional (nasal valve or respiratory dysfunction), and cosmetic (alar rim distortion/asymmetry/notching, secondary/revisionary procedures, and patient satisfaction) outcomes were extracted.

CONCLUSION

Generally favorable outcomes are seen in all flaps. Careful consideration of donor sites for interpolation flaps is needed for optimal cosmetic outcomes. Transposition flaps, including laterally based bilobed and trilobed flaps, created good outcomes, although melolabial transposition flaps may produce poorer outcomes compared with melolabial island pedicle advancement flaps. Caution is needed for rotation flaps to prevent nasal valve/respiratory dysfunction due to alar crease contracture or ridge elevation. Further research is needed.
Survey of Dermatologic Procedures in Transgender Adults
Authors: Ragmanauskaite Laura , Zhang Qi , Kim Jin , Getahun Darios , Silverberg Michael J. , Goodman Michael , Yeung Howa
Published: August 2021

BACKGROUND

Dermatologists have the opportunity to provide medically necessary procedures, including laser hair removal, to transgender patients for gender affirmation. Further research is required to better assess the unique dermatologic needs of this population.

OBJECTIVE

To examine the prevalence of dermatologic procedures among transgender people in the context of gender-affirming treatment.

METHODS

This cross-sectional study examined survey responses from 696 transgender persons enrolled in the Study of Transition, Outcomes, and Gender cohort. Prevalence of self-reported dermatologic procedures was examined and compared across participant subgroups.

RESULTS

Electrolysis was the most commonly reported procedure (32.9%). Transfeminine patients were more likely to use dermatologic procedures compared with transmasculine patients. Only 19 participants (2.8%) reported the use of dermal filler injections.

CONCLUSION

Differences in utilization of dermatologic procedures were noted in transgender populations. Motivations, barriers, and optimal timing for gender-affirming dermatologic procedures among transgender persons should be examined in future studies.
Litigation Arising From Minimally Invasive Cosmetic Procedures: A Review of the Literature
Authors: Hibler Brian P. , Eliades Philip J. , Kagha Karen C. , Avram Mathew M.
Published: August 2021

BACKGROUND

Minimally invasive cosmetic procedures are on the rise. To meet this rising demand, increasing numbers of physicians and nonphysicians are performing these procedures. Understanding malpractice trends and reasons for litigation in cosmetic medicine is important to establish safeguards for patient care and minimize liability.

OBJECTIVE

Perform a comprehensive review of the literature on litigation associated with minimally invasive cosmetic procedures and discuss strategies to avoid facing a lawsuit.

MATERIALS AND METHODS

The authors searched PubMed databases using a variety of keywords to identify studies of lawsuits arising from minimally invasive cosmetic procedures through December 2020.

RESULTS

A total of 12 studies of litigation meeting inclusion criteria were identified: botulinum toxin (1), soft tissue fillers (3), lasers (5), body contouring/liposuction (1), chemical peels/dermabrasion (1), and sclerotherapy (1). Principle factors associated with litigation included negligence, lack of informed consent, vicarious liability for action of delegates, lack of communication, poor cosmetic result, failure to inform of risks, inappropriate treatment or dose, and failure to recognize or treat injury.

CONCLUSION

Understanding malpractice trends and reasons for litigation in minimally invasive cosmetic procedures can strengthen the patient–provider relationship, establish safeguards for patient care, and may minimize future risk of a lawsuit.
Progressive Improvement in Static Glabellar Lines After Repeated Treatment With DaxibotulinumtoxinA for Injection
Authors: Glogau Richard , Kontis Theda C. , Liu Yan , Gallagher Conor J.
Published: August 2021

BACKGROUND

DaxibotulinumtoxinA for Injection (DAXI) is a novel botulinum toxin in development that has demonstrated efficacy on dynamic glabellar lines.

OBJECTIVE

To evaluate the effect of repeated DAXI treatment on static glabellar lines.

METHODS

This post hoc analysis included adults with moderate or severe dynamic glabellar lines who were treated with 40U DAXI in the SAKURA clinical program. Glabellar line severity was evaluated through validated subject and investigator scales.

RESULTS

Overall, 568 subjects received 3 DAXI treatments. Most subjects were White (92.3%) and female (85.7%). At baseline, 9.0% and 27.3% of subjects had no static glabellar lines based on subject and investigator assessment, respectively. Four weeks after DAXI Treatment Cycle 1, the proportion of subjects with no static glabellar lines increased to 57.9% and 64.8% based on subject and investigator assessment, respectively. At Week 4 after DAXI Treatment Cycles 2 and 3, the proportion further increased to 68.7% and 71.5%, respectively, based on subject assessment and 75.0% and 77.6% based on investigator assessment.

CONCLUSION

Subjects who received repeated DAXI treatment showed progressive improvement in their static glabellar lines. The extended duration of therapeutic benefit with DAXI on dynamic glabellar lines likely provides a long period of muscle inactivity/hypoactivity, during which dermal remodeling can occur.
Assessment of antidepressant-like effects of dextromethorphan on differential reinforcement of low-rate 72-s performance in rats
Authors: Lynch Cayla J. , Prus Adam Joseph
Published: August 2021

The effectiveness of ketamine for treatment-resistant depression along with several other clinical advantages, such as rapid onset and reduced adverse effects associated with serotonin transporter inhibition, has garnered interest in other similar acting psychedelics as novel antidepressant drugs. The antitussive dextromethorphan exhibits glutamate N-methyl-d-aspartate receptor antagonism, sigma-1 receptor agonism, and serotonin reuptake inhibition, which has exhibited antidepressant effects in limited human studies and animal models. The present study sought to further examine dextromethorphan using a differential reinforcement of low-rate 72-s schedule, which can be used to screen antidepressant drugs, in male and female rats. The tricyclic antidepressant drug imipramine and the psychostimulant d-amphetamine also were examined. Sex differences were not shown for baseline performance or for the drugs tested. Further, performance did not differ between the estrus and diestrus stages. Dextromethorphan alone and with quinidine produced an antidepressant-like effect by reducing the number of responses emitted, increasing the number of reinforcers earned, and shifting inter-response times to the right, although significant response suppression occurred at these doses. An antidepressant-like effect was shown with imipramine, but d-amphetamine increased the number of responses emitted and did not affect the number of reinforcers earned. The present findings provide additional support for antidepressant effects produced by dextromethorphan.
Measuring sodium intake: research and clinical applications
Authors: Judge Conor , Narula Sukrit , Mente Andrew , Smyth Andrew , Yusuf Salim , O’Donnell Martin J.
Published: August 2021

Although most current guidelines recommend a daily sodium intake of less than 2.3 g/day, most people do not have a reliable estimate of their usual sodium intake. In this review, we describe the different methods used to estimate sodium intake and discuss each method in the context of specific clinical or research questions. We suggest the following classification for sodium measurement methods: preingestion measurement (controlled intake), peri-ingestion measurement (concurrent), and postingestion measurement. On the basis of the characteristics of the available tools, we suggest that: validated 24-h recall methods are a reasonable approach to estimate sodium intake in large epidemiologic studies and individual clinical counselling sessions, methods (such as single 24-h urine collection, single-time urine collection, or 24-h recall methods), are of value in population-level estimation of mean sodium intake, but are less suited for individual level estimation and a feeding-trial design using a controlled diet is the most valid and reliable method for establishing the effect of reducing sodium to a specific intake target in early phase clinical trials. By considering the various approaches to sodium measurement, investigators and public health practitioners may be better informed in assessing the health implications of sodium consumption at the individual and population level.
Accuracy of astigmatism correction with toric intraocular lens implantation in eyes with previous radial keratotomy
Authors: Canedo Ana Laura Caiado , Wang Li , Koch Douglas D. , Al-Mohtaseb Zaina
Published: August 2021

Purpose:

To evaluate refractive outcomes of toric intraocular lens (IOL) implantation in eyes with previous radial keratotomy (RK).

Setting:

Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

Design:

Retrospective case series.

Methods:

Consecutive cases with previous RK and had undergone cataract surgery with toric IOL implantation and met the following criteria were retrospectively reviewed: (1) regular bowtie corneal astigmatism within the central 3.0 mm zone, (2) difference in corneal regular astigmatism magnitude between the IOLMaster and Lenstar of ≤ 0.75 diopters (D), (3) difference in the regular astigmatism meridians from the 2 biometers of ≤15 degrees, and (4) available postoperative manifest refraction at ≥ 8 weeks with corrected distance visual acuity of 20/30 or better. Vector analysis was used to assess the preoperative corneal and postoperative refractive astigmatism.

Results:

In 40 eyes of 31 patients with previous RK, preoperatively, the mean magnitude of corneal regular astigmatism was 2.10 ± 0.98 D; 1 (3%) and 2 (10%) eyes had anterior corneal regular astigmatism ≤0.5 D and ≤1.0 D, respectively; and the centroid value was 1.14 D @ 179 degrees ± 2.05 D. Postoperatively, the mean magnitude of refractive regular astigmatism was 0.46 ± 0.44 D; 29 (73%) and 35 (88%) of eyes had refractive regular astigmatism ≤0.5 D and ≤1.0 D, respectively (P < .05); and the centroid value was 0.12 D @ 173 degrees ± 0.63 D (P < .05).

Conclusions:

Toric IOLs can be used successfully to treat corneal regular astigmatism in eyes with previous RK.
Visual and patient-reported factors leading to satisfaction after implantation of diffractive extended depth-of-focus and trifocal intraocular lenses
Authors: Lwowski Christoph , Pawlowicz Katarzyna , Petermann Kerstin , Hemkeppler Eva , Hinzelmann Lisa , Böhm Myriam , Kohnen Thomas
Published: August 2021

Purpose:

To evaluate factors that influence postoperative satisfaction in patients with diffractive extended depth-of-focus (EDoF) and multifocal intraocular lenses (mIOLs).

Setting:

Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.

Design:

Observational case study.

Methods:

Patients were evaluated after implantation of a diffractive EDoF (Symfony, AT LARA) or trifocal/quadrifocal (AT LISAtri, Panoptix) 3 months postoperatively. A subjective refraction was performed, uncorrected and corrected visual acuities were tested for distance (UDVA, CDVA), intermediate (at 60 cm and 80 cm, UIVA, DCIVA), and near (at 40 cm, UNVA, DCNVA). A test for contrast sensitivity was performed, and the patients filled 2 different questionnaires on daily activities and optical phenomena. Parameters with a potential correlation to the postoperative overall satisfaction were investigated.

Results:

94 patients with a mean age of 66 ± 19 years were included. Patients with a better UDVA and UIVA at 60 cm were more likely to choose the same IOL again. The intensity of subjective optical phenomena and the visual quality at different tasks of daily living influenced overall satisfaction. UIVA at 80 cm, UNVA, and corrected visual acuity demonstrated no significant influence on patient satisfaction. The uncorrected visual acuity at specific distances had a direct impact on the subjective visual quality regarding the task performed at those distances.

Conclusions:

For patients with diffractive EDoF and tri-/quadrifocal IOLs, the UDVA and UIVA at 60 cm seem to be more important than the UNVA and UIVA at 80 cm. Subjective visual quality and optical phenomena influence patient satisfaction, as well.
Refractive prediction error in cataract surgery using an optical biometer equipped with anterior segment OCT
Authors: Kato Yukihito , Kojima Takashi , Tamaoki Akeno , Ichikawa Kei , Tamura Kensei , Ichikawa Kazuo
Published: August 2021

Purpose:

To evaluate refractive error after cataract surgery using an optical biometer equipped with anterior segment optical coherence tomography (AS-OCT).

Setting:

Chukyo Eye Clinic, Nagoya, Japan.

Design:

Retrospective observational design.

Methods:

In total, 150 patients with cataract (150 eyes, mean age 73.4 ± 8.2 years, men 76, women 74), who underwent measurement of parameters with the AS-OCT scanners ANTERION (AS-OCTB) and IOLMaster 700 (OCTB) before cataract surgery, were enrolled in the study. Refractive prediction error was compared between the 2 devices using the SRK/T, Haigis, and Barrett Universal II (UII) formulas for intraocular lens (IOL) power calculation.

Results:

There were significant differences between AS-OCTB and OCTB in axial length, mean corneal refractive power, anterior chamber depth, lens thickness, and corneal diameter (n = 150). In the SRK/T formula, the arithmetic means of refractive prediction errors for AS-OCTB and OCTB were −0.06 ± 0.46 diopters (D) and 0.02 ± 0.42 D, respectively. In the Haigis formula, the arithmetic means of refractive prediction errors for AS-OCTB and OCTB were −0.23 ± 0.40 D and −0.08 ± 0.35 D, respectively. In the Barrett UII formula, the arithmetic means of refractive prediction errors for AS-OCTB and OCTB were −0.02 ± 0.38 D and 0.11 ± 0.36 D, respectively. AS-OCTB showed significantly larger refractive prediction error toward myopia than OCTB in all 3 formulas (P < .0001).

Conclusions:

The refractive prediction error using AS-OCTB showed a small difference from that using OCTB. While clinically comparable, the 2 methods could drive meaningful differences in IOL selection.
Late-onset toxic anterior segment syndrome after possible aluminum-contaminated and silicon-contaminated intraocular lens implantation
Authors: Wijnants Dries , Delbeke Heleen , Van Calster Joachim , Beerlandt Nancy , Nijs Ivo , Werner Liliana , Mamalis Nick , Saelens Isabelle
Published: August 2021

Purpose:

To describe an outbreak of late-onset toxic anterior segment syndrome (TASS) after the implantation of a specific hydrophilic acrylic intraocular lens (IOL).

Setting:

University Hospitals of Leuven, Belgium.

Design:

Retrospective, single-center, observational study.

Methods:

All eyes undergoing cataract surgery with a monofocal, toric, or enhanced depth-of-focus (EDoF) Synthesis (Cutting Edge) IOL between August 2019 and March 2020 were reviewed. Data were collected on the surgical procedure, postoperative course, time until onset of symptoms, clinical features, and additional treatments. A laboratory surface analysis of all 3 IOL subtypes was performed in the Intermountain Ocular Research Center at the University of Utah, USA. Furthermore, other possible causes of prolonged postoperative inflammation rather than the IOL itself were investigated.

Results:

Among the 203 eyes included, 28 TASS cases were identified (13.8%), among which 25 received a monofocal IOL, and 3 received an EDoF IOL. The mean time until onset was 28.9 (±19.9) days. Patients presented with anterior chamber cells (92.9%), deposits on the IOL (57.1%), or fibrinous inflammation (35.7%). 4 eyes (14.3%) underwent a surgical intervention, whereas 24 eyes showed a resolution of inflammation with topical therapy alone. Laboratory analysis showed the presence of both aluminum and silicon particles on the monofocal IOL, silicon particles only on the EDoF IOL, and no particles on the toric IOL surface.

Conclusions:

This report describes an outbreak of atypical, late-onset TASS after cataract surgery, possibly correlated with aluminum and silicon contamination of the IOL surfaces.
Economic evaluation of prevention of cystoid macular edema after cataract surgery in diabetic patients: ESCRS PREMED study report 6
Authors: Simons Rob W.P. , Wielders Laura H.P. , Nuijts Rudy M.M.A. , Veldhuizen Claudette A. , van den Biggelaar Frank J.H.M. , Winkens Bjorn , Schouten Jan S.A.G. , Dirksen Carmen D. ,   on behalf of the ESCRS PREMED Study Group
Published: August 2021

Purpose:

To investigate the cost-effectiveness of prophylactic treatments against cystoid macular edema after cataract surgery in diabetic patients.

Setting:

7 ophthalmology clinics in the Netherlands and Belgium.

Design:

Prospective trial-based cost-effectiveness analysis using data from a European multicenter randomized clinical trial.

Methods:

Diabetic patients (n = 163) undergoing uneventful cataract surgery were randomized to perioperative subconjunctival triamcinolone acetonide (n = 36), perioperative intravitreal bevacizumab (n = 36), combination treatment (n = 45), or no additional treatment (control group, n = 46). The cost analysis was performed from a healthcare perspective within a 12-week postoperative time horizon. The main effectiveness outcome was quality-adjusted life years (QALYs). The main cost-effectiveness outcome was the incremental cost-effectiveness ratio (ICER; cost per QALY).

Results:

The mean total healthcare costs and QALYs were as follows: triamcinolone group €1827 (U.S. dollars [$] 2295)/0.166; bevacizumab group €2050 ($2575)/0.144; combination group €2027 ($2546)/0.166; and control group €2041 ($2564)/0.156. Bevacizumab and control treatment were most costly and least effective. The ICER was €321 984 ($404 503) per QALY for the combination group compared with that of the triamcinolone group. Assuming the willingness-to-pay as €20 000 ($25 126) per QALY, the cost-effectiveness probability was 70% and 23% in the triamcinolone and combination groups, respectively. No patient who received triamcinolone developed clinically significant macular edema (CSME). A secondary cost-effectiveness analysis based on this outcome showed a clear preference for triamcinolone.

Conclusions:

In diabetic patients, subconjunctival triamcinolone was effective in preventing CSME after cataract surgery. The cost-effectiveness analysis showed that triamcinolone is also cost-effective.
Characterizing astigmatism in the United States
Authors: Valluru Girish , Klawe Janek , Liu Bian , Ramulu Pradeep , Ahmad Sumayya
Published: August 2021

Purpose:

To study astigmatism and astigmatism rule by (1) determining changes in prevalence in the United States between 1971 to 1975 and 1999 to 2008 and (2) identifying associations with demographic factors.

Setting:

National survey.

Design:

Retrospective cross-sectional study.

Methods:

Participants of the 1971 to 1975 and 1999 to 2008 National Health and Nutrition Examination Survey (NHANES) aged 20 to 74 years representing the U.S population were included. The 1971 to 1975 NHANES measured astigmatism in participants using an algorithm based on presenting visual acuity, lensometry, and objective refraction. Similar methods were implemented using the 1999 to 2008 NHANES data for comparison. Prevalence of clinically significant astigmatism (≥1.0 diopters [D]) was identified, and logistic regression models were used to assess demographic associations with rule of astigmatism.

Results:

A total of 3371 and 13 10 participants were included from the 1970s and 2000s NHANES. Main outcomes were prevalence estimates of astigmatism and odds ratios estimating associations with demographic characteristics. There was an increase in astigmatism from the 1970s to 2000s (14% [95% CI: 13.2-14.5] vs 24% [22.8-24.6], which was more pronounced in men (12% [10.8-12.7] vs 23% [21.9-24.2]) than in women (16% [14.9-16.8] vs 24% [23.0-25.7]). In adjusted analysis of the 2000s cohort, myopic patients had 8.34 (CI: 7.30-9.54) times greater odds of astigmatism than nonmyopic patients. In the 2000s, there was increased odds of against-the-rule (ATR) astigmatism in men (odds ratio [OR], 1.4; 95% CI: 1.1-1.8) compared with women, in nonmyopic patients (OR, 2.3; 95% CI: 1.7-3.1) compared with myopic patients, and in patients aged 60 to 74 years (OR, 3.7; 95% CI: 2.7-5.1) compared with those aged 20 to 39 years.

Conclusions:

There is greater prevalence of astigmatism and ATR astigmatism in 1999 to 2008 compared with 30 years before in the U.S. Factors associated with ATR astigmatism were being male, White, and nonmyopic.
Intraocular bag-in-the-lens exchange: indications, outcomes, and complications
Authors: Dragnea Diana Carmen , Truţa Roxana Nadine , Goemaere Jordy , Tassignon Marie-José , Dhubhghaill Sorcha Ní
Published: August 2021

Purpose:

To report the indications, outcomes, and complications regarding bag-in-the-lens (BIL) intraocular lens (IOL) exchange over a period of 13 years in a tertiary ophthalmologic center.

Setting:

Department of Ophthalmology of the University Hospital of Antwerp, Belgium.

Design:

Observational retrospective study.

Methods:

Between 2003 and 2020, 12 176 patients were operated using the BIL technique. Adult patients who underwent an intraocular BIL exchange were included, and the demographics, indications, outcomes, and complications were recorded.

Results:

59 eyes (0.48%) of 59 patients who underwent a BIL exchange between 2007 and 2020 were included. The mean age was 61.15 ± 13.53 years. The mean time between primary surgery and IOL exchange was 25.73 ± 41.88 months. The main indication for explantation was refractive surprise mostly related to patient risk factors, for example, preoperative corneal and refractive surgery. The mean preoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuity were 0.36 ± 0.24 and 0.79 ± 0.24, respectively. The postoperative 1-month UDVA and CDVA were 0.66 ± 0.28 and 0.86 ± 0.19, respectively. The improvement in UDVA was statistically significant (<0.0001). The most common intraoperative complication was damage to the anterior hyaloid in 9 eyes (15%), which did not prohibit reimplantation of a secondary BIL.

Conclusions:

BIL to BIL exchange was a viable and successful technique that provides good refractive results with few, manageable complications. Because of the tertiary profile of the study center with referral of complex cases, BIL was the preferred IOL in patients at risk for postoperative refractive surprise.
The Relationship Between Psychological Resilience and Stress Perception in Nurses in Turkey During the COVID-19 Pandemic
Authors: KARABULAK Hatice , KAYA Fadime
Published: August 2021

Background

In Turkey, nurses are responsible for the treatment and care of patients with coronavirus disease (COVID-19) and for tracing their contacts. Healthcare professionals exposed to COVID-19 face high levels of stress.

Purpose

This study was designed to determine the influence of psychological resilience and several sociodemographic and professional characteristics on stress perception in nurses during the COVID-19 pandemic.

Methods

A cross-sectional design was used in this study, which was conducted between June 16 and 29, 2020. Two hundred one nurses living in Turkey were enrolled as participants. Data were collected using an information form, the Perceived Stress Scale, and the Brief Psychological Strength Scale. This study aligns with the Strengthening the Reporting of Observational Studies in Epidemiology Checklist.

Results

According to the results of the multivariate linear regression analysis, the psychological resilience score of the participants accounted for 25.2% of the variance related to stress perception (p < .05). However, several of the demographic and professional characteristics considered in this study were not found to statistically significantly influence stress perception (p > .05).

Conclusions/Implications for Practice

The findings support that psychological resilience is significant in explaining perception of stress in nurses in Turkey. Interventions targeting psychological resilience are needed to reduce nurses' stress perceptions.