bluuebunny/crossref_metadata_2025_split huggingface dataset:
Controlling a Digital Cursor With a Sterile Gyroscopic Mouse in Digitally Assisted Vitreoretinal Surgery
Authors: Bausili Montserrat M. , Gilhotra Jagjit S. , Durkin Shane R. , Chan Weng Onn 
Published: April 2020

Purpose:
To describe our experience using the gyroscopic mouse in digitally assisted vitreoretinal surgery.

Methods:
We used a commercially available gyroscopic mouse to control the on-screen cursor of the NGENUITY System for digitally assisted vitreoretinal surgery. The gyroscopic mouse is sealed in a clear sterile plastic bag to allow for intraoperative use. This allowed both the surgeon and assistant to be fully scrubbed while retaining full control of the NGENUITY system's functions. The mouse also allowed the mentor to provide detailed instructions through the on-screen cursor by highlighting important landmarks.

Conclusion:
Using a sterile gyroscopic mouse improved the teaching utility and surgical workflow of digitally assisted vitreoretinal surgery.
Bilateral XEN Stent Implantation: A Long-term Prospective Study of the Difference in Outcomes Between First-operated and Fellow Eyes
Authors: Gillmann Kevin , Bravetti Giorgio E. , Rao Harsha L. , Mermoud André , Mansouri Kaweh 
Published: April 2020

Background/Aims:
Both eyes of a same person are not completely independent entities. The purpose of this study was to assess the difference in outcome between the first-operated eye and the fellow-operated eye following bilateral XEN surgery, and to identify potential success predictors for the fellow eye.

Methods:
This single-site, prospective, nonrandomized interventional study investigated bilateral nonsimultaneous XEN gel stent implantation over 24 months. Its main outcome measure was surgical success, defined as unmedicated intraocular pressure (IOP) ≤15 mm Hg associated with a relative reduction ≥20%.

Results:
Of 149 enrolled eyes, 74 eyes of 37 patients who underwent bilateral (standalone or combined) XEN implantation, within a mean of 50.5±74.3 days of each other, were analyzed. Postoperatively, mean medicated IOP decreased from 19.0±6.6 (first-operated) and 18.2±5.2 mm Hg (fellow) at baseline (P=0.209) to 13.7±4.0 (−27.9%; P<0.001; first-operated) and 14.1±3.6 mm Hg (−22.5%; P<0.001; fellow) after 2 years (P=0.673). Rates of complete success were comparable between first-operated and fellow eyes (P=0.65). At 2 years, among patients whose first-operated eyes were considered a failure, 92.0% of fellow eyes failed (P=0.001). The odd ratio of a fellow eye experiencing complete success were 16.1 (95% confidence interval: 2.5-101.9, P=0.003) if the first operated eye experienced complete success.

Conclusions:
The present study demonstrated a strong association between first-operated eyes and fellow eyes following XEN gel stent implantation, in terms of surgical outcomes and IOP reduction. In effect, surgical success in the first-operated eye increases the odds of success in the fellow eye by 16-folds.
Pachymeter Use and Disinfection Practice in the United Kingdom: A National Survey
Authors: Jasani Kirti M. , Barua Ankur , Putri Christine , Mercieca Karl , Sattar Nayeem , Sanghrajka Anmol , Bhan-Bhargava Archana 
Published: April 2020

Objective:
Pachymetry plays a crucial role in the diagnosis and management of glaucoma and corneal diseases. There have been several outbreaks of epidemic ocular infections in ophthalmology clinics worldwide with reports of viral, parasitic, and prion disease. Contact pachymetry is a possible vehicle of transmission due to its risk of contamination. We aim to identify the types of pachymetry used and methods employed for cleaning and disinfection in eye units throughout the United Kingdom.

Methods:
A telephone survey was carried out, and a senior nurse or sister questioned based on the proforma created. A follow-up email was sent to units that did not respond with the questionnaire attached.

Results:
Of 109 responses, 10 eye units were unaware of the device name and 4 were unaware of the cleaning method used. Overall, 69/105 (66%) were cleaned with some form of alcohol wipe between patients, 12/105 (11%) used presept solution to soak the pachymetry head mainly 5 to 10 minutes, with 2 units soaking for 20 to 30 minutes. Milton solution was used by 4 units (4%) (10 s to 10 min). Three used a hydrogen peroxide solution for 10 minutes (3%). Three (3%) used an alcohol solution. Fifteen (14%) units used some chlorine-based solution (actichlor/chloraprep) for 5 to 10 minutes. Two (2%) units combined an alcohol-based wipe with solution to soak afterward.

Conclusions:
There is a large variation in methods and duration of tip disinfection with only a few units following the Royal College of Ophthalmologists (RCOphth) guidelines on pachymeter disinfection. The majority of eye units use alcohol/chlorine-based wipes for cleaning the pachymetry heads which is against the current recommended guidelines. The average immersion time when solutions were used was 5 to 10 minutes.
Propionibacterium acnes Endophthalmitis Following Baerveldt Glaucoma Device Implantation
Authors: Ely Amanda L. , Neely Kimberly 
Published: April 2020

Purpose:
The purpose of this study was to report a case of Propionibacterium acnes endophthalmitis in a patient with a Baerveldt glaucoma implant.

Patients and Methods:
An 8-year-old boy presented with left eye pain, extreme photophobia, and acute anterior uveitis >6 months after Baerveldt glaucoma implantation. A diagnosis of P. acnes endophthalmitis was made after a positive culture of the explanted Baerveldt device.

Results:
Initially, the patient was treated with intravitreal vancomycin and ceftazidime which led to mild early clinical improvement followed by deterioration of findings with recurrence of fibrin at the Baerveldt tube ostium within the anterior chamber. Repeat intravitreal injections were given to include antifungal coverage, along with intracameral moxifloxacin and subconjunctival vancomycin around the Baerveldt reservoir. Symptoms and findings again recurred, ultimately leading to the decision for complete removal of the glaucoma implant along with irrigation of the scleral bed with moxifloxacin. P. acnes was cultured from the extracted implant. The endophthalmitis resolved completely after implant removal.

Conclusions:
Despite the introduction of antibiotics into the intravitreal, intracameral, and subconjunctival space surrounding the Baerveldt implant, infection persisted until complete explantation of the device. Early explantation should be considered in glaucoma drainage device endophthamitis secondary to P. acnes.
Respiratory Syncytial Virus-related Death in Children With Down Syndrome
Authors: Löwensteyn Yvette N. , Phijffer Emily W. E. M. , Simons Juliette V. L. , Scheltema Nienke M. , Mazur Natalie I. , Nair Harish , Bont Louis J. ,   on behalf of the RSV GOLD Study Group
Published: April 2020

Background:
Respiratory syncytial virus (RSV) is a major cause of mortality in children younger than 5 years worldwide. Systematic reviews have shown that Down syndrome (DS) is an independent risk factor for severe RSV infection. We aimed to describe demographic and clinical characteristics of children with DS who died with RSV infection.

Methods:
We performed a retrospective case series in which data were shared by individual researchers, research networks and physicians worldwide as part of the RSV Global Online Database study. We included children with DS who died when younger than 5 years of age with laboratory-confirmed RSV infection.

Results:
We included 53 children with DS and RSV-related mortality from 20 countries in 5 continents. Five (9.4%) children were from low-income or lower-middle-income countries. Median age at time of death was 6.0 months [interquartile range (IQR): 3.00–12.0]. Thirteen (24.5%) children were born term and had no other risk factors for severe RSV disease. In total, 36 (67.9%) children had congenital heart disease, 8 (15.1%) had chronic lung disease and 1 (1.9%) had congenital immunodeficiency. Duration of hospitalization was significantly longer for children with DS compared with children without DS [median length of stay, 13 days (IQR: 6.8–21.0) vs. 8 days (IQR: 3.0–18.5), P=0.005].

Conclusions:
One-fourth of children with DS and RSV-confirmed death did not have risk factors for severe RSV disease, indicating that DS is an important risk factor for RSV-related mortality. Age distribution at time of death demonstrates that maternal vaccination would not be sufficient to protect children with DS against RSV-related mortality.
Cost-effectiveness of Oral Regimens for Adolescents With Chronic Hepatitis C Virus Infection
Authors: Zhou Hua , Lu Yanming , Wu Bin , Che Datian 
Published: April 2020

Background:
Novel oral regimes have been approved for treating hepatitis C virus (HCV) infection in adolescents due to their superior effectiveness and safety. However, its economic outcome is still unclear in this population. The current analysis investigates the cost-effectiveness of novel oral regimens compared with that of pegylated interferon α with ribavirin (PR) therapies in adolescents in the context of the United States and China.

Methods:
A Markov model was developed to measure the economic and health outcomes of ledipasvir/sofosbuvir (LS) for genotypes 1 and 4, sofosbuvir/ribavirin (SR) for genotype 2, and ledipasvir/sofosbuvir/ribavirin (LSR) for genotype 3 HCV infection compared with the outcomes of PR treatment. Clinical costs and utility inputs were gathered from published sources. Lifetime discounted quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs) were measured. The uncertainty was facilitated by 1-way and probabilistic sensitivity analyses.

Results:
In the United States, the ICERs of LS strategy were $14,699 and $14,946/QALY for genotypes 1 and 4 HCV infection, respectively; the ICER of SR strategy for genotype 2 was $42,472/QALY; and the ICER of LSR for genotype 3 was $49,409/QALY in comparison with the PR strategy. In Chinese adolescents, LS for genotypes 1 and 4, SR for genotype 2, and LSR for genotype 3 were the dominant alternatives to the PR strategy. The results were robust to sensitivity analyses.

Conclusions:
Novel oral regimes for adolescents with HCV infection are likely to be cost-effective in the context of the United States and China.
Corneal Neurotization for Postherpetic Neurotrophic Keratopathy: Initial Experience and Clinical Outcomes
Authors: Kim Jane S. , Rafailov Leon , Leyngold Ilya M. 
Published: April 2020

Purpose:
To assess early outcomes of corneal neurotization for postherpetic neurotrophic keratopathy (NK).

Methods:
Retrospective analysis of patients who underwent corneal neurotization for postherpetic NK by a single experienced oculoplastic surgeon was performed. Collected data included stage and etiology of NK as well as comorbidities, prior treatment history, neurotization technique, donor nerve site, preoperative and postoperative examination findings (i.e., ocular surface quality, corneal clarity, corneal sensation by Cochet-Bonnet esthesiometry, and visual acuity [VA]), and follow-up duration. Differences between preoperative and postoperative values were analyzed by Wilcoxon signed-rank test.

Results:
Of 23 adult patients who underwent corneal neurotization, 3 (13%) had history of herpes simplex keratitis and/or endotheliitis, and 4 (17%) had history of herpes zoster ophthalmicus. One patient with herpes zoster ophthalmicus was excluded due to inadequate follow-up duration. Of the 6 patients included in the study, 3 (50%) had Mackie stage 1 disease, 1 (17%) had stage 2, and 2 (33%) had stage 3 with impending perforation, but all had markedly diminished corneal sensation, with a median denervation time of 11.8 months (interquartile range [IQR] 9.4–29.2 months). Following neurotization, median corneal sensation improved significantly from 1.6 cm (interquartile range 0.0–1.9 cm) to 3.6 cm (IQR 3.0–5.6 cm, p = 0.028), with 1 patient achieving full sensation by postoperative month 5. All patients with a persistent epithelial defect preoperatively showed complete corneal healing by their last follow-up visit. VA also improved postoperatively in all patients (p = 0.028). Median follow-up duration was 11.3 months (interquartile range 9.6–17.9 months).

Conclusions:
Corneal neurotization can successfully reinnervate corneas previously devitalized by herpetic disease and halt the progressive nature of postherpetic NK. If utilized appropriately and early in the disease process, neurotization may reduce morbidity and maximize visual potential in postherpetic NK.
Bundling Probiotics With Antimicrobial Stewardship Programs for the Prevention of Clostridiodes difficile Infections in Acute Care Hospitals
Authors: Kullar Ravina , Johnson Stuart , McFarland Lynne V. , Goff Debra A. , Goldstein Ellie J.C. 
Published: April 2020

Objective
Several recommendations based on probiotics with a Clostridiodes difficile infection (CDI) prevention bundle were developed.

Methods
Using a modified Delphi process an expert panel of infectious disease specialists developed and voted on consensus statements regarding CDI.

Results
The panel voted on the following: (1) CDI prevention bundles with antimicrobial stewardship programs (ASPs) are more effective than single interventions in preventing CDI (11/11 panelists); (2) to implement a CDI prevention program that includes probiotics, an institution must have an ASP consistent with established guidelines (11/11); (3) it is important to measure adherence to all components of a CDI prevention bundle, with process and outcomes measures established (11/11): (4) sustainability of a successful probiotic intervention for CDI prevention can be enhanced by incorporating a probiotic order set in the electronic medical record (11/11); (5) champions should be identified and accountable for CDI prevention bundle implementation (11/11); (6) hospital administration support is necessary for a successful and sustained CDI prevention program (10/11); and (7) the probiotic product selected for a CDI prevention program should be a defined strain(s), with a specific formulation, timing, dose, duration, and potency at the time of consumption, with evidence-based efficacy for CDI prevention (11/11).

Conclusions
The panel members agreed with the statements developed and concluded that a bundle with specific probiotics with evidence-based efficacy should be appropriately incorporated into ASPs for the prevention of CDI. Care should be taken when planning the method of probiotic implementation and measures for monitoring adherence to protocol should be included.
Localized sympathectomy reduces peripheral nerve regeneration and pain behaviors in 2 rat neuropathic pain models
Authors: Xie Wenrui , Strong Judith A. , Zhang Jun-Ming 
Published: April 2020

Abstract
Previous studies have shown that the peripheral nerve regeneration process is linked to pain in several neuropathic pain models. Other studies show that sympathetic blockade may relieve pain in some pain models and clinical conditions. This study examined reduction in peripheral nerve regeneration as one possible mechanism for relief of neuropathic pain by sympathetic blockade. A “microsympathectomy,” consisting of cutting the gray rami containing sympathetic postganglionic axons where they enter the L4 and L5 spinal nerves, reduced mechanical hypersensitivity in 2 different rat neuropathic pain models. In the spinal nerve ligation model, in which some functional regeneration and reinnervation of the ligated spinal nerve can be observed, microsympathectomy reduced functional and anatomical measures of regeneration as well as expression of growth-associated protein 43 (GAP43), a regeneration-related protein. In the spared nerve injury model, in which functional reinnervation is not possible and the futile regeneration process results in formation of a neuroma, microsympathectomy reduced neuroma formation and GAP43 expression. In both models, microsympathectomy reduced macrophage density in the sensory ganglia and peripheral nerve. This corroborates previous work showing that sympathetic nerves may locally affect immune function. The results further highlight the challenge of improving pain in neuropathic conditions without inhibiting peripheral nerve regeneration that might otherwise be possible and desired.
Sensitization of knee-innervating sensory neurons by tumor necrosis factor-α-activated fibroblast-like synoviocytes: an in vitro, coculture model of inflammatory pain
Authors: Chakrabarti Sampurna , Hore Zoe , Pattison Luke A. , Lalnunhlimi Sylvine , Bhebhe Charity N. , Callejo Gerard , Bulmer David C. , Taams Leonie S. , Denk Franziska , Smith Ewan St. John 
Published: April 2020

AbstractPain is a principal contributor to the global burden of arthritis with peripheral sensitization being a major cause of arthritis-related pain. Within the knee joint, distal endings of dorsal root ganglion neurons (knee neurons) interact with fibroblast-like synoviocytes (FLS) and the inflammatory mediators they secrete, which are thought to promote peripheral sensitization. Correspondingly, RNA sequencing has demonstrated detectable levels of proinflammatory genes in FLS derived from arthritis patients. This study confirms that stimulation with tumor necrosis factor (TNF-α) results in expression of proinflammatory genes in mouse and human FLS (derived from osteoarthritis and rheumatoid arthritis patients), as well as increased secretion of cytokines from mouse TNF-α-stimulated FLS (TNF-FLS). Electrophysiological recordings from retrograde labelled knee neurons cocultured with TNF-FLS, or supernatant derived from TNF-FLS, revealed a depolarized resting membrane potential, increased spontaneous action potential firing, and enhanced TRPV1 function, all consistent with a role for FLS in mediating the sensitization of pain-sensing nerves in arthritis. Therefore, data from this study demonstrate the ability of FLS activated by TNF-α to promote neuronal sensitization, results that highlight the importance of both nonneuronal and neuronal cells to the development of pain in arthritis.
Hospital visiting policies in the time of coronavirus disease 2019: A nationwide website survey in Taiwan
Authors: Liu Ya-An , Hsu Ya-Chuan , Lin Ming-Hwai , Chang Hsiao-Ting , Chen Tzeng-Ji , Chou Li-Fang , Hwang Shinn-Jang 
Published: April 2020

Background:
Coronavirus disease 2019 (COVID-19), a novel infectious coronavirus disease, has become a worldwide pandemic. Infection control precautions for hospital visitors are needed to avoid cluster outbreaks, so this study investigated the visiting policies of all the hospitals in Taiwan in the time of COVID-19.

Methods:
From March 15, 2020, to March 18, 2020, we searched the official websites of all 472 National Health Insurance–contracted hospitals to determine their visiting policies. For those hospitals that had posted new visiting policies and still allowed visits to ordinary wards, we recorded the relevant details shown on their websites, including the number of visitors allowed at one time, the number of visiting slots per day, the total visiting hours per day, and the rules provided to visitors before visiting.

Results:
During the study period, 276 (58.5%) hospitals had posted new visiting policies on their websites, with higher proportions of academic medical centers (92.0%, 23/25) and metropolitan hospitals (91.5%, 75/82) than local community hospitals (48.8%, 178/365) doing so. Visits to ordinary wards were forbidden in 83 hospitals among those. Among the 193 hospitals that had new visiting policies and still allowed visits to ordinary wards, 73.1% (n = 141) restricted visitors to two at a time and 54.9% (n = 106) restricted visits to two visiting slots per day. Furthermore, history taking regarding travel, occupation, contacts, and cluster information was mentioned by 82.4% (n = 159) of these 193 hospitals, body temperature monitoring by 78.2% (n = 151), hand hygiene by 63.2% (n = 122), and identity checks by 51.8% (n = 100).

Conclusion:
In the time of COVID-19 covered by this study, about three-fifths of the hospitals in Taiwan had posted their visiting policies for ordinary wards on their websites. Furthermore, the thoroughness with which such visiting policies have been enforced also requires investigation.
Implementation and Outcomes of a Clozapine-Associated Myocarditis Screening Program in a Region of South Australia—Lessons Learned
Authors: Nachmani Major Nir , Dawson, BPharm(hons) Jessica L. , Clark Scott R. 
Published: April 2020

Abstract

Purpose
Clozapine-associated myocarditis (CAM) is a serious complication, mostly occurring in the first month of treatment. Public mental health in South Australia introduced a screening protocol in 2011 using baseline and weekly C-reactive protein and troponin. The aim of this study was to assess protocol adherence and management of cases with positive screening results.

Methods
We identified all patients commenced on clozapine in our area between 2012 and 2015. Those with abnormal C-reactive protein and/or troponin in the first 4 weeks of treatment were identified (potential cases). For those, we collected clinical characteristics and test results and reviewed their management.

Findings
Protocol compliance increased to 80%. We identified 24 potential CAM cases, 8 at high risk based on established definition (7.6% of new commencements) and 9 formally diagnosed from 143 commenced on clozapine. Potential cases not meeting CAM definition were significantly more likely commenced on clozapine for the first time and have preexisting respiratory disease. Likely CAM cases were younger, and more often prescribed additional antipsychotics, specifically quetiapine. Seven (78%) of 9 patients diagnosed with CAM met published CAM definition. In 14 undiagnosed potential cases, 10 (71%) did not have timely testing to exclude CAM.

Conclusions
Maintaining a high index of suspicion, clinical monitoring and timely testing is important to supplement CAM screening protocols. More research is needed to identify those that can be safely rechallenged or even continue clozapine treatment with monitoring.
Homeopathic Remedies in Psychiatric Disorders
Authors: Rotella Francesco , Cassioli Emanuele , Falone Andrea , Ricca Valdo , Mannucci Edoardo 
Published: April 2020

AbstractPurpose/BackgroundHomeopathy is a complementary and alternative medicine. Conclusive evidence on the plausibility, efficacy, and safety of these treatments is not currently available. Nonetheless, homeopathic remedies (HRs) are widespread throughout the world and especially in mental disorders. The aim is to assess the efficacy of HRs in the treatment of mental disorders.Methods/ProceduresWe performed a Medline/Embase search for studies written in English and published from any date to October 23, 2018. All randomized controlled trials enrolling patients with any psychiatric disorder and comparing HR with placebo, no treatment, or other psychotropic drugs were included.Findings/ResultsA total of 212 studies were screened, 9 met all selection criteria and reported data on major depressive disorder (MDD) (n = 4), generalized anxiety disorder (n = 1), attention-deficit/hyperactivity disorder (n = 2), and premenstrual syndrome/dysphoric disorder (n = 2). Eight of 9 randomized controlled trials showed high risk of bias. Homeopathy showed greater efficacy in MDD compared with fluoxetine, and in premenstrual syndrome/dysphoric disorder compared with placebo, whereas no difference emerged between homeopathy and placebo in MDD and attention deficit/hyperactivity disorder.Implications/ConclusionsAvailable data on homeopathy in psychiatric disorders are insufficient to support their use in clinical practice.