bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biochemical Pathways and Modeling
Authors: DEANGELIS ANTHONY , DEANGELIS LISA , CATHERINO WILLIAM , ROLLENE NANETTE L. 
Published: November 2020

The precise etiology of the biochemical changes and the resulting constellation of symptoms seen in polycystic ovary syndrome (PCOS) has remained a mystery. Despite advances in our knowledge, the pathogenesis and alterations in the biochemical pathways underlying this disease are still not fully understood. PCOS is a multifactorial syndrome where a combination of genetics, lifestyle, and hormone abnormalities all play an intertwining role. This article will provide an in-depth look at the multitude of biochemical pathways that are dysregulated in PCOS and their relation to alterations in female physiology.
WIDEFIELD FLUORESCEIN ANGIOGRAPHY IN THE DIAGNOSIS OF SUSAC SYNDROME
Authors: Turczyńska Monika J. , Krajewski Przemysław , Brydak-Godowska Joanna E. 
Published: November 2020

Purpose:To present the clinical manifestations and results of key diagnostic investigations in patients with Susac syndrome, with special emphasis on the principal role of fluorescein angiography (FA) of the peripheral retina.Methods:A retrospective analysis of medical records (collected 2000–2019) of 20 patients (15 women and five men), aged 20 to 51 years (mean age: 31.6 years) with complete or incomplete Susac syndrome diagnosed by an ophthalmic examination and widefield fluorescein angiography (WF-FA) by Spectralis and Optos Tx200.Results:Fluorescein angiography abnormalities included vascular changes in the posterior pole in 64.7% and in the peripheral retina in 82.4%. Widefield FA abnormalities in the peripheral retina alone were seen in 35.3% and in the posterior pole, but without peripheral vascular involvement, in 17.6%. Secondary leakage from veins was noted in 58.8%.Conclusion:Widefield FA of the peripheral retina has a key role in cases of suspected Susac syndrome as it confirms the diagnosis and assesses disease activity. In addition to the characteristic findings, late-phase FA revealed leakage from veins which is not a typical sign. Patients experiencing migraine headaches may benefit from increasing awareness of neurologists and otologists who more promptly referred patients with suspected Susac syndrome for ophthalmologic evaluation and WF-FA of the peripheral retina.
Comparative Study of Two Infrared Meibographers in Evaporative Dry Eye Versus Nondry Eye Patients
Authors: Garduño Fernando , Salinas Anna , Contreras Katia , Rios Yadira , García Naomi , Quintanilla Patricio , Mendoza Cesar , Garza Leon Manuel 
Published: November 2020

Objective:
To compare the measurement of the meibomian gland (MG) dropout between two infrared meibographers in patients with and without dry eye.

Methods:
The right eyelids of each patient were imaged using the Antares and Cobra meibography devices. All images were analyzed using Phoenix software to calculate the percentage of the MG dropout. Lipid layer thickness, eyelid margin characteristics, ocular surface staining, MG secretion, number of expressible glands, and noninvasive tear breakup time were also evaluated. A comparison between nondry eye and evaporative dry eye was performed.

Results:
Eighty participants (mean age, 36.93 years and 51.3% women) were included, of which 67.5% had nondry eye. A significant difference was observed in the dropout percentage of the superior eyelid between the Antares and Cobra devices (P=0.007) for all participants and when only the nondry eye patients were examined. In patients with dry eye, no significant differences were found in the dropout measurements of both eyelids.

Conclusions:
Statistically significant differences in the MG dropout percentage in the upper eyelid of nondry eye patients were obtained from both meibographers. The measurements were similar in patients with dry eye, suggesting that the two instruments can be interchanged.
Repeatability and reproducibility of manifest refraction
Authors: Taneri Suphi , Arba-Mosquera Samuel , Rost Anika , Kießler Saskia , Dick H. Burkhard 
Published: November 2020

Purpose:
To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction.

Setting:
Tertiary referral center.

Design:
Retrospective study.

Methods:
Patients attending at least 2 preoperative refractions before undergoing subsequent refractive surgery were included. All manifest refractions were performed by 1 of 4 experienced optometrists using an automated phoropter according to a standard protocol. The first manifest refraction was performed after obtaining automated refraction and measuring the spectacles of the patient. The second refraction was typically refined from the first also considering wavefront refraction and tomography/topography.

Results:
The latest 2 manifest refractions of 1000 eyes obtained at 2 separate visits showed a mean pairwise absolute difference of 0.16 ± 0.19 diopter (D) (range 0 to 1.38 D) in spherical equivalent (SE). This SD was better than 0.25 D (the minimum measurement increment of refraction itself). The 95% limit of agreement (LoA) was within 0.50 D for sphere, cylinder, and SE. The SD of the astigmatism axis was approximately 10 degrees, and the 95% LoA was within 22 degrees (the difference in axis decreasing significantly with the measured cylinder magnitude). The SD for corrected distance visual acuity (CDVA) was half a Snellen line and the 95% LoA was within 1.5 lines (with increasing deviation with worse vision). There were no clinically meaningful differences in reproducibility (2 optometrists) compared with repeatability (same optometrist) in sphere, axis, and CDVA.

Conclusions:
Reproducibility was 0.16 D irrespective whether refractions were performed by 1 or 2 different optometrists. Obtaining multiple refractions preoperatively might increase the predictability of surgery and decrease the enhancement rate.
Fifteen years of IOL exchange: indications, outcomes, and complications
Authors: Goemaere Jordy , Trigaux Céline , Denissen Laurens , Dragnea Diana , Hua Minh-Tri , Tassignon Marie-José , Dhubhghaill Sorcha Ní 
Published: November 2020

Purpose:
To report the indications, frequency, and outcomes regarding intraocular lens (IOL) exchange in 2 university hospital tertiary referral settings over a period of 15 years.

Setting:
Ophthalmology departments of the University Hospital Antwerp and the University Hospital Leuven, Belgium.

Design:
Retrospective cross-sectional study.

Methods:
In this retrospective study, included were patients who underwent an IOL exchange between 2002 and 2017. Patient demographics, surgical indication, comorbidities, visual outcomes, and complications were reported. Patients who underwent IOL repositioning or add-on IOL implantation or extraction, and patients who were left aphakic, were excluded.

Results:
Included in the study were 492 eyes. The mean age was 66.0 ± 13.3 years (range 19–91 years). The mean time between primary surgery and IOL exchange was 54.61 ± 67.07 months (range 0–343 months). Primary indication for explantation was IOL opacification, and the most common ophthalmic comorbidity was a previous history of vitreoretinal surgery. Preoperatively, the mean uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA) were 0.47 ± 0.27 (range 0–1) and 0.61 ± 0.32 (range 0–1.2), respectively. Postoperative UCVA and CDVA was 0.7 ± 0.3 (range 0–1.2) and 0.8 ± 0.28 (range 0.05–1.6), respectively. The increase in both CDVA and UCVA was statistically significant (P < .001, paired t test). The most common complication perioperatively was vitreous prolapse, which occurred in 61 eyes (16%).

Conclusions:
IOL exchange is a challenging yet valuable treatment option for a wide spectrum of problematic IOL outcomes. The most common indication remains IOL opacification, although IOL dislocation and patient dissatisfaction are increasing as indications.
Agreement between 2 swept-source OCT biometers and a Scheimpflug partial coherence interferometer
Authors: Tañá-Rivero Pedro , Aguilar-Córcoles Salvador , Tello-Elordi Cristina , Pastor-Pascual Francisco , Montés-Micó Robert 
Published: November 2020

Purpose:
To evaluate the agreement between different parameters obtained with 2 swept-source optical coherence tomography (SS-OCT)-based biometers and 1 Scheimpflug camera with partial coherence interferometry (PCI).

Setting:
Single center, Oftalvist, Alicante, Spain.

Design:
Prospective case series.

Methods:
Biometry was performed in 49 eyes using 3 optical biometers: ANTERION SS-OCT, IOLMaster 700 SS-OCT, and Pentacam AXL PCI. Keratometry (K), J0 and J45 vectors, anterior chamber depth (ACD), central corneal thickness (CCT), white-to-white (WTW), lens thickness (LT), and axial length (AL) were measured with each device. Bland-Altman analysis was applied.

Results:
This study comprises 49 eyes of 49 patients. There were no statistically significant differences for K1, K2, J0 and J45 between the 3 devices (P > .9). In contrast, there was a statistically significant difference in the ACD, CCT, WTW, LT, and AL between the biometers (P < .001). Specifically, there was a statistically significant difference between ACD, CCT, and WTW values for all-pairwise comparisons. IOLMaster showed the shortest ACD value and ANTERION showed the largest ACD. IOLMaster showed the highest CCT and Pentacam showed the lowest CCT. IOLMaster showed the largest WTW and Pentacam showed the shortest WTW. The LT measured with IOLMaster was thicker than that measured with ANTERION. There was a statistically significant difference in the AL between IOLMaster and Pentacam, with a shorter AL measured with IOLMaster (P < .001), but no differences were found between ANTERION and IOLMaster (P = .599) and between ANTERION and Pentacam (P = .054).

Conclusions:
Mean differences and the limits of agreement obtained in all-pairwise comparisons of the different parameters should be judged clinically to consider the interchangeability of these devices.
Anterior capsule coverage and rotational stability of an acrylic toric intraocular lens
Authors: Sasaki Koh , Eguchi Shuichiro , Miyata Akira , Nishimura Tomohisa , Miyata Kazunori , Hasegawa Yumi , Oshika Tetsuro 
Published: November 2020

Purpose:
To investigate factors related to the rotational stability of an acrylic toric intraocular lens (IOL).

Setting:
Four ophthalmic surgical sites in Japan.

Design:
Prospective case series.

Methods:
The study included 120 eyes of 120 patients undergoing phacoemulsification and implantation of a toric IOL (AcrySof IQ, Alcon Laboratories, Inc.). At 1 hour postoperatively, the area of continuous curvilinear capsulorhexis (CCC) was measured, and the state of anterior capsule coverage on the IOL optic (total on or partial on) was recorded. The toric IOL axis orientation was assessed at the end of surgery and at 1 hour, 1 week, 1 month, and 6 months postoperatively. Multiple regression analysis was performed to explore any clinical factors relevant to IOL rotation from the end of surgery to 6 months postoperatively. The explanatory variables included age, anterior chamber depth preoperatively, axial length, type of corneal astigmatism (with-the-rule, against-the-rule, or oblique astigmatism), area of CCC, state of anterior capsule overlap on IOL optic (total coverage vs partial coverage), and surgical sites (surgeons).

Results:
The multiple regression analysis in 110 eyes of 110 patients indicated that anterior capsule overlap on the IOL optic was the only variable associated with IOL rotation at 6 months postoperatively (P = .0482). The mean absolute rotation at 6 months was 1.96 ± 1.81 degrees in the total on group and 3.79 ± 3.12 degrees in the partial on group (P = .0004).

Conclusions:
Rotational stability of a single-piece, acrylic toric IOL was better in eyes with total anterior capsule coverage than that in those with partial anterior capsule coverage on the IOL optic.
Outcomes of bioptics with small-incision lenticule extraction as a sequential treatment after implantable collamer lens for management of extreme myopia
Authors: Brar Sheetal , Batra Akanksha , Shah Mamta Lakhana , Ganesh Sri 
Published: November 2020

Purpose:
To study the safety and efficacy of bioptics using implantable collamer lens (ICL) followed by small-incision lenticule extraction (SMILE) for management of extreme myopia.

Setting:
Nethradhama Superspeciality Eye Hospital, Bangalore, India.

Design:
Retrospective case series.

Methods:
Data were analyzed for patients who underwent bioptics using ICL in the first stage and SMILE in the second stage for correction of the residual refractive error. The mean interval between stage 1 and stage 2 correction was 24.2 ± 13.33 days. The mean follow-up after the SMILE procedure was 12.26 ± 1.39 (range 11 to 14) months.

Results:
Fifteen eyes from 9 patients with mean age 26 ± 4.69 years were included. Preoperatively, the mean SE was −22.89 ± 3.04 diopter (D) (−16.50 to −28.00 D), which decreased to −3.40 ± 1.89 D after ICL and further reduced to −0.48 ± 0.24 D after final correction with SMILE, at the end of the mean follow-up. The mean cylinder reduced from −2.88 ± 1.69 D to −1.93 ± 1.07D post-ICL and to −0.38 ± 0.24 D post-SMILE surgery. The mean corrected distance visual acuity (CDVA) significantly improved from 0.38 ± 0.22 to 0.068 ± 0.09 logMAR after SMILE correction (P = .00). The mean uncorrected distance visual acuity (UDVA) at the end of follow-up was 0.15 ± 0.09 logMAR, with all eyes achieving UDVA of 0.3 logMAR or greater. All eyes had gain in CDVA, with 53% eyes gaining 2 or more lines. No wound-, intraocular pressure–, or ICL-related complications were observed during and after the SMILE surgery. No patient required spectacles, contact lenses, or enhancement for further improvement of vision.

Conclusions:
Bioptics with SMILE after ICL implantation might be a valid option for extremely myopic patients, resulting in significant improvements in visual acuity and high patient satisfaction.
A picture is worth a thousand words: linking fibromyalgia pain widespreadness from digital pain drawings with pain catastrophizing and brain cross-network connectivity
Authors: Ellingsen Dan-Mikael , Beissner Florian , Moher Alsady Tawfik , Lazaridou Asimina , Paschali Myrella , Berry Michael , Isaro Laura , Grahl Arvina , Lee Jeungchan , Wasan Ajay D. , Edwards Robert R. , Napadow Vitaly 
Published: November 2020

Abstract
Pain catastrophizing is prominent in chronic pain conditions such as fibromyalgia and has been proposed to contribute to the development of pain widespreadness. However, the brain mechanisms responsible for this association are unknown. We hypothesized that increased resting salience network (SLN) connectivity to nodes of the default mode network (DMN), representing previously reported pain-linked cross-network enmeshment, would be associated with increased pain catastrophizing and widespreadness across body sites. We applied functional magnetic resonance imaging (fMRI) and digital pain drawings (free-hand drawing over a body outline, analyzed using conventional software for multivoxel fMRI analysis) to investigate precisely quantified measures of pain widespreadness and the associations between pain catastrophizing (Pain Catastrophizing Scale), resting brain network connectivity (Dual-regression Independent Component Analysis, 6-minute multiband accelerated fMRI), and pain widespreadness in fibromyalgia patients (N = 79). Fibromyalgia patients reported pain in multiple body areas (most frequently the spinal region, from the lower back to the neck), with moderately high pain widespreadness (mean ± SD: 26.1 ± 24.1% of total body area), and high pain catastrophizing scale scores (27.0 ± 21.9, scale range: 0-52), which were positively correlated (r = 0.26, P = 0.02). A whole-brain regression analysis focused on SLN connectivity indicated that pain widespreadness was also positively associated with SLN connectivity to the posterior cingulate cortex, a key node of the DMN. Moreover, we found that SLN-posterior cingulate cortex connectivity statistically mediated the association between pain catastrophizing and pain widespreadness (P = 0.01). In conclusion, we identified a putative brain mechanism underpinning the association between greater pain catastrophizing and a larger spatial extent of body pain in fibromyalgia, implicating a role for brain SLN-DMN cross-network enmeshment in mediating this association.
Occupational leg edema—use of compression stockings
Authors: Guedes Pedro M. , Saldanha Nuno A. , Matos Pedro M. , Carvalho Francisco S. , Veiga Graça , Norton Pedro 
Published: November 2020

Abstract
To analyze the use of compression stockings to avoid the formation of occupational edema of the lower limbs in jobs with prolonged orthostatism. We carried out a review of the articles published in PubMed, from the 1st of January 2008 to 31st of December 2018 using the term “Occupational Leg Swelling”. Only articles that met the following criteria were selected: prospective, observational and experimental retrospectives articles written in Portuguese or English. The research resulted in 23 articles. After reading the titles and abstracts and applying the inclusion and exclusion criteria, 5 were selected. Prolonged orthostatism is considered a risk factor for the development of chronic venous disease. The use of compression stockings reduces the occupational edema of the lower limbs. Professionals exposed to prolonged orthostatism during their work activity have a higher risk of developing lower limb edema; Despite few studies demonstrated the effectiveness of wearing compression stockings to prevent occupational edema of the lower limbs, they have showed benefit in reducing edema as well as associated symptoms. The use of compression stockings should therefore be recommended to all professionals at increased risk for occupational edema of the lower limbs.
Reducing Time to Surgery for Hip Fragility Fracture Patients: A Resident Quality Improvement Initiative
Authors: Rubenstein William , Barry Jeffrey , Rogers Stephanie , Grace Trevor R. , Tay Bobby , Ward Derek 
Published: November 2020

ABSTRACT
As part of an institutional quality improvement (QI) initiative for the 2018–2019 academic year, orthopedic residents at our tertiary center were incentivized to bring over 75% of hip fracture patients with American Society of Anesthesiologists (ASA) Class 2 or less to surgery in under 24 hours, compared to the baseline rate of 55.9%. The time between admission and surgery for hip fracture patients with ASA class 2 or less was prospectively recorded. At the end of the study period, a retrospective comparison was performed between patients treated before and after the resident QI initiative. The percentage of patients who underwent surgery within 24 hours of admission increased significantly in the Study Cohort compared to the Baseline Cohort (78.6% vs. 55.9%, p = .037). Length of stay was shorter in the Study Cohort compared to the Baseline Cohort (3 days vs. 4 days, p = .01), whereas readmissions (3.6% vs. 4.4%, p = .85) and discharges to skilled nursing facilities (60.7% vs. 57.4%, p = .76) were comparable between both cohorts. A goal-directed, resident-led QI initiative was associated with a significantly increased percentage of hip fragility fracture patients who underwent surgery in less than 24 hours.
Esophageal Fibrosis in Eosinophilic Gastrointestinal Diseases
Authors: Thaker Ameet I. , Melo Diana Montoya , Samandi Layla Z. , Huang Rong , Park Jason Y. , Cheng Edaire 
Published: November 2020

ABSTRACTObjectives:Eosinophilic esophagitis (EoE), the most common eosinophilic gastrointestinal disease (EGID), is associated with lamina propria (LP) fibrosis. The relationship of EoE to other EGIDs is still unclear. We frequently observe cases of concurrent esophageal eosinophilia and extra‐esophageal mucosal eosinophilia. The purpose of this study was to compare clinical, endoscopic, and histologic features, as well as the prevalence of esophageal LP fibrosis in children with EGID and concurrent esophageal eosinophilia to children with EoE. We also examine the current practices of pathologists in evaluating fibrosis.Methods:We reviewed esophageal biopsies from index cases of EoE (N = 38), EGID with significant esophageal eosinophilia (≥15 eos/hpf) (EGID‐SEE, N = 38), EGID with mild esophageal eosinophilia (1–14 eos/hpf) (EGID‐MEE, N = 12), and EGID with no esophageal eosinophilia (EGID‐NEE, N = 12) for LP presence, adequacy, and fibrosis.Results:EoE and EGID‐SEE cases share similar demographics, esophageal endoscopic features, and symptoms. A majority of EGID‐SEE cases (71%) had adequate LP for the evaluation of fibrosis, similar to EoE cases (87%). The prevalence of esophageal fibrosis in EoE (79%) and EGID‐SEE (55%) cases were similar, whereas no fibrosis was detected in the EGID‐MEE and EGID‐NEE cases. The fibrosis was patchy and often detected in the distal esophagus. Fourteen cases were reclassified from their original clinical diagnosis as having fibrosis by the study pathologists.Conclusions:Cases of EGID‐SEE have overlapping features with EoE, suggesting that all EGIDs are part of a disease continuum. A consensus for the evaluation of LP fibrosis is needed.
National Trends in Pediatric Facial Fractures: The Impact of Health Care Policy
Authors: Jenny Hillary E. , Yesantharao Pooja , Redett Richard J. , Yang Robin 
Published: November 2020

Background:
Traumatic injuries are significant sources of morbidity and mortality in the pediatric population. Using a national database, this study aims to characterize pediatric facial fracture management and the effect of health care policy changes on populations receiving treatment.

Methods:
A retrospective cohort study was performed using Healthcare Cost and Utilization Project Kids’ Inpatient Database databases from 2000 to 2016. Pediatric patients admitted with a facial fracture diagnosis were included. Clinical outcomes include mortality, reduction of fracture during hospital stay, and open fracture reduction. The impact of the Affordable Care Act on patient demographics and management was assessed.

Results:
Between 2000 and 2016, 82,414 patients were managed for facial fractures, 8.3 percent of whom were managed after implementation of the Affordable Care Act (n = 6841). Mean age was 15.2 years, and the male-to-female ratio was 2.9:1. Significant racial disparities were identified before the Affordable Care Act: African American and Native American patients had decreased odds of having facial fracture reduction during the initial hospital stay (OR, 0.84 and 0.86, respectively), and identifying as either Hispanic or Native American was associated with higher odds of mortality (OR, 1.4 or 2.4, respectively). Race was not contributory to patient mortality after the Affordable Care Act. Before Affordable Care Act implementation, patients receiving care with no charge (including charity care/charity research) had lower odds of having an open reduction or any reduction; insurance status was not contributory to management after the Affordable Care Act.

Conclusion:
Although the Affordable Care Act may have increased access to care for certain populations, race- and sex-associated differences in mortality rate and fracture management should be further investigated to ensure a national standard of equitable patient care.