bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjustable 6-0 polypropylene flanged technique for scleral fixation, part 1: primary fixation IOLs in aphakia, capsular stabilizing devices, and aniridia implants
Authors: Assia Ehud I. , Wong John X.H. 
Published: August 2020

Purpose:
To describe the technique and outcomes of modified adjustable flange intrascleral fixation using 6-0 polypropylene sutures in primary scleral fixation in a variety of intraocular lenses (IOLs) and capsular stabilizing devices.

Setting:
Center for Applied Eye Research, Meir Medical Center, Israel.

Design:
Case series.

Methods:
Laboratory studies were performed to test the feasibility of passing 6-0 polypropylene sutures through hydrophobic and hydrophilic IOLs. The durability of the IOL, suture, and created flange was tested. IOL implantation was performed first on porcine eyes with assessment of IOL position. Surgery was then performed using this adjustable flange technique using a variety of IOLs, including hydrophilic, hydrophobic, and poly(methyl methacrylate) aniridic IOLs and the capsular anchor (AssiAnchor) to stabilize the capsular lens in eyes with compromised zonular fibers.

Results:
Surgery was performed on 9 eyes. Both hydrophobic and hydrophilic IOLs together with the 6-0 polypropylene suture were sufficiently durable in laboratory tests. Intrascleral fixation of 3 hydrophobic IOLs and 1 hydrophilic IOL was successfully achieved in 4 aphakic eyes. Stable and secure capsular bag fixation using the AssiAnchor was achieved in 4 eyes. Fixation of an aniridia IOL was also performed with success in 1 eye. All cases had stable and securely fixated IOLs and good postoperative recovery at 3 months follow-up. There was improvement in uncorrected distance visual acuity postoperatively in all cases.

Conclusions:
The modified adjustable flange technique for scleral fixation using polypropylene 6-0 was effective, relatively quick, and technically simpler and safer than alternative methods in the management of aphakia and zonular instability.
Serial opacification of a hydrophilic–hydrophobic acrylic intraocular lens: analysis of potential risk factors
Authors: Scherer Nicolas C.D. , Müller Karolina , Prahs Philipp M. , Radeck Viola , Helbig Horst , Märker David A. 
Published: August 2020

Purpose:To identify potential risk factors related to the opacification of a hydrophilic–hydrophobic acrylic intraocular lens (IOL) model.Setting:University Hospital Regensburg, Department of Ophthalmology, Regensburg, Germany.Design:Cross-sectional study.Methods:All patients with a Lentis LS-502-1 IOL implanted at the Department of Ophthalmology were identified. Existing medical records and information from the treating ophthalmologists were reviewed to determine the IOL status (clear or opacified). Potential risk factors were analyzed using binary logistic regression models.Results:A total of 223 IOLs of 199 patients were included. Sixty-seven (30.0%) opacified (calcified) IOLs were identified and compared with a control group of 156 IOLs. Statistical analyses revealed age at IOL implantation (odds ratio [OR] = 1.05,P= .012) to be associated with an increased risk of calcification. Posterior capsulotomy (OR = 0.45,P= .011) was found to have a protective influence. No other ophthalmic or systemic condition showed a significant association. Mean corrected distance visual acuity diminished significantly under opacification from 0.21 ± 0.25 logarithm of the correct minimum angle of resolution (logMAR) to 0.42 ± 0.32 logMAR (P< .001). IOL exchange in 55 of 67 cases at 45.8 ± 20.5 months after initial implantation yielded significant visual recovery (P= .001).Conclusions:Age at implantation might be a risk factor of IOL calcification, whereas posterior capsulotomy might be a protective factor. Calcification of the LS-502-1 IOL might be caused by the interaction of 3 main factors: IOL material traits, manufacturing-associated contamination, and patients’ individual factors altering intraocular ion concentrations.
Repeatability and comparability of keratometry measurements obtained with swept-source optical coherence and combined dual Scheimpflug–Placido disk–based tomography
Authors: Lu Amy Q. , Poulsen Anne , Cui David , Seeger Catherine , Lehman Erik , Scott Ingrid U. , Pantanelli Seth M. 
Published: August 2020

Purpose:
To assess the repeatability of keratometric measurements obtained using a reflectance and swept-source optical coherence tomography (SS-OCT) based biometer and to compare these values with those obtained with a dual Scheimpflug–Placido (S-P) disk–based tomographer/topographer.

Setting:
Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA.

Design:
Prospective consecutive case series.

Methods:
Patients undergoing cataract evaluation were prospectively enrolled. Surgery-naive eyes without corneal pathology were measured 3 times with the reflectance/SS-OCT biometer and once with the dual S-P disk tomographer/topographer. Intradevice repeatability for anterior (K), posterior (PK), and total corneal keratometry (TK) readings were evaluated using within-eye SDs, test–retest repeatability (TRT), coefficients of variance, and intraclass correlation coefficients (ICCs). Bland-Altman analysis was used to assess agreement between devices.

Results:
Eighty-two eyes from 48 patients met inclusion criteria. The TRT for the anterior, posterior, and total corneal powers were 0.33, 0.08, and 0.36 diopter (D), respectively. TRT for the anterior, posterior, and total keratometric astigmatism were 0.58, 0.14, and 0.64 D, respectively. Anterior keratometric indices had higher ICCs than posterior indices. Bland-Altman analysis revealed that the SS-OCT consistently reported flatter posterior corneal curvatures than the S-P.

Conclusions:
The SS-OCT posterior keratometric measurements contain more noise (lower ICCs), but still have lower within-eye SDs and TRTs than that of anterior measurements. This may be due to the small index of refraction change at the cornea-aqueous interface. Although keratometric indices from the 2 devices are highly correlated, measurements taken using SS-OCT and S-P devices were not interchangeable.
Outcomes of IOL power calculation using measurements by a rotating Scheimpflug camera combined with partial coherence interferometry
Authors: Taroni Leonardo , Hoffer Kenneth J. , Barboni Piero , Schiano-Lomoriello Domenico , Savini Giacomo 
Published: August 2020

Purpose:
To evaluate the accuracy of the measurements provided by a Scheimpflug camera combined with partial coherence interferometry for intraocular lens (IOL) power calculation.

Setting:
I.R.C.C.S.-G.B. Bietti Foundation, Rome, Italy.

Design:
Prospective case series.

Methods:
Consecutive patients scheduled for cataract surgery were enrolled. Preoperative biometry was performed with a Pentacam AXL. All patients received the same IOL (AcrySof SN60WF). Measurements were entered into the following formulas: Barrett Universal II, Emmetropia Verifying Optical 2.0, Haigis, Hoffer Q, Holladay 1, Holladay 2 with axial length adjustment, Kane, Ladas Super Formula (LSF) 2.0, Næser 2, Pearl-DGS, SRK/T, T2, and VRF. When refraction was measured at 1 month postoperatively, the mean prediction error (PE), the median absolute error (MedAE), and the percentage of eyes with a PE within ±0.25, ±0.50, and ±1.00 diopter (D) were calculated after constant optimization.

Results:
Ninety-one eyes of 91 patients were analyzed. Comparison of the mean PE and MedAE did not reveal any statistically significant difference. However, the Pearl DGS formula achieved the lowest MedAE (0.19 D), followed by the LSF 2.0 (0.22). Twelve of the 13 formulas obtained a PE within ±0.50 D in at least 80% of eyes (range 80%-87%) and 7 of them in at least 85%. Twelve formulas yielded a PE within ±0.25 D in at least 50% of eyes (range 51%-64%).

Conclusions:
All the investigated formulas performed well using the Pentacam AXL measurements. The newest Pearl DGS formula version and LSF 2.0 showed promising results.
Review and recommendations for univariate statistical analysis of spherical equivalent prediction error for IOL power calculations
Authors: Holladay Jack T. , Wilcox Rand R. , Koch Douglas D. , Wang Li 
Published: August 2020

Purpose:
To provide a reference for study design comparing intraocular lens (IOL) power calculation formulas, to show that the standard deviation (SD) of the prediction error (PE) is the single most accurate measure of outcomes, and to provide the most recent statistical methods to determine P values for type 1 errors.

Setting:
Baylor College of Medicine, Houston, Texas, and University of Southern California, Los Angeles, California, USA.

Design:
Retrospective consecutive case series.

Methods:
Two datasets comprised of 5200 and 13 301 single eyes were used. The SDs of the PEs for 11 IOL power calculation formulas were calculated for each dataset. The probability density functions of signed and absolute PE were determined.

Results:
None of the probability distributions for any formula in either dataset was normal (Gaussian). All the original signed PE distributions were not normal, but symmetric and leptokurtotic (heavy tailed) and had higher peaks than a normal distribution. The absolute distributions were asymmetric and skewed to the right. The heteroscedastic method was much better at controlling the probability of a type I error than older methods.

Conclusions:
(1) The criteria for patient and data inclusion were outlined; (2) the appropriate sample size was recommended; (3) the requirement that the formulas be optimized to bring the mean error to zero was reinforced; (4) why the SD is the single best parameter to characterize the performance of an IOL power calculation formula was demonstrated; and (5) and using the heteroscedastic statistical method was the preferred method of analysis was shown.
Role of Race in Short-Term Outcomes for 1700 Consecutive Patients Undergoing Brain Tumor Resection
Authors: Haldar Debanjan , Glauser Gregory , Schuster James M. , Winter Eric , Goodrich Stephen , Shultz Kaitlyn , Brem Steven , McClintock Scott D. , Malhotra Neil R. 
Published: August 2020

ABSTRACT

Background:
Access to medical care seems to be impacted by race. However, the effect of race on outcomes, once care has been established, is poorly understood.

Purpose:
This study seeks to assess the influence of race on patient outcomes in a brain tumor surgery population.

Importance and Relevance to Healthcare Quality:
This study offers insights to if or how quality is impacted based on patient race, after care has been established. Knowledge of disparities may serve as a valuable first step toward risk factor mitigation.

Methods:
Patients differing in race, but matched on other outcomes affecting characteristics, were assessed for differences in outcomes subsequent to brain tumor resection. Coarsened exact matching was used to match 1700 supratentorial brain tumor procedures performed over a 6-year period at a single, multihospital academic medical center. Patient outcomes assessed included unplanned readmission, mortality, emergency department (ED) visits, and unanticipated return to surgery.

Results:
There was no significant difference in readmissions, mortality, ED visits, return to surgery after index admission, or return to surgery within 30 days between the two races.

Conclusion:
This study suggests that race does not independently influence postsurgical outcomes but may instead serve as a proxy for other closely related demographics.
Reducing Caesarean Section Surgical Site Infection (SSI) by 50%: A Collaborative Approach
Authors: Corbett Gillian A. , O'Shea Evelyn , Nazir Syeda Farah , Hanniffy Rosena , Chawke Geraldine , Rothwell Alison , Gilsenan Fiona , MacIntyre Anne , Meenan Anne Marie , O'Sullivan Niamh , Maher Niamh , Tan Terry , Sheehan Sharon R. 
Published: August 2020

ABSTRACT

Objective:
Caesarean section surgical site infection (SSI) is a surgical wound site infection occurring within 30 days of surgery with a reported incidence of 3–15%. This quality improvement (QI) project aimed to reduce caesarean section SSI by 50% in a tertiary maternity center.

Methods:
Using multidisciplinary team approach, the project was designed with evidence-based interventions. The Royal College of Physicians of Ireland/Royal College of Surgeons in Ireland “Preventing Surgical Site Infections Key Recommendations for Practice” guideline was used as standard perioperative care. A care bundle was designed targeting preoperative personal patient preparation, preoperative prophylactic antibiotics, and strict skin preparation technique, all measured using a patient survey. The rate of SSI was followed for 14 months. The Model for Improvement methodology was used to implement change.

Results:
Surgical site infection rate decreased from 6.7% (n = 684 caesarean sections, n = 46 SSI) to 3.45% (n = 3,206 caesarean sections, n = 110 SSI), p = .0006. Reduction occurred in both elective (4.4%–2.7%) and emergency (9.1%–4.1%) caesarean section groups. There was excellent adherence to all three elements of the care bundle. The 50% reduction in caesarean section SSI was sustained over the 14-month period, significantly reducing maternal morbidity.

Conclusions:
The success of this QI project is attributable to frontline ownership and empowerment of patients and staff.
Prediction of Adverse Outcomes Within 90 Days of Surgery in a Heterogeneous Orthopedic Surgery Population
Authors: Dimentberg Ryan , Caplan Ian F. , Winter Eric , Glauser Gregory , Goodrich Stephen , McClintock Scott D. , Hume Eric L. , Malhotra Neil R. 
Published: August 2020

ABSTRACT

Introduction:
The LACE+ index has been shown to predict readmissions; however, LACE+ has not been validated for extended postoperative outcomes in an orthopedic surgery population. The purpose of this study is to examine whether LACE+ scores predict unplanned readmissions and adverse outcomes following orthopedic surgery. Use of the LACE1 index to proactively identify at-risk patients may enable actions to reduce preventable readmissions.

Methods:
LACE+ scores were retrospectively calculated at the time of discharge for all consecutive orthopedic surgery patients (n = 18,893) at a multicenter health system over 3 years (2016–2018). Coarsened exact matching was used to match patients based on characteristics not assessed in the LACE+ index. Outcome differences between matched patients in different LACE quartiles (i.e. Q4 vs. Q3, Q2, and Q1) were analyzed.

Results:
Higher LACE+ scores significantly predicted readmission and emergency department visits within 90 days of discharge and for 30–90 days after discharge for all studied quartiles. Higher LACE+ scores also significantly predicted reoperations, but only between Q4 and Q3 quartiles.

Conclusions:
The results suggest that the LACE+ risk-prediction tool may accurately predict patients with a high likelihood of adverse outcomes after a broad array of orthopedic procedures.
DUSP1 Blocks autophagy-dependent ferroptosis in pancreatic cancer
Authors: Xie Yangchun , Kuang Feimei , Liu Jiao , Tang Daolin , Kang Rui 
Published: August 2020

Abstract
Ferroptosis is a oxidative damage-dependent form of regulated cell death that has become an emerging target for disease prevention and treatment. Here, we show that dual-specificity phosphatase 1 (DUSP1), a phosphatase playing multiple roles in stress-signaling pathways, is a new repressor of ferroptosis in human pancreatic cancer cells. Several classical ferroptosis activators (eg, erastin and RSL3) induce the expression of DUSP1, but not other members of DUSP, which depends on extracellular signal-regulated protein kinases 1 and 2 (ERK1/2). Moreover, shRNA-mediated DUSP1 knockdown increases the anticancer activity of ferroptosis activators in pancreatic cancer cells through activating lipid peroxidation in vitro and in vivo. Importantly, DUSP1-mediated autophagy is responsible for lipid peroxidation-mediated ferroptotic cell death. Thus, the DUSP1-related ferroptotic pathway may represent a potential target for therapeutic intervention in pancreatic cancer.
Can Bone-Specific Alkaline Phosphatase and Osteocalcine Levels Be Used to Determine the Age in Children?
Authors: Topal İsmail , Gümüş Burak 
Published: August 2020

Background
Demand for age determination by medical methods from legal authorities is of critical importance, especially for people in pubertal age. We planned this study to evaluate the potential utility of biochemical methods in these applications. We aim to investigate whether alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), and osteocalcine can be used in the determination of age.

Materials and Methods
A total of 146 children (85 girls, 61 boys) between the ages of 9 and 16 years participated in the study. Considering legally defined age limits, we did the age grouping at the following intervals: we formed 3 different subgroups, (1) 9 to 11 years age group, (2) 12 to 14 years age group, and (3) 15 to 16 years age group. As the physiological growth and development processes changed according to sex, all calculations were done separately for girls and boys.

Results
Our data indicate that ALP and BALP values for girls can be used for age determination with acceptable sensitivity and specificity. However, we could not observe such precise distinction for boys. Although BALP is claimed to be superior to ALP, we have not found any evidence to confirm this in our study.

Conclusions
This study provides sex- and age-dependent cutoff values for ALP and BALP for the girl, which may be useful for age determination.
Telmisartan for treatment of Covid-19 patients: an open randomized clinical trial - A preliminary report
Authors: Duarte Mariano , Pelorosso Facundo , Nicolosi Liliana , Salgado M. Victoria , Vetulli Héctor , Aquieri Analía , Azzato Francisco , Basconcel Mauro , Castro Marcela , Coyle Javier , Davolos Ignacio , Esparza Eduardo , Criado Ignacio Fernandez , Gregori Rosana , Mastrodonato Pedro , Rubio María C. , Sarquis Sergio , Wahlmann Fernando , Rothlin Rodolfo P. 
Published: August 2020

AbstractBackgroundCovid-19 is associated with respiratory-related morbidity and mortality. Angiotensin receptor blockers (ARB) have been postulated as tentative pharmacological agents to treat Covid-19-induced inflammation.MethodsThis is a randomized, two-arm, open, multicenter trial. Participants were 18 years or older and had been hospitalized with confirmed Covid-19 with 4 or fewer days since symptom onset. Exclusion criteria included intensive care unit admission prior to randomization and ARB or angiotensin converting enzyme inhibitors use. Treatment arm received telmisartan 80 mg bid during 14 days plus standard care; control arm received standard care. Primary outcome were differences in C-reactive protein levels at days 5 and 8. Secondary outcomes included time to discharge evaluated at 15 days and death at 30 days post randomization.ResultsThis interim analysis included 40 patients in telmisartan and 38 in control groups. CRP levels in the control and telmisartan groups were 51.1±44.8 mg/L vs 24.2±31.4 mg/L at day 5 (mean ± SD; n=28 and n=32, p<0.05), and 41.6±47.6 mg/L vs 9.0±10.0 mg/L at day 8 (mean ± SD; n=16 and n=13; p<0.05), respectively. Telmisartan treated patients had statistically significant lower time to discharge (log-rank test p=0.0124, median time: 15 days in control group vs 9 days in telmisartan group). Mortality at day 30 was 11.76% in control group vs 5.26% in telmisartan group (p=0.41).ConclusionsIn this study, ARB telmisartan, a well-known inexpensive safe antihypertensive drug, administered in high doses, was superior to standard care demonstrating anti-inflammatory effects and improved morbidity in hospitalized patients infected with SARS-CoV-2 (NCT04355936).
Viewing the US presidential electoral map through the lens of public health
Authors: Hamamsy Tymor , Danziger Michael , Nagler Jonathan , Bonneau Richard 
Published: August 2020

AbstractHealth, disease, and mortality vary greatly at the county level, and there are strong geographical trends of disease. Healthcare is a top priority for voters in the United States, and it is important to examine the relationship between voting patterns at the county level and health, disease, and mortality. We perform a comprehensive analysis of the relationship between voting patterns and over 150 different public health and wellbeing variables, comparing counties in all states, including counties in 2016 battleground states, and counties in states that flipped from Democrat to Republican from 2012 to 2016. We also investigate county-level health trends over the last 30+ years and find statistically significant relationships between a number of health measures and the voting patterns of counties in presidential elections. Collectively, this data exhibits a strong pattern: counties that voted Republican in the 2016 election counties are “sicker” than those that voted Democrat.
Tocilizumab in hospitalized patients with COVID-19: Clinical outcomes, inflammatory marker kinetics, safety, and a review of the literature
Authors: Hill Joshua A. , Menon Manoj P. , Dhanireddy Shireesha , Wurfel Mark M. , Green Margaret , Jain Rupali , Chan Jeannie D. , Huang Joanne , Bethune Danika , Turtle Cameron , Johnston Christine , Xie Hu , Leisenring Wendy M. , Kim H. Nina , Cheng Guang-Shing 
Published: August 2020

ABSTRACTBackgroundCoronavirus disease 2019 (COVID-19) due to infection with SARS-CoV-2 causes substantial morbidity. Tocilizumab, an interleukin-6 receptor antagonist, might improve outcomes by mitigating inflammation.MethodsWe conducted a retrospective study of patients admitted to the University of Washington Hospital system with COVID-19 and requiring supplemental oxygen. Outcomes included clinical improvement, defined as a two-point reduction in severity on a 6-point ordinal scale or discharge, and mortality within 28 days. We used Cox proportional-hazards models with propensity score inverse probability weighting to compare outcomes in patients who did and did not receive tocilizumab.ResultsWe evaluated 43 patients who received tocilizumab and 45 who did not. Patients receiving tocilizumab were younger with fewer comorbidities but higher baseline oxygen requirements. Tocilizumab treatment was associated with reduced CRP, fibrinogen, and temperature, but there were no meaningful differences in Cox models of time to clinical improvement (adjusted hazard ratio [aHR], 0.92; 95% CI, 0.38-2.22) or mortality (aHR, 0.57; 95% CI, 0.21-1.52). A numerically higher proportion of tocilizumab-treated patients had subsequent infections, transaminitis, and cytopenias.ConclusionsTocilizumab did not improve outcomes in hospitalized patients with COVID-19. However, this study was not powered to detect small differences, and there remains the possibility for a survival benefit.