bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Emotional Distress in Combat Military Flight Engineers
Authors: Cohen-Koren Reoot , Garbi Dror , Gordon Shirley , Yavnai Nirit , Erlich Shoham Yifat , Shelef Leah 
Published: May 2021

ABSTRACT

Objective
Exposure to distressing sights (DSs) during combat missions may cause emotional distress. The present study aimed to investigate the association between exposure to DSs involving severe injuries and fatalities during rescue missions and emotional distress, in Israeli Air Force (IAF) helicopter flight engineers (FEs).

Methods
Cross-sectional design using self-report questionnaires. The independent variables included demographics, personal, and military variables—exposure to DSs throughout a whole career service. The dependent variables included Depression (Beck Depression Inventory); State-Trait Anxiety Inventory; Post-traumatic stress disorder (PTSD Checklist—PCL-5); Somatization (Patient Health Questionnaire); Maslach Burnout Inventory; and Coping Strategies (The Brief COPE). The variables PTSD, depression, and anxiety were examined twice: once as dichotomous variables according to the pathology cutoff point and again as a continuous variable to reveal the intensity of symptoms.

Results
Participants were 106 IAF helicopter FEs (mean age = 39.32, SD = 8.75). Linear regression revealed that initial exposure to distressing battlefield sights (i.e., exposure to severe injuries and fatalities) was a predictor of depression symptoms. Career service FEs aged 31–40 were found to be at the highest risk of emotional distress, with a predictive factor for anxiety symptoms. Use of nonadaptive coping strategies was found to predict depressive symptoms, anxiety symptoms, and post-traumatic stress symptoms.

Conclusion
A significant association was found between exposure to DSs involving severe injuries and fatalities during rescue missions and anxiety, depression, somatization, and burnout. This population is generally perceived as tough and resilient, and this study has a unique contribution in identifying its vulnerabilities. Psychological intervention is crucial after participating in such missions.
Cortisol induces follicle regression, while FSH prevents cortisol-induced follicle regression in pigs
Authors: Nakanishi Tomoya , Okamoto Asako , Ikeda Maki , Tate Sachiko , Sumita Miyu , Kawamoto Rie , Tonai Shingo , Lee Joo Yeon , Shimada Masayuki , Yamashita Yasuhisa 
Published: May 2021

Abstract
During follicular development, a few dominant follicles develop to large antral dominant follicles, whereas the remaining follicles undergo atretic degeneration. Because vascularization on the follicular surface is a morphological feature of dominant follicles, we previously classified these follicles as vascularized follicles (VFs) and non-VFs (NVFs). In NVFs, progesterone producing genes were expressed similarly to that in VFs; however, the progesterone concentration in follicular fluid was low in large NVFs. Therefore, we estimated that progesterone is converted to cortisol, which induces the loss of follicular functions. In this study, we comparative analyzed the expression of genes for progesterone converting enzymes (Cytochrome (CYP)11B1, CYP21A2, Hydroxysteroid (HSD)11B2) and cortisol receptor (NR3C1) in VF and NVF granulosa cells. In NVFs, expression of cortisol producing genes (CYP11B1 and CYP21A2) was higher than in VFs. Expression of the gene for the cortisol metabolizing enzyme HSD11B2 in NVFs was significantly lower than in VFs. In NVFs, accompanied by increasing cortisol concentration in follicular fluid, apoptosis of granulosa and cumulus cells was observed. Cultivation with FSH and metyrapone (a CYP11B1 inhibitor) of NVF cumulus–oocyte complexes inhibited apoptosis of cumulus cells and induced cumulus cell proliferation and oocyte maturation. Cortisol-induced CYP11B1 and CYP21A2 expression, whereas FSH-induced HSD11B2 mRNA expression in VF granulosa cells in the presence of cortisol. Furthermore, an addition of 18β-glycyrrhetinic acid (18-GA; a HSD17B2 inhibitor) to cortisol and FSH-containing medium increased apoptosis of VF granulosa cells. These results suggested that cortisol is a stimulatory factor that induces follicular atresia; furthermore, inhibition of cortisol production by FSH might increase the number of healthy preovulatory follicles in pigs.
An immune-competent, replication-permissive Syrian Hamster glioma model for evaluating Delta-24-RGD oncolytic adenovirus
Authors: Phillips Lynette M , Li Shoudong , Gumin Joy , Daou Marc , Ledbetter Daniel , Yang Jing , Singh Sanjay , Parker Kerrigan Brittany C , Hossain Anwar , Yuan Ying , Gomez-Manzano Candelaria , Fueyo Juan , Lang Frederick F 
Published: May 2021

Abstract

Background
Oncolytic adenoviruses are promising new treatments against solid tumors, particularly for glioblastoma (GBM), and preclinical models are required to evaluate the mechanisms of efficacy. However, due to the species selectivity of adenovirus, there is currently no single animal model that supports viral replication, tumor oncolysis, and a virus-mediated immune response. To address this gap, we took advantage of the Syrian hamster to develop the first intracranial glioma model that is both adenovirus replication-permissive and immunocompetent.

Methods
We generated hamster glioma stem-like cells (hamGSCs) by transforming hamster neural stem cells with hTERT, simian virus 40 large T antigen, and h-RasV12. Using a guide-screw system, we generated an intracranial tumor model in the hamster. The efficacy of the oncolytic adenovirus Delta-24-RGD was assessed by survival studies, and tumor-infiltrating lymphocytes (TILs) were evaluated by flow cytometry.

Results
In vitro, hamGSCs supported viral replication and were susceptible to Delta-24-RGD mediated cell death. In vivo, hamGSCs consistently developed into highly proliferative tumors resembling high-grade glioma. Flow cytometric analysis of hamster gliomas revealed significantly increased T-cell infiltration in Delta-24-RGD infected tumors, indicative of immune activation. Treating tumor-bearing hamsters with Delta-24-RGD led to significantly increased survival compared to hamsters treated with phosphate buffered saline (PBS).

Conclusions
This adenovirus-permissive, immunocompetent hamster glioma model overcomes the limitations of previous model systems and provides a novel platform to study the interactions between tumor cells, the host immune system, and oncolytic adenoviral therapy; understanding of which will be critical to implementing oncolytic adenovirus in the clinic.
Evaluation of Bundled Interventions for Patients With Opioid Use Disorder Experiencing Homelessness Receiving Extended Antibiotics for Severe Infection
Authors: Beieler Alison M , Klein Jared W , Bhatraju Elenore , Iles-Shih Matthew , Enzian Leslie , Dhanireddy Shireesha 
Published: May 2021

Abstract
Hospitalizations for serious infections in patients with opioid use disorder (OUD) experiencing homelessness are common. Patients receiving 4 interventions (infectious disease consultation, addiction consultation, case management, and medications for OUD [MOUD]) had higher odds of clinical cure (unadjusted odds ratio [OR], 3.15; P = .03; adjusted OR, 3.03; P = .049) and successful retention in addiction care at 30 days (unadjusted OR, 5.46; P = .01; adjusted OR, 6.36; P = .003).
Reliability and Validity of a Modified Version of the Community Balance and Mobility Scale (CBMS-Home) for Use in Home Assessment
Authors: Ng Yoke Leng , Hill Keith D , Jacques Angela , Burton Elissa 
Published: May 2021

Abstract

Objective
The Community Balance and Mobility Scale (CBMS) has been shown to be a valid and reliable outcome measure for evaluating balance and mobility among older adults; however, some items cannot be conducted in all home environments, limiting its use in home-based assessments. The purpose of this study was to evaluate the accuracy and selected measurement properties of a modified 12-item CBMS-Home (8 original items and 4 modified items of the CBMS) feasible for use within the constraints of home assessments for older adults.

Methods
Fifty-five people (mean [SD] age = 77.2 [6.0] years) were recruited for this validation study. Participants completed the full original CBMS, CBMS-Home (the modified items of the CBMS), the Functional Reach Test, and Step Test. Principal components analysis, internal consistency, test-retest and intermethod reliability, agreements within and between methods, and criterion validity were calculated.

Results
Principal components analysis of CBMS and CBMS-Home both revealed 3 similar components and loadings. Bland-Altman and weighted κ analyses revealed that the CBMS-Home demonstrated moderate to almost perfect agreement (weighted κ = 0.45–0.84) with CBMS. The distribution of scores of CBMS-Home were satisfactory, and other results showed excellent test-retest (intraclass correlation coefficient [ICC]  = 0.95) and intermethod reliability (ICC = 0.94) and internal consistency (Cronbach α = 0.94). There were no ceiling effects (0%) or floor (1.8%) effects. CBMS-Home demonstrated a low (Spearman ρ = 0.39) and moderate positive (Spearman ρ = 0.63) relationship with the Functional Reach Test and Step Test, respectively.

Conclusions
The CBMS-Home has good psychometric properties and provides a useful multidimensional assessment tool.

Impact
A modified version of the CBMS (CBMS-Home) can be confidently used to assess older adults—within their own home—who might have mild balance impairments.
Systematizing societal effects of transdisciplinary research
Authors: Schäfer Martina , Bergmann Matthias , Theiler Lena 
Published: May 2021

Abstract
Over the past decade, transdisciplinary research has been faced with increasing demands by research policy and funding bodies to make its contribution to dealing with complex societal problems more transparent. In the literature, there is a range of methodological attempts to trace and describe the effects of transdisciplinary research, but these are characterized by inconsistent definitions regarding the scope and different forms of effects. This article aims to systematize the proposed categories and introduces a heuristic that can be used as a tool to sensitize researchers to intended effects ex ante and throughout the research process, as well as to reflect on the achieved effects ex post. The heuristic includes the temporal and spatial dimension of occurring effects (first-, second- and third-order) and characterizes possible forms of effects. It is validated and differentiated based on a multi-method empirical study involving 16 completed transdisciplinary research projects in different thematic areas. We propose a differentiation of frequently used categories, such as ‘learning effects’, and operationalize second- and third-order effects with the aim of ensuring a more consistent use of terminology in the transdisciplinary research community. We also specify methodical steps for a facilitated self-reflective application of the tool ex ante, supporting the research process, or ex post.
Sclerotherapy for Aneurysmal Bone Cysts: Scale for Response
Authors: Ramkumar Dipak B. , Ercolano Lisa B. , Allar Benjamin G. , Miller Patricia E. , Padua Horacio , Anderson Megan E. 
Published: May 2021

Background:
The objective of this study was to develop a response scale for aneurysmal bone cysts (ABCs) treated with sclerotherapy and determine its inter-rater reproducibility.

Methods:
Patients treated with sclerotherapy for an ABC between 1993 and 2014 were identified. An attending orthopaedic surgeon and an attending interventional radiologist independently reviewed the radiographic series for each patient and determined response to treatment using a novel grading system. Pain scores were collected from each visit. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). General estimating equations analysis was used to evaluate the relationship between radiographic and pain scores and outcome, to develop an algorithm for the study patient population. A receiver operating characteristic curve was constructed to evaluate the diagnostic performance of the radiographic and pain scores in identifying the necessity of further treatment. To quantify the diagnostic utility, the area under the receiver operating characteristic curve was estimated along with a 95% confidence interval (CI).

Results:
The inter-rater reliability was excellent for magnetic resonance imaging (ICC=0.83; 95% CI=0.74-0.89) and good for computed tomography/x-ray (ICC=0.69; 95% CI=0.51-0.81). The radiographic and pain scores proved to be independent predictors of treatment (P<0.001 and 0.004, respectively). An algorithm to determine the predictive probability for treatment versus observation in the study population was developed and tested based on these assessments. The area under the receiver operating characteristic curve of 0.85 (95% CI=0.79-0.92) indicated the good diagnostic performance of the algorithm.

Conclusions:
This novel grading system for radiographic response to sclerotherapy treatment demonstrates excellent to good inter-rater reliability giving providers a platform for discussion among themselves and with patients/parents. When incorporated with an assessment of pain, a predictive algorithm shows how this information could be used to determine the next steps after sclerotherapy treatment.

Level of Evidence:
Level IV—case series.
An 18-Year Overview of Serratia marcescens Ocular Infection
Authors: Atta Sarah , Perera Chandrashan , Nayyar Shannon , Kowalski Regis P. , Jhanji Vishal 
Published: May 2021

Purpose:

Serratia marcescens is a frequent ocular bacterial pathogen implicated in keratitis, endophthalmitis, and conjunctivitis. We evaluated the risk factors and treatment outcomes of ocular infections due to S. marcescens.

Methods:
In this retrospective observational study, all S. marcescens-positive cases between February 2002 and February 2020 were reviewed for ocular risk factors that included log of minimal angle of resolution visual acuity (VA), medical management, and time to epithelial defect closure.

Results:
Fifty-one patients were identified (72.5% females, 46.8±23.3 years). Forty-six patients had complete medical records, and 5 had microbiology data available. The most prevalent ocular risk factors were, contact lens (CL) use (68.6%), corneal disease (52.9%), and history of ocular surgery (41.2%). Mean presenting VA was 1.3±1.0. About half of the patients presented with a central ulcer (49%, 25), large infiltrate (20.4±31.8 mm2 mean), and hypopyon (43.1%, 22). All cases were reported to be susceptible to ciprofloxacin. Defect closure occurred in 52.3±117.1 days and final VA was 0.86±0.88. Adjunctive treatments were required in 14 cases (27.5%). One patient underwent surgical intervention. Features associated with poor VA outcomes included, history of glaucoma (P=0.038), older age at presentation (P<0.001), presence of hypopyon (0.045), poor VA at presentation (0.0086), time to epithelial defect closure (0.0196), and large infiltrate size (P=0.0345).

Conclusions:

S. marcescens keratitis and conjunctivitis is associated with CL use and history of ocular surface disease. Worse outcomes were associated with older age, infiltrate size, presence of hypopyon, worse initial VA, longer time to epithelial defect closure, and history of glaucoma.
Keratoconus Management With Customized Photorefractive Keratectomy by Artificial Intelligence Ray-Tracing Optimization Combined With Higher Fluence Corneal Crosslinking: The Ray-Tracing Athens Protocol
Authors: Kanellopoulos Anastasios John 
Published: May 2021

Purpose:
The aim of this study was to report novel ray-tracing customization of surface excimer laser ablation combined with higher fluence corneal crosslinking (CXL) in the stabilization and normalization of ectasia and visual rehabilitation of progressive keratoconus.

Methods:
A 28-year-old man with bilateral progressive keratoconus was treated with Athens protocol: CXL combined with photorefractive surface ablation customized by a novel artificial intelligence platform calculating lower- and higher-order aberrations based on wavefront, Scheimpflug tomography, and interferometry axial length data from a single diagnostic device. Visual acuity, refractive error, keratometry, optical coherence tomography and Scheimpflug tomography, and endothelial cell density were evaluated over 12 months.

Results:
Keratoconus stabilized in both eyes. Uncorrected distance visual acuity changed from 20/80 to 20/20 in the OD and from 20/40 to 20/25 in the OS at 12 months. Keratometry changes were as follows: from 40.7 and 42.7 at 165.1 degrees to 41.4 and 43.1 at 169.3 degrees in the OD and from 40.9 and 42.6 at 15.9 degrees to 44.1 and 44.7 at 9.8 degrees in the OS. Corneal surface normalization was as follows: index of height decentration from 0.115 to 0.099 and index of surface variance from 77 to 67 in the OD and index of height decentration from 0.066 to 0.014 and index of surface variance from 49 to 31 in the OS.

Conclusions:
We introduced in this study the management of progressive keratoconus with CXL combined with novel excimer laser customization using several independent up-to-now diagnostics calculated by software, evaluating bidirectional theoretical ray tracing. It bears the potential advantage of addressing more accurately normalization of the distorted human eye optics associated with corneal ectasia, compared with using anterior corneal surface data or wavefront data alone.
Effect of Previous Crosslinking on Intraoperative and Postoperative Outcomes and Complication Rates of Big-Bubble Deep Anterior Lamellar Keratoplasty for Keratoconus: A Comparative Study
Authors: Sogutlu Sari Esin , Kubaloglu Anıl , Koytak Arif , Ofluoglu Ali Nihat , Sahin Gözde 
Published: May 2021

Purpose:
To compare surgical outcomes and intraoperative and postoperative complications of big-bubble deep anterior lamellar keratoplasty (DALK) in patients with and without a history of previous corneal collagen crosslinking (CXL) for keratoconus.

Methods:
Patients with keratoconus who underwent DALK surgery with big-bubble technique between January 2013 and January 2018 were retrospectively reviewed. Operative findings, intraoperative and postoperative complications, and visual and refractive outcomes were recorded. Patients were divided into 2 groups: with previous CXL (CXL-DALK group: 27 eyes) and without previous CXL (DALK group: 50 eyes). All parameters were compared between groups.

Results:
Big bubble was successfully achieved in 24 eyes (88.9%) in the CXL-DALK group and in 45 eyes (90.0%) in the DALK group (P = 0.87). Type 1 bubble was obtained in 22 eyes (91.7%) in the CXL-DALK group and in 42 eyes (93.3%) in the DALK group (P = 0.79). Intraoperative microperforation occurred in 3 eyes (11.1%) in the CXL-DALK group and in 5 eyes (10.0%) in the DALK group (P = 1). Visual and refractive outcomes were similar between groups. The mean endothelial cell loss rates were 5.7% ± 2.3 at 1 year and 10.2 ± 3.1 at 2 years in the CXL-DALK group and 6.4% ± 4.7 at 1 year and 10.9% ± 5.4 at 2 years in the DALK group. Postoperatively, persistent epithelial defect was the most common complication in both groups, and postoperative complication rates were similar between groups.

Conclusions:
Our results have shown that previous CXL treatment does not influence the success of bubble formation and does not increase intraoperative or postoperative complication rates of DALK surgery for keratoconus. The improvement in visual acuity and refractive errors and endothelial cell loss rates were similar between CXL treated and untreated eyes after 2 years of follow-up.
Methamphetamine-Induced Keratitis Case Series
Authors: Franco Jimena , Bennett Adam , Patel Prem , Waldrop William , McCulley James 
Published: May 2021

Abstract:
Methamphetamine-induced keratitis is a recognized but not widely studied cause of corneal stromalysis and infections. These 2 cases describe the presentation and clinical course of keratitis in patients with preceding methamphetamine use.
Limbal Stem Cell Deficiency: Demographics and Clinical Characteristics of a Large Retrospective Series at a Single Tertiary Referral Center
Authors: Cheung Albert Y. , Sarnicola Enrica , Denny Matthew R. , Sepsakos Lorena , Auteri Nicholas J. , Holland Edward J. 
Published: May 2021

Purpose:
The aim of this study was to characterize a large cohort of patients presenting to a single referral center for limbal stem cell deficiency (LSCD).

Methods:
A retrospective chart review of all patients with a clinical diagnosis of LSCD from 2002 to 2015 was performed. Demographics, etiology, previous ocular surgeries, visual acuity, and treatment were assessed.

Results:
Seven hundred thirty-eight eyes of 434 patients (51.4% male subjects) were diagnosed with LSCD. The mean presenting age was 42.9 years, 70% presented with bilateral disease, and overall vision was poor. The most common etiologies were congenital aniridia (30.9%), chemical or thermal injuries (20.6%), contact lens (16.8%), Stevens–Johnson syndrome (SJS, 10.4%), and iatrogenic (7.3%). Congenital aniridia had a significantly increased association with glaucoma or ocular hypertension (P < 0.0001). Chemical or thermal injuries (P = 0.0007), SJS (P < 0.0001), and mucous membrane pemphigoid (P < 0.0001) had a significantly increased association with eyelid pathology. The mean logMAR best corrected visual acuity (analysis excluded eyes with light perception and no light perception) at presentation was 1.145 (∼20/280). Keratoplasty performed (before presentation at our center) without first addressing the LSCD was seen in 80 eyes; all keratoplasties failed due to recurrence of the LSCD.

Conclusions:
Patients presenting with LSCD were on average middle aged without sex predominance. LSCD was most commonly bilateral, comprised a wide range of etiologies, and decreased vision substantially. Ocular comorbidities may need to be treated before treating the LSCD surgically. Finally, not addressing the LSCD (primary issue) first can result in keratoplasty failure.
Repository Corticotropin Injection as an Alternative Treatment for Refractory Ocular Mucous Membrane Pemphigoid
Authors: Sharon Yael , Anesi Stephen D. , Martinez Christine E. , Huang Andrew J. W. , Foster Charles Stephen , Chu David S. 
Published: May 2021

Purpose:
The purpose of this study was to report the clinical course and outcome of patients with refractory ocular mucous membrane pemphigoid (MMP) treated by repository corticotropin injection (RCI).

Methods:
Patients with biopsy-proven ocular MMP treated with RCI from 3 tertiary medical centers were evaluated. Medical records between January 2013 and January 2021 were reviewed and deidentified to retrieve relevant disease-related data. Primary outcome measures included conjunctival inflammatory activity, change in Foster clinical conjunctival scarring staging after RCI treatment, and the development of ocular and systemic complications.

Results:
Included were 15 patients (10 women and 5 men; 36–95 yrs of age) with a mean follow-up of 4.5 years. Most of the patients (80%) had Foster stage 3 at presentation, and all patients had active MMP. Each patient had failed to respond to at least 1 immunomodulatory drug during the follow-up, and 9 (60%) patients had treatment failure of at least 2 other agents before the use of RCI. The mean duration of RCI treatment was 21 months (range, 3–54 mo). Foster stage did not change in any of the 15 patients at the last follow-up. Nine patients continued RCI therapy at the last follow-up, and in all of them, the disease activity of MMP was well controlled. No serious adverse events because of RCI were documented during the follow-up in any treated patient.

Conclusions:
RCI may serve as an alternative or an adjunctive treatment in patients with severe and refractory ocular MMP. Treatment with RCI seems to be safe and well-tolerated.