bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mobile health technologies in the diagnosis and management of atrial fibrillation
Authors: Passman Rod 
Published: September 2021

Purpose of review
Atrial fibrillation is the most common sustained rhythm abnormality and is associated with stroke, heart failure, cognitive decline, and premature death. Digital health technologies using consumer-grade mobile technologies (i.e. mHealth) capable of recording heart rate and rhythm can now reliably detect atrial fibrillation using single lead or multilead ECG or photoplethysmography (PPG). This review will discuss how these developments are being used to detect and manage atrial fibrillation.

Recent findings
Studies have established the accuracy of mHealth devices for atrial fibrillation detection. The feasibility of using mHealth technology to screen for atrial fibrillation has also been established, though the utility of screening is controversial. In addition to screening, key aspects of atrial fibrillation management can also be performed remotely and effectively using mHealth, though with some important limitations.

Summary
mHealth technologies have proven disruptive in the diagnosis and management of atrial fibrillation. Healthcare providers can leverage these advances to better care for their atrial fibrillation patients whenever necessary.
AUTOLOGOUS RETINAL TRANSPLANT FOR REFRACTORY SEROUS RETINAL DETACHMENT SECONDARY TO OPTIC DISK PIT: A NOVEL SURGICAL APPROACH
Authors: Jalil Assad , Ziaei Hadi , Ivanova Tsveta 
Published: September 2021

Purpose:
To present a new technique to treat refractory retinal detachment secondary to optic disk pit.

Methods:
An interventional case report.

Results:
A 25-year-old man with congenital optic disk pit had two failed vitrectomies involving laser around the optic disk, internal limiting membrane peel and flap to plug the disk pit, and gas tamponade to reattach the retina. With all options running out, a further vitrectomy with autologous retinal transplant and silicone oil tamponade was performed to treat the refractory serous retinal detachment; the silicone oil was removed at 6 weeks after the last procedure. The retina remained successfully attached at 6 months postsurgery with the patient maintaining his baseline visual acuity.

Conclusion:
The use of autologous retinal transplant is a new approach to treat refractory retinal detachment secondary to congenital optic disk anomalies, and adds to our options of dealing with this complex condition when first-line approaches have failed.
NONSYNDROMIC RETINITIS PIGMENTOSA WITH BILATERAL RETINAL NEOVASCULARIZATION DUE TO HGSNAT MUTATION
Authors: Carrera William , Ng Caleb , Burckhard Braden , Ng Joshua , McDonald Henry. Richard , Agarwal Anita 
Published: September 2021

Purpose:
To describe a case of nonsyndromic retinitis pigmentosa caused by presumed compound heterozygous A615T and T522M mutations in HGSNAT, characterized by bilateral cystoid macular edema and retinal neovascularization.

Methods:
Case report. The patient underwent clinical evaluation, multimodal imaging, and next-generation panel sequencing. In silico analysis was performed with PolyPhen-2, SIFT, and MutationTaster. Segregation analysis was not available.

Results:
A 35-year-old hypertensive man presented with nyctalopia, photopsia, and difficulty reading for six months. He had no family history of visual deficits. The best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. Examination revealed midperipheral bone spicules and macular neovascularization in both eyes. Multimodal imaging demonstrated cystoid macular edema, ellipsoid band loss outside the central macula, and leakage from the neovascularization in both eyes. Sequencing detected four mutations in three genes, including two heterozygous mutations in HGSNAT (c.1843G>A, p.A615T and c.1565C>T, p.T522M). A615T is a pathogenic, hypomorphic mutation. T522M has not been previously phenotypically described. It is predicted damaging by in silico analysis and occurs at a conserved position near the eighth transmembrane domain, adjacent to residues in which missense mutations result in protein misfolding.

Conclusion:
This is, to the best of our knowledge, the first reported case of retinal neovascularization in a case of nonsyndromic retinitis pigmentosa due to HGSNAT mutation. The T522M variant likely functions as a severe mutation alongside the hypomorphic A615T mutation. These findings expand the genotypic and phenotypic spectrum of nonsyndromic retinitis pigmentosa.
Corneal Toxicity After Stinging by a Sea Anemone, Anthopleura uchidai: A Case Report With Confirmation by In Vitro Study
Authors: Ono Takashi , Iwasaki Takuya , Terada Yukiko , Miyai Takashi , Mori Yosai , Nejima Ryohei , Honma Tomohiro , Aihara Makoto , Miyata Kazunori 
Published: September 2021

Purpose:
This study aimed to present a case of transient corneal damage after exposure to the effluent squirting from a sea anemone, Anthopleura uchidai, and to experimentally confirm the presence of toxic substances from an A. uchidai in the tissue culture.

Methods:
We reviewed the clinical course of a 51-year-old man who complained of decreased vision in his left eye after the stinging of a sea anemone, A. uchidai. The toxicity of the effluents from an A. uchidai in immortalized human corneal endothelial cells (HCEnC-21T) and human corneal epithelial cells in vitro were evaluated.

Results:
Corneal edema was observed, and his best-corrected visual acuity was 0.2. Corneal endothelial cell density decreased to 1435 cells/mm2. Although his corneal edema and visual acuity recovered after topical instillation with a topical steroid and 5% NaCl, corneal endothelial cell density did not recover for 3 years after the injury. The in vitro study revealed fractioned effluence from the sea anemone, by size-exclusion chromatography, containing a substance toxic to HCEnC-21T with cytoplasmic swelling and nuclear dislocation.

Conclusions:
It is necessary to be cautious of effluents from sea anemones along the coast, and ophthalmologists should be aware that sea anemones can cause corneal endothelial dysfunction.
Corneal Perforation in Patients Under Treatment With Dupilumab for Atopic Dermatitis
Authors: Phylactou Maria , Jabbour Samir , Ahmad Sajjad , Vasquez-Perez Alfonso 
Published: September 2021

Purpose:
We report, for the first time, 2 cases of corneal ulceration and perforation after treatment with dupilumab for atopic dermatitis.

Methods:
A 30-year-old woman and a 44-year-old man developed unilateral severe corneal ulceration and perforation while on dupilumab therapy after 3 and 9 months, respectively.

Results:
Corneal cultures were negative in both cases except for scanty growth of Staphylococcus species on enrichment. Both cases progressed to perforation despite intensive topical antibiotic treatment. The first case required a tectonic keratoplasty to restore globe integrity after failed attempts of corneal gluing and multilayer amniotic membrane transplantation, and the second case was managed successfully with a cyanoacrylate glue patch.

Conclusions:
Although there have been previous reports of conjunctival injection and dry eye after dupilumab, these are the first 2 reports of corneal ulceration with rapid progression to perforation in patients under treatment with dupilumab. The underlying pathophysiology for ulcerative keratitis in these cases remains unknown, but there is no doubt that cessation of dupilumab prevented progression of the melting. Severe ocular symptoms while on dupilumab require a prompt discussion with the dermatology team to potentially switch treatment and halt further keratitis progression.
Neuropathic pain and neurocognitive functioning in children treated for acute lymphoblastic leukemia
Authors: Partanen Marita , Alberts Nicole M. , Conklin Heather M. , Krull Kevin R. , Pui Ching-Hon , Anghelescu Doralina A. , Jacola Lisa M. 
Published: September 2021

Abstract
Children with acute lymphoblastic leukemia (ALL) often experience treatment-related neurocognitive deficits and significant pain. Pain may exacerbate these cognitive impairments. This study examined neuropathic pain and neurocognitive outcomes in survivors of childhood ALL treated with contemporary therapy on a clinical trial (NCT00137111). There were 345 survivors (45% female, M = 6.9 years at diagnosis) who completed neurocognitive assessments including measures of sustained attention, learning and memory, and parent ratings of attention during at least one of 4 time points: on-therapy (Induction and Reinduction), end of therapy, and 2 years post-therapy. At-risk performance was defined as a score at least 1SD below the age-adjusted mean. Data on neuropathic pain (events, duration, and severity according NCI Common Toxicity Criteria) and pharmacologic pain management (opioids and gabapentin) were ascertained. Results showed that 135 survivors (39%) experienced neuropathic pain during treatment. Compared with those without pain, survivors with pain had greater memory impairments at end of therapy (California Verbal Learning Test [CVLT]-Total, 24% vs 12%, P = 0.046). Within the pain group, survivors who experienced a greater number of pain events (CVLT-Total = −0.88, P = 0.023) and those who were treated with opioids (versus gabapentin) had poorer learning and memory performance (CVLT-Total = −0.73, P = 0.011; Short Delay = −0.57, P = 0.024; Long Delay = −0.62, P = 0.012; and Learning Slope = −0.45, P = 0.042) across time points. These are considered medium-to-large effects (SD = 0.45-0.88). Neuropathic pain may be a risk factor for learning problems after therapy completion, and treatment for pain with opioids may also adversely affect neurocognitive performance. Therefore, patients who experience pain may require closer monitoring and additional intervention for neurocognitive impairment.
Exploring sex differences in alpha brain activity as a potential neuromarker associated with neuropathic pain
Authors: Fauchon Camille , Kim Junseok A. , El-Sayed Rima , Osborne Natalie R. , Rogachov Anton , Cheng Joshua C. , Hemington Kasey S. , Bosma Rachael L. , Dunkley Benjamin T. , Oh Jiwon , Bhatia Anuj , Inman Robert D. , Davis Karen D. 
Published: September 2021

Abstract
Alpha oscillatory activity (8-13 Hz) is the dominant rhythm in the awake brain and is known to play an important role in pain states. Previous studies have identified alpha band slowing and increased power in the dynamic pain connectome (DPC) of people with chronic neuropathic pain. However, a link between alpha-band abnormalities and sex differences in brain organization in healthy individuals and those with chronic pain is not known. Here, we used resting-state magnetoencephalography to test the hypothesis that peak alpha frequency (PAF) abnormalities are general features across chronic central and peripheral conditions causing neuropathic pain but exhibit sex-specific differences in networks of the DPC (ascending nociceptive pathway [ANP], default mode network, salience network [SN], and subgenual anterior cingulate cortex). We found that neuropathic pain (N = 25 men and 25 women) was associated with increased PAF power in the DPC compared with 50 age- and sex-matched healthy controls, whereas slower PAF in nodes of the SN (temporoparietal junction) and the ANP (posterior insula) was associated with higher trait pain intensity. In the neuropathic pain group, women exhibited lower PAF power in the subgenual anterior cingulate cortex and faster PAF in the ANP and SN than men. The within-sex analyses indicated that women had neuropathic pain-related increased PAF power in the ANP, SN, and default mode network, whereas men with neuropathic pain had increased PAF power restricted to the ANP. These findings highlight neuropathic pain-related and sex-specific abnormalities in alpha oscillations across the DPC that could underlie aberrant neuronal communication in nociceptive processing and modulation.
A multicenter, randomized, double-blind, placebo-controlled, comparative study to evaluate the efficacy and safety of newly developed diclofenac patches in patients with cancer pain
Authors: Yamaguchi Shigeki , Terahara Takaaki , Okawa Koji , Inakura Hiroshi 
Published: September 2021

Abstract
This phase III multicenter randomized double-blind placebo-controlled comparative study evaluated the efficacy and safety of diclofenac sodium patches for the treatment of cancer pain. The study consisted of a 2-week to 4-week open-label dose-titration phase and a 4-week double-blind phase. In the double-blind phase, patients who were expected to continue treatment of cancer pain with nonopioid analgesics alone were randomized to the diclofenac sodium patch or placebo group. Once-daily diclofenac sodium patches were started at 150 mg/day (2 patches) and could be increased up to 225 mg/day (3 patches). The primary efficacy endpoint was the time to insufficient analgesic response. Statistical analysis of the double-blind phase included data from 120 patients of the diclofenac sodium patch group and 118 patients of the placebo group. Time to insufficient analgesic response was significantly longer with diclofenac sodium patches than with placebo (P = 0.0016). The hazard ratio for insufficient response for diclofenac sodium patch vs placebo was 0.459 (95% confidence interval, 0.275-0.768). Regarding sleep quality during the double-blind phase, the proportion of patients with “very good sleep” or “good sleep” in the diclofenac sodium patch and placebo groups was 90.8% and 88.1% at the start of the double-blind phase and 81.4% and 78.6% at the final assessment, respectively. The incidence of adverse events was 60.8% (73/120) in the diclofenac sodium patch group and 60.2% (71/118) in the placebo group. Once-daily diclofenac sodium patches are effective in treating cancer pain and are well tolerated.
A peripheral CB2 cannabinoid receptor mechanism suppresses chemotherapy-induced peripheral neuropathy: evidence from a CB2 reporter mouse
Authors: Lin Xiaoyan , Xu Zhili , Carey Lawrence , Romero Julian , Makriyannis Alexandros , Hillard Cecilia J. , Ruggiero Elizabeth , Dockum Marilyn , Houk George , Mackie Ken , Albrecht Phillip J. , Rice Frank L. , Hohmann Andrea G. 
Published: September 2021

Abstract
CB2 cannabinoid receptors (CB2) are a promising therapeutic target that lacks unwanted side effects of CB1 activation. However, the cell types expressing CB2 that mediate these effects remain poorly understood. We used transgenic mice with CB2 promoter–driven expression of enhanced green fluorescent protein (EGFP) to study cell types that express CB2 and suppress neuropathic nociception in a mouse model of chemotherapy-induced peripheral neuropathy. Structurally distinct CB2 agonists (AM1710 and LY2828360) suppressed paclitaxel-induced mechanical and cold allodynia in CB2
EGFP reporter mice with established neuropathy. Antiallodynic effects of AM1710 were blocked by SR144528, a CB2 antagonist with limited CNS penetration. Intraplantar AM1710 administration suppressed paclitaxel-induced neuropathic nociception in CB2
EGFP but not CB2 knockout mice, consistent with a local site of antiallodynic action. mRNA expression levels of the anti-inflammatory cytokine interleukin-10 were elevated in the lumbar spinal cord after intraplantar AM1710 injection along with the proinflammatory cytokine tumor necrosis factor alpha and chemokine monocyte chemoattractant protein-1. CB2
EGFP, but not wildtype mice, exhibited anti-GFP immunoreactivity in the spleen. However, the anti-GFP signal was below the threshold for detection in the spinal cord and brain of either vehicle-treated or paclitaxel-treated CB2
EGFP mice. EGFP fluorescence was coexpressed with CB2 immunolabeling in stratified patterns among epidermal keratinocytes. EGFP fluorescence was also expressed in dendritic cells in the dermis, Langerhans cells in the epidermis, and Merkel cells. Quantification of the EGFP signal revealed that Langerhans cells were dynamically increased in the epidermis after paclitaxel treatment. Our studies implicate CB2 expressed in previously unrecognized populations of skin cells as a potential target for suppressing chemotherapy-induced neuropathic nociception.
Biomechanical Measures for Fall Risk Assessment and Fall Detection in People with Transfemoral Amputations for the Next-Generation Prostheses: A Scoping Review
Authors: Monaco Vito , Aprigliano Federica , Palmerini Luca , Palumbo Pierpaolo , Chiari Lorenzo , Micera Silvestro 
Published: September 2021

ABSTRACT

Introduction
Transfemoral amputations are known to compromise balance control capabilities, thus increasing the probability of falling. Current research in robotic prostheses is exploring novel strategies to assess the risk of fall and, if required, enable assistive strategies to promote balance recovery.

Objectives
The aim of this study was to identify a set of biomechanical variables associated with fall risk and fall detection in people with transfemoral amputation (pwTFA), which can be potentially assessed through the next generation of sensorized powered prostheses.

Study Design
The study design was scoping review.

Methods
Screening of the literature (CINAHL, PubMed, Scopus, and Web of Science) carried out in February 2020 (quality assessment of retained articles through Downs and Black checklist; retrieved information: measurement tests and biomechanical variables).

Results
From the initial 595 documents, only 25 citations met eligibility criteria. The pwTFA's fall risk assessment and fall detection are usually carried out by using different measurement tests.

Conclusions
Two classes of biomechanical markers for fall risk assessment have the potential to be incorporated in self-contained transfemoral powered prostheses equipped with sensory network and suitable computational capabilities. The first consists of kinematic/kinetic variables of some prosthesis components (e.g., foot acceleration, force loading the pylon, knee angle) to detect either an abrupt lack of balance or a fall-related occurrence as a consequence of knee buckling, slipping, or tripping. The second involves implementing automatic procedures to allow pwTFA to routinely carry out clinical tests, such as the timed up and go test and/or the Four Square Step Test to monitor the decline of sensory motor capabilities, likely documenting an increased fall risk.

Clinical Relevance
The next generation of powered prostheses could both monitor decline on neuromuscular capabilities and gather early signs of an acute lack of balance based on a suitable network of sensors on board. This approach is expected to prevent the fall risk in pwTFA.
Quantifying the Pipeline of Ethnically Underrepresented in Medicine Physicians in Academic Plastic Surgery Leadership
Authors: Hall Jennifer A. , Chen Wendy , Bhayana Kovid , Lee Phoebe , Moroni Elizabeth A. , Butler Paris D. , Delacruz Carolyn 
Published: September 2021

Background
The lack of underrepresented in medicine (UIM) physicians in academic plastic surgery is emerging as a critical issue. Lack of diversity has a negative effect on patient care and on the culture of our health care system. This study reports the current status of ethnically UIM physicians in the plastic surgery pipeline, starting from the medical student level and progressing to national leadership positions.

Methods
The Electronic Residency Applications Service, National Resident Matching Program, Association of American Medical Colleges, and professional Web sites for journals and national societies were accessed for racial demographic information from 2008 to 2019.

Results
Over the past decade, there has been no change or a slight decrease in representation of Blacks among plastic surgery residency applicants, trainees, and academic faculty, at half or less than expected, compared with US Census data. The first point of drop-off occurs at the resident (3.8% of integrated and 5.6% of independent residents) to faculty level (<2.8%). Two percent of program directors and department heads/division chiefs are Black. The next point of drop-off occurs at the national level: there has never been a Black president of American Society of Plastic Surgeons or Plastic Surgery Foundation, and there are no Black editors-in-chiefs of major plastic surgery journals.
Following LatinX American surgeons down the pipeline over the past decade, there has been no change or a decrease in representation among plastic surgery residency applicants, resident physicians, and academic faculty, at one-third or less than expected, compared with US Census data. The first point of drop-off occurs at the faculty (4.8%) to local leadership level (0% of program directors and department heads/division chiefs) where there is no representation of LatinX. Once this drop-off occurs, there is no recovery at the national leadership level.

Conclusions
In order for our profession to reflect our nation's demographics, academic plastic surgery is in need of a paradigm shift now. Attrition of UIM physicians in plastic surgery begins at medical school graduation and persists through surgical training, faculty appointments, and attainment of leadership positions. Creative and innovative commitment to diversity and inclusion is necessary.
The Impact of Fellowship Training in Academic Plastic Surgery
Authors: Egro Francesco M. , Smith Brandon T. , Murphy Carolyn P. , Stavros Alexander G. , Nguyen Vu T. 
Published: September 2021

Background
The competitive nature of an academic plastic surgery career has contributed to an increase in sub-specialization. The aim of this study is to assess the benefits of subspecialty fellowship training to pursue a career in academic plastic surgery.

Methods
A cross-sectional study was conducted of all current academic plastic surgeons (APSs) participating in Accreditation Council for Graduate Medical Education–certified residency programs. Online faculty website listings were used to collect their demographics, training and practice characteristics, academic rank and leadership positions, and research productivity.

Results
A total of 927 APSs met the inclusion criteria, of which 70.2% had undergone fellowship training, with an overall significant increase in fellowship-trained surgeons within the last 10 years (odds ratio [OR], 1.66; P = 0.0005). Hand training was the most common fellowship (35.6%), followed by craniofacial (32.0%) and microsurgery (28.1%). Fellowship training was more prevalent among younger (48.7 vs 53.5 years, P < 0.0001), White (67.8%), and non-White (77.4%, P = 0.0058) APSs who had received either integrated (67.1%) or independent (81.8%, P < 0.0001) plastic surgery training and are currently working in a department (OR, 1.44; P = 0.028). Fellowship training was shown to influence academic rank (associate professor: OR, 1.68 [P = 0.0073]; full professor: OR, 0.58 [P = 0.0008]), leadership position (fellowship director OR, 10.09; P < 0.0001) and research productivity (publications: 26 vs 16.5; P = 0.0009). In addition, fellowship attainment did not correlate with the size of the employing academic program, population of the city of practice, or being a residency director or chair.

Conclusion
The majority of APSs have undergone fellowship training, and there is very strong evidence supporting its impact in current entry and advancement in academic plastic surgery.