bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Measures of Physical Function of the Neck Region Associated With Poor Prognosis Following a Whiplash Trauma?
Authors: Alalawi Ahmed , Mazaheri Masood , Gallina Alessio , Luque-Suarez Alejandro , Sterling Michele , Falla Deborah 
Published: December 2021

Objective:
The objective of this study was to synthesize the current evidence regarding the predictive ability of measures of physical function (PF) of the neck region and perceived PF on prognosis following a whiplash injury.

Materials and Methods:
Electronic databases were searched by 2 independent reviewers up to July 2020, including MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science as well as gray literature. Eligible studies were selected by 2 reviewers who then extracted and assessed the quality of evidence. Observational cohort studies were included if they involved participants with acute whiplash-associated disorders (WAD), followed for at least 3 months postinjury, and included objective measures of neck PF or self-reported measures of PF as prognostic factors. Data could not be pooled and therefore were synthesized qualitatively.

Results:
Fourteen studies (13 cohorts) were included in this review. Low to very low quality of evidence indicated that initial higher pain-related disability and higher WAD grade were associated with poor outcome, while there was inconclusive evidence that neck range of motion, joint position error, activity of the superficial neck muscles, muscle strength/endurance, and perceived functional capacity are not predictive of outcome. The predictive ability of more contemporary measures of neck PF such as the smoothness of neck movement, variability of neck motion, and coactivation of neck muscles have not been assessed.

Discussion:
Although initial higher pain-related disability and higher WAD grade are associated with poor outcome, there is little evidence available investigating the role of neck PF on prognosis following a whiplash injury.
Advances in understanding and examining lymphatic function: relevance for understanding autoimmunity
Authors: Ambler William , Santambrogio Laura , Lu Theresa T. 
Published: December 2021

Purpose of review
The aim of this review is to give insights into how novel lymphatics functions may influence autoimmunity.

Recent findings
The lymphatic system connects peripheral tissues to draining lymph nodes to regulate adaptive immunity and directly interfaces with leukocytes in lymph vessels and in the lymph node. Here, we discuss recent findings showing evidence of dysfunctional lymphatics in autoimmune disease, new understanding of how afferent lymphatic regulation can modulate immunity, lymph node lymphatic heterogeneity and how these lymphatics can directly modulate lymphocyte function, how this understanding can be harnessed for new therapeutics, and new tools for the investigation of lymphatic and immune biology.

Summary
Lymphatics have an active role in the regulation of inflammation and the adaptive immune response. Here, we review recent findings in lymphatics biology in peripheral tissues and lymph nodes and emphasize the relevance for better understanding autoimmune diseases.
Nocturnal urine 6-hydroxy sulfate melatonin is associated with the outcome of subjects with sepsis
Authors: Li Wenjie , Chen Jiameng , Pan Shuming , Gao Chengjin 
Published: December 2021

Abstract

Background
It is imperative to identify potential biomarkers for early diagnosis and intervention of severe sepsis. This study investigated the relationship between melatonin secretion and outcome of sepsis after 28-day admission.

Methods
Patients with sepsis were randomly divided into an eye mask group and a control group. Blood and urine samples were collected from day 0 to 4. Relevant clinical data and 28-day survival data were obtained. Serum melatonin and urine 6-hydroxy sulfate melatonin (6-SMT) levels were measured.

Results
The outcome of sepsis did not differ between the eye mask and control groups. Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were significantly higher and monocyte human leukocyte antigen-DR (mHLA-DR), serum melatonin, nocturnal urine 6-SMT, and 24-hour urine 6-SMT levels were significantly lower in the nonsurvivors than in the survivors. The outcome at day 28 after admission was significantly associated with APACHE II and SOFA scores and mHLA-DR, nocturnal urine 6-SMT, and 24-hour urine 6-SMT levels. The areas under the receiver operating characteristic curve were 0.785, 0.740, 0.774, and 0.858 for APACHE II score, SOFA score, mHLA-DR expression, and nocturnal urine 6-SMT amount, respectively. The optimal thresholds for mHLA-DR and nocturnal urine 6-SMT were 30.13% and 43.60%, respectively. Nocturnal urine 6-SMT level was significantly and positively correlated with mHLA-DR expression.

Conclusion
Nocturnal urine 6-SMT level may be a feasible biomarker to predict the outcome of patients with sepsis. The use of a night-time eye mask has no significant effect on the outcome of sepsis.

Clinical trials
This study was registered at clinicaltrials.gov (NCT02304224).
Associations of CYP2C19 and F2R genetic polymorphisms with platelet reactivity in Chinese ischemic stroke patients receiving clopidogrel therapy
Authors: Zhang Suli , Zhu Jinhang , Li Hua , Li Fengzhen , Zhu Bin , Li Tao , Fang Shuxin , Qin Shengying 
Published: December 2021

Objectives
Genetic variation has been considered a major contributor to the high variability in the response to dual antiplatelet therapy in patients with acute ischemic stroke or transient ischemic attack. Recently, incidences of ischemic stroke are increasing rapidly in China. We aimed to evaluate the influence of potential determinants on the response of antiplatelet therapy and adverse events in Chinese ischemic stroke patients receiving clopidogrel-aspirin treatment.

Methods
Based on the clopidogrel drug response pathway and the coagulation and anticoagulation function, we systematically selected 34 genetic polymorphisms in 12 candidate genes. Three hundred and eight patients were divided into 2 groups according to their degree of inhibition of platelet aggregation. Multivariate analysis was then performed to assess the influence of demographic, clinical and genetic factors on platelet reactivity in Chinese ischemic stroke patients.

Results
We found that polymorphisms in CYP2C19 and F2R genes were still significantly associated with platelet reactivity in Chinese ischemic stroke patients (P = 0.037 and 0.015). The newly identified rs168753 in F2R gene may influence the efficacy to clopidogrel-aspirin therapy for ischemic stroke patients. We also found that ischemic stroke patients with low level of inhibition of platelet aggregation had higher risk of recurrent ischemic events (P = 0.001).

Conclusions
Together, these results emphasized the necessity of genotype-directed antiplatelet therapy and facilitated to minimize adverse ischemic events.
RETINAL DETACHMENT IN EYES WITH BOSTON TYPE 1 KERATOPROSTHESIS
Authors: Bonnet Clémence , Chehaibou Ismael , McCannel Colin A. , McCannel Tara A. , Prasad Pradeep S. , Kreiger Allan E. , Schwartz Steven D. , Aldave Anthony , Hubschman Jean-Pierre 
Published: December 2021

Purpose:
To evaluate the mid-term outcomes of pars plana vitrectomy performed for retinal detachment (RD) repair after Boston Type 1 keratoprosthesis (KPro) implantation.

Methods:
Retrospective review of medical records of KPro implanted at the Stein Eye Institute presenting with RD and treated by pars plana vitrectomy. Functional success was defined as a postoperative visual acuity maintained within 2 Snellen lines of the corrected distance visual acuity measured before the development of the RD (baseline) and anatomical success as an attached retina after the pars plana vitrectomy. Kaplan–Meyer survival analyses were performed.

Results:
Among the 224 KPro performed, 28 (15.2%) RD were identified; of which, 21 (9.4%) were included. The mean follow-up was 42.5 ± 27.3 months. Vitreoretinal proliferation was present in 18 of 21 eyes (85.7%). Surgical techniques were adapted to the complex anterior segment anatomy of KPro eyes. Anatomical success was achieved in 18 of 21 eyes (85.7%). Functional success occurred in 17 of 21 eyes (81.0%), and 5 of 21 eyes (23.8%) reached 20/400 or better visual acuity at the final follow-up. The KPro was retained in 11 in 21 eyes (52.4%). The retention rate decreased from 94.7% at 1 year to 53.5% at 5 years. The most frequent complications were retroprosthetic membrane (47.6%) and corneal melt (23.8%).

Conclusion:
Modified pars plana vitrectomy techniques resulted in relatively good mid-term anatomical, functional, and retention rate outcomes, given the severity of RD at presentation and the numerous preoperative comorbidities of KPro eyes.
RONA Technique: A Novel ILM Peeling Method for Treatment of Large Full-Thickness Macular Holes
Authors: Nourinia Ramin , Nikzad Parisa , Abolhosseini Mohammad , Moshtaghion Seyed-Mohamadmehdi , Abtahi Seyed-Hossein 
Published: December 2021

Purpose:
To present a new technique, RONA, for internal limiting membrane peeling and show its comparable success rate in closure of large full-thickness macular holes (FTMHs).

Methods:
This prospective interventional case series was implemented from January 2018 to November 2019. Consecutive cases with large FTMH with an aperture size of more than 500 μm were included. The RONA technique was used to make consecutive flaps; the central border of which remained adherent to the FTMH edge. The emphasis is that the central border of all flaps should remain adherent to the FTMH edge, letting the flaps remain there spontaneously.

Results:
Seventeen eyes of 17 patients (4 males and 13 females; age 62.3 ± 7.8 years) were included. The mean size of opening and base of FTMH were 651.1 ± 141.1 μm (range: 501–950) and 964.6 ± 383.8 μm (range: 527–2098), respectively. One week after the surgery, complete closure of all FTMHs occurred with no hole reopening until the end of 12 months. The mean best-corrected visual acuity at baseline and 12 months after surgery were 1.57 ± 0.30 and 0.75 ± 0.028 logarithm of the minimum angle of resolution, respectively, with statistically significant improvement (P < 0.001).

Conclusion:
The first advantage of this efficacious technique is that there is no need to manipulate FTMH edge or underneath tissues. Another and of course, the most important advantage is that there is no need to care about flap unfolding during the exchange stage.
EFFICACY OF AIR TAMPONADE TREATMENT OF IDIOPATHIC MACULAR HOLES OF DIFFERENT DIAMETERS AND OF FOLLOW-UP INTRAVITREAL AIR TAMPONADE FOR PERSISTENT HOLES
Authors: Tao Jiwei , Chen Huan , Chen Yiqi , Yu Jiangxin , Xu Jiawen , Mao Jianbo , Lin Li , Shen Lijun 
Published: December 2021

Purpose:
To evaluate the efficacy of air tamponade in idiopathic macular hole (iMH) surgery and of an additional intravitreal air injection in the treatment of persistent holes.

Methods:
Retrospective, observational case series. Sixty eyes of 60 patients with an iMH underwent phacoemulsification of cataract (when appropriate), pars plana vitrectomy, and internal limiting membrane peeling, followed by air tamponade. Eyes with persistent holes underwent an additional intravitreal air injection within 1 week after surgery. The iMH closure rate and the best-corrected visual acuity were evaluated.

Results:
In all 30 eyes with an iMH diameter <400 µm, the iMH closed after the primary surgery; however, only 17 of 30 eyes with an iMH diameter of ≥400 µm closed after the primary surgery. For the 13 eyes with persistent holes, an additional intravitreal air injection resulted in successful hole closure. There was no significant difference in the best-corrected visual acuity at the final follow-up between the closed subgroup and the initially unclosed subgroup after closure.

Conclusion:
Pars plana vitrectomy combined with air tamponade effectively cured small iMHs. For large iMHs not closed after the primary surgery, an additional intravitreal air injection resulted in hole closure and achieved a good prognosis.
ASSOCIATION OF FLOW SIGNALS WITHIN POLYPS ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY WITH TREATMENT RESPONSES AFTER COMBINATION THERAPY FOR POLYPOIDAL CHOROIDAL VASCULOPATHY
Authors: Fukuyama Hisashi , Komuku Yuki , Araki Takashi , Gomi Fumi 
Published: December 2021

Purpose:
To evaluate the changes of blood circulation within the polypoidal lesions by OCT angiography in eyes with polypoidal choroidal vasculopathy after combination therapy with aflibercept and photodynamic therapy.

Methods:
A total of 46 eyes from 46 patients who underwent the combination therapy for polypoidal choroidal vasculopathy were followed for more than 6 months. OCT angiography, covering an area 6 mm2 × 6 mm2 including the macula, were performed at baseline, 2 weeks, and 3 months and 6 months post-treatment.

Results:
The subretinal fluid resolved within 3 months after treatment in 44 eyes (95.7%), and 27 eyes (58.7%) showed no recurrence, with no additional treatment. Seventeen eyes (37.0%) showed recurrence, and two eyes (4.3%) showed poor response. On OCT angiography at 2 weeks after treatment, flow signals were detected in 3 of 27 eyes (11.1%) without recurrence and in 8 of 19 eyes (42.1%) with recurrence or poor responses. A detectable flow signal at 2 weeks was significantly associated with recurrence or poor response (P = 0.032).

Conclusion:
Persistent flow signals within polyps on OCT angiography at 2 weeks after combination therapy suggest less effectiveness of the initial treatment.
CHANGES OF FIXATION STABILITY AND LOCATION AFTER EPIRETINAL MEMBRANE SURGERY
Authors: Yang Xiaohan , Wang Zengyi , Yu Yanping , Liu Lingzi , Qi Biying , Zhang Ke , Liu Wu 
Published: December 2021

Purpose:
This study aimed to evaluate fixation stability and position changes after epiretinal membrane (ERM) surgery.

Methods:
This is a retrospective study that included 60 consecutive eyes with idiopathic ERM. All patients received comprehensive ophthalmic examinations preoperatively and 1, 4, and 10 months postoperatively. Main outcome measures included fixation stability and position, bivariate contour ellipse area, and preferred retinal locus.

Results:
The number of patients with stable fixation and predominantly central fixation was increased significantly after ERM surgery (61.7 vs. 73.3%, P = 0.001; 41.7 vs. 71.7%, P = 0.037). The correlation analysis showed that the preoperative factors associated with improved postoperative fixation stability were a larger bivariate contour ellipse area value (P < 0.001), poorer visual acuity (P = 0.002), advanced stage (P = 0.002), thicker central fovea thickness (P = 0.015), and a longer preferred retinal locus–fovea distance (P = 0.025). As for the improved fixation location, the associated preoperative factors were age (P = 0.003), central fovea thickness (P = 0.044), and preferred retinal locus–fovea distance (P < 0.001).

Conclusion:
Our observations point to the changes of fixation parameters in patients after ERM surgery. We found that patients with preoperative unstable, eccentric fixation and poor BCVA can significantly benefit from the surgery. This result indicates that even in patients with severe macular damage, the ERM surgery still has great benefits in recovering visual function.
Glaucoma and biomechanics
Authors: Safa Babak N. , Wong Cydney A. , Ha Jungmin , Ethier C. Ross 
Published: December 2021

Purpose of review
Biomechanics is an important aspect of the complex family of diseases known as the glaucomas. Here, we review recent studies of biomechanics in glaucoma.

Recent findings
Several tissues have direct and/or indirect biomechanical roles in various forms of glaucoma, including the trabecular meshwork, cornea, peripapillary sclera, optic nerve head/sheath, and iris. Multiple mechanosensory mechanisms and signaling pathways continue to be identified in both the trabecular meshwork and optic nerve head. Further, the recent literature describes a variety of approaches for investigating the role of tissue biomechanics as a risk factor for glaucoma, including pathological stiffening of the trabecular meshwork, peripapillary scleral structural changes, and remodeling of the optic nerve head. Finally, there have been advances in incorporating biomechanical information in glaucoma prognoses, including corneal biomechanical parameters and iridial mechanical properties in angle-closure glaucoma.

Summary
Biomechanics remains an active aspect of glaucoma research, with activity in both basic science and clinical translation. However, the role of biomechanics in glaucoma remains incompletely understood. Therefore, further studies are indicated to identify novel therapeutic approaches that leverage biomechanics. Importantly, clinical translation of appropriate assays of tissue biomechanical properties in glaucoma is also needed.
Effects of Drama Therapy on Depressive Symptoms, Attention, and Quality of Life in Patients With Dementia
Authors: LIN Li-Wei , LU Yi-Hsin , CHANG Tasi-Hsiu , YEH Shu-Hui 
Published: December 2021

ABSTRACT

Background
The prevalence of dementia in Taiwan continues to rise, and related patient care is becoming challenging for family members and caregivers. Nondrug treatments are often used as a care strategy to alleviate the behaviors associated with worsening dementia. Many international researchers have examined the effectiveness of drama therapy on dementia care. However, there is a lack of related studies in Taiwan.

Purpose
The aim of this study was to examine the effects of drama therapy in terms of improving depressive symptoms, attention, and quality of life in patients with senile dementia.

Methods
A two-group pretest-and-posttest design was employed in this randomized controlled trial. Cluster sampling was employed at four dementia daycare centers in central Taiwan. Two centers were randomly assigned to the experimental group, and the other two centers were assigned to the control group.

Results
Forty-two patients with dementia (23 in the experimental group and 19 in the control group) participated in this study. The study results showed that, after 8 weeks of drama therapy, the experimental group showed a significant improvement in depressive symptoms (β = −5.07, p < .001), attention (β = 5.86, p < .001), and quality of life (β = −6.08, p < .001). Furthermore, after 12 weeks of drama therapy, the experimental group continued to show a significant improvement in depressive symptoms (β = −4.65, p < .01), attention (β = 6.76, p < .001), and quality of life (β = −4.94, p < .01).

Conclusions
On the basis of the results of this study, patients with senile dementia who participate in 8- and 12-week drama therapy programs significantly improved in terms of depressive symptoms, attention, and quality of life. The authors hope that the findings of this study provide a reference for the intervention method, content, frequency, and timing of drama therapy in patients with dementia.
Measurement of Incus and Stapes Velocity Following Sound Stimulus in the Setting of Incudostapedial Joint Separation and Reconstruction
Authors: Lally CPT John W. , Ryan Matthew , Ahmed MAJ Mostafa , Afzali Leila , Spear LTC Samuel A. , Esquivel Carlos 
Published: December 2021

Objective:
Understand the biophysical property changes of incudostapedial joint (ISJ) separation and ossicular hydroxyapatite application on middle ear function.

Study Design:
Basic science.

Setting:
Cadaveric temporal bone research laboratory.

Subjects and Methods:
A complete mastoidectomy was performed on five human temporal bones. A Laser Doppler Vibrometer was utilized to obtain velocity transfer function measurements of the incus and stapes across a range of frequencies in response to an acoustic stimulus. Under binocular microscopy the ISJ was separated and subsequently repaired with bone cement. Measurements were taken prior to ISJ separation, following joint separation, 30 to 60 min postrepair of the joint, and again 24 to 48 h postrepair of the joint.

Results:
The stapes measurements taken from the intact ossicular chain and from the chains repaired with bone cement demonstrated a similar distribution of measurements. The ISJ separation showed dramatically reduced velocity transfer function stapes measurements but increased incus velocity transfer function measurements. In the early and delayed repaired chains, the mean velocity of the incus and stapes velocity peaked between 1.5 and 2 kHz, matching intact maximal velocity. Pure tone average at 0.5, 1, 2, and 3 kHz demonstrated no change in reconstructed stapes velocity at 24 to 48 h.

Conclusions:
Isolated ISJ separation in fresh frozen and thawed temporal bones produces stapes velocity transfer function changes that corresponds with the clinically experienced conductive hearing loss. Repair with bone cement produced similar velocity curves to the intact ISJ curve with excellent recovery across mid-frequencies. This model would be useful for future ossicular mechanical studies.
A Rare Complication of Chronic Otitis Media: Central Skull Base Osteomyelitis Managed With Combined Endoscopic Transmastoid and Transsphenoidal Debridement
Authors: Suresh Krish , Chari Divya A. , Bartholomew Ryan A. , Tward Aaron D. , Kozin Elliott D. , Barshak Miriam B. , Holbrook Eric H. , Lee Daniel J. 
Published: December 2021

Objective:
This report describes a case of otogenic central skull base osteomyelitis (CSBO) requiring complex surgical intervention and reviews the literature on management of this entity.

Patient:
A 76-year-old man presented with a nearly 20-year history of chronic otomastoiditis and cholesteatoma with ultimate progression to severe CSBO with involvement of the petrous apex, clivus, and craniocervical junction.

Interventions:
CSBO was managed with culture-directed antibiotic therapy, hyperbaric oxygen, and surgical intervention including serial combined endoscopic transmastoid and transsphenoidal debridements.

Main outcome measures:
Symptom resolution, antibiotic holiday, and stable disease on surveillance imaging.

Results:
With antibiotic treatment and surgical debridement including creation of a drainage pathway from the skull base to the sphenoid sinus, intermittent stretches of disease quiescence were realized over the course of nearly a decade. Despite extensive debridement and skull base reconstruction, the patient ultimately succumbed to the disease process.

Conclusions:
CSBO poses significant management challenges to the otologist. Herein, we present a rare case of CSBO managed over a prolonged period of time with antibiotics and combined anterior and lateral skull base debridement.