bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treating Striae Distensae Albae in Asians: Efficacy and Safety of Combined MFU-V and CaHA
Authors: Lim Joyce Teng Ee 
Published: February 2021

Background:
This study evaluated the efficacy and safety of a single treatment combining microfocused ultrasound with visualization (MFU-V) and subdermal diluted calcium hydroxylapatite with lidocaine (CaHA+) for Striae Distensae Albae (SDA).

Methods:
Ten prospectively enrolled women with abdominal, back or thigh SDA were treated with MFU-V at 3 focal depths (4.5, 3.0, and 1.5 mm), followed by 3–6 mL of diluted CaHA+ (1:1 ratio) in the same session. Outcomes were assessed at 1 month, 3 months, and 5 months postprocedure using a 5-point quartile grading scale, an SDA scoring scale, a 10-point visual analog score, and a global aesthetic improvement scale.

Results:
All patients exhibited improvement in SDA at 3 months, with further improvement at 6 months. Physicians’ assessment with the quartile grading scale showed that 8 patients improved moderately, whereas 2 had good improvement at 6 months. The mean overall SDA score was 11.6 at baseline, 11.1 (not significant) at 1 month, 7.9 (P = 0.005) at 3 months, and 6.2 (P = 0.005) at 6 months. All patients had improved global aesthetic improvement scale at 3 and 6 months, with 4 patients being much improved, and 3 patients being very much improved at 6 months. At the end of the study, all patients were less bothered with their SDA compared with baseline with a mean reduction of 2.7 in visual analog score, and all patients were satisfied or very satisfied with the treatment. No adverse events occurred.

Conclusion:
A single combination treatment of MFU-V and diluted CaHA+ improves SDA without side effects and may be considered for patients seeking to minimize SDA.
The Anatomic Features of Müller’s Muscle: A Histology Study in Chinese
Authors: Zhang Minchen , Zhou Rong , Wu Jun , Chen Lulu , Ren Zijian , Gao Weicheng 
Published: February 2021

Background:
The purpose of this article is to clarify the character of Müller’s muscle in Chinese specimens.

Methods:
Ten upper eyelids of 10 formalin-fixed Chinese cadavers (9 elderly people, from 68 to 86 years of age; 1 male child, 10 years old) were examined. Full-thickness sagittal sections of the central part of the upper eyelids were microscopically examined using hematoxylin-eosin, Masson trichrome, and anti–smooth muscle actin antibodies staining.

Result:
In 9 elderly specimens, Müller’s muscle inserted onto tarsus via fibers, and the smooth muscle components decreased gradually and even faded away from the originated inferior branch of levator palpebrae superioris muscle to the upper margin of tarsus, although, in 1 child specimen, Müller’s muscle inserted directly onto tarsus rather than connective fibrous structure, and smooth muscle components did not decrease obviously. Both in elderly and young specimens, the aponeurotic structure that originated from Müller’s muscle extended to the tarsal plate.

Conclusion:
This study suggests that Müller’s muscle inserts onto the tarsus via fibrous tissue or smooth muscle, and also indicates that the smooth components of Müller’s muscle may decrease gradually in elderly people.
Assessment of the Academic Productivity of Plastic Surgeons in Saudi Arabia Using the h-index
Authors: Shah Mardan Qutaiba N. M. , Mrad Mohamed Amir , Alhumsi Taghreed R. , Almarghoub Mohammed A. , Alsavaf Mohammad B. , Alsaghier Ruah M. , Kattan Abdullah E. 
Published: February 2021

Background:

Hirsch-index (or h-index) is a bibliometric measure calculated for researchers based on number of publications and their citations. This study examined the h-index of board-certified plastic surgeons in Saudi Arabia and the different factors that may influence it.

Method:
In this cross-sectional study, an electronic questionnaire was sent to 156 board-certified plastic surgeons practicing in Saudi Arabia. Using their names, we conducted an online search on Scopus, Semantic scholar, and Google scholar to calculate their h-index. Bivariate and multiple regression analyses were conducted to determine the relationship of those factors with the index.

Results:
A total of 84 surgeons participated in this study, of whom 83.3% were men. Our sample scored a mean index of 1.7 and published a mean of 5 articles. More publications and a higher academic rank predicted a higher h-index, (β = 0.79, P < 0.001) and (β = 0.14, P 0.017), respectively. On the other end of the spectrum, the country of residency training (P 0.33), the year of training completion (P 0.95), attaining fellowship training (P 0.95), the number of fellowships (P 0.20), interest in research (P 0.74), working in an academic hospital (P 0.44), or attaining a higher degree (P 0.61) were not significant independent predictors of the index.

Conclusions:
More publications and a higher rank predicted increased academic productivity among the plastic surgeons in Saudi Arabia. Despite its limitations, h-index is a useful measure that can be considered in promotions and applications to prestigious plastic surgery centers in adjunct to other factors.
Service Lines: Working Toward a Value-Based Future
Authors: Lutz John A. , Zalucki Paula M. , Finarelli Maria 
Published: February 2021

SUMMARY
The primary drivers for service line development have historically been market differentiation and profitable growth. In the current transition to value-based care, however, several other factors are now driving service line strategy. Specifically, in a value-based world, service lines must be patient centric, not provider centric; they must focus on more than hospitals; and they must be market facing.
To build the operating model of the future and succeed in a value-based world, health systems need to reimagine the clinical, operational, and financial features of today’s service lines. In working toward this future state, a coordinated, evidence-based care model with a multidisciplinary care team must replace today’s episodic care. Easy access to prompt solutions and a seamless, low-stress experience for both patients and providers will be new competitive differentiators, along with cost transparency. Outcomes, patient convenience, and the total cost of care will drive future service line relationships between health systems and physicians. The criteria for selecting physician partners will be materially different, too.
In implementing this future-state model, healthcare organizations will need to reconcile several opposing forces and tear down structural and operational silos. Health systems that can navigate through these challenges can realize numerous benefits.
Clinical approach to genetic testing in amyloid cardiomyopathy: from mechanism to effective therapies
Authors: Alreshq Rabah , Ruberg Frederick L. 
Published: February 2021

Purpose of review
To highlight the evolving understanding of genetic variants, utility of genetic testing, and the selection of novel therapies for cardiac amyloidosis.

Recent findings
The last decade has seen considerable progress in cardiac amyloidosis recognition given the advancement in cardiac imaging techniques and widespread availability of genetic testing. A significant shift in the understanding of a genetic basis for amyloidosis has led to the development of disease-modifying therapeutic strategies that improve survival.

Summary
The systemic amyloidoses are disorders caused by extracellular deposition of misfolded amyloid fibrils in various organs. Immunoglobulin light-chain or transthyretin amyloidosis are the most common types associated with cardiac manifestations. Genetic testing plays a central role in the identification of genotypes that are associated with different clinical phenotypes and influence prognosis. Given the emergence of effective therapies, a systematic approach to the diagnosis of cardiac amyloidosis, with the elucidation of genotype when indicated, is essential to select the appropriate treatment.
Misdiagnosis of Acute Myocardial Infarction: A Systematic Review of the Literature
Authors: Kwok Chun Shing , Bennett Sadie , Azam Ziyad , Welsh Victoria , Potluri Rahul , Loke Yoon K. , Mallen Christian D. 
Published: February 2021

Background:
Despite the availability of tests to diagnose acute myocardial infarction (AMI), cases are still missed.

Methods:
We systematically reviewed the literature to determine how missed AMI has been defined, the reported rates of misdiagnosed AMI, the outcomes patients with misdiagnosed AMI have, what diagnosis was initially suspected in missed AMI cases, and what factors are associated with misdiagnosed AMI. We searched MEDLINE and EMBASE in September 2020 for studies that evaluated missed AMI. Data were extracted from studies that met the inclusion criteria and the results were narratively synthesized.

Results:
A total of 15 studies were included in this review. The number of patients with missed AMI in individual studies ranged from 64 to 4707. There was no consistently used definition for misdiagnosed AMI, but most studies reported rates of approximately 1%–2%. Compared with AMI that was recognized, 1 study found no difference in mortality for misdiagnosed AMI at 30 days and 1 year. The common initial misdiagnoses that subsequently had AMI were ischemic heart disease, nonspecific chest pain, gastrointestinal disease, musculoskeletal pain, and arrhythmias. Reasons for missed AMI include incorrect electrocardiogram interpretation and failure to order appropriate diagnostic tests. Hospitals in rural areas and those with a low proportion of classical chest pain patients that turned out to have AMI were at greater risk of missed AMI.

Conclusions:
Misdiagnosed AMI is an unfortunate part of everyday clinical practice and better training in electrocardiogram interpretation, and education about atypical presentations of AMI may reduce the number of misdiagnosed AMIs.
THE NATIONWIDE INCIDENCE OF RETINAL ARTERY OCCLUSION FOLLOWING DIALYSIS AS A RESULT OF END-STAGE RENAL DISEASE
Authors: Moon Tae Hwan , Kang Minseok , Lee Seungheon , Seo Eoi Jong , Kwon Soon Kil , Kang Gilwon , Han Joung-Ho , Chae Ju Byung , Kim Dong Yoon 
Published: February 2021

Purpose:To examine the incidence and risk of retinal artery occlusion (RAO) in patients who have undergone dialysis in Korea.Methods:A nationwide, population-based study using South Korean national health insurance data from 2004 to 2013 was used for analysis. All patients who began dialysis between 2004 and 2013 and the same number of control subjects were selected via propensity score matching. The incidence of RAO in the dialysis and control cohorts was calculated for 2004 to 2013 using washout data from 2003. The multivariable Cox proportional hazards model was used to evaluate the risk of developing RAO in dialysis patients. Cumulative RAO incidence curves were generated using the Kaplan–Meier method. Whether dialysis modalities influenced the incidence of RAO was also evaluated.Results:Seventy-six thousand seven hundred and eighty-two end-stage renal disease patients on dialysis were included in the dialysis cohort, and 76,782 individuals were included in the control cohort. During the study period, 293 patients in the dialysis cohort and 99 patients in the control cohort developed RAO. The person-years incidence of RAO was significantly higher in the dialysis cohort than in the control cohort (dialysis = 1.1/1,000 person-years; control = 0.3/1,000 person-years;P< 0.001). The incidence of RAO was not significantly different between the two methods of dialysis (hemodialysis vs. peritoneal dialysis;P= 0.25, log-rank test).Conclusion:The current study provided epidemiological evidence that undergoing dialysis for end-stage renal disease was associated with an increased risk of developing RAO. The incidence of RAO rapidly increased as the duration of dialysis increased. These results strengthen the significant role of the renal function in retinal vascular disease.
Photobiomodulation therapy in age-related macular degeneration
Authors: Muste Justin C. , Kalur Aneesha , Iyer Amogh , Valentim Carolina C.S. , Singh Rishi P. 
Published: February 2021

Purpose of review
To review the available data supporting the use of photobiomodulation therapy (PBT) in the treatment of age-related macular degeneration (AMD).

Recent findings
PBT might be used in treating nonexudative AMD. Limited evidence suggests that exudative AMD may also benefit from PBT.

Summary
The optimal device would deliver doses of 60 J/cm2 or more with a multiwavelength composition through the pupil over short treatment intervals. Safe upper limits have not been established. More studies are needed to evaluate the efficacy of PBT in treating exudative and nonexudative AMD.
Orbital inflammatory disorders: new knowledge, future challenges
Authors: Kahana Alon 
Published: February 2021

Purpose of review
This review aims to bring together recent advances in basic, translational and clinical research on the pathogenesis and treatment of orbital inflammatory conditions.

Recent findings
Basic science studies provide mechanistic insights into why the orbit is targeted for inflammation by autoimmune inflammatory disorders. Using Graves’ disease as a test case reveals that endocrine pathways, such as the TSH and IGF1 receptor pathways play important roles in stimulating orbital inflammation. Furthermore, orbital tissues contain high concentrations of retinoids – byproducts of the visual pathway that diffuse across the sclera and can activate de novo transcription of inflammatory cytokines. Such cytokine expression places the orbit in a hyper-inflammatory ‘resting’ state, prone to respond to any additional systemic or local pro-inflammatory signals. The HIF2A--LOX pathway appears important for orbital tissue fibrosis. Lastly, bench-to-bedside studies of the IGF1R pathway have led to an FDA-approved drug, teprotumumab that represents a novel treatment approach for Graves’ orbitopathy. Unfortunately, high drug costs and misplaced insurance company ‘step-therapy’ policies may block patients from receiving therapy that can protect vision and improve quality of life.

Summary
Improved understanding of orbital inflammatory conditions has led to a new drug and promises additional breakthroughs. Translational research is successful, but requires time, resources, and patience.
Novel vitreous substitutes: the next frontier in vitreoretinal surgery
Authors: Schulz André , Januschowski Kai , Szurman Peter 
Published: February 2021

Purpose of review
After removing the native vitreous during vitreoretinal surgery, an adequate substitute is required to ensure homeostasis of the eye. Current clinically used endotamponades (silicone oil, gases, semifluorinated alkanes) are effective in promoting retinal reattachment, but lead to complications such as emulsification, prolonged inflammation, blurred vision, raised intraocular pressure, cataract formation or the need for revision surgery. The aim of this review is to provide an update on novel vitreous substitutes with a focus on polymer-based systems.

Recent findings
Polymeric hydrogels provide favourable properties such as high water content, optical transparency, suitable refractive indices and densities, adjustable rheological properties, injectability, biocompatibility and their ability to tamponade the retina via viscosity and swelling pressure, comparable to the native human vitreous body. Here, vitreous replacement strategies can be divided into chemically or physically crosslinked hydrogel systems that are applied as preformed or in-situ gelling matrices.

Summary
Several hydrogel-based vitreous substitutes have already been positively evaluated in preclinical tests and have the potential to enter the clinical phase soon.
Emerging treatments for geographic atrophy in age-related macular degeneration
Authors: Mahmoudzadeh Raziyeh , Hinkle John W. , Hsu Jason , Garg Sunir J. 
Published: February 2021

Purpose of review
This review describes therapeutic research programs for geographic atrophy (GA) due to age-related macular degeneration (AMD). We highlight clinical trial data from phase I, II, and III studies.

Recent findings
There are currently no treatments for GA, a form of advanced AMD that causes significant visual morbidity. Currently, therapeutic candidates are being developed to delay further progression of GA or even attempt to reverse some of the damage. The approaches to therapy range from molecular targets to cell transplantation. Studies of these novel treatment approaches have demonstrated varying degrees of success. The progress in understanding the disease pathophysiology as well as clinical trial data is reviewed.

Summary
There are promising new treatments to prevent GA progression as well as some that may reverse the disease course.
Glaucoma Publication Trends in Leading General Ophthalmology Journals During the Past Quarter Century: Where Are the Clinical Trials?
Authors: Leshno Ari , De Moraes C. Gustavo , Mezad-Koursh Daphna , Belkin Michael , Singer Reut , Jaber Wasim , Barkana Yaniv , Skaat Alon 
Published: February 2021

Précis:
During the past quarter century, the rate of glaucoma-related publication in general ophthalmology journals increased due to higher representation in “experimentally oriented” journals. The rate of glaucoma randomized controlled clinical trial (RCT) articles decreased during the same time period.

Purpose:
To evaluate trends in rate of glaucoma publications in leading general ophthalmology journals over the past quarter century.

Materials and Methods:
Q1 ophthalmology journals Web sites were reviewed. Only journals not limited to certain subspecialty were considered “general” and included in the analysis. In addition we categorized journals orientation as either “clinical” or “experimental.” The PubMed search engine was used to collect publications from the selected journals between January 1, 1995 to December 31, 2019. Publications captured by “glaucoma” or “ocular hypertension” filters were considered glaucoma related. The fraction of glaucoma articles out of total number of articles within each year for each journal was calculated. A linear mixed effects model was applied to detect trends in glaucoma publication rates during the study period.

Results:
Eight journals were included: 4 “clinically oriented” and 4 “experimentally oriented.” The PubMed search yielded 72,750 publications, of which 9329 (12.8%) considered “glaucoma related.” Percentage of glaucoma publications remained stable within “clinically oriented” journals, and significantly increased within “experimentally oriented” journals (annual change of 0.3%, P<0.001). The number of glaucoma-related RCTs decreased significantly in each (annual change of −0.21% and −0.13%, respectively, P<0.05).

Conclusions:
There has been a significant rise in the rates of glaucoma publications in “experimentally oriented” journals, while their representation in “clinically oriented” journals remained stable over the past quarter century. This change might be due to the increasing efforts to develop more advanced methods for evaluation and treatment in glaucoma, although still unable to address clinical demands. The decrease in glaucoma-related RCT articles might indicate reduced funding for such research.
Lower Success in Trabeculectomies in Exfoliation Compared With Primary Open-angle Glaucoma Patients in Sweden
Authors: Ayala Marcelo 
Published: February 2021

Précis:
In a Sweden-based study, a lower success rate in exfoliation than in open-angle glaucoma patients was found in a 5-year follow-up after trabeculectomy.

Purpose:
The present study aimed to compare the success of trabeculectomies in exfoliation versus open-angle glaucoma patients.

Patients and Methods:
Data were gathered through a retrospective chart review. Included patients underwent primary trabeculectomy from January 1 2009 till December 31, 2014 (6 y). All included patients were operated on at the Eye Department, Skaraborg Hospital, Sweden, and followed for at least 5 years after surgery. Included patients had primary open-angle glaucoma (POAG) or exfoliation glaucoma (EXFG). The study followed the recommendations of the World Glaucoma Association (WGA). Successful result: criterion A: eye pressure ≤18 mm Hg and pressure reduction ≥30% without medications (complete success: A1), with or without medications (qualified success: A2). Criterion B: eye pressure ≤15 mm Hg and pressure reduction ≥40% without medications (complete success: B1), with or without medications (qualified success: B2).

Results:
A total of 147 patients were included in this study, 92 in the EXFG and 55 in the POAG group. At the baseline, only 3 variables (intraocular pressure, number of medications, and the number of laser treatments) showed a significant difference between EXFG and POAG patients. Complete and qualified success for both criterion A (A1 and A2) and B (B1 and B2) were significantly lower in the EXFG compared with the POAG group (Mantel-Cox test, P<0.0001, P=0.01, P<0.001, P=0.008).

Conclusions:
Trabeculectomies in EXFG seem to have a lower success rate than in POAG patients. EXFG patients should be checked often after trabeculectomy to detect the failure of the surgery.
Differences Between Pediatric Acute Myocarditis Related and Unrelated to SARS-CoV-2
Authors: Vukomanovic Vladislav A. , Krasic Stasa , Prijic Sergej , Ninic Sanja , Minic Predrag , Petrovic Gordana , Nesic Dejan 
Published: February 2021

Background:
Acute myocarditis (AM) is defined as inflammation of the myocardium. The aim of our study is a comparative analysis of the differences between AM related and unrelated to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods:
The retrospective study included children with AM treated from January 2018 to November 2020.

Results:
The study included 24 patients; 7 of 24 had AM related to SARS-CoV-2 and they were older than 7. They were more likely to have abdominal pain (P = 0.014), headache (P = 0.003), cutaneous rash (P = 0.003), and conjunctivitis (P = 0.003), while fulminant myocarditis was commonly registered in AM unrelated to SARS-CoV-2 (P = 0.04). A multisystem inflammatory syndrome in children associated with COVID-19 was diagnosed in six adolescents. Patients with AM related SARS-CoV-2 had lower serum cardiac troponin I (cTnI) (P = 0.012), and platelets (P < 0.001), but had a higher C-reactive protein (CRP) value (P = 0.04), and N-terminal-pro hormone BNP in comparison to patients with AM unrelated to SARS-CoV-2. The patients with AM related to SARS-CoV-2 had significant reduction of CRP (P = 0.007). Inotropic drug support was used for shorter durations in patients with AM related to SARS-CoV-2, than in others (P = 0.02). Children with AM related to SARS-CoV-2 had significant improvement of left ventricle systolic function on the third day in hospital (P = 0.001). Patients with AM unrelated to SARS-CoV-2 AM had more frequent adverse outcomes (P = 0.04; three died and four dilated cardiomyopathy).

Conclusions:
In contrast to patients with AM unrelated to SARS-CoV-2, patients with AM related to SARS-CoV-2 had a higher CRP value, polymorphic clinical presentation, shorter durations of inotropic drugs use as well as prompt recovery of left ventricle systolic function.