bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral Immune-Mediated Keratolysis After Immunization With SARS-CoV-2 Recombinant Viral Vector Vaccine
Authors: Khan Tanveer Alam , Sidhu Navneet , Khan Livia , Sen Seema , Hussain Nishat , Tandon Radhika , Gupta Noopur 
Published: September 2021

Purpose:
The purpose of this study was to report an unusual case of bilateral immune-mediated corneal melting and necrosis after ChAdOx1 nCoV-19 (Covishield) vaccination.

Methods:
This is a case report and literature review.

Results:
A 48-year-old man presented to the ophthalmic emergency department with progressive bilateral corneal melting 5 weeks after receiving the first dose of ChAdOx1 nCoV-19 (Covishield) vaccine. Systemic complaints of fever, diarrhea, and vomiting were noted in the first 2 weeks, which subsided before the onset of ocular symptoms at day 21 of vaccine administration. The patient could only perceive light bilaterally and demonstrated features of bilateral keratolysis with choroidal detachment on ultrasonography. The microbiological scraping specimen did not reveal growth of any microorganism. Tectonic penetrating keratoplasty was performed, and the host corneal tissue was sent for histopathology, bacterial culture, fungal culture, polymerase chain reaction for herpes simplex virus, varicella zoster virus, cytomegalovirus, adenovirus, and SARS-CoV-2. Microbial culture was sterile, and viral polymerase chain reaction reports were negative. Histopathological examination revealed dense inflammatory cell infiltration. Detailed systemic workup revealed no underlying systemic or autoimmune pathology.

Conclusions:
Immune-mediated keratolysis after ChAdOx1 nCoV-19 (Covishield) vaccination is a rare entity, and we believe that this is the first report of a temporal association between a serious ocular adverse event after a single dose of any SARS-CoV-19 vaccine. It may be included as a possible adverse event associated with this vaccine.
Effect of Azithromycin on the Ocular Surface Microbiome of Children in a High Prevalence Trachoma Area
Authors: Doan Thuy , Gebre Teshome , Ayele Berhan , Zerihun Mulat , Hinterwirth Armin , Zhong Lina , Chen Cindi , Ruder Kevin , Zhou Zhaoxia , Emerson Paul M. , Porco Travis C. , Keenan Jeremy D. , Lietman Thomas M. 
Published: September 2021

Purpose:
The aim of this study was to evaluate the effect of the 4 times per year mass azithromycin distributions on the ocular surface microbiome of children in a trachoma endemic area.

Methods:
In this cluster-randomized controlled trial, children aged 1 to 10 years in rural communities in the Goncha Seso Enesie district of Ethiopia were randomized to either no treatment or treatment with a single dose of oral azithromycin (height-based dosing to approximate 20 mg/kg) every 3 months for 1 year. Post hoc analysis of ocular surface Chlamydia trachomatis load, microbial community diversity, and macrolide resistance determinants was performed to evaluate differences between treatment arms.

Results:
One thousand two hundred fifty-five children from 24 communities were included in the study. The mean azithromycin coverage in the treated communities was 80% (95% CI: 73%–86%). The average age was 5 years (95% CI: 4–5). Ocular surface C. trachomatis load was reduced in children treated with the 4 times per year azithromycin (P = 0.0003). Neisseria gonorrhoeae, Neisseria lactamica, and Neisseria meningitidis were more abundant in the no-treatment arm compared with the treated arm. The macrolide resistance gene ermB was not different between arms (P = 0.63), but mefA/E was increased (P = 0.04) in the azithromycin-treated arm.

Conclusions:
We found a reduction in the load of C. trachomatis and 3 Neisseria species in communities treated with azithromycin. These benefits came at the cost of selection for macrolide resistance.
Correlation of hair cortisol and interleukin 6 with structural change in the active progression of keratoconus
Authors: Stival Larissa R. , Avila Laryssa P. , Araujo Daniella C. , Chaves Luis F. , Toledo Marcia C. , Silva Artur C. , Cunha Luiz C. , Oliveira Tiago F. , Santhiago Marcony R. 
Published: September 2021

Purpose:
To evaluate interleukin (IL) and hair cortisol concentrations (HCCs) in progressive keratoconus (KC) and compare them with KC-stable eyes and healthy control, and to determine the correlation of these inflammatory mediators and HCCs and their relationship with structural damage represented by increased corneal curvature.

Setting:
University of Sao Paulo, Brazil.

Design:
Prospective observational comparative study.

Methods:
133 eyes of 74 patients were included. The concentrations of tear cytokines: IL1B, IL6, IL8, IL10, IL12p70, and tumor necrosis factor α were obtained by capillary flow and measured using a flow cytometer. HCCs were determined from the most proximal hair segment as an index of cumulative secretion and measured by liquid chromatography mass spectrometry.

Results:
133 eyes of 74 patients. Only IL6 was increased in progressive KC tears compared with stable KC (6.59 ± 3.25 pg/mL vs 4.72 ± 1.91 pg/mL; P < .0001) with a positive correlation between IL6 and maximum keratometry (Kmax) (P < .0001). Progressive KC exhibited significantly higher HCC than stable KC (0.624 ± 0.160 ng/mg vs 0.368 ± 0.0647 ng/mg; P < .0001) and healthy controls (0.624 ± 0.160 ng/mg vs 0.351 ± 0.0896 ng/mg; P < .0001). There was a significant correlation between HCC and Kmax (P < .0001).

Conclusions:
KC eyes that are progressing have a higher concentration of IL6 and long-term cortisol than patients with stable forms of KC; second, there is a significant correlation between this increase in IL6 and cortisol with corneal structural damage. Finally, there is a meaningful relationship between this interleukin and the previous few months' cortisol levels.
Evaluation of intraoperative aphakic eye axial length measurements using swept-source OCT
Authors: Hienert Julius , Amir-Asgari Sahand , Matz Holger , Hirnschall Nino , Findl Oliver 
Published: September 2021

Purpose:
To evaluate intraoperative aphakic eye axial length (AL) measurements using swept-source optical coherence tomography (SS-OCT).

Setting:
Hanusch Hospital, Vienna, Austria.

Design:
Prospective single-center study.

Methods:
Patients scheduled for cataract surgery were measured using SS-OCT (IOLMaster 700, Carl Zeiss Meditec AG) to assess the AL. Intraoperatively (intra-OP), SS-OCT measurements were performed with a prototype device (IOLMaster 700 connected to an OPMI Lumera 700 microscope, CZM) at the beginning of cataract surgery furthermore of the aphakic eye and 2 months after surgery.

Results:
106 patients were included. Of the 59 eyes of 59 patients, the phakic median AL preoperatively and intra-OP was 23.61 mm ± 0.96 (standard deviation [SD]) and 23.51 mm ± 0.96 (SD), respectively. The absolute median difference was 0.028 ± 0.02 (SD) (P = .049). Median phakic AL intra-OP vs 2 months postoperatively (post-OP) was 23.51 mm ± 0.97 (SD) vs 23.49 mm ± 0.95 (SD). The absolute median difference was 0.049 ± 0.04 (SD) (P = .000). Median AL intra-OP aphakic vs 2 months post-OP pseudophakic was 23.42 mm ± 0.97 (SD) vs 23.42 mm ± 0.97 (SD), respectively. Absolute median difference was 0.038 ± 0.04 (SD) (P = .379).

Conclusions:
Intra-OP, SS-OCT technology of the phakic and aphakic eye shows excellent comparability to preoperative and postoperative measurements. This technique allows AL measurements with high precision in cases in which preoperative biometric measurements are not possible.
Beneath the Surface: Mental Health and Harassment and Abuse of Athletes Participating in the FINA (Aquatics) World Championships, 2019
Authors: Mountjoy Margo , Junge Astrid , Magnusson Christer , Shahpar Farhad Moradi , Ortiz Lizcano Edgar Ivan , Varvodic Josip , Wang Xinzhai , Cherif Mohamed Yahia , Hill Lee , Miller Jim 
Published: September 2021

Objective:
To assess the mental health and experience of sport-related harassment and abuse of elite aquatic athletes and to analyze it in relation to gender and discipline.

Design:
Cross-sectional study using an anonymous survey.

Setting:
The FINA World Championships 2019.

Participants:
Registered athletes in the disciplines of swimming, diving, high diving, water polo, artistic swimming, and open water swimming.

Interventions:
Athletes completed an online or paper-based questionnaire.

Main Outcome Measures:
The main outcome measures included screening for depression (10-item version of the Center for Epidemiological Studies Depression Scale revised), eating disorders (Brief Eating Disorders in Athletes Questionnaire), the subjective need for psychotherapeutic support, and the experience of sport-related harassment and/or abuse.

Results:
A quarter (24.6%) of the 377 responding athletes were classified as depressed and 2.5% as having an eating disorder. More than 40% of the athletes stated that they wanted or needed psychotherapeutic support. Fifty-one athletes (14.9%) had experienced harassment/abuse in sport themselves, and 31 (9%) had witnessed it in another athlete. The experiences of harassment and abuse ranged from unwanted comments about body or appearance (40.2%) to rewards in sport for sexual favors (2.5%) and rape (0.3%). Athletes who had experienced harassment/abuse in sport themselves had higher average scores for depression and eating disorders, and more of them felt they needed psychotherapeutic support. Up to a third would not talk or report to anybody if they saw or experienced harassment/abuse, and less than 20% would talk to an official for help.

Conclusion:
Targeted initiatives are required to address mental health issues and harassment and abuse in sport in the FINA aquatic disciplines.
Practical Management: Telehealth Examination for Sport-Related Concussion in the Outpatient Setting
Authors: McPherson Jacob I. , Saleem Ghazala T. , Haider M. Nadir , Leddy John J. , Torres Daniel M. , Willer Barry 
Published: September 2021

Abstract:
This article presents the telehealth version of the Buffalo Concussion Physical Examination (BCPE) (Tele-BCPE). It is a brief, focused telehealth PE for use in the outpatient setting by sports medicine physicians, pediatricians, neurologists, and primary care physicians. It is derived from the BCPE and includes general considerations for providers performing telehealth services and instructions for adapting traditional clinical tests for virtual use. The Tele-BCPE includes an orthostatic intolerance screen, examination of the cranial nerves, and tests of the oculomotor, vestibular, and cervical systems. It is meant to be used at initial and follow-up outpatient visits for patients acutely after concussion and in those with prolonged symptoms. This telehealth PE, when combined with other assessments, can help provide direct treatment to patients at any stage after concussion and reduce barriers to healthcare access posed by the COVID-19 pandemic and for patients living in rural or underserved areas.
Optimal extent of lymphadenectomy for radical surgery of pancreatic head adenocarcinoma
Authors: Wang Ziyao , Ke Nengwen , Wang Xin , Wang Xing , Chen Yonghua , Chen Hongyu , Liu Jinheng , He Du , Tian Bole , Li Ang , Hu Weiming , Li Kezhou , Liu Xubao 
Published: September 2021

Abstract

Background:
Radical pancreaticoduodenectomy is the only possible cure for pancreatic head adenocarcinoma, and although several RCT studies have suggested the extent of lymph node dissection, this issue remains controversial. This article wanted to evaluate the survival benefit of different lymph node dissection extent for radical surgical treatment of pancreatic head adenocarcinoma.

Methods:
A total of 240 patients were assessed for eligibility in the study, 212 of whom were randomly divided into standard lymphadenectomy group (SG) or extended lymphadenectomy group (EG), there were 97 patients in SG and 95 patients in EG receiving the radical pancreaticoduodenectomy.

Result:
The demography, histopathology and clinical characteristics were similar between the 2 groups. The 2-year overall survival rate in the SG was higher than the EG (39.5% vs 25.3%; P = .034). The 2-year overall survival rate in the SG who received postoperative adjuvant chemotherapy was higher than the EG (60.7% vs 37.1%; P = .021). There was no significant difference in the overall incidence of complications between the 2 groups (P = .502). The overall recurrence rate in the SG and EG (70.7% vs 77.5%; P = .349), and the patterns of recurrence between 2 groups were no significant differences.

Conclusion:
In multimodality therapy system, the efficacy of chemotherapy should be based on the appropriate lymphadenectomy extent, and the standard extent of lymphadenectomy is optimal for resectable pancreatic head adenocarcinoma. The postoperative slowing of peripheral blood lymphocyte recovery might be 1 of the reasons why extended lymphadenectomy did not result in survival benefits.

Clinical trial registration:
This trial was registered at ClinicalTrials.gov (NCT02928081) in October 7, 2016. https://clinicaltrials.gov/
Successful endovascular therapy for an adolescent patient with cerebral venous sinus thrombosis
Authors: Peng Tao , Zhang Zini , Zu Bifeng , Dan Bitang 
Published: September 2021

Abstract

Rationale:
Cerebral venous sinus thrombosis associated with protein S deficiency is rare in adolescent patients and has high disability and fatality.
Patient concerns: A 15-year-old male student presented in the hospital with sudden headache, nausea, and vomiting and was diagnosed with protein S deficiency by gene testing.

Diagnoses:
Cerebral venous sinus thrombosis due to protein S deficiency was diagnosed in this adolescent patient, who underwent successful endovascular therapy (EVT).

Interventions:
The patient was treated with standard anti-coagulation therapy including low-molecular-weight heparin (90 IU/kg/Q12 h) and dehydrant (mannitol 125 mL Q8 h); however, the symptoms were not alleviated. Successful EVT was implemented.

Outcomes:
Both the superior sagittal sinus and bilateral transverse sinus were recanalized after thrombus clearance. The patient achieved a complete recovery without any other stroke recurrence during follow-up.

Lessons:
EVT can be performed with favorable and effective clinical outcomes in adolescent cerebral venous sinus thrombosis patients with protein S deficiency. EVT associated with standard anti-coagulation therapy may improve the prognosis and reduce mortality among such patients.
Analysis of the clinical manifestations and 18F-FDG PET-CT findings in 40 patients with histiocytic necrotizing lymphadenitis
Authors: Zhang Rui , Liang Lidan , Li Daoming , Bai Yuling , Li Xiangzhou 
Published: September 2021

Abstract
Histiocytic necrotizing lymphadenitis (HNL) is a rare, benign, and self-limiting inflammatory disease that mainly involves the lymph nodes. There is a lack of large sample studies concerning the clinical manifestations and imaging features of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of HNL.
The clinical symptoms, laboratory examination results, 18F-FDG PET/CT imaging features, and treatment outcome were investigated in this retrospective study.
A total of 40 HNL patients were recruited. The onset age was between 14 and 65 years, with a median of 25 years. The white blood cell count was 3.9 (2.9, 7.1) × 109/L, C-reactive protein level was 20.2 (6.6, 63.8) mg/L, erythrocyte sedimentation rate was 29.0 (18.0,45.0) mm/h, and ferritin was 616.5 (205.6, 2118.1) ng/mL. An abnormal liver function was observed in 23 patients. 18F-FDG PET-CT showed that an abnormal lymph node metabolism was observed in 38 patients, among which the highest 18F-FDG maximal standard uptake value (SUVmax) of the lymph nodes ranged between 3.4 and 41.9; the nodes were mainly distributed in the neck and axilla regions. Meanwhile, a total of 2502 lymph nodes (721 lymph nodes with a short axis greater than 10 mm) were found in the 38 patients, including 1837 lymph nodes with an 18F-FDG SUVmax ≥ 2.5. The 18F-FDG SUVmax of the spleen ranged from 2.5 to 9.2 in 20 patients, while that of central and peripheral bone marrow ranged from 2.7 to 36.0 in 30 patients. After follow-up for an average period of 1 month, the symptoms improved after prednisone treatment.
HNL often occurs in adolescents. Scanning with 18F-FDG PET/CT showed that most patients had multiple involved lymph nodes that were hypermetabolic, and only few lymph nodes are enlarged. Besides, the spleen or central and peripheral bone marrow could sometimes be hypermetabolic. Glucocorticoid treatment for the HNL patients is effective.
Circulating platelet count and glycans
Authors: Rivadeneyra Leonardo , Falet Hervé , Hoffmeister Karin M. 
Published: September 2021

Purpose of the review
This review highlights recent advancements in understanding the regulation of platelet numbers, focusing on mechanisms by which carbohydrates (glycans) link platelet removal with platelet production in the bone marrow in health and disease.

Recent findings
This review is focused on the role of carbohydrates, specifically sialic acid moieties, as a central mediator of platelet clearance. We discuss recently identified novel mechanisms of carbohydrate-mediated platelet removal and carbohydrate-binding receptors that mediate platelet removal.

Summary
The platelet production rate by megakaryocytes and removal kinetics controls the circulating platelet count. Alterations in either process can lead to thrombocytopenia (low platelet count) or thrombocytosis (high platelet count) are associated with the risk of bleeding or overt thrombus formation and serious complications. Thus, regulation of a steady-state platelet count is vital in preventing adverse events. There are few mechanisms delineated that shed light on carbohydrates’ role in the complex and massive platelet removal process. This review focuses on carbohydrate-related mechanisms that contribute to the control of platelet numbers.
Associations Between Transcranial Doppler Flow Velocities, Laboratory Parameters, and Clinical Features in Turkish Children With Sickle Cell Disease
Authors: Aydin Sultan , Yeral Hakan , Oktay Gönül , Çoban Yasemin , Akbaş Yilmaz , Köker Alper , Öz Tunçer Gökçen 
Published: September 2021

Objective:
Stroke is one of the major complications of sickle cell disease (SCD). Stroke features either occlusion of, or stenosis at, the origin of one of the large intracerebral arteries, the internal carotid artery (ICA), and/or the middle cerebral artery (MCA).

Purpose:
We sought correlations between cerebral blood flow velocities and the laboratory and clinical findings of patients with SCD.

Materials and Methods:
Fifty-three pediatric SCD patients (39 with HbSS, 14 with HbSβ0) were analyzed. The mean patient age was 12.9±3.9 years. The control group contained 24 healthy individuals. The time-averaged maximum mean velocity (TAMMV) and resistive index (RI) of the MCA, the TAMMVs of the ICA and vertebral artery (VA), and the diameter of the VA were estimated through transcranial Doppler ultrasonography using a 2.5 MHz transducer, in accordance with the Stroke Prevention Trial in Sickle Cell Anemia (STOP) protocol. We evaluated the relationships between the TAMMVs, laboratory parameters, and clinical findings.

Results:
The mean±SD MCA TAMMV was 161.2±35.4 cm/s in patients with HbSS and 185.8±62.9 cm/s in patients with HbSβ0. The mean MCA TAMMV, RI, ICA TAMMV, VA TAMMV, and VA diameter were 168.5±43.9 cm/s, 0.63±0.06, 116.8±25.5 cm/s, 69.2±18.5 cm/s, and 3.5±0.61 mm for all SCD patients, respectively. In the control group, the mean MCA TAMMV, RI, ICA TAMMV, VA TAMMV, and VA diameter were 103.8±28.8 cm/s, 0.53±0.04, 96.4±27.8 cm/s, 40.3±12.1 cm/s, and 3.4±0.6 mm, respectively. Although the differences were not significant, TAMMVs were higher in HbSβ0 patients taking hydroxyurea; those with hemoglobin levels <8 g/dL, ferritin levels >1000 ng/dL, mean platelet volume >12 fL, or red cell distribution width >18%; or required chelation, or were below the third percentiles of weight and height. The TAMMV was significantly higher only in SCD patients who complained of headache.

Conclusions:
High ferritin and low hemoglobin levels, a high mean platelet volume, a high red cell distribution width, low weight (below the third percentile), and a short height (below the third percentile) may be associated with elevated cerebral blood flow velocities and an increased stroke risk in children with SCD. Children with such features should be closely followed-up through transcranial Doppler ultrasonography examination.
Assessment of Primary Care Content in a Nursing Curriculum
Authors: Dolansky Mary A. , Nikstenas Colleen , Badders Ashley , Brannack Lisa , Burant Patricia A. 
Published: September 2021

Background
Because of the rapidly emerging need for more RNs in primary care, schools of nursing are challenged with preparing students for these roles.

Purpose
The purpose of the project was to use the Faculty Primary Care Assessment Tool to evaluate the extent of primary care content in the prelicensure curriculum and identify strategies for primary care content integration.

Methods
A quality improvement approach was used for this evaluation. Thirty-one faculty (44%) completed the Faculty Primary Care Assessment Tool.

Results
The majority of the content items were scored between 1.55 and 3.4, indicating minimal integration of primary care concepts. Courses that had high integration of primary care content were leadership and psychiatric-mental health courses.

Conclusions
Our findings provide a valuable tool to assist with the integration of primary care content in the prelicensure curriculum.
Mask-Ed™
Authors: Crownover JoAnn G. , Henrichs Kelly , Oja Kenneth John 
Published: September 2021

Background:
With the increasing shortage of clinical placement sites, nurse educators must be creative in providing alternative learning modalities that prepare students for nursing practice. Mask-Ed™ simulation may help address this challenge.

Purpose:
The purpose of this study was to describe junior-year undergraduate nursing students' experiences with Mask-Ed™ simulation in the context of caring for older adults.

Methods:
Using a qualitative descriptive design, focus groups were conducted with 18 students who experienced Mask-Ed™ during 1 semester.

Results:
Six themes emerged: (1) seeing the older adult as a person, not just a patient; (2) seeing the older adult in a new light; (3) authenticity of the experience and realistic scenarios; (4) ability to give myself to it; (5) safe space to practice; and (6) dress rehearsal for the RN role.

Conclusions:
Mask-Ed™ changed participants' perceptions of older adults and their consideration of pursuing a nursing career with this patient population. Participants also expressed Mask-Ed™ was a safe and authentic simulation to help prepare for nursing practice.