bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL ASSOCIATIONS AND PROGNOSTIC IMPLICATIONS OF REPAIR TISSUE PROLIFERATION IN EYES WITH RETINAL PIGMENT EPITHELIUM TEARS
Authors: Cicinelli Maria V. , Rabiolo Alessandro , Montesano Giovanni , Marchese Alessandro , Barresi Costanza , Introini Ugo , Parodi Maurizio B. , Bandello Francesco 
Published: November 2021

Purpose:
To investigate demographic and clinical factors influencing the longitudinal changes of retinal pigment epithelium (RPE) dehiscence area after RPE tears, including the presence of RPE tear-associated repair proliferation (TARP), and identify factors associated with TARP development over follow-up.

Methods:
Retrospective, single-center, observational cohort study of patients with a history of macular neovascularization and RPE tear. The area of RPE dehiscence was measured on repeated short-wavelength fundus autofluorescence imaging. Associations between covariates and RPE dehiscence areas were tested with multivariable linear mixed models. Associations between TARP development and clinical variables were investigated with Cox regression models. Factors associated with visual acuity changing rates were explored with linear mixed models.

Results:
Thirty-seven eyes of 36 patients were included in this study and followed for a median time of 18 months. Tear-associated repair proliferation was identified in 27 eyes (73%). The median time for TARP detection was 112 days; none of the investigated factors was significantly associated with TARP occurrence. The presence of TARP (estimate: −0.042 mm2/month; P = 0.001) and female gender (estimate: −0.035 mm2/month; P = 0.006) were associated with slower rates of RPE dehiscence enlargement over time. Faster rates of visual improvement were observed in eyes with TARP compared with those without TARP (estimate = −0.010 logarithm of the minimum angle of resolution/month if TARP was present; P = 0.008).

Conclusion:
Retinal pigment epithelium tear repair with TARP and female gender were associated with slower RPE degeneration after RPE tears. The presence of TARP was associated better visual prognosis. Additional research on factors promoting TARP development may have therapeutic and prognostic implications.
UVEAL MELANOMA PRESENTING AS HEPATIC METASTASIS IN A PATIENT WITH OCULODERMAL MELANOCYTOSIS
Authors: Evans William I. , Wilson Matthew W. , Bahrami Armita , Pappo Alberto S. , Hoehn Mary E. 
Published: November 2021

Purpose:
To report an atypical case of occult uveal melanoma in a patient with oculodermal melanocytosis that first presented with symptoms of hepatic metastasis.

Methods:
A previously healthy 16-year-old boy with noted ocular hyperpigmentation developed abdominal pain and vomiting and was found to have a hepatic mass consistent with a metastatic lesion from an occult uveal melanoma.

Results:
On examination, the patient's visual acuity was 20/20, and pupils were reactive without an afferent pupillary defect in both eyes. Examination of the left eye revealed normal findings. In the right eye, conjunctiva was freely moving over hyperpigmented sclera. Dilated fundus examination demonstrated a hyperpigmented, minimally elevated, choroidal mass in the right eye. Results of fundus autofluorescence, IV fluorescein angiography, spectral-domain optical coherence tomography, and ultrasonography were suspicious for uveal melanoma. Genetic testing of the hepatic mass was positive for BAP1, confirming that the metastasis originated as uveal melanoma rather than cutaneous or intracranial melanoma. Magnetic resonance imaging of the brain and orbits showed negative impression for intracranial lesions. A PET scan revealed numerous additional metastatic lesions, and the patient was referred to palliative care.

Conclusion:
Patients with oculodermal melanocytosis are at an increased risk for both uveal melanoma and subsequent metastasis, and frequent monitoring should be performed because treatment options for metastatic uveal melanoma are limited.
Deep Anterior Lamellar Keratoplasty: Current Status and Future Directions
Authors: Yu Angeli Christy , Spena Rossella , Pellegrini Marco , Bovone Cristina , Busin Massimo 
Published: November 2021

Abstract:
Deep anterior lamellar keratoplasty (DALK) involves selective replacement of diseased corneal stroma while preserving normal healthy endothelium. Despite several well-recognized advantages, the uptake of DALK has remained sluggish with an adoption rate that has plateaued over the past decade. Misconceptions such as the rarity of complications of penetrating keratoplasty, lack of standardization of the DALK technique, and limited substantial benefit in visual and refractive outcomes are frequently cited as arguments against performing DALK. This brief review discusses the recent findings that refute these perceived barriers; describes contemporary techniques, tools, and modifications in the surgical approach; and evaluates the evidence regarding the clinical outcomes of DALK.
Ultrasound-Enhanced Transcorneal Drug Delivery for Treatment of Fungal Keratitis
Authors: Allison Claire , Cellum Blake , Karpinecz Bianca , Nasrallah Fadi , Zderic Vesna 
Published: November 2021

Purpose:
Transcorneal drug delivery is hindered by ocular physical and biochemical properties, such as tear production, the epithelial layer of the cornea, and blinking. The aim of this study was to determine whether ultrasound can be applied to increase the transcorneal drug delivery of natamycin used in the treatment of fungal keratitis without dangerously overheating the surrounding ocular tissues.

Methods:
To verify the safety of various sets of ultrasound parameters, modeling studies were conducted using OnScale, an ultrasonic wave modeling software. Ultrasound parameters determined optimal for ocular tissue safety were used in a laboratory setting in a jacketed Franz diffusion cell setup. Histological images of the cross-section of the corneas used in experiments were examined for cell damage under a microscope.

Results:
Increases in transcorneal drug delivery were seen in every treatment parameter combination when compared with the sham treatment. The highest increase was 4.0 times for 5 minutes of pulsed ultrasound at a 25% duty cycle and a frequency of 400 kHz and an intensity of 0.5 W/cm2 with statistical significance (P < 0.001). Histological analysis revealed structural damage only in the corneal epithelium, with most damage being at the epithelial surface.

Conclusions:
This study suggests that ultrasound is a safe, effective, and minimally invasive treatment method for enhancing the transcorneal drug delivery of natamycin. Further research is needed into the long-term effects of ultrasound parameters used in this study on human ocular tissues.
Remote Surgeon Virtual Presence: A Novel Telementoring Method for Live Surgical Training
Authors: Din Nizar , Chan Clara C. , Cohen Eyal , Iovieno Alfonso , Dahan Amit , Rootman David S. , Litvin Gilad 
Published: November 2021

Purpose:
We describe the first known use of telementoring in corneal surgery and technology combining a 3-dimensional microscope system, 5G live streaming technology, group chat software, and a virtual reality headset for intercontinental surgical supervision.

Methods:
Three surgeons in Toronto were proctored by a surgeon in Israel in the implantation of a novel keratoprosthesis device (CorNeat KPro; Ra'anana, Israel) into cadaver eyes. In Toronto, the NGENUITY platform (Alcon) transmitted high-definition, 3-dimensional images to the proctor in Israel who viewed the live video through a GOOVIS Virtual Reality headset with subsecond latency. This was made possible by the LiveU technology (Hackensack, NJ), which is a portable device to increase the bandwidth of transmission. The primary outcome was the successful completion of CorNeat KPro implantation. After each procedure, all surgeons completed a Likert scale questionnaire that assessed opinions on telementoring.

Results:
All participants implanted the CorNeat KPro device. There was significant satisfaction reported. A total cumulative score from the questionnaire was 149 of 150 from the operating surgeons, with a score of 135 of 150 by the proctor. All felt that there was excellent AV quality with no lag time and recommended the technology.

Conclusions:
Telementoring is a promising tool that can traverse large distances for ophthalmic education.
Indications for surgical management of retained lens fragments
Authors: Salabati Mirataollah , Mahmoudzadeh Raziyeh , Wakabayashi Taku , Hinkle John W. , Ho Allen C. 
Published: November 2021

Purpose of review
Retained lens fragments are a relatively rare occurrence after cataract surgery. While no definite guidelines for the surgical management or timing of surgery of this complication exist, surgery is indicated for patients with large lens fragments, persistent inflammation, secondary glaucoma, corneal edema, retinal tears or detachments, and associated endophthalmitis. The aim of this review is to summarize the current surgical management of retained lens material.

Recent findings
The Intelligent Research in Sight registry database of 2.26 million patients who underwent cataract surgery in the US indicated that 0.18% (1 in 563) had secondary removal of retained lens fragments in the anterior chamber in the operating room within 1 year of the original cataract surgery. The risk of returning to the operating room for retained lens material removal was greater among men, smokers, patients with Medicaid or military insurance, and those who had complex cataract surgery. Medical management with topical corticosteroids or observation may be considered for small lens fragments, but surgical removal remains the mainstay of the treatment for large lens fragments.

Summary
Retained lens fragments following cataract surgery may result in various vision-threatening complications. Understanding the risk factors, diagnosis, and surgical management of retained lens fragments are critical to preserving good visual outcomes. Vitrectomy is effective in patients with posterior nuclear fragments, retinal detachment, endophthalmitis, or uncontrolled glaucoma not responding to medical management. The best timing for surgery for retained lens fragments should be further investigated in a prospective study.
Bilateral Acute Retinal Necrosis From Ocular Syphilis in a Nonimmunocompromised Patient
Authors: Jumah Ammar , Joshi Seema , Nair Sashi , AlAttal Sara , Jumah Fareed , Eltous Lara , Zervos Marcus 
Published: November 2021

Abstract
Acute retinal necrosis (ARN) is an inflammatory condition of the eye usually caused by viral infection, predominantly herpes simplex virus or varicella-zoster virus. More rarely, noninfectious conditions or infection with other viral and nonviral pathogens can lead to ARN. Onset of disease, which may occur unilaterally or bilaterally, is usually rapid and characterized by a range of symptoms, including pain of eye movement, eye redness, light sensitivity, impaired vision, and narrowing of the visual field. While infectious ARN may develop in otherwise healthy individuals, those who are immunocompromised may be more susceptible to this eye pathology, especially patients who are infected with HIV. Left untreated, ARN can lead to permanent vision loss; thus, rapid identification of the specific etiology of ARN is crucial for implementing appropriate therapies. However, infection with rare pathogens in patients who are at risk for common causes of ARN can complicate diagnosis and treatment, highlighting the need for physicians to know the full range of possible etiologies for the differential diagnosis. We present a case of bilateral ARN in an immunocompetent woman who was infected with genital herpes simplex virus 2, and therefore at high risk of viral infection, but whose ARN was an example of ocular syphilis caused by the bacterial pathogen Treponema pallidum. A review of the literature on ocular syphilis is also discussed.
Immersion ultrasound biometry vs optical biometry
Authors: Cooke David L. , Waldron Rhonda , Savini Giacomo , Riaz Kamran M. , Taroni Leonardo , Murphy David A. , Guaraldi Fabio 
Published: November 2021

Purpose:
To compare axial length (AL) measurements obtained by optical biometry (OB) and immersion ultrasound (iUS) to investigate the agreement between the 2 techniques and how to use OB constants for eyes with AL by iUS.

Setting:
Multicenter study.

Design:
Retrospective observational case series.

Methods:
Agreement between OB and iUS ALs was investigated in 4 subsets. Also, in a test database, the prediction error (PE) for iUS AL was assessed with 4 methods: (1) data-optimized constants; (2) user group for laser interference biometry (ULIB) constants with iUS biometry; (3) with recalibrated AL; and (4) ULIB A-constant − 0.23.

Results:
A Combined 1970 eyes were measured with both OB and iUS biometry. OB mean AL was 0.0873 mm longer than iUS AL. The latter was made equivalent to OB ALs with this equation: Recalibrated iUS AL = 1.0228 × iUS AL − 0.4556. In a fifth database (n = 1079) with OB AL measurements only, after AL was artificially shortened by 0.0873 mm, the original A-constant had to be reduced by 0.23 to maintain a zero PE. In a sixth database (n = 127) with iUS AL, the original ULIB A-constant provided the poorest outcomes. Using either recalibrated iUS AL or ULIB A-constant − 0.23 zeroed out the mean PE and achieved the lowest median absolute error.

Conclusions:
AL measurements by iUS can be used with ULIB constants for OB by subtracting 0.23 from the A-constant; alternatively, the iUS AL may be recalibrated. The recalibrated iUS AL should be treated as AL measurements obtained by OB. It is longer than iUS AL in long eyes.
Home-based noninvasive pelvic floor muscle training device to assist women in performing Kegel exercise in the management of stress urinary incontinence
Authors: Horng Huann-Cheng , Chao Wei-Ting , Chen Jui-Fa , Chang Chia-Pei , Wang Peng-Hui , Chang Po-Lun 
Published: November 2021

Background:
Stress urinary incontinence (SUI) is a major health problem affecting approximately 50% of the female population over 45 years of age. We evaluated the therapeutic effects of a home-based non-invasive wireless sensor pelvic floor muscle training (PFMT) device with assisted Kegel exercise for SUI.

Methods:
We included 60 women 40 to 60 years of age who were diagnosed with urodynamic SUI (mean pad test, 10.52 g). The PFMT device applicator was clamped on the upper inner thigh, and the patients could self-train at home. The signal was recorded and delivered to a 3G/4G smartphone via Bluetooth, which also allows guided feedback via the smartphone’s voice. To evaluate the therapeutic effect, all patients completed the following questionnaires: a 3-day bladder diary, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Urogenital Distress Inventory-Short Form, and the Incontinence Impact Questionnaire-7 (IIQ-7). One-hour pad test measurements were performed before the test (M0) and at 1 (M1), 2 months (M2), and 3 months (M3) after the PFMT device-assisted Kegel exercise.

Results:
The 1-hour pad test and the scores of the ICIQ-SF, UDI-6, and IIQ-7 questionnaires were improved at M1, M2, and M3, compared with the M0 values. The mean value of the post-voiding residual urine (PVR) significantly decreased at M2 and M3. The subjective and objective improvement rates at M3 were 80% and 72%, respectively.

Conclusion:
The data demonstrated that 3 months of Kegel exercise assisted with a home-based PFMT device improved the number and severity of episodes, PVR, and quality of life in patients with SUI, suggesting that this device might serve as an alternative non-invasive therapy for mild and moderate SUI.
Kenyan HIV Clinics With Youth-Friendly Services and Trained Providers Have a Higher Prevalence of Viral Suppression Among Adolescents and Young Adults: Results From an Observational Study
Authors: Wilson Kate , Onyango Alvin , Mugo Cyrus , Guthrie Brandon , Slyker Jennifer , Richardson Barbra , John-Stewart Grace , Inwani Irene , Bukusi David , Wamalwa Dalton , Kohler Pamela 
Published: November 2021

Abstract
Sustained viral suppression in adolescents and young adults living with HIV (AYALWH) is necessary for epidemic control. We evaluated facility and individual correlates of viral suppression using programmatic data from AYALWH between ages 10 and 24 years at 24 HIV clinics in Kenya. Binomial regression was used to evaluate correlates of viral load (VL) suppression (<1,000 copies/ml). Of 5,316 AYALWH on antiretroviral therapy ≥6 months, 2,081 (39%) had VLs available in the medical record, of which 76% were virally suppressed. In multivariable analyses, antiretroviral therapy initiation among AYALWH older than 10 years was associated with higher viral suppression than initiation younger than 10 years (adjusted risk ratio [aRR] 10–14 = 1.03, 95% confidence interval [CI] 0.97–1.10; aRR 15–19 = 1.30, 95% CI 1.19–1.41; aRR 20–24 = 1.43, 95% CI 1.24–1.63). Facilities with both youth-friendly services (YFS) and trained providers had significantly higher VL suppression compared with facilities without YFS or trained providers (adjusted odds ratio: 2.07, 95% CI: 1.71–2.52). Viral suppression remains suboptimal among AYALWH. YFS and trained providers plus greater use of VL data may help increase viral suppression among AYALWH.
Occupational Differences in Deaths of Despair in the United States, Using Data From the Using the National Occupational Mortality Surveillance System
Authors: Rayhall Cherish , Hawkins Devan 
Published: November 2021

Objective: :
To assess occupational differences in proportional mortality ratios (PMRs) and trends in these PMRs due to the deaths of despair in the United States.

Methods: :
PMRs for deaths due to drug overdoses, suicide, and alcoholic liver disease were obtained from the National Occupational Mortality Surveillance system. Data came from various states for the years 1985 to 1998, 1999, 2003 to 2004, and 2007 to 2014.

Results: :
Occupations with the highest risk for deaths of despair included construction; architects; and food preparation and service. Occupations with the highest increases in deaths due to deaths of despair included personal care and service and home aides.

Conclusions: :
Identifying occupations with elevated risk factors for deaths of despair makes it possible to focus interventions on these occupations. Occupational hazards and exposures may increase risk to deaths of despair for specific workers.
Prevalence, Clinical Characteristics, and Self-Reported Treatment of Exercise-Associated Muscle Cramping Differ Between 21.1- and 56-Km Running Race Entrants—SAFER XXII
Authors: de Jager Izaan , Schwellnus Martin , Viljoen Carel , Korkie Elzette , Sewry Nicola , Swanevelder Sonja , Jordaan Esme 
Published: November 2021

Objective:
To determine whether the lifetime prevalence and clinical characteristics of exercise-associated muscle cramping (EAMC) differ between runners entering a 21.1- versus 56-km road race.

Design:
Cross-sectional study

Setting:
The 2012 to 2015 Two Oceans Marathon races (21.1 and 56 km), South Africa.

Participants:
Participants were consenting race entrants (21.1 km = 44 458; 56 km = 26 962) who completed an online prerace medical screening questionnaire.

Independent Variable:
A history of EAMC.

Main Outcome Measures:
The main outcome variables were lifetime prevalence (%) and clinical characteristics (muscle groups affected, timing of occurrence, severity, frequency of serious EAMC, and self-reported treatment) of a history of EAMC. Differences between 56- and 21.1-km race entrants were explored (relative risk [RR]).

Results:
The lifetime prevalence of EAMC was 12.8%, which was higher in 56- (20.0%; 95% CI 19.5-20.6) versus 21.1-km race entrants (8.5%; 8.2-8.8) (P = 0.0001). In all entrants, the fourth quarter was the most common onset (46.4%), calf muscles were the most commonly affected (53.1%), and most EAMCs were of mild-to-moderate severity (95%). In 56- versus 21.1-km entrants, hamstring (RR = 1.7; 1.5-1.9) and quadriceps muscle groups (RR = 1.5; 1.3-1.7) were more frequently affected (P = 0.0001), the onset of EAMC during racing was less common in the first quarter (RR = 0.3; 0.2-0.4) (P = 0.0001), and serious EAMC was more frequent (RR = 1.6; 1.4-1.9) (P = 0.0001).

Conclusions:
In 56- versus 21.1-km runners, a history of EAMC is 2 times more frequent and muscle groups affected, onset in a race, and severity of EAMC differed. The lifetime prevalence was lower than previously reported in other events. Risk factors associated with EAMC may differ between entrants for different race distances.
A Visual Task-Based Assessment of Theory of Mind and Social Perception Within Bipolar Disorder
Authors: Aidelbaum Robert , Goghari Vina 
Published: November 2021

Abstract
Evidence suggests that theory of mind (TOM) and social perception (SP) may be impaired within bipolar disorder (BD). However, it remains unclear whether these deficits are facet specific and predictive of functioning. This study assessed the manifestation of TOM and SP in a BD sample. Twenty-six individuals diagnosed with BD and 25 controls were recruited and assessed for TOM, SP, and functioning. Whereas differences were observed regarding functional outcome, differences were not observed regarding social cognitive performance, regardless of facet. Correlations between social cognitive and functional outcome domains were nonsignificant, whereas significant associations were observed between the social cognitive measures. Results suggest that despite functional differences, TOM and SP, independent of facet assessed, seem preserved within the BD sample. Although evidence was not provided supporting the utility of TOM and SP in the prediction of functional outcome, evidence supports the possible dependence of these social cognitive domains on shared underlying processes.