bluuebunny/crossref_metadata_2025_split huggingface dataset:
Employment and Career Choice Satisfaction among Saudi Plastic Surgeons: A Cross-sectional, Questionnaire-based Study
Authors: Mortada Hatan , Mustafa Nashwa , Bamakhrama Basma , Alshateb Marwa , Gelidan Adnan G. , Arab Khalid 
Published: October 2021

Background:
Career choice satisfaction among plastic surgeons has a significant effect on the quality of patient care and workforce shortages. This study investigated career choice satisfaction among Saudi plastic surgeons to identify associated factors.

Method:
A cross-sectional study was conducted via an online self-administered questionnaire sent in April 2021 to all Saudi plastic surgeons. The questionnaire was composed of 23 items in four domains: demographics, plastic surgery training, current practice workload, and job satisfaction. The analysis was performed at a 95% confidence interval using the Statistical Package for Social Sciences, version 23.0 (IBM, Armonk, N.Y.).

Results:
A total of 63 plastic surgeons were included in this study (82.5% men; 17.5% women), with an overall response rate of 76.8%. The leading cause of job dissatisfaction for women was financial remuneration (28.8%) (P = 0.008). The main factor for men was work–life balance (38.5%) (P = 0.028). Of the different backgrounds, the highest satisfaction was among those with a background in German residency programs, and the lowest was among those with French residency programs (P = 0.045). Surgeons from the southern region had a higher satisfaction rate than those from other regions; those from the central region had the lowest rate (P < 0.001).

Conclusions:
Our survey-based study found that Saudi plastic surgeons with German residency training, practicing in the southern region or who exceeded 11–20 years post-training had the highest job satisfaction. As such, surgeons’ job satisfaction can be improved by ensuring work–life balance.
Cerebrospinal fluid and ophthalmic disease
Authors: Ford Richard L. , Frankfort Benjamin J. , Fleischman David 
Published: October 2021

Purpose of review
The purpose of this review is to discuss the contemporary body of literature examining the relationship between cerebrospinal fluid (CSF) and ophthalmic disease. This review focuses on diseases that have a pathogenesis related to the translaminar pressure difference, defined as the pressure difference between the orbital subarachnoid space (OSAS) and the intraocular pressure. The diseases discussed include glaucoma, idiopathic intracranial hypertension, and spaceflight associated neuro-ocular syndrome.

Recent findings
The relationship between cerebrospinal and ophthalmic disease has been investigated for over 100 years. Recent research provides insight into the mechanisms that dictate CSF circulation in the OSAS and how alterations in these mechanism lead to disease. This review discusses these recent findings and their relationship to major ophthalmic diseases.

Summary
The recent findings provide insight into diseases that have pathogenic mechanisms that are not fully understood. This information will help physicians gain a clearer understanding of the relationship between CSF and ophthalmic disease and guide future research.
Surgical management of a white cataract induced by a metallic intralenticular foreign body
Authors: Vasco Alessandro , Caruso Giulia , Vasco Eugenia 
Published: October 2021

Introduction:
A patient with an intralenticular metal foreign body in the right eye who, following initial antibiotic treatment for a corneal wound, developed a traumatic cataract a month after the initial event.

Patient and clinical findings:
Upon presentation, the clinical examination of the patient showed just a small corneal leucoma, no signs of inflammation in the anterior segment, and a white cataract.

Diagnosis, intervention, and outcomes:
Ultrasound B-scan and orbital computed tomography were performed, which suggested the presence of a metallic foreign body in the crystalline lens. The surgical management of the case, where, given the integrity of the posterior capsule and verified intraoperatively, a triple procedure was performed, with foreign body extraction, phacoemulsification, and IOL implantation, resulting in a good visual outcome.

Conclusions:
Metallic intralenticular foreign bodies represent a rare finding that sometimes goes unnoticed in the clinical examination, but which can lead to serious sight-threatening complications and should therefore not be underestimated. When a foreign body sensation is referred, an accurate examination of the anterior segment is necessary. The surgery required in case of complications can be challenging and demands attentive preoperative evaluation and readiness to adapt to conditions found intraoperatively.
Evaluation of a New Bone Conduction Device for the Rehabilitation of Single-Sided Deafness: Effects on Speech Understanding in Noise
Authors: Potier Morgan , Seldran Fabien , Sonthonnax Mélanie , Péan Vincent , Berger Paul , Norena Arnaud , Gallégo Stéphane 
Published: October 2021

Introduction:
A new external, adhesive, no-pressure bone-conduction device provides rehabilitation for conductive hearing loss and single-sided deafness (SSD). The purpose of the study is to evaluate speech recognition performance with the bone-conduction contralateral routing of signal (aBC-CROS) and compare it to an air-conduction CROS (AC-CROS) used by subjects for at least 1 year.

Methods:
Ten SSD patients underwent speech understanding in noise tests with their AC-CROS, the aBC-CROS, and unaided. The 1st test session took place the day the aBC-CROS was fitted, with the second session after 2 weeks of aBC-CROS use. Two configurations were used: speech presented on the deaf side and noise on the normal side and the reverse.

Results:
The speech recognition threshold (SRT) improved with both devices when speech was presented to the deaf side. Nine patients showed significant improvement (p < 0.016) with the AC-CROS (mean: 2.8 dB) and the aBC-CROS (mean: 3.0 dB). Mean difference of improvement was significant between unaided and aBC-CROS (p = 0.001) or AC-CROS (p = 0.006). The SRT deteriorated by an average of 2.3 dB with the AC-CROS with noise presented on the deaf side, with significance found for six patients (p < 0.016). The aBC-CROS did not affect performance in this configuration (mean improvement: 0.3 dB) and only one patient had a significant SRT degradation (p < 0.016). Mean difference of improvement was significant between the AC-CROS and aBC-CROS (p = 0.021) or unaided (p = 0.05).

Discussion:
The aBC-CROS is a good alternative to the existing CROS devices for SSD rehabilitation, as it offers the same benefit with none of the drawbacks when noise is on the patient's deaf side.
Nitric Oxide Is Locally Produced in the Human Middle Ear and Is Reduced by Acquired Cholesteatoma
Authors: Westerberg Johanna , Granath Anna , Drakskog Cecilia , Tideholm Ellen , Kumlien Georén Susanna , Weitzberg Eddie , Cardell Lars-Olaf 
Published: October 2021

Objective:
To find out if nitric oxide (NO) can be locally produced in the middle ear and if chronic otitis media (COM) and acquired cholesteatoma affect the production.

Design:
Case-control study.

Setting:
Two tertiary-referral hospitals.

Patients:
Gaseous NO from 11 patients with unilateral perforations or grommet openings was measured with chemiluminescence. Middle ear mucosa from 48 patients with COM and 26 patients with cholesteatoma was investigated.

Main Outcome Measures:
Detection of NO. Expression of nitric oxide synthase (NOS) mRNA, in mucosa from COM, cholesteatoma and healthy controls, quantified using polymerase chain reaction.

Results:
The gaseous NO from ears with a unilateral tympanic membrane perforation or a grommet was higher (9 ± 3 ppb, n = 11) than among the controls (4 ± 1 ppb, n = 11, p = 0.04). Lower levels of eNOS (2.64 ± 0.86 mol/100,000 mol ACTB) were detected in the pooled samples from the COM group (n = 48), compared with the control group (140.48 ± 92 mol/100,000 mol ACTB, n = 45, p = 0.010). In the cholesteatoma group (n = 26), a lower expression of nNOS (5.78 × 10−6 ± 1.13 × 10−6 ΔCt) was found in comparison with the controls (1.23 × 10−4 ± 3.18 × 10−5 ΔCt, n = 15, p = 0.011).

Conclusions:
NO is likely a natural and permanent part of the gas mixture in the human middle ear. The presence of NOS enzymes in the middle ear mucosa indicates an ongoing NO production and the reduction of NOS in ears with cholesteatoma, and pooled samples from ears with COM, suggest a role for locally produced NO in middle ear disease.
Revision Surgery for Pediatric Nontumor Auditory Brainstem Implant Users: Audiological, Rehabilitative, and Surgical Outcomes
Authors: Yarali Mehmet , Aslan Filiz , Çinar Betül Çiçek , Batuk Merve Özbal , Bajin Münir Demir , Sennaroğlu Gonca , Bilginer Burçak , Sennaroğlu Levent 
Published: October 2021

Objective:
To report the audiological, rehabilitative, and surgical outcomes of revision surgery for pediatric auditory brainstem implant (ABI) users.

Study Design:
Retrospective cohort.

Setting:
Tertiary referral center.

Patients:
Five pediatric ABI users who had revision surgery for device malfunctions.

Intervention(s):
Revision surgery for ABI malfunctions.

Main Outcome Measures:
The findings of free-field audiometry with the device, the Meaningful Auditory Integration Scale, and the pattern discrimination, word identification, sentence recognition, and expressive and receptive language tests before the device failure and after revision surgery were obtained from the patient records and compared.

Results:
The revision rate for pediatric ABI was 6.45%. The Meaningful Auditory Integration Scale and expressive-receptive language scores showed improvements following revision surgery, while the aided thresholds, pattern perception, and word identification scores did not change. Individual differences in performance for these measures were observed.

Conclusion:
Equal or improved performance after the revision surgeries in the current study showed that revision surgery is successful and important for pediatric ABI users. It is essential to consider remedying the loss of auditory input in sensitive periods of pediatric development.
The relationship between sarcopenia and central hemodynamics in older adults with falls: a cross-sectional study
Authors: Öztorun Hande Selvi , Bahsi Remzi , Turgut Tugba , Surmeli Deniz Mut , Cosarderelioğlu Caglar , Atmis Volkan , Yalcin Ahmet , Aras Sevgi , Varli Murat 
Published: October 2021

Purpose
Falls are an important cause of morbidity and mortality in geriatric patients. Sarcopenia and central blood pressure may be associated with falls. This study aimed to investigate the association between sarcopenia and blood pressure parameters in older patients with falls.

Methods
A comprehensive geriatric evaluation of 72 elderly patients was performed using established assessment tests. Peripheral and central hemodynamic measurements, including office DBP and SBP, daytime-night peripheral and central DBP and SBP, cardiac output, augmentation index, pulse wave velocity (PWV), pulse rate, and peripheral resistance and reflection, were measured with a 24-hour ambulatory blood pressure measuring device.

Results
Of 72 patients with a mean age of 77.51 ± 6.5 years, 12 (16.7%) were non-sarcopenic, 32 (44.4%) were probable, nine (12.5%) were confirmed, and 19 (26.4%) were severe sarcopenic. PWV, which is an indicator of arterial stiffness, was found to be significantly higher in the sarcopenic group. The other cardiac risk markers [daytime peripheral SBP, mean arterial pressure (night), pulse pressure (daytime), and peripheral resistance (daytime and night)] were significantly lower in the sarcopenic patients. PWV correlated with gait speed, Katz score, and hand grip strength (Spearman’s rho: −0.337, −0.310, and −0.334; P < 0.001, 0.008, and 0.001, respectively). Age and hypertension were the most important factors increasing the risk of falls.

Conclusion
Sarcopenia is associated with central and peripheral blood pressure changes in patients with falls. When sarcopenia is diagnosed in older people with falls, 24-hour ambulatory peripheral and central pressures should be evaluated for cardiac risk screening.
Sneddon Syndrome: Case Report and Literature Review
Authors: Hardy Naomi , Markidan Janina , Pfau Richard , Ma Linglei 
Published: October 2021

Abstract
Sneddon syndrome (SS) is a rare disorder that has a variety of pathologic associations, often described as the first cutaneous manifestation of antiphospholipid syndrome. Sneddon syndrome is characterized by livedo racemosa (LR), cerebrovascular symptoms, and microangiopathic disease in the deep vessels on skin biopsy. We discuss a case of a 55-year-old woman with a complex history of arterio-occlusive disease who presented with a violaceous and painful rash on her thigh. Skin biopsy showed thrombotic vasculopathy. Her clinical and cutaneous manifestations led to the question and the diagnosis of SS. Our case is one of the few cases of SS where LR occurred long after cerebrovascular disease. We discuss the range of skin biopsy findings of LR and approach to SS from a dermatopathologic perspective.
Celiac Plexus Block to Treat Refractory Feed Induced Dystonia in Children with Severe Neurodisability: A Single Center Case Series
Authors: Campbell David I. , Rabone Rosalind M. , Fadilah Ala , Raghavan Ashok , Urs Arun N. , Eissa Ayman , Lindley Richard M. , Mordekar Santosh 
Published: October 2021

Objectives:
This observational study describes the procedure technique, safety outcomes, and patient responses to celiac plexus blockade (CPB) in children with severe neurodisability with refractory feed intolerance, feed induced pain or feed induced dystonia (FID).

Method:
A review of the pathophysiological response to feeding in children with significant neurodisability and the effect on the neuroenteric system. A 2-stage CT-guided temporary celiac plexus blockade followed by neurolysis technique is described. We compile a case series of 5 patients with life limiting conditions and significant disability undergoing CPB in a single tertiary pediatric hospital.

Results:
A total of 10 separate procedures in 5 children were completed. A positive outcome was observed in 3 out of 4 cases of pediatric FID. Two of the three patients on parenteral nutrition had improved feed tolerance postprocedure. All children tolerated the procedure well, no postprocedure complications were documented.

Conclusions:
In selected cases, children with life-threatening feed induced dystonia or effective intestinal failure can be safely treated with celiac plexus blockade when other therapies have failed.
The Cardiovascular Side Effects of Electroconvulsive Therapy and Their Management
Authors: Hermida Adriana P. , Mohsin Mamoona , Marques Pinheiro Ana P. , McCord Elizabeth , Lisko John C. , Head Lyndsay W. 
Published: October 2021

Abstract
Electroconvulsive therapy (ECT) remains stigmatized in the broader medical community because of misunderstandings about treatment procedures, mortality rates, and cardiovascular complications. Electroconvulsive therapy causes periprocedural hemodynamic variability because of the surges in parasympathetic and sympathetic nervous systems after the administration of the electrical charge. Patients experience an increase in cardiac workload, which is potentially dangerous for patients with preexisting heart disease. Several findings suggest that cardiac complications occur most frequently in patients with underlying cardiovascular disease. We describe the cardiovascular complications that may result from ECT treatment and offer insight on how to mitigate these concerns if they occur. PubMed was queried using terms “electroconvulsive therapy” and “cardiovascular adverse effects.” A table is provided with the common cardiovascular side effects of ECT and the most recent evidence-based treatment strategies to manage them. Generally, ECT is a safe procedure in which complications are minor and manageable. Most major complications caused by ECT are related to the cardiovascular system; however, with an appropriate pre-ECT evaluation and a comprehensive multidisciplinary team approach, the cardiovascular complications can be well managed and minimized. Providing proper cardiac clearance can prevent cardiac complications and provide timely care to treatment-resistant populations who are at risk for excessive morbidity and suicide.
The Genetic Determinants of Aortic Distension
Authors: Pirruccello James P. , Choi Seung Hoan , Chaffin Mark D. , Nekoui Mahan , Chou Elizabeth L. , Jurgens Sean J. , Friedman Samuel F. , Juric Dejan , Stone James R. , Batra Puneet , Ng Kenney , Philippakis Anthony A. , Lindsay Mark E. , Ellinor Patrick T. 
Published: October 2021

AbstractAs the largest conduit vessel, the aorta is responsible for the conversion of phasic systolic inflow from ventricular ejection into more continuous blood delivery to peripheral arteries. Distension during systole and recoil during diastole conserves ventricular energy and is enabled by the specialized composition of the aortic extracellular matrix. Aortic distensibility decreases with age and prematurely in vascular disease. To discover genetic determinants of aortic distensibility we trained a deep learning model to quantify aortic size throughout the cardiac cycle and calculate aortic distensibility and aortic strain in 42,342 participants in the UK Biobank with available cardiac magnetic resonance imaging. In up to 40,028 participants with genetic data, common variant analysis identified 12 and 26 loci for ascending and 11 and 21 loci for descending aortic distensibility and strain, respectively. Of the newly identified loci, 22 were specific to strain or distensibility and were not identified in a thoracic aortic diameter GWAS within the same samples. Loci associated with both aortic diameter and aortic strain or distensibility demonstrated a consistent, inverse directionality. Transcriptome-wide analyses, rare-variant burden tests, and analyses of gene expression in single nucleus RNA sequencing of human aorta were performed to prioritize genes at individual loci. Loci highlighted multiple genes involved in elastogenesis, matrix degradation, and extracellular polysaccharide generation. Characterization of the genetic determinants of aortic function may provide novel targets for medical intervention in aortic disease.
A randomized, controlled, feasibility study of RD-X19 in patients with mild-to-moderate COVID-19 in the outpatient setting
Authors: Stasko Nathan , Cockrell Adam S. , Kocher Jacob F. , Henson Ibrahim , Emerson David , Wang Ye , Smith Jonathan R. , Henderson Nathan H. , Wood Hillary , Bradrick Shelton S. , Jones Terry , Santander Jorge , McNeil John G. 
Published: October 2021

ABSTRACTThese studies aimed to further understand the antiviral effects of safe, visible light and demonstrate a therapeutic effect of an investigational treatment device for outpatients with mild to moderate COVID-19. RD-X19 is a handheld medical device precisely engineered to emit blue light through the oral cavity to target the oropharynx and surrounding tissues. At doses that are well-tolerated in an in vitro human epithelial tissue model, the monochromatic visible light delivered by RD-X19 results in light-initiated expression of IL-1α and IL-1β cytokines with corresponding inhibition of SARS-CoV-2 replication. A randomized, double-blind, sham-controlled early feasibility study using the investigational device enrolled 31 subjects with a positive SARS-CoV-2 antigen test and possessing at least two moderate COVID-19 signs and symptoms. Subjects were randomized 2:1 (RD-X19 to sham), treated twice daily for four days, and evaluated over one week. Prespecified outcome measures included assessments of SARS-CoV-2 viral load and clinical assessments of COVID-19. There were no local application site reactions and no device-related adverse events. The time-weighted average change in log viral load throughout the study demonstrated a favorable reduction for RD-X19 compared to sham and at the end of study the mean change in log10 viral load was -3.29 for RD-X19 and -1.81 for sham at Day 8, demonstrating a treatment benefit of -1.48 [95% confidence internal (CI), -2.88 to -0.071]. Among the clinical outcome measures, differences between RD-X19 and sham were also observed, with a 57-hour reduction of median time to sustained resolution of COVID-19 signs and symptoms.
Mathematical modeling of COVID-19 in British Columbia: an age-structured model with time-dependent contact rates
Authors: Iyaniwura Sarafa A. , Falcão Rebeca C. , Ringa Notice , Adu Prince A. , Spencer Michelle , Taylor Marsha , Colijn Caroline , Coombs Daniel , Janjua Naveed Z. , Irvine Michael A , Otterstatter Michael 
Published: October 2021

AbstractFollowing the emergence of COVID-19 at the end of 2019, several mathematical models have been developed to study the transmission dynamics of this disease. Many of these models assume homogeneous mixing in the underlying population. However, contact rates and mixing patterns can vary dramatically among individuals depending on their age and activity level. Variation in contact rates among age groups and over time can significantly impact how well a model captures observed trends. To properly model the age-dependent dynamics of COVID-19 and understand the impacts of interventions, it is essential to consider heterogeneity arising from contact rates and mixing patterns. We developed an age-structured model that incorporates time-varying contact rates and population mixing computed from the ongoing BC Mix COVID-19 survey to study transmission dynamics of COVID-19 in British Columbia (BC), Canada. Using a Bayesian inference framework, we fit four versions of our model to weekly reported cases of COVID-19 in BC, with each version allowing different assumptions of contact rates. We show that in addition to incorporating age-specific contact rates and mixing patterns, time-dependent (weekly) contact rates are needed to adequately capture the observed transmission dynamics of COVID-19. Our approach provides a framework for explicitly including empirical contact rates in a transmission model, which removes the need to otherwise model the impact of many non-pharmaceutical interventions. Further, this approach allows projection of future cases based on clear assumptions of age-specific contact rates, as opposed to less tractable assumptions regarding transmission rates.
Evidence for Influenza and RSV interaction from 10 years of enhanced surveillance in Nha Trang, Vietnam, a modelling study
Authors: Waterlow Naomi R , Toizumi Michiko , van Leeuwen Edwin , Nguyen Hien-Anh Thi , Myint-Yoshida Lay , Eggo Rosalind M , Flasche Stefan 
Published: October 2021

AbstractInfluenza and Respiratory Syncytial Virus (RSV) interact within their host posing the concern for heterologous ecological changes following vaccination. We aimed to estimate the population level impact of their interaction.We developed a dynamic age-stratified two-pathogen mathematical model that includes pathogen interaction through competition for infection and enhanced severity of dual infections. We used parallel tempering to fit it’s parameters to 11 years of enhanced hospital-based surveillance for acute respiratory illnesses (ARI) in children under 5 years old in Nha Trang, Vietnam.The data supported either a 41% (95%CrI: 36 - 54) reduction in heterologous acquisition during infection and for 10.0 days (95%CrI 7.1 -12.8) thereafter, or no cross protection. We estimate that co-infection increased the probability for an infection in <2y old children to be reported 7.2 fold (95%CrI 5.0 - 11.4); or 16.6 fold (95%CrI 14.5 - 18.4) in the respective scenarios. Absence of either pathogen was not to the detriment of the other.We find stronger evidence for severity enhancing than for acquisition limiting interaction. In this setting vaccination against either pathogen is unlikely to have a major detrimental effect on the burden of disease caused by the other.