bluuebunny/crossref_metadata_2025_split huggingface dataset:
GUNN's DOTS AS INDICATORS OF RENAL FUNCTION, FINDINGS FROM THE TONGREN HEALTH CARE STUDY
Authors: Xue Can Can , Gao Li Qin , Cui Jing , Zhang Chun , Chen Dong Ning , Wang Ya Xing , Jonas Jost B. 
Published: December 2021

Purpose:
To investigate the prevalence of Gunn's dots (GDs) and associated systemic factors in adult Chinese.

Methods:
A cross-sectional study enrolling participants older than 45 years from a community-based study. Gunn's dots were evaluated using fundus photography, and associated systemic factors were analyzed. Patients with any retinal or optic neuropathy were excluded.

Results:
The study included 4,118 participants (mean age: 58.3 ± 9.9 years; male: 1,699/41.3%). Gunn's dots were found in 931 participants, with a prevalence of 22.6 ± 0.8% (95% confidence interval [CI]: 21.3–23.9). Systemic factors associated with a higher GD prevalence were younger age (odds ratio [OR]: 0.92; 95% CI: 0.91–0.93; P < 0.001), higher estimated glomerular filtration rate (eGFR) (OR: 1.01; 95% CI: 1.001–1.02; P = 0.022), and higher serum concentration of triglycerides (OR: 1.08; 95% CI: 1.004–1.16; P = 0.040). The GD prevalence was 3.5 (OR = 3.46; 95% CI: 1.06–11.35) and 4.4 (OR = 4.37; 95% CI: 1.27–15.09) times greater for participants with an eGFR of ≥90 mL/minute/1.73 m2 and an eGFR of ≥100 mL/minute/1.73 m2, respectively, as compared with participants with an eGFR of <60 mL/minute/1.73 m2.

Conclusion:
The GD prevalence (mean: 22.6%) was associated with younger age, higher eGFR, and higher serum triglyceride concentrations. The presence of GDs may serve as indicators of healthy renal function.
RELATIONSHIP BETWEEN CHOROIDAL FINDINGS AND GROWTH FACTORS, CYTOKINES, AND OTHER INFLAMMATORY MEDIATORS AFTER INTRAVITREAL RANIBIZUMAB INJECTION IN PATIENTS WITH MACULAR EDEMA SECONDARY TO BRANCH RETINAL VEIN OCCLUSION
Authors: Noma Hidetaka , Yasuda Kanako , Mimura Tatsuya , Shimura Masahiko 
Published: December 2021

Purpose:
To examine possible associations between subfoveal choroidal thickness (SCT), choroidal blood flow, aqueous flare value, and aqueous humor levels of multiple growth factors, cytokines, and other inflammatory mediators in patients with branch retinal vein occlusion and macular edema who received antivascular endothelial growth factor (anti-VEGF) therapy.

Methods:
We recruited 65 patients with macular edema due to branch retinal vein occlusion who received intravitreal ranibizumab injection and measured aqueous levels of eight factors by the suspension array method. Furthermore, we evaluated choroidal blood flows by laser speckle flowgraphy and quantified them as the mean blur rate and measured aqueous flare values using a laser flare meter and SCT and central macular thickness by optical coherence tomography.

Results:
At 1 month after intravitreal ranibizumab injection, central macular thickness was significantly improved and SCT, choroidal mean blur rate, and aqueous flare value were significantly decreased. SCT was significantly correlated with vascular endothelial growth factor and placental growth factor, and the change in both SCT and central macular thickness was significantly correlated with the change in aqueous flare value. However, only SCT was significantly negatively correlated with the aqueous flare value.

Conclusion:
Growth factors seem to play a role in SCT. In macular edema with branch retinal vein occlusion, antivascular endothelial growth factor agents may decrease SCT by reducing inflammation.
Acute Hydrops After Bowman Layer Transplantation for Keratoconus May Indicate that Descemet Membrane Rupture Is Secondary to Hydrops
Authors: Musayeva Aytan , Santander-García Diana , Quilendrino Ruth , Parker Jack , van Dijk Korine , Henrat Carole , Dapena Isabel , Binder Perry S. , Melles Gerrit R.J. 
Published: December 2021

Purpose:
The aim of this study was to review the postoperative course and imaging features of 7 eyes that presented with corneal hydrops after Bowman layer (BL) transplantation was performed for advanced keratoconus to determine the potential mechanisms of hydrops formation.

Methods:
A retrospective analysis was performed of 7 eyes of 5 patients with advanced keratoconus that underwent midstromal BL transplantation at 2 tertiary referral centers and developed acute corneal hydrops on average 64 (±30) months (range 14–104 months) postoperatively. Corneal tomography and anterior segment optical coherence tomography (AS-OCT) images were reviewed to document the postoperative and posthydrops course.

Results:
For all eyes, the post-BL transplantation course was uneventful until hydrops development. Despite stable postoperative topographies in 5 of 7 eyes, eyes developed hydrops with typical hypodense areas on AS-OCT that were limited to the stromal layers posterior to the BL graft. With AS-OCT (6/7 eyes), 2 eyes showed a break in Descemet membrane, whereas Descemet membrane was intact across the cornea in 2 eyes; in 2 eyes, the images were inconclusive. All patients admitted to continued eye rubbing, and all but 1 had a clinically significant allergy and/or atopic constitution. Most eyes (5/7) showed a relatively quick (visual) recovery within 1 to 4 months after hydrops.

Conclusions:
Hydrops formation in keratoconic corneas after midstromal BL transplantation may indicate that a break in Descemet membrane is secondary to hydrops development (and not vice versa). With a midstromal BL graft in situ limiting hydrops dimensions, resolution of the hydrops seemed relatively quick with recovery to prehydrops visual acuity in most eyes.
Rescue Technique to Solve Postoperative Refractory Double Anterior Chamber in Deep Anterior Lamellar Keratoplasty
Authors: Hayashi Takahiko , Siebelmann Sebastian 
Published: December 2021

Purpose:
The purpose of this study was to describe a simple rescue technique to solve postoperative double anterior chamber refractory to rebubbling in deep anterior lamellar keratoplasty (DALK).

Methods:
This study analyzed consecutive patients who underwent DALK between June 2014 and March 2018 and required a postoperative reattachment of Descemet membrane because of macroperforation-led persistent double chambers. The technique entails placing anchoring sutures to attach Descemet membrane to the donor's posterior stroma. Anchoring sutures were removed within 1 month of surgery. The postoperative best spectacle–corrected visual acuity (BSCVA) [converted to logarithm of the minimum angle of resolution (logMAR) units], endothelial cell density (cells/mm2), graft survival, postoperative complications, and corneal astigmatism (diopters) were evaluated.

Results:
Five eyes from 5 patients were included in this study [5 women, 63.6 ± 6.0 yrs (32–80 yrs); mean follow-up duration, 72.0 ± 23.3 mo (30–100 mo)] (mean ± SD). The grafts survived successfully in all patients without primary or secondary graft failure. The best spectacle–corrected visual acuity improved from 1.26 ± 0.66 logMAR preoperatively to 0.25 ± 0.15 logMAR postoperatively (n = 5, P = 0.042). The endothelial cell density was 1468 ± 810 cells/mm2 at the last visit.

Conclusions:
Macroperforation of Descemet membrane during DALK with incomplete removal of the stroma can lead to persistent double anterior chamber. This complication could be solved by the technique devised by this study.
New views on three-dimensional imaging technologies for glaucoma: an overview
Authors: Guzman Aparicio Maria A. , Chen Teresa C. 
Published: December 2021

Purpose of review
To summarize the literature on three-dimensional (3D) technological advances in ophthalmology, the quantitative methods associated with this, and their improved ability to help detect glaucoma disease progression.

Recent findings
Improvements in measuring glaucomatous structural changes are the result of dual innovations in optical coherence tomography (OCT) imaging technology and in associated quantitative software.

Summary
Compared with two-dimensional (2D) OCT parameters, newer 3D parameters provide more data and fewer artifacts.
Antimicrobial Susceptibility Profiles Among Neonatal Early-onset Sepsis Pathogens
Authors: Flannery Dustin D. , Puopolo Karen M. , Hansen Nellie I. , Gerber Jeffrey S. , Sánchez Pablo J. , Stoll Barbara J. 
Published: December 2021

Background:
Empiric administration of ampicillin and gentamicin is recommended for newborns at risk of early-onset sepsis (EOS). There are limited data on antimicrobial susceptibility of all EOS pathogens.

Methods:
Retrospective review of antimicrobial susceptibility data from a prospective EOS surveillance study of infants born ≥22 weeks’ gestation and cared for in Neonatal Research Network centers April 2015–March 2017. Nonsusceptible was defined as intermediate or resistant on final result.

Results:
We identified 239 pathogens (235 bacteria, 4 fungi) in 235 EOS cases among 217,480 live-born infants. Antimicrobial susceptibility data were available for 189/239 (79.1%) isolates. Among 81 Gram-positive isolates with ampicillin and gentamicin susceptibility data, all were susceptible in vitro to either ampicillin or gentamicin. Among Gram-negative isolates with ampicillin and gentamicin susceptibility data, 72/94 (76.6%) isolates were nonsusceptible to ampicillin, 8/94 (8.5%) were nonsusceptible to gentamicin, and 7/96 (7.3%) isolates were nonsusceptible to both. Five percent or less of tested Gram-negative isolates were nonsusceptible to each of third or fourth generation cephalosporins, piperacillin-tazobactam, and carbapenems. Overall, we estimated that 8% of EOS cases were caused by isolates nonsusceptible to both ampicillin and gentamicin; these were most likely to occur among preterm, very-low birth weight infants.

Conclusions:
The vast majority of contemporary EOS pathogens are susceptible to the combination of ampicillin and gentamicin. Clinicians may consider the addition of broader-spectrum therapy among newborns at highest risk of EOS, but we caution that neither the substitution nor the addition of 1 single antimicrobial agent is likely to provide adequate empiric therapy in all cases.
Kikuchi Disease in Children
Authors: Abdu Ahmed , Pajkrt Dasja , Bijker Else M. 
Published: December 2021

Background:
Kikuchi disease (KD) is a rare and generally benign condition of uncertain etiology that presents with nonspecific symptoms including fever and cervical lymphadenopathy. Clinical presentations can vary. Here, we present an atypical case of KD in a 10-year-old girl, as well as an updated literature review of the clinical presentation, laboratory features and management of KD in children.

Methods:
Studies (published up until February 2020) were identified through searches of PubMed using the following search items: Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis or Kikuchi disease. Our primary search resulted in 1117 publications. A total of 34 publications with a total of 670 patients were included in the final analysis.

Results:
All children present with lymphadenopathy. Almost all (96.3%) have cervical lymphadenopathy. Fever is recorded in the majority of children (77.1%). Analysis of laboratory features found that the majority of children have leukopenia (56.0%) and a raised erythrocyte sedimentation rate (56.0%). Over 30% have a raised C-reactive protein and anemia. Other features such as leukocytosis, thrombocytopenia and antinuclear antibodies positivity are less common. KD is mostly self-limiting, but steroids, hydroxychloroquine and intravenous immunoglobulin are used in protracted courses. Their efficacy has yet to be established in clinical trials.

Conclusions:
The presentation of KD is variable, and there is no specific set of symptoms or laboratory features that reliably establishes the diagnosis. Thus, histopathology is crucial. Definitive evaluation and establishment of effective treatments will require future prospective research studies for a more comprehensive description of the clinical course and effects of treatment. Given the rarity of the disease, this will have to be performed in collaborative consortia.
The Suboptimal Pediatric HIV Viral Load Cascade
Authors: Muhairwe Josephine A. , Brown Jennifer A. , Motaboli Lipontso , Nsakala Bienvenu L. , Lerotholi Malebanye , Amstutz Alain , Klimkait Thomas , Glass Tracy R. , Labhardt Niklaus D. 
Published: December 2021

Background:
Children living with HIV and taking antiretroviral therapy (ART) are a priority group for routine viral load (VL) monitoring. As per Lesotho guidelines, a VL ≥1000 copies/mL (“unsuppressed”) should trigger adherence counseling and a follow-up VL; 2 consecutive unsuppressed VLs (“virologic failure”) qualify for switching to second-line ART, with some exceptions. Here, we describe the pediatric VL cascade in Lesotho.

Methods:
In a prospective open cohort study comprising routine VL results from 22 clinics in Lesotho, we assessed outcomes along the VL cascade for children who had at least 1 VL test from January 2016 through June 2020. Data were censored on February 10, 2021.

Results:
In total, 1215 children received 5443 VL tests. The median age was 10 years (interquartile range 7–13) and 627/1215 (52%) were female; 362/1215 (30%) had at least 1 unsuppressed VL. A follow-up VL was available for 325/362 (90%), although only for 159/362 (44%) within 6 months of the first unsuppressed VL. Of those with a follow-up VL, 172/329 (53%) had virologic failure and 123/329 (37%) qualified for switching to second-line ART. Of these, 55/123 (45%) were ever switched, although only 9/123 (7%) were switched within 12 weeks of the follow-up VL. Delays were more pronounced in rural facilities. Overall, 100/362 (28%) children with an unsuppressed VL received a timely follow-up VL and, if required, a timely regimen switch.

Conclusions:
Despite access to VL monitoring, clinical management was suboptimal. HIV programs should prioritize timely clinical action to maximize the benefits of VL monitoring.
Risk of Breast Cancer With Prolactin Elevating Antipsychotic Drugs
Authors: Rahman Tahir , Sahrmann John M. , Olsen Margaret A. , Nickel Katelin B. , Miller J. Phillip , Ma Cynthia , Grucza Richard A. 
Published: December 2021

Abstract

Purpose/Background
Antipsychotic drugs are well established to alter circulating prolactin levels by blocking dopamine D2 receptors in the pituitary. Prolactin activates many genes important in the development of breast cancer. Prior studies have found an association with antipsychotic use and risk of breast cancer.

Methods/Procedures
The IBM MarketScan Commercial and Medicaid Databases were used to establish a large, observational cohort of women taking antipsychotics drugs compared with anticonvulsants or lithium. A new user design was used that required 12 months of insurance enrollment before the first antipsychotic or anticonvulsant/lithium prescription. Invasive breast cancer was identified using diagnostic codes. Multivariable Cox proportional hazards models were used to evaluate the risk of breast cancer with antipsychotic drug exposure controlling for age and other risk factors.

Findings/Results
A total of 914 cases (0.16%) of invasive breast cancer were identified among 540,737 women. Exposure to all antipsychotics was independently associated with a 35% increased risk of breast cancer (aHR [adjusted hazard ratio], 1.35; 95% confidence interval, 1.14–1.61). Category 1 drugs (high prolactin) were associated with a 62% increased risk (aHR, 1.62; 95% CI, 1.30–2.03), category 2 drugs a 54% increased risk (aHR, 1.54; 95% CI, 1.19–1.99), and category 3 drugs were not associated with breast cancer risk.

Implications/Conclusions
In the largest study of antipsychotics taken by US women, a higher risk between antipsychotic drug use and increased risk for breast cancer was observed, with a differential higher association with antipsychotic categories that elevate prolactin. Our study confirms other recent observational studies of increased breast cancer risk with antipsychotics that elevate prolactin.
A Randomized Clinical Trial on the Impact of Individually Targeted Computerized Cognitive Training on Quality of Life Indicators in Adults With HIV-Associated Neurocognitive Disorder in the Southeastern United States
Authors: Vance David E. , Pope Caitlin N. , Fazeli Pariya L. , Azuero Andres , Frank Jennifer S. , Wadley Virginia G. , Raper James L. , Byun Jun Y. , Ball Karlene K. 
Published: December 2021

Abstract
HIV-associated neurocognitive disorder (HAND) is experienced by 30% to 50% of people living with HIV (PLWH), potentially affecting their quality of life (QoL). In the Training on Purpose Study, we investigated whether targeted cognitive training can improve QoL in PLWH with HAND. Using a two-group experimental design, we randomized 109 adults with HAND to either (a) the Individualized-Targeted Cognitive Training group or (b) a no-contact control group. Those in the training group were assigned 10 hr of cognitive training per two selected cognitive domains (20 hr total) for which impairment was observed. Overall, two patterns emerged. First, significant improvements in measures of everyday cognitive complaints, depression, and mental health were consistently observed after the completion of many cognitive training protocols. Second, immediate and delayed spatial learning and memory training resulted in more significant indicators of QoL improvements compared with the other cognitive domain trainings. The findings suggest that some types of cognitive training may have advantages over others in improving aspects of QoL.
Anticoagulation Management and Outcomes in Patients With Covid-19 With Propensity Score Matching: A Multicenter Retrospective Cohort Study
Authors: Kaur Jasmeet , deLongpre Jennifer , Koehler Tracy , Laclair Heather , Bowen Monica , Khine Justin , Khosrodad Nadia , Jena Nihar , Dixit Priyadarshini , Yadav Sumeet , Mogulla Swathi M. , Coakley Rob , Sule Anupam , Krishnamoorthy Geetha 
Published: December 2021

Background:
Therapeutic doses of anticoagulation have been administered to patients with coronavirus-19 disease (Covid-19) without thromboembolism, although there is a lack of robust evidence supporting this practice.

Study Question:
To compare outcomes between patients admitted to the hospital for Covid-19 who received full-dose anticoagulation purely for the indication of Covid-19 and patients who received prophylactic doses of anticoagulation.

Study Design:
This is a multicenter retrospective cohort study, including 7 community hospitals in Michigan. Patients were >18 years of age, confirmed positive for Covid-19 by polymerase chain reaction, and admitted to the hospital between March 10 and May 3, 2020. Exposed group: Patients receiving therapeutic dose anticoagulation for Covid-19 for any duration excluding clinically evident venous thromboembolism, atrial fibrillation, and myocardial infarction; control group: Patients receiving prophylactic anticoagulation. Propensity score matching was used to adjust for the nonrandomized nature of the study.

Measures and Outcomes:
The primary endpoint: 30-day in-hospital mortality. Secondary endpoints: intubation, length of hospital stay, and readmissions in survivors.

Results:
A total of 115 exposed and 115 control patients were analyzed. Rates of 30-day in-hospital mortality were similar (exposed: 33.0% vs. control: 28.7%). Controlling for institution, there was no significant association between treatment and 30-day in-hospital mortality (hazard ratio: 0.63; 95% confidence interval: 0.37–1.06). Survivors had statistically similar length of hospital stay and readmission rates.

Conclusions:
We found no difference in mortality in patients with Covid-19 without clinically evident venous thromboembolism, atrial fibrillation, and myocardial infarction who received therapeutic versus prophylactic doses of anticoagulation.
Emerging concepts in sinonasal tumor research
Authors: Lopez Diana C. , Wadley Andrew E. , London Nyall R. 
Published: December 2021

Purpose of review
Sinonasal malignancies are rare and understudied, often diagnosed at late stages, and may behave aggressively. This review explores investigative diagnostic, therapeutic, and scientific advances specific to sinonasal undifferentiated carcinoma (SNUC), intestinal-type adenocarcinoma (ITAC), and olfactory neuroblastoma (ONB).

Recent findings
A number of studies have recently contributed more robust knowledge of the genetic and molecular landscapes of SNUC, ITAC, and ONB. These analyses have identified SMARCB1 and IDH2 mutations in SNUC, potentially allowing for the tumor's subdivision. Recent studies have also defined a role for induction chemotherapy in SNUC. Somatic mutations for ITAC have been identified and may be potentially targetable with FDA approved therapies. Studies defining the tumor microenvironment for ITAC and ONB have introduced the possibility of immune checkpoint inhibition for these tumor types.

Summary
Studies reviewed here detail promising results of the most current and novel characterization of SNUC, ITAC, and ONB genetic and molecular landscapes, which have informed ongoing therapeutic discovery. With continued multi-institutional efforts, the field of sinonasal tumor research will achieve higher disease control and improved treatment outcomes for patients afflicted with these rare cancers.
Fertility preservation in children and young adults with cancer
Authors: Brungardt Joseph G. , Burns Karen C. , Dasgupta Roshni 
Published: December 2021

Purpose of review
The issue of fertility preservation has become increasingly relevant as survival rates of children with cancer exceeds 80% at 5 years. Fertility preservation options are being utilized alongside less gonadotoxic therapeutic regimens in the treatment of these patients. The purpose of this review is to summarize the recent advances in fertility preservation in the pediatric, adolescent, and young adult population.

Recent findings
Education research involves both patient and provider; to increase understanding on both sides for improved adoption of techniques and higher rates of posttreatment fertility. Basic science research, specific to the pediatric population, has worked to further understanding of protective techniques and cryopreserved tissue transfer. Research on the techniques of preservation confirms the safety of surgical gonadal (ovarian and testicular) tissue retrieval for cryopreservation but a viable pathway for testicular tissue utilization, as it has for ovarian, has yet to be realized. Outcomes may be improving but it is apparent that robust registries are necessary to track patients long-term. Possibly the largest advancement in the recent past are group efforts, such as by PanCareLIFE, to create guidelines for these issues using larger cohorts and registries than were available.

Summary
Current research implies the need for the development of a national strategy to ensure that pediatric patients undergoing gonadotoxic regimens are educated, alongside their family, about fertility options and outcomes thereafter.