bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Thrombosis in Severe COVID-19 Requiring Extracorporeal Membrane Oxygenation: A Multicenter Study
Authors: Weir-McCall Jonathan R. , Galea Gabriel , Mun Mak Sze , Joshi Kushal , Agrawal Bobby , Screaton Nicholas , Toshner Mark , Ruggiero Alessandro , Benedetti Giulia , Brozik Jan , Machin Ruth , Das Indrajeet , Kotnik Marusa , Sun Julia , Mackay Michael , Jacob Joseph , Rodrigues Jonathan C. L. , Camporota Luigi , Vuylsteke Alain 
Published: September 2021

OBJECTIVES:
Coronavirus disease 2019 has been reported to be a prothrombotic condition; however, multicenter data comparing this with other viral pneumonias in those requiring extracorporeal membrane oxygenation are lacking. We conducted a multicenter study using whole-body CT to examine the prevalence, severity, and nature of vascular complications in coronavirus disease 2019 in comparison with patients with other viral pneumonias.

DESIGN:
We analyzed whole-body CT scans for the presence of vascular thrombosis (defined as pulmonary artery thrombus, venous thrombus, systemic arterial thrombus, or end-organ infarct). The severity, distribution, and morphology of pulmonary artery thrombus were characterized. Competing risk cumulative incidence analysis was used to compare survival with discharge.

SETTING:
Three centers of the English national extracorporeal membrane oxygenation service.

PATIENTS:
Consecutive patients admitted with either coronavirus disease 2019 or noncoronavirus disease 2019 viral pneumonia admitted from January 2019.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
One-hundred thirty-six patients (45.2 ± 10.6 yr old, 39/146 [27%] female) requiring extracorporeal membrane oxygenation support underwent whole-body CT scans at admission. Of these, 86 had coronavirus disease 2019 pneumonia, and 50 had noncoronavirus disease 2019 viral pneumonia. Vascular thrombosis was seen more often in patients with coronavirus disease 2019 (odds ratio, 12.9 [95% CI 4.5–36.8]). In those with coronavirus disease 2019, 57 (73%) demonstrated pulmonary artery thrombus or pulmonary perfusion defects. Eighty-two percent of thrombus exhibited emboli-like morphology. The location of pulmonary artery thrombus and parenchymal perfusion defects was only concordant in 30% of cases. The risk of mortality was higher in those with coronavirus disease 2019 compared with noncoronavirus disease 2019 pneumonia (χ2 = 3.94; p = 0.047). Mortality was no different in coronavirus disease 2019 patients with or without vascular thrombosis (χ2 = 0.44; p = 0.51).

CONCLUSIONS:
In patients who received extracorporeal membrane oxygenation, coronavirus disease 2019 is associated with a higher prevalence of vascular thrombosis compared with noncoronavirus disease viral pneumonias. The pattern of pulmonary vascular changes suggests concurrent embolic disease and small vessel disease. Despite this, vascular thrombosis was not linked to poorer short-term prognosis in those with coronavirus disease 2019.
MULTIMODAL IMAGING OF UNILATERAL ACUTE IDIOPATHIC MACULOPATHY IN A CHILD PATIENT
Authors: Ava Sedat , Hazar Leyla , Karahan Mine , Erdem Seyfettin , Dursun Mehmet Emin 
Published: September 2021

Purpose:
To report a case of the clinical manifestation of unilateral acute idiopathic maculopathy in a child patient.

Methods:
Case report.

Results:
An 11-year-old male patient complaining of visual impairment in the left eye that had persisted for 3 weeks was admitted to the Dicle University Ophthalmology Clinic. Fundus examination, optical coherence tomography (OCT), enhanced depth imaging OCT, fundus autofluorescence, and fundus fluorescence angiography examinations were conducted. During the fundus examination, a yellowish gray area of swelling with yellowish granules spanning approximately half the diameter of the disk was found on the left macula. Optical coherence tomography revealed serous detachment and hyperreflective debris, OCT angiography showed hyperreflective spots on the outer retina, enhanced depth imaging OCT revealed an increase in choroidal thickness, fundus autofluorescence showed hyperreflective spots, and fundus fluorescence angiography revealed late-phase hyperfluorescence accumulation. Acute idiopathic maculopathy was diagnosed from these findings.

Conclusion:
Acute idiopathic maculopathy should be considered in the differential diagnosis of children presenting with a complaint of unilateral low vision.
BACILLARY LAYER DETACHMENT AFTER PHOTODYNAMIC THERAPY FOR CENTRAL SEROUS CHORIORETINOPATHY
Authors: Ledesma-Gil Gerardo , Desmettre Thomas , Mainster Martin A. 
Published: September 2021

Purpose:
To report the clinical and optical coherence tomography findings of a patient with chronic central serous chorioretinopathy who developed a short-term bacillary layer detachment after photodynamic therapy (PDT).

Methods:
A 56-year-old man presented with metamorphopsia and 20/100 visual acuity in his right eye. He was diagnosed with active, chronic central serous chorioretinopathy based on clinical findings and multimodal imaging. His visual problems and retinal findings persisted for 3 months before he was treated with half-fluence, half-dose verteporfin PDT.

Results:
The patient had a prominent decrease in his vision postoperatively. Two days after treatment, multimodal imaging showed a marked increase in exudation that merged preoperative neurosensory retinal detachments. A prominent subfoveal bacillary layer detachment was also present. The subretinal fluid and bacillary layer detachment resolved over the next 8 weeks, with a return of visual acuity to its baseline level and normalization of retinal structures except for a small zone of subfoveal ellipsoid zone and interdigitation zone disruption.

Conclusion:
Half-fluence, half-dose verteporfin PDT caused a fulminant increase in subretinal fluid and an associated subfoveal bacillary layer detachment. We hypothesize that chronic central serous chorioretinopathy-related chorioretinal dysfunction contributed to the severe PDT-induced local inflammatory reaction that caused the patient's bacillary layer detachment. Hyperacute choroidal exudation too fulminant for containment in subretinal space extended into and exceeded photoreceptor inner segment tensile strength, cleaving the myoid layer and/or dissecting it from the ellipsoid layer. This finding broadens the causality spectrum of bacillary layer detachments and vision losses that can follow PDT.
HIGH-RESOLUTION SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY OF MULTIPLE EVANESCENT WHITE DOT SYNDROME
Authors: Spaide Richard F. , Lally David R. 
Published: September 2021

Purpose:
To evaluate a patient with multiple evanescent white dot syndrome with multimodal imaging including high-resolution spectral-domain optical coherence tomography.

Methods:
The patient was evaluated with wide-field color and autofluorescence imaging, microperimetry, and near-infrared imaging. Spectral-domain optical coherence tomography was performed using an instrument capable of 3-μm axial resolution, the high-resolution Heidelberg Spectralis.

Results:
A 28-year-old woman developed photopsias and a scotoma in the field of vision of her left eye. She had multiple whitish spots with granularity in her fovea, consistent with the diagnosis of multiple evanescent white dot syndrome. She had supportive fluorescein angiographic and autofluorescence findings. Because of the high resolution and good layer contrast, it was possible to create en face slab images of the external limiting membrane, ellipsoid zone, interdigitation zone, and retinal pigment epithelium. The external limiting membrane showed no abnormalities. There were multiple regions of decreased reflectance in the ellipsoid zone slab but even more prominent changes in the interdigitation zone. The retinal pigment epithelium showed nearly no variation in layer reflectivity. With resolution of symptoms, the color and autofluorescence images returned to normal, the defects in the ellipsoid zone almost completely resolved, and the interdigitation zone continued to show abnormalities.

Conclusion:
Although past studies concluded that the ellipsoid zone was the main region of involvement in multiple evanescent white dot syndrome, high-resolution spectral-domain optical coherence tomography suggests the interdigitation zone was more prominently affected in this case.
Cancer Risk in Patients With Fuchs Endothelial Corneal Dystrophy
Authors: Xu Timothy T. , Baratz Keith H. , Fautsch Michael P. , Hodge David O. , Mahr Michael A. 
Published: September 2021

Purpose:
The purpose of this study is to quantify cancer risk in patients with Fuchs endothelial corneal dystrophy (FECD).

Methods:
Using the 2014 to 2016 Medicare Limited 5% Data Sets—Carrier Line File, US Medicare fee-for-service beneficiaries (aged 65 years or older) with FECD and cancer were identified through International Classification of Diseases, ninth and 10th Revision diagnostic codes from January 1, 2014, to December 31, 2016. The main outcome measures were odds ratios (ORs) of cancer at various anatomic locations in patients with versus without FECD.

Results:
Of the 1,462,740 Medicare beneficiaries, 15,534 patients (1.1%) had an International Classification of Disease code for FECD. Compared with US Medicare beneficiaries without FECD, patients with FECD were at increased risk for the following malignancies: breast [OR: 1.32; 95% confidence interval (CI): 1.22–1.43; P < 0.001], cutaneous basal cell (OR: 1.42; 95% CI: 1.35–1.49; P < 0.001), cutaneous melanoma (OR: 1.20; 95% CI: 1.03–1.40; P = 0.02), cutaneous squamous cell (OR: 1.45; 95% CI: 1.38–1.53; P < 0.001), ovarian (OR: 1.84; 95% CI: 1.48–2.30; P < 0.001), and thyroid (OR: 1.32; 95% CI: 1.04–1.68; P = 0.02). By contrast, FECD cases were at lower odds of having lung (OR: 0.81; 95% CI: 0.71–0.93; P = 0.003) and prostate cancer diagnoses (OR: 0.88; 95% CI: 0.81–0.96; P = 0.002).

Conclusions:
Patients with FECD aged 65 years or older may be at increased risk for cancer at several anatomic locations. Follow-up studies are needed to further explore the association of FECD and malignancy, elucidate potential disease mechanisms, and identify genetic and/or environmental risk factors.
Penetrating Keratoplasty With Minimal Endothelial Replacement: A Novel Technique for High-Risk Large-Diameter Corneal Grafting
Authors: Suchismitha Thotapalli 
Published: September 2021

Purpose:
The purpose of this study was to analyze the outcome of large-diameter penetrating keratoplasty with minimal endothelial replacement (PKMER).

Methods:
Two eyes (2 patients) with advanced keratoconus and central full-thickness pathology, namely, scar and failed graft, were studied. Both eyes had relatively healthy endothelium in the periphery. They were operated using the PKMER technique that involved a large-diameter keratoplasty with retained central island of endothelium in the donor corresponding to the visual axis, whereas the peripheral Descemet membrane was removed. In effect, the peripheral endothelium and deep stroma of the recipient were preserved. Patients were followed up using anterior segment optical coherence tomography and specular microscopy postoperatively for a minimum period of 6 months in one eye and 3 years in the other.

Results:
In both eyes, the central cornea maintained clarity throughout follow-up. The astigmatism reduced significantly, and the final uncorrected and best-corrected vision improved from hand motions close to the face to 6/12/n8 in one eye and 6/12/n12 in the other. Anterior segment optical coherence tomography in both eyes showed satisfactory apposition of interfaces at 1 month postkeratoplasty, and the same was maintained throughout follow-up. Both eyes withstood phacoemulsification for preexisting cataracts, which was performed in the second sitting after the PKMER. There were no complications noted except a temporary initial detachment of the peripheral interface in some quadrants in the early postoperative period.

Conclusions:
PKMER may be considered as an alternative technique to large-diameter full-thickness keratoplasty. It is a relatively easier and cost-effective manual technique, which may be used as an alternative to traditional mushroom keratoplasty in selected cases.
Long-term alterations in somatosensory functioning in survivors of childhood cancer
Authors: Tutelman Perri R. , Chambers Christine T. , Cornelissen Laura , Fernandez Conrad V. , Flanders Annette , MacLeod Julia , Sherry Simon B. , Stewart Sherry H. , Urquhart Robin , de Gagne Sitara , Guilcher Gregory M.T. , Hashmi Javeria , Heathcote Lauren C. , Noel Melanie , Schulte Fiona S.M. , Stinson Jennifer N. , Stern Maya 
Published: September 2021

Abstract
Cancer and its treatment can have lasting consequences on somatosensation, including pain, which is often underrecognized and undertreated. Research characterizing the impact of cancer on pain and sensory processing in survivors of childhood cancer is scarce. This study aimed to quantify generalized differences in pain and sensory processing in survivors of childhood cancer compared with reference data using a standardized thermal and mechanical quantitative sensory testing (QST) protocol. The association between demographic, clinical (eg, leukemia vs other cancers and treatment exposures), and psychosocial (eg, anxiety and pain catastrophizing) variables and sensitivity to pain and sensory stimuli were also evaluated. Participants were 56 survivors of various types of childhood cancer (52% male, Mage = 13.5 years, SD = 3.2, range = 8-17 years). On average, children were 7 years (SD = 4.1, range = 1.2-16.5) post treatment. Almost all participants (86%) had at least 1 abnormal QST parameter compared with age- and sex-matched reference data; however, few participants self-reported the presence of sensory abnormalities. Generally, participants exhibited reduced sensitivity across the QST parameters examined (Ps < 0.05, ds = 0.40-3.45). A significant minority (45%) also exhibited pain sensitization (P <0.001, d = 0.42). Several risk factors for changes in sensory processing were identified, including current age, history of leukemia, certain treatment exposures (eg, vincristine cumulative dose, major surgery, and bone marrow or stem cell transplant), time off treatment, and higher anxiety and pain catastrophizing scores. Overall, this study demonstrated that somatosensory changes are prevalent in survivors of childhood cancer years after the completion of treatment. Future research is needed to understand long-term implications of altered somatosensation in this complex population.
Modulation of the nociceptive flexion reflex by conservative therapy in patients and healthy people: a systematic review and meta-analysis
Authors: Dhondt Evy , Van Oosterwijck Sophie , Van Branteghem Thomas , Rhudy Jamie L. , Danneels Lieven , Van Oosterwijck Jessica 
Published: September 2021

Abstract
The nociceptive flexion reflex (NFR) is a spinally mediated withdrawal response and is used as an electrophysiological marker of descending modulation of spinal nociception. Chemical and pharmacological modulation of nociceptive neurotransmission at the spinal level has been evidenced by direct effects of neurotransmitters and pharmacological agents on the NFR. Largely unexplored are, however, the effects of nonpharmacological noninvasive conservative interventions on the NFR. Therefore, a systematic review and meta-analysis was performed and reported following the PRISMA guidelines to determine whether and to what extent spinal nociception measured through the assessment of the NFR is modulated by conservative therapy in patients and healthy individuals. Five electronic databases were searched to identify relevant articles. Retrieved articles were screened on eligibility using the predefined inclusion criteria. Risk of bias was investigated according to Version 2 of the Cochrane risk-of-bias assessment tool for randomized trials. The evidence synthesis for this review was conducted in accordance with the Grading of Recommendations Assessment, Development and Evaluation. Thirty-six articles were included. Meta-analyses provided low-quality evidence showing that conservative therapy decreases NFR area and NFR magnitude and moderate-quality evidence for increases in NFR latency. This suggests that conservative interventions can exert immediate central effects by activating descending inhibitory pathways to reduce spinal nociception. Such interventions may help prevent and treat chronic pain characterized by enhanced spinal nociception. Furthermore, given the responsiveness of the NFR to conservative interventions, the NFR assessment seems to be an appropriate tool in empirical evaluations of treatment strategies.
PROSPERO registration number: CRD42020164495.
Efficacy of nonpharmacological interventions for individual features of fibromyalgia: a systematic review and meta-analysis of randomised controlled trials
Authors: Kundakci Burak , Kaur Jaspreet , Goh Siew Li , Hall Michelle , Doherty Michael , Zhang Weiya , Abhishek Abhishek 
Published: September 2021

Abstract
Fibromyalgia is a highly heterogeneous condition, but the most common symptoms are widespread pain, fatigue, poor sleep, and low mood. Nonpharmacological interventions are recommended as first-line treatment of fibromyalgia. However which interventions are effective for the different symptoms is not well understood. The objective of this study was to assess the efficacy of nonpharmacological interventions on symptoms and disease-specific quality of life. Seven databases were searched from their inception until June 1, 2020. Randomised controlled trials comparing any nonpharmacological intervention to usual care, waiting list, or placebo in people with fibromyalgia aged >16 years were included without language restriction. Fibromyalgia Impact Questionnaire (FIQ) was the primary outcome measure. Standardised mean difference and 95% confidence interval were calculated using random effects model. The risk of bias was evaluated using the modified Cochrane tool. Of the 16,251 studies identified, 167 randomised controlled trials (n = 11,012) assessing 22 nonpharmacological interventions were included. Exercise, psychological treatments, multidisciplinary modality, balneotherapy, and massage improved FIQ. Subgroup analysis of different exercise interventions found that all forms of exercise improved pain (effect size [ES] −0.72 to −0.96) and depression (ES −0.35 to −1.22) except for flexibility exercise. Mind–body and strengthening exercises improved fatigue (ES −0.77 to −1.00), whereas aerobic and strengthening exercises improved sleep (ES −0.74 to −1.33). Psychological treatments including cognitive behavioural therapy and mindfulness improved FIQ, pain, sleep, and depression (ES −0.35 to −0.55) but not fatigue. The findings of this study suggest that nonpharmacological interventions for fibromyalgia should be individualised according to the predominant symptom.
Immunosuppression after uterus transplantation
Authors: Martin Friederike , Tullius Stefan G. 
Published: September 2021

Purpose of review
Clinical uterus transplantation (UTx) is growing rapidly. The procedure represents the only therapy for women with absolute uterine factor infertility to give birth to a biological baby. Immunosuppression after UTx needs to carefully balance effects with the healthy mother and baby. Unique for UTx is the ‘temporary’ character of the procedure with a transplant hysterectomy being performed after delivery. Most of the practice on immunosuppression in UTx is currently based on the experience in solid organ transplantation (SOT).

Recent findings
Clinical UTx-trials have been performed in centers worldwide during the recent years and experience on immunosuppression has accumulated.

Summary
Immunosuppression in UTx has been successfully applied as maintenance treatment in addition to effectively treating acute T- and B-cell mediated rejections. Understanding the biology of UTx in more detail is expected to refine future approaches.
Timing of Nerve Recovery After Nerve Grafting in Obstetrical Brachial Plexus Palsy Patients With Isolated Upper Trunk Neuromas
Authors: Lee Jessica A. , Smith Brandon T. , Egro Francesco M. , Stanger Meg , Koster Wendy , Grunwaldt Lorelei J. 
Published: September 2021

Background
The timing of nerve recovery after nerve grafting in obstetrical brachial plexus palsy patients has not been well reported. One prior study reported a return to baseline function at 3 to 6 months postoperatively. However, there is a paucity of studies to corroborate this timing, and there have been no studies delineating the timeline to obtain clinically meaningful function.

Methods
OBPP patients with upper trunk neuromas-in-continuity who were treated with resection and sural nerve grafting at a single institution were studied. Time to return to baseline function was assessed by Active Movement Scale (AMS) scores preoperatively and postoperatively. Time to clinically meaningful function, defined as an AMS score of ≥6, was also assessed.

Results
Eleven patients with isolated upper trunk neuromas-in-continuity underwent excision and reversed sural nerve grafting. Three of 11 patients also underwent spinal accessory to suprascapular nerve transfers. Average age at surgery was 9.8 ± 1.9 months. One patient did not have follow-up data and was excluded. Average follow-up was 37.1 ± 16.8 months. Average return to baseline AMS score was approximately 4 to 8 months for shoulder abduction, shoulder flexion, shoulder external rotation, elbow flexion, and forearm supination. Clinically meaningful function was obtained in most patients between 9 and 15 months. The remaining patients who did not achieve clinically meaningful function had all obtained scores of 5, which reflects less than one half normal range of motion against gravity.

Conclusions
Nerve recovery after surgical intervention in OBPP patients who undergo resection of an upper trunk neuroma-in-continuity and nerve grafting is more rapid than in adults but longer than previously reported in OBPP literature. This study provides an important data point in delineating the timeline of nerve recovery.
Surgical Results and Patient Satisfaction After A New Surgical Technique for Asian Medial Epicanthoplasty
Authors: Mo Young Woong , Jung Gyu Yong 
Published: September 2021

Background
The double eyelid operation is the most common cosmetic procedure conducted in Asians. However, the epicanthal fold presents a conundrum that limits the cosmetic results of double eyelid surgery. Despite not being a pathologic condition, numerous procedures have been developed and introduced to address this issue, but these techniques have potential disadvantages that include an unnatural ciliary position of the lower lids and prominent scarring.

Method
A total of 156 patients who underwent a double eyelid operation with medial epicanthoplasty using the modified skin redraping method using a horizontal point incision and staged dog ear correction between 2015 and 2019 at our medical center were enrolled in the study. A single senior plastic surgeon performed all surgical procedures. The Patient-Reported Outcome Measures (PROM) questionnaire was used to obtain objective satisfaction scores, and patient satisfaction scores were obtained using some criteria.

Result
Of 147 patients, 8 (0.05) complained of visible scarring at the medial epicanthal and upper fold line region; there were only 2 (0.01%) epicanthal fold recurrences and 1.36% wound-related complications. The PROM scores and patient satisfaction scores showed a strong positive linear correlation according to linear regression analysis (P < 0.001).

Conclusion
We performed double eyelidplasty with epicanthoplasty by using “a modified skin redraping method using a horizontal point incision and a staged ‘Y-shaped’ dog ear correction.” Few complications were encountered, and almost all patients were satisfied with their surgical outcome as determined by the PROM questionnaire.