bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurotrophic Keratopathy: Ophthalmology's Diabetic Foot Problem
Authors: Margolis Todd P. 
Published: February 2021

Abstract:
This article summarizes key elements of the 2020 Harold A. Stein Lecture presented at the Eye and Contact Lens Special Symposium “Healing the Ocular Surface: What's New for Neurotrophic Keratitis.” The major point that I made in this talk is that we need to think about neurotrophic keratopathy as ophthalmology's diabetic foot problem; as a chronic condition that is, often best managed by prevention. Neurotrophic keratopathy is not primarily an inflammatory condition, as suggested by the term ‟neurotrophic keratitis.” The epitheliopathy in this condition is a consequence of the dysregulated epithelial cell migration, differentiation, and homeostasis that occurs with denervation of the ocular surface. Although this epitheliopathy may be complicated by poor lid closure, or rarely, aqueous tear deficiency, most of these eyes are not dry and do not require exogenous lubrication for comfort, prophylaxis, or healing. The use of topical agents in these eyes inevitably leads to unrecognized iatrogenic injury, with poor outcomes because of inherently poor wound healing and delays in seeking medical care. Tarsorrhaphy is a time-honored method of protecting the neurotrophic cornea, shielding the eye from iatrogenic injury. Alternative methods for protecting the ‟at risk” surface of the neurotrophic cornea include patient education, minimizing topical agents, and the use of protective eyewear.
Rituximab as an Adjuvant Rescue Treatment for Ocular Cicatricial Pemphigoid
Authors: Bevans Stephanie L. , Parker John , Ivey Jordan M. , Pavlidakey Peter , Sami Naveed 
Published: February 2021

Purpose:
Ocular cicatricial pemphigoid (OCP) can lead to devastating ocular complications without prompt treatment. A number of immunomodulatory agents have been attempted with varying success. The objective of this study was to evaluate the use of rituximab as an adjuvant to immunomodulatory treatments (IMTs) in refractory OCP.

Methods:
The clinical records of 14 patients with treatment refractory OCP treated with rituximab as monotherapy or in combination with IMTs were retrospectively reviewed, with a focus on demographics, treatments prerituximab and postrituximab, total number of rituximab infusions, response to treatment, and ocular outcomes including staging and best-corrected visual acuity.

Results:
Thirteen patients (92.9%) achieved a complete response with rituximab over a mean period of 4.3 months. The average sustained complete response time in those without relapse was 29.7 months. Five patients relapsed over a mean period of 15 months, 2 of whom were able to regain control over a mean of 2.5 months with additional rituximab treatments. At the final evaluation, rituximab-based therapy improved ocular outcomes in OCP by stabilizing Foster staging and preventing the deterioration of best-corrected visual acuity in 72% of eyes. In total, 90% of eyes with Foster stages 3 or less did not progress. All patients were able to decrease IMT dosage and/or transition to less potent adjuvant treatments.

Conclusions:
The consideration of rituximab earlier in treatment of OCP as a rescue and/or maintenance therapy could result in an earlier arrest of disease progression, resulting in preservation of patients' vision, and enable tapering of adjuvant IMT.
Recovery of Contrast Sensitivity After Descemet Membrane Endothelial Keratoplasty
Authors: Gundlach Enken , Pilger Daniel , Brockmann Tobias , Dietrich-Ntoukas Tina , Joussen Antonia M. , Torun Necip , Maier Anna-Karina B. 
Published: February 2021

Purpose:
To study the change in contrast sensitivities in eyes with Fuchs endothelial dystrophy and bullous keratopathy after Descemet membrane endothelial keratoplasty (DMEK).

Methods:
In this prospective study, 50 pseudophakic eyes of 50 patients who received DMEK surgery at the Charité—Universitätsmedizin Berlin were included. Visual acuity; contrast sensitivity using OPTEC 6500 at spatial frequencies of 1.5, 3, 6, 12, and 18 cycles/degree in photopic and mesopic light with and without glare; central corneal thickness (CCT); and anterior and posterior corneal aberrations were measured preoperatively and at 3 and 12 months postoperatively.

Results:
Best-corrected visual acuity (preoperative 0.67 ± 0.46 and after 12 months 0.19 ± 0.16 LogMAR, P < 0.001) and photopic and mesopic contrast sensitivities with and without glare improved significantly, whereas CCT decreased significantly (preoperative 677 ± 114 μm, after 12 months 527 ± 29 μm, P < 0.001). Preoperative CCT correlates significantly with preoperative photopic contrast sensitivity (correlation coefficient −0.462, P = 0.002), and postoperative total anterior aberrations correlates with postoperative photopic contrast sensitivity (correlation coefficient −0.361, P = 0.006).

Conclusions:
Photopic and mesopic contrast sensitivities, especially with glare, are impaired in patients with Fuchs endothelial dystrophy and bullous keratopathy. The extent of the corneal thickening seems to mainly influence the contrast sensitivity preoperatively. DMEK surgery improves the contrast sensitivity significantly. However, higher postoperative anterior corneal aberrations limit the postoperative contrast sensitivities.
Safety of 3 Tesla Magnetic Resonance Imaging on iStent Implants: An Ex-Vivo Study
Authors: Ayalon Anfisa , Fanadka Feda , Belkin Avner , Burgansky Zvia , Moisseiev Elad 
Published: February 2021

Précis:
Our study shows that iStent implant does not cause significant image artifacts, heating, or displacement during magnetic resonance imaging (MRI) scan. This device can be safely used in patients undergoing MRI scans using 3 Tesla (3T) machines.

Purpose:
The iStent is a medical grade titanium implant commonly implanted in the anterior chamber angle of glaucomatous eyes in order to reduce intraocular pressure and medication burden. As many people now have these devices implanted in their eyes, the issue of their compatibility with MRI in terms of safety and interference with interpretation of these studies commonly arises. The purpose of this study is to evaluate the safety of 3T MRI scans in eyes that have undergone iStent implantation and to assess the interference of the implant to the scan interpretation.

Materials and Methods:
An ex vivo model of sheep eye with an iStent and proximately placed heat detector probe was used to study changes in the temperature during MRI 3T scan. The study included 2 fresh eyes with preserved extraocular muscles and orbital fat tissue placed in the orbital cavity of a human skull. Each eye with orbital content was scanned with a 3T MRI machine.

Results:
No displacement of the implant was observed during MRI scanning. The heat detector showed mild temperature elevation during the first minutes of the scan from 14.6 to 16.5°C. The iStent was best visualized in T2 turbo spin echo sequences and showed no significant artifacts.

Conclusion:
iStent implants did not move during the MRI scan, showed minimal interaction with the magnetic field in terms of heating and image distortion. These interactions were not strong enough to present a substantial risk to patients with this implant undergoing an MRI scan.
Surgical Outcomes of Ahmed Glaucoma Valve Implantation Without Plate Sutures: A 10-Year Retrospective Study
Authors: Kapelushnik Noa , Singer Reut , Barkana Yaniv , Rosenfeld Alik , Tucker Yisrael , Jaber Wasim , Gaton Dan , Leshno Ari , Skaat Alon 
Published: February 2021

Précis:
Ahmed glaucoma valve (AGV) implantation without plate fixation resulted in high rates of complications related to plate or tube movement.

Purpose:
Scleral suturing of the plate of AGV is associated with technical difficulty and potential complications. This study summarizes the surgical outcomes of 10 years of experience with AGV implantation without suture plate fixation.

Methods:
The medical records of all glaucoma patients who underwent AGV implantation surgery without plate fixation between 2009 and 2019 at the Sheba Medical Center (Tel Hashomer, Israel) were retrospectively reviewed. Clinical data on intraoperative and postoperative complications, best-corrected visual acuity, intraocular pressure, and number of intraocular pressure-lowering medications were retrieved.

Results:
Included were 95 eyes of 95 patients (53 men, 42 women; mean age, 54.9±17.5 y). The mean follow-up was 687±673 days. In total, 37 patients (37/95, 38.%) had AGV-related complications, of whom 28 (29.5%) required additional intervention. Women had a significantly higher rate of complications than men (21/42, 50% vs. 16/53, 30.2%, respectively, P=0.049). The 2 most common complications were AGV migration in 13 eyes (13.7%) and tube exposure/AGV extrusion in 9 eyes (9.5%). AGV was removed in 10 cases.

Conclusions:
In this cohort, omitting suture AGV plate fixation resulted in high rates of complications related to plate or tube movement, the need for further intervention, and AGV removal. Therefore, we cannot recommend this surgical technique.
Comparison of the iCare, Tono-Pen, non-contact airpuff, and Goldmann applanation tonometers in eyes with corneal edema after penetrating keratoplasty
Authors: Yeh Shih-Jung , Chen Ko-Hua , Kuang Tung-Mei , Liu Catherine Jui-Ling , Chen Mei-Ju 
Published: February 2021

Background:
To compare the utility of the iCare, Tono-Pen, and non-contact airpuff (NCT) tonometers with the Goldmann applanation tonometer (GAT) for measuring intraocular pressure (IOP) in patients with corneal edema after penetrating keratoplasty (PKP) and to assess the effects of central corneal thickness (CCT) and corneal curvature (CC) on IOP measurements.

Methods:
Thirty-two eyes of 27 patients with corneal edema after PKP due to corneal abnormalities and 43 control eyes of 30 patients with normal corneas were recruited. Before IOP measurements, all patients underwent a baseline examination, including auto-refraction, keratometry, slit lamp biomicroscopy, and CCT measurement. IOP was measured using the devices in the same order: first the NCT, followed by the iCare, Tono-Pen, and GAT. The differences between the iCare, Tono-Pen, NCT, and GAT were calculated with repeated-measures analysis of variance. The Bland-Altman method was used to assess the agreement between the iCare, Tono-Pen, and NCT versus the GAT. The influences of CCT and CC on IOP measurement were evaluated by correlation analysis using Pearson’s correlation coefficient.

Results:
Mean IOP measurements were significantly higher with the NCT and Tono-Pen than with the GAT in the PKP and control groups. When compared with GAT, iCare showed significantly higher IOP readings in the control group, but the IOP readings did not differ between the iCare and GAT in the PKP group. Poor agreement was noted between the NCT and GAT in both groups. The Tono-Pen showed clinically acceptable agreement with GAT in control eyes and poor agreement in PKP eyes. The agreement between the iCare and GAT appeared to be clinically acceptable in both groups. Correlation analysis of the results from control eyes showed that the IOP measurements with the GAT and NCT were weakly related to CCT and moderately correlated with CC. The iCare IOP readings were weakly correlated with CCT and CC.

Conclusion:
In the PKP group, the NCT and Tono-Pen significantly overestimated IOP, whereas the iCare IOP readings were similar to those obtained using the GAT. Poor agreement was noted between the NCT and GAT as well as between the Tono-Pen and GAT, but the iCare showed clinically acceptable agreement with GAT. In normal corneas, the GAT, NCT, and iCare were affected by CCT and CC. The iCare tonometer was less affected by corneal edema than were the NCT and the Tono-Pen. The iCare appears to be a useful device for IOP measurement in eyes with corneal edema after PKP.
Impact of screening COVID-19 on orthopedic trauma patients at the emergency department: A consecutive series from a level I trauma center
Authors: Ma Hsuan-Hsiao , Tsai Shang-Wen , Chen Cheng-Fong , Wu Po-Kuei , Chen Chao-Ming , Chiang Chao-Ching , Chen Wei-Ming 
Published: February 2021

Background:
Coronavirus disease 2019 (COVID-19) posed a major threat to the clinical practice of orthopedic surgeons, especially in the emergency department. We aim to present: (1) the criteria established by the Surgery Management Committee of Taipei Veterans General Hospital in response to COVID-19 and (2) the impact of COVID-19 screening on orthopedic trauma patients in the emergency department.

Methods:
From April 1 to April 30, 2020, all orthopedic trauma patients in the emergency department were screened for COVID-19 if they fulfilled any of the following: (1) travel from abroad within 14 days, (2) high-risk occupation, (3) contact or cluster history with a COVID-19–positive patient, and (4) any associated symptom, including fever up to 38°C, cough, sore throat, rhinorrhea, loss of taste or smell, muscle soreness, malaise, or shortness of breath. We recorded details on the injury, fever, management, and associated outcomes.

Results:
Of the 163 orthopedic trauma patients presenting to the emergency department, 24 were screened for COVID-19; of these, 22 received surgery. Sixty-two patients received surgery without screening for COVID-19. Fever was the most common reason to screen for COVID-19 (N = 20; 83.3%). No patients were COVID-19 positive. Screened patients had a significantly longer mean interval from presentation to the emergency department to surgery (2.7 ± 2.5 vs. 1.5 ± 0.8 days, p = 0.037). Of the 20 patients screened because of fever, the focus was not identified in 12 (60.0%) patients. The other eight had urinary tract infection (N = 6; 27.2%), septic hip (N = 1; 4.6%), and concomitant pneumonia and urinary tract infection (N = 1; 4.6%). The mean duration of fever and hospital stay was 4.3 ± 4.6 and 8.7 ± 4.9 days, respectively. There were no thromboembolic events, surgical complications, or in-hospital mortality.

Conclusion:
We developed safe and reliable screening criteria for this COVID-19 pandemic. The delay in surgery was reasonable and did not adversely affect in-patient outcomes.
Possible acquired gastrointestinal polyposis in a childhood cancer survivor
Authors: Snyder Cynthia T. , Bird Patricia 
Published: February 2021

ABSTRACT
Childhood cancer survivors (CCSs) are at an increased risk for secondary cancers, including colorectal, thyroid, lung, and breast. Treatment with abdominal radiotherapy and/or alkylating agent chemotherapy has been associated with an increased risk for colorectal adenomas and colorectal cancer (CRC) in CCSs. The phenotype of therapy-associated polyposis (TAP) is not well-understood, given the paucity of cases described in the literature. Further defining the phenotype of TAP is important to increase the primary care provider's awareness of when to begin CRC screening in these patients. We present a case of a patient with possible acquired polyposis that seems to meet the criteria identified in the literature for TAP. The purpose of this case study is to add to the body of knowledge related to TAP, further defining the phenotype. Better understanding of therapy-related risks in CCSs and hereditary predisposition will provide primary care providers and their patients with an improved plan for CRC screening.
Anticoagulant management by low-dose of low molecular weight heparin in patients with nonvalvular atrial fibrillation following hemorrhagic transformation and complicated with venous thrombosis
Authors: Zhang Ling , Kong Yu-Han , Wang Da-Wu , Li Kai-Ting , Yu He-Ping 
Published: February 2021

Abstract
For patients with nonvalvular atrial fibrillation (NVAF) following hemorrhagic infarction (HI)/hemorrhage transformation (HT) and complicated with venous thrombosis, the management of anticoagulation is controversial. Our study intends to explore the safety and effectiveness of using low-dose of low molecular weight heparin (LMWH) to treat NVAF patients with HI (or HT) and complicated with venous thrombosis.
Between January 2018 and January 2019, NVAF related acute ischemic stroke patients with HT/HI, hospitalized in the department of neurology or rehabilitation in our hospital, are enrolled retrospectively. Among them, those who were found to have venous thrombosis and undergo anticoagulation (LMWH) during the treatment were extracted. We investigate the efficacy and safety in those patients who have been treated with anticoagulant of LMWH.
Five cases accepted LMWH within 3 weeks attributed to the appearance of venous thrombosis, and all of them did not display new symptomatic bleeding or recurrent stroke. However, based on the results of a head computed tomography scan, there were 2 cases of slightly increased intracranial hemorrhage, and then we reduced the dose of anticoagulant. In addition, color ultrasound showed that venous thrombosis disappeared or became stable.
Patients with NVAF following HI/HT have a higher risk of thromboembolism. Early acceptance of low-dose LMWH as an anticoagulant is relatively safe and may gain benefit. However, in the process of anticoagulant therapy, we should follow-up head computed tomography/magnetic resonance imaging frequently, as well as D-dimer values, limb vascular ultrasound. Besides, the changes of symptoms and signs should be focused to judge the symptomatic bleeding or recurrent stroke. Furthermore, it is better to adjust anticoagulant drug dosage according to specific conditions.
Novel signaling pathways regulate SARS-CoV and SARS-CoV-2 infectious disease
Authors: Cheng Li-Chin , Kao Tzu-Jen , Phan Nam Nhut , Chiao Chung-Chieh , Yen Meng-Chi , Chen Chien-Fu , Hung Jui-Hsiang , Jiang Jia-Zhen , Sun Zhengda , Wang Chih-Yang , Hsu Hui-Ping 
Published: February 2021

Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV)-2 induces severe infection, and it is responsible for a worldwide disease outbreak starting in late 2019. Currently, there are no effective medications against coronavirus. In the present study, we utilized a holistic bioinformatics approach to study gene signatures of SARS-CoV- and SARS-CoV-2-infected Calu-3 lung adenocarcinoma cells. Through the Gene Ontology platform, we determined that several cytokine genes were up-regulated after SARS-CoV-2 infection, including TNF, IL6, CSF2, IFNL1, IL-17C, CXCL10, and CXCL11. Differentially regulated pathways were detected by the Kyoto Encyclopedia of Genes and Genomes, gene ontology, and Hallmark platform, including chemokines, cytokines, cytokine receptors, cytokine metabolism, inflammation, immune responses, and cellular responses to the virus. A Venn diagram was utilized to illustrate common overlapping genes from SARS-CoV- and SARS-CoV-2-infected datasets. An Ingenuity pathway analysis discovered an enrichment of tumor necrosis factor- (TNF-) and interleukin (IL)-17-related signaling in a gene set enrichment analysis. Downstream networks were predicted by the Database for Annotation, Visualization, and Integrated Discovery platform also revealed that TNF and TNF receptor 2 signaling elicited leukocyte recruitment, activation, and survival of host cells after coronavirus infection. Our discovery provides essential evidence for transcript regulation and downstream signaling of SARS-CoV and SARS-CoV-2 infection.
Partial trisomy 16q and partial monosomy 7p of a fetus derivated from paternal balanced translocation
Authors: Xie Hui-Hui , Liu Tong , Zhang Jing-Bo , Zhai Jing-Fang , Liu Ying 
Published: February 2021

Abstract

Introduction:
Subchromosomal deletions and duplications could currently be detected by noninvasive preliminary screening (NIPS). However, NIPS is a screening test that requires further diagnosis. Here we report a fetus with an autosomal abnormality revealed by NIPS and conventional karyotype combined with copy number variations sequencing (CNV-seq) confirmed the fetus with an unbalanced translocation.

Patient concern:
This was the fourth pregnancy of a 30-year-old woman who underwent 2 spontaneous abortions and gave birth to a child with a normal phenotype. The woman and her husband were healthy and nonconsanguineous. NIPS indicated a repeat of about 19-Mb fragment at the region of 16q22.1-q22.4 at 17-week gestation.

Diagnoses:
The combination of traditional karyotype and CNV-seq could better locate the abnormal chromosomal region and further identify the source of fetal chromosomal abnormalities. Simultaneously, we evaluated the fetal morphology by ultrasound examination. The karyotype of the fetus was 46,XX,der(7)t(7;16)(p22;q23) and CNV-seq results showed an approximately 20.96-Mb duplication in 16q22.1-q24.3 (69200001-90160000) and an approximately 3.86-Mb deletion in 7p22.3-p22.2 (40001-3900000). Prenatal ultrasound revealed the fetal micrognathia. The paternal karyotype was 46,XY, t (7;16) (p22;q23), while the maternal was normal. The fetus inherited an abnormal chromosome 7 from its father.

Interventions:
No treatment for the fetus.

Outcomes:
Pregnancy was terminated.

Conclusions:
To our knowledge, the occurrence of de novo partial trisomy 16q (16q22.1-qter) and partial monosomy 7p (7p22.2-pter) has not previously been reported up to now. Here, we present the perinatal findings of such a case and a review of the literatures. CNV-seq combined with karyotype is a useful tool for chromosomal abnormalities indicated by NIPS.
The role of estrogen receptor-beta gene +1730G/A polymorphisms in recurrent pregnancy loss
Authors: Mu Fangxiang , Shi Minge , Huang Li , Wang Dafen , Shen Aiqun 
Published: February 2021

Abstract

Objective:
To identify the role of estrogen receptor-beta (ER-β) gene +1730G/A (rs4986938) polymorphisms in recurrent pregnancy loss (RPL).

Methods:
All relevant case-control studies will be systematically searched in multiple databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Internet (CNKI), Wanfang and Cqvip. Both pooled odds rations (ORs) and 95% confidence intervals (CIs) will be used to assess the association between ER-β gene +1730G/A polymorphisms and RPL risk. The publication bias will be evaluated using Egger test.

Results:
ER-β gene +1730G/A variation may be associated with a higher risk of RPL in Caucasian population.

Conclusions:
The findings of this meta-analysis will provide high-quality evidence for the association between ER-β gene +1730G/A polymorphisms and RPL, facilitating clinical practice and further scientific studies.

OSF registration number:
10.17605/OSF.IO/EW9FB.