bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysphotopsia and functional quality of vision after implantation of an intraocular lens with a 7.0 mm optic and plate haptic design
Authors: Bonsemeyer Małgorzata Kalina , Becker Eckhard , Liekfeld Anja 
Published: July 2021

Purpose:
To determine the impact of an intraocular lens (IOL) with a 7.0 mm optic and plate haptic design on incidence of dysphotopsia and visual functions after cataract surgery.

Setting:
Day-care clinic.

Design:
Prospective monocentric randomized patient-blinded comparative clinical study.

Methods:
Following preoperative measurements, patients underwent cataract surgery with implantation of 2 IOL designs—with 7.0 mm optic and plate haptics (Group 1) or with 6.0 mm optic and C-loop haptics (Group 2). In month 1, 3, and 12 follow-ups, patients were examined, answered a questionnaire regarding satisfaction, spectacle dependence, frequency, and extent of positive and negative dysphotopsia, and underwent contrast sensitivity (CS), mesopic vision, and glare sensitivity testing. The data were analyzed as nominal, ordinal, and metric with chi-square, Mann-Whitney U, Wilcoxon, and t tests.

Results:
Out of a total number of 120 eyes (86 patients), Group 1 comprised 57 eyes (43 patients), Group 2 comprised 63 eyes (43 patients). Corrected distance visual acuity was the same between groups throughout the study. Group 1 showed significantly lower incidence of positive and negative dysphotopsia in month 1 follow-up (P = .021 and .015, respectively) and a higher satisfaction rate in month 3 follow-up (P = .006). Mean CS and mesopic vision with and without glare were the same in both groups. Positive dysphotopsia cases in month 12 follow-up revealed lower photopic CS (P = .005, .036, and 0.047, respectively), longer axial length, and greater preoperative pupil dynamics (P = .04 and .06).

Conclusions:
The IOL design with 7.0 mm optic diameter and plate haptics reduced dysphotopsia and provided good visual acuity, CS, mesopic vision with and without glare, and high patient satisfaction.
A Comparison of Medication-Assisted Treatment Options for Opioid Addiction
Authors: Spayde-Baker Amanda , Patek Jennifer 
Published: July 2021

Abstract
In individuals in the United States with opioid addiction, what is the effect of a medication-assisted treatment (MAT) in reducing the relapse and harm reduction when comparing the use of buprenorphine, methadone, and naltrexone? In 2017, it was estimated that 1.7 million individuals suffer from overuse of prescription opiates, 652,000 individuals suffer from heroin use disorder, and greater than 130 individuals die from opiate overdose daily (National Institutes of Health, 2019). Using a systematic literature review, the following results were found. Buprenorphine is currently the second most effective MAT in harm reduction and relapse prevention, can be initiated and maintained through primary care, has a low risk for overdose, but needs to be started only when moderate withdrawals have begun. Methadone is currently the gold standard in MAT and can be started in any stage of withdrawal; however, titrating to effective dose is a lengthy process, and it must be administered at a specialty clinic. Naltrexone in oral form has not been shown to be effective because of lack of adherence; however, the extended-release intramuscular injection form has been shown to reduce relapse and increase the quality of life before initiation individuals must be opioid free for 7–14 days. Choosing the proper MAT is highly individualized. It is recommended that more research be conducted in comparing all MAT options, looking at the quality of life on each MAT, researching motivations to stay on MAT and remain opioid free, and looking at the impact of external reward on adherence to the MAT program.
Comparison of Sagittal Plane Stiffness of Nonarticulated Pediatric Ankle-Foot Orthoses Designed to be Rigid
Authors: Fatone Stefania , Owen Elaine , Gao Fan , Shippen Garth , Orendurff Michael S. , Bjornson Kristie 
Published: July 2021

ABSTRACT

Introduction
When studying the effect of ankle-foot orthoses (AFOs) on gait, it is important to know their sagittal plane stiffness. However, there are no established thresholds for stiffness of nonarticulated AFOs designed to be rigid. If wanting to implement published algorithms for ankle-foot orthosis-footwear combinations (AFO-FCs), the AFOs must be equally as stiff as those of the developer of the published AFO-FC algorithms. Hence, the aim of this work was to compare the sagittal plane stiffness of AFOs designed to be rigid, made for a clinical trial in the United States, and following algorithms for AFO-FC designs, to those made and used clinically in the United Kingdom by the developer of the AFO-FC algorithms.

Materials and Methods
Stiffness of nine pediatric polypropylene AFOs was tested (United Kingdom, six; United States, three). A computer-controlled motorized device was used in which all AFOs were clamped with the calf shell in a fixed vertical component and the foot section in a rotating plate. Each AFO was tested for three trials, loading the foot plate 30 Nm toward dorsiflexion and 20 Nm toward plantarflexion. Torque-angle graphs were plotted, and deflection and stiffness were compared descriptively across AFOs.

Results
Average deflection of AFOs was 3.42° ± 0.83° for United Kingdom and 4.81° ± 1.05° for United States. Average stiffness of AFOs was 14.34 ± 3.34 Nm/° for United Kingdom and 10.30 ± 1.92 Nm/° for United States.

Conclusions
All tested AFOs deflected only a few degrees in either direction (range, 2.59°–6.02°), providing the first information reported for the stiffness of rigid pediatric nonarticulated AFOs. Overall, the UK AFOs were stiffer and deflected less than the US study AFOs. AFO design features should be carefully considered as they likely influence sagittal plane stiffness and deflection under load.
Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: advances in patient and lesion selection
Authors: Shimokawahara Hiroto , Ogawa Aiko , Matsubara Hiromi 
Published: July 2021

Purpose of review
Balloon pulmonary angioplasty (BPA) has been performed worldwide for patients who are ineligible for pulmonary endarterectomy (PEA). However, the technical details of BPA have not been standardized, and no international consensus regarding patient and lesion selection for BPA has been reached. Evidence for the combination of BPA with PEA or medical therapy is also lacking. This review highlights recent progress in BPA in terms of patient and lesion selection and the current procedural approach for BPA, including combination treatment.

Recent findings
The indications for BPA have expanded with recent reports describing the improved safety and efficacy of BPA. Because lesions are generally present in all segmental and subsegmental pulmonary arteries, it is recommended to treat all the lesions to achieve desirable hemodynamic improvement. Selective pulmonary angiography is the gold standard for lesion selection in modern BPA aimed at total revascularization. Despite the lack of randomized controlled studies, combination treatment with BPA may be well tolerated and effective.

Summary
BPA, alone or in combination with PEA or medical therapy, may be a treatment option for patients who are not candidates for monotreatment of PEA. However, further investigation is required to standardize patient and lesion selection for BPA.
Transient Severe Motion Artifact on Arterial Phase in Gadoxetic Acid-Enhanced Liver Magnetic Resonance Imaging
Authors: Kim Dong Wook , Choi Sang Hyun , Park Taeyong , Kim So Yeon , Lee Seung Soo , Byun Jae Ho 
Published: July 2021

Objectives
The aims of this study were to determine the incidence of transient severe motion artifact (TSM) on arterial phase gadoxetic acid-enhanced magnetic resonance imaging of the liver and to investigate the causes of heterogeneity in the published literature.

Materials and Methods
Original studies reporting the incidence of TSM were identified in searches of PubMed, Embase, and Cochrane Library databases. The pooled incidence of TSM was calculated using random-effects meta-analysis of single proportions. Subgroup analyses were conducted to explore causes of heterogeneity.

Results
A total of 24 studies were finally included (single arterial phase, 19 studies with 3065 subjects; multiple arterial phases, 8 studies with 2274 subjects). Studies using single arterial phase imaging reported individual TSM rates varying from 4.8% to 26.7% and a pooled incidence of TSM of 13.0% (95% confidence interval, 10.3%–16.2%), which showed substantial study heterogeneity. The pooled incidence of TSM in the studies using multiple arterial phase imaging was 3.2% (95% confidence interval, 1.9%–5.2%), which was significantly less than in those studies using single arterial phase imaging (P < 0.001). In the subgroup analysis, the geographical region of studies and the definition of TSM were found to be causes of heterogeneity. The incidence of TSM was higher in studies with Western populations from Europe or North America than in those with Eastern (Asia/Pacific) populations (16.0% vs 8.8%, P = 0.005). Regarding the definition of TSM, the incidence of TSM was higher when a 4-point scale was used for its categorization than when a 5-point scale was used (20.0% vs 11.0%, P = 0.008), and a definition considering motion artifact on phases other than arterial phase imaging lowered the incidence of TSM compared with it being defined only on arterial phase imaging (11.3% vs 20.3%, P = 0.018).

Conclusions
The incidence of TSM on arterial phase images varied across studies and was associated with the geographical region of studies and the definition of TSM. Careful interpretation of results reporting TSM might therefore be needed.
Upper Airway Characteristics in Young Individuals With Class II Division 1 Malocclusion: A Retrospective Inter-Ethnic Cephalometric Comparison
Authors: Al Ayoubi Alaa , Madléna Melinda 
Published: July 2021

Abstract
This study aimed to compare the upper-airway morphology between strictly matched Syrian (n = 43) and Hungarian (n = 43) adolescents with Class II/1 malocclusion and identify potential associations between upper airway depths and skeletofacial characteristics. Lateral cephalograms were analyzed, and independent-samples tests and correlation coefficients were used for the statistical analyses. The upper-pharyngeal airway was significantly narrower and the soft palate angle was significantly greater in the Syrian adolescents. Alternatively, the hyoid bone was more posteriorly positioned in the Hungarian adolescents when compared to their counterparts. Depths of the upper and middle pharynx were moderately correlated with sagittal and vertical skeletal dimensions only among Syrian subjects. The depth of the lower pharynx was moderately correlated with hyoid bone position, cervical length, and lip–chin–throat angle only among Hungarian subjects. These findings might have potential implications for optimizing the effects of orthognathic/orthodontic treatments on airway structures in these 2 groups.
Application of Three-Dimensional Printed Customized Surgical Plates for Mandibular Reconstruction: Report of Consecutive Cases and Long-Term Postoperative Evaluation
Authors: Ma Hongyang , Van Dessel Jeroen , Bila Michel , Sun Yi , Politis Constantinus , Jacobs Reinhilde 
Published: July 2021

Abstract
This study aims to evaluate the use of customized surgical plates in patients with mandibular defects concerning postoperative aesthetics and functional outcomes during the 2-year follow-up. Preoperative virtual surgical plans and patient-specific three-dimensional printed plates were tailored for consecutive patients. Preoperative preparation, surgical produces, postoperative aesthetics, and functional outcomes were described in detail. The average follow-up period was over 2 years. In the presented clinical cases, aesthetic and functional outcomes were reported to be satisfactory.
A Novel Three-Dimensional Robot Arm Steered Camera for Ear Surgery
Authors: Tekin Ahmet M. , Saadi Mohammad Al , Topsakal Vedat 
Published: July 2021

Abstract
Ear surgery requires magnified imaging of anatomical structures from its beginning to achieve safe and successful surgical outcomes. The historical evolution of magnification in otology has developed from monocular to binocular, and to three-dimensional and even to digital in modern times. Current technological advancements pursue high-quality visualization for the best surgical outcomes but also ergonomic for surgeons. Here, we evaluated the usability of such new technology in common otological surgeries like cochlear implantation and stapedectomy for the first time in patients. A three-dimensional camera mounted to a robot arm has hands-free control by goggles worn by the surgeon on a head mount. The camera at a distance of the patients but can also be draped in a sterile way that it forms a barrier tent between patient and surgical personnel in the theatre. The main reason to evaluate the feasibility of this new exoscope was driven by COVID-19 obligate measures for elective surgery such as hearing restoration. This new technology can be considered an important advantage for the surgeons working in microsurgery to perform their elective operations without aerosolization of the drill rinsing water possibly containing contaminated tissue. From a subjective point of view, the image quality is equivalent to conventional microscopes to provide safe otologic surgery.
Missense Variants Within GJB2 Gene Locus and the Risk of Hearing Defects in Nonsyndromic Cleft Lip and Palate
Authors: Adeyemo Wasiu Lanre , James Olutayo , Bamigboye Babatunde A. , Akinola Moronke D. , Adamson Olawale O. , Nkemjika Benjamin N. , Ibikunle Adebayo A. , Ogunlewe Mobolanle O. , Ladeinde Akinola L. , Butali Azeez 
Published: July 2021

Aim:
The aim of the study was to investigate the role of variants in GJB2 gene in the etiology of hearing defects in nonsyndromic cleft lip/palate.

Method:
Saliva samples were obtained from cases (subjects with orofacial clefts) and control (subjects without orofacial clefts) who consented to the study. Deoxyribonucleic acid (DNA) was extracted using standardized protocol at Butali Lab (Iowa, IA). Primers for the coding region of GJB2 was designed using Primer 3 (http://bioinfo.ut.ee/primer3-0.4.0/) and optimized in the Butali lab using a gradient polymerase chain reaction to determine the annealing temperature for each primer set (forward and reverse). We measured the DNA concentration using Qubit and XY genotyping done for quality control. A concentration of 5 ng/μL of DNA was used for Sanger sequencing.

Results:
A total of 150 subjects were sequenced (66 cases; 84 controls). Mutations in GJB2 gene were detected in 2 individuals with cleft palate. We found p.Arg165Trp variant in 1 case and p.Leu81Val variant in the second case. Although p.Arg165Trp was predicted to be either benign or tolerated by SIFT/POLYPHEN, the single nucleotide change from C>T, that is, CGG>TGG leads to a premature stop codon preventing the protein formation. The p.Leu81Val variant was predicted to be probably damaging/ deleterious.

Conclusions:
The present study implicates variants in the GJB2 gene in the etiology of hearing defects in nonsyndromic cleft lip and palate in the Nigerian population. Screening for variations in GJB2 gene is important for genetic counseling especially in high-risk families.
Ergonomics Among Craniofacial Surgeons: A Survey of Work-Related Musculoskeletal Discomfort and Injury
Authors: Shah Jinesh , Wang Fei , Kest Joshua , Greige Nicolas , Sandoval Tyler , Nash David , Tepper Oren , Ricci Joseph A. 
Published: July 2021

Introduction:
Surgical procedures with loupe magnification, headlights, and microscopes expose craniofacial surgeons to mechanical stress that can increase risk of long-term musculoskeletal pain and injury. Identifying the prevalence and cause of work-related musculoskeletal discomfort may guide preventative strategies to prolong well-being, job satisfaction, and greater duration of surgical careers.

Methods:
A 29-question online survey was distributed to the surgeon members of the American Cleft Palate-Craniofacial Association. Eight hundred seventy-three surveys were distributed, and the anonymous responses were recorded using Google forms.

Results:
One hundred ninety-six unique responses were recorded (22.5% response rate). A total of 64.2% reported experiencing musculoskeletal symptoms during their career, with neck, lower back, and shoulders being the most common problem areas. Multivariate analysis demonstrated surgical loupes (odds ratio 2.36, P = 0.03) and length of surgical practice >15 years (odds ratio 1.95, P = 0.04) were independently associated with greater odds of developing symptoms. Headlights (median pain = 3, P < 0.001), loupes (median pain = 3.5, P < 0.001), and operative microscope use (median pain = 2, P = 0.02) were all associated with higher pain while operating. A total of 52.5% respondents sought medical treatments, 50.5% were concerned musculoskeletal discomfort would affect their careers, 56.6% reported a colleague that required an operation, and 30.2% reported a colleague on temporary or permanent disability.

Conclusions:
Craniofacial surgery often involves long procedures, use of surgical adjuncts, and ergonomically straining postures, which can lead to musculoskeletal discomfort and injury. This under-reported and important phenomenon merits candid conversation and active preventative strategies to prolong surgical careers, improve professional satisfaction, and maximize patient safety.
A Heart Surgery Simulator With an Integrated Supervision System for Self-Learning the Key Steps and Pitfalls of the Mitral Valve Repair
Authors: Tozzi Piergiorgio , Solida Alessandra , Siniscalchi Giuseppe , Ferrari Enrico 
Published: July 2021

Introduction
Over the years, surgical education has dramatically improved and has become increasingly innovative. Almost all educational programs in surgery now rely on sophisticated training boxes and simulators that enable surgical instruments to be handled and surgical procedures to be trained in a safe environment. However, simulators need constant feedback from supervising senior surgeons, who only have limited teaching time available. We describe a cardiac surgery simulator with an integrated supervision system for self-learning how to repair a mitral valve.

Methods
We developed a mitral surgery simulator with integrated sensors to generate, record, and display quantitative data on trainee performance in relation with the mitral valve repair procedure. A team of experienced cardiac surgeons defined critical areas of the model and an algorithm to identify inconsistent movements, in terms of error types and out-of-bound actions. The device provided real-time feedback on the accuracy of the stitches placed. Four experienced cardiac surgeons and 3 advanced cardiac-surgery used the simulator and were asked to evaluate specific parameters of the system on a scale ranging from 1 to 10.

Results
All surgeons completed a P2 resection, followed by implanting a 32-mm mitral ring. The simulator detected 2 stitches that were placed in dangerous zones and another stitch that was placed in an inappropriate position. Users scored the real tissue feeling and interactivity of the model 9.5/10.

Conclusions
This heart-surgery simulator offers a real-life model for learning about and training in mitral valve surgery, which could potentially replace the experienced surgeon's teaching role.
Optic Perineuritis Presenting as the Initial Manifestation of Central Nervous System Involvement in Rai Stage 0 Chronic Lymphocytic Leukemia
Authors: Parker James L. , Mays Kevin M. , Pratibhu Parakash P. , Pick Peter W. , Block Danielle K. 
Published: July 2021

Background:
To describe the first case of optic perineuritis because of meningeal involvement of early stage chronic lymphocytic leukemia (CLL).

Methods:
A case report and review of the literature.

Results:
A case of unilateral optic neuropathy associated with enhancement of the optic nerve sheath is described in a patient with a prior 2-year history of Rai Stage 0 CLL. Lumbar puncture revealed a lymphocytic pleocytosis. Cerebrospinal fluid flow cytometry revealed a monoclonal expansion of CD5+ B cells compatible with CLL, matching the flow cytometry characteristics of his peripheral blood.

Conclusions:
Optic perineuritis is often initially diagnosed as optic neuritis, yet the 2 have different etiologies and follow a different clinical course. Orbital MRI with contrast structurally separates the 2, revealing a characteristic pattern of peripheral optic nerve sheath rather than primary optic nerve enhancement. Etiologies of optic perineuritis are varied and include inflammatory, infectious, neoplastic, and toxic entities. Central nervous system (CNS) involvement by chronic lymphocytic leukemia is unusual, but cranial nerve and meningeal involvement have been reported. This case adds central nervous system chronic lymphocytic leukemia to the list of differential diagnostic possibilities for optic perineuritis. It also alerts clinicians to consider optic perineuritis as a potential presenting feature of CNS involvement in otherwise asymptomatic and stable CLL.
Men and loneliness in the Covid-19 pandemic: insights from an interview study with UK-based men
Authors: Ratcliffe John , Galdas Paul , Kanaan Mona 
Published: July 2021

AbstractAs the SARS-COV-2 pandemic hit, the UK, like many countries, introduced severe restrictions on social contact, and injunctions of ‘social distancing’, to reduce transmission. This led to a concern that loneliness may increase, facilitating poorer mental and physical health. Twenty qualitative interviews were conducted, with a diverse group of UK-based men, between January and March 2021, during severe restrictions. Our aim was to generate new insights into men’s experience of loneliness during the pandemic, and consider the ramifications of these for continued/future restrictions, the easing of restrictions, and the future beyond the pandemic. Thematic analysis, focused on semantic themes, was employed as part of a ‘grounded’ epistemology whereby the stated perspectives of the interviewees drove the content of the study. Six themes were constructed: i) people to see and things to do (broken, changed, and new); ii) rethought and renewed recognition of what is important; iii) loneliness with a purpose; iv) loneliness as normal; v) anxiety of social contact; and vi) easier for some than others. The restrictions did cause some loneliness, particularly because of lost routines and opportunities, and the reduction in face-to-face interaction. However, a need to reduce transmission of SARS-COV-2, and a fear of catching it, became important features of participants lives that also affected loneliness and its causes. Remote forms of interaction were often utilised, and though they were imperfect, those that were dependable, were smaller than might be desired in person, and ensured a chance to speak, were constructed as more positive. The fear of Covid-19, and a loss of social skills, may mean that reducing restrictions alone will not return everyone to pre-pandemic levels of loneliness. Some believed the building of supportive local communities, and a destigmatisation of loneliness, may allow for the building of a more compassionate and less lonely society.What is known about this topicLoneliness is a public health concern, and is often a gendered experience.Pandemic related restrictions greatly reduced opportunities for social contact.We have a limited understanding of whether, and how, men experienced loneliness during the SARS-COV-2 pandemic.What this paper addsThe loss of routines, and a lack of face-to-face interaction, were the greatest challenges to loneliness, particularly among solo-living men.Remote interaction may be better when routinised or dependable, in smaller groups, and with a structure facilitating the opportunity to speak.Anxiety of SARS-COV-2, and identities built in relation to reducing transmission, were important influences on the causes and severity of loneliness.