bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Sterile Keratolysis Complication With Decellularized Porcine Corneal Inlay Implant: A Case Report and Cautionary Tale
Authors: Borgia Alfredo , Airaldi Matteo , Lagali Neil , Ahmad Mohammad , Riaz Amina , Kaye Stephen , Romano Vito 
Published: November 2024

Purpose:
To describe an early sterile keratolysis associated with a decellularized porcine corneal inlay implant for keratoconus.

Methods:
This is a case report of a 23-year-old man with keratoconus who underwent lenticular intrastromal keratoplasty in his OD. Within 4 weeks, the patient presented with anterior sterile keratolysis and partial inlay extrusion, leading to surgical inlay removal.

Results:
After inlay removal, despite aggressive topical treatment including steroid drops, antibiotic ointment, and bandage contact lenses, the patient developed severe anterior scarring and corneal flattening, resulting in decreased visual acuity. Over a period of 4 months, the cornea underwent long-term remodeling, with vision improving to a best-corrected distance visual acuity of 0.1 logarithm of the minimum angle of resolution.

Conclusions:
The removal of the porcine corneal inlay because of severe keratolysis highlights the potential risks of this procedure. In addition, the spontaneous improvement in visual acuity over 4 months emphasizes the need for adequate healing time before further surgeries, such as keratoplasty.
The Use of Classic Psychedelics for Depressive and Anxiety-Spectrum Disorders
Authors: Kim Vivian , Wilson Scott M. , Woesner Mary E. 
Published: November 2024

Abstract
Following a decades-long decline in psychedelic research resulting from social, political, and legislative factors, there has been greatly renewed interest in these compounds' ability to treat psychiatric disorders. Classic psychedelics, encompassing both natural and synthetic psychoactive compounds, are characterized by their action as agonists or partial agonists of serotonin 5-hydroxytryptamine 2A receptors. In this comprehensive review, we summarize the latest clinical trials of classic psychedelics on depression and anxiety, attending to the patient demographics and methodology of each study. Overall, studies published since 2020 affirm the potential for classic psychedelics to treat major depressive disorder, treatment-resistant depression, bipolar II, and anxiety-spectrum disorders. However, findings are limited by short follow-up durations and nonstandard dosing and study designs. Given that many of the studies identified were post hoc analyses or follow-up studies from a select few parent studies, it is recommended that more original research be undertaken, with more diverse and larger sample sizes, standardized methodologies including blinding assessment, and long-term follow-up to identify duration of benefits and adverse reactions. It is also important to consider the role of psychological support and the therapeutic alliance in the psychedelic treatment of psychiatric disorders.
Association between lactate-to-albumin ratio and short-term prognosis of acute-on-chronic liver failure treated with artificial liver support system
Authors: Ma Yuanji , Du Lingyao , Bai Lang , Tang Hong 
Published: November 2024

Background
The impact of lactate-to-albumin ratio (LAR) on the outcome of acute-on-chronic liver failure (ACLF) is scant.

Aims
To investigate the relationship between LAR and short-term prognosis in patients with COSSH (Chinese Group on the Study of Severe Hepatitis B) ACLF.

Methods
A retrospective cohort study was conducted in patients with COSSH ACLF treated with an artificial liver support system. Restricted cubic splines, linear regression models, and Cox regression models were used to investigate the relationships of LAR with disease severity and 28-day prognosis.

Results
The 28-day transplant-free and overall survival rates in the 258 eligible patients were 76.4% and 82.2%, respectively. The LAR in 28-day transplant-free survivors was lower than that in transplant or death patients [0.74 (0.58–0.98) vs. 1.03 (0.79–1.35), P < 0.001]. The LAR was positively associated with disease severity, 28-day transplant-free survival [adjusted hazard ratio (HR) (95% confidence interval (CI)) for transplant or death: 2.18 (1.37–3.46), P = 0.001], and overall survival [adjusted HR (95% CI) for death: 2.14 (1.21–3.80), P = 0.009]. Compared with patients with LAR < 1.01, patients with LAR ≥ 1.01 had poor 28-day prognosis [all adjusted HR (95% CI) > 1, P < 0.05]. Lactate was not a potential modifier of the relationship between LAR and short-term prognosis.

Conclusion
LAR was positively associated with disease severity and poor short-term prognosis in patients with COSSH ACLF.
Utility of preoperative 18F-flurodeoxyglucose PET/CT scanning in preoperative evaluation and surgical planning for pulmonary tuberculosis
Authors: Li Lei-Lei , Wang Lin , Li Hong-Wei , Chen Hui , Shi Lei , Wan Lai-Yi , Song Yan-Zheng 
Published: November 2024

Objective
The objective of this study was to investigate the utility of preoperative 18F-FDG PET/CT scanning in preoperative evaluation and surgical planning for pulmonary tuberculosis.

Methods
The study involved a retrospective analysis of clinical data and preoperative chest 18F-FDG PET/CT data of 24 patients with pulmonary tuberculosis who underwent pneumonectomy at the Shanghai Public Health Clinical Center between December 2017 and January 2022.

Results
All 24 patients successfully underwent chest 18F-FDG PET/CT imaging, and complete data pertaining to the maximum standardized uptake value, mean standardized uptake value, minimum standardized uptake value, total lesion glycolysis, and metabolic tumor volume were obtained. Surgical excision plans were finalized using the chest 18F-FDG PET/CT findings along with the conventional chest CT scans. Pneumonectomy was successfully completed in all 24 patients, and these included 13 cases of pulmonary lobectomy, two cases of total pneumonectomy, one case of combined pulmonary lobectomy, one case of segmentectomy, and seven cases of pulmonary wedge resection. The actual surgical procedures had a conformity rate of 100% to the preoperative surgical plans that were made. The intraoperative bronchial stump embedding rate was 69% (11/18 cases), the incidence rate of postoperative air leakage was 3.8% (1/24 cases), and there were no reported cases of postoperative bronchopleural fistula or death.

Conclusion
Preoperative 18F-FDG PET/CT scans had significant utility in surgical planning, the selection of surgical methods, and the formulation of postoperative antituberculosis treatment courses for patients with pulmonary tuberculosis. The use of 18F-FDG PET/CT shows considerable promise in being promoted clinically for the surgical management of patients with pulmonary tuberculosis.
HCT in the widening spectrum of congenital immunodeficiencies
Authors: Muratori Rafaella , Bonfim Carmem 
Published: November 2024

Purpose of review
Hematopoietic stem cell transplantation (HSCT) and inborn errors of immunity (IEI) have been closely linked since transplantation was first used to cure severe combined immunodeficiency (SCID) in 1968. Since then, novel genes and diseases have been continually added to the ongoing list of IEI, and new data on indications and outcomes have emerged. We review recent data and progress in the field of hematopoietic cell transplantation (HCT) for IEI including new diseases and complications.

Recent findings
Emerging data from haploidentical transplants, newborn screening results, and multicentric studies reveals promising outcomes for IEI. Immune dysregulation diseases deserve special attention regarding disease control and may require additional drugs pretransplant. Female carriers of X-linked Chronic granulomatous may present with a severe phenotype warranting the need for HCT. Insights from infectious complications and long-term comorbidities should help guide decisions to treat IEI patients.

Summary
From classical indications to recently described diseases, HCT for immunodeficiencies is a rapidly growing field. Novel data regarding alternative donor transplants, results from large cohorts, and long-term complications provide valuable knowledge for clinical practice.
Implementation science and genetic testing for familial hypercholesterolemia
Authors: Birkenhead Karen , Sullivan David , Watts Gerald F. , Sarkies Mitchell N. 
Published: November 2024

Purpose of review
Familial hypercholesterolemia is a treatable genetic disorder of cholesterol metabolism. Genetic testing is the most specific method for diagnosing familial hypercholesterolemia, but it remains underutilized. Implementation science aims to bridge the gap between evidence and practice and, thereby, support improved familial hypercholesterolemia care. This review presents the current evidence on the use of implementation science to improve the use of genetic testing for familial hypercholesterolemia.

Recent findings
Recent research has focused on developing implementation strategies to improve the use of genetic testing, particularly cascade testing of at-risk blood relatives of known familial hypercholesterolemia cases. Stakeholder informed strategies aimed at improving communication between families and detection of familial hypercholesterolemia in primary care have been developed and implemented. Findings demonstrate implementation science methods can help remove barriers and improve the uptake of cascade genetic testing.

Summary
Significant gaps in familial hypercholesterolemia care emphasize the importance of practical and realistic approaches to improve the detection of this preventable cause of premature heart disease, and recent efforts using implementation science have shown some promising results. More implementation science studies are needed that address the considerable gaps in familial hypercholesterolemia care, including the underutilization of genetic testing, so that all individuals receive the best clinical care.
Enhancing Pancreatic Cancer Therapy With Targeted CD133-Exosome Delivery of PD-L1 siRNA
Authors: Yoon Young Chul , Lee Dosang , Park Jung Hyun , Kim Ok-Hee , Choi Ho Joong , Kim Say-June 
Published: November 2024

Objectives
This study assessed the anticancer potential of genetically modified exosomes engineered to express CD133-binding peptides on their surface and carry PD-L1 siRNA for the treatment of murine model of metastatic pancreatic cancer.

Materials and Methods
CD133-targeting exosomes (tEx) were generated by harvesting conditioned media from adipose-derived stem cells (ASCs) that had undergone transformation using pDisplay vectors encoding CD133-binding peptide sequences. Subsequently, siPD-L1-loaded CD133-targeting Exosomes, referred to as tEx(s), were created by incorporating PD-L1 siRNA into the tEx using Exofect kit

Results
tEx(s) demonstrated superior targetability compared to other materials, including Ex, Ex(p), and tEx. This was substantiated by higher total radiant efficiency (TRE) observed in metastatic liver and pancreatic tissues following intravenous administration of tEx(s) (P < 0.05). Furthermore, the intravenous delivery of tEx(s) resulted in the most pronounced upregulation of proapoptotic markers (BIM and c-caspase 3) and the least downregulation of the antiapoptotic markers (Mcl-1 and Bcl-xL), which has been demonstrated in various methods, including real-time polymerase chain reaction, western blot analysis, and immunohistochemistry in the metastatic lesions in the livers (P < 0.05).

Conclusions
PD-L1 siRNA-loaded CD133-tEx demonstrated remarkable anticancer efficacy, characterized by specific binding to CD133-positive pancreatic cancer cells and suppression of PD-L1 expression within these cells.
The effect of antidepressant treatment on viral suppression among people with HIV diagnosed with depression in an urban clinic
Authors: Lesko Catherine R. , Fojo Anthony T. , Hutton Heidi E. , Falade-Nwulia Oluwaseun O. , Zalla Lauren C. , Seamans Marissa J. , Jones Joyce L. , Schweizer Nicholas P. , Moore Richard D. , Snow LaQuita N. , Keruly Jeanne C. , Chander Geetanjali 
Published: November 2024

Objective:
To estimate the effect of antidepressant initiation on viral nonsuppression among people with HIV (PWH) with clinically recognized, untreated depression.

Design:
Retrospective, observational cohort study.

Methods:
We included clinical diagnoses of depression from January 2012 to June 2022 among PWH in the Johns Hopkins HIV Clinical Cohort without another serious psychiatric illness who had initiated antiretroviral therapy. We excluded diagnoses less than 90 days from a prior diagnosis, antidepressant prescription, or greater than one mental health visits. We estimated the association between initiating an antidepressant within 1 month of the index depression diagnosis and viral load nonsuppression (>200 copies/ml) on the first viral load 3–12 months subsequent. We adjusted for a comprehensive set of demographic and clinical confounders.

Results:
We included 2346 depression diagnoses among 946 patients; patients initiated an antidepressant following 16%. The risk of viral nonsuppression in the absence of antidepressant treatment was 15.6% [95% confidence interval (CI): 13.1–18.4]. Antidepressant initiation was not associated with viral nonsuppression (risk difference: 0.5%; 95% CI: −3.7 to 4.8) or secondary outcomes: improvement or resolution of depressive symptoms or adherence to scheduled clinic visits.

Conclusion:
In this sample of patients with as-yet-untreated depression, in a setting with co-located, low-barrier psychiatric services, antidepressant treatment was not associated with improved viral suppression. Pharmacologic management of depression has documented benefits in other studies. However, there may be a subset of PWH with depression who have been previously unsuccessfully treated with antidepressants who are less likely to respond to approved pharmacologic options and who require different interventions to improve their viral suppression.
Differential immunophenotype and proviral composition in young adults with perinatally acquired HIV
Authors: Baquero Lucia , Stover Sofia , Armani-Tourret Marie , Perbeils Ailen Daniela , Urioste Alejandra , Osegueda Peña Ariel Amadeo , Cruces Leonel Hernán , Coll Cardenas Patricia , Lattner Jorge , Sisto Alicia , Rolón María José , Arazi Solange , Ghiglione Yanina , Polo Maria Laura , Yu Xu G. , Lichterfeld Mathias , Turk Gabriela , Laufer Natalia 
Published: November 2024

Objective:
To characterize the immune functionality and phenotype and the proviral composition of a cohort of young adults with perinatally acquired HIV (p-YA) from Argentina.

Design:
Cross-sectional study of 18 p-YA, 15 young adults with nonperinatally acquired HIV matched by age with p-YA and 14 adults with nonperinatally acquired HIV, matched by time from HIV diagnosis with p-YA, all from Argentina.

Methods:
Immune memory/effector phenotype, exhaustion, activation, PTK-7 and Ki-67 expression were evaluated by flow cytometry on natural killer (NK) and T cells. Total, intact and defective proviral (TP, IP and DP) HIV-DNA were measured in CD4+ T cells by IPDA. Soluble markers were determined by ELISA.

Results:
p-YA displayed lower expression of PD-1, higher levels of CD38+ CD4+ T cells and increased levels of naive T cells than control groups. Also, a trend of lower levels of IP HIV-DNA normalized to CD4+ T-cell counts and to the proportion of naive T cells was found in p-YA.

Conclusion:
The higher frequency of naive CD4+ T cells in p-YA cannot be explained by elevated thymic activity nor by a higher T-cell proliferation rate. This imbalance could have been generated early in life and persisted during adulthood. Naive CD4+ T cells may not serve as a major viral reservoir in p-YA. Also, the lower PD-1+ CD4+ T-cell count suggests that p-YA did not present higher levels of exhaustion. These findings suggest that acquiring HIV perinatally may imply different challenges for proviral eradication.
Unusual FDG PET Appearances in a Patient With Metastatic Breast Carcinoma
Authors: Kaleemi Raima , Dudek Alexandra , Priftakis Dimitris , Bomanji Jamshed 
Published: November 2024

Abstract
This was a case of a 52-year-old woman with a history of multiorgan, metastatic breast cancer, who underwent several lines of treatment. She had brain metastases, which were treated with gamma knife. She progressed at other organ sites with additional recurrence of brain metastases and leptomeningeal disease, which demonstrated an interesting pattern of intracranial FDG uptake with further seizure-related muscular uptake.
“Motion Capture Suit Sign” for Immunotherapy-Induced Inflammatory Arthritis on 99mTc-MDP Bone Scintigraphy
Authors: Yew Dallas Shun-Yu , Lai Chun-Liang 
Published: November 2024

Abstract
We report the 99mTc-MDP bone scan of a 44-year-old man with a history of lung adenocarcinoma and recent multiple joint pain after completing pembrolizumab immunotherapy treatment. This interesting image of symmetric uptakes around bilateral joints throughout the skeleton resembles the ball sensors on a motion capture suit. Hence, we recommend naming this distinctive imaging appearance as the “motion capture suit” sign.
Analysis of Added Postoperative Diplopia After Transnasal Endoscopic Inferomedial Wall Decompression for Thyroid-Associated Ophthalmopathy
Authors: Zhu Suhui , Deng Rongjin , Wu Jianhao , Dai Baozhu , Gu Kaiming , Chen Xiaohu , Dai Yan 
Published: November 2024

Background:
The authors retrospectively analyzed the reported rate of added diplopia and associated factors in patients with thyroid-associated ophthalmopathy (TAO) after transnasal endoscopic inferomedial wall decompression, to illuminate the issue and look for ways to improve prognosis.

Methods:
Retrospective analysis was done on the medical records of patients with moderate-to-severe TAO between 2023-01 and 2024-01. Under general anesthesia, transnasal endoscopic inferomedial wall decompression was carried out on each subject. Clinical outcomes included postoperative added diplopia (including new-onset and aggravated), strabismus, and alterations in the extraocular muscles.

Results:
Sixty-five eyes in 65 patients received treatment. Nineteen patients (29.3%) had new-onset horizontal diplopia at 1 month and 10 patients (15.4%) at 6 months postoperatively; 9 patients (13.8%) experienced aggravated horizontal diplopia at 1 month and 6 patients (9.2%) at 6 months (C2=4.947, P<0.05). The average volume of the medial rectus muscle was the only one to increase in the extraocular muscles (F=34.131, P<0.001), and the preoperative medial rectus muscle volume was higher in the added diplopia patients than in the no-added diplopia patients (F=267.405, P<0.001).

Conclusions:
Postoperative diplopia (both new-onset and aggravated) increased in TAO with transnasal endoscopic inferomedial wall decompression. Most added diplopia was horizontal and most added strabismus was esotropia. They were closely associated with changes in the medial rectus’s thickness, displacement, and structural alterations. The preoperative medial rectus volume is one of the possible markers of further postoperative diplopia.
The Readability, Understandability, and Suitability of Online Resources for Ostomy Care
Authors: Ficarino Hannah , Moses Cara , Wood Lauren , Byrd Gabby , Bhatia Smita , Chu Daniel , Hollis Robert 
Published: November 2024

PURPOSE
the purpose of this study was to evaluate the content, readability, understandability, and suitability of online resources for patient specific ostomy care.

DESIGN
Retrospective cohort study

SUBJECT AND SETTING
Online websites for ostomy care designed for patients.

METHODS
Ostomy care websites designed for patients were identified by querying three online search engines. Content areas were established following assessment of all websites by two reviewers. Readability of each website was determined using the Flesch Reading Ease Test and the Simple Measure of Gobbledygook (SMOG) index. Understandability was measured using the Patient Education Materials Assessment Tool (PEMAT), and suitability was determined using the Suitability Assessment of Materials (SAM). Chi-Square and rank sum tests were used to compare these measures across website type and by number of content areas.

RESULTS
Twenty-three websites met inclusion criteria; 26.1% were for-profit, 13% were government, 26.1% were academic, and 34.8% were non-profit. Nineteen content areas were identified including themes related to pouching, bathing, physical activity, managing output, lifestyle, mental health, and eating. The median number of content areas covered was 8.5 [interquartile range (IQR) 4-13]. The most common content areas were changing/emptying a pouching system (82.6% of websites), preventing/managing peristomal skin irritation (78.3%), eating (60.9%), and odor management (60.9%). Less than 27% of websites had content on irrigation, blockage/constipation, and body image. Readability scores using the Flesch Reading Ease (mean 58, IQR 54.7-69.5) and SMOG Index (mean 9.1, IQR 7.6-9.9) correlated to a high-school or “fairly difficult” reading level. The mean PEMAT measuring understandability was 80 (IQR 78.9-84.0). The mean SAM score checking for suitability (literacy demand, graphics, layout and type, learning stimulation and motivation and cultural appropriateness) was 55% (IQR 48.4%-61.3%), indicating “adequate material.” A greater number of content areas on the websites were associated with worse readability (SMOG and Flesch Reading Ease scores) than websites presenting fewer content areas (P = .001 & P < .001, respectively).

CONCLUSIONS
We found significant variability in the content, readability, understandability, and suitability of online materials for ostomy care. Websites with more content areas were associated with worse readability.
Effects of Skin Microclimate Changes on Skin Condition in Healthy Adults
Authors: Borzdynski Caroline , Miller Charne , McGuinness William 
Published: November 2024

PURPOSE
The purpose of this study was to examine the effects of moisture, as a skin microclimate variable, at the skin-support surface interface on repeated measures of skin erythema, stratum corneum hydration and skin temperature at pressure-prone areas of healthy adults.

DESIGN
Quasi-experimental repeated measures study.

SUBJECTS AND SETTING
Forty-eight healthy adults participated in a single center-controlled study conducted in a simulated hospital setting in an urban setting (Melbourne, Australia). This research project was conducted from November 2021 to June 2022.

METHODS
The effects of moisture and intermittent pressure-loading on skin overlying the sacrum, heels, and elbows were investigated. Participants followed a standardized immobilization protocol of 60 minutes, with 10-minute brief pressure off-loading, in the semi-recumbent position on a standard hospital bed/mattress. The intervention comprised laying with the sacrum in contact with an absorbent pad saturated with normal saline; control skin sites (elbows and heels) were not exposed to the moistened absorbent pad. Skin measures were obtained consecutively at each anatomical testing site upon brief off-loading. Linear mixed models (LMMs) were used to compare skin parameters over time and between conditions.

RESULTS
Differences in stratum corneum hydration scores between control and intervention conditions at the sacrum were significant (P = .001). Differences in erythema and skin temperature scores between control and intervention conditions at the sacrum did not significantly differ; however, significant changes in skin temperature (P = .025) at the sacrum were observed at the 10-minute measurement intervals over 1 hour in the sample, suggesting change in skin temperature over time. No participant displayed non-blanching erythema as a subjective indicator of skin injury in any of the testing conditions.

CONCLUSIONS
Skin moisture/wetness, over a period of 1 hour, does not appear to impact erythema and skin temperature at the sacrum. In contrast, the introduction of moisture at the sacrum significantly increases sacral stratum corneum hydration. Study findings suggest that more frequent monitoring cycles of wet sacral skin may be required to identify moisture-associated skin changes.