bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Cyclosporine Ophthalmic Emulsion 0.05% Use in Pediatric Blepharokeratoconjunctivitis
Authors: Salini Raul Plasencia , Ma Elise L. , Huang Tiffany L. , Dallalzadeh Liane O. , Fung Simon S. M. 
Published: September 2024

Purpose:
Pediatric blepharokeratoconjunctivitis (BKC) is a chronic ocular surface inflammatory disease. In this article, we report our experience using low-dose topical cyclosporine (CsA) 0.05% for the treatment of pediatric BKC.

Methods:
A retrospective review was conducted on pediatric patients treated with topical CsA 0.05% for BKC between 2018 and 2022 at a single academic institution. Patients with less than 6 weeks of follow-up, a history of ocular infectious disease, or previous usage of topical/systemic immunomodulators (except corticosteroids) were excluded. The primary outcome was the change in the number of episodes of disease reactivation (flare) before and after the use of CsA 0.05%. Secondary outcomes included the number of clinic visits per year, success rate in corticosteroid tapering, and usage of rescue topical corticosteroid.

Results:
A total of 21 patients (13 male patients and 8 female patients) treated with CsA 0.05% twice daily were included in this study. The mean age of patients was 9.7 ± 4.2 years, and the mean follow-up period was 62.2 ± 62.5 weeks. The median number of flares per year was 5.6 (95% CI, 3.9–7.3) before treatment with CsA 0.05%, which reduced to 0.0 (95% CI, 0.0–0.9) while on CsA 0.05% (P = 0.01). The median number of clinic visits significantly reduced from 9.5 (95% CI, 7.3–11.7) to 4.5 (95% CI, 3.7–6.8) visits per year (P < 0.0001). After 3.5 ± 2.7 weeks, 90.4% of patients using topical CSs concomitantly with topical CsA 0.05% could be successfully tapered off their topical CSs. Of the patients who tapered off their topical CSs, 3 patients (15%) later required rescue topical CSs despite ongoing CsA 0.05% treatment because of acute flare episodes. No adverse effects were reported with CsA use.

Conclusions:
This study demonstrates the efficacy of low-dose topical CsA 0.05% in reducing the frequency of acute flares and clinic visits per year in pediatric BKC.
INTIMASY-TBI Guideline: Optimization of INTIMAcy, SexualitY, and Relationships Among Adults With Traumatic Brain Injury
Authors: Patsakos Eleni M. , Backhaus Samantha , Farris Kathryn , King Marisa , Moreno Jhon Alexander , Neumann Dawn , Sander Angelle , Bayley Mark T. 
Published: September 2024

Introduction:Traumatic brain injury (TBI) can negatively impact intimacy, relationships, and sexual functioning through changes in physical, endocrine, cognitive, behavioral, and emotional function. Without intervention, diminished intimacy and/or sexual functioning in individuals with TBI may persist. Although most health care professionals agree that sexuality and intimacy in relationships are significant concerns and should be addressed in rehabilitation, these concerns are not typically discussed during rehabilitation and discharge planning for people with TBI. To address this gap, an expert panel of North American clinicians and researchers convened to develop evidence-informed recommendations to assist clinicians in providing a framework and guidance on how clinicians can support individuals after TBI.Methods:A systematic search of multiple databases was conducted to identify relevant evidence published from 2010 to 2023. The INTIMASY-TBI Expert Panel developed recommendations for optimizing discussions and interventions related to intimacy and sexuality for people with TBI in rehabilitation and community-based programs. For each recommendation, the experts evaluated the evidence by examining the study design and quality to determine the level of evidence.Results:A total of 12 recommendations were developed that address the following topic areas: (1) interprofessional team training, (2) early education on the effects of TBI on intimacy, relationships, and sexuality, (3) creating individualized interventions, (4) education, assessment, and management of the causes of sexual dysfunction, and (5) providing written materials and relationship coaching to persons with TBI and their partners. Two recommendations were supported by Level A evidence, 1 was supported by Level B evidence, and 9 were supported by Level C (consensus of the INTIMASY-TBI Expert Panel) evidence. A decision algorithm was developed to assist clinicians in navigating through the recommendations.Conclusion:The INTIMASY-TBI Guideline is one of the first comprehensive clinical practice guidelines to offer strategies to trained clinicians to discuss the physical, psychosocial, behavioral, and emotional aspects of intimacy and sexuality with persons with TBI.
The Predictive Value of Preoperative Measurements of Cochlear Nerve Diameters From MRT and Postoperative Speech Perception in Adult Patients With Cochlear Implant
Authors: Zhang Lichun , Schmidt Florian Herrmann , Cantré Daniel , Brenzel Robert , Ehrt Karsten , Großmann Wilma , Langner Sönke , Mlynski Robert 
Published: September 2024

Objective
The current study aims to investigate whether objective measurements of the cochlear nerve (CN), derived from preoperative MRI images, correlate with postoperative speech perception in CI patients.

Study Design
Retrospective cohort study.

Setting
University Medical Center, tertiary academic referral center.

Patients
Patients undergoing a cochlear implant surgery including MED-EL (Synchrony 2, FLEX electrode series; MED-EL, Innsbruck, Austria) Cochlear (slim straight electrodes; Cochlear Ltd., Sydney, Australia), Advanced Bionics (HiRes Ultra 3D CI, HiFocus SlimJ electrodes; Sonova, Zürich, Switzerland), and Oticon (Neuro Zti EVO; Oticon A/S, Smørum, Denmark) between 2020 and 2023.

Intervention
Preoperative MRI images were utilized to measure the volume of the modiolus (VM), the cross-sectional areas of the CN (ACN), and for normalization, the area of the facial nerve (AFN) and the area of the internal ear canal (AIEC). Postoperative speech perceptions were assessed through word recognition scores (WRS) at several stages following the first fitting (FF) of the CI processor: immediately after FF, 1 month, 3 months, and 6 months after FF.

Main Outcome Measures
Sixty-eight patients were enrolled in this study. A statistically significant positive correlation between the ratio between ACN and AFN (ACN/AFN) and WRSFF was identified (R = 0.36, p < 0.003). However, this correlation disappeared in subsequent follow-up tests. Moreover, upon grouping patients based on their degree of asymmetrical hearing loss, it was observed that the correlation was primarily driven by patients with moderate to severe asymmetrical hearing loss (AHLm) on the contralateral side (R = 0.62, p = 0.0003).

Conclusion
The present results suggest that assessing the size of the CN through MRI has limited predictive utility for postoperative speech perceptions during CI consultations. This limitation seems to be particularly relevant for AHLm patients and is confined to the initial activation period.
A Selection Protocol to Identify Therapeutics to Target NLRP3-Associated Sensory Hearing Loss
Authors: Schiel Viktoria , Eftekharian Kourosh , Xia Anping , Bekale Laurent A. , Bhattacharya Ritwija , Santa Maria Peter L. 
Published: September 2024

Objective
We propose a selection process to identify a small molecule inhibitor to treat NLRP3-associated sensory hearing loss.

Background
The NLRP3 inflammasome is an innate immune sensor and present in monocytes and macrophages. Once the inflammasome is activated, a cleavage cascade is initiated leading to the release of proinflammatory cytokines IL-1β and IL-18. The NLRP3 inflammasome has been implicated in many causes of hearing loss, including autoimmune disease, tumors, and chronic suppurative otitis media. Although the target has been identified, there is a lack of available therapeutics to treat NLRP3-associated hearing loss.

Methods
We created a target product profile with specific characteristics that are required for a compound to treat sensory hearing loss. We then looked at available small molecule NLRP3 inhibitors at different stages of development and selected compounds that fit that profile best. Those compounds were then tested for cell toxicity in MTT assays to determine the dosage to be used for efficacy testing. We tested efficacy of a known NLRP3 inhibitor, MCC950, in a proof-of-concept screen on reporter monocytes.

Results
Six compounds were selected that fulfilled our selection criteria for further testing. We found the maximum tolerated dose for each of those compounds that will be used for further efficacy testing. The proof-of-concept efficacy screen on reporter monocytes confirmed that those cells can be used for further efficacy testing.

Conclusion
Our selection process and preliminary results provide a promising concept to develop small molecule NLRP3 inhibitors to treat sensory hearing loss.
Education differences in blood pressure trajectories by sex through midlife: Findings from the National Health and Nutrition Examination Survey, 1999–2018
Authors: Calixte Rose , Besson Ayanna , Chahal Kunika , Kaplan Mark S. 
Published: September 2024

Objective
Although it has long been established that age and sex play a role in blood pressure levels across the lifespan, the extent to which educational attainment moderates these relationships has been understudied. Thus, the purpose of this study was to assess educational differences in SBP, DBP, and pulse pressure (PP) trajectories among men and women through the midlife years.

Method
We conducted an analysis of pooled data from the 1999 to 2018 National Health and Nutrition Examination Survey to assess whether education moderates blood pressure measurements among men and women over the midlife years. Statistical analyses were performed using survey-weighted linear and quadratic regressions to assess these trajectories.

Results
During midlife, women with at least a college degree maintained the lowest average level of SBP compared to men at all education levels and women with a high school diploma or less. They also maintained the lowest level of PP, though not different from men with at least a college degree and women with less than a college degree. However, no educational differences were observed in DBP between men and women during the midlife years.

Conclusion
Our study shows clear delineation in the trajectories of PP and SBP by education such that a 4-year education is more protective than some college and a high school degree, particularly among women. These results highlight the need to consider upstream policy interventions (education policy initiatives) that could reduce population-wide elevated blood pressure.
Unattended versus conventional blood pressure measurements in hospitalized hypertensive patients
Authors: Hu Zhe , Chu Rui , Gao Yang , Chen Xin , Sheng Chang-Sheng 
Published: September 2024

Background
This study aims to compare the differences between unattended and conventional blood pressure measurements in hospitalized hypertensive patients.

Methods
In fall of 2019, hypertensive patients at Ruijin Hospital underwent two rounds of unattended and conventional (nurse-monitored) blood pressure measurement. Both rounds used the same electronic blood pressure monitor with measurements taken three times, 30 s apart. Comparison was made using intra-class correlation coefficients, Bland–Altman plots, paired t-tests, etc.

Results
Among the 92 subjects in the study, the median age was 50 years old, with women accounting for 33.7%. Among the subjects, the median duration of hypertension was 8.0 years. The prevalence of diabetes, coronary heart disease, and stroke were 26.1%, 5.4%, and 6.5%, respectively. Whether unattended or conventional measurements were taken first, the average blood pressure measured first was slightly higher than the one measured later, but the difference was within 1–2 mmHg. Except that the average DBP during the round of conventional blood pressure measurements was significantly reduced by 1.6 mmHg compared to the conventional DBP, there were no other significant differences. Subgroup analysis by age, gender, BMI, and diabetes showed no significant difference in blood pressure measurement results between unattended and conventional methods.

Conclusion
No significant difference was observed between unattended and conventional methods of blood pressure measurement in hospitalized hypertensive patients. Unattended blood pressure measurement can be adopted as the current standard for blood pressure management in hospitalized patients.
Using Patient Experience Surveys to Identify Potential Diagnostic Safety Breakdowns: A Mixed Methods Study
Authors: Baker Kelley M. , Brahier Mark , Penne Mara , Hill Mary A. , Davis Siara , Gallagher William J. , Miller Kristen E. , Smith Kelly M. 
Published: September 2024

Objectives
One in 20 outpatients in the United States experiences a diagnostic error each year, but there are no validated methods for collecting feedback from patients on diagnostic safety. We examined patient experience surveys to determine whether patients’ free text comments indicated diagnostic breakdowns. Our objective was to evaluate associations between patient-perceived diagnostic breakdowns reported in free text comments and patients’ responses to structured survey questions.

Methods
We conducted an exploratory mixed methods study using data from patient experience surveys collected from adult ambulatory care patients March 2020 to June 2020 in a large U.S. health system. Data analysis included content analysis of qualitative data and statistical analysis of quantitative data.

Results
In 2525 surveys with negative comments, 619 patients (24.5%) identified diagnostic breakdowns, including issues with accuracy (n = 282, 46%), timeliness (n = 243, 39%), or communication (n = 290, 47%); some patients (n = 181) reported breakdowns in multiple categories. Patients who gave a low average score (50 or less on a 100-point scale) on provider questions were almost seven times more likely to perceive a diagnostic breakdown than patients who scored their provider higher. Similarly, patients who gave a low average score on practice-related questions were twice as likely to perceive a diagnostic breakdown.

Conclusions
Patient feedback in routinely collected patient experience surveys is a valuable and actionable information source on diagnostic breakdowns in the ambulatory setting. The more easily monitored structured survey data provide a screening method to identify encounters that may have included a patient-perceived diagnostic breakdown and therefore require further examination.
Proteinuria and albuminuria among a global primary cardiovascular disease prevention cohort of people with HIV
Authors: Overton Edgar T. , Kantor Amy , Fitch Kathleen V. , Mosepele Mosepele , Aberg Judith A. , Fichtenbaum Carl J. , McComsey Grace A. , Malvestutto Carlos , Lu Michael T. , Negredo Eugenia , Bernardino Jose , Hickman Aubri B. , Douglas Pamela S. , Grinspoon Steven K. , Zanni Markella , Ribaudo Heather , Wyatt Christina ,   for the REPRIEVE Trial Investigators
Published: September 2024

Objective(s):
To determine baseline prevalence of proteinuria and albuminuria among participants from the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) and evaluate associated risk factors.

Design:
Cross sectional analysis of a baseline sample of participants from the REPRIEVE Trial.

Methods:
REPRIEVE is an international primary cardiovascular prevention randomized controlled trial (RCT) of pitavastatin calcium vs. placebo among people with HIV (PWH) on antiretroviral therapy (ART). A representative subset (2791 participants) had urine collected at study entry. Urine protein to creatinine ratios (uPCR) and albumin to creatinine ratios (uACR) were classified as normal, moderately increased and severely increased. These were dichotomized to Normal or Abnormal for log-binomial regression analysis. Demographic, cardiometabolic, and HIV-specific data were compared among those with normal versus abnormal results.

Results:
Overall, median age 49 years, 41% female sex, 47% black or African American race, 36% had estimated glomerular filtration rate (eGFR) less than 90 ml/min/1.73 mm2. For uPCR, 27% had moderately or severely increased values. For uACR, 9% had moderately or severely increased values. In the fully adjusted model for proteinuria, female sex, older age, residence in sub-Saharan Africa or East Asia, lower BMI, lower CD4+ cell count, and use of tenofovir disoproxil fumarate (TDF) were associated with abnormal values. In the fully adjusted model for albuminuria, a diagnosis of hypertension (HTN) was associated with abnormal values.

Conclusion:
Abnormal proteinuria and albuminuria remain common (27 and 9%) despite controlled HIV. Lower current CD4+ count and TDF use were strongly associated with proteinuria. Certain modifiable comorbidities, including HTN and smoking, were associated with abnormal values. In PWH with preserved eGFR, urine measures identify subclinical kidney disease and afford the opportunity for intervention.
CSF Susceptibility Variation in Patient With Intracranial Hemorrhage: Implications for Quantitative Susceptibility Mapping Reference Selection
Authors: Wang Shutao , Spincemaille Pascal , Selim Magdy , Hasan David , Thomas Ajith J. , Filippidis Aristotelis , Wen Yan , Wang Yi , Soman Salil 
Published: September 2024

Background
Quantitative susceptibility mapping (QSM) is an emerging MRI technique with multiple clinical applications. As tissue susceptibility cannot be directly measured using MRI, QSM imaging techniques must indirectly compute susceptibility values, requiring regularization methods. CSF is a popular choice for regularization due to its near water susceptibility in healthy controls. However, the impact of pus, elevated protein, or blood dissolved in CSF on QSM regularization is not well defined.

Objective
This study aimed to investigate the effects of intracranial hemorrhage (ICH) on selecting CSF as reference for QSM imaging.

Materials and Methods
A total of 87 subjects, 53 with ICH (5 intraventricular, 19 subarachnoid, 27 both, and 2 intraparenchymal only) and 37 without hemorrhage (27 with MS, 10 without MS), were included in this study. Imaging was performed using 3D multiecho gradient echo, FLAIR, and multiecho complex total field inversion (mcTFI) at 3 T. McTFI with and without CSF zero-referencing regularization was generated from the 3DMEGRE data and reviewed with FLAIR images. Regions of hemorrhagic (H+) and nonhemorrhagic (H−) CSF were manually selected in reference to head CT and FLAIR images by a PGY III diagnostic radiology resident and Certificate of Added Qualification–certified neuroradiologist with 10 years' experience. Paired Student t test and one-way ANOVA were used with post hoc multicomparisons. A P value <0.05 was considered statistically significant.

Results
Areas of H− CSF were noted to have higher regularized QSM values in subjects with ICH relative to subjects without. Unregularized H− QSM values were also noted to have a systematically higher value in ICH subjects relative to subjects without blood. Subjects with MS and without ICH did not show significant difference in H− CSF regularized or unregularized QSM values.

Conclusions
QSM values of areas suggested to not have hemorrhage on other imaging showed significantly higher QSM values in ICH subjects relative to subjects without ICH. Additionally, areas of hemorrhage did not show significant QSM value difference between regularized and unregularized QSM images. These findings suggest that, in subjects with any area of ICH, QSM values for no-hemorrhagic areas may be significantly altered using CSF regularization relative to subjects without ICH, with implications for intra- and intersubject QSM value analysis.
Assessing Bronchiectasis Progression in Low-dose Screening for Lung Cancer
Authors: Cai Qiang , Triphuridet Natthaya , Zhu Yeqing , Yip Rowena , Yankelevitz David F. , Metersky Mark , Henschke Claudia I. 
Published: September 2024

Purpose:
Bronchiectasis is associated with loss of lung function, substantial use of health care resources, and increased morbidity and mortality in people with cardiopulmonary diseases. We assessed the frequency of progression or new development of bronchiectasis and predictors of progression in participants in low-dose computed tomography (CT) screening programs.

Materials and Methods:
We reviewed our prospectively enrolled screening cohort in the Early Lung and Cardiac Action Program cohort of smokers, aged 40 to 90, between 2010 and 2019, and medical records to assess the progression of bronchiectasis after five or more years of follow-up after baseline low-dose CT. Logistic and multivariate-analysis-of-covariance regression analyses were used to examine factors associated with bronchiectasis progression.

Results:
Among 2182 baseline screening participants, we identified 534 (mean age: 65±9 y; 53.6% women) with follow-up screening of 5+ years (median follow-up: 103.2 mo). Of the 534 participants, 34 (6.4%) participants had progressed (25/126, 19.8%) or newly developed (9/408, 2.2%) bronchiectasis. Significant predictors of progression (progressed+newly developed) were: age (P=0.03), pack-years of smoking (P=0.004), baseline components of the ELCAP Bronchiectasis Score, including the severity of bronchial dilatation (P=0.01), its extent (P=0.01), bronchial wall thickening (P=0.04), and mucoid impaction (P<0.001).

Conclusions:
Assuming similar progression rates, ~136 out of 2182 participants are expected to progress on follow-up screening. This study sheds light on bronchiectasis progression and its significant predictors in a low-dose CT screening program. We recommend reporting bronchiectasis as participants who have smoked are at increased risk, and continued assessment over the entire period of participation in the low-dose CT screening program would allow for the identification of possible causes, early warning, and even early treatment.
Cerebral, Splanchnic, and Renal Transit Time Measurement and Blood Volume Estimation Using Contrast-Enhanced Ultrasonography
Authors: Monahan Ken , Kerrigan Deborah , Shibao Cyndya , Fissell William , Perri Roman , Planz Virginia 
Published: September 2024

Abstract
We aimed to measure cerebral, splanchnic, and renal transit times and the associated blood volumes using contrast ultrasound. In healthy individuals, regional transit times were calculated from time-intensity curves generated as ultrasound contrast passed through the associated inflow and outflow vessels. These included the internal carotid artery and internal jugular vein (brain), the superior mesenteric artery and portal vein (intestines), and the renal artery and renal vein (kidney). An organ's blood volume relative to the stroke volume delivered to that organ with each cardiac cycle was calculated from the product of heart rate and transit time of contrast passage through the associated vascular bed. The fraction of systemic stroke volume received by each organ was calculated from the respective velocity-time integral and inflow vessel cross-sectional area and used to estimate absolute organ blood volume. The cohort consisted of 16 participants (age: 42 ± 13 years; 5 female) without known cerebrovascular, gastrointestinal, or renal disease. Cerebral, splanchnic, and renal transit times were obtained for 15, 14, and 8 individuals, respectively. Anatomic variability of the renal vessels confounded the acquisition of renal transit times. For all organs, transit times were reproducible and the associated blood volumes were generally comparable to reference values. Cerebral, gastrointestinal, and renal transit times/blood volumes can be reasonably acquired from contrast ultrasound, although the latter is less reliably available. Assessment of the impact on regional blood volumes of pharmacologic or other interventions is a next step toward clinical application of this technique.