bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive Assessment of the Meibomian Glands by Meibography: Why the Upper Eyelids Matter
Authors: Gupta Preeya K. , Karpecki Paul 
Published: October 2024

Abstract:
The clinical value of upper eyelid meibographic imaging remains relatively underexplored; consequently, it is not commonly used in clinical assessments. However, its significance could be particularly important for the early detection of various ocular diseases and systemic conditions related to the eyes. An analysis of the current literature from the PubMed database, covering the years 2005 to 2023, with additional relevant papers added from cited references was conducted. Failure to diagnose dry eye disease and meibomian gland dysfunction associated with conditions such as Sjögren syndrome or thyroid eye disease in the early stages and taking appropriate action may result in persistent signs and symptoms. This could potentially lead to the development of chronic conditions that directly affect a patient's visual quality, functionality, and overall well-being. Therefore, this review aimed to demonstrate the potential clinical significance of upper eyelid examination as an integral component of comprehensive meibomian gland evaluation.
Unilateral Sensorineural Hearing Loss in Congenital Cytomegalovirus Retrospective Observational Study
Authors: Alkoby-Meshulam Layah , Rosenthal-Shtern Daisy , Snapiri Ori , Levy David , Sachs Nimrod , Sokolov Merav , Bilavsky Efraim 
Published: October 2024

Background:
The leading nonhereditary cause of childhood sensorineural hearing loss has been attributed to congenital cytomegalovirus (cCMV). Sensorineural hearing loss can be unilateral (UHL) or bilateral (BHL), and may be progressive. Our objective was to describe the characteristics, clinical nature and follow-up of ears in cCMV-associated UHL.

Methods:
This 16-year retrospective study was performed at Schneider’s Medical Center, Israel. Data were collected from all cCMV infants with UHL at birth who were treated with antiviral treatment initiated within the first 4 weeks of life and had a follow-up period of at least 1 year.

Results:
We enrolled 67 infants diagnosed with UHL at birth: 17 (25%) with mild hearing loss, 22 (33%) with moderate hearing loss and 28 (42%) with severe hearing loss. At the last follow-up visit, 7 (41%) ears in the mild hearing loss group improved to normal hearing, 8 (47%) ears exhibited no change and 2 (12%) ears deteriorated. In the moderate hearing loss group, 9 (41%) ears improved, 7 (32%) remained static and 6 (27%) deteriorated to the severe hearing loss group. One (4%) ear in the severe hearing loss group showed improvement. Of the 67 ears with normal hearing at birth, 4 (6%) ears deteriorated.

Conclusions:
This study assessed and elucidated the characteristics, clinical nature and long-term follow-up of both the affected and unaffected ears diagnosed with UHL due to cCMV. These data are crucial when medical and/or surgical interventions are considered.
The Recent Increase in Invasive Bacterial Infections: A Report From the National COVID Cohort Collaborative
Authors: Martin Blake , DeWitt Peter E. , Russell Seth , Haendel Melissa , Sanchez-Pinto Nelson , Albers David J. , Jhaveri Ravi R. , Moffitt Richard , Bennett Tellen D. ,   on behalf of the N3C Consortium
Published: October 2024

Background:
When coronavirus disease 2019 (COVID-19) mitigation efforts waned, viral respiratory infections (VRIs) surged, potentially increasing the risk of postviral invasive bacterial infections (IBIs). We sought to evaluate the change in epidemiology and relationships between specific VRIs and IBIs [complicated pneumonia, complicated sinusitis and invasive group A streptococcus (iGAS)] over time using the National COVID Cohort Collaborative (N3C) dataset.

Methods:
We performed a secondary analysis of all prospectively collected pediatric (<19 years old) and adult encounters at 58 N3C institutions, stratified by era: pre-pandemic (January 1, 2018, to February 28, 2020) versus pandemic (March 1, 2020, to June 1, 2023). We compared the characteristics and outcomes of patients with prespecified VRIs and IBIs, including correlation between VRI cases and subsequent IBI cases.

Results:
We identified 965,777 pediatric and 9,336,737 adult hospitalizations. Compared with pre-pandemic, pandemic-era children demonstrated higher mean monthly cases of adenovirus (121 vs. 79.1), iGAS (5.8 vs. 3.3), complicated pneumonia (282 vs. 178) and complicated sinusitis (29.8 vs. 16.3), P < 0.005 for all. Among pandemic-era children, peak correlation between RSV cases and subsequent complicated sinusitis cases occurred with a 60-day lag (correlation coefficient 0.56, 95% confidence interval: 0.52–0.59, P < 0.001) while peak correlation between influenza and complicated sinusitis occurred with a 33-day lag (0.55, 0.51–0.58, P < 0.001). Correlation among other VRI–IBI pairs was modest during the pandemic and often lower than during the pre-pandemic era.

Conclusions:
Since COVID-19 emerged, mean monthly cases of iGAS, complicated pneumonia, and complicated sinusitis have been higher. Pandemic-era RSV and influenza cases were correlated with subsequent cases of complicated sinusitis in children. However, many other VRI–IBI correlations decreased during the pandemic.
Enriching Clinical Trials Enrolling Children With Cerebral Malaria Using Admission Demographics, Physical Examination and Point-of-care Testing Results
Authors: Imam Rami , Chastang Kennedy M. , Olowojesiku Ronke , Sherman Meredith G. , Mukadam Amina M. , Barber John R. , Liomba Alice M. , Seydel Karl B. , Postels Douglas G. 
Published: October 2024

Background:
Multiple clinical trials evaluating therapies for cerebral malaria (CM) have failed to demonstrate improved outcomes. This may derive from inclusion of children at all risk levels, including those at low risk of mortality or neurologic morbidity, limiting power to detect significant differences between intervention arms. One solution is enrichment, enrolling clinical trial participants at higher risk of adverse outcomes. We assessed if demographic, physical examination and point-of-care laboratory testing results in combination could identify children with CM at higher risk of death or neurologic disability.

Methods:
Retrospective case–control study of 1674 children hospitalized with CM in Blantyre, Malawi. We used univariate and multivariate analyses of admission factors to find the most parsimonious model associated with death or neurologic disability. To assess the clinical utility of the models, we evaluated derived probability density curve separation.

Results:
Blantyre Coma Score (BCS), deep breathing and high blood lactate were independently associated with mortality. The derived receiver operating curve yielded an area under the curve of 0.7118. There was poor separation of derived probability density curves predicting death or survival, indicating limited clinical utility of this model. On multivariate modeling of neurologic sequelae in CM survivors, only BCS was associated with adverse outcomes (area-under-the-curve = 0.6151). Probability density curves again largely overlapped, demonstrating limited utility of BCS alone in outcome prediction.

Conclusions:
Combinations of admission demographic, clinical and point-of-care laboratory factors are inadequate to predict prognosis in children with CM. Higher technology assessment methods are necessary for clinical trial enrichment.
Epidemiologic Characterization and Risk Factors for Congenital Syphilis in Northeast Mexico: A Case-control Study 2016–2024
Authors: Mascareñas de los Santos Abiel Homero , Castillo Bejarano José Iván , Vaquera Aparicio Denisse Natalie , Arcos Viscarra Paul Santiago , Rosales González Sara Paulina , Alvarado Lara Diego Armando , Cid Ramírez María Fernanda , Cantú González Susana Patricia 
Published: October 2024

Background:
Congenital syphilis (CS) is an infectious disease caused by Treponema pallidum, which is transmitted through the placenta during pregnancy. Since 2001, a notable and consistent rise in the prevalence of CS cases has been observed, especially in low- and middle-income countries. Currently, information regarding the risk factors for this phenomenon has been scarcely addressed.

Methods:
A case-control study was conducted to analyze the risk factors for CS. Cases of CS were defined according to scenarios 1 and 2 from Centers for Disease Control criteria, while controls were considered those from scenarios 3 and 4. Data were collected from clinical records from 2016 to 2024 from a hospital in the metropolitan area of Monterrey, Mexico. Statistical analysis was conducted through SPSS V.22.

Results:
In total 297 syphilis-infected mothers were included in the analyses. Multivariable logistic regression analysis showed that CS was related to late maternal diagnosis, especially after birth [OR: 4.352 (1.313–14.423)]. Additionally, women with a high nontreponemal serum test titer (≥1:8) had an increased risk of delivering an infant with CS [OR: 4.380 (1.946-9.856)]. Infants born to mothers receiving adequate treatment [OR: 0.213 (0.101-0.450)] were a protective factor.

Conclusion:
CS is a major public health worldwide. Adequate treatment is critical for the prevention of CS. Strategies focusing on prenatal care, early diagnosis, and adequate treatment among those with high nontreponemal titer should be strengthened to prevent CS.
Postoperative Outcomes of Enucleation without Closure of the Conjunctiva
Authors: Kornhauser Tom , Chauhan Muhammad Z. , Pemberton John D. 
Published: October 2024

Purpose:
To evaluate the long-term outcomes of enucleation without conjunctival closure in a large patient cohort.

Methods:
A retrospective chart review was conducted from January 2011 to January 2024, examining 144 eyes of 143 patients who underwent enucleation without conjunctival closure by a single oculoplastic surgeon. Data collected included patient demographics, indications for surgery, implant types, and complications.

Results:
This study included 144 eyes from 143 patients undergoing enucleation without conjunctival closure. Patients had a mean age of 46.47 years (SD: 19.76; range: 4–92 years), with a mean follow-up of 14.66 months (range: 2–142 months). Indications for enucleation included blind painful eyes for a variety of reasons (e.g., endophthalmitis, end-stage glaucoma, irreparable corneal graft failure, irreparable corneal melt, and intraocular tumors, etc.) which was the most common reason in our practice (72.92%). Porous polyethylene spheres (86.11%) and polymethyl methacrylate spheres (13.89%) were the primary implants used, with no observed implant complications. Three cases (2.08%) developed conjunctival cysts post-trauma.

Conclusions:
Enucleation without conjunctival closure in an otherwise normal eye with no evidence of severe conjunctival shrinkage appears to be a safe and effective procedure with a low complication rate comparable to traditional techniques involving suture-based conjunctival approximation. Meticulous closure of Tenon’s capsule may be sufficient to prevent implant-related complications. This approach could potentially reduce surgical time and simplify the enucleation procedure without compromising patient outcomes.
DIFFUSE PUNCTATE DEPOSITS ON THE SURFACE OF HYDROPHILIC ACRYLIC INTRAOCULAR LENSES EARLY POSTOPERATIVELY: CASE SERIES AND LABORATORIAL ANALYSES
Authors: Menelau Rhaíssa , Wallace-Carrete Christopher , Nakahara Edson , Werner Liliana , Ventura Camila V. , Kelkar Neil , Eid Kevin , Espósito Kayo 
Published: October 2024

Purpose:
To describe cases of hydrophilic acrylic intraocular lenses (IOLs) (Eyecryl, Biotech) exhibiting surface punctate deposits early postoperatively, and provide laboratorial analyses of unused lenses of the same model.

Setting:
Altino Ventura Foundation (FAV), Recife, Brazil, and John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

Design:
Observational, descriptive, clinical study with laboratorial analysis.

Methods:
A thorough review of records of patients undergoing phacoemulsification with Eyecryl implantation in December 2022 at FAV was performed, with data collection. Five Eyecryl IOLs (never implanted/unused) were removed from the original package and underwent gross examination, light microscopy, and ultrastructural analyses using scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS).

Results:
Details on 5 clinical cases exhibiting surface IOL deposits on the first postoperative day after uneventful surgery, and followed for at least 6 months were included. The deposits disappeared by the 60th postoperative day. No inflammatory or toxic reactions were noted, visual outcomes were favorable, and IOL explantation was not necessary. Three of the 5 unused lenses undergoing laboratorial analyses revealed diffuse, star-like shaped deposits that could not be removed by thorough irrigation with distilled water. SEM/EDS revealed a composition of the deposits that primarily consisted of carbon and oxygen.

Conclusion:
Laboratorial findings suggest the etiology of the deposits might be related to the manufacturing/packaging process of lenses from specific lots. While the deposits did not appear to be associated with inflammatory or toxic reactions in the clinical cases, further investigations are necessary to elucidate their precise origin.
Risk and protective factors of late in-the-bag intraocular lens dislocations – a systematic review
Authors: Gabriel Maximilian , Mester Amalia , Mayer-Xanthaki Christoph 
Published: October 2024

Topic:
This article aimed to identify and review published articles addressing risk and protective factors of late in-the-bag (ITB) intraocular lens (IOL) dislocations.

Clinical relevance:
Prevention of this complication is of great importance considering the great number of cataract cases and its vision threatening capacity.

Methods:
A structured search on PubMed (MEDLINE) using both Medical Subject Headings (MeSH) and key words was conducted. Additionally, the reference lists of the resulting articles were screened for further publications. Articles were eligible if they included 20 or more patients. Hazard and odds ratios were analyzed if they were calculated in the original study. The relative frequency of risk factors was recorded if hazard or odds ratios were not available. The threshold for clinical significance was set at 10%. Risk-of-bias in individual studies was evaluated using the revised Cochrane risk-of-bias tool in randomized trials (RoB 2.0) and the Cochrane risk-of-bias in non-randomized studies of interventions tool.

Results:
Database search identified 3474 records and no further records were obtained from the reference lists. After exclusion of records not related to the topic, 177 articles were assessed for eligibility. Of these, 39 were considered eligible and read in full. Three studies were prospective, while all other investigations were retrospective. In total, 18 614 cases of late ITB dislocations were analyzed across all studies. The risk of bias within studies was considerable, as only three studies were prospective and statistical significance of risk factors was assessed in only five studies.

Conclusions:
Typical patient age of this condition is between 70 and 85 years and there appears to be a slight male predominance. Risk factors with a good level of evidence include preoperative trauma and zonular dehiscence, previous vitrectomy, retinitis pigmentosa, pseudoexfoliation, high myopia, glaucoma/previous glaucoma surgery, corneal endothelial damage, and uveitis. Hydrophilic, quadripode and haptic-angulation IOLs are further risk factors. Capsular tension rings, Nd:YAG capsulotomy, three-piece IOLs and IOLs with large optic diameters protect from ITB dislocations. Typically, no risk factors can be identified in approximately one-fourth of patients.
Wnt5a/Ryk signaling contributes to bone cancer pain by sensitizing the peripheral nociceptors through JNK-mediated TRPV1 pathway in rats
Authors: Zhai Mingzhu , Peng Bo , Zhu Hanxu , Xiao Jie , Xu Lihong , Song Xue-Jun 
Published: October 2024

Abstract
Treating bone cancer pain (BCP) continues to be a clinical challenge, and the underlying mechanisms of BCP remain elusive. This study reports that Wnt5a/Ryk signaling in the dorsal root ganglion neurons is critical to the development of BCP. Tibia bone cavity tumor cell implantation produces spontaneous and evoked behaviorally expressed pain as well as ectopic sprouting and activity of Wnt5a/Ryk signaling in the neural soma and peripheral terminals and the tumor-affected bone tissues. Intraplantar, intratibial, or intrathecal injection of Wnt5a/Ryk signaling blockers significantly suppresses the painful symptoms. Peripheral injection of exogenous Wnt5a in naïve rats produces pain, and the dorsal root ganglion neurons become more sensitive to Wnt5a. Wnt5a/Ryk signaling activation increases intracellular calcium response and expression of transient receptors potential vanilloid type-1 and regulates capsaicin-induced intracellular calcium response. Blocking Ryk receptor activation suppresses Wnt5a-induced mechanical allodynia and thermal hyperalgesia. Wnt5a facilitation of transient receptors potential vanilloid type-1 sensitization is blocked by inhibiting c-Jun N-terminal kinase activation. These findings indicate a critical peripheral mechanism of Wnt5a/Ryk signaling underlying the pathogenesis of BCP and suggest that targeting Wnt5a/Ryk in the primary sensory neurons and the tumor-invasive area may be an effective approach for the prevention and treatment of BCP.
Vestibular Dysfunction in Patients With Sickle Cell Disease: A Systematic Review
Authors: Laredo Jonathan , Torres-Small Sofia , Wu Lin , Makishima Tomoko , Richard Celine 
Published: October 2024

Introduction
Sickle cell disease (SCD) often leads to sensorineural hearing loss due to vaso-occlusive events in the cochlear vasculature. Although the vestibule and cochlea share a blood supply, information on vestibulopathy in SCD is limited. This systematic review aims to consolidate current knowledge on vestibular dysfunction in SCD patients.

Methods
This study, registered on PROSPERO, involved a thorough electronic search using MEDLINE-Ovid, Embase, Google Scholar, The Cochrane Library, and Scopus databases from inception to December 2023. Data extraction adhered to PRISMA guidelines. Authors independently assessed bias and evidence quality using NIH Study Quality Assessment tools. Inclusion criteria covered articles mentioning vestibular symptoms in SCD patients, whereas exclusion criteria comprised non-English articles and vestibular symptoms limited to treatment side effects.

Results
Out of 2,495 studies, only 12 met the criteria. Among SCD patients undergoing head imaging, 19% reported inner ear complaints, and 70% experienced dizziness/imbalance. In a group of SCD children, there was a significant relationship between endothelial dysfunction and vertigo duration. The recommended imaging sequence was T1-weighted thin-section temporal bone MRIs, which revealed abnormal findings even without clinical symptoms. Imaging showed labyrinthine hemorrhage and labyrinthitis ossificans, mostly unilateral. Vestibular symptoms emerged with older age, suggesting cortical compensation kept most subjects asymptomatic. In asymptomatic adult SCD patients, there was no significant difference compared with controls in tracking test batteries and positional tests; however, saccadic latency was longer in SCD patients.

Conclusion
The existing data on vestibulopathy in SCD were limited and often of poor quality. Although a connection between SCD and vestibular symptoms was noted, information on treatment approaches was scant. Further research in this area could contribute to the early diagnosis of vestibular dysfunction, potentially enhancing outcomes for SCD patients.
Cochlear Implantation for Single-Sided Deafness in Pediatric Patients: A Critical Assessment of Usage Rate
Authors: Macielak Robert J. , Richard Celine , Malhotra Prashant S. , Adunka Oliver F. , Findlen Ursula M. 
Published: October 2024

Objective
To assess the usage rate of pediatric patients undergoing cochlear implantation (CI) for single-sided deafness (SSD).

Study Design
Retrospective cohort study.

Setting
Tertiary care pediatric referral center.

Patients
Pediatric patients who underwent CI for SSD.

Interventions
CI with requisite audiometric follow-up.

Main Outcome Measures
Device use and audiometric testing.

Results
Sixty-six patients were implanted for SSD between 8/2015 and 7/2023 at a median age of 4.7 years (interquartile range, 1.7–7.7 yr). The cause of hearing loss was unknown in the majority of cases (28 patients, 42%), with cytomegalovirus being the most common known cause (17 patients, 26%). Hearing loss was prelingual in 38 patients (58%). Post-implantation, 12 patients (18%) were identified as lost to follow-up. For the remaining 54 patients, the median length of audiometric follow-up was 1.4 years (interquartile range, 0.9–2.2 yr). At last evaluation, only 10 of these 54 patients (19%) were designated as users (≥6 h per day), and 13 patients (24%) were designated as limited users (>2 but <6 h per day). Of patients capable of performing speech-in-noise testing (n = 13), 11 patients (85%) showed improvement on BKB-SIN SNR-50 testing with their implant on versus off with a mean improvement of 3 dB. Notably, 4 of these 11 patients (36%) were categorized as nonusers despite this benefit.

Conclusions
Despite audiometric benefit from CI in the pediatric SSD population, usage rates over time remain markedly lower than anticipated at a high-volume, well-resourced tertiary care pediatric center. No influencing factors were identified, warranting critical assessment to ensure appropriate resource allocation.
Omega-3 polyunsaturated fatty acids in depression: insights from recent clinical trials
Authors: Dyall Simon C. , Malau Ikbal A. , Su Kuan-Pin 
Published: October 2024

Purpose of review
This review examines evidence from recent clinical trials on the therapeutic potential of omega-3 polyunsaturated fatty acids (PUFAs) in major depressive disorder (MDD). We focus on the effects in MDD with comorbidities, younger populations, and high-inflammation presentations.

Recent findings
PubMed, Cochrane, and Embase databases were systematically searched for studies published between May 2022 and May 2024. The search was conducted on randomized controlled trials using omega-3 PUFAs with participants with a clinical diagnosis of depression.
Higher doses of eicosapentaenoic acid (EPA) (>1 g/day) improved measures of depression, particularly in MDD with elevated inflammation markers, comorbid cardiovascular diseases, late-life onset, and children and adolescent populations. Improvements in depressive symptoms were associated with increases in omega-3 PUFA-derived anti-inflammatory and proresolving lipid mediators. As adjuvant treatments, omega-3 PUFAs have potential benefits in mood, cognitive and metabolic functions, kynurenine and serotonin pathways, and alterations in corticolimbic functional connectivity.

Summary
While evidence suggests promise, particularly for high-dose EPA and in inflammatory MDD subtypes, more research is needed to establish optimal dosing regimens, treatment duration, and patient subgroups most likely to benefit. Future studies should focus on sex differences, long-term effects, and potential synergies with other treatments.