bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Analysis of Combined Topography-Guided Photorefractive Keratectomy and Corneal Crosslinking in Progressive Versus Stable Keratoconus
Authors: Gil Pedro , Gil João Quadrado , Dias Margarida , Cunha Bruna , Alves Nuno , Rosa Andreia , Murta Joaquim 
Published: July 2024

Purpose:
To perform a comparative analysis of visual, refractive, and tomographic outcomes of combined topography-guided photorefractive keratectomy (TG-PRK) and corneal crosslinking (CXL) in patients with progressive versus stable keratoconus.

Methods:
Longitudinal retrospective case–control study. Patients with keratoconus submitted to simultaneous TG-PRK and CXL were included, with a minimum follow-up of 12 months up to 3 years. According to predefined disease progression criteria, patients were considered as progressive or stable.

Results:
A total of 101 eyes from 93 patients were included, 62 considered progressive and 39 stable keratoconus. All baseline characteristics were similar between groups, except for age at surgery (progressive: 23.40 ± 4.22 years; stable: 35.97 ± 9.09; P < 0.001). Logarithm of the minimum angle of resolution CDVA improved significantly in progressive (baseline: 0.48 ± 0.24; 12 months: 0.33 ± 0.29; P < 0.001) and stable (baseline: 0.51 ± 0.24; 12 months: 0.28 ± 0.21; P < 0.001) patients, with no differences between groups. Maximum keratometry decreased significantly in progressive (baseline: 59.18 ± 5.63 diopters; 12 months: 54.73 ± 5.95; P < 0.001) and stable (baseline: 57.77 ± 5.02; 12 months: 53.59 ± 4.20; P < 0.001) patients, with no differences between groups. Index of surface variance significantly improved in progressive (baseline: 109.18 ± 31.74 diopters; 12 months: 94.11 ± 34.11; P < 0.001) and stable (baseline: 102.87 ± 29.52; 12 months: 86.95 ± 27.21; P < 0.001) patients, with no differences between groups. Other tomographic outcomes were also similar between groups. Pachymetry significantly decreased after surgery but remained stable throughout the follow-up.

Conclusions:
Combined TG-PRK and CXL is a safe and effective procedure for improving CDVA and regularizing the cornea, with comparable visual, refractive, and tomographic outcomes in both progressive and stable keratoconus. Combined TG-PRK and CXL may be added to the armamentarium of therapeutic tools for visual rehabilitation in patients with stable keratoconus.
Minimally invasive, maximally impactful: minimally invasive glaucoma surgery and the changing glaucoma landscape
Authors: Sharma Arjun , Tijerina Jonathan D. , Bitrian Elena 
Published: July 2024

Purpose of review
The advent of minimally invasive glaucoma surgery (MIGS) procedures has ushered in a new era of interventional glaucoma. MIGS has expanded the treatment options for surgeons necessitating a rethinking of the optimal management strategy for patients with glaucoma.

Recent findings
There are several new MIGS devices and procedures available to glaucoma surgeons. With several options available, patient selection is crucial to maximize the utility of MIGS in the context of traditional glaucoma surgery.

Summary
A management algorithm is presented based on our practice pattern to help guide decision-making for glaucoma surgeons. Although we encourage surgeons to continue to broaden their toolkit, we emphasize the continued importance of teaching the next-generation traditional glaucoma surgery in the MIGS era. Future prospective studies are warranted to elucidate the optimal treatment strategy for patients with glaucoma.
Combined Phacoemulsification and Hydrus Microstent Implantation in Asian Eyes With Moderate-to-Severe Normal Tension Glaucoma—12-Month Outcomes
Authors: Ang Bryan Chin Hou , Chen Elizabeth Jiahui , Chee Wai Kitt , Betzler Bjorn Kaijun , Chua Chun Hau , Yip Vivien Cherng Hui , Yip Leonard Wei Leon 
Published: July 2024

Précis:
This study reports 12-month outcomes of combined phacoemulsification and Hydrus Microstent implantation in Asian eyes with moderate-to-severe normal tension glaucoma (NTG), demonstrating a significant reduction in glaucoma medications with an excellent intra and postoperative safety profile.

Objective:
To evaluate the 12-month safety and efficacy outcomes of combined phacoemulsification and Hydrus Microstent (Ivantis Inc.) implantation in Asian eyes with moderate to severe NTG.

Methods:
Retrospective study of consecutive surgeries performed from August 2019 to August 2021 in a single tertiary eye centre in Singapore. Outcome measures included a reduction in intraocular pressure (IOP), number of glaucoma medications, and intra and postoperative complications.

Results:
Data from 21 eyes of 21 subjects were analyzed. All subjects were ethnic Chinese, and the majority were males (14, 66.7%). At baseline, the mean IOP was 13.3 (2.3) mm Hg, all eyes had a Humphrey visual field mean deviation of ≥−6 dB [mean: −13.9 (4.3) dB], and all eyes were on at least one glaucoma medication. There was no statistically significant reduction in IOP at all time points compared with baseline (all P > 0.05). However, the median number of medications was reduced from 2 to 0 at all time points, up to postoperative month (POM) 12 (all P < 0.001). There were no intraoperative complications. No eyes underwent secondary glaucoma procedures nor lost any Snellen line of visual acuity by POM12. One (4.8%) eye experienced numerical hypotony at postoperative day 1, which resolved conservatively. Two (9.5%) eyes underwent laser iridoplasty for stent occlusion by iris. There was no deterioration in Humphrey visual field mean deviation at POM12 compared with baseline (n = 20, P > 0.05).

Conclusion:
Combined phacoemulsification and Hydrus Microstent implantation were effective in reducing medication burden in Asian eyes with moderate to severe NTG, up to 12 months postoperatively.
Patient Experience and Barriers to the Visual Field Test for Glaucoma
Authors: Lu Siyuan J. , Girgis Shenouda , Shah Peter , Lee Graham A. 
Published: July 2024

Précis:
There are significant mental, physical, and perceptual challenges in patients undergoing visual field testing, particularly in the elderly population with glaucoma.

Purpose:
To quantitatively and qualitatively investigate patient experiences of undergoing visual field testing.

Methods:
This cross-sectional, mixed-methods study involves adult patients attending a private outpatient ophthalmology clinic in Brisbane, Australia. Participant experiences of visual field testing were assessed using a 100 mm visual analog scale (VAS), followed by face-to-face semi-structured interviews. Outcome data comprised of VAS scores (1–100) and thematically analyzed verbatim notes.

Results:
Of the 152 participants [M:F 79 (52.0%):73 (48.0%)], the age group with the highest proportion of participants was 71–80 years [n=56 (36.8%)], and most had a primary ocular diagnosis of glaucoma [n=107 (70.4%)]. The mean VAS score for visual field testing experience was 60.45 (SD=30.38). The mean VAS score of participants with glaucoma was significantly lower than that of participants without glaucoma [55.34 (31.13) vs. 72.67 (25.04); P<0.05]. Prevalent themes regarding participant experiences of visual field testing consisted of concentration difficulties, intra-test and peri-test anxiety, skepticism in the testing process, and physical discomfort. Age, sex, and mean visual field index did not influence participant experiences of visual field testing.

Conclusions:
Mental and physical barriers to visual field testing tolerability were identified in a predominantly elderly population with glaucoma. Our findings highlight the importance of addressing patient concerns and apprehensions regarding visual field testing and emphasize the value of patient-initiated breaks, particularly for individuals experiencing concentration difficulties and physical discomfort.
Iris defect management in the context of presbyopia-correcting intraocular lenses
Authors: Fram Nicole R. , Safran Steven G. , Pratte Eli , Sheybani Arsham , Agarwal Ashvin , Houser Kourtney , Garg Sumit , Schoen Marisa 
Published: July 2024

A 65-year-old man had uneventful cataract surgery in the right eye with a toric diffractive intraocular lens (IOL) placed fully within the capsule bag. On postoperative day 1 and week 1, the IOL was well positioned and his eye was healing normally. The plan was to proceed with cataract surgery in the left eye in the near future. One month postoperatively, he presented with blurred vision, glare, and halos and was noted to have iris prolapse out of the temporal clear corneal main incision. Of interest, the patient reported some itching and eye rubbing in the early postoperative period. He was taken back to surgery by the referring doctor, and despite 2 heroic attempts to reposit and save the iris tissue, there was significant iris loss causing transillumination defects and debilitating glare and halos.
Ocular examination revealed an uncorrected distance visual acuity (UDVA) of 20/40 − 2 J3 and binocular corrected distance visual acuity (CDVA) 20/30 J1 in the right eye and UDVA of 20/60 J3 and binocular CDVA of 20/25 J1 in the left eye. Manifest refraction was −0.25 −1.25 × 155 in the right eye and plano −2.25 × 090 in the left eye. Fortunately, there was no relative afferent pupillary defect, and intraocular pressures were normal off all drops.
On slitlamp examination of the right eye, pertinent findings revealed a protective ptosis, trace conjunctival injection with 1 large subconjunctival polypropylene flange at 8:30 o'clock 1.5 mm from the limbus and 1 exposed irregular polypropylene flange eroded through the conjunctiva at 10 o'clock 0.5 mm from the limbus (Figures 1 and 2

JOURNAL/jcrs/04.03/02158034-202408000-00019/figure1/v/2024-07-30T221851Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202408000-00019/figure2/v/2024-07-30T221851Z/r/image-tiff

). There was a localized area of erythema and scleral thinning surrounding the exposed flange. The cornea was edematous over the main incision. The iris was disinserted with atrophic changes and a residual iridodialysis extending from 8:30 to 10 o'clock. The trifocal IOL was fully in the capsule bag with trace fibrosis of the capsule and rotated approximately 7 degrees off the capsulotomy tab, designating the intended axis of 1 degree. The anterior chamber was deep and quiet, and the posterior segment was unremarkable with a 0.45 cup-to-disc ratio. Pertinent examination findings in the left eye included a 2 + NS cataract and a 0.45 cup-to-disc ratio. The remainder of the examination was otherwise unremarkable.
What testing and surgical plan would you offer this patient? How would you counsel regarding postoperative expectations?
TSHR-IGF-IR complex drives orbital fibroblast misbehavior in thyroid eye disease
Authors: Smith Terry J. 
Published: July 2024

Purpose of review
Evolving understanding of thyroid eye disease (TED) has led to rapidly advancing therapeutic options. Most new treatments under development or recently available to patients are predicated on insights into disease mechanism.

Recent findings
TED, a disfiguring process, involves inflammation and remodeling of the connective tissues around the eye. TED most frequently presents as a component of Graves’ disease. Advances in our understanding of cells involved in TED and their molecular interactions have led to novel therapeutic targets. Among these cell types are orbital fibroblasts and a subset comprising monocyte progenitor cells, known as CD34+CXCR4+ fibrocytes. Among the attributes of fibrocytes is their expression of several autoantigens associated with Graves’ disease, including TSHR, thyroglobulin and thyroperoxidase. Fibrocytes also express high levels of the insulin-like growth factor-I (IGF-I) receptor, thought to mediate fibroblast activation. Therapeutically targeting the TSHR/IGF-IR receptor complex using an IGF-I receptor antagonist, teprotumumab, has resulted in substantial clinical benefit for patients with TED. The neural axon repellent, Slit2, and its cognate receptor, ROBO1, appear to modulate the inflammatory phenotype of these orbit-infiltrating fibrocytes.

Summary
More detailed understanding of orbital fibroblasts and the distinctions between cell subsets comprising them should lead to more effective therapies with fewer side effects.
Outcomes and safety of atezolizumab plus bevacizumab in the treatment of hepatocellular carcinoma: treatment prognosis and comparison with tyrosine kinase inhibitors in a French multicenter matched real-life study
Authors: Adhoute Xavier , Gonzalez Alexia , Levi-strauss Thomas , Mineur Laurent , Pénaranda Guillaume , Sellier Floriane , Toullec Clémence , Pietri Olivia , Castellani Paul , Tran Albert , Perrier Hervé , Bourliere Marc , Anty Rodolphe 
Published: July 2024

Background and aimsThe combination of atezolizumab plus bevacizumab (Atz/Bev) has radically changed the treatment strategy for advanced hepatocellular carcinoma (HCC) but raises questions. Our objectives were to determine survival outcomes and safety in a real-life multicenter French cohort, to investigate the on-treatment prognostic value of the bioinflammatory RECA score, and to perform a matched comparison with patients who previously received tyrosine kinase inhibitors (TKIs).MethodologyA retrospective analysis of 109 consecutive patients enrolled from September 2020 to January 2023 and a post matched comparison with a TKI cohort (n = 79) by the propensity score matching method.ResultsThe Atz/Bev population was mainly nonviral disease patients (69%) with Child–Pugh grade A (90%), performance status 0/1 (90%), and Barcelona Clinic Liver Cancer stage B (38%) or stage C (62%) classification. After a median follow-up of 6.5 months (3.6–11.7), overall survival (OS) was 13.0 (5.1–28.7) months. OS was independently associated with metastasis, increased alkaline phosphatase, and serum bilirubin levels. Treatment-related adverse events were reported in 78% of patients, mostly grade 1 or 2. The RECA score clearly revealed two different prognosis groups after three cycles. No difference in OS was observed after matching between sequential treatment with TKIs and Atz/Bev.ConclusionThis real-life study highlights the importance of liver function when using Atz/Bev combination and the necessity of identifying predictive markers of response to HCC therapies. Our findings suggest a change in practices, with a marked proportion of intermediate stages, and support the on-treatment prognostic value of an inflammatory score.
Fetal, neonatal, and infant death among offspring of pregnant women with HIV in Tanzania
Authors: Manji Karim P. , Muhihi Alfa , Duggan Christopher P. , Alwy Al-beity Fadhlun M. , Perumal Nandita , Ulenga Nzovu , Fawzi Wafaie W. , Sudfeld Christopher R. 
Published: July 2024

Objective:
Assess the risk of death for offspring of pregnant women with HIV (PWHIV) and the association with sociodemographic, pregnancy, HIV-related, and birth factors.

Design:
We conducted a prospective cohort study of PWHIV on antiretroviral therapy (ART) and their offspring in urban Tanzania who were enrolled in a vitamin D trial conducted from June 2015 to October 2019.

Methods:
We described rates of fetal, neonatal, and infant death and assessed risk factors for these outcomes with generalized estimating equations. We also estimated population-attributable risk percentages for the contribution of prematurity and small-for-gestational age (SGA) to neonatal and infant mortality.

Results:
Among 2299 PWHIV, there were a total of 136 fetal deaths (5.6%) and the stillbirth rate was 42.0 per 1000 total births. Among 2167 livebirths, there were 57 neonatal deaths (26.3 per 1000 livebirths) and 114 infant deaths (52.6 per 1000 livebirths). Twin birth was associated with neonatal death, while maternal CD4+ T-cell count <350 cells/μl in pregnancy was associated with infant death (P-values < 0.05). As compared to term-appropriate-for-gestational age (AGA) births, the relative risks for neonatal mortality for term-SGA, preterm-AGA, and preterm-SGA infants were 2.07 [95% confidence interval (CI): 1.00–4.28], 2.87 (95% CI 1.54–5.35), and 7.15 (95% CI: 2.11–24.30), respectively. We estimated that 42.7% of neonatal and 29.4% of infant deaths were attributable to prematurity and SGA in the cohort.

Conclusions:
The risk of death is high for offspring of PWHIV in Tanzania and the combination of prematurity and fetal growth restriction may account for nearly half of neonatal deaths.
Joint Damage and Low Lean Body Mass in a Cohort of Peruvian Patients With Rheumatoid Arthritis
Authors: Velarde-Mejía Yelitza , Gamboa-Cárdenas Rocío , Ugarte-Gil Manuel F. , Pimentel-Quiroz Victor R. , Reátegui-Sokolova Cristina , Rodriguez-Bellido Zoila , Perich-Campos R. A. , Pastor-Asurza Cesar , Alarcón Graciela S. 
Published: July 2024

ObjectivesTo determine the association between radiologic joint damage (JD) and a lower lean body mass (LBM) in rheumatoid arthritis (RA) patients.MethodsA cross-sectional study from a single center established RA cohort. JD and appendicular LBM (arms and legs) were measured with the Sharp/van der Heijde (SvdH) score and dual x-ray absorptiometry expressed as kg/m2, respectively. A univariable analysis was used to determine the association between JD an LBM; then, a multivariable regression model was performed to evaluate the persistence of this association, adjusted by age, gender, disease duration, socioeconomic status (by the Graffar method), tobacco use, anticitrullinated protein antibody levels, Disease Activity Score in 28 joints for RA with erythrocyte sedimentation rate, glucocorticoid use (as prednisone equivalent), disease-modifying antirheumatic drug use, body mass index, and disability (by the multidimensional Health Assessment Questionnaire).ResultsTwo hundred forty-seven patients were included; the average (SD) age was 63.0 (12.8) years, disease duration 20 (15.00) years, the total SvdH was 66 (86.75), and the aLBM was 13.6 (3.82) kg/m2. In the univariable analysis, a lower appendicular LBM was associated with higher SvdH score on the female population, in terms of the total (B= −8.6,p< 0.01), bone erosion (−4.4,p< 0.01), and joint space narrowing (−4.2,p< 0.01) scores; this correlation remained in the multivariable analysis in terms of total SvdH (B= −9.5,p< 0.01), bone erosion (−5.2,p< 0.01), and joint space narrowing (−4.3,p< 0.01).ConclusionsA lower LBM in female patients was associated with more severe JD independently of other variables examined. Strategies aimed at preserving LBM could have a favorable impact on the course of disease.
Family Planning in Genetic Optic Atrophies in Israel, a Case Series and a Discussion of Ethical Considerations
Authors: Rozanes Eliane , Ben-Arzi Assaf , Boas Hagai , Ehrenberg Miriam , Bialer Omer , Stiebel-Kalish Hadas 
Published: July 2024

Background:
Patients with genetic optic atrophies must navigate all stages of life with their visual impairment, including the important milestone of family planning. Advances in genetic testing now allows physicians and affected families to consider medical help with the aim of preventing blindness through preconception, preimplantation, and perinatal methods.

Methods:
This case series presents 4 patients with different genetic optic atrophies (Leber hereditary optic neuropathy [LHON], autosomal dominant optic atrophy, Wolfram syndrome, and papillorenal syndrome) who were followed by the Neuro-Ophthalmology Unit at a tertiary medical center between 2010 and 2023 and were of child-bearing age. The aim of this study was to increase understanding in family planning options for patients with optic atrophies, raise awareness of the solutions available, and provide guidance for clinicians to support their patients.

Results:
Advances in medicine, genetics, and medical technology allow multidisciplinary teams to assist patients in fulfilling their desire for a genetically healthy offspring. Customized solutions can be designed to meet the specific challenges posed by each type of genetic optic atrophy. The solutions proposed in this series are based on genetic testing done in the parents, which then allows to plan medical and genetic intervention individually. The solutions opted for in this series range from the decision to not have another child until PGD (Preimplantation genetic diagnosis).

Conclusion:
We describe how genetic advancements have made it possible for patients with the 4 most common hereditary optic atrophies to fulfill their wish to have children without visually threatening genetic mutations. We also review the recent literature on the penetrance of optic atrophy in OA-mutation carriers and raise 2 significant ethical considerations: the reduction of a future life to a non–life-threatening impairment and that of public expenditure for non–life-threatening conditions.
wQFM-TREE: highly accurate and scalable quartet-based species tree inference from gene trees
Authors: Rafi Abdur , Rumi Ahmed Mahir Sultan , Hakim Sheikh Azizul , Sohaib  , Tahmid Md. Toki , Momin Rabib Jahin Ibn , Zaman Tanjeem Azwad , Reaz Rezwana , Bayzid Md. Shamsuzzoha 
Published: July 2024

AbstractSummary methods are becoming increasingly popular for species tree estimation from multi-locus data in the presence of gene tree discordance. ASTRAL, a leading method in this class, solves the Maximum Quartet Support Species Tree problem within a constrained solution space constructed from the input gene trees. In contrast, alternative heuristics such as wQFM and wQMC operate by taking a set of weighted quartets as input and employ a divide-and-conquer strategy to construct the species tree. Recent studies showed wQFM to be more accurate than ASTRAL and wQMC, though its scalability is hindered by the computational demands of explicitly generating and weighting Θ(n4) quartets. Here, we introduce wQFM-TREE, a novel summary method that enhances wQFM by circumventing the need for explicit quartet generation and weighting, thereby enabling its application to large datasets. Unlike wQFM, wQFM-TREE can also handle polytomies. Extensive simulations under diverse and challenging model conditions, with hundreds or thousands of taxa and genes, consistently demonstrate that wQFM-TREE matches or improves upon the accuracy of ASTRAL. Specifically, wQFM-TREE outperformed ASTRAL in 25 of 27 model conditions analyzed in this study involving 200-1000 taxa, with statistically significant differences in 20 of these conditions. Moreover, we applied wQFM-TREE to re-analyze the green plant dataset from the One Thousand Plant Transcriptomes Initiative. Its remarkable accuracy and scalability position wQFM-TREE as a highly competitive alternative to leading methods in the field. Additionally, the algorithmic and combinatorial innovations introduced in this study will benefit various quartet-based computations, advancing the state-of-the-art in phylogenetic estimations.