bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Faculty Development in Advancing Change at the Organizational Level
Authors: Steinert Yvonne , O’Sullivan Patricia S. , Irby David M. 
Published: June 2024

Abstract
Although the traditional goal of faculty development (FD) has been to enhance individual growth and development, this goal may no longer suffice to address the compelling challenges faculty members are facing, such as increasing workloads, emotional well-being, and institutional support for education. Addressing these challenges will require change at the organizational level. The purpose of this perspective is to articulate a vision for FD programming that describes ways in which FD leaders, together with other educational leaders, can bring about change at the organizational level to support excellence and innovation in health professions education. To impact the organization at large, the authors propose a model that includes 4 major goals: (1) promoting individual and group development, through educational and leadership development programs, coaching and mentoring, and advanced degrees; (2) advocating for infrastructure and resources, including academies of medical educators, educational scholarship units, educational awards, and intramural funding for educational innovation and scholarship; (3) influencing policies and procedures, by engaging educators on key committees, reviewing appointment and promotion criteria, defining educator roles and portfolios, and valuing diversity, equity, and inclusion; and (4) contributing to organization-wide initiatives, such as addressing “hot button” issues, identifying value factors that support investments in FD and medical education, and enhancing the visibility of educators. In this model, the 4 goals are dynamically interconnected and can impact the culture of the organization. For each goal, the authors offer evidence-informed actions that FD leaders, along with other educational leaders, can adopt to improve the organizational culture and inspire institutionally relevant actions. Because each institution is unique, the options are illustrative and not prescriptive. The intent is to provide examples of how FD leaders and programs can enhance the educational mission through broader engagement with their institutions.
Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO
Authors: Björk Dennis , Hasselgren Kristina , Røsok Bård I. , Larsen Peter N. , Sparrelid Ernesto , Lindell Gert , Schultz Nicolai A. , Bjørnbeth Bjorn A. , Isaksson Bengt , Lindhoff Larsson Anna , Rizell Magnus , Björnsson Bergthor , Sandström Per 
Published: June 2024

Objective:
The objective of this study was to evaluate the long-term oncological outcomes of patients with colorectal liver metastasis (CRLM) randomized for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) or 2-stage hepatectomy (TSH).

Introduction:
For advanced CRLM, TSH or ALPPS may be needed for tumor freedom. The randomized, controlled, multicenter trial LIGRO showed an increased resection rate in patients who underwent ALPPS but no difference in morbidity or mortality. The 2-year survival analysis revealed better overall survival in the ALPPS group. Here, the long-term survival analysis from the LIGRO trial is reported.

Methods:
In the LIGRO trial, 100 patients were randomized to TSH or ALPPS, with the option of rescue ALPPS if insufficient growth was found after the initial step of TSH. Patients were enrolled between June 2014 and August 2016. Follow-up data for this study were collected between November 2022 and February 2023.

Results:
In total, 16 patients were alive at the end of the follow-up period. The estimated median follow-up time was 93 months. Estimated median overall survival times were 45 months in the ALPPS group and 27 months in the TSH group (P = 0.057), with 5-year survival rates of 31% and 20%, respectively. Positive prognostic factors were liver tumor-free status at the first follow-up and rectal primary tumor. Negative prognostic factors were extrahepatic disease and increasing CLRM size.

Conclusion:
Liver tumor-free status is a predictor of long-term survival, along with extrahepatic disease, large CRLM size, and rectal primary tumor. Survival did not significantly differ between patients treated with ALPPS or TSH.
An Enigmatic Fluid Accumulation Following Descemet Membrane Endothelial Keratoplasty After Prior Laser In Situ Keratomileusis
Authors: Özen Aydin , Linke Stephan J. , Spitzer Martin S. 
Published: June 2024

Purpose:
To report a case of interface fluid syndrome (IFS) following Descemet membrane endothelial keratoplasty (DMEK) 13 years after laser in situ keratomileusis (LASIK).

Methods:
A 79-year-old patient with bullous keratopathy underwent uneventful DMEK. Thirteen years prior, he had undergone LASIK. After DMEK, he developed an IFS, which was confirmed by a fluid accumulation in the flap interface, visible in the anterior segment optical coherence tomography (AS-OCT). In this case, IFS is presumed to have been triggered by the corticosteroid eye drops administered postoperatively. Measurements of the intraocular pressure (IOP) via applanation tonometry yielded erroneously low results.

Results:
The discontinuation of the corticosteroid eye drops, along with the initiation of IOP-lowering therapy, led to an improvement in fluid accumulation and a decrease in IOP. Regular ophthalmic examinations with a palpatory assessment of IOP and monitoring of fluid via AS-OCT are recommended. In this case, no more fluid could be detected in the flap interface after 14 months, and IOP was normal.

Conclusions:
IFS can occur many years after LASIK treatment. Corticosteroids should be discontinued, and IOP-lowering therapy should be initiated to prevent irreversible damage to the optic nerve. Applanation tonometry leads to inaccurately low IOP measurements; therefore, a palpatory assessment of IOP is recommended. AS-OCT is a crucial imaging modality that should be employed for monitoring.
Association Between Cross-Stapling Technique in Mechanical Colorectal Anastomosis and Short-term Outcomes
Authors: Guerra Francesco , Coletta Diego , Giuliani Giuseppe , Turri Giulia , Pedrazzani Corrado , Coratti Andrea 
Published: June 2024

BACKGROUND:
The double-stapled technique is the most common method of colorectal anastomosis in minimally invasive surgery. Several modifications to the conventional technique have been described to reduce the intersection between the stapled lines, as the resulting lateral dog-ears are considered possible risk factors for anastomotic leakage.

OBJECTIVE:
This study aimed to analyze the outcomes of patients receiving conventional versus modified stapled colorectal anastomosis after minimally invasive surgery.

DATA SOURCES:
A systematic review of the published literature was undertaken. PubMed/MEDLINE, Web of Science, and Embase databases were screened up to July 2023.

STUDY SELECTION:
Relevant articles were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles reporting on the outcomes of patients with modified stapled colorectal reconstruction compared with the conventional method of double-stapled anastomosis were included.

INTERVENTIONS:
Conventional double-stapling colorectal anastomosis and modified techniques with reduced intersection between the stapled lines were compared.

MAIN OUTCOME MEASURES:
The rate of anastomotic leak was the primary end point of interest. Perioperative details including postoperative morbidity were also appraised.

RESULTS:
There were 2537 patients from 12 studies included for data extraction, with no significant differences in age, BMI, or proportion of high ASA score between patients who had conventional versus modified techniques of reconstructions. The risk of anastomotic leak was 62% lower for the modified procedure than for the conventional procedure (OR = 0.38 [95% CI, 0.26–0.56]). The incidences of overall postoperative morbidity (OR = 0.57 [95% CI, 0.45–0.73]) and major morbidity (OR = 0.48 [95% CI, 0.32–0.72]) following modified stapled anastomosis were significantly lower than following conventional double-stapled anastomosis.

LIMITATIONS:
The retrospective nature of most included studies is a main limitation, essentially because of the lack of randomization and the risk of selection and detection bias.

CONCLUSIONS:
The available evidence supports the modification of the conventional double-stapled technique with the elimination of 1 of both dog-ears as it is associated with a lower incidence of anastomotic-related morbidity.
Empagliflozin: Primus Inter Pares Among Sodium–Glucose Cotransporter-2 Inhibitors?
Authors: Biondi-Zoccai Giuseppe , Frati Giacomo , Peruzzi Mariangela , Booz George W. 
Published: June 2024

Abstract:
Sodium/glucose cotransporter-2 (SGLT2) inhibitors are a novel class of antidiabetic medications which have proved capable of providing breakthrough cardiovascular (CV) benefits in a variety of clinical scenarios, including patients with heart failure or obesity, irrespective of diabetic status. Several SGLT2 inhibitors are available, but the most prominent ones are canagliflozin, dapagliflozin, and empagliflozin. Several studies have focused on empagliflozin and its effects on the risk of heart failure incidence and recurrences. Most recently, empagliflozin has been recently tested in patients with recent myocardial infarction in the EMPAgliflozin on Hospitalization for Heart Failure and Mortality in Patients With aCuTe Myocardial Infarction randomized trial, with apparently ambiguous findings. The present viewpoint succinctly illustrates the main features of SGLT2 inhibitors as a pharmacologic class, their ever expanding role as a CV medication, and the comparative effectiveness of different individual SGLT2 inhibitors, explicitly commenting on the recent data on empagliflozin in patients with acute myocardial infarction. The reader will find in this article a poignant perspective on this novel avenue for CV prevention and treatment, which greatly expands the management armamentarium of CV practitioners. Indeed, we make the case that SGLT2 inhibitors have a clearly favorable class effect, with differences between individual agents mainly suitable for personalization of care and minimization of side effects.
Three-Dimensional Reconstruction of Subbasal Nerve Density in Eyes With Limbal Stem Cell Deficiency: A Pilot Study
Authors: Stoddard-Bennett Theo , Bonnet Clémence , Deng Sophie X. 
Published: June 2024

Purpose:
Corneal subbasal nerve parameters have been previously reported using 2-dimensional scans of in vivo laser scanning confocal microscopy (IVCM) in eyes with limbal stem cell deficiency (LSCD). This study aims to develop and validate a method to better quantify corneal subbasal nerve parameters and changes from reconstructed 3-dimensional (3D) images.

Methods:
IVCM volume scans from 73 eyes with various degrees of LSCD (mild/moderate/severe) confirmed by multimodal anterior segment imaging including IVCM and 20 control subjects were included. Using ImageJ, the scans were manually aligned and compiled to generate a 3D reconstruction. Using filament-tracing semiautomated software (Imaris), subbasal nerve density (SND), corneal nerve fiber length, long nerves (>200 μm), and branch points were quantified and correlated with other biomarkers of LSCD.

Results:
3D SND decreased in eyes with LSCD when compared with control subjects. The decrease was significant for moderate and severe LSCD (P < 0.01). 3D SND was reduced by 3.7% in mild LSCD, 32.4% in moderate LSCD, and 96.5% in severe LSCD. The number of long nerves and points of branching correlated with the severity of LSCD (P < 0.0001) and with declining SND (R2 = 0.66 and 0.67, respectively). When compared with 2-dimensional scans, 3D reconstructions yielded significant increases of SND and branch points in all conditions except severe LSCD. 3D analysis showed a 46% increase in long nerves only in mild LSCD (P < 0.01).

Conclusions:
This proof-of-concept study validates the use of 3D reconstruction to better characterize the corneal subbasal nerve in eyes with LSCD. In the future, this concept could be used with machine learning to automate the measurements.
Trends in Corneal Donation From 2013 to 2022 in Aotearoa-New Zealand: Impact of Donor Age, Gender, Ethnicity, and COVID-19
Authors: Allen Natalie , Niederer Rachael , Brookes Nigel , McGhee Charles 
Published: June 2024

Purpose:
To evaluate corneal donation demographics in New Zealand (NZ) and explore changes over time.

Methods:
Data were collected from all donated corneas processed by the New Zealand National Eye Bank over a 10-year period from January 2013 until December 2022. Demographic data including age, self-identified ethnicity, and gender were collected, along with location and cause of death. National death data for the corresponding period were collected online from Statistics New Zealand.

Results:
A total of 1842 donors were processed; 1414 (76.8%) were sourced from Aotearoa-New Zealand and the remainder from Australia/United States. There was a small but statistically significant median age difference between NZ donors (68 years, interquartile range 55–76) and overseas donors [66 years (interquartile range) 51–70]. Most (n = 1151 81.4%) of NZ donors died in hospital settings, with the most common cause of death being cerebrovascular (n = 444 31.4%). Individuals were less likely to donate their cornea if they were female, [incidence rate ratio (IRR) 0.746, P < 0.001] older age (IRR 0.968, P < 0.001), or if they were of Māori (IRR 0.178, P < 0.001) or Pasifika ethnicity (IRR 0.125, P < 0.001). There was also a statistically significant decrease in donation rates over time (IRR 0.945, P < 0.001).

Conclusions:
There remains a profound gap between the demand for corneal transplantation and corneal tissue donation, which is worsening with time. Donor age, gender, and ethnicity seem to influence corneal donation rates. These demographic differences may be ameliorated by increased education, cultural safety, further research into those willing to donate, and the establishment of an organ/tissue donation registry.
Criteria for premium intraocular lens patient selection
Authors: Chen Jacqueline L. , Al-Mohtaseb Zaina N. , Chen Allison J. 
Published: June 2024

Purpose of review
To discuss available premium intraocular lenses (IOLs), patient selection, and important considerations for each premium IOL.

Recent findings
We review important topics and considerations for premium IOL selection: specifically, toric, extended depth of focus (EDOF), multifocal/trifocal, light adjustable lenses (LALs), and small aperture IOLs. Toric lenses are an excellent option for patients with astigmatism. However, to achieve optimal patient satisfaction, it is critical to account for the ATR astigmatism contribution from the posterior cornea and high angle alphas. Additionally, examining the ocular surface prior to placement of EDOF/multifocal IOLs is important, yet the significance of HOAs on outcomes after implantation still must be elucidated more. Finally, recent studies reveal that the small aperture lens is a good alternative for those with corneal irregularities, and second generation LALs are a great option to achieve target refractions in those with less predictable refractive outcomes, such as in Fuchs’ dystrophy or in eyes with previous refractive surgery.
Ocular manifestations of juvenile Sjögren's disease
Authors: Nguyen Robert , Gomez-Castillo Luis , Gonzales John A. 
Published: June 2024

Purpose of review
This review aims to enhance understanding of juvenile Sjögren's disease (jSjD) by exploring diagnostic criteria, ocular clinical features, ancillary ophthalmic testing, and management strategies specific to this rare pediatric condition.

Recent findings
Unlike adults, children with jSjD often present with recurrent parotitis and extra-glandular symptoms before developing sicca symptoms. Adult SjD classification criteria do not consider pediatric-specific symptoms and physiological differences. Underutilization of diagnostic tests such as the ocular staining score (OSS) and Schirmer I may result in an incomplete understanding of the prevalence of keratoconjunctivitis sicca in jSjD.

Summary
Timely referral to an ophthalmologist can address perceived feasibility issues with respect to ocular features in jSjD. Management of keratoconjunctivitis sicca in jSjD includes improving ocular surface lubrication and decreasing inflammation. Recognition of pediatric-specific clinical features and development of universally accepted jSjD classification criteria will allow for better identification of potential participants for future jSjD studies.
Increased Severity of Mycoplasma pneumoniae Infections in Spanish Children
Authors: Méndez-Echevarría Ana , Calle-Miguel Laura , Miralbés Sheila , Barreiro-Pérez Sagrario , Afonso-Rodriguez Olga , Soler-Simón José Antonio , Espeleta-Fox Ana , Jiménez-Jiménez Ana Belén , Méndez-Sánchez Alejandra , Rementeria-Radigales Joseba Iñaki , Guerrero-Del-Cueto Fuensanta , Laveglia Vanessa , Ortiz-Valentín Irene , Gómez-Mera Emilio , Fernández-Puentes Verónica , Rodríguez-Noriega-Bejar Lucía , Bustillo Matilde , Retuerta Azucena , Fernàndez-Cantalejo José , Sanz-Rueda Laura , Ibáñez María Mercedes , Berzosa Arantxa , Fernández-Ledesma Berta , Álvaro Alicia , Santamaría-Barrena Teresa , Carazo-Gallego Beatriz , Moraleda Cinta , Calvo Cristina ,   on behalf of the Spanish Mycoplasma Study Group
Published: June 2024

Background:
Since the end of 2023, an elevated incidence and severity of Mycoplasma pneumoniae infections among children in Asia has been noted. Subsequently, this trend was observed in several European countries although limited data are currently available. We conducted a national study to delineate the ongoing M. pneumoniae outbreak in our country.

Methods:
A multicenter retrospective observational study was conducted across 32 hospitals in Spain, encompassing patients under 18 years old hospitalized for M. pneumoniae infection from January 2023 to March 2024. Infection was confirmed by positive polymerase chain reaction and/or by 2 serological tests.

Results:
A total of 623 children were included, with 79% of cases diagnosed in the final 3 months of the study period. Pneumonia was the most common diagnosis (87%). Respiratory symptoms were present in 97% of cases, with 62% requiring oxygen supplementation and 14% requiring admission to the pediatric intensive care unit (PICU). Risk factors for PICU admission included the presence of neurological symptoms, hypoxemia and a history of prematurity. Children admitted to the PICU exhibited significantly higher neutrophil counts upon admission.

Conclusions:
We have observed a notable increase in hospital admissions, including PICU support by up to 14%, due to M. pneumoniae infection in our country since November 2023, indicative of a more severe clinical course associated with this pathogen.
Self-Assessment of Cochlear Health by New Cochlear Implant Recipients: Daily Impedance, Electrically Evoked Compound Action Potential and Electrocochleography Measurements Over the First Three Postoperative Months
Authors: Mushtaq Faizah , Soulby Andrew , Boyle Patrick , Papoutselou Efstratia , Nunn Terry , Hartley Douglas E.H. 
Published: June 2024

Hypotheses
In newly implanted cochlear implant (CI) users, electrically evoked compound action (eCAPs) and electrocochleography (ECochGs) will remain stable over time. Electrode impedances will increase immediately postimplantation due to the initial inflammatory response, before decreasing after CI switch-on and stabilizing thereafter.

Background
The study of cochlear health (CH) has several applications, including explaining variation in CI outcomes, informing CI programming strategies, and evaluating the safety and efficacy of novel biological treatments for hearing loss. Very early postoperative CH patterns have not previously been intensively explored through longitudinal daily testing. Thanks to technological advances, electrode impedances, eCAPs, and ECochGs can be independently performed by CI users at home to monitor CH over time.

Methods
A group of newly implanted CI users performed daily impedances, eCAPs, and ECochGs for 3 months at home, starting from the first day postsurgery (N = 7) using the Active Insertion Monitoring system by Advanced Bionics.

Results
Measurement validity of 93.5, 93.0, and 81.6% for impedances, eCAPs, and ECochGs, respectively, revealed high participant compliance. Impedances increased postsurgery before dropping and stabilizing after switch-on. eCAPs showed good stability, though statistical analyses revealed a very small but significant increase in thresholds over time. Most ECochG thresholds did not reach the liberal signal-to-noise criterion of 2:1, with low threshold stability over time.

Conclusion
Newly implanted CI recipients can confidently and successfully perform CH recordings at home, highlighting the valuable role of patients in longitudinal data collection. Electrode impedances and eCAPs are promising objective measurements for evaluating CH in newly implanted CI users.
Sudden Sensorineural Hearing Loss Before COVID-19, During COVID-19, and After Inactivated Vaccination: Experience From a Tertiary Referral Center in China
Authors: Cao Xin , Yi Haijin 
Published: June 2024

Objective
The purpose of this study was to investigate the incidence rate and audiological characteristics of sudden sensorineural hearing loss (SSHL) before the COVID-19 pandemic, during the COVID-19 pandemic, and after inactivated vaccination, and to analyze whether the novel coronavirus or inactivated vaccination have an impact on hearing loss.

Materials and Methods
The clinical data of all patients who visited the hospital in July 2019 (before pandemic), July 2020 (during pandemic) and July 2021 (after the inactivated vaccination at least the first basic dose of COVID-19 vaccination) were retrospective analyzed. All patients diagnosed with sudden sensorineural hearing loss in these three periods were screened, and their incidence rate, hearing characteristics, and prognosis were compared.

Results
Overall, the incidence rates of sudden hearing loss in July 2019, July 2020, and July 2021 were 0.59, 0.60, and 0.52% (25 of 4225, 20 of 3322, 28 of 5432), respectively, without significant difference (χ
2 = 0.372, p = 0.830). A significant difference was noted in the incidence of hypertension (p = 0.02), whereas no significant difference was noted in age (p = 0.591, p = 0.66), sex (p = 0.19, p = 0.08), main symptoms (p = 0.18, p = 0.15), side (p = 0.483, p = 0.89), audiogram shape (p = 0.56, p = 0.989), average hearing threshold of affected frequency (p = 0.81, p = 0.89), average hearing threshold of normal ear affected frequency (p = 0.65, p = 0.68), average hearing threshold of affected frequency after treatment (p = 0.49, p = 0.38), days between symptoms onset and hospital visit (p = 0.62, p = 0.85), treatment plan (p = 0.551, p = 0.474), and effectiveness (p = 0.104, p = 0.050).

Conclusion
Our study failed to find a correlation between the novel coronavirus pandemic and inactivated vaccination and SSHL, and there was no direct evidence supporting that COVID-19 or inactivated vaccination had an impact on the incidence rate and prognosis of SSHL patients.