bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser of the Haptic-Optic Junction to Fix a Tilted Yamane Intrascleral-Fixated Lens
Authors: Piccini Angelica , Meshkin Ryan S. , Hoyek Sandra , Doobin David J , Chaaya Celine , Patel Nimesh A. 
Published: May 2024

Purpose:
To report a case of tilted sutureless intrascleral fixated IOL, emphasizing its management with 23-gauge laser to strengthen the haptic-optic junction.

Methods:
Case report.

Results:
A 27-year-old man was referred for treatment of traumatic cataracts in his left eye. He underwent pars plana vitrectomy, lensectomy, membrane peel, and capsulectomy without complications. Five days after the surgery, he developed ocular hypertension that ultimately required insertion of an Ahmed glaucoma valve in the left eye. 16 months after the initial procedure, the patient underwent secondary lens implantation with a CT Lucia 602 IOL in the left eye using the Yamane technique. The day following surgery, the patient presented with a significantly tilted lens. Three weeks later, the patient underwent surgery for IOL repositioning. The manipulation of the haptics was ineffective in repositioning the IOL. The temporal sclerotomy was removed and a 23-gauge probe was used to laser both optic-haptic junctions while a light pipe held the lens in place. The tilt was corrected, and visual acuity improved to 20/40 at one year follow-up.

Conclusions:
Successful repositioning of tilted sutureless intrascleral fixated IOLs can be achieved using 23-gauge laser reinforcement at the haptic-optic junction. Consideration could be made to perform this laser at the time of implantation as a prophylactic approach to mitigate tilt and reduce the risk of reoperation.
Prospective Assessment of Adjuvant Netarsudil Use in Patients Undergoing Descemet Stripping Only
Authors: Bal Sila , Pineda Roberto , Davies Emma 
Published: May 2024

Purpose:
We sought to determine whether adjuvant use of netarsudil improves corneal clearance rate and regeneration of corneal endothelial cells in patients undergoing Descemet stripping only (DSO).

Methods:
We conducted a prospective assessment on the use of adjuvant netarsudil in 50 eyes from 25 patients undergoing DSO at Massachusetts Eye and Ear between May 2021 and May 2023. Our comparison group was a retrospective cohort of patients (23 eyes from 15 patients) who previously underwent DSO without the use of a postoperative rho-kinase inhibitor between September 2014 and March 2020.

Results:
Use of netarsudil after DSO statistically significantly reduced time to corneal clearance, improved best corrected visual acuity, reduced pachymetric thickness, and increased central endothelial cell count (ECC) at 6 months postoperatively. Importantly, central ECC continued to increase beyond 12 months after DSO with central ECC still statistically significantly greater in eyes that received netarsudil than in eyes that received no netarsudil.

Conclusions:
A rho-kinase inhibitor, such as netarsudil, after DSO should be used if available to achieve the best corneal clearance, best corrected visual acuity, and ECC after surgery.
Efficacy and Safety of Surgical Peripheral Iridectomy, Goniosynechialysis, and Goniotomy for Advanced Primary Angle Closure Glaucoma Without Cataract: 1-Year Results of a Multicenter Study
Authors: Gao Xinbo , Lin Fengbin , Lu Ping , Xie Lin , Tang Li , Zhu Xiaomin , Zhang Yao , Lv Aiguo , Tang Guangxian , Zhang Hengli , Yan Xiaowei , Song Yunhe , Xu Jiangang , Huang Jingjing , Zhang Yingzhe , Hu Kun , Peng Yuying , Wang Zhenyu , Li Xiaoyan , Chen Weirong , Wang Ningli , Barton Keith , Park Ki Ho , Aung Tin , Weinreb Robert N. , Lam Dennis S.C. , Fan Sujie , Tham Clement C. , Zhang Xiulan ,   for the TVG study group
Published: May 2024

Précis:
The combination of surgical peripheral iridectomy, goniosynechialysis, and goniotomy is a safe and effective surgical approach for advanced primary angle closure glaucoma without cataract.

Purpose:
To evaluate the efficacy and safety of surgical peripheral iridectomy (SPI), goniosynechialysis (GSL), and goniotomy (GT) in advanced primary angle closure glaucoma (PACG) eyes without cataract.

Patients and Methods:
A prospective multicenter observational study was performed for patients who underwent combined SPI, GSL, and GT for advanced PACG without cataract. Patients were assessed before and after the operation. Complete success was defined as achieving intraocular pressure (IOP) between 6 and 18 mm Hg with at least a 20% reduction compared with baseline, without the use of ocular hypotensive medications or reoperation. Qualified success adopted the same criteria but allowed medication use. Factors associated with surgical success were analyzed using logistic regression.

Results:
A total of 61 eyes of 50 advanced PACGs were included. All participants completed 12 months of follow-up. Thirty-six eyes (59.0%) achieved complete success, and 56 eyes (91.8%) achieved qualified success. Preoperative and postsurgical at 12 months mean IOPs were 29.7±7.7 and 16.1±4.8 mm Hg, respectively. The average number of ocular hypotensive medications decreased from 1.9 to 0.9 over 12 months. The primary complications included IOP spike (n=9), hyphema (n=7), and shallow anterior chamber (n=3). Regression analysis indicated that older age (odds ratio [OR]=1.09; P=0.043) was positively associated with complete success, while a mixed angle closure mechanism (OR=0.17; P=0.036) reduced success rate.

Conclusions:
The combination of SPI, GSL, and GT is a safe and effective surgical approach for advanced PACG without cataract. It has great potential as a first-line treatment option for these patients.
Effect of Social Distancing Caused by Heavy Snowfall on Seasonal Influenza Epidemic in a Local Region in Japan
Authors: Yamada Kenta , Shinozaki Tomohiro , Ohshima Yusei 
Published: May 2024

Background:
The effectiveness of social distancing in controlling influenza epidemics is debatable. We analyzed the local impact of large-scale social distancing caused by heavy snowfall on influenza epidemic.

Methods:
Surveillance data from the National Institute of Infectious Diseases on influenza diagnosed at registered Fukui Prefecture institutions were plotted in epidemic curves. We also compared the number of elementary and junior high school students suspended attendance due to influenza during the 2017/2018 season between the northern and southern Fukui Prefecture territories. Weekly incidence influenza rates and average rates before, during and after school closure caused by heavy snowfall in the northern territory were compared with those of the southern territory using Poisson generalized estimating equations to account for school variability.

Results:
The northern territory epidemic curve, like the nationwide trend, rapidly declined during the heavy snowfall and formed a second peak 4 weeks later. The southern territory’s curve was like the nationwide trend throughout. Weekly incidence rate ratios in schools for the northern versus southern territories varied from 0.23 during heavy snowfall to 2.32, 4 weeks after the snowfall. Cumulative incidence ratio (95% confidence interval) of the northern-to-southern territories was 0.92 (0.74–1.13; P = 0.42). School closure significantly reduced the incidence rate to 0.41 (95% confidence interval, 0.19–0.89; P = 0.02).

Conclusions:
Although relatively large-scale, simultaneous school closures and social distancing could temporarily suppress seasonal influenza epidemic, they could not impede the cumulative incidence. Large-scale social distancing may contribute to slowing infection spread during seasonal influenza epidemics.
The Effect of Proprioceptive Insoles on Gait Kinematics in Healthy Participants
Authors: Tramonti Caterina , Griguoli Francesca , Di Martino Siria , Lamola Giuseppe , Falossi Francesca , Palattella Giovanni , Raffaetà Gloria , Chisari Carmelo , Parchi Paolo 
Published: May 2024

ABSTRACT

Introduction
Proprioceptive neuromuscular stimulating insoles (PNIs) enhance somatosensory information from the plantar region, thus modifying standing posture, balance, and ambulatory function. The present study investigated the short-term effects of customized PNIs on lower-limb kinematics during human locomotion.

Materials and Methods
Fifteen able-bodied volunteers were recruited and first examined with clinical evaluation of postural and feet behavior. Subjects performed 3-dimensional gait analysis (GA) while walking at self-selected speed in three different conditions: baseline, subjects barefoot; placebo, subjects wearing neutral insoles; and proprioceptive, subjects wearing PNIs. Spatiotemporal and kinematics data of the main lower-limb joints were acquired through a system of six photogrammetric infrared cameras acquiring at a sampling frequency of 100 Hz. Then, acquired parameters were compared in the three different conditions.

Results
We found a significant difference in the percentage of double-support phase (P = 0.022) and in ankle plantarflexion values during the toe-off phase of gait cycle (P = 0.022) between the three conditions. Post hoc analysis revealed that subjects wearing PNIs presented a significant reduction in percentage of double-support phase (P = 0.009) and reduced values of ankle plantarflexion during the toe-off phase of gait cycle (P = 0.02), compared with subjects in placebo condition.

Conclusions
Results suggest that proprioceptive insoles may induce modifications of gait biomechanics in able-bodied subjects, thus modulating movement strategies during human locomotion.

Clinical Relevance
These findings provide a basis for future investigation of the efficacy of these foot devices in a long-term period in able-bodied individuals and potentially in subjects with neurological impairment.
A New Normal: A Pilot Examination of the Modern Cephalic Index
Authors: Chaikind Sarah R. , Utay Joshua B. , Wang Jijia , Graham Tiffany D.F. 
Published: May 2024

ABSTRACT

Introduction
The cephalic index (CI) is the width-to-length ratio of the head. Brachycephalic head shapes are wider than the norm and have a higher CI. In 1994, the American Academy of Pediatrics recommended babies sleep on their backs to combat rates of sudden infant death syndrome, which correlated to a sudden increase in the incidence of brachycephaly in the American population. The commonly accepted “normal” CI comes from a table that was published in the 1970s and should be updated for the modern population. The purpose of this study is to examine the modern average CI, compare measurements from today’s population to the highly referenced 1970s table, and examine what genealogical factors may impact a person’s CI measurement.

Methods
Fifty-nine subjects were measured for cephalic width and length. CI was calculated for all subjects, and statistical analysis was performed.

Results
There was a clinically significant increase in CI in every age group since the 1970s. The only statistically significant differences were between ethnicity and ethnicity-sex subgroups (not between age or sex groups).

Conclusions
The CI has changed in recent years, and based on these pilot data, the modern CI may be impacted more by ethnicity than age and sex.

Clinical Relevance
The typical CI in the modern generation is higher from the previously used 1970s standard tables. Updated measurements would aid clinicians when determining the need for cranial remolding orthoses and provide insight into the outcomes of treatment for deformational head shapes (whether via orthoses or other methods).
Bone Scan With SPECT/CT Demonstrated Phthisis Bulbi
Authors: Lin Shih-Tsung , Wang Yuh-Feng , Chuang Tzyy-Ling 
Published: May 2024

Abstract
A 46-year-old man has a history of right eye vision loss from childhood due to an injury, right hypopharyngeal cancer with metastasis to right neck lymph nodes treated with concurrent chemoradiotherapy, and left tonsillar cancer after resection and adjuvant chemotherapy. Whole-body bone scan showed abnormal uptake to the right eye region, whereas SPECT/CT imaging localized this uptake to sharply defined, round to oval bone density foci of calcium scattered in the sclera and surrounding tissues, indicative of phthisis bulbi with posttraumatic calcification. Phthisis bulbi represents a shrunken ocular globe with calcification or ossification, typically as a sequela of trauma.
Pediatric Gastrointestinal Outcomes During the Post-Acute Phase of COVID-19: Findings from RECOVER Initiative from 29 Hospitals in the US
Authors: Zhang Dazheng , Stein Ronen , Lu Yiwen , Zhou Ting , Lei Yuqing , Li Lu , Chen Jiajie , Arnold Jonathan , Becich Michael J. , Chrischilles Elizabeth A. , Chuang Cynthia H. , Christakis Dimitri A , Fort Daniel , Geary Carol R. , Hornig Mady , Kaushal Rainu , Liebovitz David M. , Mosa Abu Saleh Mohammad , Morizono Hiroki , Mirhaji Parsa , Dotson Jennifer L. , Pulgarin Claudia , Sills Marion R. , Suresh Srinivasan , Williams David A. , Baldassano Robert N. , Forrest Christopher B. , Chen Yong 
Published: May 2024

AbstractImportanceThe profile of gastrointestinal (GI) outcomes that may affect children in post-acute and chronic phases of COVID-19 remains unclear.ObjectiveTo investigate the risks of GI symptoms and disorders during the post-acute phase (28 days to 179 days after SARS-CoV-2 infection) and the chronic phase (180 days to 729 days after SARS-CoV-2 infection) in the pediatric population.DesignWe used a retrospective cohort design from March 2020 to Sept 2023.Settingtwenty-nine healthcare institutions.ParticipantsA total of 413,455 patients aged not above 18 with SARS-CoV-2 infection and 1,163,478 patients without SARS-CoV-2 infection.ExposuresDocumented SARS-CoV-2 infection, including positive polymerase chain reaction (PCR), serology, or antigen tests for SARS-CoV-2, or diagnoses of COVID-19 and COVID-related conditions.Main Outcome(s) and Measure(s)Prespecified GI symptoms and disorders during two intervals: post-acute phase and chronic phase following the documented SARS-CoV-2 infection. The adjusted risk ratio (aRR) was determined using a stratified Poisson regression model, with strata computed based on the propensity score.ResultsOur cohort comprised 1,576,933 patients, with females representing 48.0% of the sample. The analysis revealed that children with SARS-CoV-2 infection had an increased risk of developing at least one GI symptom or disorder in both the post-acute (8.64% vs. 6.85%; aRR 1.25, 95% CI 1.24-1.27) and chronic phases (12.60% vs. 9.47%; aRR 1.28, 95% CI 1.26-1.30) compared to uninfected peers. Specifically, the risk of abdominal pain was higher in COVID-19 positive patients during the post-acute phase (2.54% vs. 2.06%; aRR 1.14, 95% CI 1.11-1.17) and chronic phase (4.57% vs. 3.40%; aRR 1.24, 95% CI 1.22-1.27).Conclusions and RelevanceIn the post-acute phase or chronic phase of COVID-19, the risk of GI symptoms and disorders was increased for COVID-positive patients in the pediatric population.Key PointsQuestionDoes COVID-19 increase the risk of gastrointestinal (GI) symptoms and diseases during the post-acute phase in children and adolescents?FindingsNewly diagnosed GI symptoms and disorders such as diarrhea, constipation, and vomiting are seen more commonly in children and adolescents with SARS-CoV-2 infection.MeaningClinicians need to be mindful that after SARS-CoV-2 infection in children, lingering GI symptoms without a unifying diagnosis may be more common than among uninfected children.
Open-source machine learning pipeline automatically flags instances of acute respiratory distress syndrome from electronic health records
Authors: Morales Félix L. , Xu Feihong , Lee Hyojun Ada , Navarro Helio Tejedor , Bechel Meagan A. , Cameron Eryn L. , Kelso Jesse , Weiss Curtis H. , Nunes Amaral Luís A. 
Published: May 2024

AbstractPhysicians could greatly benefit from automated diagnosis and prognosis tools to help address information overload and decision fatigue. Intensive care physicians stand to benefit greatly from such tools as they are at particularly high risk for those factors. Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition affecting >10% of critical care patients and has a mortality rate over 40%. However, recognition rates for ARDS have been shown to be low (30-70%) in clinical settings. In this work, we present a reproducible computational pipeline that automatically adjudicates ARDS on retrospective datasets of mechanically ventilated adult patients. This pipeline automates the steps outlined by the Berlin Definition through implementation of natural language processing tools and classification algorithms. First, we used labeled chest imaging reports from two different hospitals over three different time periods to train an XGBoost model to detect bilateral infiltrates, and a subset of attending physician notes from one hospital labeled for the most common ARDS risk factor (pneumonia) to train another XGBoost model to detect a pneumonia diagnosis. Both models achieve high performance when tested on out-of-bag samples—an area under the receiver operating characteristic curve (AUROC) of 0.88 for adjudicating chest imaging reports, and an AUROC of 0.86 for detecting pneumonia on attending physician notes. Next, we integrate the models and validate the entire pipeline on a fourth cohort from a third hospital (MIMIC-III) and find a sensitivity of 93.5% — an extraordinary improvement over the 22.6% ARDS recognition rate reported for these encounters — along with a false positive rate of 18.8%. We conclude that our reproducible, automated diagnostic pipeline exhibits promising ARDS retrospective adjudication performance, thus providing a valuable resource for physicians aiming to enhance ARDS diagnosis and treatment strategies. We surmise that real-time integration of the pipeline with EHR systems has the potential to aid clinical practice by facilitating the recognition of ARDS cases at scale.
Measuring Institutional Research Culture: An Analysis of Accepted Abstracts at the Academic Surgical Congress
Authors: Sathe Tejas S. , Sathe Ojas S. 
Published: May 2024

AbstractIntroductionUnderstanding which institutions have a strong research culture is important for trainees, but existing metrics such as NIH funding do not always reflect a trainee’s lived experience. Here, we present a descriptive analysis of accepted abstracts at the Academic Surgical Congress (ASC).MethodsWe analyzed accepted abstracts at the Academic Surgical Congress between 2016 and 2024. We identified institutions with the most accepted abstracts, overall and by year. We also identified institutions with the greatest year-over-year improvement between 2022 and 2024. Finally, we calculated associations between accepted abstracts and NIH funding and also between accepted abstracts and leadership in the ASC’s hosting societies.ResultsA total of 12,142 abstracts were accepted by the ASC between 2016 and 2024. The University of Alabama and the University of Michigan led overall abstract acceptances and also led in most years. Baylor and Massachusetts General Hospital had the greatest absolute and percent year-over-year increase in abstract acceptances in the post-COVID era. There was a positive association between NIH funding and abstract acceptances. Among the top 40 institutions by accepted abstracts in 2024, institutions in the top 10 were over 10 times as likely to have leadership representation in the societies that host the ASC.ConclusionsConference abstracts may serve as a useful measure of trainee-relevant research culture. Trainees can utilize this information when selecting residency programs, and programs can use this information to optimize trainee research experiences.
Intrinsic Dynamics and Neural Implementation of a Hypothalamic Line Attractor Encoding an Internal Behavioral State
Authors: Vinograd Amit , Nair Aditya , Linderman Scott W. , Anderson David J. 
Published: May 2024

SummaryLine attractors are emergent population dynamics hypothesized to encode continuous variables such as head direction and internal states. In mammals, direct evidence of neural implementation of a line attractor has been hindered by the challenge of targeting perturbations to specific neurons within contributing ensembles. Estrogen receptor type 1 (Esr1)-expressing neurons in the ventrolateral subdivision of the ventromedial hypothalamus (VMHvl) show line attractor dynamics in male mice during fighting. We hypothesized that these dynamics may encode continuous variation in the intensity of an internal aggressive state. Here, we report that these neurons also show line attractor dynamics in head-fixed mice observing aggression. We exploit this finding to identify and perturb line attractor-contributing neurons using 2-photon calcium imaging and holographic optogenetic perturbations. On-manifold perturbations demonstrate that integration and persistent activity are intrinsic properties of these neurons which drive the system along the line attractor, while transient off-manifold perturbations reveal rapid relaxation back into the attractor. Furthermore, stimulation and imaging reveal selective functional connectivity among attractor-contributing neurons. Intriguingly, individual differences among mice in line attractor stability were correlated with the degree of functional connectivity among contributing neurons. Mechanistic modelling indicates that dense subnetwork connectivity and slow neurotransmission are required to explain our empirical findings. Our work bridges circuit and manifold paradigms, shedding light on the intrinsic and operational dynamics of a behaviorally relevant mammalian line attractor.