bluuebunny/crossref_metadata_2025_split huggingface dataset:
FROM OUTER RETINAL NEOVACULARIZATION TO EXUDATIVE SUBRETINAL NEOVASCULARIZATION IN MACULAR TELANGIECTASIA TYPE 2
Authors: Krivosic Valérie , Zureik Abir , Mph  , Tadayoni Ramin , Gaudric Alain 
Published: March 2024

Purpose:
To describe the progression from outer retinal neovascularization (ORNV) to exudative subretinal new vessels (SRNV) in idiopathic macular telangiectasia type 2 (MacTel2)

Patients and Methods:
A total of 135 patients (270 eyes) imaged with optical coherence tomography angiography (OCTA) were included.

Main Outcome Measures:
Ellipsoid zone (EZ) loss, outer retinal hyperreflectivity (ORHR), ORNV, and SRNV. ORNV was defined as a flow signal passing through the outer plexiform layer, with or without vertical linear ORHR on the OCT B-scan. SRNV were defined as an abnormal capillary network with a peripheral anastomotic arcade seen on en face OCTA, and a convex hyperreflectivity at the retinal pigment epithelium.

Results:
SRNV were observed in 38/270 eyes (14%). SRNV were at a fibrotic stage in 24/38 eyes, at an exudative stage in 6/38 eyes, and a progression from ORNV to SRNV was documented in 8/38 eyes. All cases showed an EZ loss. In 7 eyes (2.5%), SRNV were also associated with subepithelial neovascularization. No retinochoroidal anastomosis was detected. The visual acuity dropped when SRNV were present.

Conclusion:
In this case series, SRNV were found in 14% of eyes. In all cases, they were associated with an EZ loss and with ORHR. A progression from ORNV to SRNV was observed.
Comparison of the Effects of Eight Different Topical Non-Steroidal Anti-Inflammatory Drugs on Reducing Intravitreal Injection-induced Pain.
Authors: Sakallioğlu Ahmet Kürşad , Kaya Sultan , Garip Rüveyde , Güçlü Hande 
Published: March 2024

Purpose:To compare topical nonsteroidal anti-inflammatory drug (NSAID) efficacy on intravitreal injection (IVI)-induced pain reduction, and determine the most efficient topical NSAID.Methods:This randomized controlled study included 662 eyes of 662 patients. Based on the types of NSAID administered before IVI, eight subgroups were formed. In the control group, a sterile saline solution was applied instead of NSAIDs. The visual analog scale (VAS) was used to assess pain scores after IVI. The VAS scores were noted immediately and 6 hours following injection (6thhour).Results:Nepafenac 0.3%, 0.1%, and bromfenac had the lowest scores, immediately after and after 6 hours, with no significant differences. Diclofenac and ketorolac had higher VAS scores than the first trio but lower scores than the control group. Flurbiprofen, pranoprofen, and indomethacin did not significantly affect immediate pain; however, at the 6thhour, the VAS scores were significantly reduced.Conclusion:Nepafenac 0.3%, 0.1%, and bromfenac were the most effective NSAIDs for pain reduction. Although some NSAIDs did not have a significant effect on immediate pain, they all provided significant benefit at the 6thhour.
Multiple Choroidal Neovascularizations in Choroidal Osteoma Treated with Anti-VEGF Injections: A 6-Year Follow-Up Case Report
Authors: Xuan Yi , Wang Min 
Published: March 2024

Purpose:
To report a case of multiple choroidal neovascularizations (CNVs) secondary to choroidal osteoma injected with a total of 13 anti-vascular endothelial growth factor (VEGF) drugs over a long-term follow up of 6-year period.

Methods:
Case report.

Results:
A 29-year-old female presented with a peripapillary choroidal osteoma in her left eye with the best-corrected visual acuity (BCVA) of 20/25. After 2 years of follow-up, two foci of CNV (one was at the infra-nasal of the optic disc, and the other was near the sub-temporal vascular arch), and massive subretinal hemorrhage developed overlying the osteoma, causing decreased BCVA of 20/33. The patient was treated with four consecutive intravitreal injections of conbercept and the two CNVs regressed with BCVA recovered to 20/25. While 17 months later, the third CNV lesion locating at the fovea appeared and nine more injections of aflibercept were given during which repeated recurrence of it occurred. At last follow-up, 6 years from baseline, all the three CNV foci were controlled, with final BCVA of 20/33.

Conclusions:
Multiple CNVs may appear simultaneously at different locations in one osteoma and prompt treatment with intravitreal anti-VEGF may be a good option to control the progression and recurrence of these CNVs. Long-term follow-up and multimodal imaging are vital in the management of CO-associated CNV.
Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study
Authors: Årnes Anders Pedersen , Fjeld Mats Kirkeby , Stigum Hein , Nielsen Christopher Sivert , Stubhaug Audun , Johansen Aslak , Hopstock Laila Arnesdatter , Morseth Bente , Wilsgaard Tom , Steingrímsdóttir Ólöf Anna 
Published: March 2024

Abstract
Knowledge is needed regarding mechanisms acting between physical activity (PA) and chronic pain. We investigated whether cold pain tolerance mediates an effect of leisure-time physical activity on the risk of chronic pain 7 to 8 years later using consecutive surveys of the population-based Tromsø Study. We included participants with information on baseline leisure-time PA (LTPA) and the level of cold pressor–assessed cold pain tolerance, who reported chronic pain status at follow-up as any of the following: chronic pain for ≥3 months, widespread chronic pain, moderate-to-severe chronic pain, or widespread moderate-to-severe chronic pain. We included 6834 participants (52% women; mean age, 55 years) in counterfactual mediation analyses. Prevalence decreased with severity, for example, 60% for chronic pain vs 5% for widespread moderate-to-severe chronic pain. People with one level higher LTPA rating (light to moderate or moderate to vigorous) at baseline had lower relative risk (RR) of 4 chronic pain states 7 to 8 years later. Total RR effect of a 1-level LTPA increase was 0.95 (0.91-1.00), that is, −5% decreased risk. Total effect RR for widespread chronic pain was 0.84 (0.73-0.97). Indirect effect for moderate-to-severe chronic pain was statistically significant at RR 0.993 (0.988-0.999); total effect RR was 0.91 (0.83-0.98). Statistically significantly mediated RR for widespread moderate-to-severe chronic pain was 0.988 (0.977-0.999); total effect RR was 0.77 (0.64-0.94). This shows small mediation of the effect of LTPA through pain tolerance on 2 moderate-to-severe chronic pain types. This suggests pain tolerance to be one possible mechanism through which PA modifies the risk of moderate-to-severe chronic pain types with and without widespread pain.
When Can Children Perform Valsalva and Toynbee Maneuvers? An Exploratory Study
Authors: Alsayegh Raihanah , Silver Jennifer , Agnihotram Raman , Gurberg Joshua 
Published: March 2024

Objectives
Barochallenge-induced Eustachian tube dysfunction (ETD) is difficult to diagnose because the examination is often normal during clinical assessment. In adults, functional tympanometry testing, performed by asking the patient to Valsalva and Toynbee while measuring the pressure shift, can aid in the diagnosis of ETD. However, standardized values do not exist in children. We aim to determine the age at which children can perform these maneuvers and the normative values in this population.

Methods
Patients with a normal basic ear examination 4 years and older, presenting to the pediatric Otolaryngology clinic, were recruited. Otoscopy, baseline tympanometry, followed by Valsalva and Toynbee maneuvers were performed. Because there are no pediatric norms, we hypothesized that children would achieve the same minimum normal pressure shift as cited in the adult literature (+20 daPa or higher for Valsalva and −20 daPa or lower for Toynbee). The data were analyzed using receiver operating characteristic curves and logistic regression.

Results
One hundred sixty-eight children (276 ears) were assessed. Participants as young as 4 years old were able to perform a Valsalva and Toynbee. Age cut-offs at which children achieved adult norms were 12.5 years (p = 0.016) and 8.5 years (p = 0.071) for Valsalva and Toynbee maneuvers, respectively. Mean pressure shift ranged from +29 to −36 daPa, and males were 2.5 times more likely to achieve Toynbee compared with females (p = 0.006).

Conclusions
Functional tympanometry testing may be used to help diagnose barochallenge-induced ETD in older children.
Improved Postoperative Speech Recognition and Processor Use With Early Cochlear Implant Activation
Authors: Patro Ankita , Lindquist Nathan R. , Holder Jourdan T. , Freeman Michael H. , Gifford René H. , Tawfik Kareem O. , O'Malley Matthew R. , Bennett Marc L. , Haynes David S. , Perkins Elizabeth L. 
Published: March 2024

AbstractObjectiveTo report speech recognition outcomes and processor use based on timing of cochlear implant (CI) activation.Study DesignRetrospective cohort.SettingTertiary referral center.PatientsA total of 604 adult CI recipients from October 2011 to March 2022, stratified by timing of CI activation (group 1: ≤10 d, n = 47; group 2: >10 d, n = 557).Main Outcome MeasuresAverage daily processor use; Consonant-Nucleus-Consonant (CNC) and Arizona Biomedical (AzBio) in quiet at 1-, 3-, 6-, and 12-month visits; time to peak performance.ResultsThe groups did not differ in sex (p= 0.887), age at CI (p= 0.109), preoperative CNC (p= 0.070), or preoperative AzBio in quiet (p= 0.113). Group 1 had higher median daily processor use than group 2 at the 1-month visit (12.3 versus 10.7 h/d,p= 0.017), with no significant differences at 3, 6, and 12 months. The early activation group had superior median CNC performance at 3 months (56% versus 46%,p= 0.007) and 12 months (60% versus 52%,p= 0.044). Similarly, the early activation group had superior median AzBio in quiet performance at 3 months (72% versus 59%,p= 0.008) and 12 months (75% versus 68%,p= 0.049). Both groups were equivalent in time to peak performance for CNC and AzBio. Earlier CI activation was significantly correlated with higher average daily processor use at all follow-up intervals.ConclusionCI activation within 10 days of surgery is associated with increased early device usage and superior speech recognition at both early and late follow-up visits. Timing of activation and device usage are modifiable factors that can help optimize postoperative outcomes in the CI population.
Micronutrients as therapy in critical illness
Authors: Stoppe Christian , Dresen Ellen , de Man Angelique 
Published: March 2024

Purpose of review
Recent large-scale randomized controlled trials (RCTs) challenged current beliefs about the potential role of micronutrients to attenuate the inflammatory response and improve clinical outcomes of critically ill patients. The purpose of this narrative review is to provide an overview and critical discussion about most recent clinical trials, which evaluated the clinical significance of a vitamin C, vitamin D, or selenium administration in critically ill patients.

Recent findings
None of the most recent large-scale RCTs could demonstrate any clinical benefits for a micronutrient administration in ICU patients, whereas a recent RCT indicated harmful effects, if high dose vitamin C was administered in septic patients. Following meta-analyses could not confirm harmful effects for high dose vitamin C in general critically ill patients and indicated benefits in the subgroup of general ICU patients with higher mortality risk. For vitamin D, the most recent large-scale RCT could not demonstrate clinical benefits for critically ill patients, whereas another large-scale RCT is still ongoing. The aggregated and meta-analyzed evidence highlighted a potential role for intravenous vitamin D administration, which encourages further research. In high-risk cardiac surgery patients, a perioperative application of high-dose selenium was unable to improve patients‘ outcome. The observed increase of selenium levels in the patients‘ blood did not translate into an increase of antioxidative or anti-inflammatory enzymes, which illuminates the urgent need for more research to identify potential confounding factors.

Summary
Current data received from most recent large-scale RCTs could not demonstrate clinically meaningful effects of an intervention with either vitamin C, vitamin D, or selenium in critically ill patients. More attention is needed to carefully identify potential confounding factors and to better evaluate the role of timing, duration, and combined strategies.
Remission in asthma
Authors: Lommatzsch Marek 
Published: March 2024

Purpose of review
To review the current concepts of remission in asthma.

Recent findings
Until 2023, asthma guidelines have been promoting the concept of disease control, recommending the step-wise addition of drugs until the best possible disease control is achieved. With the advent of highly effective, anti-inflammatory disease-modifying antiasthmatic drugs (DMAADs), treatment goals of asthma have changed. Several national guidelines have now announced remission as a general treatment goal in asthma. Currently, all guidelines agree that asthma remission is defined by the presence of at least three characteristics over a period of at least one 1 year: absence of exacerbations, no systemic corticosteroid use for the treatment of asthma and minimal asthma-related symptoms. In the future, a generally accepted, evidence-based and easy-to-use definition of remission will be needed for daily clinical practice. It is clear, however, that precise phenotyping (including measurement of biomarkers) is an essential prerequisite to achieve clinical remission in each individual patient.

Summary
Remission has been included as the treatment goal in asthma in several national guidelines, reflecting the paradigm shift in asthma, from short-term symptom control to long-term symptom prevention. An international consensus on the criteria for asthma remission is expected in the near future.
Chronic underlying gastrointestinal amyloidosis was revealed by cardiac echography - A case report from Syria
Authors: Asaad Ali , Ranjous Yahia , Hassan Zein Aldeen , Alahmad Nazir , Ghanimeh Lama , Ali Ayman 
Published: March 2024

Introduction and importance:
Amyloidosis is an infiltrative disease caused by the deposition of abnormal proteins. While cardiac amyloidosis is relatively common, gastrointestinal (GI) tract involvement is less frequent. In this case, we report a delayed diagnosis of systemic amyloidosis presenting mainly with digestive symptoms.

Case presentation:
An 81-year-old male presented with the complaint of persistent diarrhea for over a year and the progressive development of edemas during the last four months. Echocardiogram findings revealed the presence of the characteristic sparkling sign. The diagnosis of amyloidosis was confirmed by histopathological biopsies taken from the duodenum. Serum electrophoresis findings strongly suggested the possibility of plasma cell dyscrasia.

Clinical discussion:
What distinguishes this case is that the suspicion of amyloidosis as the underlying cause of the diarrhea did not arise until an incidental echocardiogram revealed cardiac hypertrophy and a sparkling appearance.

Conclusion:
This case reminds us to consider amyloidosis as a possible underlying cause for unexplained gastrointestinal symptoms such as diarrhea, especially in bad economic situations where the diagnosis of rare diseases may be delayed.
Extremity Injuries in Pillion Riders of Fatal 2-Wheeler Road Traffic Accidents
Authors: Ayyappan Sathish , Sukumar Sanjay , Chaudhari Vinod Ashok 
Published: March 2024

Abstract
The extremities are the important anatomical regions that are disproportionately injured during road traffic accidents in poor and medium-income countries. The data regarding extremity injuries, particularly in pillion passengers, are minimal globally. We analyzed the pattern of extremity injuries and their association with various parameters such as collision type, seating position, road type, and type of vehicle. This was a hospital-based cross-sectional study. The pillion riders of fatal motorized 2-wheeler road accident cases that were subjected to autopsy were studied over a period of 2 years. We analyzed 73 cases of pillion riders. Females (60%) were the most commonly affected group. The upper extremities were injured in 55 cases (75.3%) and the lower extremities in 49 cases (67.1%). The shoulder (41%), hand (31.3%), and elbow (23.2%) were the predominantly injured anatomical regions of the upper limb. In the lower extremity, knee (41%) and foot (21.9%) were mostly affected. Forty-nine (67.1%) and 48 (65.8%) cases had abrasions in the upper limbs and lower limbs, respectively, followed by lacerations and contusions. Upper extremity injuries are more common compared with lower extremity. The majority of the pillion riders were seated in a side-saddle position, and self-fall from the bike without any collision with other vehicles was the most common mode of injury. Thus, appropriate seating posture with safety gear can be used to reduce extremity injuries.
East Asia Superciliary Arch Augmentation With Silicone Implant
Authors: Liu Jianfeng , Qiao Jia , Fu Xi , Yu Bing , Chen Ying , Jin Qi , Xu Shixing , He Yu , Niu Feng 
Published: March 2024

Objective:
A flat superciliary arch is relatively common in East Asian women. Superciliary arch augmentation aims to increase the facial three-dimensionality of the upper face. However, there are few reports in the literature specifically introducing the surgery. In this study, the authors present the clinical outcomes after a series of superciliary arch augmentation with silicone implants.

Methods:
From May 2020 to December 2022, 54 patients underwent superciliary arch augmentation with silicone implants. Silicone implants generally have a length of 50 to 60 mm, a width of 13 to 14 mm, and an arc of 170 degrees. The thickness was 2 to 7 mm. The implant was placed subperiosteal at the lower edges of the eyebrows through a 7 mm incision below the brow tail. All patients evaluated the outcome according to the Global Esthetic Improvement Scale. Four plastic surgeons evaluated postsurgery results with a 5-point Likert Scale (5 = excellent, 4 = good, 3 = fair, 2 = no change, and 1 = worse).

Results:
Fifty-four patients were successfully enrolled. The mean follow-up period was 12.02 ± 3.38 months. The mean thickness was 4.55 ± 0.67 mm for the thickest part of the implant. The minor complication rate was 44.44%. They all subsided within 1 month without treatment. Patients’ outcome ratings were 4.45 ± 0.55 (3 mo), 4.51 ± 0.48 (6 mo), and 4.51 ± 0.45 (1 y). The surgeons’ outcome scoring was 4.49 ± 0.31.

Conclusions:
Superciliary arch augmentation with silicone implants is a quite simple, effective, inexpensive, and safe strategy to improve the three-dimensionality and contour of the upper face in East Asians.
Financial toxicity part II: A practical guide to measuring and tracking long-term financial outcomes among acute care surgery patients
Authors: Knowlton Lisa Marie , Scott John W. , Dowzicky Phillip , Murphy Patrick , Davis Kimberly A. , Staudenmayer Kristan , Martin R. Shayn 
Published: March 2024

ABSTRACTAcute care surgery (ACS) patients are frequently faced with significant long-term recovery and financial implications that extend far beyond their hospitalization. While major injury and emergency general surgery (EGS) emergencies are often viewed solely as acute moments of crisis, the impact on patients can be lifelong. Financial outcomes after major injury or emergency surgery have only begun to be understood. The Healthcare Economics Committee from the American Association for the Surgery of Trauma previously published a conceptual overview of financial toxicity in ACS, highlighting the association between financial outcomes and long-term physical recovery. The aims of second-phase financial toxicity review by the Healthcare Economics Committee of the American Association for the Surgery of Trauma are to (1) understand the unique impact of financial toxicity on ACS patients; (2) delineate the current limitations surrounding measurement domains of financial toxicity in ACS; (3) explore the “when, what and how” of optimally capturing financial outcomes in ACS; and (4) delineate next steps for integration of these financial metrics in our long-term patient outcomes. As acute care surgeons, our patients' recovery is often contingent on equal parts physical, emotional, and financial recovery. The ACS community has an opportunity to impact long-term patient outcomes and well-being far beyond clinical recovery.
Re-emergence of dengue virus 3 genotype III in Cabo Verde, 2023
Authors: Santos Menilita dos , Dieng Idrissa , Fernandes Varela Isaias Baptista , Rosa Carvalho Kevin Sanders Da , Texeira Domingos Dias , Furtado Ullardina , Hungria Liliane , Souza Letícia , Tavares Leidiza , Barry Mamadou Aliou , Talla Cheikh , Sagne Samba Niang , Faye Ousmane , Dia Ndongo , Loucoubar Cheikh , Faye Oumar , Sall Amadou Alpha , Diallo Boubacar , Diagne Moussa Moïse , Luz Lima Maria da , Sow Abdourahmane 
Published: March 2024

AbstractWe characterized 11 autochthonous dengue virus serotype 3 cases from Santiago and Fogo islands (Cabo Verde), 14 years after Cabo Verde’s latest noticed DENV outbreak involving this serotype. Identified viruses are closely related to Asian strains and falling into a clade distinct from known circulating West African DENV-3/Genotype III isolates.
Calcium-dependent regulation of neuronal excitability is rescued in Fragile X Syndrome by a tat-conjugated N-terminal fragment of FMRP
Authors: Zhan Xiaoqin , Asmara Hadhimulya , Pfaffinger Paul , Turner Ray W. 
Published: March 2024

AbstractFragile X Syndrome arises from the loss of Fragile X Messenger Ribonucleoprotein (FMRP) needed for normal neuronal excitability and circuit functions. Recent work revealed that FMRP contributes to mossy fiber LTP by adjusting Kv4 A-type current availability through interactions with a Cav3-Kv4 ion channel complex, yet the mechanism has not yet been defined. In this study using wild-type andFmr1knockout (KO) tsA-201 cells and cerebellar sections fromFmr1KO mice, we show that FMRP associates with all subunits of the Cav3.1-Kv4.3-KChIP3 complex, and is critical to enabling calcium-dependent shifts in Kv4.3 inactivation to modulate A-type current. Specifically, upon depolarization Cav3 calcium influx activates dual specific phosphatase 1/6 (DUSP1/6) to deactivate ERK1/2 (ERK) and lower phosphorylation of Kv4.3, a signalling pathway that does not function inFmr1KO cells. InFmr1KO mouse tissue slices cerebellar granule cells exhibit a hyperexcitable response to membrane depolarizations. Either incubatingFmr1KO cells orin vivoadministration of a tat-conjugated FMRP N-terminus fragment (FMRP-N-tat) rescued Cav3-Kv4 function and granule cell excitability, with a decrease in the level of DUSP6. Together these data reveal a Cav3-activated DUSP signalling pathway critical to the function of a FMRP-Cav3-Kv4 complex that is misregulated inFmr1KO conditions. Moreover, FMRP-N-tat restores function of this complex to rescue calcium-dependent control of neuronal excitability as a potential therapeutic approach to alleviating the symptoms of Fragile X Syndrome.Significance StatementChanges in neuronal excitability and ion channel functions have been a focus in studies of Fragile X Syndrome. Previous work identified ion channels that are regulated by FMRP through either protein translation or direct protein-protein interactions. The current study reveals FMRP as a constitutive member of a Cav3-Kv4 complex that is required for a Cav3-DUSP-ERK signalling pathway to increase A-type current and reduce cerebellar granule cell excitability. InFmr1KO cells, Cav3-Kv4 function and calcium-dependent modulation of A-type current is lost, leading to a hyperexcitable state of cerebellar granule cells. Pretreating with FMRP-N-tat restores all Cav3-Kv4 function and granule cell excitability, providing support for FMRP-tat peptide treatment as a potential therapeutic strategy for Fragile X Syndrome.