bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic Factors Associated With Differential Access to Treatment in Patients With Keratoconus at a US Urban Safety-Net Hospital
Authors: Ihionu Oluchi C. , Samra Jasmeet K. , Rashad Ramy M. , Arsiwala Mohsin A. , Del Plato Nedda S. , Lee Hyunjoo J. 
Published: February 2025

Purpose:
The purpose of this study was to examine the effects of area deprivation index (ADI)—a measure of overall socioeconomic status—as well as insurance status, race, and preferred language, on patients’ odds of receiving corneal cross-linking (CXL) or medical contact lenses (CL), and the association of these factors with keratoconus severity at presentation.

Methods:
We reviewed the records of 540 patients with keratoconus presenting to Boston Medical Center (Boston, MA) between 2012 and 2020. CXL and CL treatment odds based on ADI and other socioeconomic factors were calculated using logistic regression. Amsler–Krumeich (AK) classification and keratoplasty rates were used to classify severity at presentation, and associations with socioeconomic factors were evaluated by logistic regression and the Chi-square test.

Results:
We did not find a significant association between ADI and CXL treatment (P = 0.440) or CL treatment (P = 0.823), nor did we find a significant association between insurance status and CXL treatment in multivariate analysis (OR = 2.26, 95% CI, 0.91–5.48, P = 0.079). However, patients whose preferred language was not English were less likely to receive CL treatment (OR = 0.63, 95% CI, 0.42–0.96, P = 0.031). In addition, when adjusted for all other factors, White patients were more likely to receive CXL relative to Black/African American patients (OR = 7.44, 95% CI, 2.20–27.02, P = 0.028). We also found that White patients presented with less severe disease than Black/African American patients (OR = 0.33, 95% CI, 0.13–0.75, P = 0.027).

Conclusions:
Although we did not find associations between ADI and keratoconus treatment access, we found lower rates of CXL and CL treatment of keratoconus and worse severity on presentation for commonly disadvantaged groups. Further studies are warranted to investigate these disparities to more equitably reduce disease burden.
Rho Kinase Inhibitor–Induced Visually Significant Vortex Keratopathy
Authors: Ciulla Lauren , Nottage Jennifer 
Published: February 2025

Purpose:
The purpose of this case report is to describe a case of visually significant vortex keratopathy in a patient using a Rho kinase inhibitor.

Methods:
A 69-year-old male patient was found to have bilateral vortex keratopathy while taking a Rho kinase inhibitor. The case was reviewed and detailed in this report.

Results:
Approximately 5 months after starting netarsudil/latanoprost, the patient complained of ongoing right worse than left blurred vision and glare. Best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/20 in the left eye. Corneal exam was significant for vortex keratopathy with iron deposition diffusely in the right eye and mildly in the left eye. The patient underwent superficial keratectomy with diamond burr debridement in his right eye. One month after procedure, the BCVA improved to 20/25. The patient subsequently underwent the same procedure in his left eye and BCVA remained stable at 1 month. At 13 months after right eye procedure, the patient returned complaining of declined vision. There was moderate recurrent pigmented vortex keratopathy in the central visual axis in the right eye. The patient underwent repeat superficial keratectomy/diamond burr debridement in the right eye and the Rho kinase inhibitor was discontinued. The patient has been followed for approximately 31 months after stopping the medication without further recurrence of the vortex keratopathy.

Conclusions:
We present a case of visually significant and reoccurring vortex keratopathy in a patient taking a Rho kinase inhibitor. This case is notable as Rho kinase inhibitor–associated vortex keratopathy is typically not visually significant.
Evaluation of factors related to the need for surgery in patients with intestinal obstruction due to adhesions in a third-level clinic in Bogotá, Colombia. A case control study
Authors: Brito Rojas Isabel Cristina , Padrón Pardo Oscar Luis , Pilar Montilla María Del 
Published: February 2025

Introduction and importance:
Intestinal obstruction due to adhesions is a common reason for emergency department visits. Initial management includes bowel rest, nasogastric tube placement, hydration optimization, and pain control, among other measures. Patients who do not respond adequately to conservative treatment are candidates for surgical management. However, delays in identifying patients in need of surgery can lead to increased morbidity, mortality, and costs.

Materials and methods:
An analytical observational case-control study was conducted, involving 102 patients diagnosed with intestinal obstruction due to adhesions, evaluated in the emergency department of a third-level clinic in Bogotá between 2019 and 2023. The patients were divided into two groups: Intervention and non-operative intervention. Clinical, paraclinical, and radiological data were obtained from the electronic review of medical records and entered into an Excel database. Statistical analysis was performed based on this data. This work has been reported in line with the STROCSS criteria.

Clinical discussion:
The mean age of the patients included in the study was 58.57 years, with a predominance of males. Patients with a history of laparotomy were less frequently taken to surgical management. Similarly, a history of infraumbilical open surgery and colorectal surgery was associated with a reduced need for surgery. On the other hand, the presence of complete obstruction was associated with a OR 16.74-fold increase (95% CI 3.98-97.86) in the likelihood of operative intervention.

Conclusion:
The presence of complete intestinal obstruction is associated with the need for operative intervention, in contrast to a history of infraumbilical open surgery and colorectal surgery, which reduce the risk of surgery.
Deletion of sphingosine 1-phosphate receptor 1 in myeloid cells reduces hepatic inflammatory macrophages and attenuates MASH
Authors: Parthasarathy Gopanandan , Venkatesan Nanditha , Sidhu Guneet Singh , Song Myeong Jun , Liao Chieh-Yu , Barrow Fanta , Mauer Amy , Sehrawat Tejasav , Nakao Yasuhiko , Daniel P. Vineeth , Dasgupta Debanjali , Pavelko Kevin , Revelo Xavier S. , Malhi Harmeet 
Published: February 2025

Background:
Immune cell–driven inflammation is a key mediator of metabolic dysfunction–associated steatohepatitis (MASH) progression. We have previously demonstrated that pharmacological sphingosine 1-phosphate (S1P) receptor modulation ameliorates MASH and is associated with attenuated accumulation of intrahepatic macrophage and T-cell subsets. Although S1P receptors are expressed on several immune cell types, given the prominent role of monocyte-derived recruited macrophages in the sterile inflammation of MASH, we hypothesized that deletion of S1P receptor 1 (S1P1) on myeloid cells may ameliorate MASH by reducing the accumulation of proinflammatory monocyte-derived macrophages in the liver.

Methods:
The LyzMCre approach was used to generate myeloid cell–specific knockout mice, termed S1pr1

MKO
. Littermate S1pr1

loxp/loxp
mice were used as wild-type controls. MASH was established by feeding mice a high-fat, -fructose, and -cholesterol (FFC) diet for 24 weeks, which led to the development of steatohepatitis and MASH-defining cardiometabolic risk factors. Liver injury and inflammation were determined by histological and gene expression analyses. Intrahepatic leukocyte populations were analyzed by mass cytometry and immunohistochemistry.

Results:
Histological examination demonstrated a reduction in liver inflammatory infiltrates and fibrosis in high-fat, -fructose, and -cholesterol–fed S1pr1

MKO
compared to wild-type. There was a corresponding reduction in alanine aminotransferase, a sensitive marker for liver injury. As determined by mass cytometry, a significant decrease in recruited macrophages was noted in the livers of high-fat, -fructose, and -cholesterol–fed S1pr1

MKO
mice compared to wild-type. Gene ontology pathway analysis revealed significant suppression of the peroxisome proliferator–activated receptor gamma and mitogen-activated protein kinase pathways in S1pr1

MKO
consistent with attenuated MASH in mice.

Conclusions:
Deletion of S1P1 in myeloid cells is sufficient to attenuate intrahepatic accumulation of monocyte-derived macrophages and ameliorate murine MASH.
Children with autoimmune hepatitis receiving standard-of-care therapy demonstrate long-term obesity and linear growth delay
Authors: Steg Saban Or , Vandriel Shannon M. , Fatima Syeda Aiman , Bourdon Celine , Mundh Amrita , Ng Vicky L. , Ling Simon C. , Bandsma Robert H.J. , Kamath Binita M. 
Published: February 2025

Background:
Standard-of-care therapy in children with autoimmune hepatitis (AIH) includes induction with prednisone 1–2 mg/kg daily with gradual weaning of the dose. We aimed to test the hypothesis that children with AIH receiving standard-of-care treatment have altered growth trajectories.

Methods:
Children diagnosed with AIH between 1997 and 2023 at SickKids had serial growth measurements. Mixed effect models assessed the impact of time and daily steroid exposure on z-scores. Kaplan-Meier survival methods were used to estimate the cumulative incidence of new-onset growth impairments. A time-dependent Cox proportional hazards model was constructed to determine predictors for growth impairments.

Results:
Sixty-one children (66% females, median age at diagnosis 11.5 y) were included. BMIz showed a sharp increase, and HAZ declined significantly without returning to baseline. Each 1 mg/kg/d prednisone exposure increased BMIz gain in the first 6 months by 0.27 ([95% CI: 0.11, 0.42], p = 0.001), and decreased HAZ by −0.02 ([95% CI: −0.03, −0.01], p = 0.005). Children diagnosed before puberty exhibited a higher occurrence of excessive weight gain (72.2% vs. 49.3%; log-rank p < 0.01) and obesity (63% vs. 31.5%; log-rank p < 0.01) compared to those diagnosed during puberty. In a Cox proportional-hazards model, young age at diagnosis and daily prednisone dose >10 mg 6 months after diagnosis were predictors for linear growth delay.

Conclusions:
This study demonstrates that children with AIH receiving standard-of-care therapy demonstrate altered growth trajectories, long-term excess weight gain, obesity, and linear growth delay. Young age at diagnosis and >10 mg of daily prednisone at 6 months are predictors for linear growth delay. These data indicate the need to re-evaluate standard treatment algorithms for pediatric AIH in terms of steroid dosing and potential nonsteroid alternatives.
The Link Between Perceived Racism and Health Services Utilization Among Older Adults
Authors: Ambade Preshit N. , Hoffman Zachary , Mehra Kaamya , Gunja Munira , Moore Justin X. 
Published: February 2025

Objectives:
To understand the link between perceived racial/ethnic discrimination among older adults and 2 health service utilization processes: (1) visiting health care providers or emergency room (ER), and (2) repeated visits after the first encounter.

Methods:
Analysis of 2021 Commonwealth Fund International Health Policy Survey of Older Adults—a nationally representative, self-reported, and cross-sectional survey from Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. We used a 2-part multivariable hurdle model.

Results:
Perceived discrimination was associated with 18% reduced odds of visiting at least 1 primary care provider (OR: 0.82; 95% CI: 0.68–0.99). Among those who have visited at least 1 provider, those who perceived discrimination were more likely to visit different providers when compared with those who did not (RR: 1.06; 95% CI: 1.01–1.11). Perceived racism was associated with first (OR: 1.13; 95% CI: 1.01–1.27) and frequent (RR: 1.14; 95% CI: 1.01–1.29) ER visits.

Conclusions:
Perceived racial discrimination is linked with higher health service utilization among older adults in high-income countries.

Policy Implications:
A multilevel policy response that includes workforce sensitization and diversification, system transparency and accountability, and addressing structural barriers to accessing health care is warranted.
The Effect of Three Different Local Cold Applications on Pain Severity, Anxiety Level, and Physiological Parameters in Intra-Articular Injections for Knee Osteoarthritis Treatment
Authors: Çulha Yeliz , Büyükyılmaz Funda , Avşar Murat Tolga , Karagöz Esra 
Published: February 2025

Minimizing pain and anxiety associated with intra-articular injection interventions is important for patient satisfaction and comfort. The sample of this quasi-experimental study consisted of 120 patients who received intra-articular knee injections for the first time. Patients were divided into four study groups before injection. The inter-group comparisons of the vital signs and mean pain and anxiety scores obtained immediately after the injection (0th minutes) and after 30 minutes indicated that mean systolic blood pressure, diastolic blood pressure, and pain scores were lower in the icepack application group, mean pulse rate score was lower in the cold spray group, and mean respiratory rate score was lower in the buzzy device group, with differences being statistically significant (p < .05). We conclude that icepack application is effective in reducing pain severity in intra-articular injections.
Factors Affecting Pain Intensity Among Korean Women With Rheumatoid Arthritis
Authors: Oh Hyunjin , Boo Sunjoo 
Published: February 2025

This cross-sectional study investigated the factors affecting pain intensity among Korean women with rheumatoid arthritis (RA) (n = 246). Data included pain site and intensity, physical function, fatigue, medication attitudes, and learned helplessness (LH) from patient self-report, and Disease Activity Score 28 (DAS28) from chart review. The overall pain intensity was 3.59 out of 10, with a median of 3. The mean number of painful joints was 8.4, with the most commonly reported painful joint groups being the fingers, wrists, and knees. Higher DAS28, impaired physical function, eight or more painful joints, higher levels of fatigue, and higher levels of LH were significantly associated with pain intensity. Our results suggest that pain in women with RA is closely associated with cognitive or psychological variables such as fatigue and LH in addition to inflammation itself. For improved pain management, patients with RA should receive regular counseling to address their feelings of LH and fatigue.
Repeatability of tear film lipid layer interferometry measurements: A randomized, crossover study
Authors: Wang Michael T. M. , Misra Stuti L. , Gokul Akilesh , Kim Ji Soo , Kim Andy D. , Xue Ally L. , Cruzat Andrea , Craig Jennifer P. 
Published: February 2025

SIGNIFICANCE
Tear film lipid layer interferometry is one of the most sensitive diagnostic markers for evaporative dry eye disease. However, the dynamic structure breaks up and reforms rapidly during each blink cycle, and it remains yet to be established whether there may be significant intrasessional, diurnal, or day-to-day variability.

PURPOSE
This study aimed to assess intrasession repeatability, diurnal intravisit and day-to-day intervisit reproducibility of qualitative tear film lipid layer interferometry grading obtained from the Keratograph 5M (Oculus Optikgeräte GmbH, Wetzlar, Germany), and automated quantitative layer thickness measurements obtained from the TearScience LipiView II Ocular Surface Interferometer (Johnson & Johnson Vision, Milpitas, CA), in community residents, not stratified by dry eye or blepharitis status.

METHODS
Forty community residents (24 women, 16 men; age mean ± standard deviation, 36 ± 14 years) were recruited in an investigator-masked, randomized, crossover study. Participants attended two sessions 6 hours apart on the same day and a third session on a separate day. During each session, tear film lipid layer grading and thickness measurements were performed in triplicate, in a masked manner, with 10-minute intervals between each measurement.

RESULTS
There were no significant differences in lipid layer grading and thickness measurements in all pairwise intrasession, diurnal intravisit, and day-to-day intervisit comparisons (all p≥0.19), and positive correlations were observed in all cases (all p<0.001). The weighted Cohen κ coefficients for intrasession repeatability and diurnal intravisit and day-to-day intervisit reproducibility of qualitative lipid layer grading ranged from 0.670 to 0.867. The test-retest repeatability of quantitative lipid layer thickness measurements ranged from 4.5 to 11.7 nm, and the Bland-Altman biases were within the order of 3 nm in all pairwise comparisons. The intraclass correlation coefficients for lipid layer thickness measurements exceeded 0.80 for all intrasession comparisons and were between 0.60 and 0.80 for all diurnal intravisit and day-to-day intervisit comparisons.

CONCLUSIONS
Both qualitative grading and automated quantitative thickness measurements of tear film lipid layer interferometry demonstrated relatively favorable levels of intrasession repeatability and diurnal intravisit and day-to-day intervisit reproducibility. The study findings would support the use of either qualitative or quantitative measurement in clinical and research settings, as a reliable tool for assessing lipid layer interferometry.
Peritoneal Scintigraphy Identified the Reason for Scrotal Edema in a Patient Undergoing Peritoneal Dialysis
Authors: Sun Hui , Chen Suyun , Cheng Weiwei 
Published: February 2025

Abstract
Scrotal edema is a complication in continuous ambulatory peritoneal dialysis patients, and its etiology can be challenging to determine. We performed peritoneal scintigraphy in a case of a patient who developed pronounced scrotal edema following peritoneal dialysis. The imaging revealed clear visualization of the right inguinal canal and right scrotum, suggesting the usefulness of peritoneal scintigraphy in identifying the etiology of scrotal edema in continuous ambulatory peritoneal dialysis patients.
Detection of the Cingulate Island Sign by Early Perfusion Imaging in Dopamine Transporter SPECT With Multiple-Pinhole Collimators
Authors: Karimzadeh Amir , Burkhardt Anne , Klutmann Susanne , Apostolova Ivayla , Buchert Ralph 
Published: February 2025

Abstract
Multiple-pinhole collimators provide considerable improvement of SPECT system count sensitivity. This case report suggests that SPECT with brain-specific multiple-pinhole collimators enables cerebral perfusion imaging with diagnostic quality by an early 12 minutes scan immediately after injection of a standard dose of the dopamine transporter ligand 123I-FP-CIT. Thus, 123I-FP-CIT SPECT with multiple-pinhole collimators could assess nigrostriatal degeneration (late image) and extrastriatal involvement (early perfusion image) during the same imaging session. The early image may serve as an alternative to FDG PET in patients with suspicion of an atypical neurodegenerative parkinsonian syndrome. This could streamline diagnostic workflows by reducing the need for additional imaging modalities.
Endoscopic Papillary Balloon Dilation Versus Small Endoscopic Sphincterotomy for Endoscopic Retrograde Cholangiopancreatography–Related Adverse Events in Patients With Non–Dilated Distal Bile Duct
Authors: Gao Lili , Yan Huafang , Bu Limei , Zhang Hao 
Published: February 2025

Objective:
Endoscopic papillary balloon dilation (EPBD), small endoscopic sphincterotomy (EST), and small EST plus EPBD are commonly used as rescue techniques to remove bile duct stones. However, we often encountered challenging cases with non–dilated distal bile ducts, especially in those undergoing EPBD. We aimed to explore the reasons by assessing whether patients without the dilated bile duct had a higher risk of early complications and whether it was impacted by the rescue techniques.

Methods:
We performed a retrospective cohort study by frequency matching design in patients diagnosed with stones in non–dilated distal bile duct who received rescue techniques from July 2016 to June 2022. Besides, patients with stones and without dilatation of the distal bile duct (DDBD) were divided into 3 subgroups according to the rescue technique received. Outcomes were compared between the subgroups.

Results:
The non-DDBD group was more likely to develop post–endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and hyperamylasemia (HP) than the DDBD group (P < 0.05). Some cases had mild or moderate pancreatitis, but no one in either group developed severe pancreatitis. For subgroup analysis, each technique resulted in complete stone removal; the EPBD group had a higher HP rate than the other subgroups and reached statistical significance: the EPBD group versus the small EST group (P = 0.013) and the EPBD group versus the EPBD plus small EST group (P = 0.008). Although there was no statistical significance, PEP incidence in the EPBD group was 13.7% higher than in other subgroups (P > 0.05/3).

Conclusion:
Non-DDBD patients have a higher risk for endoscopic retrograde cholangiopancreatography-related pancreatic inflammation. EPBD should be used cautiously due to the significant association with increased rates of PEP and HP. Conversely, small EST and combination therapy are suitable for non–dilated bile duct stones because of their high safety profile and efficacy.
Accuracy of SEEG Source Localization: A Pilot Study Using Corticocortical Evoked Potentials
Authors: Cox Benjamin C. , Smith Rachel J. , Mohamed Ismail , Donohue Jenna V. , Rostamihosseinkhani Mahtab , Szaflarski Jerzy P. , Chatfield Rebekah J. 
Published: February 2025

Introduction:
EEG source localization is an established technique for localizing scalp EEG in medically refractory epilepsy but has not been adequately studied with intracranial EEG (iEEG). Differences in sensor location and spatial sampling may affect the accuracy of EEG source localization with iEEG. Corticocortical evoked potentials can be used to evaluate EEG source localization algorithms for iEEG given the known source location.

Methods:
We recorded 205 sets of corticocortical evoked potentials using low-frequency single-pulse electrical stimulation in four patients with iEEG. Averaged corticocortical evoked potentials were analyzed using 11 distributed source algorithms and compared using the Wilcoxon signed-rank test (P < 0.05). We measured the localization error from stimulated electrodes and the spatial dispersion of each solution.

Results:
Minimum norm, standard low-resolution electromagnetic tomography (sLORETA), LP Norm, sLORETA-weighted accurate minimum norm (SWARM), exact LORETA (eLORETA), standardized weighted LORETA (swLORETA), and standardized shrinking LORETA-FOCUSS (ssLOFO) had the least localization error (13.3–15.7 mm) and were superior to focal underdetermined system solver (FOCUSS), logistic autoregressive average (LAURA, and LORETA, 17.9–21.7, P < 0.001). The FOCUSS solution had the smallest spatial dispersion (7.4 mm), followed by minimum norm, L1 norm, LP norm, and SWARM (20.8–28.3 mm). Gray matter stimulations had less localization error than white matter (median differences 3.1–6.1 mm) across all algorithms except SWARM, LORETA, and logistic autoregressive average. A multivariate linear regression showed that distance from the source to sensors and gray/white matter stimulation had a significant effect on localization error for some algorithms but not SWARM, minimum norm, focal underdetermined system solver, logistic autoregressive average, and LORETA.

Conclusions:
Our study demonstrated that minimum norm, L1 norm, LP norm, and SWARM localize iEEG corticocortical evoked potentials well with lower localization error and spatial dispersion. Larger studies are needed to confirm these findings.